Category Archives: Physical Therapy/Rehabilitation

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

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

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

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

Cart is here…and it fits!

Juli, the rehab specialist, brought Ali’s cart by yesterday and I am SO happy to report that it fits perfectly!! I have been on pins and needles all week worrying about that and I am so relieved!!! (If it didn’t fit, we would have had to send it back and wait over three weeks for another cart.) After getting him used to the cart inside, we walked him outside around the building and he loved it – he looked so happy. He was definitely ready to go, go, go but he can only be in it for short, ten minute walks at first until he builds up his strength and endurance. He has been “down” for about two months now, which is a long time. Maggie videotaped everything and we will put footage of his first steps with his new wheels on the website as soon as we figure out how.

The best part, however, is the fact that Juli said she saw his legs moving a little bit while he was walking in the cart (yes, his back legs!). Her exact words: “He’s got motor!” Obviously, this is really exciting!! Next step is she is going to check on him in a couple weeks, after we are settled into our new place, and if everything is going well, we will schedule him for a hydro-therapy session (which was not on the table until his legs started moving), where we get into a water tank and see if he will move his legs, I guess (I’m not entirely sure but I have to be strong for it apparently!). So now we are planning to move at the end of the week, after he has a few days to get used to his wheels. At my new place there will be lots more to get used to – including loading in and out of my van and getting up and down the porch ramp. I am nervous about all that but I hope it will become routine, just like living in my office eventually did! Everything was so hard at the beginning – there were times when I really thought I couldn’t do it – but we made it through that and things got easier. Obviously, things improved tremendously when he started going to the bathroom outside. I really can’t overempashsize how much that changed things. I feel so fortunate.

Anyway, I must say it was really great to see him walking again – even if it was just around the building. It was a very good day!

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Filed under Doggie Wheelchair, Milestones/Progress, Physical Therapy/Rehabilitation, Ramp, Relocating, Underwater Treadmill

New medications.

I started Alec on Rimadyl and Ciproflaxin today. The Ciproflaxin is an antibiotic for a urinary tract infection – which I knew dogs in his condition were prone to but I was kind of bummed he contracted one so soon – and the Rimadyl is an anti-inflammatory to help with his front legs, which are becoming swollen and painful from his putting so much weight on them. He is already showing signs of arthritis. I can’t wait for his cart to arrive since that should help balance out his weight more evenly. The good news is that Dr. Leavey (my amazing local vet from Animal Hospital of Cotati) just had a bunch of Rimadyl donated and she said we could have it for free! I had just ordered another brand of anti-inflammatory from PetMeds.com that was going to cost $100 for just a few weeks supply (why are all the medications he needs so expensive??), but luckily I was able to cancel the order after talking to Dr Leavey, who was has truly been our angel throughout this ordeal. She has been making house calls to check on Alec ever since his surgery and has not charged me once (in the beginning she was coming almost everyday). I am so grateful for her compassion! I really don’t know how we could have managed this far without her, especially during those first difficult weeks after surgery when I was struggling so much with expressing his bladder and had no idea if I was doing it right.

The photo: Juli the rehab therapist brought by a p-nut ball (aka physio-roll) to try to help with Ali’s standing exercises. Someone (in this case, Maggie, my friend, co-worker, and future roommate) holds a peanut butter kong while I (try to!) hold his back legs in position and gently rock him back and forth to try to stimulate his nerves to “remember” walking. It’s harder than it looks.

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Filed under Medications, Physical Therapy/Rehabilitation, Relocating

Blog post on ALDF website.

My friend and co-worker, Paula, posted a sweet blog about me and Ali on the Animal Legal Defense Fund website. You can read it here.

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Filed under Bladder Expression/Urination, Doggie Wheelchair, Paralysis, Physical Therapy/Rehabilitation, Relocating, Trans-Species Bond