Maverick the paralyzed puppy had entered my life and it was time to get to work. I needed a baseline so I decided to do the one thing I could think of to check how contracted his muscles were. I grabbed a goniometer to measure his range of motion. In hindsight this may have been a bad idea. Talk about depressing. For example, the normal range of motion for flexion (bending) of a normal stifle is 41 degrees. Maverick’s range of motion (if you could call it that)? 22 degrees. Barely halfway. Ditto for his elbows. The angle for normal elbow flexion is 36 degrees. Maverick could only get to 90 degrees. Not even close! In human terms he had the equivalent of “frozen shoulder” and “frozen elbow”, but it was everywhere. The puppy was frozen! I started massaging and massaging and massaging. Then I added a little heat. He hated it! Tried to bite me, cried, moaned and groaned when I attempted to bend his joints. This wasn’t going well at all. I was absolutely exhausted as it was the end of a long day, so I carried the puppy outside to pee (which he wasn’t very good at), put his diaper back on, carried him to the car and drove home.
When we arrived Bryan examined the puppy and looked stricken. He clearly was reading my mind. So he said, “Um, hon, what if we can’t get him walking again?” and I replied, “Then we will be carrying him around the house for the next 14 years.” That quickly shut him up. I just wanted to cry. Maverick was worse than I could have possibly imagined. This was the disaster that could have been prevented had the owners gotten him to me in the week or two after he became paralyzed. What happened was that his bones continued to grow but he had absolutely no muscle to support them and ensure that everything grew in the right direction. His ligaments and tendons essentially stopped growing because he wasn’t bearing any weight on them, so his limbs looked shortened and were essentially twisted in every way but the right way. The ligaments and tendons pulled his front feet basically upside down and facing each other. The back feet were the same. Not only was there no way he could stand on any of them, even if you tried to hold him up all four feet were so twisted that he would be walking on upside down feet. Just a disaster. And my biggest fear was that as he continued to develop, without being able to stand and weight-bear, the bones would grow longer and the legs even more twisted because the ligaments would be pulling his joints in, compounding the shortening of his limbs. What a tragedy.
My anger grew and grew. This was so damn preventable! Had I seen him and done intensive therapy immediately he would have been walking and probably running by now. I would have put him in the pool and the treadmills with my team of experts to build muscle so that he never would have developed the contractures that were paralyzing him. Now, seven weeks later it was like trying to massage and stretch a steel rod. Linda had been so worried about the state of his legs that she had actually had her hospital take x-rays of every single part of his body. Her concern (understandably) was that he was congenitally deformed and that something else was going on. She couldn’t figure out why his legs were so twisted and strange looking. But palpating them I knew the bones were straight. It was the ligaments causing so much harm. I had only seen two cases of polyradiculoneuropathy and both of them resolved nicely with physical therapy but both dogs had been older and in perfect shape to begin with. Maverick was practically an embryo when this happened so he had nothing to work with. He had no strength, no stamina, no muscles and, for all intents and purposes, no hope.
I needed to see some experts. My own in-house expert, Medical Director Dr. Ettinger was as grim as I’ve ever seen him. He went over the puppy meticulously and finally turned to me and said, “Really interesting, but this dog is never going to walk.” Great. Go, team! Another in-house vet, Dr. Tsai went over Maverick, smiled and shook his head sadly. Wonderful!!! Dr. Son is a board-certified criticalist and my other in-house vet. She looked him over and said that she had no idea what it was but she didn’t think it was caused by a vaccine. She was highly suspicious it was something else but had no idea what….. So I called my favorite neurologist, Dr. Robles. She read his report and said that if all of this was recent I shouldn’t worry too much as it can take weeks for recovery. (Ok, too late for that now!) Then she said exactly what I suspected but didn’t want to hear: if he had already developed contractures 1. they may not be reversible, 2. they lead to orthopedic abnormalities in puppies (yup!) and 3. it might be a lost cause. She said she’d probably give it a few weeks and if I got no results that it wouldn’t be wrong to euthanize.
Awesome. Me and my big dumb offers to save a puppy. But at least all my vets thought it was a REALLY INTERESTING CASE!
If you’d like to contribute towards Maverick’s recovery please call the front desk at Two Hands Four Paws. Thanks!