Posts tagged ‘rehab’

Jan 10

DIY Wobble Board For Your Dog

Birdie is doing well these days (knock on all the wood) and she’s been fully mobile for a while, so our new goal is to rebuild muscle in her leg. In order to do that, she has to learn that’s it’s ok to use it again, since she’s been avoiding putting weight on it for so long. (Need to catch up? You can read about Birdie’s ACL tear and rehab here and here)

One way to do that is to use a Wobble Board. At physical therapy, our therapist had Birdie stand on one as we gently moved the board around. This forced Birdie to shift her weight to the atrophied leg and activated those weaker muscles as she balanced herself.

I don’t have any photos of Birdie on the board because my hands are always full – I’m holding her in place so she’s secure, but you can see a Wobble Board in action here.

We wanted to keep this up at home, but money is tight, so I couldn’t buy a new Wobble Board. Birdie’s therapist suggested I make my own.

I found a piece of kitchen counter top from the 1950’s (check out that mid-century metallic flecking) sitting around the house and it practically screamed “I wanna rock your dog’s world!”. Who am I to deny an old kitchen counter a new life as physical therapy equipment for my dog?

And so it was born: The Kitchen Counter Weeble Wobble. Also known as the DIY project for people who don’t want to measure much or cut anything.

This is how you can make something similar at your house:

1. Find a piece of counter top, a table top, or get some plywood. It should be big enough that your dog can stand on it with all four legs.

2. Next you’ll need a softball, an approx. 4 inch screw, and a couple of washers. Find the center of the ball and with a drill, screw that, uh, screw through the ball and into the center of the board. We stuck a washer between the board and the ball for good measure.

3. Now you’ll need something to act as tread for your dogs. I used rubbery shelf liners. You can also use adhesive stair treads/strips or any variety of gripping, non-skid tape. To get my drawer liners to stick, I used Gorilla Glue (with rubber gloves because I prefer my fingertips with the skin on them).

4. After I laid down the tread, I smushed it down real good. If you’re wondering, that’s exactly how Bob Villa describes this step in “This Old Wobble Board.” And then I let it dry overnight.

5. Done! Wobble it Baby.

Note: this is a pretty steeply angled board. I hold Birdie while she’s on it so she doesn’t hurt herself launching off of it. You can learn how to make a real deal, cut your own pieces of wood, lower wobble board here so you can do more rehab exercises like these.

Don’t want to make one? You can buy a Wobble Board. Check out this one from Fit Paws.

Not sure if you need one of these bad boys in your life? Here’s a few ways your dogs might benefit from the Wobble Board:

1. They improve balance, mobility, and joint strength.

2. If your dog wants to impress all the other dogs at Pilates, they’ll need one of these to work their core.

3. They can help boost your dog’s confidence. Shy dogs can benefit from from tackling weird stuff like this. Start slow and reward generously. Next thing you know, your shy dog will be boldly asking the head cheerleader to Prom.

4. They can help get your dog ready for the Teeter Totter in agility. This is a good intro to all moving thingamajigs.

5. They increase body awareness which can be helpful for just about any dog. Working with the board helps them to become more aware of all four of their limbs. Or two limbs.

In other Birdie-Busts-a-Move news, her physical therapist got a brand new, state of the art ~~space ship~~ hydrotherapy treadmill which we got to try out for the first time last month.

Birdie, who is as excited about swimming as I am about doing my taxes, did much better on the treadmill than in the pool. I think she liked that she could keep her head above water. She walked at a good pace for 10 minutes. The point? To rebuild that skinny leg!

Wobble On!

Nov 5

93 Comments

No Surgery, No Problem: Treating Our Dog’s ACL Tear

Birdie graduated this month (from physical therapy, not Yale).

Turns out, we are doing pretty ok without that surgery she was supposed to get. Conservative Management has officially saved the day by taking care of Birdie’s injury and respecting our budget. Let’s discuss:

First of all, I’m double-dog-daring myself to believe that she really is doing as well as she seems to be doing. The pessimist in me isn’t entirely convinced. Frankly, I’m afraid that as I write about how well she’s doing, Birdie’s leg is going to spontaneously combust. I have a fire extinguisher next to my desk, just in case.

Anyway, when Birdie tore her ACL this summer (a complete tear, not just a partial), surgery was the recommended course of action. For better or worse, we couldn’t afford it, so we had to explore other options. We landed on a conservative management plan. Here’s what we did: First we restricted her activity. No jumping on and off the couch, no running around in the yard. The goal was to restrict movement and allow stabilizing scar tissue to form. Birdie didn’t mind this lack of activity as her DNA test revealed that Birdie is indeed half Beagle and half a baked potato.

That being said, Birdie isn’t overweight. If she was, we would have had to put her on a diet. Extra weight is hard on injured legs. We did add a new heavy duty joint supplement, plus lots of stinky fish oil to her diet. After a couple of weeks on NSAIDs (which were too hard on her liver and kidneys to continue using them), she’s been off any and all medications. We also added non-slip area rugs around the house, so that Birdie wouldn’t slide on our hard wood floors and tweak her leg or back.

