Newbie! Needing advice re knuckling and stiff feet

Neurological Disorders Resources. Treatment and care for pets having pain or trouble walking or standing due to spinal injuries or neurological disorders like IVDD, FCE and DM.
JimmyMac12
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Newbie! Needing advice re knuckling and stiff feet

Post by JimmyMac12 »

Hi, thanks for allowing me to join this forum, I only found you recently and was wondering if anyone had any advice to offer about my situation.

I am at the sixth month mark now with my Greyhound Jimmy, he is 8 years old, he had surgery for a herniated disc in January at L5-L7 vertebrae after an accident (jumping up at a fence to bark at a dog passing by our garden :roll: ) He didn't become paralysed immediately, this was about 24 hours later, so was misdiagnosed initially and just given pain meds.

He had dps in both rear feet straight after the op so the prognosis was relatively good, although I was warned by the neurologist that most dogs with an injury so low down the spine don't completely recover. He came home after a week in the specialist vets with complete muscle loss in his rear legs which was shocking and very little movement in the legs at all, and he had no bowel control and limited control of his bladder.

Since then he has made significant improvement, he now uses wheels and a sling for walking and has full movement in both legs, almost full control of his bladder (he only leaks a bit when it is full) I express him once a day and the rest he does himself. He still has no control of the bowel. He can get himself up with some effort, although he only does this occasionally and usually only in the car when he thinks he is going for a walk! He can stand on his own for some time and can take a few steps forward but then gets his legs in a knot and falls over. The muscle is gradually coming back but it is a slow process.

So I am encouraged by the progress and have been told by my physio that he will walk but it is going to take time. The main thing I am concerned about is his feet, particularly the left which is his bad side that was operated on. Both feet were very stiff right from the start and would not lie flat to the ground. The right foot now flexes and he can stand on this and puts it down when walking although still knuckles from time to time. The left foot is still very stiff and will hardly flex at all and he only stands on this with his toes, or when placing it knuckles back straight away. I was told by my physio that the stiffness might be arthritis, it might be the nerves still yet to heal. My vet looked at it and had no clue! He wears boots and I have been through several pairs already as they wear out quickly with the knuckling, without boots his toes get easily injured. I did try no knuckling boots which helped initially but it was still a struggle to keep his left foot up and when he became tired he would just knuckle again. I was hopeful that someone else may have experienced the same problem and have any advice as to whether this is likely to improve given time? He is having daily massage and physio which I have been shown how to do at home as well as the exercise. He was doing hydrotherapy in a treadmill but hated it and in the end refused to move his back legs at all so we gave up and now continue with wheels and walking which he enjoys.

Getting him to this point has been exhausting both mentally and physically as I'm sure everyone on this forum will understand. He weighs 30kg and until recently didn't like using the wheels which have had many adjustments to accommodate his long legs, and so I was virtually carrying him with a sling which was exhausting. Now in the sling he powers forward so fast that I can hardly keep up! Which is great for his legs but not for his boots or my arms :lol: However, if anyone has had any experience of Greyhounds or similar breeds they will know that they can be very lazy and very stubborn, if he doesn't want to move he won't and no amount of pulling or pushing will do it, so a lot of it has been about encouraging him with food or struggling to get him into and out of the car just so he is eager to do the exercise somewhere different :lol:

I really feel that the problem with his foot is letting him down, and if he could just get to use his feet properly he would be a lot further forward, but maybe this is something that once again just takes time and patience? Any advice would be greatly appreciated. I would like to say that since finding this forum I have been hugely encouraged by other people's stories as there have been times when I was ready to give up hope that he would ever get any better. It has been invaluable for advice and at times just helps keep me going! :)

:thankyou:
Karen
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CarolC
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Re: Newbie! Needing advice re knuckling and stiff feet

Post by CarolC »

:gang:
Hi Karen,

Congratulations on the consistent progress. And on being able to stick it out for 6 months with a 30kg dog that pulls, which is a lot of effort! You must indeed be exhausted. My golden retriever, Merlin, was 63 lbs (29kg) and he did the same thing. If I put a sling on his hindquarters and helped him to his feet, off he'd go in an instant, dragging me behind like he was a sled dog. He was so excited to be up on his feet, he'd just start powering forward, and no amount of "Wait! Wait" would slow him down. :lol: I know exactly what you mean. :roll:

I have not had experience with this exact situation with the foot, but there have been a number of posts here about contractures, which is what this sounds like. There are some possible solutions. Not sure what is the best option.

