Category Archives: At-Home PT Exercises

September 1, 2008 · 10:34 pm

Underwater Treadmill Redux.

Ready to go!

Note the rubber ducky in the corner. It squeaks; Ali likes!

Those who have been following along will remember that after Ali’s first successful session in the underwater treadmill a few months ago, he balked the second time and refused to walk, so we decided to give it a rest for awhile. In the mean time we continued with swimming therapy in the river and our standing exercises at home. Well, as I mentioned in my last post, we decided to try the underwater treadmill again and I am happy to report that Ali has decided he loves it now! Last week, he was so excited he tried to climb into the tank while still in his wheelchair, which is great. It’s cute how enthusiastic he is now about going to the Animal Care Center for these weekly appointments. I think we have done a good job of making it fun for him. And it doesn’t hurt that he has such a good attitude about everything! He is such a sweet, happy boy. People remark on it when they see us on the street or in the park. First they notice and ask about his wheelchair, then they say, “He looks so happy!” And he is. We both are. I’m happy because I know how lucky we are; he’s happy just because. And isn’t that one of the cool things about sharing your life with a nonhuman animal: this zen-like just because? Not to digress into turgid sentimentality, but sometimes when I look at this dog, as am doing now over my laptop screen, in addition to the usual feelings of fierce love and quiet admiration, every now and then my heart melts, turns to liquid, and I feel it rush to my feet. This isn’t as unpleasant as it sounds, but it can be an overwhelming feeling at times. It makes me feel helpless. What do you do with such a strong feeling? You recognize it and honor it as best you can with your actions, I guess. What else is there?

Alright, leaving crazy I-love-my-dog-so-much-it-makes-my-head-hurt land, during the last couple treadmill sessions, Juli has noticed some further improvement in his back right leg. Between two sessions she said his right leg had more movement than the week before, which is pretty exciting. The last two weeks he has been able to move his right leg on his own, whereas the week before she had to bend over the whole time and complete each step for him. He is still “knuckling” on his right foot when he steps, but last time he placed his foot once on his own, which Juli said is a milestone. She also said the muscles in his back legs were less tight and more supple this week, which is cool because during the last week I have been massaging his legs during standing exercises at home (per her recommendation to relieve some of the tightness), so it seems the massage is helping. After a week of not being able to swim (nobody to help), Ali has gone twice this weekend and we are going out to the Russian River again later today to meet Steve. So he has gotten some great exercise this long holiday weekend. I just hope the Labor Day revelers do not make the river too crowded today! It is always more difficult with lots of people and dogs around. Swimming Ali regularly is an ongoing challenge, but a necessary one to tackle because it is so incredibly therapeutic and the benefits for him are invaluable. Okay, now go forth and hug your companion animal and appreciate the unsettling yet not unpleasant feeling of your own heart melting.

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Filed under At-Home PT Exercises, LOVE, Milestones/Progress, Physical Therapy/Rehabilitation, River Swimming, Underwater Treadmill

August 17, 2008 · 6:19 pm

6-month update: realism and optimism



Photo: Yesterday, Ali stood up and took a couple steps off his bed when he noticed I was getting his peanut butter Kong from the freezer. He has been doing this more lately – standing up on his own and taking a couple baby steps without falling over.

It has been six months since Ali’s surgeries and he continues to make functional progress. We are back at Animal Care Center doing underwater treadmill therapy once a week. Although Ali balked at the treadmill the second time, he is doing okay with it now. We think it is probably because his confidence level is higher as he is much stronger and has more mobility in his hind limbs. I have also worked hard to make it fun and not stressful for him. It’s not too difficult. He is so social that he loves going there and seeing people, and I just make sure I have lots of treats on hand along with a tennis ball to distract him. He has been walking 6-10 minutes on the treadmill each time. In the water he takes independent steps with both legs, but needs assistance with placement of his right hind leg.

