Only Time Will Tell...

I don't know what it is about the cart, but Cassi will not use it.  She will get excited to see someone and MAY walk over to them, but she will usually wait for somebody to walk by so she can greet them.  I have tried taking her to our little shopping center to visit and she isn't excited enough to move about.  I have actually given up trying anymore with the cart because she trembles when I even put my hands on it to load her up.  She is a stubborn girl...which hasn't necessarily been a bad thing...I think?  She is stubborn to the point of trying real hard to prove to us that she doesn't NEED the cart.  Even though I am with her every day, I still see improvement EVERY DAY.

The picture at the above right is just before this video on our walk day before yesterday.  Since Cassi refuses to move when we place her in the cart, I have decided to just start walking her around the block without it. This is part 1 of 2 and on this walk, I started with the uphill. When we start out, Cassi is pulling on the leash, almost in a run...excited to be out! I have to keep the leash taut to slow her down, other wise she does this "bunny-hop" gait...it's cute, but not preferred.  She still shows some curve, or scoliosis, to her spine but I can feel the muscles on the surgery side (left) developing some strength from where they were atrophied. 

The picture at the left shows where Cassi's hair (not fur, as my wife constantly reminds me) has grown back darker over the scar tissue...sort of a deep red.  We were told that the hair might not even grow back because of the sharpness of the surgical shaving blade.  Now, she has her own little reminder "tattoo".  Anyway, here is part 2 of or walk on 4/19.  Notice she is straightening out more and more?

Another thing she has been slowly relearning is the "scratch with the back feet" process...she has come a long way with this. I didn't get video of her first attempts, but she would just move her foot without contacting her face. I would scratch her face, which kept her foot moving. Eventually, as you see, she got the two together. :^)

I have made another accomodation for Miss Cassi...a "Handicap Ramp" of sorts.  Initially, I bought the lumber to make a wider ramp to let her come and go through the open back door with the cart, but since she won't use the cart, I made a ramp for the doggie door.  She has no problem going up one step, but the doggie door created a second "step" for her, which she wasn't willing to do.   She would just sit at the back door and "arf"..."arf arf"...for us to let her in. Prior to the ramp, I had cinder blocks placed as a "step".  Oh yeah, finally found a good place for the sigh Sandi and Sharon gave us when we first got the pups...Thanks!

Another few videos and I am done here for now...Part 1 of our walk on 4/20. 

This day, we started in the downhill direction.  I think this is the way to go, because the leash will pull more to the left side to straighten her out.  In part 2, she is not so energetic after completing the block...but it doesn't take long for her to get it back!  Later in the evening, she taunts her brother, Orion into chasing her by stealing his toy.  No lack of energy here!

For Juli, Amanda and Dr. Cheri, if you read here PLEASE leave me comments as to your thoughts on Cassi's progress without the cart.  Will she eventually get "straightened out" and get her strength back on our walks?  We have also started back to the dog park with great success so far...but only the small MHS dog park...no big doggies.  Also, is there any sort of dog "back brace"?

Thanks for checking in!

A little bit of progress with Cassi and the cart...

Working daily with Miss Cassi and the cart is beginning to pay off a little bit.  I try to think of things that will get her excited, like meeting up with other doggies or visiting the dog park (see photo at right) but I am running out of ideas.  She doesn't get excited for treats she normally would get excited about when she's in the cart, so that isn't an option.  The one thing that gets her excited...is people.  NEW people.  I call her our "Little Ambassador" because she is always wanting to meet people...no matter which side of the street they are on.  She'll see someone across the street and her tail will start wagging...and she will start pulling that direction!  Of course, both of them together are easy to handle (at least for me) because of their size.  She can't pull me into the street and she knows we have a rule about staying on the sidewalk.

In the last entry, I posted a link to a video of Cassi "walking" around the block.  Here's a link to the second part of video from that day showing us rounding the corner at the top of the hill and starting downhill.  She is scooting right along!  You may have seen this cross-posted on FaceBook if you are there also.  Here's another video from our progress a few days later in the back yard.  In this video, she decided to "poop" right after...or while...I was putting her in the cart.  Don't worry, I don't show it...only praise her for another accomplishment.