One idea is progressive splinting. It would involve a series of appointments. It is explained near the end of this article. The article is about a front leg but you are still dealing with flexion contractures.
https://www.ivis.org/library/braunds-clinical-neurology-small-animals-localization-diagnosis-and-treatment/canine wrote: Case Two

Cassidy is a 3 year old mixed breed dog that had been severely neglected. The dog presented with a flexion contracture of the right carpus and digits. Cassidy was referred for splinting to decrease excessive soft tissue tightness that has caused the contracture.

Over a course of 5 months, the dog was seen weekly to bimonthly for custom static progressive splinting to gradually increase dorsiflexion and decrease the flexion contractures present. Throughout the course of treatment, the foot was maintained in a constant state of low, static tension, which allowed the realignment of collagen present in the scar tissues, slowly remodeling of all soft tissues.
They used to make contracture release braces. I don't know if they are available for feet. They take a mold of the dog's leg, make a custom brace, with a feature that allows you to put tension on a joint and increase it gradually over time. Here is an example from a long time ago. Their web address no longer works. I think this is their new address. One of their splints has thick tread on the bottom, very non-slip.

You mentioned you tried no knuckling boots. That's what I would have done, too. There are quite a few brands, and some have only one strap to hold the toes up, and some have two straps. I wonder if a 2-strap boot would make a difference. Here is one with 2 straps. This company has been in business a long time. I would trust them. They also make a custom one. Here is another 2-cord boot. Have not heard if they are any good.

There is one other option I don't know if you've tried, but it wouldn't cost too much. Just a sturdy lightweight splint (not custom) with some padding in it. It might help or it might not. This one is for the foot only and is so lightweight. Don't know how it would compare to a no knuckling boot. I'm not sure it will put enough lift on the toe, but isn't it interesting? The main website here (handicappedpets) has some splints as well as foam padding to make them fit a slender leg better, if you haven't already seen them.

You mentioned he is wearing out the toes of his boots. The trick is to take your new boot, and put several layers of duct tape on the toe. When he starts to wear through the duct tape, pull off the old duct tape and put some new layers on, and let him wear through that. That way he is always wearing out the tape and saving the boot. :D

And also you mentioned he didn't like the treadmill. Dogs have their own opinions sometimes, don't they. :) By any chance do you have a pond or lake he could swim in? It might be that he likes swimming, he just doesn't like the treadmill. Quite a few people here have rehabbed their dogs in natural lakes and ponds. Some rehab facilities have a swimming pool, but the one I took my dog to didn't and I guess yours doesn't. One member here had a beagle who had disk surgery, and he swam in a horse rehab pool at an equine hospital.

Here is a great picture of Buster in the pool.
viewtopic.php?f=4&t=10699&start=90#p59198

Here is Koro at the lake.
https://www.youtube.com/watch?v=iuiwh96Cc6o

This may sound funny, but I was thinking of renting a swimming pool, if I could find one. It isn't much more expensive than the price of a PT session. :D
viewtopic.php?f=4&t=22863
JimmyMac12
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Re: Newbie! Needing advice re knuckling and stiff feet

Post by JimmyMac12 »

Hi Carol

Thanks for the quick response and the information, it has been really helpful.. if only I had thought of duct tape! What a brilliant idea, I could have saved myself a small fortune in boots :lol: I actually bought the very expensive maximus paws up boots and they were very good until they fell apart about 5 weeks in, mainly due to him going very fast in the sling over rough ground. I have been looking at videos I took when he first used them and it was keeping his left foot up but not as much as I'd hoped, because it was so stiff it was difficult to pull up the straps enough to keep the foot up properly, but they have been the best so far to stop him completely knuckling over. I don't know if I had kept using them if it would have helped long term.

When he first started using his legs he would thrust the left leg forward without his foot really touching the ground properly so I don't know if this is how it started, it was almost like a hop and a jump, now the legs move normally but the left foot knuckles all the time :(

The splints look really good but my concern is that they are very stiff and flat at the bottom and as his foot doesn't flex I'm not sure if it would sit properly. I've struggled to find boots that will fit him, being a Greyhound he has long thin feet and most boots are just too big and bulky for him and he ends up dragging in them. It's really an awkward situation all round! :roll: I think you are right about contracture though, I have never heard of this before. I think now I have some idea what it is I might try and get some advice from the vet school where he had his surgery and see if they can help me with a splint or tell me what might be best to try.

As regards the swimming, I'm in the UK in the north of Scotland so there are plenty of lochs around and sea nearby, the problem being that he doesn't really like water so I don't think this is an option! :lol: I can just imagine trying to drag him in, it would probably be worse than the treadmill. When he first went in the treadmill and the water came up he was hyper-ventilating so we had to take it slowly with him, he then seemed to get used to it and I thought he was doing well, then some weeks later decided he wouldn't bother and just sat his rear end on the PT who was struggling to hold him up :lol: If we took the water up too far he would freak out again so when the initial physio course ended I decided to keep going at home instead.

