Anis, a mongrel with paraparesis due to accident

SPECIES: Dog
BREED: Mongrel
GENDER: Female
AGE: 1 year
NAME: Anis

Clinical case
Hit by a motorcycle one month previously, resulting in a sudden onset of non-ambulatory paraparesis, the hind limbs are brought into an extended position under the abdomen.
Previously treated with traditional therapy (NSAIDs, antibiotics) with no evident improvement

Clinical examination

  • Inability to assume and maintain her stance
  • Severe non-ambulatory paraparesis with trailing hind limbs
  • Serious myotrophy to thigh and rump muscles
  • Bilaterally absent hind limbs proprioceptive positioning
  • Bilaterally absent hind limb flexor reflex, L1-L5 panniculus reflex absent, no response and sensitivity at L6-Cd level, weak L7-S1 response.
    Bilaterally present hind limb tenderness.
  • No tail movements, no sensitivity on tail tip pressure
  • Bladder and bowel incontinence
  • Presence of right hind limb trochanteric sore

TCVM (Traditional Chinese Veterinary Medicine) clinical exam

  • Sensorium status alert, fearful, anxious, nervous, unpredictable, bored animal, unable to stay calm and still for long, playful (constitution: fire)
  • State of the Shen: good
  • Ear: warm
  • Tongue: Moist pink/red
  • Heartbeat: slow-strong (weaker on the left)
  • Distal end of hind limbs: warm
  • Body temperature on palpation: hot
  • No desire to drink

TCVM diagnosis

  • Spinal cord Qi and blood stasis and kidney Qi and Yin deficiency

Treatment

  • Resolve Qi/blood stasis to return to proper Qi/blood flow, reduce pain and resolve paresis/paralysis
  • Tone Kidney Yin to nourish the intervertebral discs
  • Tone Kidney Qi to resolve paresis/paralysis

Laser puncture protocol

acupoints - protocol

Therapeutic protocol

  • Laser therapy with acupuncture for 6 months
  • Treatment frequency: 1x/week for 4 weeks then every 15 days for 8 times
  • Frequencies used: 584Hz, 1168 Hz, 292 Hz. 21 Acupoints, 8 sec/point, 1.5 J/cm2
  • Duration of treatments: 4 months (total 13 sessions)

Results
3rd therapy: 

  • able to stand on her hind legs
  • tries to walk 1-2 steps

5th therapy:

  • maintains its stance for eating and drinking
  • initial tail wagging 
  • urination control
  • wound healing with reduction of dimensions

7th therapy: 

  • walks independently on all 4 limbs, incoordination persists sometimes
  • Control of urination which is back to normal
  • Dry and small wound

8th therapy:

  • maintains stance, able to walk and run slowly on all 4 limbs, ataxia and incoordination persist
  • Hind limbs brought to correct position (not in flexion)
  • Further reduction in the size of the lesion which presents partial re-epithelialisation of the wound bed
  • Active and spontaneous tail wagging with the ability to lift the tail
  • Improved muscle tone

Courtesy of Dr Wita Wahyu Widyayandani, Semer Vet Clinic – Bali, Indonesia