12.31.15

Giving Physical Therapy a Second Shot

Posted in Uncategorized at 6:55 pm by eborzage

1. We all thought it would be helpful to have a few more attendee’s at Baloo’s second physical therapy session, both to for our information, and to get a sense of whether this particular therapist was a good fit for our pup, so I left work yesterday a bit early to join my mom and dad at the session.

After the first comments on my post, I thought it best to update with clarifications that we’ve since learned that the “physical therapist” is a DVM, CVA, CCRT, though with a background more focused in equine health. Our closest CRI alternative option to this provider would be in Davis, 90 minutes away.

I will say that I thought the vet/therapist was personable with us, but interestingly enough, Baloo was not drawn to him in the way that he often is with people who work with animals. I trust my dog, and found it telling that Baloo was basically indifferent to him. He LOVED assistant, so go figure!

The vet/therapist was perfectly kind, so that is not the issue. We first discussed long-term goals for Baloo.  He acknowledged that looking ahead to supporting his muscular and joint health as he ages would be reasonable, and that he would benefit less from exercises to for surgical recovery and pain at this point.  I appreciated his point that the underwater treadmill would build stamina, too, and felt positive about being proactive with PT. I know many folks encouraged us to give PT another try, and I’m on board with pursuing therapy. We do plan to pursue plenty of things at home, and are searching for other options locally, but the single current option is not inspiring – and bear with me, but here is a recent example of why:

During the hour visit the first forty-five minutes were primarily his description of exercises we could set up at home for him, and repeated information regarding supplements from the first visit. Had he demonstrated the exercises with Baloo or the products, the overall impact may have had value, but to describe PT is really not provide physical therapy. This was the exact same routine that took place during the first session, so I understand now why my mom left after the first session feeling Baloo didn’t get much value – and when it comes to our dogs, we will justify value in nearly anything.

I have done physical therapy with other dogs, and this feels slightly unprofessional. There were no session notes.  He did not know when Baloo had surgery, and did not ask until the session was done.  He has no idea we are in chemo, or that his last dose (#3) was the day prior to our visit. I could have overlooked the organization had there been any impressive aspect to the visit, but the experience was subpar.

With about 15 minutes left in the hour visit, I mentioned that our primary goal was to provide physical rehabilitation Baloo during these visits, so he rummaged through a closet and set up a course with cones and PVC barricades. I walked Baloo over it a couple of times, he watched for a few seconds, and then walked away. He was in the large room, but Baloo was not in his line of sight.  I had no idea whether the speed, or gait was right, whether he can, or should, go higher, etc. I had no idea when Baloo should stop. He literally did not watch Baloo do this exercise for more than about a couple hops.  He did come back, a few minutes later, to tell me that to intensify the routine, I could move the bars into a pattern (similar to an agility course). He moved a couple cones to create a more complicated pattern, and again, walked away. I had no idea whether to have him make a sharp zig-zag agility type pass through the pattern, or a sloping, gentle loop around the pattern, or how to pace it.

I realized he wouldn’t know how we should approach that course either, because he hadn’t watched Baloo move at all since our arrival.

As frustrating as the experience was, I was happy that we were finally DOING something physically therapeutic!! Making progress!  Being proactive!

After I determined Baloo was fatigued, and suggested that it was probably enough to the physical therapist/vet, who agreed, we moved him to the underwater treadmill.

Baloo did not want to go into the tank, and they needed some special rubber mat because the floor was too slippery for the dogs, and they didn’t have it nearby.  My job is to solve problems quickly, so rather than run around trying to deal with the slick floor, I picked Baloo up and put him half way into the tank, and that was enough to get him to walk forward the rest of the way, but it didn’t go very smoothly.  A food treat would have also gotten Baloo into the tank, but they didn’t have any handy in the rehab clinic, which was going to be a problem once that treadmill started moving – (labs will work for food, and that’s about it) so I sent my dad up to the main vet clinic for proper kibble motivation while the tank was filling.

For some reason Baloo was more anxious in the tank this time when it was filling.  Even with that scary tank filling with water, for a lab, there’s nothing a little petting and some treats can’t fix.

Baloo was moving pretty slowly in that tank initially, but he was pretty fatigued to start. When all else fails, bring out the bribes. The best scenario to move him through the water ended up being having me cheerlead him during the walking sessions (my high pitched “come when called” is down pat, and he can’t resist it), and concealing a treat in my hand.  He was so interested in getting near me to see what might be in my fist that he’d have fought through quicksand to get there.  Of course, I had to give the treat up a few times so he didn’t lose interest.

The treats were those big, hard, vet biscuits, and chewing slowed him down, so I tried to hold off on actually giving up the food as long as I could with him giving me those puppy eyes.  I wish you luck resisting that face!  He did two 4 minute sessions at 4mph, with a little rest in the middle.

So we did get about 15 minutes of actual physical therapy.

My previous end to this post was acceptance of our situation, but after comparing notes with my family, we were all very uncomfortable with the poor interaction between this DVM and Baloo. We were so thrilled with our care at UCD and the success of his surgery and the chemo to date that I would prefer we be as pleased with the PT. UCD does not make scheduling appointments for PT, which is tricky when chemo takes 3 hours and we’re driving 90 minutes to get there, but we’re going to try to add PT to his chemo days. He’ll have more infrequent visits as they coincide with treatment, but we’ll hopefully trust our caregiver, and find someone wonderful to work with!

Hoppiest of New Years in 2016 to you, your packs, and everyone in your life. We wish you all the very best!

Erin and Baloo

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