We do have a hydrotherapy pool for dogs but it is about 60 miles away, not too many options round here. I don't think for a moment he would like it but it might be worth a try just for one session to see how he goes. Renting a pool sounds a great idea if you are able to do that, I don't think we have that option here either :|

Thanks for the brilliant advice, it's really given me some thinking to do! I will keep you posted as to how it goes :thumbup:

Karen
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Re: Newbie! Needing advice re knuckling and stiff feet

Post by CarolC »

Hi Karen,

Thank you for saying whether the Maximus paws up boots were any good. You're the first person who's reported on them. That may help other people. Think they are relatively new on the market compared to some brands.
:thankyou:
I suspect they would help to the extent you could tighten them. I hear what you're saying, his paw is stiff and his toes are simply not pulling up easily. Maybe a little, but not as much as you would like?

Using duct tape on boots is an old trick. :wink: Wish I knew who first posted it. I also wonder about the possibility of a double boot. Put the paws up boot on, and over it a "cover boot" to protect the expensive boot. I very well understand the probem of having a dog with slender legs and feet and you bring boots home from the store and they don't fit or won't stay on, and then you have to take them back. I had the same problem with my chihuahua. Here are a couple of my old comments.
CarolC wrote: Sat Dec 17, 2005 10:03 pm (My dog has slender feet and her ankles are not much smaller than her feet so regular boots slipped off).
CarolC wrote: Fri Jun 10, 2005 11:07 pm I did try an Orthovet splint for my chihuahua. I had to order the cat size, and it turned out to be designed for a wide kitty foot and leg, like a Persian. My dog's slender foot and leg floated in it. Supposedly you can mold them to fit better by heating them but I guess I felt too inept to try. You can also add padding, which I didn't try.
When I needed foot protection for my dog with slender legs, and her foot was not much bigger than her ankle, I found some made by a company in Ireland (that might be convenient to where you live :D ) that fasten over the hock, and they stayed on. They will sew leather over the toe for a disabled dog, where your dog drags his toes. It occurred to me this might be an option, because they could probably make it to fit over a paws up boot. You'd just slip it on over the boot and fasten the velcro above the hock. You could probably send them a photo of your baby in the paws up boot so they can design accordingly. They were extremely nice when I dealt with them in 2003, and even followed up with a personal email afterward to see how they were working for us.
https://dogbootsactive.com/ (click on DISABILITIES)

For what it's worth, I think the Therapaw company has (or at least had) a focus on greyhounds. Here is a copy of an old webpage they had, saved in the Wayback Machine from 2007. You see on their webpage about Paw & Pad Conditions they are quoting an article about racing greyhounds. I wish the Wayback Machine had saved the photos, but as I recall, they were greyhound paw photos. So they know how to fit a greyhound foot. On their current 2023 website, I'm pretty sure this is a greyhound (is it?)
https://www.therapaw.com/custom-forelim ... lex-assist
and the first picture here (brindle or grey dog) is a greyhound (do you think?)
https://www.therapaw.com/custom-hindlim ... lex-assist

I totally do not know if this is the case or not, but *possibly* the Therapaw boot with double straps would enable you to get a little more lift on the toes. Those straps look like they may be stronger than the cords on the Maximus, but I have not compared the 2 products, I'm only looking at them. I think it is worth whatever it costs to keep him in a boot as much as you can. I think you had the right idea, and I would stick with it. If he's not wearing his boot all day, then at least for a number of minutes a couple of times a day to put whatever stretch on the foot you can.

One idea is, if you can't get that one paw into a pads-down position, and it is not bending enough to allow use of a splint with padding inside, perhaps an option would be a custom boot. Not a Gore-tex boot, but a solid custom orthotic boot made exactly to fit, with some rigid support. I'm picturing the inside of the boot being built up so the insole (so to speak) is at the angle his foot is. When he wears it, he will not be putting his pads down flat as he does on the other front, but it will prevent him from knuckling under, giving stability. He won't flip his paw. Sometimes a maker of human orthotics will make something for a dog. There have been quite few stories online where someone enlisted a local company (normally catering to humans) to help with their pet, and I get the impression some of them enjoy doing something a little different like that for a change. :)

