Category Archives: Physical Therapy/Rehabilitation

September 20, 2009 · 8:12 pm

What wheelchair?



I am ecstatic to report that Alec has not used his doggie wheelchair since June!! He is walking without assistance for up to 1/2 hour walks a few times a day. He has a pronounced limp and needs to wear a shoe to keep him from damaging his paw when we walk outside (his right hind leg will probably never be completely “normal,” but his left leg is pretty much 100%) and because he drags his back toes, the fabric of the shoe wears through really quickly. The shoe is not cheap ($60 for one!), but duct tape can do wonders to keep things from falling apart, so each day I put a new layer of tape over the toes and it seems to be working pretty well. Luckily, a client of his physical therapist donated a couple of these shoes to the rehab center and she in turn donated them to me and Alec, so I am trying to make them last as long as possible. He has not had any toe scrapes or paw issues in some time (knocking furiously on wood!!); that was a recurring problem for awhile and a source of constant worry and stress. But the shoe seems to be working really well to protect his foot and he gets around so well it is just incredible. Recently when I was walking Ali back to the car after one of our river swims (sans shoe – he doesn’t need to wear it on the grass or sand), a gentleman remarked with concern, “I think your dog might have a rock stuck in her paw. She seems to be limping.” I replied, “Actually he was paralyzed not long ago, and is learning to walk again” and I realized, wow – if he can be mistaken for a dog that has nothing wrong with him other than a rock stuck in his paw, he is walking pretty well!!

He is still not allowed to run or get rambunctious on land (it is a balance with which I continually struggle – letting him be a dog and not being overprotective, yet remaining cautious and mindful to prevent further injury), but he loves to chase the ball in the water and this summer has been a blessing. I have taken him swimming in the rivers around Portland at least once, and often multiple times, a week. This is the #1 reason I am sad to see this summer slip away. I took him swimming once per week last winter but it was so cold he could only swim for about 20 minutes, whereas this summer he has been able to swim for unlimited amounts of time. There is an indoor warm water swimming facility in Vancouver, Wash., about 30 miles from Portland, called Unsinkable Dogs that I am going to look into for when the weather turns cold. The tanks look pretty small in the photos on their website, so I’m not sure if he will have room to chase the ball, but I will give it a try. I hate to see his happy days in the water come to an end. Maybe we need to move somewhere with an all-year-around warm climate – just so he can swim everyday! In all seriousness, I probably would move us somewhere warmer if I could – preferably near a pristine river or lake with a flat sandy bank – but alas, my job is here. And I suppose there are colder places than Portland, though it didn’t feel that way last winter!

A word about serendipity… back in June, Alec developed pressure sores from the cart that became infected. It happened really quickly, like overnight. At this point he was still using his wheelchair for longer walks and I was also taking him for short round-the-blocks about once per day. But due to this skin infection the vet told me I should keep him out of the cart for a couple weeks to allow his skin to heal. When I heard this, I was crestfallen. Would he get enough exercise without being able to use the cart? He was barely walking around the block at that point. Well, those weeks were a turning point, and the infection was a blessing in disguise, because by the end of those weeks, I realized he didn’t really need the cart anymore! He was able to walk longer and longer and seemed to be getting sufficient exercise from walking on his own, and he has only used it once since then. While it was always my goal for him to make the transition to exclusively walking on his own, and this is what we were working toward, being forced to keep him out of the cart for a period of time certainly expedited the revelation that it was possible and he was ready.

I have mentioned the steady barrage of comments (some nice, some rude, most harmless but annoying) I have gotten since being out in public with a big dog in a wheelchair, but I must say there is one comment I never get tired of hearing, and that’s when people see us walking in the neighborhood now and stop to ask (usually after studying us inquisitively for a moment), “Is that the dog that used to have the wheels?” And I happily reply, “Yes, it is! He is walking now.” How I beam when I say that. The words feel so good in my mouth and I can hardly contain my joy. Yes, he’s the dog who used to have the wheels… the dog who doesn’t need them anymore.

*** Some people have left comments here about their own dogs having similar issues with paralysis, or grappling with canine physical therapy, and I would be happy to talk you about anything related to my experience with Alec. Please feel free to email me at nrpallotta at gmail dot com. I realize that Alec and I are extremely fortunate, but I also know that time and regular physical therapy can do amazing things, so don’t give up!

