Newbie! Needing advice re knuckling and stiff feet

[JimmyMac12]

Wow! That's brilliant, thanks for sharing. But so awful to have other problems crop up after all you'd been through
This is a vet I've never been to before so I'm a bit worried of course, but we do have the vet school to fall back on if I'm not happy, just a long drive away.

Jim does manage quite well with going round on the bed but I'm still having to help if he gets his feet tangled in the pee pads I still have to help him up as well, he can do it but with a lot of effort.. and he won't usually unless he's about to go out in the car or thinks he's getting left behind!
I think his long weedy legs are not helping him much, he still needs to build a lot of muscle. I'm sure it must be easier for smaller dogs, they don't have so far to get up or to fall! It's definitely a learning curve, for him as well as me

[CarolC]

Oh, I totally agree. I have always thought how much easier it must be for a short dog like a dachshund to learn to walk again. With tall dogs, the center of gravity is so far up off the ground, it's easier to keel over, and the wheel base is shorter. Greyhounds are a good example, some boxers are another, but even chihuahuas can be long legged in proportion to length. I expect his muscle tone will come back.

[JimmyMac12]

An update to my last post.. I visited the orthopaedic vet last Friday and he wasn't much help at all. He basically said he couldn't and wouldn't operate as he would be worried about the foot becoming floppy and useless, he also didn't think fusing would be a good idea either. He said if I could find anyone else willing to operate he would be glad to be proved wrong but he didn't think any other orthopaedic vet would!

He also told me he shouldn't be left to walk on his knuckles, even on grass (like I didn't know that, but how else does he get to learn to walk? ) And he referred me back to the physio and said a six week intensive course should cure it!!

Thankfully he didn't charge me anything for all that useless information! So I'm back to the physio and we're trying another three months of treadmill once a week with lots more balance and proprioception exercises at home. An intensive course is out of the question, certainly where I live!

The PT thinks now that it is nerve damage rather than a contracture, and my neurologist seems to think so too. So I'm keeping fingers crossed that it may improve with time and more effort. I'm still letting him walk across the garden on his knuckles as he needs to practice, but trying to place the feet as much as possible and trying to get him to put more weight on the bad foot. I've also been advised to try hair bands under his feet, he's not a great fan of this and screams when I try to get them off, so it's all making for fun and games

He's still not a fan of the treadmill either and wasn't impressed by being dragged in again, in fact he tried his best just to collapse and sit down without making any effort. My physio I think needs a medal just to keep him upright! However, we've found that by forcing him to accept a higher volume of water to support him and upping the speed he can actually do it. She was placing his paws for him and it looked much better.. maybe the faster speed makes him concentrate more? I don't know, but we'll keep with it and see how it goes.

As for the boots, I'm still struggling to get something to work again but I'm thinking that walking him with a foot dragging or letting him knuckle is better than him not moving at all! So much for vet advice!

[CarolC]

Replies in blue...

An update to my last post.. I visited the orthopaedic vet last Friday and he wasn't much help at all. He basically said he couldn't and wouldn't operate as he would be worried about the foot becoming floppy and useless, he also didn't think fusing would be a good idea either. He said if I could find anyone else willing to operate he would be glad to be proved wrong but he didn't think any other orthopaedic vet would! Hmm. Well. If he's giving you his best professional judgment, then here's hoping he'll be right. You never want a doctor to be too hasty or overconfident. I don't know whether at this point you get a second opinion, or just accept it and know you tried. Sounds like he was pretty sure about it.

He also told me he shouldn't be left to walk on his knuckles, even on grass (like I didn't know that, but how else does he get to learn to walk? ) And he referred me back to the physio and said a six week intensive course should cure it!!
If only it were so simple...wouldn't that be nice...

Thankfully he didn't charge me anything for all that useless information! Well, there's one bright spot! So I'm back to the physio and we're trying another three months of treadmill once a week with lots more balance and proprioception exercises at home. An intensive course is out of the question, certainly where I live!