Here is one link to look at, but you may find more by searching under 'animal orthotics UK' (or go with a company for humans). With you being up in the north of Scotland, and this is in Gloucestershire, it isn't super close. They may be able to work with your vet remotely, though. Some places will send a kit of casting material to the local vet, who makes a mold of the dog's foot/leg/whatever and sends it back, and the orthotics company can work from that. Doesn't cost anything to email and ask.
https://www.orthopets.co.uk/
It appears that Orthopets Europe has their custom fabrications done in Denver, Colorado in the US. Here is a quote from the US website, highlighting added:
https://www.orthopets.com/post/orthotics-basics wrote: Orthoses provide protected motion within a controlled range, prevent or reduce severity of injury, prevent or relieve contracture, allow lax ligaments and joint capsules to shorten, and provide functional stability for an unstable limb segment. These devices should not be seen as a replacement for surgery, but complementary or adjunctive. They can be designed to restrict, block, enable, or guide range of motion. They can absorb, store, and return energy. They may provide progressive, controlled dynamic return to motion.
If he doesn't like to swim, then a lake won't work. :swim: But he was OK with the treadmill for a while, and that is such good exercise. It's probably what he really needs right now, because it will help retrain his gait when he makes stepping motions in the water (or if the therapist patterns it for him). And it will help rebuild the muscle you say is slowly coming back. Sounds like you are so close to having him walking.

My dog got scared with a high water level, too. Your dog is not alone.
https://handicappedpet.net/helppets/viewtopic.php?p=50228#p50228 wrote: My dog has been helped greatly by hydrotherapy on an underwater treadmill. They got her used to it by putting her in for 5 minutes, then 10 minutes, then 15 minutes, building up to 30 minutes. She was so scared one time she started hyperventilating and we had to take her out and get her calmed down. Now she loves it so much she squeals when we are still on the highway getting close to the rehab place.
But you can't have him sitting on the therapist again, so...here are some photos of ways they found to keep dogs upright in the treadmill.

This shows a dog in a double harness. It looks like the therapist used dog leashes to hold him in a standing position. viewtopic.php?p=61673#p61673

Rehab1.JPG
rehab3.JPG

Here is an older photo of the same idea, dog in a double harness inside the treadmill.
/https://www.walkaboutharnesses.com/success_story_devon.html


Image

Here is an adorable picture of a dog in a treadmill, and it looks like the therapist drew a peanut butter heart on the glass. That might keep him on his feet! Does your dog like peanut butter? :D It's actually a video if you click this link.
viewtopic.php?p=111558#p111558

treadmill_heart2.JPG
Note that when the first 2 pics talk about Walkabout harnesses, they are talking about this site, but I think the idea would work with many harnesses.
http://www.walkaboutharnesses.com

And here is one more idea, where they actually had the dog in her wheelchair inside the treadmill. I think it would depend on how well the wheelchair fit inside, and you wouldn't want to scratch the glass. The underwater treadmill I've seen has a moving belt down the middle and an unmoving ledge along each side (where the therapist may place her/his feet) so I suppose you could rest wheelchair wheels on it too. If your dog will move his feet on the treadmill without the therapist holding his ankles, then it might work for him. If he still benefits from the therapist holding his ankles, then it would be in the way. It is from this link.
viewtopic.php?f=3&t=17651



I think the use of a harness or double harness would be better than a wheelchair, because it allows the therapist to hold the dog's ankles and move the feet in a stepping pattern, but I guess it is up to the therapist. I :wub: like the photo above of Devon, and the therapist working her feet. :pardon:
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Re: Newbie! Needing advice re knuckling and stiff feet

Post by critters »

:whale: It sounds to me like he has contractures, so he may not be able to use off-the-shelf splints. My Koi had been shot in the spine and came with severe contractures and was able to use a custom splint. Maybe CarolC can come up with a pic of his splint; he was a hock walker, and his toes were completely contracted under. Koi was a cat, but just saying the orthotist put a bar in the splint, like they do babies, to help straighten his toes and to keep them from breaking down from the pressure. Shoes helped some with protection but little with correction.
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Re: Newbie! Needing advice re knuckling and stiff feet

Post by CarolC »

Here is a thread with pictures of one kind of splint and a GOLDMINE of information, including botox and tendonectomy. :arrow: :arrow: :arrow: :arrow: viewtopic.php?f=4&t=14611 :book: :smart:

Are these the custom splints from OrthoVet?

splint_029.JPG
splint_030.JPG

Below are pictures of the other splints. Are these the standard off-the-shelf ones?

splint+001sm.JPG
splint+002sm.JPG

critters wrote: Thu Nov 25, 2010 11:46 am I tried every kind of shoe and splint, including Tammy and Teddy's, with Koi, my spinal cord injured boy who was shot in the spine in LA. He developed contractures in his L foot that drove us both nuts. It was a long, hard, creative road, but he's FINALLY better.
JimmyMac12
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Re: Newbie! Needing advice re knuckling and stiff feet

Post by JimmyMac12 »

Hi

Thanks for all the advice! So much to look through and so much more informative than my vet who still doesn't seem to have much clue! :shock:

I contacted her today to ask about getting a custom made splint as I need a vet prescription to order one, she was interested in his progress but just advised me to go ahead and order whatever I thought was best, some help! :roll: So I'm waiting now to hear back from Thera-Paw and see what they advise, I like the look of their no knuckling boot, yes the brindle dog modelling one is a Greyhound and they seem from their website to have experience of modelling things for sighthounds with sheepskin etc to provide comfort for skinny legs so I'm thinking they might be the best bet. If they could make something similar with a splint type support that can be modified as he progresses, maybe that will help.

