The older K9 Fax got, the worse his ability to walk normally became; we grew accustomed to his abnormal gait and John and I thought that he would die or need to be put to sleep from something else before he ever completely lost the ability to walk.  We were wrong.  On April 1st, Fax stopped using his rear legs.  We knew from many veterinary exams over the years, including trips to the surgeon and the neurologist, that Fax suffered from several diseases that impaired his ability to walk normally.  With age, Fax is now 12 1/2 years old, he had developed arthritis in many of his joints and his back.  He also showed signs of German Shepherd Degenerative Myelopathy (a neurologic disorder); he had surgery on his lower back for a compressed spinal cord, and had fibrosis or hardening of the major tendon in his rear legs, preventing him from extending his legs normally.

John and I were devastated.  Fax seemed so happy otherwise and we hated to put him to sleep because of his inability to get around.  But since Fax had retired, he spent 90% of his time with me and I was finding it very difficult to lift and carry Fax's 95 pound body around outside and up and down our stairs.  Before making the final decision about euthanasia we decided to make sure that we had investigated and researched and had done everything for him that we could.

I went on the Internet to www.caninecarts.com (#800-578-6960) and ordered him some neoprene and velcro slings, one set for his rear quarters and another for his front legs.  The web site gave measuring directions but I also called them directly as the person over the phone helped me fine tune my measurements; they Fed-Ex'd them to me and they have worked wonders in my ability to get Fax around without hurting him or my back.  I only use the front quarter one when lifting him a flight of stairs; the handles allow me to lift him like a suitcase (a very heavy and uncooperative one), rather than trying to lift him up from underneath.  They also make carts, protective booties and other items for mobility impaired pets.

I made an appointment with TOPS Veterinary Rehabilitation (847-548-9470), near Gurnee Mills/Great America in northeastern Illinois.  This is one of only a handful of facilities in the entire country dedicated to providing intensive canine physical therapy.  The first appointment is for a new consult and was 10 days away and I was put on a waiting list in case an earlier appointment opened up.  Later that day, Dr. McCauley, the veterinarian in charge of rehabilitation at TOPS called me from her home (she was out on maternity leave) and she offered to come in and see Fax herself in 2 days, since he had deteriorated so rapidly.

My first appointment at TOPS took about four hours from start to finish.  Dr. McCauley did a complete physical, orthopedic and neurologic exam.  She measured the range of motion of Fax's joints and measured the size of his major limb muscles.  Being a veterinarian and a specialist, I have conducted and observed thousands of exams and I can say without hesitation that her exam of Fax was one of the most detailed, thorough and encompassing ones I had ever seen.  She found small things on his physical that I had shrugged off as being incidental; for example, the chew sore's on Fax's feet which I, super vet, had attributed to his allergies.  She pointed out that the sores were only on several of his joints and it was those joints that were the most painful and had limited mobility.  Fax was chewing at them because they hurt him, not because he was itchy!  She, like all the other vets, also felt that Fax had several underlying disorders that were working together to prevent him from walking.  Dr. McCauley also pointed out that the majority of Fax's neck and front limb pain was a result of his having to use the front half of his body so much to compensate for the weakness of the rear.  She put together a treatment and rehabilitation regimen for Fax to address his many different issues.

To better understand his treatment plan, let me summarize for you the factors that work together to allow or prevent an animal from using its legs properly.

Neurologic System - the brain, spinal cord and nerves of the leg must be intact and communicating to one another properly (Fax has damage to his lower spinal cord from compression several years ago; he also has a degenerative disease of he spinal cord).

Muscular System - the muscles receive input from the neurological system and must have good tone and strength (Fax has significant muscle atrophy in both his rear legs from not using them but rather his front legs to get around well for the past several years).  We did labwork to rule out diseases that would cause muscle weakness such as thyroid, blood sugar abnormalities, etc.

Cardiovascular System - the heart must pump blood adequately to the legs through open blood vessels (thankfully Fax has no cardiovascular problems).

Orthopedic System - the bones and joints must be in good condition and have the correct ligamentous and tendenous connections (Fax's bone density is good but he does have arthritis in many joints.  He also has a very tight tendon in both rear legs that prevents him from extending (straightening) his rear legs enough to support his weight).

Pain / Discomfort - If an animal has enough pain he will be unwilling to walk or use the limb (Fax has pain in all his limbs and up and down his neck and back).

Strong Spirit / Drive to Succeed - If an animal gives up the desire to try then no matter how well the above works, he won't get up and walk. (Fax, like most K9 dogs, has a good drive and puts in a good effort to get around).

