Falls

I am working on a recommendations list. Today I checked out the costs for acupuncture and listed on Craigslist my need for a swimming location. I have yet to take that stupid measurement.

Sierra fell down the bottom three steps yesterday and ended up with hind legs under the stairs and her front paws on the second step. She needed help to regain her footing and it was a bad way to start the day, but she doesn't seem to worried by her falls and slips. She now waits for me to help her down the steps at the end of the night for bedtime. I am trying to teach her to "stay" either upstairs or downstairs when I am running around the house with one last errand to do, rather than let her follow me. I think conserving her energy is going to be important in the coming summer months.

Daily DM

Sierra has been holding steady and has improved from her physical status at her original evaluation. I have been especially careful to protect her from the heat and over exhaustion. I have had to make some very hard decisions about leaving her home rather then taking her on longer walks or hot car rides- walks and car rides have been some of her favorite activities. However, the physical toll these activities take on her requires a day or more of recovery time. I worry that much like human MS, these stressors could send her into an exacerbation.

I continue to do exercises with her a few times a week. These exercises address range of motion, strength and endurance, sensory stimulation and balance.

ROM, strength and endurance- stabilize metatarsal and distal to the stifle, bring hind leg through anterior/posterior range of motion while dog stabilizes with contralateral HL. I feel a significant amount of spasticity when doing range of motion with Sierra's HL, this makes it harder for her to walk and clear her HL over rough terrain and contributes to knuckling

Strength and endurance- HL is held in dynamic flexion requiring co-contraction of trunk and contralateral hip, gluteal and biceps femoris stability, position is held until Sierra begins to fatigue

Sensory stimulation- HL is ranged to toe touch position in anterior/posterior plane, hind limb lifted to flexion and brought to floor with firm contact to increase proprioceptive input to joints, paw touching to contralateral HL, tail stroking. These exercises help Sierra recieve more information about her HL's. Also use of Linda Tellington Jones "promise wrap" for 20 minutes twice a day when she is having increased difficulty. I have also noticed that Sierra does her own form of sensory stimulation when she goes down the three stairs to go outside. She does not walk down the steps with her HL, but instead bunny hops off with a significant concussion upon landing.

Balance- I provide balance challenges through pelvis at the ishium in an anterior direction and watch for co-contraction and stabilization through trunk and scapula. Balance challenges are provided laterally on point of hip to increase stabilization of latissimus dorsi and oblique abdominals. Sierra has a significant right and left difference on her reactions to balance challenges with difficulty stabilizing her left side when a balance stimulus is applies through R hip. I would like to use a header or handler with her for these exercises to help keep her straight and symmetrical, as she often likes to turn to look at me.

Hopefully I will get some pictures of Sierra doing her exercises soon. I re-stuffed her begs about two weeks ago and this has provided her with increased comfort. I have one additional measurement to call into Eddies' Wheels to see if they might have a cart that would fit her. I want to have her transitioned onto a cart by fall before the weather gets too bad. I am still looking for a swimming option for her.

Weekly update

It's been harder to keep ahead of the things I feel I "need" to do this past week. Sierra has been holding steady and the weather has been wet, but mild here. I have one more measurement to send to Eddie's wheels, but a friend mentioned that I should call in the measurement to see how friendly and helpful the staff might be. The people at doggon wheels were very helpful and friendly and called me to talk about what carts that might work for Sierra.

We haven't been taking her on long walks, but several shorter ones per week and she is maintaining her strength and toe dragging less. The diet appears to be helping her hold her ground. I am doing some strengthening and balance exercises a few times a week as well. Still no where for her to swim.

My goal for the coming week is to get the last measurement done and a chart to record her exercises and walks.

Damn DM

I am new to this journey, but so far one of the worst aspects has been the good days/bad days aspect!!

Last week after starting the nutritional protocol and home rehab Sierra looked really good. She didn't cross, knuckle or drag all week. She looked straighter when standing and seemed perkier.

This week we're back to where we were prior to her official diagnosis. She's been draggin and knuckling, but she now knows, "Fix your foot" and will usually step correctly. At least she can still get up and down the stairs and sleep with us downstairs. I worry about her getting depressed when she can no longer be "part of the pack" at night!

I have a few leads on carts and have asked two manufacturers if they have any used carts available. I have been considering Eddie's Wheels and Doggon. I think my preference is for Eddie's Wheels. I took measurements last week, but will double check them before finalizing anything.

Static Standing

I tested Sierra's static (for the most part) standing on carpet: 3minutes 24 seconds

I honestly thought she would stand for longer- I woke her up from a nap for the test- so perhaps she wasn't very motivated.

I will also do the static standing test on the tile floor in the kitchen. I wanted to be able to monitor or measure changes in her condition. I will post her exercise/rehab schedule next week.

Clean bill of health

Sierra has a clean bill of health, outside of DM. She just had her blood work done, heartworm and lyme screen. Heartworm and lyme came back negative and her blood work all came back normal.

She is on intensive nutritional support for DM, following most of Dr. Clemmons protocol with some adjustments/additions for her diet. The first thing I have noticed since starting the nutritional support is that her nose is now soft and wet again- it's been dry and a bit crusty for a very long time. I don't think having a dog soft nose will help her DM, but it's an interesting change. I have also been monitoring her water intake closely because it is appearing to drop back to "normal" levels after being elevated for over a year!

I need to do a standing test and time how long she is able to stand- plan to do that this weekend and try to get more/better video of her current walking.

Diagnosis

Sierra is my 8y7m old Harlequin Great Dane. She received a rule-out diagnosis of Degenerative Myelopathy (DM) on Saturday 5/30/09.

She had been having symptoms for the last three months.

I am an occupational therapist and have been researching canine rehabilitation since learning of her diagnosis. I feel that I have a lot to offer my girl Sierra as well as others going though a rehabilitation with their pet. DM is degenerative as the name suggests- she will not recover from this- it will take her life eventually, but it's what we do between now and then that will matter most for her.

Sierra has had a full life. She has traveled many places with her people, she's hiked, swam and ran alongside my horses when I rode. She has many people who love her.

Here she is at Christmas time with her little brother, a chinese crested, Poe.