I'm also really interested in the SAM splint which I see you can get from Amazon. Can this be cut to size? I'm thinking this might help in the interim if I can find some way of moulding it to keep his foot up. He's using the wheels much better now but dragging the feet is obviously not helping. I've managed to keep the Maximus boots going for a bit longer with the help of duct tape and a bit of new fabric, they definitely help with the right foot which he places forward now ALMOST all the time. They really are good boots and the people at Maximus were very helpful with getting the right size for him and advising on how to use them. I'm finding though that the straps are starting to fall apart, the little plastic piece at the top of the cord comes off very easily and then they start to fray. Maybe for other dogs who are moving a bit steadier they would be a good bet but Jim is mostly wanting to go at 90mph so they have a lot of work to do :lol:

The pictures of the hydrotherapy treadmills are interesting, when we did it with Jim we had one person each side holding him up with a sling as there were no hooks to hang a sling from. I did suggest to the PT that this might be a good idea! She was in the tank helping to move his legs and place his paws. It did definitely help him, the first few weeks his bottom just used to fall back as he had no strength to keep it up, but it came good, I think in the end it was just laziness on his part. I could see on his face he was just determined not to try, we tried treats and chicken which is his favourite, he ate the chicken but still refused to move, and if not held up I'm sure would have just plopped down in the water.

I still have the option of going back to do some more time in the treadmill and I think after your advice I will give it another go, maybe once his muscle has built a bit more and I have the foot support which I'm thinking he could use in the water too. I would like to see if he could do it this time without the sling.

I'll let you know anyway when I hear back from therapaw and see what they can do, thanks again for all the advice!

Karen
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Re: Newbie! Needing advice re knuckling and stiff feet

Post by CarolC »

If you want to try him without a sling, that would be interesting. There are a couple of other options that might work. (greyhound featured in these illustrations is from freepik.com).

Maybe your therapist could lay a board across the top of the treadmill and attach the sling to it, either by the straps or by bungee cords. Saves your arms, standing outside the treadmill holding him for half an hour. Doesn't have to be bungees. Clothesline, spare leashes, whatever you have handy. I don't know why I drew it with 2 bungees. You could probably attach both handles with one bungee. Duh, right? :hysterical:

stick_treadmill.PNG
stick_treadmill_bungees.PNG

This picture is from an old Swedish physiotherapy website and you have to put it in the Google translator to read it. The therapist put stretch-tape on this Dachshund to correct knuckling. :smart:

stretch-bandage.jpg

I noticed reading the downloaded literature from the TheraPaw Custom Hindlimb Dorsi-flex that it appears to come with standard straps (which may be elastic, I'm not sure) but they also have heavy duty straps available.
https://www.therapaw.com/standard-dorsi ... 3acb36f180

It says on their FAQ that the physical therapist can also order their products.
https://www.therapaw.com/faqs wrote: What is a "Veterinary Professional"?
A "Veterinary Professional" is an individual whose job it is to treat animal patients in a medical manner.

This includes:
- Veterinarians
- Veterinary technicians/assistants/nurses/nurse practitioners
- Veterinary physical therapists / physiotherapists and occupational therapists
- Veterinary massage therapists

The individuals above are considered "Veterinary Professionals" and are therefore allowed to order Thera-Paw veterinary products.
It also says you may not need a professional for custom products, if they aren't going to require a lot of customization. I suppose the interpretation is up to them on that. It sure would make life easier not to have to get someone else involved.
https://www.therapaw.com/faqs wrote: Who can purchase Thera-Paw products?
Pet owners and Veterinarians can order a Thera-Paw Boot.

The following products do require a veterinary professional's approval, prescription, and sometimes completed order form to purchase:

Custom products - any product with the word "custom" associated with its name (custom boots and slippers MAY be ordered directly by pet owners as long as the customized work is not too intricate)
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Re: Newbie! Needing advice re knuckling and stiff feet

Post by JimmyMac12 »

That's definitely interesting, I don't know why the hydrotherapy unit doesn't come with some form of hooks to attach a sling to! I'll forward it to the physio, see what she thinks :)

I did think of involving the physio in ordering some boots, the vet has signed a letter for me with her contact details, if this isn't enough I'll get on to the physio instead. She was very interested in hearing about the maximus boots as has other clients faced with the same problem. The information from my vet and the neurologist was just to get ordinary boots to protect his feet and not worry too much about knuckling as it would sort itself out. In hindsight I wish I had tried to find something to keep his feet up a lot sooner.