Most importantly, we started hanging out with our physical therapist, Gayle Hickok, a lot. We started with five visits in a row that first week post-surgical consult. At each visit, Birdie got some time with the cold laser, manual treatments and exercises, and then hydrotherapy in Gayle’s heated saltwater pool.

Ton o’ Bricks hits the high seas

Birdie was not interested in swimming – never, not once, not at all. She chose to practice nonviolent resistance by standing still on the pool’s ramp without budging or blinking. Birdie is the Rosa Parks of canine hydrotherapy.

She is also surprisingly strong for a small senior citizen and “Ton o’ Bricks” Birdie had to be lifted into the water, all dead weight, by her life jacket. Once she was in the water, Gayle would gently guide her through exercises. Birdie occasionally faked massive reverse sneezing attacks in order to escape the pool (we know she was faking because the reverse sneezing stop the second her paws hit the concrete. Also, she was laughing at us).

On the other hand, Birdie thought the laser and manual treatments were exquisite, since that part of the rehab required that she be hand fed chicken while lying down on a soft bed. That’s my girl. I was also happy that these treatments were addressing her whole body, not just her bum leg.

Over the past three months we reduced our visits to twice a week, then once a week, then just every other week. From the start, Gayle felt that we had made the right choice – conservative management – rather than surgery, and Birdie’s improvements have backed that up.

About a month into Birdie’s physical therapy visits, we also began using a product at home called the Loop which produces a Pulsed Electromagnetic Field around her injured bits.The Loop is supposed to reduce inflammation and pain and increases blood circulation. I can’t say for sure if it’s helped, but it does compliment the other therapies we’re doing and Birdie continues to be pain-med-free.

Birdie, wearing the Loop, looks sad because no one is feeding her chicken right-this-second.

Last week, Gayle said that Birdie was good to go for a month or more until our next visit. This worried me (my DNA test reveals I’m part Eeyore). But Gayle swore to me that Birdie’s leg is in great condition. She has full extension, is weight bearing and can walk and run around, plus she has no obvious signs of pain when her leg is being manipulated. She’s come a long way since our first visit when she was only using her leg about 50% of the time.

Birdie won’t be competing in a decathlon any time ~~soon~~ ever, but our hope was to reduce Birdie’s pain and help her get mobile again. It looks like we did it. She still has days where she’s a little gimpy, which could be the injury or it might be coming from her atrophied leg muscles. We’re working on rebuilding her muscle and strength in that leg. But most of the time, she’s doing fine.

It’s hard to say which piece of the puzzle had the biggest impact on her recovery. Our physical therapist isn’t sure either. She keeps reminding me that all of the therapies and supplements are playing a part in her recovery and are working together to support her overall health and well being.

That’s the funny thing about taking this approach – it’s clearly working, but there are days when I still doubt myself and the choices I’ve made for Birdie. The surgical option, plus the recovery and physical therapy that would have followed it, seems so much more tangible and measurable. With the conservative management approach, it’s a bit more subtle and there are fewer vets involved. Things have been going so well, we haven’t been back to see a vet since our original surgical consult.

Birdie and Gayle: What’s a little laser between BFFs?

I’m not sure why it’s so hard for me to believe Birdie is really ok. Sometimes I get a little panicky with an internal dialogue that goes something like this: “What if she’s not really better? What if we were wrong and she really does need the surgery? What if her leg is only pretending to be a real leg, but it’s really made up of marshmallows and candy canes, which is why she’s always licking herself? Will we have to buy her a whole new leg then? What if? What if? What if?”

That’s why I have to keep reminding myself that when Birdie runs across the yard it’s the real deal. She’s not faking it so that I won’t worry about her. Dogs are a pretty honest bunch, which I really appreciate. They don’t put on a show for our benefit (They will do it for their own benefit. See: Birdie sneezing in pool).

Dogs don’t tell fibs or fake it to save us from feeling badly or worrying about them. If you give them a toy that they don’t like, dogs won’t play it. Or eat food they think it’s awful. Or sleep on a bed they think is uncomfortable. Dogs don’t tell white lies to spare our feelings.

So I’m starting to believe that Birdie really is as good as she looks. Her life is back to normal. Opting out of that surgery we couldn’t afford in the first place wasn’t such a bad choice after all. In fact, it might have been the right choice, even if we could have afforded the surgery.

It makes me wonder how many dogs would benefit from a conservative management approach as a first option, not a “that’s all we can afford” option. Based on your earlier comments, many people never hear a peep from their vet that conservative management/physical therapy might be an option. That’s a shame. Some dogs do need the surgery, of course, but depending on the individual dog and/or the financial situation of the owner, there are other routes to explore. Vets should at least mention it.

I don’t want to jinx anything – Birdie’s leg hasn’t burst into flames yet – so I’ll just end things by knocking on wood and sharing some resources for non-surgical options if you’re in a similar boat and want to learn more about what’s out there.