Out of the water, he can take active steps with his left hind leg and his right hind leg is showing motor function down to about the knee, according to Juli. I think this is amazing considering his right leg was barely moving at all a few weeks ago. I don’t know if it’s a coincidence but it was when we started acupuncture that I noticed his right leg started to make subtle movements; now it is moving quite a lot in the cart! We also raised the cart about an inch and now he can take active steps with his left leg while in the cart. Before he was not able to clear the ground and place his left paw – he would “knuckle.” But with the added height he can take actual steps, which should be good for him. (Although the added height has caused us to have to make some other adjustments to the cart involving foam and duct tape – looks pretty DYI but we need to make sure the added height does not pressure his front shoulders too much. It’s challenging to get the correct balance.) The right leg is moving some, but not making complete steps. He continues to stand up on his own and it seems much easier for him now. I think is making great improvements with his balance. He can almost take a few steps on his own and he is really good about catching his balance if he starts to sway – he is able to reposition his left leg pretty well to catch himself.

We continue to go swimming as often as we can, which usually is not more than once a week, but ideally I would take him every other day if I could. There are just no good swimming spots around. The Petaluma River, close to our house, is really an estuary and as such is subject to the ocean tides. If it is low tide it is very treacherous to try to swim Ali there (speaking from experience – Ali and I have both sustained minor injuries on the exposed rocks. Luckily, I haven’t face planted on these jagged rocks yet, a fact Maggie was marveling at last time we were there. It’s only a matter of time, though, if we keep turning up there at low tide, and it will be extremely counterproductive if one of us gets seriously injured!). It is really only safe to go when the tide is high, but it only happens occasionally that the tide is high enough either after work (but before dark) or on the weekend during daylight hours. Plus, I am dependent on Maggie’s schedule and availability because I cannot take him out without assistance and she is my only friend in this godforsaken little town. Even more rarely we make it out to the Russian River, about an hour’s drive away. I go whenever I can, though – which means whenever one of my two friends who live out there can accompany me and Alec. I try to make it happen as often as I can because, although it’s hard trying to coordinate, I think swimming is the best thing for Ali to do regularly. I really think it has contributed immensely to his back strength, and I’m sure coordination as well.

We also continue to do acupuncture, once every 1-2 weeks, as well as standing exercises at home.

Alec’s official status at this point is “ambulatory with assistance; mild-moderate pelvic limb paraparesis.” Paraparesis means a slight paralysis or weakness of the hind legs – as opposed to paraplegia, which is complete paralysis of both legs. After his surgeries he was classified as “non-ambulatory and deep pain negative” and then “ambulatory paraplegic.” So parapetic is the proper word to describe his current condition, not paraplegic. In case you’re interested in the fine points. I am.

The neurologist had noted on his three-month evaluation report that “peak recovery may occur at 3-6 months post-injury; however recovery continues through a patient’s lifetime.” So this six-month mark is a little scary to me. I know it shouldn’t be, but as long as these improvements, incredible improvements, really, occurred before six months had passed…I don’t actually know. I just know I heard myself saying proudly several times when people remarked on this or that improvement he had made: “And it hasn’t even been six months yet!” Well, now it has been six months and part of me is afraid that he will stop progressing. I mean, that has been my fear all along. And it is not an ungrounded fear; nobody knows what will happen. The physical therapists talk a lot of being “realistic” but also “optimistic.” There are no guarantees in this field, and I remind myself of that a lot when I realize how far he has come and how grateful I am for that. I just really hope his right leg improves the point his left leg has, but that is not a given. Mobility could stop at the knee. But I guess I need to focus on the optimistic part of the equation. I feel like I have done a good job of balancing the realism/optimism equation thus far (of course, Ali’s amazing progress has helped with that!), and I know the six-month mark is just an approximate guideline; of course I know that. Juli has a client whose dog is two years post-surgery and just started walking on her own. So, we won’t give up! Bring on the next six months…I’m ready. And really thankful for how far he has come in just six months.

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Filed under Acupuncture, At-Home PT Exercises, Doggie Wheelchair, Milestones/Progress, Physical Therapy/Rehabilitation, River Swimming, Underwater Treadmill

July 18, 2008 · 4:34 am

Reasons to be happy.

