Re: Carpal and tarsal laxity with mpl

[Guest guest]

Hi,

With regular management stuff like evaluating and maximizing thyroid function to get really good collagen contracture, I find these dogs do fabulously with prolotherapy. You can treat 4 -6 joints per treatment and they do really well. The biggest problem is not having them over do before they get sufficient strength and having a full stifle blowout that has to go to surgery. Doing the carpi in the first round gives them something to stand on and they do better if they start to bear weight more symmetrically as quickly as possible.Judith M. Shoemaker, DVMAlways Helpful Veterinary Services305 Nottingham RoadNottingham, PA 19362ph fax info@... www.judithshoemaker.com

To: VetRehab From: drangiekrause@...Date: Thu, 20 Mar 2008 22:09:33 +0000Subject: Carpal and tarsal laxity with mpl

Hello,I have a 7 year old MN Pomeranian that has Grade 3 MPLs with secondary DJD in the stifles. The dog also has severe carpal and tarsal laxity with a plantigrade and palmograde stance. Both the carpus and tarsus have abnormal (too much) lateral and medial motion. The pelvic limbs stand in external rotation with a 'cow hocked appearance'. The owners are trying to avoid surgery for the mpl and want to try rehabilitation. I am concerned about the grade of mpl coupled with the laxity in the joints. Any advice or suggestions?Thanks,Angie Krause, DVM Windows Live Hotmail is giving away Zunes. Enter for your chance to win.

[Guest guest]

Judith, I'm sorry I'm not familiar with prolotherapy. Would you be able to give a brief summary. I'm intrigued. Thanks! Jeanine Freeberg, PT, DPTJudith Shoemaker wrote: Hi, With regular management stuff like evaluating and maximizing thyroid function to get really good collagen contracture, I find these dogs do fabulously with prolotherapy. You can treat 4 -6 joints per treatment and they do

really well. The biggest problem is not having them over do before they get sufficient strength and having a full stifle blowout that has to go to surgery. Doing the carpi in the first round gives them something to stand on and they do better if they start to bear weight more symmetrically as quickly as possible.Judith M. Shoemaker, DVMAlways Helpful Veterinary Services305 Nottingham RoadNottingham, PA 19362ph fax infojudithshoemaker www.judithshoemaker.com To: VetRehab From:

drangiekrauseDate: Thu, 20 Mar 2008 22:09:33 +0000Subject: Carpal and tarsal laxity with mpl Hello,I have a 7 year old MN Pomeranian that has Grade 3 MPLs with secondary DJD in the stifles. The dog also has severe carpal and tarsal laxity with a plantigrade and palmograde stance. Both the carpus and tarsus have abnormal (too much) lateral and medial motion. The pelvic limbs stand in external rotation with a 'cow hocked appearance'. The owners are trying to avoid surgery for the mpl and want to try rehabilitation. I am concerned about the grade of mpl coupled with the laxity in the joints. Any advice or suggestions?Thanks,Angie Krause, DVM Windows Live Hotmail is giving away Zunes. Enter for your chance to win.

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[Guest guest]

Prolotherapy, or proliferative therapy, is a treatment that has been used in both conventional and alternative medicine for 50 years or so. see www.prolosports.com for more info from the M.D. that I learned the technique from. There are several short pieces by several vets in the AHVMA proceedings archives on the subject as well. The premise is to inject multiple tiny amounts of a solution of substances that are stem cell attractants into the ligaments, their periosteal attachments, joint and capsular attachments (and whatever else you can find that is abit dystrophic feeling-and you get a feel for the points that are needing the stuff.)

