On 5th July 2016 Matteo presented at our rehabilitation facility with a diagnosis of cervical vertebral instability (CVI) also known as cervical spondylomyelopathy or cervical vertebral malformation. In layman’s terms Matteo was diagnosed as a Wobbler 6, months prior to our assessment. Matteo is a 64 kg BoerBoel and was 2 years and 2 months old in July 2016. He was referred to Animal Health and Hydro by Dr. Sara Boyd of Johannesburg Specialist Veterinary Centre (JSVC). Over the period of therapy we have also worked closely with Matteo’s regular veterinarian Dr. Brian Romberg of Orange Grove Veterinary Hospital in Johannesburg. Matteo had undergone an MRI scan which revealed some disc protrusion at C2/C3 and a bulbous facet joint at C5/C6. Matteo’s guardian, a medical doctor, was against surgery.
Upon presentation Matteo was very nervous and unsettled. He sat down rather than remain standing. When asked to stay standing it was difficult for him to maintain the position and he sank down into a crouched position and held that pose. His hind limb stance was very wide-based in order to provide the stability he lacked as a result of his neurological deficits. He had been put on a weight loss diet Hills Metabolic and also medicated with cortisone. Matteo responded positively to both. Matteo showed no evidence of pain but he was mildly ataxic in all 4 limbs with slight knuckling of the left forelimb. Twice weekly underwater treadmill (UWTM) sessions were advised in order to focus on improving coordination and facilitating weight loss.
Therein lay our next challenge! Matteo was too frightened to walk into the UWTM and he was too large to carry into the machine! Everytime he was asked to perform an exercise with which he was uncomfortable or uncertain he simply lay down and refused to move. Fortunately an animal behaviourist and trainer had been working with Matteo and she was present at all of his sessions. With patience, diligence, praise and reward Matteo was coaxed into the UWTM. His reticence and quiet nature were considered and he was only taken to a point with which he was comfortable. Every session we were able to coax him a little closer to our goal. The AHAH team also challenged him at each session to perform physical activities which enhanced his balance and proprioception. These exercises included individual leg lifts, cavalettis, weave poles and walking on different surfaces. There was homework to be performed during which we made use of Tellington Touch wraps to further enhance his sensory awareness.
Over the ensuing months Matteo progressed very well. All veterinarians and specialists involved were pleased with his progress. He was weaned off his medication. Neurological evaluations improved each time Matteo was assessed (approximately every 8 weeks) by the veterinarians at AHAH.
In December 2016 Matteo began to show discomfort on his left rear limb. He was short striding on that limb and lifting it up when standing. The discomfort resolved with the use of NSAIDs. In March 2017 Matteo began to lean to the right in the UWTM and again show discomfort on the left rear leg. The symptoms were completely different to the original clinical signs. Matteo was rested and after 2 weeks returned to AHAH. His thigh circumferences showed a difference of 2.3 centimetres with the left being less. Matteo was examined by both his general practitioner and JSVC and cranial cruciate ligament disease was suspected. No surgery was done. It was decided to continue with land based therapy as the diagnosis was not certain.
Matteo still has therapy sessions at AHAH once a week, at the request of his guardian, as it is a great outing for him and he enjoys the time with us a great deal. His thigh circumferences have equalised and his neurological status is stable. He is able to ‘plank’ with forelimbs on a BOSU and hind limbs on another. This is a difficult exercise which requires strength in all four limbs, core strength and body awareness. Quite an achievement for a giant breed dog with Wobblers!
It has been wonderful to work with a dog that has presented our team members with so many challenges. It has also been rewarding to engage with veterinary colleagues and specialists whose primary goal is the same – the best outcome, specific and individualised for our canine patient. The dedication and diligence of his trainer and his guardian have been integral to the success of Matteo’s program. Our humble thanks to each one of you.