Guest guest Posted September 10, 2008 Report Share Posted September 10, 2008 Hello again, I have a patient that came to see me w/ terrible stifles (2 operations each stifle to fix patella luxation, no improvement) and hip arthritis (right side already had FHO). One of the problems we want to fix right now is his hamstrings have contracted so much that the dog cannot extend his knees more than 90 degrees w/ manipulation and after U/S. Voluntarily, the dog will/cannot stand up straight. I have heard of using thermoplast to slowly loosen the contractures. I know a Dynasplint($300/month to rent/splint) would be ideal, but money is any issue for the client (when isn't it, right?). So, I am looking into other options, ie thermoplast. Any thoughts on that? Or is there something else out there that would do the job better and affordable. Also, if anyone has had a similar case, is it justifiable to try to straighten the leg when both knees are unstable. BTW, after all the surgeries, both patellas are still luxated. The only other option the surgeon could do is place pins in the stifle and basically eliminate any mobility of the stifles, permanently. The owner does not want to try this yet b/c of questionable results. Thank you in advance for any advice. Regards, Jackie ~~~~~~ Jackie Honghern Sharp CCRP Louisville Veterinary Specialists and Emergency Services www.lvses.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 10, 2008 Report Share Posted September 10, 2008 It may be very difficult to find a purchase point over the femur to extend the stifle without making straps that run over the pelvis and then maybe even to a harness on the front of the dog. I think it can be done and have made splints like you have described in the passed with mixed results. Another option, though it may not work for this dog, is to hang him in a full sling and weight his distal extremities to help relieve the flexion contractures through traction. This may provide you with the prolonged stretch that you are looking for without all the arts and crafts work. Robby J Porter III, VT, LMT, CCRPAnimal Rehabilitation CenterMandeville, LA70448 Thermoplast Hello again,I have a patient that came to see me w/ terrible stifles (2 operations each stifle to fix patella luxation, no improvement) and hip arthritis (right side already had FHO). One of the problems we want to fix right now is his hamstrings have contracted so much that the dog cannot extend his knees more than 90 degrees w/ manipulation and after U/S. Voluntarily, the dog will/cannot stand up straight. I have heard of using thermoplast to slowly loosen the contractures. I know a Dynasplint($ 300/month to rent/splint) would be ideal, but money is any issue for the client (when isn't it, right?). So, I am looking into other options, ie thermoplast. Any thoughts on that? Or is there something else out there that would do the job better and affordable. Also, if anyone has had a similar case, is it justifiable to try to straighten the leg when both knees are unstable. BTW, after all the surgeries, both patellas are still luxated. The only other option thesurgeon could do is place pins in the stifle and basically eliminate any mobility of the stifles, permanently. The owner does not want to try this yet b/c of questionable results. Thank you in advance for any advice.Regards,Jackie~~~~~~Jackie Honghern SharpCCRPLouisville Veterinary Specialists and Emergency Serviceswww.lvses.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2008 Report Share Posted September 11, 2008 I saw a dog w/very similar history to yours (10 surgeries toal between the two stifles!!!!) One hind limb we were able to stretch out using prolonged stretching, like Robbie mentioned (I'd sit at edge of treatment talbe and hang his hind limbs over my legs, and slowly abduct my leg to increase hip ext stretch. We finally ended up using a Dynasplint on one side, and received really good results in one month, so I felt it was worth the money. Good luck! Bedenbaugh, PT, CCRP Thermoplast Hello again,I have a patient that came to see me w/ terrible stifles (2 operations each stifle to fix patella luxation, no improvement) and hip arthritis (right side already had FHO). One of the problems we want to fix right now is his hamstrings have contracted so much that the dog cannot extend his knees more than 90 degrees w/ manipulation and after U/S. Voluntarily, the dog will/cannot stand up straight. I have heard of using thermoplast to slowly loosen the contractures. I know a Dynasplint($ 300/month to rent/splint) would be ideal, but money is any issue for the client (when isn't it, right?). So, I am looking into other options, ie thermoplast. Any thoughts on that? Or is there something else out there that would do the job better and affordable. Also, if anyone has had a similar case, is it justifiable to try to straighten the leg when both knees are unstable. BTW, after all the surgeries, both patellas are still luxated. The only other option thesurgeon could do is place pins in the stifle and basically eliminate any mobility of the stifles, permanently. The owner does not want to try this yet b/c of questionable results. Thank you in advance for any advice.Regards,Jackie~~~~~~Jackie Honghern SharpCCRPLouisville Veterinary Specialists and Emergency Serviceswww.lvses.