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Jenson - Golden Retriever How animal Physiotherapy - including massage - helped after TPLO surgerY for cruciate ligament disease & led to my life changing forever!

Summary

Conditions Treated - Post TPLO Surgery, Osteoarthritis in Stifle, Hips & Spondylosis

Jenson is my inspiration and the reason I decided to get qualified. In short, he changed my life in ways I never expected .... and my career!

At about the age of 18 months, Jenson (Golden Retriever) had a noticeable weaker hind and lameness, especially on the right. This led to TPLO surgery for cruciate disease, but with continued lameness after the usual amount of recovery, further investigation was carried out. The investigation process included looking at different therapies which included hydrotherapy, osteopathy, acupuncture, physiotherapy and canine massage which could help improve hind lameness. Natural alternatives such as green lipped mussels and turmeric based golden paste were also considered as opposed to medication traditionally prescribed for lameness such as Metacam.

I’d like to highlight how complementary therapies – including massage – and natural alternatives to medication has helped Jenson in his recovery. After a 18 month journey, we got Jenson to the the best he has ever was biomechanically. Whilst maintaining a healthy amount and controlled exercise he was more comfortable in his movement and such a happy boy.

History and Context

At about the age of 18 months, Jenson had a noticeable weaker hind and lameness, especially on the right and he showed signs of stiffness not expected in such a young dog. This gradually got more and more pronounced.

As you can see, when Jenson moved, not only did he have a subtle limp on his right hind, his back was roached and his spine was incredibly tight with very little movement. He was a very active boy, especially at 2 years old, so all his activity was contributing more and more to his condition.

So, Jenson was taken to his local vet where he was examined and assessed for possible hip dysplasia and x-rayed. Hip dysplasia at the time seemed the most likely cause for his symptoms.

What is hip dysplasia?

Hip dysplasia in dogs is a disease of the hip in which the ball and socket joint is malformed. This malformation means that the ball portion and its socket don’t properly meet one another. More information can be found here.

Jenson’s hips sit very close in the ball and socket joint

Whilst – according to the vets - the x-rays didn’t show severe hip dysplasia, Jenson was referred to specialists, Anderson Moores, for further investigation who found that Jenson was 2/10ths lame on his right hind limb, unloaded the limb at rest, had subtle right side quadriceps atrophy and positive tibial thrust which indicated cruciate disease.

What is cruciate disease?

Cruciate disease (affecting the cranial -or anterior- cruciate ligament) is one of the most common orthopedic conditions seen in dogs. In people cruciate ligament (or ‘ACL’) ruptures are typically seen as acute sporting injuries. But in most dogs the condition is a more chronic degenerative condition. The ligament degenerates and gets weaker with time and at some point will start to tear. The signs associated with the initial stages of the condition can be subtle and may be missed –signs such as stiffness on rising from rest and mild, occasional lameness. As the ligament continues to tear the signs may become more obvious but it is not uncommon for owners to first realise their dog has a problem when the already weakened ligament finally tears completely, often during relatively normal activity. At this stage the stifle will be unstable –the two bones of the stifle (the tibia and femur) will rock back and forth during walking. This instability will often lead to the menisci (cartilage ‘shock absorbers’ of the knee) being torn, which can cause significant lameness and discomfort unless treated appropriately. You can read more here.

Surgery was carried out which confirmed a partial rupture (10-20%) of the cranial cruciate ligament with no meniscal injury. TPLO surgery was performed which takes 8-12 weeks to recover from.

3 days after TPLO Surgery - Bruised and Swollen

Twenty weeks after surgery, Jenson was still lame so returned to the specialist. Upon examination, Jenson remained 2/10ths lame on the right hind, had good consistent weight bearing and no difficulty moving through gaits walk to trot. He had normal range of motion in right stifle and was pain free. Marked discomfort on hip extension on right and moderate on left. Jenson had further x-rays which showed some bridging spondylosis between L6 and L7.

Bridging showing on lower lumbar

What is Spondylosis?

