Nell is a 7 month old Labrador who started coming for therapy at the young age of 6 weeks old. Nell came for therapy so early in life because she is what is known as a swimmers puppy.
Swimmers syndrome, also known as swimming puppy syndrome, flat pup syndrome or turtle pup is a rare developmental deformity of newborn dogs whereby the limbs, predominantly the hind limbs, are splayed laterally (outward) resulting in the puppy being physically unable to stand and walk causing them to lay flat on their chest and belly. These puppies are known as "swimmers" because forward movement is only accomplished by lateral pedalling motions, i.e. paddling as though they are swimming. As well as mobility issues, the prolonged inability to stand and walk flattens a swimmer pup’s thorax leading to problems with breathing, eating and digestion.
When Nell first came to the clinic she was unable to stand or move properly. She had a lot of stiffness in her shoulder and carpal (wrist) joints and her forelimbs were too weak to hold her upper body up. Her hind limbs were severely splayed out to the side, with her left hind limb also having hyperextension of the tarsus (ankle) joint. She had very limited stifle extension and had very stiff hips with reduced range of motion.
Nell also had pectus excavatum, i.e. the sternal and costal cartilages were deformed resulting in a narrowing of the chest and inversion of the sternum, which resulted in an increased respiratory (breathing) rate.
Nell's initial therapy, in clinic and at home, included a lot of gentle massage and passive movements of the limbs to help mobilise her joints. We worked on placing her in various positions. This included placing her on her side to help her breath easier and try to help the rib cage develop a more normal structure. We also helped Nell into as correct as possible down, sit and stand positions, to help her learn how she should place her limbs.
As she progressed we added in other more active therapies such as gentle balance exercises and hydrotherapy treadmill to help strengthen Nell's muscles.
As Nell grew her ribcage became less flat and she is able to breath normally. She has gained strength and mobility, but she also developed some new ongoing concerns including muscle contractures in her quadriceps muscles which limit her stifle (knee) joint movement making it difficult for her to walk, and sores on her lower limbs where they contact the ground in the wrong places, i.e. not on her pads.
To help manage these issues Nell was fitted with a cart to help her mobilise. The cart is a walking aid for Nell, it helps stabilise her and allows her to use her hind limbs more normally without stumbling and losing her balance. She also wears boots to help protect her lower hind legs and paw.
Nell also continues to come for regular therapy to help alleviate the compensatory problems caused by her musculoskeletal issues. These days her sessions include a mixture of pulsed electromagnetic field therapy, Class IV red photobiomodulation (LASER) therapy, therapeutic ultrasound as well as lots of massage and passive limb/joint movements.
Well done Nell. We think you have done amazingly well and look forward to seeing you again soon!