Brachial plexus/radial nerve injury - estim quest.

[Guest guest]

I was hoping to get some help with a case. I have a 2yr m/c Cavalier HBC 3

months ago

with a partial brachial plexus injury primarily associated with the radial

nerve. Generalized

atrophy of the limb but primarily focused on the triceps. The forelimb extensors

palpate

almost equal in size with the contralateral limb. The dog holds the limb in

flexion while

walking but will occasionally touch the ground to maintain balance or while

resting. There

is good ROM at all joints. On neuro exam I can elicit a biceps response and

sometimes I

think I get response on the extensors but not on the triceps. The dog has

superficial pain

along the medial aspect of the 1st and 2nd digit but no other area I can elicit.

The dog

wears a carpal extension brace during the day and the owner performs PROM and

massage at home. The dog has been receiving laser therapy, e-stim and UWT. I

have just

been asked to consult on the case so I don't have all the specifics. My main

questions

concerns the e-stim. When the pads are placed over what is left of the triceps

m. we are

unable to elicit extension of the elbow however when we move the pads just right

we can

get extension of the carpus (very close to the caudal aspect of the humerus). Is

the lack of

elbow extension due to the severity of the muscle atrophy in this region or due

to poor

placement?

In addition does anyone have any other recommendations for alternate things to

try with

this dog since there has been no obvious improvement since the injury 3 mos ago?

Hope this wasn't too wordy.

Thanks

Au