Spondylosis deformans is a degenerative, noninflammatory condition of the spinal column characterized by the production of bone spurs along the bottom, sides, and upper aspects of the vertebrae of the spine. These bone spurs are simply projected growths of bone, usually grown in response to aging, or injury. Spondylosis deformans occurs most often along the spine, in the area behind the chest, and on the upper section of the vertebrae of the lower back. Older, large-breed dogs are at highest risk for developing spondylosis deformans.

It was also suggested that Jenson most likely had inflammation associated with osteoarthritis. Whilst not un-heard of in young dogs, this condition is more common in more mature dogs.

What is Osteoarthritis?

Osteoarthritis, also known as degenerative joint disease (DJD), is defined as the progressive and permanent long-term deterioration of the cartilage surrounding the joints. Arthritis is the medical term for inflammation of the joints, while osteoarthritis the term referring to a form of chronic joint inflammation caused by deterioration of joint cartilage. Older dogs are at the highest risk.

Chronic, hidden inflammation is a silent killer. It’s the root of nearly all disease. Cancer, arthritis, allergies, kidney disease, dental disease, digestive disease … it’s all caused by inflammation. Not all inflammation in the body is a bad thing. If your dog is exposed to viruses or bacteria, acute inflammation will release white blood cells to the body tissues and start the healing process. But chronic inflammation – the kind of low-grade inflammation that stays for weeks, months and even years – is the real culprit behind most degenerative and inflammatory health issues in your dog. Researchers are finding that chronic low-grade inflammation is a major driver of joint degeneration.

After some investigation on best ways of improving the effects of spondylosis and osteoarthritis, Jenson started a course of hydrotherapy sessions. As Jenson’s owner, I was keen to ensure Jenson has the best quality of life and to experience the minimal amount of pain and need for medication on an ongoing basis.

What is Hydrotherapy?

Hydrotherapy is a non impact, non weight bearing exercise carried out in a swimming pool or aquatic treadmill. Extensive work in human physiotherapy has demonstrated that a suitably monitored course of hydrotherapy acts by encouraging a full range of joint motion in reduced weight bearing conditions, thus improving muscle tone and promoting tissue repair, without imposing undue stress on damaged tissues.

Jenson was not a fan of the pool! Mark, the hydrotherapist was amazing with him.

Jenson showed improvement (although he did not enjoy swimming) after the very first session (out of 10) but once his improvement plateaued after around 6 sessions, the hydrotherapist suggested physiotherapy.

What is Animal Physiotherapy?

A variety of soft tissue techniques (e.g. massage), Joint techniques (e.g. mobilisations and stretches), and electrotherapy treatments (e.g. LASER, ultrasound, TENS) are incorporated into animal physiotherapy treatments as appropriate. Exercise rehabilitation is also a very important part of animal physiotherapy. Physiotherapy can ease the pain of dogs with a range of problems including arthritis, sprains, strains, back pain, and performance problems as well as post-operative rehabilitation. Dogs with spinal and neurological problems can also benefit greatly from physiotherapy.

A large proportion of the physiotherapy Jenson received was for soft tissue, ie massage based which really had a noticeable positive impact. And in hindsight should have been started earlier. His back started to become less roached and he started to move more comfortably, but the limp never disappeared.

Jenson saw a physiotherapist (I wasn’t qualified then!) every 2-3 months – or as needed

It was around this time, that other natural supplements were considered. I was keen to avoid medication as much and as often as possible. During my investigation process, I discovered the benefits of turmeric being a natural anti-inflammatory and started to make Golden Paste as an alternative to medicated anti-inflammatories such as Metacam.

Why Turmeric/Golden Paste?

A 2014 study found that the curcumin found in turmeric (its active ingredient) outperformed ibuprofen in people with arthritis. But turmeric doesn’t just control the inflammation in joint disease. Another 2004 study in Oncogene found that curcumin (as well as resveratrol) worked just as well as anti-inflammatory drugs … and worked better than both aspirin and ibuprofen. Inflammation is the key driver of most disease in the body … and turmeric is one of the best natural anti-inflammatories either nature or medicine has to offer.

