Saturday, March 7, 2009

Jinx in rehab

Jinx isn't ready to sing Amy Winehouse tunes yet, but she is in rehab. On December 12, 2008 she underwent surgery for a near complete tear of the medioglenohumeral ligament, also called the collateral ligament.

As you can see by the photo, she wears a hobble restraint manufactured by DoggLegs, 24/7. The physical therapist said that some dogs just do not tolerate them, but Jinx has not bothered them at all. They stabilize the shoulder and keep it from splaying out to the side.

We don't know how it happened, and never witnessed a particular injury. Because this type of injury is caused by an impact where one front leg ends up on either side of an obstacle- smack!!-- it is likely that she was running (and my guess is that her head was turned, looking at Cooper) and she ran headlong into one of the PVC septic pipe vents. The height is right. Too little, too late, but my plan had been to create a raised garden to surround those last year but it never got done. It started with the tiniest of limps, barely discernable. Our vet was here on a kennel call, and I asked him to look at it. He manipulated the shoulder and got no pain response, twisting it every which way. He said to try NSAIDs and keep an eye on it, and check back in a couple weeks. The limp had gotten worse, and NSAIDs didn't affect it. Neither did exercise, or lack of. It was no better or worse when she got up, or after she ran around. We Xrayed and didn't find anything and were referred to the orthopedic specialist. Of course, each one in turn twisted on that shoulder and Jinx never so much as whimpered or pull away. Unfortunately, her stoic attitude made it more difficult to assess what was going on.

The ortho surgeon thought it might be a rotator cuff tendon tear. I was told to let her run around all she wanted to see if we could isolate the area of injury. In hindsight, this may have created more problems. I debated whether the best course of action was to go in and look around, or do a scan. I talked to a vet who works with the Iditerod teams about his experience with rotator cuff tear injurys. I visited the holistic vet with her "magic wand" (biocom) and she said she wasn't *getting* tendon tear; she was being shown there was nerve damage, and indicated the shoulder/armpit area. She described to me the type of impact that would have caused that. Oddly enough, it was the same scenario later posed by the orthopedic surgeon.

In the meantime, the limp progressed to non-weight bearing. The muscle tone dimished, the limb atrophied and when we arrived for our scan, the vet examined her and this time, did get a pain response. It was an aha! moment. He recognized what the injury was and suggested we take her to surgery. I am tearing myself up over my reluctance to let him cut her open to begin with, but I simply did not feel comfortable with a very expensive fishing expedition when they were saying they did not know what was wrong. Once he identified the problem, I was on board. Unfortunately, I agonize over whether that delay will ultimately prevent Jinx from returning to duty. Earlier this year, when she was spayed in emergency surgery due to pyometra, I had to face the fact that this exceptionally talented and qualified dog would never be bred. Now I have to consider she might not work again.

At this stage, almost three months post surgery there is still hope. I continue to over-estimate the amount of time that has passed post surgery and think she should be showing more progress. The physical therapist has said that the dogs can generally return to function in 4-5 months, so I need to be patient. In the meantime, we have PAGES of exercises to do for rehabilitation. I asked how in the world you could ever do this with an untrained dog. I think it would be impossible! In addition to simply being restricted, and restrained by hobbles, how many dogs are going to cooperate in the rehab exercises? The therapist said that she does get an "you want me to do WHAT?" response many times from pet owners. If Jinx does not return to disaster work, she will have the training to be a movie dog when we are done, I think! For example, she has to do bending/flexing exercises where she brings her head to her shoulder from both a standing and laying position. In the laying position, she has to be flat on her side and keep the shoulder on the floor when her head flexes. Therefore, I taught her a "lay" command, which is essentially your typical "dead dog" thing, where the dog lays in its side, with the head flat on the floor. Then the therapist said she should learn to sit up and balance on her rear quarters and ultimately "wave" to exercise the bad shoulder. Well, we aren't at the wave stage yet but have added "sit pretty' to our reportoire. She has to balance like a wheelbarrow, with me holding both her back legs in the air as she puts weight on the front. I make trails of dog food through the house, and she sight-tracks her meals because it forces her to move each front leg independently. In fact, I am thinking that tracking is something she can do without putting undue pressure on the shoulder and may give us something to work toward as she continues her rehabilitation.

Jinx is an exceptional dog and I think that requires me to give exceptional effort on her behalf.