I take Fax to TOPS two or three times a week as my schedule allows.  Each pet has a regimen that is put together specifically for its' own problems.  Fax's regimen includes underwater treadmill exercises, whirlpool, massage, chiropractic sessions, acupuncture, electromyostimulation, tendon ultrasound and joint and pain medication.  The underwater treadmill allows Fax to walk in a environment where his body weighs much less thereby allowing him to use his limbs and build his muscles without the normal stress and strain of walking on land.  A window cut out on the side of the pool allows the vets to see his legs moving underwater and monitor his progress.  Fax started at one minute and has worked his way up to 5 1/2 minutes.  The whirlpool is for muscle relaxation and to relieve discomfort.  The massage therapy, (I do this for him at home every night), is for muscle relaxation and to relieve discomfort.  The chiropractic sessions are meant to realign his spine thereby decreasing pain.  The acupuncture is to decrease pain, and increase blood flow and to stimulate neurologic input to a specific area.  The electromyostimulation is to build up tone of specific muscles by small electrical bursts that result in muscle contraction.  The tendon ultrasound is to help relieve the tightness of those tendons in his rear legs.  For pain and joint health, we have Fax on Cartiflex (a joint nutrient similar to Arthriflex, Jointease).  He takes Rimadyl (carprofen) an anti-inflammatory; other similar drugs are Etogesic, Aspirin etc.  He receives weekly injections of Adequan (polysulfated glycosaminoglycan; cosequin) to improve joint cartilage health and reduce discomfort.  He takes a Chinese herb supplement Kang Gu Zeng Shen Pian (specifically used to slow the progression of arthritis of his neck and back).

It sounds like a lot, doesn't it?  Well it is.  But John and I decided that we could not let Fax go on as he was - we either had to put him to sleep or to try and do something for him.  Once I got into a daily regimen of his pills, massage and TOPS appointments, it is not as complicated as it sounds.  It is time consuming; including driving time, each appointment takes about 4 to 5 hours out of my day.  But it has been very rewarding for us.  After his first appointment, Fax was able to get up the stairs by himself - this was a great relief to me and my back!  Fax seems much less painful and sleeps soundly at night.  The muscles in his rear legs seem strong and the tendon seems less tight.  He has stopped chewing on his front feet and the lick sores have gone away.  With each week, Fax seemed to get stronger and better able to walk - not normally you understand, but at least able to get outside and get around by himself.

Unfortunately, on May 17th, Fax suffered what we believe was a clot (FCE - fibrocartilagenous emboli) to his spinal cord which made his condition even worse than when we had started at TOPS because now he had significant neurologic impairment to his spinal cord.  John and I were devastated because he had made so much progress over 6 weeks only to be sent back to start from the beginning!  He is still going to TOPS and we now have a cart for him - the same cart the K9 Harry belonging to Dale Racer used about 8 years ago.  If it was an FCE, there is a chance that Fax could improve again with time, we just don't know.  The only thing I do know for sure is that without TOPS he has not chance at all.

The reason I wanted to write this article was so you could spread the word about the TOPS facility to any pet owner or canine handler that you know who has a pet or canine with chronic pain, lameness or altered ability to walk.  Many of TOPS patients are dogs who have not fully recovered from simple orthopedic procedures such as knee surgery.  They have put many show, field trial and working dogs back to 100% when others had given up.  When sitting there waiting for my appointment I talk with other pet owners; some of the stories are heart breaking and happy at the same time.  There was a rottweiler there would could not use any of its four limbs from an FCE, he could only flail around on the floor.  He lived at TOPS for four months and received intensive physical therapy and now he is able to walk and run normally and you wouldn't know there had ever been anything wrong with him!  All of the owners of pets with severe walking problems say the same thing - that their vet had said that there was nothing left that they could do and that euthanasia needed to be considered.  TOPS give people the opportunity to offer their pet a second chance at a good quality of life.

It is not uncommon for me to see a squad car and K9 there while I am there with Fax.  Each department has its own willingness / unwillingness to pay for such care though some pet insurances also cover the care as well.  It is not inexpensive, but John and I feel it is well worth the money since Fax has been such a loyal partner and friend for all these years.  I would encourage anyone to at least go for an initial consultation, and see what they have to say.  Many of the things can be done at home by the owners, we just need the knowledge.  This is not meant to say that your pet wouldn't get much more out of intensive and expert therapy performed by their staff, but when there are no other options, the TOPS staff can show you what you can do for your pet on your own.  There was one canine handler who did the whirlpool therapy in his own hot tub at home and the hydrotherapy in his neighbor's pool!  Obviously when you want something bad enough, you'll do whatever is in your power to make it happen.

TOPS only works by referral, which means the pets' veterinarian must refer them for consultation.  Should any of you or your vets have questions about TOPS do not hesitate to call me or the TOPS facility.

Sue Leonard-Sullivan

(John Sullivan, Milwaukee PD)