I also have two pairs of Hunnyboots, made in Australia specifically for greyhounds and dogs with similar type of feet and I would definitely recommend these if there's anyone else out there looking for something. They don't keep the feet up but they have a very thick and flat rubbery sole which has helped him with standing. If I place his feet he can stand for a long time in these. They also fit perfectly and don't drop off which is a bonus! :D
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Re: Newbie! Needing advice re knuckling and stiff feet

Post by FYI »

JimmyMac12 wrote: Mon Jul 03, 2023 11:15 am the straps are starting to fall apart, the little plastic piece at the top of the cord comes off very easily and then they start to fray.
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Re: Newbie! Needing advice re knuckling and stiff feet

Post by CarolC »

Replies in blue...
JimmyMac12 wrote: Mon Jul 03, 2023 2:36 pm That's definitely interesting, I don't know why the hydrotherapy unit doesn't come with some form of hooks to attach a sling to! I'll forward it to the physio, see what she thinks :)
I agree about some form of hooks. Maybe they expect everyone to use the water level high enough to support the dog, and therefore they consider a sling unnecessary. But they should know that some dogs panic with high water in the beginning, until they get used to it. My dog did. Your dog did the same thing. The treadmill people should know some dogs will need support till they are comfortable being in chest level water. And some rehab places ask family to wait in a waiting room during the session (insurance? personal preference?) so there isn't always someone to help hold the harness for a big dog.

I looked through a bunch of videos on Youtube, trying to see if I could find any with other ideas for support, and also looked at different models of treadmills to see if some come with hooks or similar. Apparently the profession calls these tether points. A few have railings along the top that look like hand rails that you could tie something to. I found an Israeli rehab place that has some neat clamps on the side of the treadmill, but I don't know where they get them.
https://www.youtube.com/shorts/hUQa6sg4FJQ

clamp.JPG

I did think of involving the physio in ordering some boots, the vet has signed a letter for me with her contact details, if this isn't enough I'll get on to the physio instead. She was very interested in hearing about the maximus boots as has other clients faced with the same problem. The information from my vet and the neurologist was just to get ordinary boots to protect his feet and not worry too much about knuckling as it would sort itself out. In hindsight I wish I had tried to find something to keep his feet up a lot sooner.

That's good about the letter. Hopefully that will work with Thera-Paw. It's great about your physio being so interested! Maybe your perseverance with your dog will help many others. :D

I found a very readable article about contractures in humans that explains the process.
https://www.physio-pedia.com/Contractur ... ord_Injury

I also found an article that says they can treat the joint with medication in humans. I'm not sure what they are talking about, and I didn't think it was that simple, but maybe the neurologist will know.
https://www.upmc.com/services/orthopaed ... treatments


I also have two pairs of Hunnyboots, made in Australia specifically for greyhounds and dogs with similar type of feet and I would definitely recommend these if there's anyone else out there looking for something. They don't keep the feet up but they have a very thick and flat rubbery sole which has helped him with standing. If I place his feet he can stand for a long time in these. They also fit perfectly and don't drop off which is a bonus! :D

Those look really high quality, not to mention attractive!

I just had a thought. You said your dog is dragging his feet in the treadmill and refusing to move them. Maybe try it on a faster speed. The therapist may be thinking he won't be able to keep his hind feet moving in time with his front feet at a fast speed, which is true, but he doesn't need to have a correct gait right now, he just needs to move them. A slow, sedate walk is probably annoying to him. Slow and plodding is not his nature. The same was true of my dog (chihuahuas are an active breed). With my dog being small, the therapist would hold her ankles and help her hind feet take steps in the treadmill, but the steps were not in time with the front feet. It didn't matter.
:thinking:

CarolC wrote: Fri May 27, 2005 10:38 pm My dog was put in the treadmill for a number of sessions and was only able to use her front feet, so every time we went the therapist took off her socks and shoes and rolled her pants above the knees and got in the treadmill with my dog. She stood there bent over from the waist churning my dog's back feet in a stepping motion on the treadmill while my dog walked with her front feet. After a while, the therapist could tell my dog was aware of it, because the therapist couldn't make her back feet take steps in time with her front feet (she's a chihuahua, taking many small steps) and it was bothering my dog because she knew the back feet were going too slow. Before long, my dog began taking the steps herself. You should have heard the cheering in the PT room that day.

CarolC wrote: Thu Jul 09, 2009 7:02 pm Both of my dogs need help with balance and having the treadmill go faster lets them do a better job of working out and staying on their feet. Think of a small child learning to ride a bike. If the bike goes slow, they wobble wobble wobble. If the bike goes fast, they stay more upright.