With further investigation, I discovered that glucosamine has also helped reduce arthritis discomfort in people and animals. Whilst glucosamine is found in some kibble, it isn’t usually in particularly high quantities, so adding additional amounts to Jenson’s diet would be beneficial. So I started to add green lipped mussel powder to his food too.

Why Glucosamine?

Glucosamine is naturally produced within the joints, combining with collagen to produce and repair cartilage. Healthy cartilage is naturally flexible and spongy, acting as a shock absorber in the joints. Synovial fluid naturally lubricates the joints and glucosamine can help maintain its viscous consistency. With the aging process, glucosamine production in the body reduces, leading to deterioration of cartilage (meaning less cushioning in the joints) and reduced lubrication from synovial fluid, causing the joints to become “creaky.” Green lipped mussels contain high levels of glucosamine and they’ve been shown to reduce arthritis discomfort in people and animals.Glucosamine is naturally produced within the joints, combining with collagen to produce and repair cartilage. Healthy cartilage is naturally flexible and spongy, acting as a shock absorber in the joints. Synovial fluid naturally lubricates the joints and glucosamine can help maintain its viscous consistency. With the aging process, glucosamine production in the body reduces, leading to deterioration of cartilage (meaning less cushioning in the joints) and reduced lubrication from synovial fluid, causing the joints to become “creaky.” Green lipped mussels contain high levels of glucosamine and they’ve been shown to reduce arthritis discomfort in people and animals.

Why Green Lipped Mussels?

Green lipped mussels contain high levels of glucosamine. You and your four-legged friends can benefit from the mussels because, when harvested in peak condition, they are a rich source of omega fatty acids and minerals. Powdered extract of GLM contains very high concentration of omega-3s and a unique combination of fatty acids that is not found in any other marine or plant life. Studies have also shown that they are used in order to reduce pain, and they can act as a feeding stimulant. However, their greatest healing properties correspond to the fact that they are a natural anti-inflammatory due to them being an excellent source of glucosamine and chondroitin.

In addition to the above, we have realized – the hard way – that exercise management plays a huge role too. As an example, Jenson was off lead and chased a cat in a field and turned awkwardly, which made him immediately lame and in a lot of pain. At this stage, in addition to seeing our regular physiotherapist, we also consulted with an osteopath and vet for acupuncture.

Why Osteopathy?

Osteopathy is a manual therapy not dissimilar to physiotherapy but with a greater emphasis on quality of soft tissue and joint mobility, and overall function of the body, rather than just the immediate symptoms.

Jenson sees an osteopath every 2-3 months – or as needed

Why Acupuncture?

Acupuncture involves inserting very fine needles into the body to help it deal with a range of diseases and offer pain relief, most commonly to help with arthritis. The needles help to block pain messages and produce more of the body’s own natural pain killers.

Jenson had 3 sessions of acupuncture

With adequate rest and gradual increase in exercise, regular physiotherapy, osteopathy and short series of acupuncture, Jenson was the best he ever looked in his movement.

His back is flat, his limp is the most subtle it has ever been, his spine has good movement and he generally looks the most comfortable he has ever looked!

Conclusion

There is no silver bullet or magic formula. Lameness varies so much in different animals. I've come to realise that lameness, whatever the cause can be properly managed by utilizing a variety of therapies, good diet, controlled but fun exercise, patience, time, dedication and natural supplements. This means less trips the vets, avoids long term medication (which can create new issues of their own) and a very happy dog and family member. 😊

NOTE - Thanks to Jenson I’m now a fully qualified Animal/Veterinary Physiotherapist! He inspired me to retrain & change my career, so I could help him & other dogs move & feel better.

Sadly Jenson passed away very suddenly in February 2018, a week after his 5th birthday leaving us heartbroken. He passed away due to suspected spontaneous pneumonthorax, unrelated to the above conditions. I’m forever grateful that he came into my life & think of him every day. I will never, ever forget him.

Family Beach Day - Jenson's Favourite Place!
Me & My Boy!
Jenson on his 5th & Last Birthday

January 2017

Credits:

Harriet Kitcat - MassageMy.Dog