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Filed under Doggie Wheelchair, Milestones/Progress, Physical Therapy/Rehabilitation, River Swimming

March 21, 2009 · 4:30 pm

One Year Later…

This time last year, Alec was one month out of surgery and had just returned for his first recheck exam with the neurologist. Based on his persistent lack of deep pain sensation, she told me (as any neurologist would have) that he “had a poor prognosis for return to normal function.” In other words, chances were slim that Alec would ever walk again.

At this point, we had moved into a vacant office on the first floor of ALDF headquarters in Sonoma County, Calif. Because Alec had come out of surgery for a herniated disc paralyzed, I could not take him home to our house in San Francisco, which had become inaccessible due to the stairs. We had nowhere to go. That’s how we ended up living in my office. I was sleeping on an air mattress next to Ali’s bed, eating microwave dinners, showering in the sink, and relying on my friends to take garbage bags full of laundry home every couple of days for me (Alec could not control his bladder or bowels and we went through towels, blankets, and sheets at mind boggling speeds). It seemed I did not leave his side for weeks, except to scurry to the bathroom.

I don’t think I registered the stress because there was no room for it. If you have ever been in a similarly stressful situation you will know what I mean. I proceeded hour by hour, minute by minute, doing the best I could with very little information, none of it especially good or encouraging. Alec had been hospitalized for two weeks, and I was terrified to bring him home and have the team of vet techs and doctors who were on hand 24/7 at the emergency facility shrink pathetically to just me, who had no idea what she was doing. Alec could not urinate by himself and I had to manually express his bladder several times a day (if done incorrectly, he would quickly develop an infection). I was shown how to do this at the vet hospital a few times and it was clearly difficult even for the professionals. This daunting task was made more difficult by his size. Although bladder expression is much easier when a dog is standing, Alec could not stand up and I was not strong enough to hold him up (at the vet hospital it took three vet techs to accomplish this task – once he was discharged there was only me) so I had to do it with him lying on his side, which is much harder. We went through box after box of piddle pads and diapers, because in between expressing his bladder, he would constantly dribble/leak and soil his bed. His bowels worked without my help but he had no control over them, so he would begin to poop and then try to get away from it but could only drag himself through it, smooshing it into his fur and his bed. I cleaned him and his bed up many times each day.

These first several weeks were difficult for both of us. But there were bright spots: my good fortune to work at an animal protection organization that allowed Ali and me to move into my office temporarily, a group of generous friends who supplied me with meals, laundry service, moral support, and donations of needed supplies, and an amazing local veterinarian who made “house calls” to my office to check on us every few days to make sure I was emptying Alec’s bladder completely and that he had not developed an infection. Oh, and the brightest spot of all – that Ali did not die, which I certainly thought he was going to during the harrowing days between his first and second surgeries (first surgery: 2/9/08; second surgery: 2/13/08). At this point, he was going downhill and nobody could figure out why. As his condition deteriorated, the neurologist speculated the spinal bruising might be moving up his spine (a fatal condition called “ascending myelomalacia”), which would have eventually paralyzed his vital organs, including his lungs. This was the first time she used the word “terminal” and I will never forget that feeling of falling.

As it turned out, the exact same disc that had been operated on mere days before had shattered again, for no apparent reason. Neither this neurologist nor anyone I have talked to since has heard of this happening before. It is a mystery, an apparently rare occurrence. This is why he had the second surgery. The neurologist told me she could operate again but warned me that it might not make any difference at all. and he could come out no better than before the surgery. It was a gamble. But we were out of options at that point so I said, yes, do it… do anything you can.

So Alec did not die and that was the best gift of all. But he was paralyzed. My playful, goofy, beloved shepherd who only a week before was running in the park playing his favorite game, “stick,” could no longer move his hind legs. However, I was told he could use a mobility cart (doggie wheelchair) to get around, even if he never walked again, and I was eager to do whatever it took to help Alec get his life back. Of course, I still hoped he would regain the ability to walk, but that hope became increasingly dim as the days passed and he still did not recover deep pain sensation, which brings us back to that first re-check in March 2008: my hope dissipated further when he was given that poor prognosis.

