Written by: Kira Ellsasser, Michigan State University College of Veterinary Medicine Class of 2019
Patient: Cassie
Signalment: 10 yr old female, spayed Schipperke
Clinical Problems: Cassie initially presented to Pawsitive Steps Rehabilitation Center for severe hind limb lameness that had worsened over the past ten months. She was fitted with a hind limb orthotic to provide stability. She returned today to have othrotics fit for both of her carpal joints.
Rehabilitation Goals:
- Strengthen hip, thigh, shoulder, and core muscles
- Improve her quality of life
- Ensure proper fit for orthotic devices
Modalities:
- Laser therapy
- PEMF bed
Assessment: Cassie is likely afflicted by Immune Mediated Polyarthritis. This is a condition in which the immune system “attacks” the joints in the body leading to discomfort, decreased mobility, and degradation of the joints. Cassie had already been fitted with an orthotic to stabilize the laxity in her right tarsal (ankle) joint. She returned to address the instability in both carpal (wrist) joints. The laxity in her carpal joints was causing hyperextension leading to an irregular stance causing her to walk differently. The change in her gait was causing her to over work certain muscles and put more strain on her joints. Our hope is that with new, supportive orthotics, we can return Cassie to a happy, pain-free, mobile life!
Plan: We measured both of Cassie’s carpal joints for custom orthotic supports made through OrthoPets. Once they arrived, we fit Cassie with her new support orthotics. The goals of the initial orthotic fitting is to make sure each orthotic comfortably fits properly. Cassie will spend the next few weeks acclimating to her new carpal supports with increasing time spent in the orthotics. The process is slow to ensure a safe transition into the device. Over the next few weeks, Cassie will come back for further evaluation to ensure correct placement of the device and proper usage. We’ll work with Cassie to teach her how to correctly place her orthotics in a proper gait. She’ll acclimate to the weight of the boot as we work her through a series of controlled exercises. Our first goal is to ensure she can comfortably stand on her own then we will progress to taking steps. We look forward to watching Cassie progress and return to her daily activities!
Take home exercises:
- Down to Sit
- Standing
- Weight shifting while standing