I'm not an orthopaedic vet or a rehab specialist, but I still believe the dog can only do as much as the nerves are ready for, and consistent PT over time is the key. I'm remembering Joel's dog, Chase. It was a different situation, and the timeline for every dog is different. Chase had an FCE (spinal stroke) and was walking at 4 months but it took a couple more months until he wasn't knuckling so badly. I wouldn't take that as a guideline to how long it might be till you see improvement, but the problem is similar. Joel had a particularly hard time with Chase tearing up his feet because at that time of year there was sand and salt on the roads. Chase was a lab, 70 lbs / 32 kg. Joel just kept doctoring his feet and in time Chase improved. viewtopic.php?p=7214#p7214

The PT thinks now that it is nerve damage rather than a contracture, and my neurologist seems to think so too. So I'm keeping fingers crossed that it may improve with time and more effort. Yeah, this would be good news. I'm still letting him walk across the garden on his knuckles as he needs to practice, I'd be doing the same thing but trying to place the feet as much as possible and trying to get him to put more weight on the bad foot. I've also been advised to try hair bands under his feet, he's not a great fan of this and screams when I try to get them off, so it's all making for fun and games

I've heard of putting them around the ankles, but not around the actual paw, but I don't know why not. It's supposed to help with proprioception. Lucky you that he doesn't like having his feet messed with!

He's still not a fan of the treadmill either and wasn't impressed by being dragged in again, in fact he tried his best just to collapse and sit down without making any effort. My physio I think needs a medal just to keep him upright! However, we've found that by forcing him to accept a higher volume of water to support him and upping the speed he can actually do it. She was placing his paws for him and it looked much better.. maybe the faster speed makes him concentrate more? I don't know, but we'll keep with it and see how it goes.

This is extremely cool! Woohoo!!!

Speed of the treadmill also makes a big difference to my dog. If it is too slow she cannot keep her balance. You're right, the person controlling the treadmill has a lot to do with the success of the exercise session.

As for the boots, I'm still struggling to get something to work again but I'm thinking that walking him with a foot dragging or letting him knuckle is better than him not moving at all! I have to agree. I'd do it, too. And I don't understand the vet saying there's something wrong with grass. It might depend on the grass, but surely it is easier on his feet than pavement. If he has a suggestion of a better surface, I wonder what it is. So much for vet advice! Well, kudos to you, because you have done all due diligence to get the best advice you can from the best qualified professionals you can find. You can't say you didn't consult all the experts. You know you're doing your absolute best for him. He's one lucky dog. You can tell him I said so!

[JimmyMac12]

Thanks Carol for your advice, you always make me feel so much more positive!

There are other professionals out there who would most likely be more helpful but it's a matter of distance and cost. So I think at this point I'm going to take a big chill pill, try not to get so stressed over the situation and give it time. At least we seem to be moving in the right direction

[NatureTechie]

Yeah based on what I read, it might be a good idea to take a step back for now and see how it goes

[critters]

Well, Koi needed surgery for his contracture (he'd been shot in the spine), but she tried to reassemble his tendons, so it didn't work. If you ask me, it's better to be floppy than contracted, because floppy is easy to correct and stabilize in a relatively normal position with a splint. Contracted has to be dealt with in the position it's in; for Koi, his paw was completely turned under, so it had to be protected from the pressure of walking. A custom splint turned out to be the answer for him.

[JimmyMac12]

Hi Critters, yes I agree with you, I wish someone would consider some type of surgery but everyone I've spoken to so far seems to be worried it might cause him more damage. How long did it take your cat to get right with the splint?

I have a 14 week plan with the PT now, we're doing underwater treadmill which he still hates and struggles with, but we're making a bit of progress at getting the foot down. She's also doing laser therapy and massage which I'm trying to keep up at home as much as possible. He still needs to get back a lot of muscle, so I think a lot of the problem is strength and not picking his feet up enough, if he doesn't wear boots he just drags the feet. Some days his foot feels a bit more flexible, others it seems just as stiff

My PT has today come up with the idea of using a hairband with a large bobble on, sitting the bobble just under his foot in the crook and using this in the boots. She thinks it will prevent the knuckling. So I'm going to give that a go. We're both determined not to give up so I'm sure there'll be a solution somewhere!

[critters]

Once we got the right splint he took to it quickly. We had to kiss a lot of toads before that, though. It's absolutely possible he's more spastic some days than others; it's true of humans, too.

[CarolC]

Hi JimmyMac12,

Thought of you today because another dog is needing custom support (not a greyhound, and not boots) and it reminded me of what you went through fitting Jimmy.

By coincidence it was a year ago today that you first posted. Normally I don't keep track, it just worked out that way today!

Hope you and Jimmy are both doing well, one year on.

[JimmyMac12]

Hi Carol

Hope you are well. It's weird actually because I was just thinking the other day that I ought to post an update! Can't believe it's one year on and 18 months now since Jim's accident.

Well, we're still going that's all I can say! Jim is ok and happy, he gets around really well now, walks, trots and runs at some speed, but he still has a stiff foot and still knuckles and drags his feet.