There is a lot more I could tell, both about those scary/crazy/stressful early days, and about how Alec began to slowly but steadily improve. I am going to skip over everything that has happened in the last year because much of our rehabilitation journey has been chronicled in this blog. I wanted to write this one-year anniversary post to emphasize how far Alec has come in the last 12 months. Because all you really need to know is that in early Feb. 2008 a disc suddenly shattered in Alec’s spine and he became paraplegic. He could not walk, could not control his bladder or bowels, and was expected to be paralyzed for the rest of his life. But he is walking now. Yes, walking…first with a lurch, now with a limp. Last month, he walked around the block without his wheels for the first time and we haven’t looked back. I am gradually increasing his time outside of his cart and he is doing great.

Let me just say it one more time, because it feels so damn good to write this: ALEC IS WALKING. Sometimes it’s hard for me to believe, just like it is hard for me to remember how I groped my way through those first few days and weeks without the panic swallowing me. Alec has defied all expectations. He is amazing. And hey, I am not going to sing my own praises here, but I did not give up on him either, which was also important. I gave him every chance and he took it, from one milestone to the next. Some people have wondered what his attitude was like when he came out of surgery paralyzed. I want to write more about this issue in another post, but I will tell you, Alec means the world to me, and I watched him closely for signs of depression. While there were of course changes and adjustments, Alec always had a good attitude. Honestly, his resilience and irrepressible spirit astonished me. His great attitude continues to this day, and has helped with his physical therapy and everything else we have been through on this road to recovery. Which by the way is not over…but I am happy to report that perhaps the biggest milestone of all has been reached. One year later, my boy is walking again.

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Filed under Bladder Expression/Urination, Doggie Wheelchair, Milestones/Progress, Paralysis, Physical Therapy/Rehabilitation, Relocating, Spinal Surgery

November 27, 2008 · 7:31 pm

Portland, so far…

This is our first update from our new city! We have been in Portland now almost two months and much of this initial period has been dedicated (both in terms of time and mental/emotional energy) to getting us settled into our new home and establishing new routines; besides the fact that we moved to a place where I barely know anyone (change enough!) there have been many additional changes for Ali. (True to form this blog post is going to be about Ali, but just in case you are wondering: I love Portland so far and am very happy here. I think it was a good move for both Ali and me.)

There was definitely an adjustment period for Ali after the move, but he is now settled in and doing quite well in his new surroundings. We are plugging along with the physical therapy, and I thank my lucky stars every single day for Ali’s continued progress, good health, and his amazing joie de vivre…and of course, his companionship. If you are new to this blog, you may want to check out the first post. Alec has come so far since those early days and weeks after surgery that it is easy to forget how amazing, how vast, his improvements have been. In eight months he has gone from being completely paraplegic and unable to urinate on his own to, well – how he is today!

He is getting around quite well by himself in the apartment and at the office, “walking” with an abnormal gait where he often drags (or “knuckles”) his back right foot, but walking nonetheless. This “walk” is not quite ready for prime time and he still uses his doggie wheelchair and the walk-about harness when we go outside. Because of the knuckling, I have to be very careful about him injuring his back right foot, which he has done several times, from scrapes to ripped toe nails (our use of “soft claws” nail caps have helped solve the latter problem). But I am encouraging him to practice walking, and my main challenge is to maintain balance between letting him practice bopping around (especially in the office, where he has a lot more room to explore than in our little apartment) and making sure he does not overdo it. Compared to the challenge of expressing his bladder all by myself, which I did for the first several unforgettable weeks after surgery, this doesn’t even qualify as a challenge! At the recommendation of his new rehab place, we are also using a sciatica wrap on his right leg for a few hours every day, which helps him to take steps and not knuckle (this is basically a wrap that goes under his foot and up around his ankle and helps keep his toes up when he walks).