This leads to last night's video..."This just in...Cassi running!"  If you read the blurb associated with this video on the YouTube page, you might agree with me that Orion is probably the best "physical therapist" that Cassi has! (No offense, Juli :^})  When she "roughhouses" with her brother, I see three things I think are beneficial;  Her head is up which straightens out her back from the "up" curve; when she lunges at her brother both her legs are pumping from a "sit" position which, coupled with her head up, keeps her from "cheating" when standing; and lastly, when she does stand still coaxing her brother, she has great balance!  Yes, she does "fold" a bit when she gets tired, but I can see and feel the muscles on her spine strengthening.  Now, if she would just take to the cart...to get her straightened AND strengthened.

Here's the last link to a video from today showing even more pogress with the cart!  Read the blurb there for more details on our walk today.  Any suggestions on getting her moving would be extremely appreciated!  Thanks for checking in!

Moving ahead...

As you may or may not know, we have purchased and received a cart, or "wheelchair", for Miss Cassi based on the recommendation by the physical therapist at Animal Care Center in Rohnert Park, Juli Dell'Era which, at the time, seemed like a solid recommendation.  This was about 4 weeks ago and today it still seems like a solid recommendation except for one thing...Miss Cassi doesn't want to move when we put her in the cart!  

Yes, she did move when we first placed her in the cart at the ACC, but I fear that she was only trying to use them to high-tail it out the front door, figuring I would leave the scary torture device (her words) behind.  But that was not the case...it rode home with us.

And she did so well in the cart at the ACC.  It looked like we would have no problem getting her to go outside for "walkies", as she hadn't done this about 4 months and everytime we even mentioned going for a walk, she would perk up like she used to before the incident.

Something...and I am not sure what...made her think of this cart as a "punishment" rather than a good thing.  She did bump the doorjamb a couple times at the fitting, but she walked down the hall and out the door after that...even wagging her tail a bit when we praised her.  But she just flat-out won't budge now that we are home.  I am guessing she figures she can walk, or at least get around, better without the aid of the cart.

What do you think? This is a link to a video I took the other day while folowing the recommendation from Leslie at Eddie's Wheels, the fabricator of the cart.  She suggested taking Cassi out for a walk and, when she gets tired, offer her the cart as a benefit...that didn't work.  She is a stubborn little girl!  She did the same "laydown" thing she has been doing.  So I removed the cart and let her walk the rest of the way home. 

Ok, time for "tough love"...another suggestion was to place her in the cart and put her in the yard...and leave her there.  The photo at the left is the result of that...she did lay down, again, and when I came close to pick her up to bring her in the house she stood up...like I was going to take her out of the cart again...but I fooled her...I only picked her up and moved her inside...she hadn't won this round...

Once I got her inside, she did the same...stood frozen with a forlorn look on her little doggie face (see pic on the left...again)...but I wasn't budging this time.  She was going to take a few steps before I removed her from the cart this time.

I found one of our extendo-leashes and attached it to her collar...then I backed away from her the 16 feet the lead allowed...and sat down.  Calling her in my best "girlie voice", I told her that "daddy loves her and wants her to walk to him so he can take the cart off..." and gave a slight tug on the lead...she walked, with all four feet (and the cart...remember?) right over to me!  I backed off again after I turned her around...called her again...and she repeated the behavior!  Now, being the good daddy and honest person I am, I removed the cart after praising her highly for what she had accomplished!  A few steps!  It is better than NO STEPS, no?  We are trying again this evening...

More later...and sorry about the double FB posts with the videos...minor hiccup...

Happy St. Patrick's Day!

Just passed three months...

Actually, three months to the day on Monday (2/15), Cassi was fitted for a cart...a doggie "wheelchair" so to speak.  But let me back up a little to our last physical therapy appointment...