Photos: Ali doing his “standing exercises” at our front door. He can stand for quite a while on his own now; not that long ago, I’d have to hold him to keep him from falling over. Also, Ali in action doing swim therapy. We found a closer place to swim at the Petaluma marina (5 min. drive vs. 50 minutes to the Russian River), but it has not been without problems – however that is a story for another post!

Well, there are certainly many reasons to be happy, but I am cautiously optimistic (okay, let’s face it, pretty darn excited) about some recent developments…mainly the fact that Ali has not yet hit a plateau, i.e. stopped improving (yes, I just knocked on my wood paneling when I wrote that, even thought I am NOT superstitious, ha ha).

We had our appointment at UC-Davis last Tuesday and met with Jackie Woelz, the rehabilitation specialist at the veterinary medical teaching hospital. I really liked her (so did Ali) and the best part was how clearly impressed she was with Ali’s condition. She said I was doing a great job with him and she could tell we had been working hard at home. She was most impressed with his strength through his middle and back – in fact, she said she had never seen a dog so strong through his core who was not yet walking! Jackie’s reaction made me feel pretty good because you never really know if all the standing, etc. is actually doing anything. But seeing how impressed she was made me realize how far we have come in the last five months. She said both the standing and swimming therapy combined have helped make him strong.

While she was evaluating him and showing me new variations on his current home therapy program, Ali was basically standing for the entire hour and a half appointment. Jackie said, “I’ll give you another first…” and she told me she had never seen a dog able to stand for that long, without getting fatigued, who was just 5 months out of surgery. Obviously, this is something else to be happy about! I’m sure Jackie has seen a lot of cases like Ali’s over the years (the vet school at UC Davis is highly regarded), so it really meant something to me that she was that excited about his physical condition.

Juli had told me a while back she can always tell when her clients are not doing the at-home therapy with their dogs. She said many times these dogs regain mobility in their legs, but their back/core is not strong enough to hold them up, so they just sort of drag and flop around, not really able to walk. So I am glad that Ali is strong! If he continues to make improvements in the area of mobility – in other words, if he regains normal motor function in his legs (could it happen??) – he will be strong enough to support himself. I don’t know if my math is accurate (in fact, generally speaking, I am quite sure it is not!), but it would seem that building up his muscle strength and addressing the post-surgery atrophy is half the battle for Ali right now. Of course the other half – movement – is the sexy part; but he needs to be strong too!

So, the plan moving forward is to continue to do standing exercises with him as often and for as long as I can, and to encourage him to take steps while doing it. Jackie said Ali was giving us a lot of material to work with. He can almost take steps with his left leg now, but his right leg holds him back because it does not have as much mobility. We have moved his standing exercises to yoga mats at home since he can do them without the cart now. While he is in standing position, I stand or sit behind him (or hover round him taking photos, ha ha) and make sure his form is good while massaging his hind legs and along each side of his spine (to stimulate the nerves). It continues to be a little challenging because, although he was a perfect angel at UC-Davis, when I am alone he just wants to turn around and look at me! He won’t stand straight; he just keeps twisting around. Jackie suggested putting the yoga mat in front of a door or window, which I did, but he is not interested in what’s outside as much as he is in turning and to look at me! Oh well, we have to keep trying.

Our saving grace is the peanut butter Kong. I am guaranteed at least twenty minute of good solid standing each day for the time he is working his way through the jumbo Kong toy, which I fill with peanut butter and freeze each morning. His attention is so rapt while he excavates the peanut butter that he stands still and does not try to wander off while we do these very important standing exercises. We have another appointment at UC-Davis next week during which we will try the land and water treadmills; for now, though, Jackie said the best “equipment” for Ali’s therapy is my own two hands.

Finally, my boss just told me I don’t have to go on the work trip I mentioned a few posts back (the Taking Action for Animals conference in DC), which is great because it will save me at least $300 in boarding costs for Ali (not to mention the stress of leaving him). Yay! I am so relieved because I have NO money. Of course I am also disappointed because I really wanted to go to this conference and if circumstances were different… but circumstances are not different, and so this is one more reason to be happy.