As I mentioned, there have been plenty of changes for Ali above and beyond what a “normal” dog would face upon moving to a new place. Ali has moved many times thanks to me, and he typically handles it very well. But compared to previous moves, this one involved more adjustments. First, there was the matter of finding a new rehab facility where Ali could continue his underwater treadmill therapy. We started going to a veterinary rehab facility here called Back on Track, about which I have mixed feelings, but I am trying to keep an open mind. After a few initial setbacks on the treadmill, which could have been due to the fact that there was about 3-4 weeks between sessions during the move, Ali seems to be back to where he was before we left California. We are continuing to do the treadmill sessions once a week. We were lucky enough to be getting a break at our last rehab place, which is not the case here, and the weekly sessions cost more than twice as much ($55 vs. $25). There is one doctor and the rest are vet techs (or possibly training to be vet techs; there are so many I’m not sure) and they don’t even have the same person in the water with Ali each week, so it is much different from California where we primarily worked with Juli. But my main concern– and everyone I talk to thinks this is weird – is that they have loose dogs running around the facility, usually several. They have to whisk them away into side rooms when Ali comes down the hall (because he’s a bad shepherd!), but whoever heard of a rehab place with loose dogs running hither and thither? They also have two treadmills in the room, which means there is usually another dog on the other treadmill at the same time Ali is in there, so of course that is distracting. However, I think the treadmill is important for him and we are making it work so far. He is doing quite well with the chaotic situation, all things considered. There is only one other rehab place in town and I may give them a try at some point too.

My second goal was to find a safe accessible place where I could continue to take Ali swimming on a regular basis, an activity that in my opinion has been invaluable for him both physically and psychologically. I spent a lot of time during our first few weekends driving around to scout out possible swimming locations, after quizzing many random Portlanders and searching online to get ideas. After a few initial trips to less than ideal spots, I believe I have found our regular spot! George Rogers Park, recommended by my colleague Stephan, is in the town of Lake Oswego, a 20-min. drive south of Portland. This park is right on the Willamette River and is completely accessible. There is a steep staircase leading from the parking lot down to the river, which almost made me turn away before I noticed the long handicapped ramp, with about seven switchbacks, snaking back and forth, bisecting the steps leading to the beach. Unbelievable! I was so happy when I saw that on my reconnaissance mission, because it has been hard to find places on the river that Ali can actually get to using his wheelchair. The beach itself is flat and sandy and the water is calm. There are usually other people and some dogs there but not too many and we have not had any problems yet (knock on wood!). The park also has trails that I think a lot of people take their dogs running and hiking on. Since it is the cold rainy season, fewer people are down by the water, which is good for us. This morning was our fifth trip there. As I have written here before, I never took Ali swimming without a “buddy” in California, just because there are too many things that can go wrong. However, because here I lack the social network I had in Calif., I have no choice; it’s either brave it alone or he doesn’t swim. The latter simply not being an option, I now take him alone and am nervous every second doing it, but just hope for the best! I also have some pepper spray in case of errant dogs or people. I am never happier than after a successful swimming outing. Ali just has so much fun, and he can really let loose in the water and chase the ball at top speeds, which he obviously can no longer do on land. It is very satisfying for me to see him having fun in this way, getting to engage in one of his former favorite pastimes: fetch!

The third big adjustment was our new office and the surrounding downtown environment, which is different in many ways from ALDF headquarters in California where we spent the last three years. I will write more about that soon, but today is Thanksgiving and it’s time to start preparing the vegan feast: Tofurkey roast, cranberry sauce, stuffins, sauteed rainbow chard, garlic smashed potaters, lots and lots of gravy, and something special for Ali too! But first I want to say THANK YOU to everyone who has left nice comments for Ali and me on this blog. I am incredibly grateful for your support and encouragement, and I have appreciated your kind words. I am thankful for so much, but most of all I am thankful to be spending Thanksgiving with my best friend, and thankful for every single second we have spent together since that happiest day when he came to live with me five years ago. Happy Thanksgiving!

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Filed under Milestones/Progress, Physical Therapy/Rehabilitation, Relocating, River Swimming, Underwater Treadmill

October 1, 2008 · 4:16 am

Good-bye California…Hello Oregon!

Wickersham Park in Petaluma, where we spent so much time over the last 6 months…farewell!

The Relo-Cube… which is hopefully right now en route to Portland with all my belongings!