We had a follow-up appointment with Juli, the canine physical therapist at Animal Care Center in Rohnert Park on Thursday the 11th.  Juli was checking out Cassi, determining what progress she had made in the two weeks since our last visit and, I guess, she thought Cassi was making excellent strides (so to speak).  After about 5 minutes of checking Cassi out, Juli says "so these are my thoughts for her...and I always wait a while before I make this recommendation, but I am going to recommend, and don't be alarmed when I say this, but I'm going to recommend you consider getting a cart for her..."

She continued..."not as a permanent solution but as a rehab tool for her...".  OK, I must admit, at first this took me by surprise...because Cassi was (is) virtually walking...she beats her brother running down the path outside in our backyard...she is fast!  The exercises seem to be doing her a lot of good and I do see improvement daily...so why go to further expense?  Took me only a moment, but then I though about it further...see, as strong as her legs are getting, she does still have a curvature to her spine, or scoliosis.  The muscles on the surgery side (left) have atrophied so she favors the right side, mostly when she's tired.   On the visit with Juli prior to this, Juli ended the session by saying that "Cassi might be ready for the underwater treadmill next time...".  She mentioned that we could do a regimen of 8-10 weeks of the UTM, which would only be once a week, or we could achieve similar results with a cart as a DAILY physical therapy tool.   To me this was a no brainer, especially adding up the cost of the 8-10 weeks of sessions and comparing it to the $375.00 cost of the cart...

To the left you see the style cart we have ordered.  Juli recommended a company called EDDIE'S WHEELS because she believes they make the best, custom fit carts.  You can find lots of other companies, but their carts are adjustible and don't appear to be as stable as Eddie's.  I asked fellow blogger, Nicole, at http://www.alec-story.blogspot.com/ if she would second this recommendation, even though she had had problems with Eddie's customer service (which you would know if you have read her heart-wrenching story of love and devotion to her best friend, Alec...(if not, click the link above and read it!)) and Nicole agreed...Eddie's is best.  Fortunately, Cassi's needs a "standard" cart...because these things can get expensive!  You should checkout the Eddie's Wheels site by clicking the link above and see all the great stuff the do for our best friends!  They even have a Facebook page that shows current "patients" posting their "firsts", which I am sure I will be doing with Cassi's.  We have to wait 3 weeks (from 2/16) before the cart arrives.   Then I have to wait for an appointment for "fitting" with Juli and the very nice, LOCAL rep from Eddie's, Amanda Jacobs...testing my patience AGAIN, waiting to get Cassi moving!  In the meantime, it's sticking with the daily exercise routine that's made her stronger to this point and will be key until the cart arrives...and after.

Cassi chillin' in the backyard...

Orion doing the same...after it finally stopped raining!

Counting our blessings...and eating humble pie...

Ok, ok...so I must eat humble pie...

In the last entry,  I lamented on my "impatience" with the progress Cassi is making and was kindly reminded to go back to the day we received the diagnosis for Cassi's IVDD.  I have to remind myself that we were told that we might not see ANY movement out of her rear end for 6 MONTHS after the surgery.  6 MONTHS!   Right out of surgery, Dr. Cheri had mentioned she was not too encouraged since the surgery had not restored, at least, a trace of "deep pain response".  There was nothing.

And now, let me tell you about the server of the "humble pie"...Nicole...

Juli, the physical therapist at Animal Care Center in Rohnert Park, mentioned on our first visit that I might find information and insipration in the blog of a young woman that has a dog with this same spinal injury.  The blog is at http://www.alec-story.blogspot.com/ and is the story, much like mine, from the start of the incident with her perecious Alec.  Remember I said that intervertebral disc disease was most common in short-legged, long-bodies breeds...well, it is possible in larger dogs also.  Nicole's boy, Alec, is a 67 pound German Shepard.  If you read this latest entry in Nicole's blog, it will pretty much catch you up on her story, which is an incredible journey of love, patience and devotion to this wonderful animal that has touched my heart immensely.  And in that latest entry, yes...I am the impatient one she writes about...hence the "humble pie"...

