Use of Physical Therapy in a Dog with Bilateral Severe Plantigrade Stance

Abstract

A 3.5 yr old spayed female Staffordshire terrier weighing 25.5 kg was presented with a 7 wk history of bilateral plantigrade stance in the pelvic limbs directly following an ovariohysterectomy procedure. Upon presentation, the dog had bilateral atrophy of the distal pelvic limb muscles, enlarged popliteal lymph nodes, and ulcerative wounds on the dorsa of her rear paws. Orthopedic examination revealed intact calcaneal tendons bilaterally and neurologic examination localized the lesion to the distal sciatic nerve. A diagnosis of compressive and stretch neuropathy was made affecting the distal sciatic nerve branches. Physical therapy modalities included neuromuscular electrical stimulation, ultrasound, and low-level laser therapy. Other therapeutic modalities included the use of orthotics and progressive wound care. The dog had increased muscle mass, return of segmental reflexes, return of nociception, and the ability to walk on pelvic limbs with higher carriage of the hock 15 mo following presentation. The use of custom orthotics greatly increased the quality of life and other physical therapy modalities may have improved the prognosis in this dog with severe bilateral plantigrade stance due to neuropathy.

Traumatic and iatrogenic sciatic nerve injury in 38 dogs and 10 cats: Clinical and electrodiagnostic findings

“…[52][53][54] Indeed, physiotherapy would help maintain muscle tone and avoid fibrosis, whereas the use of orthosis could stabilize the hock joint and prevent cutaneous lesions arising from dragging the hindlimb. [52][53][54] When paresthesia and automutilation occur, or in absence of clinical improvement, hindlimb amputation should be considered. Hence, patients with CMAPs <1.45 mV should be frequently re-evaluated either clinically or with EDX, or both.…”

“…[47][48][49][50][51] With or without surgical intervention, physiotherapy and the use of tarsus-foot orthosis might be suggested as soon as possible in veterinary patients regardless of predicted outcome. [52][53][54] Indeed, physiotherapy would help maintain muscle tone and avoid fibrosis, whereas the use of orthosis could stabilize the hock joint and prevent cutaneous lesions arising from dragging the hindlimb. [52][53][54] When paresthesia and automutilation occur, or in absence of clinical improvement, hindlimb amputation should be considered.…”

“…Surgical intervention for traumatic SNI has been widely described, but decision‐making remains to be tailored to the individual patient according to clinical, imaging, and EDX results 47‐51 . With or without surgical intervention, physiotherapy and the use of tarsus‐foot orthosis might be suggested as soon as possible in veterinary patients regardless of predicted outcome 52‐54 . Indeed, physiotherapy would help maintain muscle tone and avoid fibrosis, whereas the use of orthosis could stabilize the hock joint and prevent cutaneous lesions arising from dragging the hindlimb 52‐54 .…”