In Maine: Pawsitive Results K-9 Rehabilitation

Whole Dog Journal: Alternatives to Canine Surgery

Whole Dog Journal: Laser Therapy for Rehab

Yahoo Group: Canine Conservative Management

If you know of others, please share in the comments!

Jul 24

61 Comments

You’re Old and I’m Broke: Conversations With My Dog About Surgery

Remember that time my dog tore her cruciate from lying in the sun too hard? Yep, that would be Birdie. My 11.5 year old dog decided to go blow a ligament in her rear leg the other week. Super expensive surgery has been recommended. Beer, please.

Here’s the thing about working with dogs all my adult life: I’m pretty good at giving compassionate, reasonable advice to people who are struggling to make the right call for their dogs.

And here’s the thing when it comes to my own dogs: I am not very good at hearing the kind, reasonable, forgiving lady that lives in my head. She talks to everyone else, but clams up when I ask her to weigh in on my problems. Most times, I can only hear a weepy confused kid spinning around in panicked circles calling me a dick for not being a better dog owner. That kid is such a drag.

So during our recent consult with a very nice surgeon, I found myself suddenly fighting off hot tears when I forced myself to ask her what would happen if I couldn’t afford the surgery that Birdie needs. It made me feel like I was saying, “I don’t love my dog.” Which couldn’t be further from the truth.

Here’s what the surgeon said, “You should feel supported if you choose not to do the surgery.”

You should feel supported. Those are some good words right there.

And she went on to say it was reasonable for me to weigh all the variables, including my dog’s age, her activity level, and my financial situation when making the decision to opt for surgery – or not.

Surgery is how much? Just cut it off. I have three more.

The surgeon also patiently answered my two million questions about Birdie’s pain levels and what would happen over time to her other limbs since they’d have to pick up the slack of her bum leg.

We ultimately agreed that this was not emergency surgery and it was reasonable to give Birdie four weeks of rest combined with cold laser treatments and hydrotherapy (with an awesome physical therapist Birdie knows and loves). And then we’d revisit the idea of surgery.

Of course, four weeks from now, if the results from physical therapy aren’t what we hope they’ll be, it still won’t change the gist of the conversation I had with Birdie on the way home from the surgical consult:

Me: Your dad and I are broke.

Birdie: Phumpfh.

Me: You’re kind of old.

Birdie: Phumpfh.

Me: We’re broke and you’re old. I feel like maybe it’s ok to choose not to sink an entire line of credit into one of your legs. Right?

Birdie: Phumpfh.

Me: Birdie, listen. I feel like an asshole trying to figure out how much your leg is worth. I don’t want you to be in pain, but that’s a lot of money. If you want the surgery, I’ll rob a bank to pay for it (or use a credit card). Just tell me what you want me to do. I don’t want to make the wrong choice and have you suffer for the rest of your life. I hate the idea of putting a dollar sign on your leg. You deserve all the bionic legs a dog could ever dream of having…I’m sorry I’m not rich. Just tell me: What do you want me to do?

Birdie: zzzzz-phumpfh-zzzzzzz.

Me: Dammit.

Birdie on bed rest looks just like Birdie on every other day.

I wish dogs could tell us what they want. One of the hardest parts of caring for our dogs is making decisions on their behalf and feeling badly that we’re not doing the right thing. A lot of us are beating ourselves up and second guessing everything – from the everyday decisions about diet and training to the excruciating choices we need to make at the end of their lives.

It’s no fun being the one in charge of making the call. As humans we carry around all these conflicting, painful thoughts – about the various options available and what the future holds for the dogs we love so much. Luckily, our dogs continue living in the moment. Knowing stuff is our burden, not theirs.

You might think that those of us who make a living working with dogs would have an easier time making choices for our pets. We know all the questions to ask about quality of life and the different scales to help measure their good days and bad days. Plus we have tons of personal stories from clients and colleagues, etc. to mentally reference in order to help us put our own situations in perspective.

Turns out, when it comes to my own dogs, like most pet care pros, I’m in need of the same sort of outside perspective and compassionate counsel as everyone else. The situation isn’t life threatening (for the record, I’m grateful the diagnosis wasn’t something more serious), but I needed someone else to help me get my footing. And to tell me I’m not a jerk.

I really appreciate that the surgeon told me not to feel guilty for considering my financial situation. And I could have hugged her for saying I should feel supported in trying a non-surgical option first.

It’s what I would have told myself if the confused, weepy kid in my head wasn’t busy shouting about how I was turning into Cruella De Ville for allowing money to pop up when thinking about what Birdie needs. It’s what I would have told any of you, if you were in the same spot.

Thanks for the compassionate advice Doc.

We’re starting rehab next week. In the meantime, Birdie still seems to love me, despite the fact that I’m thinking about the value of her leg repair versus the potential span of her life divided by my credit line. Maybe that’s because she’s thinking about snacks and smelly stuff to roll in, not surgery. That’s my job.

p.s. if you’re interested in some alternatives to surgery, this article at Whole Dog Journal is really helpful.