JimmyMac12
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Re: Newbie! Needing advice re knuckling and stiff feet

Post by JimmyMac12 »

Thanks for the further advice, it is much appreciated. I haven't heard back from the neurologist yet, but hoping he might be able to offer advice, if there was medication that would help that would be great but probably just for humans at present.. :roll:

An update, I have ordered a custom made hunnyboot from the lady at Therapaw, not overly expensive and hoping against hope that it will work as I am tearing my hair out at the moment with his knuckling! The maximus boots really are not doing the job any more which is a shame, I've been covering them in tape which is definitely keeping them going but the cords now work loose after a relatively short time and I have to keep stopping to re adjust his feet and pull them up. After a while he just ends up dragging the back feet along, even his right foot which he can put forward when he tries, so is either laziness or going too fast and not concentrating, his leg muscles are getting a good work out but the feet are really hindering him.

The lady at therapaw advised to try some thera band, attached to the front of the boot one end and to the middle of his harness. I wish I could post a video but the content is too big! It worked to a point by bringing his foot forward but then it would knuckle back over, probably because that is the easiest position for it to lie at the moment. She has come up with the idea of attaching keep-up cords to the hunnyboots, like on the maximus boots and then moulding some thermoplastic to the shape of his foot which can be attached over the front of the boot. I'm still a bit clueless as to how this will work but she seems to think it will prevent the foot knuckling over.

So at the moment I'm waiting for these boots to be made and attempting to fit new cords to some other boots to keep him going in the meantime, the cords on the maximus boots are now getting too short to keep using even if I mend them. There's been trial and error with several boot ideas but I'm hoping the new hunnyboots will work.

The theory about the treadmill is good and I will mention this when I next see the physio, I really want him to be able to put the feet forward before he tries the treadmill again, there is space at the side for wheels but I think they are too wide, if we could get the water high enough he should be able to try on his own but I somehow don't think he will tolerate that.

On the positive side, he has made two attempts at walking in the past week :hurray: He upped and walked down the length of our living room with me just holding on to the back of his pants (not holding him up), quite a considerable distance and striding out with both legs and with determination, just to get to another bed :lol: Then the second occasion was yesterday when I came home from work and he heard the car and was standing at the door waiting. My mother was looking after him and said he got up and moved like a shot although he was wobbly on his bad side, but still managed to stand for a while before plopping down again.

So it's reasons to be cheerful, I know he can do it, he just needs the motivation, and I think if he could get the feet sorted he'd be away.. onwards and upwards hopefully! :)
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CarolC
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Re: Newbie! Needing advice re knuckling and stiff feet

Post by CarolC »

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JimmyMac12 wrote: Sun Jul 09, 2023 10:07 am Thanks for the further advice, it is much appreciated. I haven't heard back from the neurologist yet, but hoping he might be able to offer advice, if there was medication that would help that would be great but probably just for humans at present.. :roll:

An update, I have ordered a custom made hunnyboot from the lady at Therapaw, not overly expensive and hoping against hope that it will work as I am tearing my hair out at the moment with his knuckling! The maximus boots really are not doing the job any more which is a shame, I've been covering them in tape which is definitely keeping them going but the cords now work loose after a relatively short time and I have to keep stopping to re adjust his feet and pull them up. After a while he just ends up dragging the back feet along, even his right foot which he can put forward when he tries, so is either laziness or going too fast and not concentrating, his leg muscles are getting a good work out but the feet are really hindering him.

OK, so, the Maximus boots work well for as long as they work, but they fall apart under heavy use. If he starts dragging his good leg, it could also be fatigue. I am not a vet, but my understanding is, during recovery the signals start coming through, but it still takes more effort to do everything. Kind of like someone who just had a stroke and gets tired doing the smallest thing. But I would expect that should improve. Also, I don't know if you've seen any info on long term recovery, but recovery from spinal injury continues for years. You've got him nearly walking at 6 months, but neurologically dogs seem to continue to improve to some degree for at least several years. My dog was about the same age as yours when she was injured:
https://handicappedpet.net/helppets/viewtopic.php?p=60666#p60666 wrote:Today in physical therapy, the therapist said that when she was on the treadmill, there was another dog in the room and my dog kept barking at him, and the whole time she barked she was bounding along on the treadmill with her back legs together hopping, and she was bending her knees to put a spring in her hops. This is something she has never been able to do since she was paralyzed, but she learned to do it this week. This week she has been paralyzed 4 years and 10 months.
The lady at therapaw advised to try some thera band, attached to the front of the boot one end and to the middle of his harness. I wish I could post a video but the content is too big! It worked to a point by bringing his foot forward but then it would knuckle back over, probably because that is the easiest position for it to lie at the moment.