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2008 Report Share Posted September 11, 2008 Hi Robby, I am interested in the full sling option. However, I have not tried it before, do you have pictures of the contraption and methods for stretching the dog. I am such a visual person, it helps to see. Also, did your dogs begin using the hindlimbs better? Did yours have luxated patellas? Again, that is a big concern for me, straighten the leg, but the patellas are still luxated, will it help the dog walk more " normal " . Regards, Jackie ~~~~~~ Jackie Honghern Sharp CCRP Louisville Veterinary Specialists and Emergency Services www.lvses.com > > Subject: Re: Thermoplast > To: VetRehab > Date: Wednesday, September 10, 2008, 9:37 PM > It may be very difficult to find a purchase point over the > femur to extend the stifle without making straps that run > over the pelvis and then maybe even to a harness on the > front of the dog. I think it can be done and have made > splints like you have described in the passed with mixed > results. > Another option, though it may not work for this dog, is to > hang him in a full sling and weight his distal extremities > to help relieve the flexion contractures through traction. > This may provide you with the prolonged stretch that you are > looking for without all the arts and crafts work. > Robby > J Porter III, VT, LMT, CCRP > Animal Rehabilitation Center > Mandeville, LA > 70448 > > > > > Thermoplast > > > Hello again, > > I have a patient that came to see me w/ terrible stifles (2 > operations each stifle to fix patella luxation, no > improvement) and hip arthritis (right side already had FHO). > One of the problems we want to fix right now is his > hamstrings have contracted so much that the dog cannot > extend his knees more than 90 degrees w/ manipulation and > after U/S. Voluntarily, the dog will/cannot stand up > straight. I have heard of using thermoplast to slowly loosen > the contractures. I know a Dynasplint($ 300/month to > rent/splint) would be ideal, but money is any issue for the > client (when isn't it, right?). So, I am looking into > other options, ie thermoplast. Any thoughts on that? Or is > there something else out there that would do the job better > and affordable. Also, if anyone has had a similar case, is > it justifiable to try to straighten the leg when both knees > are unstable. BTW, after all the surgeries, both patellas > are still luxated. The only other option the > surgeon could do is place pins in the stifle and basically > eliminate any mobility of the stifles, permanently. The > owner does not want to try this yet b/c of questionable > results. Thank you in advance for any advice. > > Regards, > Jackie > > ~~~~~~ > > Jackie Honghern Sharp > CCRP > Louisville Veterinary Specialists and Emergency Services > www.lvses.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 11, 2008 Report Share Posted September 11, 2008 Hey Jackie, I use an engine hoist as a lift. You can get them at auto parts or big hardware stores and they generally cost between $100-200. The sling part, as seen in the attached photo, is cargo netting that is used in helicopters, planes ext. but a groomers sling or even a nice front harness and a belly sling would work too in some situations. Sorry I don't have any pictures of patients in traction; I'll try and remember to take some next time. For weights I use wrist weights that can be found at Walmart/ Kmart, they generally come in 1 or 2 lb pairs. If this is too heavy then I just cut open a few cells and dump out some of the lead pellets. The last dog that I used this on was a chronic IVDD that had been down for 1-2 years without any treatment and had severe hamstring shorting. For him I would sling him with weight just proximal to his hocks and let him hang for about 10 min. heat then manually stretch him. In hindsight I may have also used NMES, during traction, to his quads to help hamstrings to relax. Though my patient never walked again without assistance, he was down for a very long time, we did gain about 15-20 degrees of stifle extension in about 5 weeks. I don't think anyone can tell you if your patient will walk normal, it is kind of doubtful from what you have described. I think your goal is to make him as functional and pain free as possible and restricted ROM appears to correlate with some daily function in my experience. Also if the patella¢s are still luxating then that posses a severe mechanical problem for the dog; if hamstrings are shortened then it would only be logical to think that quads are elongated. Furthermore as you gain stifle extension and the origin and insertion of the quads becomes smaller/closer then it would more then likely allow the patella luxations to become worse. Hence engagement and strengthen of quads would be my foremost plan concerning exercises as well as the obvious core strengthening for compensatory movements. Hope some of this helps, Robby J Porter III, VT, LMT, CCRPAnimal Rehabilitation CenterMandeville, LA70448 Thermoplast> > > Hello again,> > I have a patient that came to see me w/ terrible stifles (2> operations each stifle to fix patella luxation, no> improvement) and hip arthritis (right side already had FHO).> One of the problems we want to fix right now is his> hamstrings have contracted so much that the dog cannot> extend his knees more than 90 degrees w/ manipulation and> after U/S. Voluntarily, the dog will/cannot stand up> straight. I have heard of using thermoplast to slowly loosen> the contractures. I know a Dynasplint($ 300/month to> rent/splint) would be ideal, but money is any issue for the> client (when isn't it, right?). So, I am looking into> other options, ie thermoplast. Any thoughts on that? Or is> there something else out there that would do the job better> and affordable. Also, if anyone has had a similar case, is> it justifiable to try to straighten the leg when both knees> are unstable. BTW, after all the surgeries, both patellas> are still luxated. The only other option the> surgeon could do is place pins in the stifle and basically> eliminate any mobility of the stifles, permanently. The> owner does not want to try this yet b/c of questionable> results. Thank you in advance for any advice.> > Regards,> Jackie> > ~~~~~~> > Jackie Honghern Sharp> CCRP> Louisville Veterinary Specialists and Emergency Services> www.lvses.com Quote Link to comment Share on other sites More sharing options...
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