I'm with a new vet now who gives him acupuncture every fortnight. I gave up on the hydrotherapy unfortunately as it really wasn't helping in any way and he got to a stage where he would just sit his bottom on the physio and refuse to do it. I'm sure for most dogs it works but Jim is probably the most difficult dog this could happen to and getting him to do things has been an uphill struggle

He gets PT at home, still uses wheels for longer walks and a sling for shorter, I don't have to hold him up now just give him a bit of support. He can get up and down off his bed, struggles a bit still if he's on the floor but on a raised bed he's fine. And he can climb up and down steps now.

The acupuncture seems to be helping, I'm keeping at it mainly to help with arthritis if it sets in. He's coming up to 10 yrs old in October and I think maybe we've come as far as we can go with him, mainly because of his age and the severity of the injury. I still see little improvements now and then so I still hold out hope but I'm also trying to be realistic. As long as he's happy and otherwise healthy we will keep going.

One thing I have tried recently which seems to help is a massage gun. The vet advised me to try it on the muscles on his legs and along his spine, he really enjoys it and goes to sleep! And I think it helps to prevent tightness in his back.

His feet remain a problem and it's just a case of managing them, he wears the maximus boots out walking and some padded ones I have made up for round the house and garden. These are just cheap ones from Amazon which velcro further up the leg to stop them pulling off, he has socks inside them and padding which I've added to prevent sores. He did get bursitis on one foot which hasn't completely gone away, this was just from walking on grass without boots, so now he wears them most of the time. I've tried everything with the stiff foot, it's no worse and no better. Sometimes the boots hold it up, sometimes they don't. The vet has said while he's obviously not in pain it's best to let him knuckle as he needs to walk, so it's just a case of preventing them from getting worse.

It's still a lot of work but it's worth it just to see him still enjoying life. He plays with our other dog and with his toys and occasionally does things that make you go yay! Another milestone! Then it goes back to normal.. but I guess that's how these things go

[CarolC]

Wow! It sounds like he really keeps you busy. The term "special needs" certainly fits, doesn't it. It's one of those cases where his needs are so specific that nobody else would know what to do to take care proper of him. You'd have to write a multi-page guide for someone else to take care of him for a couple of days! I've got a dog like that, where I wrote an illustrated guide to his care that was 27 pages single-spaced in Word. Maybe you can relate!

I know what you mean about seeing something new and thinking. "Yay!" My dog used to do something new, then she wouldn't do it again for a long time. I guess neuro recovery is like that. It's not just you!

All during her recovery, she would do something new, then not repeat it again until much later.

I'm glad you aren't having to support him so much with the sling now, just kind of steady him. I hope your back is still mostly OK.

He can get up and down off his bed, struggles a bit still if he's on the floor but on a raised bed he's fine.

My Merlin (golden retriever) was the same way. He had a dense foam "flip bed" that was about 9" off the floor. He could get onto it from walking, or put his feet down on the floor and stand up quite well after lying on it. The raised height gave him the advantage. If he was just lying on the floor, that took more effort and usually a boost. It's almost like the difference between getting up from a chair or getting up from being seated on the floor, for one of us (humans).

Jimmy is a super lucky dog to have the kind of support you give him. I'm glad he's doing so well. I hope you can take good care of yourself, too. We have a saying here. It's like the instructions they give you when flying on an airplane. Put the oxygen mask on yourself first, then your children. It's easy to be so other-focussed that you somehow don't give yourself the attention you need. I hope you can give yourself a little "treat" now and then. You have absolutely earned it!

[JimmyMac12]

Hi Carol

Thanks for your kind words, I forget sometimes how much we've been through and all of the struggles early on just to get to this stage, I had no idea then it would take so long and that he might not fully recover.

The vet told me that no one can really say how much more recovery he might make as most people wouldn't have carried on so long, so they have very little experience to go by. Most dogs with this problem tend to be smaller breeds and they seem to progress quicker just due to shorter legs and the whole process being easier to deal with. Hefting a large dog around really does take a lot of commitment as I'm sure you understand.

Yes it's hard and I haven't had a proper break in the last 18 months as I don't think I could get anyone to do what I do and wouldn't really want to put on them so much. It would be a very long list to write! And taking him away with me would really be just as difficult. Maybe in the future.

But looking back on the worries and sleepless nights I had at the start, my daily routine now is a breeze in comparison. And I am able to get out and about more as he can be left for short periods with the other dog and is quite happy, I don't have to worry about him as much.

I hope this may be a small source of inspiration to other people going through the same thing. It really is worth it every day to see him so happy that you forget all the hard work. There's always light at the end of the tunnel, no matter how small!

[critters]

for the update!