I'm sorry there's a file size limit, because it would be SO nice to see it. If you could possibly upload it to Youtube, you can give the link for people to click, or enclose the link in tags and it will display inside the post.

This theraband idea is similar to the Biko brace, which has been around "forever". If you have a minute to search youtube, you'll see tons of dogs walking with a Biko brace. It consists of elastic straps that go from the harness (over the shoulder area) to one or both hind feet. They help bring the hind foot forward. Seems to work well. The Biko brace can also be used in conjunction with a wheelchair.


Biko_with_cart_sm.JPG

There is a newer product by a company called Canine Mobility, and I haven't heard anyone report on it. They've been in business since at least 2012. I'm inclined to think it probably works, but I hesitate to recommend something without knowing. You've no doubt spent a small fortune on surgery and boots and PT, etc. It's like a Biko brace in that it has elastic straps. It is also like a no-knuckling training sock in that it goes around and between the toes. I have NO idea whether it is advisable to use such a thing on toes that may be experiencing a contracture. :shock: You don't want anything that would risk hurting his toes. The suggestion of Therapaw to attach the theraband to the toe of his Maximus boot was safer because it is lifting all his toes (inside the boot) together, just as a Therapaw dorsi-flex will do.

The no-knuckling training sock encircles the toes and according to professional physical therapists, it will "Encourage Pet to Pick Their Foot Up: Stimulates a pet between its toes, evoking a withdrawal reflex". So if that is the case, then it appears this new Canine Mobility product has both the advantage of a Biko brace (using elastic straps to help the feet forward) as well as the advantage of a training sock (stimulating the foot to get additional response). Here is a fairly close up view of the CM brace.




She has come up with the idea of attaching keep-up cords to the hunnyboots, like on the maximus boots and then moulding some thermoplastic to the shape of his foot which can be attached over the front of the boot. I'm still a bit clueless as to how this will work but she seems to think it will prevent the foot knuckling over.

So you are sending her an extra pair of Hunnyboots and she's going to customize it? Really? How extremely cool! I see where it says they can do that. Looks like they've done it before. Worth a try!

Therapaw_custom.PNG

So at the moment I'm waiting for these boots to be made and attempting to fit new cords to some other boots to keep him going in the meantime, the cords on the maximus boots are now getting too short to keep using even if I mend them. There's been trial and error with several boot ideas but I'm hoping the new hunnyboots will work.

I hope so too. This is really exciting. :bounce:

The theory about the treadmill is good and I will mention this when I next see the physio, I really want him to be able to put the feet forward before he tries the treadmill again, there is space at the side for wheels but I think they are too wide, if we could get the water high enough he should be able to try on his own but I somehow don't think he will tolerate that.

On the positive side, he has made two attempts at walking in the past week :hurray: He upped and walked down the length of our living room with me just holding on to the back of his pants (not holding him up), quite a considerable distance and striding out with both legs and with determination, just to get to another bed :lol: Then the second occasion was yesterday when I came home from work and he heard the car and was standing at the door waiting. My mother was looking after him and said he got up and moved like a shot although he was wobbly on his bad side, but still managed to stand for a while before plopping down again.

Woohoo!!!!! That is the best news!!!!! Happy days!
:newyear: :snoopy: :yay: :applaud: :elephant: :hurray: :party:

So it's reasons to be cheerful, I know he can do it, he just needs the motivation, and I think if he could get the feet sorted he'd be away.. onwards and upwards hopefully! :)

:cheerleader: :cheer: Go, Jimmy! :cheer: :cheerleader:
JimmyMac12
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Joined: Fri Jun 30, 2023 10:51 am

Re: Newbie! Needing advice re knuckling and stiff feet

Post by JimmyMac12 »

Hi Carol

Thanks for the encouragement, yes it's great he's attempting to walk but I'm aware it probably won't happen again now for a while as that's how it seems to go.. one minute there's a breakthrough then nothing for ages. I'm sure he'd rather pull me around on the sling given the choice! :lol:

The biko brace and the new one you mentioned look really cool, I'm not sure like you if it's a good idea to use a cord between his toes where they are stiff. I think I prefer the boots because whenever he just uses his feet he manages to scrape the knuckles, even on the carpet. But it's a great idea and something to think about, if it helped with the wobbling on one side it would be useful

I was reading some of the stuff on Dodgers list and it's made me think maybe I'm being a bit too impatient with his feet, it says they need to re learn how to place them once they can walk, so I don't know. I suppose I should just be so grateful he has got to this stage already, like you said it can take years.

I will try and post some stuff on You Tube, but I'm not very good at it so bear with me! :shock: I'll let you know when I get the custom boots and hope they'll make a difference.
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