fibroticmyopathyeva

Eva is back to work after being treated for fibrotic myopathy

Jeff Corey, DVM
RIVMA NEWS | SPRING 2007

Simply put, Eva is a remarkable German Shepherd. From humble beginnings living on a farm as little more than a lawn ornament, to being one of two Search and Rescue Dogs trained and handled by RI State Trooper Matt Zarrella, Eva’s spirit and will to achieve have shone through. However, about a year ago, this newly-found career was seriously jeopardized when Eva was diagnosed with fibrotic myopathy. During training, Corporal Zarrella noticed that Eva had an unusual lameness that worsened with exertion. On physical exam, Dr. John Turco, Eva’s general practitioner, noticed a fibrous band where her right semimembranosus muscle should have been. Dr. Turco then sought a consultation with boarded surgeon Dr. David Clark, who subsequently agreed with the tentative diagnosis of fibrotic myopathy.

Fibrotic myopathy is a little understood chronic progressive disease which commonly affects working dogs and German Shepherds in particular. Although not obviously painful, it does affect the dog’s gait simply because the dynamic nature of a muscle is now reduced to a taut band. Eva’s presenting lameness was typical of a dog with this problem in that her knee would rotate medially while her hock twisted laterally, causing her foot to have a jerky kick when completing her gait. Faced with the diagnosis of fibrotic myopathy, Eva’s handler contacted Dr. George Coronado at Ocean Sate Veterinary Specialists to see if he had any suggestions regarding treatment. Although surgery was an option, the long-term prognosis with surgery was guarded since the scar tissue could possibly return. Additionally, as a working dog, if surgery were pursued Eva would have to be out of service for 4-8 weeks while recovering. This period of convalescence would not only have an effect on her ability to perform her job as needed, but would also be quite difficult to enforce since Eva has tremendous drive and would not do well with restricted activity.

Eva, Corporal Zarrella and Maximus

An alternative approach suggested by Dr. Coronado was to consider rehabilitative therapy with the hope of slowing down the progression of her disease. I was approached to devise an appropriate rehabilitation program in collaboration with Louise Anderson Nicolisi, MCSP, CCRP (certified canine rehabilitative practitioner), based out of Westerly. It was agreed between us that a program consisting of stretching, strengthening exercises, underwater treadmill sessions, therapeutic laser and therapeutic ultrasound would benefit Eva.

Initially, Eva was seen by Louise twice weekly in Westerly for stretching, transverse friction massage, physioball exercises and low level laser therapy. Of these modalities, the low level laser relies on the generation of photons that travel through the skin without any heating or damage to the skin. The photons are then absorbed by chromophores and cytochromes within the mitochondria of the injured tissue, resulting in oxygen production and ATP synthesis. Due to the stimulation of cellular metabolism and growth, lasers can potentially accelerate tissue repair and cell growth of tendons, ligaments, and muscles.

At the same time, Eva came to see me at Healing Paws, my rehabilitation center in Providence, twice weekly. I introduced her to therapeutic ultrasound, more stretching, massage, balance board exercises and underwater treadmill sessions. Of these modalities, therapeutic ultrasound utilizes an ultrasonic beam to increase deep tissue temperature and increase collagen extensibility, blood flow, pain threshold and enzyme activity. With the above properties the goal of the ultrasound was to break down scar tissue and replace it with functional muscle. While the ultrasound broke down scar tissue, the underwater treadmill was used to actively increase her range of motion. Being a quick study, Eva easily learned to walk backwards on the underwater treadmill which served as a way for her to actively stretch her semimembranosus, semimtendinosus, and gracillis muscles which were the main muscles of concern.

Within a few weeks of this program Corporal Zarrella noted that Eva’s lameness was not as evident after her eight hour training sessions and also that she was able to work as long and with the same intensity as his other German Shepherd, Maximus. After about three months of therapy, a physical exam showed that the taut band of tissue was reduced by approximately 50%. It was also around this time that Eva was credited with her first missing person find while searching a river by boat.

Due to her favorable response to therapy, her sessions were spaced further apart and her disease has remained stable. From having therapy four times weekly, Eva is now seen only twice monthly and continues to do well. The collaborative nature of this process has meant the best possible outcome for Eva. Multiple professionals bringing multiple perspectives and expertise to bear on this case mean Eva will most likely continue to do her job in full capacity for years to come.

Jeff Corey can be reached at his clinic, Healing Paws Veterinary Rehabilitation Center at 401-453-7297.

reprinted with kind permission from Dr. Jeff Corey DVM
Susan Frisolone
Rhode Island Veterinary Medical Association
302 Pearl Street, #108 Providence, RI 02907
401-751-0944
www.rivma.org
rivma@rivma.org

The above information is simply informational. It's intent is not to replace the advice of a veterinarian nor to assist you in making a diagnosis of your pet. Please consult with your own veterinarian for confirmation of any diagnosis. Your pets life may depend on it.