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Filed under At-Home PT Exercises, Milestones/Progress, Physical Therapy/Rehabilitation, River Swimming

May 18, 2008 · 5:02 pm

It looks like he is just standing there, but…


…this is an important part of Ali’s physical therapy: weight bearing. At least twice a day we come to the park and I have him “stay” for ten minutes in a standing position so that he can put weight on his back legs. This type of exercise is important to counteract the effects of atrophy, which are already quite pronounced (his right hind leg, the weaker, is more atrophied than his left). If and when his motor function returns, it is important that he be strong enough to hold his own weight – otherwise we will have a situation where he can move his legs but is not strong enough to do really anything with them (stand up, walk). I also do “sit-to-stand” exercises with him a few times a day, which are pretty much as they sound. I start with him in a standing position and ask him to “sit” back onto my knee. Lots of praise! Then, with me supporting his hind end, I encourage him to push off and stand up. We repeat this a few times…as many as a wiggly, restless German shepherd can tolerate! This is good for strength and reawakening muscle memory.

So, in terms of Ali’s ongoing physical therapy, it is important to have him bear weight on a regular basis. It can be challenging; ten minutes seems like nothing but it can feel like an eternity to both of us while we are just standing there. I try to distract him with sticks and cookies to make the time go by quickly. It’s hard of course because he is a dog and standing still is not exactly a natural posture at the park! He is such a good boy, though. I can only imagine how much more difficult this exercise that looks like “nothing” would be with some other dogs who are less inclined to want to please their guardians (my late great husky, Kobi, immediately comes to mind!).

It is also challenging because people just love to walk right up to us in the park, with their dogs no less, even when we are hiding behind a rosebush trying to be inconspicuous. Of course no dog – no matter how well-behaved – can stay still in these circumstances so I have to politely tell them we are doing physical therapy and cannot talk at the moment, and sorry, but no, he cannot meet your dog right now. Ali’s wheelchair is an oddity and I knew he would draw attention but I am patently shocked at how many people flat out stare at us, turn their vehicles around in the street, and just approach us constantly with questions and comments, some innocuous and polite, others just plain annoying and nosy. Some dogs have reacted badly to Ali’s wheelchair and so I am much more cautious about him meeting other dogs in the park. In fact, I pretty much avoid it now. But I can’t take any chances. My neighbor’s dog recently tried to start a fight with Ali after they came up to us in the park and she assured me her dog was friendly. As soon as they sniffed noses her dog went for Ali and I had to pull him away from her – trying to make sure his wheelchair did not tip over in the process! Immediately she apologized and said she realized too late that her dog might react badly to Ali’s wheels as she barks at strange objects…including people in wheelchairs (!). Um, I wish you had thought of that beforehand! Anyway, Ali was alright but it has made me even more cautious than I already was, which is why it is a constant challenge dealing with people walking right up to us with their dogs, without even asking if it is okay first. Even when I turn around and walk in the other direction they sometimes follow us! And this is not an off-leash dog park I should add, lest I sound overly harsh. There are signs posted that your dog must be on a leash. It is a de facto dog park however and I really don’t care if people violate the leash law, as long as their dogs are under control, which unfortunately usually they are not! Nothing new – careless dog owners abound in general – but the stakes are higher for sure now that Ali is disabled.

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Filed under At-Home PT Exercises, Physical Therapy/Rehabilitation, Social Interaction

April 29, 2008 · 3:00 pm

Ah, moving…does it ever go smoothly?



