Multi-focal lumbar spondylosis, bilateral hip dysplasia and osteoarthritis
Bonnie had a 1-year history of ‘slowing down’ and reluctance to exercise with signs of discomfort when walking or being stroked. Radiographs in 2022 revealed multi-focal lumbar spondylosis and bilateral hip dysplasia with osteoarthritis. This was managed by Meloxicam and Pardale-V which was prescribed by Bonnie’s referring Vets. Bonnie was referred to the pain clinic for conservative management.
On initial assessment, Bonnie had a Body condition score of 9/9 she had a stilted hind limb gait with a kyphotic posture. Bonnie would guard hip extension and elected a pain response with lumbar spinal palpation. Fasciculation was present throughout palpation of her epaxial muscles. Bonnie displayed signs of allodynia with light touch to her lumbar spine. A neurological examination was unremarkable. The client reported that Bonnie had vomited after taking meloxicam.
The aim for pain clinic for Bonnie was to improve pain management to allow Bonnie a rehabilitation window for soft tissue and myofascial release alongside weight management and a home exercise programme to develop her strength and exercise tolerance.
From the assessment, a problem list, patient centred goals and treatment plan was created.
On initial assessment, Bonnie had a Body condition score of 9/9 she had a stilted hind limb gait with a kyphotic posture. Bonnie would guard hip extension and elected a pain response with lumbar spinal palpation. Fasciculation was present throughout palpation of her epaxial muscles. Bonnie displayed signs of allodynia with light touch to her lumbar spine. A neurological examination was unremarkable. The client reported that Bonnie had vomited after taking meloxicam.
The aim for pain clinic for Bonnie was to improve pain management to allow Bonnie a rehabilitation window for soft tissue and myofascial release alongside weight management and a home exercise programme to develop her strength and exercise tolerance.
From the assessment, a problem list, patient centred goals and treatment plan was created.
Problem list
- Overweight
- Reduced exercise tolerance
- Reluctance to jump
- Allodynia to touch of thoracic and lumbar spine
Goals
- Weight loss of 5% body weight per month (current weight is 10.55kg)
- To tolerate light touch of lumbar spine with no pain response twitching 1 month
- Return to 1.5-2mile daily walks within 3 months
Treatment Plan
- Pain medication - Pardale-V increase frequency to every 8 hours, start Galliprant once daily.
- Advice and education were given on weight loss,
The owner was signposted to the Canine Arthritis Management website. - Bonnie was set a home exercise programme
- Bonnie is to have regular physio appointments to address the soft tissue and myofascial tightness throughout her thoracic and lumbar spine
- Bonnie is having a course of acupuncture for myofascial release and pain control
Outcome
Bonnie responded well to physiotherapy, the owner reported that after every treatment session Bonnie acted like a puppy, with more energy and wanting to play with her toys. Initially Bonnie was anxious about having acupuncture but by the 3rd treatment, she would relax with needles in place for 20 minutes. Bonnie is continuing to lose weight; she has returned to 2-mile walks with some off-lead time. The owner reports that Bonnie has become more social and now does not hide when visitors come to the house.
Outcome
Bonnie responded well to physiotherapy, the owner reported that after every treatment session Bonnie acted like a puppy, with more energy and wanting to play with her toys. Initially Bonnie was anxious about having acupuncture but by the 3rd treatment, she would relax with needles in place for 20 minutes. Bonnie is continuing to lose weight; she has returned to 2-mile walks with some off-lead time. The owner reports that Bonnie has become more social and now does not hide when visitors come to the house.