Sunday, September 23, 2012

Diagnosis: The Long Version

Here are Lexi's notes from our appointment at TOPS.  I am only going to post (somewhat) briefly about our experience because I honestly probably won't explain it right, and you can read the summary on the above documents.

Dr. Jurek was great.  She took her time with Lexi because Lexi was quite nervous.  Dr. Jurek just sat on the floor and talked quietly to her.  She went through each and every of Lexi's muscles and joints to determine if anything seemed out of place, misaligned, odd, or off balance.

The first thing she noted was that she did feel Lexi's luxating patellas, but that it was very minor.  She diagnosed them as a Grade 1, and nothing to really worry about other than doing our best to keep her in shape and strengthen the muscles around her knees.  She did feel that it was odd that we saw the limp the way we did, and she felt that it may have been the patellas manifesting in an odd way, or it could have been something else.  She felt no soreness or pain indicators during the exam.

The other thing of importance that she noted is Lexi's misaligned jaw.  We have always known that she has an underbite, and I guess we knew her jaw was misaligned (thanks to my husband, the dentist!) but never thought much of it.   Dr. Jurek explained that she believes Lexi has slight TMD (temperomandibular disorder) because of this.  That means that the disparity in development in both sides of her TMJ (jaw joints) caused issues with her bite and threw off her musculoskeletal balance.  

On the chiropractic exam she did confirm that one side of Lexi's jaw and neck were aligned differently, in an effort to make up for the imbalance in her mouth.  This can affect the entire body as the neck and spine attempt to make up for the imbalance.

Dr. Jurek also did a gait analysis which I thought was very interesting. I  had never really thought about Lexi's gait before (or knew the different kinds) but we learned that Lexi often paces.  Pacing means that the dog's 2 legs on the same side are moving in the same direction.  This is not what you want, as it does not improve the dog's balance or coordination.

We then moved to the therapy room to learn some exercises and tricks to "resolve impaired segmental spinal mobility so that Lexi's body is more balanced; improve strength in the quadriceps to minimize patella laxity; prevent further injury for continued competition in agility as well as maintaining good overall musculoskeletal health in general".

Our routine includes the following:

1.  Cookie Stretches (5 stretches, 7 days per week).  The dog stretches up, down, left and right (in various places and ways) and holds for about 3 seconds each.

2.  Alternate Snoopies (5 times per week).  Dog balances their weight on opposite legs (meaning we hold one front and one back--on opposite sides--and Lexi balances on 2 feet).   This strengthens the paraspinal muscles and stabilizes the thorax.  It also assists in strengthening hip and shoulder stabilizers.

3.  Cavaletti Poles (5 times per week).  This teaches the dog to become aware of where their feet are in space, to teach them to pick their feet up higher and for paraspinal muscle strengthening.  And in Lexi's case, it will encourage her to trot vs. pace.

4.  Side Stepping (5 times per week).  Gently nudge the dog so that your dog is encourage to step sideways.  

5.  Crawling (3-4 days per week).  This encourages shoulder, elbow, carpus, hip, stifle and hock flexion as well as strengthens forelimb and hind limb muscles.  
6.  Ball Work (2-3 days per week).  Stand, sit, and down on the donut ball and the peanut ball along with transitions between the two.  A slight bend in the knee when standing is preferred.

I'm sure I'll be posting a lot more about Lexi's rehab in the days to come.

1 comment:

  1. Wow, what a lot of information. Sounds like she really got a once over. Pacing kinda means different things to different people. Miley paces but not all the time. I really wish I had paid more attention to her gait when she was a puppy so I knew if pacing was new for her or something she always did. Now Java, has paced from a puppy. So Im not to concerned about it. Pacing is also a way to conserve energy. But you should be able to break your dog out of a pace and into a trot. Which both Miley and Java do. Guiness, he paces no matter what. Not good.