Pumba is my beloved Labrador, the only pup in the litter out of my family's other labs Scrumpy and Snowy. He was born on 30/07/17, and had quite a tough time in his first 6 months regarding musculoskeletal and neurological health.
As the only pup in the litter he grew rapidly in the first 12 weeks, and it was in the 12th week in which he rapidly deteriorated neurologically. He presented with ataxia (lack of voluntary coordination of muscle movements), extensor rigidity and loss of stifle and hock flexion of the left hind limb (meaning his back left leg was extended as he lost the ability to flex his leg). He was immediately taken to the vets, and after physical examination, X-rays, and blood tests, he was diagnosed with Neospora Canium which affected his Sciatic nerve pathway. This provided an explanation for Snowy only having one puppy as she was a carrier of the protazoan (parasitic) disease, which Pumba contracted congenitally.
Neospora Canium, is a protozoan disease, which affects the neurological system. Neospora Canium can be contracted by dogs in areas which have housed cattle; as the disease affects cattle as well as dogs. As Snowy and Scrumpy live on a farm as farm dogs, it made sense how the disease had been transmitted, providing an explanation to Snowy's abnormal litter size. Puppy's appear normal at birth and don't show signs of the disease until early growth periods. Prognosis in puppy's is generally very poor/fatal, however recovery does depend on the individual.
Physiotherapeutic intervention is vital immediately after diagnosis, to maintain joint range of motion (ROM), prevent muscle contracture (permanent muscle shortening); prevent joint stiffness; to encourage the nerve signals to fire; improve proprioception (his ability of knowing where his legs are in space) and also to mitigate the effects of rapid muscle atrophy (muscle wasting).
After just two days Pumba was showing signs of a rapid recovery, the muscles were receiving the nerve signals and he began flexing his stifle and hock and protracting (stepping forward) with his left hind leg. This was an incredible recovery, in such a short amount of time.
At 13 weeks old, despite him being very weak in his left hind and still showing signs of ataxia, he began using it within his gait properly. This was an immense relief, as it gave him a better chance of making a full recovery without muscle contracture manifesting.
Week by week I formed an exercise plan for Pumba, specifically designed for his stage of recovery. As Pumba continued to grow so rapidly, hip dysplasia was a big concern; as the rate of growth, and the fundamental bilateral hind limb weakness all heightened the risk of laxity within the hip joint; and thus predisposed hip dysplasia. Therefore, controlled exercise and strengthening exercises were vital to help build muscle to support the hip joint by stabilizing the joint. However, it was a fine balance between strengthening within his current ability, and being careful to build muscle correctly and slowly within the constraints of his bone density. Not only was he now being rehabilitated neurologically but also conservatively managing his hip dysplasia which inevitably manifested.
At six months old, he was the size of an adult Labrador, the same size as both his parents (Snowy left, Pumba middle and Scrumpy right). Neurologically he had fully recovered, however his left hind limb weakness had remained, and pacing had manifested which is a compensatory dynamic gait adaptation, that manifests in response to lameness or weakness.
Between 6 months and 12 months, physiotherapeutic treatment and exercise involved building hind limb strength to support the hips; preventing forelimb compensatory injuries arising, due to the abnormal load onto the forelimbs due to hind limb weakness; addressing Pumba's pacing and maintaining mobility and suppleness throughout the thoracolumbar spine.
Exercises such as cavaletti poles; walking and trotting through long grass and on underlulating terrain encouraged joint range of motion, but also provided proprioceptive benefit to retrain Pumba's gait, encouraging the correct gait sequence. Hill work, sit to stands, and core stability exercise all featured in his rehabilitation plan.
As a keen swimmer, Pumba loves the local river, and as a slow flowing shallow river, with deeper water in places, it provided the perfect strengthening exercise in summer. Walking and trotting through water encourages joint range of motion and strengthening of the hind limb and forelimb major muscle groups; Triceps, Quadraceps and Hamstrings due to the resistance the water provides. As swimming for dogs is fundamentally a forelimb action, this provided a great exercise to help with elbow range of motion, and strengthening of the Triceps muscles. Elbow issues have always been a concern, due to his rapid growth rate, and due to the complex anatomical structure of the elbow joint which requires correct growth synergy between the humerus, radius and ulna. This combined with the Labrador predisposition to elbow dysplasia heightened Pumba's risk of developing this condition. In addition, as Pumba overloads onto his forelimbs due to his hind limb weakness, preventing injuries manifesting in the forelimbs is equally important as addressing the hind limb issues.
Ideally sessions in an underwater treadmill would be most advantageous, however on a daily basis a controlled stroll down the river helped make a significant difference with regards to Pumba's muscle strength and joint range of motion.
At 1 years old, it is amazing to see how active and happy he is. He is now on YuMove Young and Active, to help support his joints by providing the all essential Omega-3 EPA in his diet. He has come along way in the last few months, his core strength and hind limb strength have significantly improved and he is gradually beginning to trot correctly and break out of his pacing.
Keep posted to see what South West Veterinary Physiotherapy's mascot Pumba is
up to on instagram @southwestvetphysio and to keep following his journey.....