Saturday, January 2, 2010

Iliopsoas Muscle Strain

I posted a couple of weeks back that Heffner was diagnosed with an iliopsoas muscle strain. The initial treatment plan was two weeks of no exercise. The week after that he was allowed to go on one five minute walk a day. This walk could increase by 5 min. each week. While it seemed pretty extreme at the time, I was so relieved that it wasn't anything more major that I was happy to just listen and go along with it.

Heffner has already done the two week stint and now we're to the point where he can start getting a 5 min. walk a day. Which, by the way, is really pretty much a quick potty walk. Initially I did a quick internet search on iliopsoas injuries in dogs and what I found was an article on chronic non-responsive iliopsoas pain. Thankfully, right now, that's not Heffner. As far as I can tell, it's an acute thing and this is our first attempt at treating it. Over these past two weeks I did a little bit more digging around trying to find out anything else that I could on the subject. There are some academic veterinary papers out there that I found that I'll have to wait until I head back to work to look more in depth into (we've got a subscription thingy so I can view the full paper instead of just the abstract) the papers. What I've found so far is that Heffner's case is really on the light side of things. Most of the individual instances of this that I've read about are more on the obvious side of things. The dogs experienced pain in their affected leg. There was limping and obvious pain and discomfort. With the agility dogs (which it most commonly occurs in, and not too surprisingly considering how physical the sport is), there was a lot of knocking the bars with the rear feet, slow pace going through the weaves, and when the leg was being manipulated to find out where the discomfort was, there was a lot of trembling and spasming in the leg and specific muscle region. Heffner has had none of these.

He didn't exhibit any of the tell tale signs and symptoms of the problem that I've read about in these other dogs. The only thing off with him was how he was standing. He wasn't limping, but there was a slight hitch in his step. Otherwise, he was totally normal. If anything, the night that I noticed it, in his agility class he had knocked a few bars with his front feet, but that was because of my handling errors. I'm not sure if his lack of knocking bars with his rear feet might have to do with his height? Maybe because he's taller than your average border collie (by just a smidge), knocking bars wouldn't otherwise occur? But he also didn't have any shaking in his rear leg and no spasms when the vet was manipulating it. He showed obvious discomfort, but that's it.

So here we are, we've reached the two week time point and our next visit with the vet isn't until the 13th. And I'm starting to wonder if the initial treatment plan isn't a bit extreme for his case. Not to mention, he completely acts like nothings wrong. And he's off the Rimadyl completely. He's his normal self and back to standing like normal on the rear legs. Yes he's still straight in the rear, but that's a permanent part of his conformation that will probably predispose him to these sorts of things. I know that with two weeks of rest most dogs are going to act completely better. But I'm starting to think that a single 5 min. walk a day is kind of over the top. I'm going to stick with it until we see the vet again and I can ask her all the questions that I've now got. Either way, I won't be putting Heffner back in any agility training for a couple months at least. One of the activities that was mentioned as a causing exercise was jumping, tight turns, and weave poles. I'm even more than happy to only exercise him on leash. That's fine by me. I'm even more than happy to stay away from jogging as well. Long walks on leash are a-OK by me. I can think of all sorts of ways to get both dogs exercised while staying within those parameters. As a matter of fact, long walks was one of the recommended rehabbing exercises recommended on some of the articles that I read. Which also leads me to believe that a single 5 min. walk a day is more restrictive than he needs.

We'll see in a week and a half what the vet says. I'm also really interested in what I can do to prevent this from happening. It seems like plenty of warm up time before runs is a really good precursor. I'm also wondering if doing some ultrasound on the area how ever many times a week might also be beneficial? I know that ultrasound gets used frequently in the healing process for other injuries, so maybe this as well? The benefit for me there is that I have access to an ultrasound machine through work. I just need to get brushed up on how to use it again. I was shown how once, but it's just not something that I ever actually do on my projects. The big bonus for me there would be a better healing dog (and potentially doing this after trials and practice would be good as well for preventative measures) and it's free!:) I'm also thinking that an acupuncture appointment should be in the works. That was also part of some of the treatment plans. And I have been meaning to get him in to see his acupuncturist and get some reflexology done as well. many thoughts!

Does anyone else out there have any experience or words of wisdom?

In other news, tomorrow Bess and I are meeting up with Kennedy and Vegas for some cross country skiing! It should be a blast. And after this past week at work, I really need to get outside, get some fresh air and exercise, and blow off all this pent up ickiness that I've been feeling.

I also am going to have what will hopefully be a fun little challenge that involves getting rid of some of that holiday weight and getting out with the dog(s) more. I'm still figuring things out, but there will be little weekly challenges and I'm hoping that plenty of people will join in because I think it could be really fun!! More details on Monday! (if you've managed to read this far through this long meandering post!LOL)


Anonymous said...