Nicole is one of those that didn't see ANY movement for the first 6 months following, not one, but TWO surgeries!  I am not going to re-tell her story here, you really need to read it for yourself.  Suffice it to say, we are extremely lucky that Cassi is making the progress that she is so rapidly.  There is no set time for recovery from this and each dog progresses at their own pace, some not at all. I envy Nicole for her strength to deal with this, not only spiritually but also literally.  It seems ironic to me that she is dealing with this injury in her 67 pound dog at small her size and I get a 17 pound patient...but love has no boundries...

I am counting our blessings that she is recovering so rapidly.  I believe my impatience might stem from her making such a rapid recovery...I just want to do everything I can for this little girl and sometimes feel I am not doing enough. She is getting stronger...and so am I. 

Thank you, Nicole...

PS- Our third PT appointment is tomorrow (02/11/10)...stay tuned for an update and more pictures and video!

Patience, Matt...Patience...

Patience is not one of my stronger virtues...not at all...I want Cassi to walk NOW!  Poof!  Magically or divinely, I don't care.  I just want things back to normal...NOW!  Sadly, this is not going to happen real soon.  It takes a lot of PATIENCE and hard work to get her back to her pre-injury condition.  She will get there...just not "tomorrow".


We had our second physical therapy appointment at Animal Care Center in Rohnert Park with Juli Dell'Era and, while Juli saw some improvement, we are not moving as rapidly as I would like to believe.  Cassi and I do her exercises 1 to 3 times a day (as much as she can handle) and I, too, noticed improvement in the 2 weeks passed since her last PT appointment.  Juli says the last thing to come back is the proprioception I mentioned in the last entry.  She has conscious proprioception, meaning she is aware of her rear end only when I stimulate the knuckled foot by pinching the pads causing her to return the foot to normal position.  Apparently, the last thing to return is the unconscious proprioception, where she turns her foot back immediately (or shortly after knuckling) on her own...with no stimulation.  This makes total sense.

Although we are seeing Cassi "walking" a bit better each day, she still is favoring the front end.  Her front "arms" are so strong, she holds on like a little monkey when I carry her.  She does, still, have a tendancy to "inch-worm" or arch her back when she shifts to the front and Juli says we need to develop her abdominal muscles.  In addition to the arching, she also curves to the right, favoring those muscles due to the rupture affecting her left side.  Juli has added a few more exercises to help with this.

Since removal of the diapers, Cassi has slipped backwards a bit on the potty training.  She was holding everything in until I took the diaper off in the morning, but now we have had a couple "accidents" in the middle of the night.  Dr. Cheri at PESCM thought the diapers might be contributing to the bladder infections she keeps experiencing.  At least the last two tests (at $152 a pop!) have come back negative, so I think we are past that.  I only revert to the diaper if she doesn't "potty" before bed time.   Then I check it when I get up during the night (many times...for some reason...). 

All in all, progress has slowed a bit.  Yes, we are still seeing something different every day, like her scratching her face with her hind legs or chasing her own tail...things she hasn't done for awhile and we usually take for granted...but she is still walking like a "drunkin' sailor" when she gets lazy.  When she's "alerted", she walks straight and places her feet properly, but when she doesn't pay attention, she "leans" and "knuckles".

I just keep working with her daily...patiently...

Thanks for checking in!

Noun: Proprioception...

1. "The ability to sense the position and location and orientation and movement of the body and its parts..."

This is the technical name for what Cassi is lacking at this point.  Cassi has no ability to sense the position and location and orientation and movement of her rear end...and she walks like a drunken sailor on shore-leave.  The term is actually called "drunk-walking".  Good news is, she is already responding to the new exercises that I learned on our first physical therapy visit this past Wednesday.