This creates a mild inflammatory response resulting in (documented) about 3 times the ligament strength and speed of healing that can be achieved with standard therapies alone. I have had multiple joints of my high wear and tear and intrinsically weak musculoskeletal system done and I can tell you it really works. It is minimally painful when done accurately. I have had no complications other than some local minor pain and swelling, usually from small hematomas, just as with acupuncture. I have used this for 5 years in practice and have hosted seminars on it. The results are great for me and my colleagues that have started to use it regularly, many dogs avoiding surgery, dogs after surgery doing much better, chronic cases resolving, and performance dogs getting better. The solution I use is 1/3 50% Dextrose, 1/3 2% procaine without epinephrine (compounded by McGuff), 1/3 1000mcg/ml B12 with 1 vial of Zeel injectable divided between however many syringes I need. The dextrose is a stem cell attractant. (The drug companies don't want you to know that they haven't come up with any thing that is a whole lot better at this than this unpatentable substance.) The procaine is a "Qi" mover, local anesthetic for the procedure and a mild counter irritant, the B12 is terrific nerve food both locally and systemically and seems to make the treatment inflammatory /proliferative phase work longer. The Zeel seems to make both treated and untreated joints much happier. I do a lot of pecking of the bone, that is key. I don't have to tranquilize or restrain heavily, ever. I rarely ever have to even muzzle them.Many just lie down to recieve the treatment after a few sessions. I don't clip or scrub, just ask them not to swim in the farm pond before or after. And I routinely follow with an ozone treatment for maximum effect and antiinfective insurance.I treat every 2-3 weeks for 3-6 treatments. Younger dogs do very well with few treatments, some have been perfect with one for an isolated injury. older dogs and chronic cases may take more treatments and a periodic tuneup single treatment every few months. I treat up to 10 cases a week regularly. My doctor that does my own treatments has 90 year olds that come in for their tuneups so that they can keep playing tournament tennis!!

Hope this piques your interest, I has been a blast to have so many animals so much better. Even a little Cushings-then-ian teacup poodle that had broken down its carpi completely to walking on its accessory carpals responded well to this and bracing. It couldn't tolerate bracing prior to the treatment!

Judith M. Shoemaker, DVMAlways Helpful Veterinary Services305 Nottingham RoadNottingham, PA 19362ph fax info@... www.judithshoemaker.com

To: VetRehab From: jeaninefreeberg@...Date: Thu, 20 Mar 2008 16:16:38 -0700Subject: RE: Carpal and tarsal laxity with mpl

Judith,

I'm sorry I'm not familiar with prolotherapy. Would you be able to give a brief summary. I'm intrigued.

Thanks!

Jeanine Freeberg, PT, DPTJudith Shoemaker <judithshoemakerhotmail> wrote:

Hi, With regular management stuff like evaluating and maximizing thyroid function to get really good collagen contracture, I find these dogs do fabulously with prolotherapy. You can treat 4 -6 joints per treatment and they do really well. The biggest problem is not having them over do before they get sufficient strength and having a full stifle blowout that has to go to surgery. Doing the carpi in the first round gives them something to stand on and they do better if they start to bear weight more symmetrically as quickly as possible.Judith M. Shoemaker, DVMAlways Helpful Veterinary Services305 Nottingham RoadNottingham, PA 19362ph fax infojudithshoemaker www.judithshoemaker.com

To: VetRehab From: drangiekrauseDate: Thu, 20 Mar 2008 22:09:33 +0000Subject: Carpal and tarsal laxity with mpl

Hello,I have a 7 year old MN Pomeranian that has Grade 3 MPLs with secondary DJD in the stifles. The dog also has severe carpal and tarsal laxity with a plantigrade and palmograde stance. Both the carpus and tarsus have abnormal (too much) lateral and medial motion. The pelvic limbs stand in external rotation with a 'cow hocked appearance'. The owners are trying to avoid surgery for the mpl and want to try rehabilitation. I am concerned about the grade of mpl coupled with the laxity in the joints. Any advice or suggestions?Thanks,Angie Krause, DVM

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[Guest guest]

Judith

terrific explanation-

can't wait to read it again and agin so I have it down-

Carpal and tarsal laxity with mpl

Hello,I have a 7 year old MN Pomeranian that has Grade 3 MPLs with secondary DJD in the stifles. The dog also has severe carpal and tarsal laxity with a plantigrade and palmograde stance. Both the carpus and tarsus have abnormal (too much) lateral and medial motion. The pelvic limbs stand in external rotation with a 'cow hocked appearance'. The owners are trying to avoid surgery for the mpl and want to try rehabilitation. I am concerned about the grade of mpl coupled with the laxity in the joints. Any advice or suggestions?Thanks,Angie Krause, DVM