Oy! Juno has pectineus muscle (inner thigh, high groin area) strain (opposite muscle of illeopsoas.) but her illeopsoas is in not great shape either, in fact, they're weak. this was due to a few things: her genetic hip dysplasia, a MAJOR dog sled team run at only 12 months old that her fosters had her do (not me) which probably caused her to strain it (she came to me limping the next day when i adopted her), and from there, restrainning it over and over while doing agility (which she adores) which i didn't key into because i just thought she was a bit clumsy at times. Knowing her "breed" now, that is very silly. Sibes are INCREDIBLY agile, fast runners and jumpers. so i could kick myself for not knowing.

we were ordered 6 weeks of rest.... not going to happen though. just not. instead, i basically don't let her do anything that will strain that muscle, such as running/playing on slippery surfaces where her back end can splay out and pull those muscles. I also do a ton of PT with her. she's got to do "sit pretty" (which is a beg position sitting on back legs, front legs up), she has to walk on cusions, do weaves, walk over pipes that are about 6 inches above the ground (stepping over obstacles). walk on air cushions and finally, she does underwater treadmill PT. she actually loves it. i'm going to try to find a place to swim her as well. She also goes to accupuncture which helps relax the tight muscles that are overcompensating for the strained muscles. that helps A LOT! she LOVES her accupunture and goes right to sleep with the needles in.

its so weird, we're finding weirder and weirder "human like" injuries and sicknesses in dogs from torn muscles, blown out knees to cancer, colds, flus, etc. Mainly because we expose them so much and many "work" them in agility or other sports. people are really getting into dog sports but don't realize the complications of injury, just like a person who is getting into sports. we have to be very sensitive to injury because they can't talk so we have to touch them and watch for sensitivity, weakness in their sport or daily activities and adjust as we need to.

good luck with Heff!
wild dingo

M.T. said...

HATS OFF to you for sticking to the "5 minute" walk plan. My dogs would probably MURDER me if i just took them out for 5 minutes and then expect them to sweetly come back inside LOL

I wish i knew more about Heff's condition and could offer you more constructive input. But i just wanted to comment on you observing that he is showing no obvious discomfort: Dogs in general have very high thresholds of pain and discomfort, which is why often times serious injury does not get detected or diagnosed until some kind of damage has been done, simply because the dog cannot tell us in so many words how it is feeling different and they don't begin to show "discomfort" until it has gotten quite bad. I totally agree with wild dingo that we are seeing increasing incidents of injuries in dogs similar to what human athletes get, simply because we expect them to do so much more "work" like what human athletes do! Since our dogs can't verbalize and know what to look out for, it's our responsibility as their handlers to set limits and err on the safe side. Whenever doing any intense physical activity, i always try to baseline my dog's condition on mine: EG. As a fit (i hope lol) human in pretty good health condition, would i be too cold in this weather? Would i get too hot? Too tired? Am i jumping too much? Do i need more warm up? Etc. Not ideal, but it's the best way so far and i like to be on the safe side. All this rambling aside, i'm sure you take all the necessary precautions and are on the ball in watching out for your dogs. I'm probably just "preaching to the choir" LOL

That said, i've read about other dogs with strain/injuries doing really well with swimming and underwater exercise work. Might be something worth looking into!

Brenda's Arizona said...

Your post is interesting but frightening all at the same time. I appreciate learning this. I am glad Hef is doing well! Fingers crossed and keep posting. Those of us who have not had dogs in this situation can learn.

The Comstocks said...

Hey Lindsay, sign up for a library card. That way you can search pubmed from home too and don't just have to wait until you're at work. No WOW on the muscle thingy... I have no clue. Sarah

Kennedy said...

Hey Linds, I know we talked about this post today but when I just read through it, I go to thinking of something I didn't think to mention earlier. You should consider asking about teaching him to crawl. I had posted on this a while back on my blog and what Rachel had learned in school. Since you're considering preventatives, perhaps that might be one since it has to do with the hind end and hind end injuries.

I agree with what MT said, too. They too often don't let us know and perhaps his odd stance was his way of letting you know. The good thing is, you've got a lot of resources and tools and the vet to see again soon.

Emma Rose said...

So glad Heff is doing better. Is he going crazy though, without being able to burn off his energy? I have no wisdom to impart - sorry - but it is very interesting to read about this. We have a 5 month old Border Collie that will have to do SOMETHING when he gets older and now I'm not too sure agility is in his future. Please keep us posted on your findings.

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Anonymous said...

Hi There

My dog was diagnosed with a possible ACL partial tear about 10 weeks ago and ordered to rest which we did and he improved. However after starting activity again he now limping. After reading your story im beginning to suspect a groin injury like heff, rather than his knee. What exactly were his symptoms? Was he toe touching? Limping? Was there swelling?


Never Say Never Greyhounds said...

I hope he heals quickly! So tired of injuries myself. You might looking k-laser or cold laser. Its suppose to speed healing, isn't painful, and it was fairly inexpensive when I did it for Riley's fractured hock. Its one of those things that isn't proven effective but it doesn't hurt. I felt it was reasonably priced enough that I went for it.