Sometimes you have to think way outside of the box..

Updated: Apr 3

One of the best things about being a veterinary physiotherapist, especially dealing with dogs, is the constant challenge of finding new ways to provide effective therapy. Dogs especially are not known for wanting to sit around whilst you massage, stretch and provde any number of therapies to them, but the following example is an even more challenging case.

This is Pippa, a gorgeous French poodle, who was born with a congenital defect, known as bilateral, medial, grade 4 luxating patellas.

The majority of dogs born like this tend to be euthanised as no one wishes to take them on as pets, however a brave couple with big hearts decided to give Pippa a chance, as she is a happy and loving dog, and the condition itself is not painful.

You can see from the x-rays and picture below the extent of the problem - the arrow on the right hand side of the x-ray shows where the patella currently is, and the arrow on the left shows where it should be.

The condition cannot be corrected without surgery to relocate the patella, allowing the quadriceps muscles to extend the stifles, but because she is so young, and so small, she will have a better chance of sucess if surgery is delayed until she has finished growing.

The problem is that whilst her legs are almost fixed in the position they are, the tendons, muscles and skin are not stretching in a way that will allow the surgery to be succesul - the patella can be moved to where it should be, but the surgeon will then have major issues trying to re-attach some of the soft tissue structures. Similarly, as Pippa is unable to weight bear properly at the moment, her leg muscles are not growing to any great extent

Our role as physiotherapists was to find a way to slowly and gently stretch all of the structures around the hindlimbs, and help Pippa build the muscle mass she needs to be able to support herself both before and after surgery.

This is no mean feat, as it takes a huge amount of time and dedication from everyone involved, especially as she is such a small dog. After racking our brains for days (there are no protocols for this kind of thing) we devised what we hope is going to help - leg weights, attached by velcro to the lower limbs, to gently apply stretch whilst Pippa is supported. Now Pippa only weights 1.7Kg, so we had to start with 10 grams of weight on each leg (thats about the wieght of a 50 pence piece), so as not to cause her any discomfort. We cut down a pair of childrens socks, and created bags filled with rice and secured with velcro

As you can see she is not overly impressed with her new accesories, but so far they seem to be doing the trick! As the limbs start to elongate we can add increasing amounts of weight which will also help to develop some muscle mass. The only way they can work at the moment is if the owner carries her around like a newborn baby, but eventually we hope that Pippa will use them whilst walking, to help gain the muscle she needs to get through surgery. The owners are also spending a great deal of time manually stretching the limbs, as well as encouraging Pippa to put weight through her hind end (usually involving treats!)

Its going to be a long process for Pippa, and in all honesty there is no guarantee of success, but she is lucky enough to have really dedicated owners, and we hope in the future to be able to repost her story with a very happy ending!.

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