Ali and I are leaving California and moving to Portland… tomorrow! I have been too busy preparing for this big move to write anything about it, and I will keep it brief. Suffice it to say that after living in Petaluma for six months I am very happy we are moving on. There are many reasons why Sonoma County has not been working. And although I loved San Francisco (except for the commute!), moving back there is just not an option anymore because 1.) Every dang place has stairs and 2.) Rents are way too high for me to live alone, and with Ali’s condition I am just not prepared to risk another Craigslist experiment and move in with total strangers. Luckily for me, ALDF has a secondary location in downtown Portland and I have been granted permission to transfer to this smaller office. Although I am daunted by the thought of starting all over again with Ali in a new city – not to mention one where it never stops raining! – there are many reasons why I feel this move will be a good one for us. I recently found the perfect apartment, too, which seemed like an auspicious sign. It’s an affordable one bedroom, totally on the ground floor (no more steep ramp for Ali to negotiate), carpeted (so Ali won’t slip), and in a nice neighborhood within walking distance to lots of great stuff, including a park. We are leaving tomorrow morning; the drive is about 9 hours. Big moves are always difficult, especially when doing it alone, but luckily I have amazing friends to help.

Most importantly, the improvements Ali has made over this last week are nothing short of amazing. His right leg is taking full steps in the cart now. I was able to get an appointment for Ali to be seen one last time by Jackie, the rehab specialist at UC-Davis, before we moved. I was hoping she could suggest some new rehab techniques for me to try now that he is starting to take steps. She basically said to keep doing what we are doing and to continue underwater treadmill sessions if possible in Portland. More soon…I have to finish packing the van. Wish us luck on our new adventure!

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Filed under Milestones/Progress, Physical Therapy/Rehabilitation, Relocating

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

June 8, 2008 · 8:21 pm

Plan B

After Ali’s first successful session with the underwater treadmill, the plan was to go back once a week, gradually increasing his time in the hydrotherapy tank. I guess Ali decided he did not like that plan, because the next time we went back he refused to walk. Juli, the therapist, would not struggle with him, saying it is not good if he is fighting it. So we left and, feeling disappointed, I cancelled our remaining appointments. Ali had done so well the first time; I had really high hopes! But for some reason he was feeling stressed the second time. Because I had mentioned Ali liked to go swimming before his injury, Juli suggested an alternative to the hydrotherapy tank: taking him to a river to see if he would swim. So that weekend Kevin and I took him to the Napa River and, despite some stress getting him up and down an unexpectedly steep embankment and navigating the ridiculously rocky river bottom, it went really well. I started off slow, letting him wade (me holding his back end up) and then I gently tossed a tennis ball to see if he wanted to swim and he did… he was even kicking with both his back legs!

Each week since, I have taken him to Johnson’s Beach on the Russian River in downtown Guerneville, usually with a friend or three in tow, to swim for about 20 minutes. The Russian River is much better suited to the purpose of therapeutic swimming; it is flatter with a sandy bottom. Once we arrive, I load Ali up in his wheelchair and let him wade around with his wheels in the shallow water for a few minutes. Then I take him out of his wheelchair and, holding onto his “float coat” (life vest thingy) with one hand and rear harness with the other, I walk him into the water until it is deep enough for him to not touch, and then I toss a tennis ball until he seems like he is getting tired. At first we did this for 10 minutes but I have gradually increased the time to 20 minutes. I always expect him to crash after all that exercise and I need to be careful he does not overdo it, but surprisingly he never seems tired afterwards! Juli says anything that gets his back legs moving is excellent therapy, and swimming is great cardio and good for him psychologically. So that is Plan B. Out with the treadmill, into the river…stay tuned!

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Filed under Physical Therapy/Rehabilitation, River Swimming, Underwater Treadmill

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

May 4, 2008 · 8:36 pm

Underwater.

Both Dr. Tieber and Juli were happy with Ali’s progress at his re-check appointment on Friday. Dr. Tieber thinks he definitely has some pain sensation and this is good. She did not seem concerned about the cross extensor reflex. She said this is just a sign of a severe upper motor neuron lesion but does not mean he will not recover motor function. We put him in the underwater treadmill and he did well. When the tank filled up with water and Juli (who was in the tank with Ali) let go of him, he was able to stand with the weight of the water helping him. Although he wasn’t able to walk by himself on the treadmill, his left leg was definitely moving. Juli said he was not strong enough to break through the water on his own, but he was initiating movement and then she would help him complete the arc of a forward step. The right leg is his weaker and though she did not feel it moving she thinks there is “something there.” I am going to bring him back for hydro-therapy appointments once a week moving forward. He will only be in the tank for about 5 minutes each session until he gets stronger. Combined with the exercises we continue to do at home, it is my fervent hope he will continue to improve a little each day. I know he can do it!

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Filed under Physical Therapy/Rehabilitation, Underwater Treadmill