Case Summary: Bella, a 4-Year-Old Female French Bulldog
Case Background:
Bella, a four-year-old female French Bulldog, sustained a spinal cord compression due to a T13-L1 intervertebral disc extrusion (IVDE) and hemorrhage from T10-L2 on September 27, 2024. She underwent a left T13-L2 and right T10-T13 hemilaminectomy on the same day at a referral clinic. Bella was referred to us for an initial rehabilitation evaluation on November 4, 2024, which included assessments of gait and posture, functional mobility, manual palpation of muscles and joints, range of motion, strength, and neurologic function. She was off all medications at this time.
Rehabilitation Evaluation:
Bella exhibited multiple gait abnormalities, including ataxia in the hind limbs, weight shifting onto her forelimbs, a widened hind limb stance, and reliance on her forelimbs for propulsion. Functionally, she demonstrated difficulty transitioning from a seated to sternal position and from sternal to standing, which was attributed to her hind limb weakness. Manual assessment revealed muscle tension in the cervical epaxials and latissimus dorsi, likely due to compensatory mechanisms, decreased hind limb strength, limited spinal rotation to the left, and delayed conscious proprioception (CP) in the right hind limb.
Rehabilitation Goals:
The primary objectives of Bella’s rehabilitation included:
- Minimizing gait deviations
- Enhancing ease of postural transitions
- Reducing muscle tension
- Increasing strength in all limbs
- Improving spinal rotation to the left
- Enhancing conscious proprioception in the right hind limb
Treatment Plan:
Bella’s treatment plan incorporated laser therapy, acupuncture, manual therapy for flexibility and muscle tension reduction, therapeutic exercises, and a home exercise program for owner to do regularly to assist in Bella’s recovery process. Initial exercises focused on improving hind limb engagement, weight shifting, and transitional movements. As Bella gained stability, her regimen was progressively intensified to include more advanced exercises such as weight shifting on an unstable surface, sit-to-stand transitions, and three-legged stances. These exercises aimed to strengthen her limbs and improve core stability.
Acupuncture was added to not only help manage her pain but also support her nervous system by regulating pain signals, improving neuromodulation, and encouraging the natural healing process. It also helps relax the muscles around her spine, decreasing nerve pain/impingement, while also improving her range of motion and easing post-surgical stiffness. With this integrative approach- acupuncture with rehabilitation therapy – Bella regained mobility much faster than expected and returned to her playful, happy self.
Outcomes:
Bella demonstrated significant improvement in her gait, with reduced weight shifting onto the forelimbs, decreased ataxia, a normalized hind limb stance, and appropriate propulsion using her hind limbs. Additionally, she exhibited improved stifle flexion during gait, reduced muscular compensation (eliminating latissimus dorsi twitching), and enhanced strength (3/5 in all limbs). Spinal rotation became symmetrical. Although delayed CP persisted , it was mild in the right hind limb and was not affecting her normal daily activity.
From the owner:
“Prior to Bella doing rehab at Acupetvet, she was very unstable and weak in her back legs as a result of IVDD. Through a combination of laser therapy, acupuncture and progressing with at home rehabilitation, she is stronger than ever. She has not only gained strength, but has become more confident and is able to go on longer walks. Her quality of life has increased and we are so thankful to the entire staff at Acupetvet for their execution and expertise!”
Ongoing Management:
Bella continues to receive acupuncture twice monthly to help support her long-term health, mobility, and overall well-being. These sessions are aimed at improving nerve pathway function (CP deficit), reducing back tension and disc inflammation, and maintaining comfort as she ages, helping her stay as healthy as possible. She will also follow a structured home exercise program under the diligent care of her owners. She will continue refining her mobility in the coming months as part of her ongoing recovery.
Dr. Tasha Wilson is certified in veterinary acupuncture and rehab therapy. Lynn Low, PT, has her certification in rehab therapy.