I am happy to report that the move went very well! Except for the unfortunate accident I had involving a beer bottle, my wrist, and a lot of blood. No, I wasn’t drunk! I wasn’t even drinking. I swear. I was unloading my van, trying to get Ali’s big orthopedic bed out, when an errant 6-pack started tumbling toward the door (in that weird combination of slow and fast motion). A couple bottles hurtled past me to the ground and smashed in the gutter and in my panicked attempt to keep more from falling somehow I caused another one to crack open and the jagged pieces hit my wrist on the way down. What a mess…glass and beer everywhere (hi, new neighbors)! Once the blood started gushing and I saw where the three main cuts were (one was right in the suicide place, scarily near my vein, and the other was so deep it would more accurately be described as a “gash”), I started to get faint and called my roommate Maggie at work, just so someone would know where I was in case I passed out and bled to death, and she came immediately with our dusty ALDF first aid kit and bandaged me right up. She is awesome!! Why is this relevant to my Ali blog? Well, it was my right wrist and it was really painful (not to mention disgusting) for a couple days and I need both my hands and arms to deal with Ali without hurting us, so it was tricky. But a little over a week later I am completely healed and trying to be much more careful around glass. Although I think I may be accident prone.

To get to the raison d’être of this blog, Ali is doing really well and has settled nicely at our new place in Petaluma. He is using the ramp successfully and the park across the street is very convenient for us. I take him there 3 times a day (2 on work days) to exercise, go potty, and do ten minutes of standing exercises in his cart. He and Rita, Maggie’s dog, are getting along great and I couldn’t ask for a better canine roommate for him right now. She is pretty low key which is good, because he wanted to play immediately when he met her, and when Ali plays he throws his whole body into and even likes to spin around (his infamous “play spins”), so I had to watch him pretty carefully to make sure he did not overexert himself. It has been interesting adjusting to life outside of one room, because of course he sometimes wants to travel from room to room, or greet Maggie and Rita when they come home, and meet new people when they come over. I have to watch him so he does not drag himself, which he definitely was trying to do a lot at first (and still does sometimes) and when he wants to get up I run over and grab him by his Walkabout rear harness (aka his “shepherd handles”), which I leave on him all day until we go to bed, and assist him by lifting his rear legs so he can walk where he wants using his front. The rest of the time he is on one of his beds. Getting to and from work has been a challenge (obviously compared to the convenience of living in my office, ho, ho, ho). Everything takes so much longer, getting him in and out of the car is kind of tricky (and making sure he doesn’t get himself into some weird position while I am driving), but we are getting into the new routine. Last week we were able to join in our first staff dog walk since his surgery over two months ago, which was great. The other dogs were not quite sure what to make of his wheelchair at first, but it didn’t stop Alec from his favorite activity while walking with a group dogs – trying to pull to the head of the pack so he can be the first one in what must appear to onlookers like a dog parade.

I still need to keep his walks short and it’s better for his joints if he walks on grass (hence the park across the street being so convenient), but Juli, his rehab therapist, says eventually he can take long walks in the cart. For now though, she emphasizes that physical therapy is the most important thing I can do with him in the cart, more important than going on walks, and I need to keep doing his exercises throughout the day. She showed me a new exercise where I assist him to sit and then stand several times throughout the day for one minute. She came by last weekend to help with his cart problems and showed me a way to get him to urinate in the cart and it is working so I am very happy about that! Moreover, she believes she see some slight movement at the top of his back legs, where they meet the rest of his body (this is called “proximal motor”). She also believes he has deep pain perception (I pinched his tail once in front of her and she saw him react – the reaction I could not get for the neurologist during our initial re-check exam back in March). Since Juli believes Ali is showing some improvement, she suggested I make an appointment at Animal Care Center with the Dr. Tieber for another re-check. She said because she is not a doctor she can only “assess” Ali’s condition but not “diagnose” and thinks I should get a neurologist’s opinion on what she believes she is observing (i.e. some return of motor function).

After we see the neurologist, Dr. Tieber, we are going to have a rehab appointment with Juli and put Ali in the hydro-therapy tank for the first time. I really hope Dr. Tieber confirms what Juli is seeing. I feel like he is improving too – it seems like I can see his legs moving slightly sometimes in the cart – but I am afraid to get my hopes too far up. Our appointment is on Friday morning. Wish us luck!!!

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Filed under At-Home PT Exercises, Bladder Expression/Urination, Doggie Wheelchair, Milestones/Progress, Physical Therapy/Rehabilitation, Ramp, Relocating