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Treating IVDD with the Assisi Loop--Puppers' Spotlight

Jan 09, 2018

Liz.jpgMany clinicians have told us they value the Assisi Loop as a tool for managing neurological inflammatory conditions. We're pleased to share a case looking at the benefits of the Loop for IVDD as presented by Lis Conarton, LVT, VTS (Physical Rehabilitation), OC, CCRP, CVPP. Ms. Conarton is with CARE Pet Therapy at the Veterinary Medical Center of Central New York. Dr. Polly Fleckenstein was the supervising veterinarian on Puppers' case.

Puppers, an 11.5-year-old  cocker spaniel, began receiving physical rehabilitation at Veterinary Medical Center of NY under the care of Dr. Fleckenstein in 2013 for hind end paralysis after a hemi-laminectomy on his right side.

Puppers had presented to VMC's surgical team as deep pain negative (unaware of pain or sensation) and non-ambulatory in his hind end. After discussing the risks, Puppers' owner chose to pursue surgery in hopes that it would decrease the chance of Puppers developing long-term spinal pain.

puppers2.jpgFollowing hemi-laminectomy surgery, Puppers had fecal and urinary incontinence, weakness and reduced muscle tone in his hind end, and was still in deep pain negative with no withdrawal present. Medications were provided to aid in bladder control. Over the next two weeks, a decrease in pain medication was recommended.

Puppers spent three months in physical rehabilitation before his post-surgical recheck evaluation was scheduled. During the evaluation, it was determined that Puppers would remain paralyzed in his hind limbs. 

Puppers' owner decided to continue Physical Rehabilitation and Pain Management to maintain comfort throughout his life by returning for bi-monthly appointments for rehabilitation. Puppers rehab routine at the Medical Center of NY included laser therapy, massage/soft tissue mobilization, and underwater treadmill to aid in compensatory discomfort and maintain muscle mass in his hind limbs.

His owner was prepared to provide the necessities of good nursing care, including medications, supplements, and a home exercise program for the long term. Puppers was fitted for a wheel cart that allowed him and his owner to continue to enjoy daily walks together. Puppers loves to watch wildlife and play in his yard and was able to do so on his own with his wheels.

Puppers4.jpgEarly in 2017, Puppers developed cervical pain with signs of nerve irritation in his left forelimb. He was limping and elevating his left forelimb which is troubling for a dog with who is paralyzed in his hind limbs. His owner decided to pursue medical management as his appetite was unchanged (he loves his food!) and personality remained vibrant. Puppers' gabapentin dose was adjusted, tramadol was given regularly and an additional medication, methocarbamol was added.  NSAID therapy continued as needed. His home support plan included heat and cold therapy, massage, passive range of motion and supplements were continued (omega 3 fa's, duralactin).

Puppers' was able to improve on medications. However, he relapsed a short while after running in his cart while chasing animals in his yard. Amantadine was prescribed and he continued to return weekly to every other week for laser therapy, massage, and mobilization. 

Throughout the summer, Puppers' owner noticed behavioral changes. Puppers began panting often at night, as well as moving to reposition. There was no significant pattern and other disease processes were ruled out with tests which would cause painting, trembling, increased thirst and restlessness.

Puppers' owner wanted to do more for him as adding on additional pain medications have caused drowsiness continuing through the next day. She was concerned about his quality of life and how she could provide more comfort for him.

We discussed the Assisi Loop, a medical device we have often recommended for clients who have pets with osteoarthritis, nerve pain and neurologic conditions among many other issues and ailments. The Loop delivers targeted pulsed electromagnetic field therapy to accelerate anti-inflammatory processes. Puppers' owner was glad to have an additional tool for her home exercise and care plan that she could use daily. We chose to add the Loop to Puppers' multi-modal treatment plan.

puppers3.jpgThe Loop was used every 8 hours over the C4-C5 of his cervical area. Within two weeks, Puppers was sleeping through the night and, for the first time in four years since his surgery, laid on his side to rest. Puppers' owner was excited to share this information with us since this was the only recognizable change in his schedule over the past year. Puppers' owner was glad to have an easy to use device which provided comfort for her beloved boy. She feels it was the Assisi Loop that gave Puppers comfort and rest. 

During rehabilitation at CARE Pet Therapy, it was noted that a greater range of motion and improved comfort performing cervical mobilization was achieved compared to sessions from the two weeks before the Assisi Loop was integrated.

Puppers is currently under the primary care of Chittenango Animal Hospital and checks in with Dr. Fleckenstein as needed for pain management. Assisi Animal Health wishes Puppers the best in his rehab and continued therapy. 

Care Pet Therapy Logo.jpgCARE Pet Therapy (Complementary and Animal Rehabilitation Essentials) at Veterinary Medical Center of Central New York opened in July 2016 and is the premier rehabilitation facility in the Syracuse, New York area. The CARE addition was added to an existing specialty referral and 24-hour emergency practice where rehabilitation services were previously housed.

Their facilities include a hydrotherapy room with a resistance pool and two underwater treadmills, class 3 and 4 lasers, a land treadmill, a gym room for therapeutic exercises, and four exam rooms.

Polly Fleckenstein, DVM, MS, CVA, cVSMT, CAC, CVPP

Certified Veterinary Acupuncturist, Certified Veterinary Spinal Manipulation Therapist, Certified Animal Chiropractor, Certified Veterinary Pain Practitioner

Dr. Fleckenstein grew up in a family that spent much of their time out of doors, hiking, eating wild foods, and enjoying nature. Dr. Fleckenstein's mother is a licensed wildlife rehabilitator and their house was home to many orphaned or injured animals and birds over the years.  When she started working during high school summers she only considered work that took place outdoors, and so she worked on a beef cattle farm in Maine.  It was there that she became trained in artificial insemination of cattle.  She delayed starting college and worked on a farm in Switzerland, where she learned to her shock that women there had only just gained the vote, learned from a co-worker that "women's work" didn't involve driving a tractor (or so he thought), and that women "didn't become large animal veterinarians". 

Melissa (Lis) Conarton BS, LVT, VTS (Physical Rehabilitation)-OC, CCRP, CVPP (pictured at the beginning of this post) began her career in the field of Veterinary Medicine over a decade ago after receiving her bachelor degree from Ithaca College. She went on to receive her licensing in Veterinary Technology shortly after joining the Veterinary Medical Center of CNY team of qualified individuals. She is a founding member of the Academy of Physical Rehabilitation Veterinary Technicians (APRVT) and now holds the title of Veterinary Technician Specialty in Physical Rehabilitation through the Organizing Committee of the APRVT. She is also certified in Canine Rehabilitation through the University of Tennessee Certificate Program (CCRP) and certified through the International Veterinary Association of Pain Management as a Veterinary Pain Practitioner (CVPP). Because of her passion for helping companion animals and attaining additional certifications, Lis has become an influential voice for the care and comfort of companion animals in the Central New York area.

Lis has lectured at various professional veterinary conferences and routinely contributes to newspaper articles, journal submissions, and book chapters regarding physical rehab and pain management. 

Lis developed the Physical Rehabilitation Service at the Veterinary Medical Center of CNY. In 2010, she initiated the Pain Management Service helping to establish the Veterinary Medical Center of CNY as the leader in Pain Management and Physical Rehabilitation in the Central New York region. 

Category: Patient Stories

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