by Pete van Dongen, Drs(Utrecht), MRCVS, CertVR, CCRT, Clinical Director at Pennard Vets
Robbie was an 11 year old, male neutered, Tricolour Shetland Sheepdog (Sheltie), who had been coming to Pennard Vets, Sevenoaks, Kent, UK, for the last five years now. Robbie was a beautiful and lovely little dog, owned by a very caring owner, Miss Steel from Chislehurst, who, over the years, has proved to be the most dedicated carer for Robbie.
Robbie had, over the years, suffered from lots of different conditions, including intestinal allergies/ sensitivities, osteo-arthritis, paw injuries, bilateral shoulder injuries (mild MSI), dental disease, Cushing’s Disease, weight problems (partially due to his other problems!) and various benign skin tumours.
For the last year or two, he also suffered from various orthopaedic problems, in both his hind legs, but at slightly different times, mainly caused by a weakness / failure of the plantar ligament. This led to severe hyperextension at the tarso-metatarsal joint level. (see pictures below).
This was initially dealt with through orthopaedic operations (Calcaneoquartal arthrodesis) on both hind legs, performed by two different specialist orthopaedic surgeons, but eventually both of these failed, due to lack of boney healing (chronically delayed unions / malunions, see X-rays opposite) and chronic recurrent infections and possible implant reactions, mainly due to some of Robbie’s other conditions, including his hormonal imbalance caused by the Cushing’s Disease. In the end, therefore, the orthopaedic implants unfortunately had to be removed. Robbie then had to again deal with collapsing hind legs and he got subsequent skin lesions to deal with as well! He also had very weak muscles and tendons, again due to his Cushing’s Disease, which made walking ever more difficult.
For a long time, Robbie was on various medical treatments, including pain killers (NSAIDs and opioids), antibiotics and hormonal replacement therapy, and he had regular hydrotherapy (using an underwater treadmill) for his arthritis and muscle weakness and therapeutic (Class 4) K-LASER treatments for his recurrent skin lesions as well! The two latter treatments are not available everywhere, but at Pennard Vets, Sevenoaks, we have the most up-to-date modern complementary treatments available for all our patients.
Although all the combined treatments gave Robbie some respite, it felt he needed more help with his functional movement. Pete van Dongen, Clinical Director at Pennard Vets, and a certified canine rehabilitation therapist (‘CCRT’, one of only 13 in the country), suggested that Robbie had ‘orthotics’, or orthopaedic braces, fitted. These were made-to-measure, by OrthoPets UK. Robbie’s legs had to be photographed, measured, x-rayed and casted to ensure they were manufactured precisely to his measurements. After a few weeks, Robbie’s ‘new legs’ were complete! (see picture opposite).
Initially, when his orthotics were fitted, Robbie struggled to use them, as they didn’t bend where his natural legs would (they were nonarticulating at the tibio-tarsal joint), but he soon got used to using them. Within minutes he was walking around outside!
Pete designed a programme of ever increasing lengths of time for Robbie to use his ‘new legs’. The programme was designed to reduce the stress on his other joints, while further therapeutic exercises supported and developed his general muscle weakness. In no time at all Robbie was now walking well without causing any further damage to his legs or skin, and without any pain! He could even sit, lie down and get up again, and he seemed happy and content. He would wear the orthotics whenever he went out with his mum. Miss Steel even sent us a video of him running in the field and sniffing the flowers and grass, something he had not done for quite some time! He was clearly a ‘new dog’ with his new legs.
This interesting case highlights the many different treatment methods available to vets, their clients and their pets. Sophisticated specialist surgery, the use of many different modern drugs, the access to hydrotherapy, rehabilitation and physiotherapy, and therapeutic K-LASER treatment to name a but a few enabled little Robbie got to be ‘RoboDog’!
Unfortunately, a few weeks later Robbie became ill, due to an unrelated illness, and the difficult decision had to be made. Miss Steel kindly agreed for this article to be written after his death in the hope that it may help another dogs in the future. I would like to extend my gratitude and sincere condolences to her and her family. This is in memory of Robbie!
Here is Pete Van Dongen performing K Laser treatment on another of his patients. Unfortunately we were unable to get photos of Robbie’s treatment.