Re: Vet Rehab exam question.

[Guest guest]

I hope that we don't decide on prognoses on a very limited group of signs, as the longer I practice the less I find that one can give a poor prognosis based a given set of signs. I have seen far too many "miracle cures" that have been fixed with great surgery, great therapy, and sometimes just tincture of time, some with terrible signs and prognostic indications for months.

We need a larger, better paradigm for evaluation of cases and hopefully test questions will reflect this eventually.Judith M. Shoemaker, DVMAlways Helpful Veterinary Services305 Nottingham RoadNottingham, PA 19362ph fax info@... www.judithshoemaker.com

To: VetRehab From: dvmcliff@...Date: Sun, 15 Jun 2008 14:31:56 -0700Subject: Vet Rehab exam question.

Hi everyone. I was wondering if someone can help me out with the following question, which is part of an exam question in my rehab course.In an IVDD case, if superficial and deep pain are present post-op, but no voluntary motion after 5 days, can we say anything about the dog's prognosis, or is it too early to tell? Does the presence of deep pain automatically give us some optimism?Thanks!Clifford Mardinger, DVMToronto, Canada Now you can invite friends from Facebook and other groups to join you on Windows Live™ Messenger. Add them now!

[Guest guest]

These articles are all great (Natasha Olby) is a leader in this area. I would

recommend

reading these 3 for anyone in rehab. In terms of the question they would help

formulate a

good evidence-based response.

Olby N, Halling KB, Glick TR. Rehabilitation for the neurologic patient. Vet

Clin North Am

Small Anim Pract. 2005 Nov;35(6):1389-409

Olby N, T, Burr J, Muñana K, Sharp N, Keene B. Recovery of pelvic limb

function in

dogs following acute intervertebral disc herniations. J Neurotrauma. 2004

Jan;21(1):49-

59.

Olby N, Levine J, T, Muñana K, Skeen T, Sharp N. Long-term functional

outcome of

dogs with severe injuries of the thoracolumbar spinal cord: 87 cases

(1996-2001). J Am

Vet Med Assoc. 2003 Mar 15;222(6):762-9

Dave L

In VetRehab , Clifford wrote:

>

> Hi everyone. I was wondering if someone can help me out with the following

question,

which is part of an exam question in my rehab course.

>

> In an IVDD case, if superficial and deep pain are present post-op, but no

voluntary

motion after 5 days, can we say anything about the dog's prognosis, or is it too

early to

tell? Does the presence of deep pain automatically give us some optimism?

>

> Thanks!

>

> Clifford Mardinger, DVM

> Toronto, Canada

>

[Guest guest]

I work as the rehab tech for a neurology clinic and I

would NOT say the pet has a bad prognosis. We often

tell owners it will take 4-6 weeks before the pet

plateaus at where they will be for the rest of their

lives. In a perfect world we prefer to see them leave

our clinic with some degree of motor but we have

witnessed them leave with only deep pain, requiring

passive range of motion and bladder expression. To

have them come back for a 2 week recheck with motor.

I hope that helps

Jerri

[Guest guest]

We have had post-op disc patients come to us 6-8 weeks after surgery with little to no RL motor and reflex movement only. With 2-3x/week rehab the majority of them Have been ambulatory within 2-3 months. although it is not always pretty, it is functional. Sooner is always better but rehab can make a big difference especially if the owner is motivated to follow through at home and has the ability to stay with the rehab. We have had a few come for up to a year because they and we continue to see improvements though the rate of improvement does slow down and sometimes plateau for periods. Good luck and hang in there:)

Pavlakos, PT, CCRP

-----Original Message-----From: VetRehab [mailto:VetRehab ]On Behalf Of JerriSent: Tuesday, June 17, 2008 8:52 AMTo: VetRehab Subject: Re: Vet Rehab exam question.

I work as the rehab tech for a neurology clinic and Iwould NOT say the pet has a bad prognosis. We oftentell owners it will take 4-6 weeks before the petplateaus at where they will be for the rest of theirlives. In a perfect world we prefer to see them leaveour clinic with some degree of motor but we havewitnessed them leave with only deep pain, requiringpassive range of motion and bladder expression. Tohave them come back for a 2 week recheck with motor. I hope that helpsJerri