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[Guest guest]

Hi All,

I would be very curious as to why this dog has complete collapse of both the

carpi and tarsi with medial and lateral instability. Have any radiographs been

done? Joint taps? Any other diagnostics? When I see dogs like this, what

screams out to me is a chronic Cushings dog or a dog with end stage

polyarthritis, usually immune-mediated (but possibly tickborne). I have seen

many dogs of those flavors that have gone on to tear their ACLs secondary to the

chronic inflammation that is also affecting their knees or the support structure

weakening of various joints, including their knees. Also common in a 7 year old

with grade 3 MPLs would be ACL tears +/- meniscal damage due to the loss of the

anterior support of the patellar tendon and quadriceps mechanism. I suppose

what I would suggest is to establish a diagnosis before jumping in to treat, as

the cause may have a significant effect on the success of any treatment.

Hope this helps

Mark B. Parchman, DVM, CVA, DACVS

Carpal and tarsal laxity with mpl

> Hello,

>

> I have a 7 year old MN Pomeranian that has Grade 3 MPLs with

> secondary

> DJD in the stifles. The dog also has severe carpal and tarsal

> laxity

> with a plantigrade and palmograde stance. Both the carpus and

> tarsus

> have abnormal (too much) lateral and medial motion. The pelvic

> limbs

> stand in external rotation with a 'cow hocked appearance'. The

> owners

> are trying to avoid surgery for the mpl and want to try

> rehabilitation.

> I am concerned about the grade of mpl coupled with the laxity in

> the

> joints. Any advice or suggestions?

>

> Thanks,

>

> Angie Krause, DVM

>

>

[Guest guest]

Mark,

so glad to hear someone chime in about being certain to have a diagnosis before "jumping in to treat"

Freedman VMD CCRT

Carpal and tarsal laxity with mpl> Hello,> > I have a 7 year old MN Pomeranian that has Grade 3 MPLs with > secondary > DJD in the stifles. The dog also has severe carpal and tarsal > laxity > with a plantigrade and palmograde stance. Both the carpus and > tarsus > have abnormal (too much) lateral and medial motion. The pelvic > limbs > stand in external rotation with a 'cow hocked appearance'. The > owners > are trying to avoid surgery for the mpl and want to try > rehabilitation. > I am concerned about the grade of mpl coupled with the laxity in > the > joints. Any advice or suggestions?> > Thanks,> > Angie Krause, DVM > >

[Guest guest]

Indeed, a point well taken. We always do those diagnostics mentioned before prolotherapy, or they have been done by other referring veterinarians. If there is any doubt about accurate testing having been done within a reasonable time period, make sure you have it done and treat accordingly. I do not do prolo until I have determined the tickborne disease status, and either treat concurrently or begin ab's and ozone and other appropriate treatments and then do prolo abit later.

Judith M. Shoemaker, DVMAlways Helpful Veterinary Services305 Nottingham RoadNottingham, PA 19362ph fax info@... www.judithshoemaker.com

To: VetRehab From: rfreedman@...Date: Sat, 22 Mar 2008 08:14:44 -0400Subject: Re: Carpal and tarsal laxity with mpl

Mark,

so glad to hear someone chime in about being certain to have a diagnosis before "jumping in to treat"

Freedman VMD CCRT

Carpal and tarsal laxity with mpl> Hello,> > I have a 7 year old MN Pomeranian that has Grade 3 MPLs with > secondary > DJD in the stifles. The dog also has severe carpal and tarsal > laxity > with a plantigrade and palmograde stance. Both the carpus and > tarsus > have abnormal (too much) lateral and medial motion. The pelvic > limbs > stand in external rotation with a 'cow hocked appearance'. The > owners > are trying to avoid surgery for the mpl and want to try > rehabilitation. > I am concerned about the grade of mpl coupled with the laxity in > the > joints. Any advice or suggestions?> > Thanks,> > Angie Krause, DVM > >

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