Cookie - Hydrotherapy / Physiotherapy

Cookie :


- Physiotherapy

- Crossbreed

- Eight years and eight months

- Female




Problem


Cookie presented with a sudden onset of right forelimb lameness. After a visit to our orthopaedic vet and a CT scan, she was diagnosed with right carpus (wrist) chronic ulnaris lateralis tendinopathy. Tendinopathy refers to the breakdown or swelling of collagen in a tendon, which can cause a burning pain, in addition to reduced flexibility and range of motion of the joint it is associated with. The ulnaris lateralis is a forelimb muscle, its action being extension of the carpal joint.



Treatment


When first seeing Cookie for physiotherapy she had improved with medication but was suffering with right forelimb carpal and shoulder stiffness. She had muscle soreness over her elbow and shoulder muscles. She was also leaning onto left forelimb to offset the weight off her painful wrist, so there was some mild overdevelopment on the left limb and associated tightness in these elbow muscles also.


To treat these issues Cookie underwent weekly hydrotherapy to improve the strength in her forelimbs, aiming to relieve the strain from her painful wrist by strengthening the surrounding structures and the ulnaris lateralis itself. We also massaged areas of tight muscle to relieve tension and reduce pain, performed gentle stretching and specific exercises to continue to improve her range of motion and function of the right forelimb. Cookie’s owners were given similar physio exercises to do at home also, to continue her rehabilitation in between sessions.


These main exercises were:


- Give paw: engaging Cookie’s elbow and wrist to improve strength and range of motion


- Massage to the right shoulder and the left elbow


- Baited neck stretches: using a treat to move her head left to right to stretch these tight muscles



When Cookie began to improve we made the exercises harder:


- Sit to lie down and sitting again: a doggy version of a push up to increase strength


- Wobble cushion work: a great way to improve core strength and balance


- Pole work: aiming to increase stride length to strengthen forelimbs


Throughout this, Cookie’s owners were slowly increasing her walks by five minutes each week. This was done to not overload her sore wrist too quickly, slowly increasing her fitness to avoid re-injury.



Outcome


Despite some intermittent flare ups where she required rest, Cookie became much more comfortable after four weeks. She is now no longer lame on the right forelimb and enjoys shorter but more frequent walks to avoid re-injury. Cookie’s owners have chosen to continue bringing her for hydrotherapy one to two times a month for maintenance sessions to keep her strong and fit.