August 2017

Pet of the Month: 
Reggie McCarthy, 9 Year 4 Month Old WHWT

Reggie first came to the clinic in June of this year for rehabilitation following acute onset of progressive tetraparesis at the beginning of May. Radiographs were taken at this time that showed that Reggie suffered from spondylosis in his thoracolumbar spine. However on the 20th May 2017 his condition suddenly deteriorated, he became non-ambulatory and developed bilateral neurological deficits in the hindlimbs. He was referred to Langford Veterinary Service’s neurology department for further diagnostic work up and treatment. Reggie had extensive blood work, EMG evaluation, analysis of CSF and underwent a CT scan on Monday 22nd May. Test results of the EMG, CSF and blood work were consistent with an inflammatory/immune-mediated pathology and the diagnosis of polyradiculoneuritis was made.

At the time of presentation to the Smart Clinic Reggie was still non-ambulatory and remined mainly in lateral recumbency during the appointment.   He was able to support himself in a sitting position for 5-10 seconds and in sternal recumbency with head raised for approximately 1 minute. At home, Reggie had started to shuffle off his bed and was able to turn himself and roll over on his back.

At this first appointment Reggie was not very tolerant of handling, he would become quite agitated and hypersensitive to palpation making it difficult to perform a full clinical examination. We could however establish that with support he could maintain a standing position and that he did have voluntary but uncoordinated movement in all four limbs and voluntary movement of his tail to counter-balance.

Reggie was started on a rehabilitation programme aiming to restore a functional ambulatory gait pattern. We initialled focused on improving Reggie’s ability to support himself in sternal recumbency, sitting and standing positions and also prescribed home exercises aiming to stimulate the return of his neurological function in his limbs. In order to maximise the effects of treatment we started by seeing Reggie twice a week as a day patient.

As previously mentioned, Reggie was not the happiest about being handled following the onset of his clinic symptoms and initially he put up quite a fight through most of his daily visits with us. We had to quickly come up with new ways to approach Reggie’s treatment in order to maximise the benefits without causing undo stress and irritation. As such, we kept Reggie on bi-weekly treatment sessions, but altered his schedule to allow one day’s focus on physical examination and treatment progress, and two separate sessions aimed purely at supporting a functional gait pattern.

This coupled with the dedicated involvement of Reggie’s owners with his treatment, who were supporting our work at the clinic using a treadmill at home to encourage Reggie to walk as well as completing his daily exercises, saw Reggie making general improvements and steps towards functional mobility.

Following just over a month’s treatment with us at the clinic, Reggie took a break from treatment with us. Although this was not ideal, due to the difficulties faced with Reggie’s behaviour we were also hopeful that a break from veterinary handling may allow us to do more with him in the near future. His owners were provided with a list of exercises to assist in his progress and were to continue with his treadmill work at home.

When we saw Reggie back for his first treatment following this break, we couldn’t believe the difference. He walked in to the clinic with a wagging tail and happy face! He had made excellent progress and was fully ambulatory with no proprioceptive placement deficits. There was still work to do to rebuild muscle lost through his hind limbs but his mobility had markedly improved. Although still weary of a full ‘hands on’ examination he was generally much happier and brighter and we were all so pleased to see him doing so well! All in all a very speedy recovery! Well done Reggie!