Last Wednesday, we visited Animal Care Center and saw Juli Dell'Era, RVT, CCRP for about 1-1/4 hours and Cassi and I learned a lot!  I was able to video the session so I didn't have to take notes and could concentrate on learning the exercises to help Cassi.  Juli was very patient at answering all my questions, most of which had to do with stuff I had been trying with Cassi.  But a lot of the things I wanted to try need to wait...right now, we neet to work on her "ability to sense the position and location and orientation and movement of the body and its parts"...

At least twice a day (and always as much as I can push her to do), we do a short workout routine that Juli showed us.  The tools are the harness you see in the picture above, a couple rolled up towels (taped around) and a book I have covered with a non-slip material.  A carpeted floor is also required.  The harness if so I don't hold Cassi down in the rear by her tail...BAD DADDY!  (Disregard previous videos...)

After we put the harness on and get her legs (front and rear) planted firmly in a Lhasa stance, the idea is to shift her weight towards the rear and keep her from shifting it all to the front legs.  It is easy to see when she does this shift forward because she drops her head and "inch-worms" her back.  Until I saw Juli, I thought (incorrectly) that this was good...she was strengthening her front end...right?  WRONG!  She was putting un-Lhasa like pressure on the front end...and possibly doing other damage!  Harness on...CHECK!

While in the standing position, I use the 2 towels between her rear legs for a "half-squat" exercise...basically a sit, but not all the way down.  Juli feels Cassi needs to work up to standing from a full (on the ground) sit.  Eventually I will remove one towel so she will sit closer to the ground...and eventually no towels.  While she is in the sitting position, I rub and massage her back end, legs and feet all while I have her maintain the "squat".  After a few minutes, I then ask her to "stand".  She will slowly rise on her own, but sometimes needs engouragement from me with a little "tickle" to her rear-end. (VIDEO LINK)

When she stands and is in an aligned position, I start a "range of motion" exercise. Holding her leg just above the ankle, I start a "bicycle" motion, circling her leg forward and placing it on the ground...then sliding the foot along the carpet for "tactile" feeling in the foot...and continuing in the bicycle motion for 15 reps.  Then I move to the other foot and repeat another 15 reps.  The hard part is keeping her head up because she "cheats" by leaning downward in front, which takes the weight off the rear.  I have to stop and correct her.  I grab Diane for this whenever she's available because it's easier with two people...but I can do it with one.

After the "bicycle" exercise, we do another 1/2 squat.  After she stands from that part, we test her "orientation" sense by, first, having her stand correctly...then, I take her paw on the rear and "knuckle" it so she is standing on the top of her foot.  I then press on the pad of her foot and see how long it takes her to correct it to the proper position.  When she does the correction, she gets the high-pitched "good girl"  "good Cassi" from me and I praise her and rub her foot in the corrected position.  She is getting pretty good at this game, turning her foot before I get to pressing the pad...which is a good thing!

After repeating this 3-4 times per foot, I have her go to the "half-squat" once more and massage and rub her legs once more to make her feel it.  And once again she stands.  Done with the towels.  Onto the book...

As you will see on the VIDEO, Cassi doesn't like this one very much.  She constantly adjusts her front feet to "cheat" on me...but as you'll see, I am persistent, replacing her feet and raising her head when she tries.  The idea of this is to, again, get her weight to shift and give her a sense of where she is at.

Towards the end of the exercise session, the doorbell rings and she runs from the livingroom. When I came back to the bedroom, she had beat her brother back! But I must heed Juli's warning...QUALITY OVER QUANTITY! It' s like trying to hold a 2 year old back from the cookie jar. (VIDEO LINK)

Another recommendation was that we elevate Cassi's food and water bowls.  This also makes her keep her head up and her weight shifted to the stern.   We also decided to get a new bed for the pups to fit the corner where they sleep instead of bunching both beds into the corner.  There is another story around the bed that I won't go into now.  Suffice it to say, they love it...now.

And, with no more diapers...no more urinary tract infection!  Got the call today that she is clear!  But continue the course of antibiotics...of course...

Thanks for checking in...