We are almost at 1-month post-operative abdominal surgery for Rainey! If we are counting by the weeks, we will be at week 4 tomorrow. To keep things specific, we are at day 27 post-op. Rainey has been doing very, very well! Her spirits are high and she seemingly has her physical status back. This week we played scent work, and she excelled! I attribute Rainey’s seemingly speedy recover to the multi-modal approach to her health, or a whole health approach to her care. This has included her diet, physical fitness, appropriate supplements, appropriate herbal medicines, and her mental stimulation. I have worked hard to engage her and make her feel important and included. Her life was thrown upside down the weekend she got sick, and in one day she went from pregnancy hormones to no hormones. Throughout my entire career I have heard that you should not spay a bitch when she is cycling or during pregnancy, as the affects on her mental state could be devastating. But, did anyone have any data to support this? Or even antidotal data? Or was this just hearsay? I will not lie; I was terrified Rainey would be locked in a constant state of pregnancy or false pregnancy brain, unable to function and too emotionally sensitive to rebound. I was determined to keep her mentally stimulated throughout this process so that she would not become depressed and her mental acuity would suffer. Whether it be my process of inclusion or the fact that trapping a bitch in a state of pregnancy brain isn’t really a thing, Rainey is exceeding expectations!
Whenever a patient has a surgery that involves cutting of a tendon or ligament or a sport dog with a strain, the herbal formulation I reach for is Tendon/Ligament Formula by Jing Tang Herbal. Its Chinese name is Zhuang Jin Jian Fang and it is a modified Bu Gan Qiang Jin San. Tendon/Ligament Formula nourishes Liver Yin and Blood, as well as strengthens tendons and ligaments. For centuries, Chinese herbal medicines have been used to treat martial arts injuries. These herbals can also be used to strengthen tendons and ligaments, which is the reason I recommend once a year an active performance dog go on Tendon/Ligament Formula. The micro abrasions to the tendon and ligaments can be nourished, and potentially prevent major injury. In TCVM, by supplying and nourishing the tendon and ligaments with Blood and Yin, the Liver dominates and controls them. When there is weakness or poor growth of tendons and ligaments, there is usually Liver Yin/Blood Deficiency. Therefore, the key to treating tendon and ligaments injuries is to nourish Liver Yin and Liver Blood. In horses, there is ultrasonic evidence of complete healing of a tendon injury after just 3 months of administration of Tendon/Ligament Formula. You may be asking yourself ‘if this formulation is so amazing, why hasn’t it made it’s way to mainstream medicine?’ That is an excellent question! The answer is because mainstream medicine wants evidence-based medicine, and evidence-based medicine involves studies. The purpose of Chi Universities Master in TCVM Program is aid in providing this evidence-based medicine in hopes of bringing the benefits of TCVM to Western Medicine, making it a more accepted practice for our patients.
The ingredients and actions of Tendon/Ligament Formula are as follows:
*White mulberry – Soothes limbs
*Epimedium – Nourishes Kidney Yang and Yin
*Dang Quai (Angelica Sinensis) – Nourishes Blood
*Chinese Peony – Nourishes Blood and Yin; soothes Liver Yang
*Cyathula – Strengthens the Kidney and benefits the knees
*Sichuan Lovage – Moves Blood, resolves Stagnation
*Lycium – Nourishes Liver Yin and Blood
*Cinnamomum Aromaticum – Activates the Channels and Limbs
*Asiatic Dogwood – Nourishes Liver Yin
*Rehmannia (Shu Di Huang) – Nourishes Blood and Yin
*Psoralea – Nourishes Kidney Yang and Yin
*Eleutherococcus Sessiliflorus – Strengthens ligaments and tendons
This week I am running low on mental power, and would like to expand on Rainey’s diet, but I am going to wait until I have more time and brain power. Therefore – onto her fitness!
This week I confused myself by over thinking, was she on week 3 or week 4? I couldn’t decide, so I called it week 3 to 4. This week Rainey had 3 full rest days – Monday, Wednesday, and Sunday. Despite these appearing to be perfectly placed, they are actually the consequence of my schedule. This week we increased our intensity, and I wanted to see what Rainey could give me, strength wise.
Day 21-27 – Regaining Function
At the start of the week Rainey was assessed with diagonal leg lift to see if she could balance better than last week. The answer was yes, but unfortunately a valid video was not obtained. Once it was determined that Rainey was engaging and utilizing her core better, I decided to push her a little harder. Instead of doing 2-4 exercises per day, we did 4-5 different exercises per day. We started the week working on down to stands, pivots, static stands on mini FitBones, and sprints. At this time, Rainey continued to rise equally in her down to stands, showing significant improvement from just a week ago. I decided to start focusing this week on her shoulders and rear legs, as it had now been a solid 3 weeks since these areas were specifically engaged in fitness exercises. If Rainey is to perform sharp turns, weave poles, and contact bottoms she must have a strong front and hind end to support her core and back. A pivot is typically seen as an obedience move. I see you it as an opportunity to work on forelimb and hindlimb adduction and abduction, as well as emphasizing foot awareness. Initially, I have the dog place front paws on a disc, and pivot all the way left, then all the way right. This works the back legs. Ideally, the dogs’ neck is kept in a neutral position with their spine, which is straight. Their rear legs are in a stacked type position, and they are not arching their back. The key here is the dogs’ neck is not up looking at you. That can be harmful to their cervical-thoracic junction (I see another subject to be discussed – transitional spinal zones). The dog will move around the disc with each hind foot moving independently. No hopping. A dog that hops indicates a dog that is either weak or has a groin injury. No hopping. Next, release the dog and reset with their front feet on the floor, and their back feet in a stacked position on the disc. Neck is in a neutral position with the spine. Now ask the dog to pivot all the way to the left, then all the way to the right. Again, legs should not be hopping. In an ideal world, the front legs will actually cross each other as they move sideways around the disc. In both of these exercises, the feet on the disc DO pivot. They do not shuffle.
Next, we worked more on our static stands. In the video, you will see static stands from 2-3-2021. The FitBones used were over inflated. When a FitPaws piece of equipment is OVER inflated it increases its difficulty, as it is more easily rolled. One important piece to note is that if your dog stands on a piece of fitness equipment and shakes uncontrollably STOP, just stop. They are not fit enough for that piece of equipment! This maybe they truly are not fit or they are guarding a stabilizing muscle. Regardless, get them off of it. If they shake, but within 2-3 seconds stabilize and stop shaking, they have engaged the needed muscles for stabilization. Keep the session short and sweet, as to not over work them.
Next, we worked on sprints. Nothing crazy, my room is only 24 feet (or so) long. I placed Rainey in a sit stay, lead out across the room, and called her to me. In this space she couldn’t get up a tremendous amount of speed, but she gets fast. I was actually assessing her push off from the stay, making sure she’s still pushing from her rear vs pulling from her front. I did not want her compensating for a weak core by not using her back legs. How would this happen? In dogs, a primary muscle for hip flexion, or bringing the hind leg forward, is the iliopsoas muscle. This muscle complex starts at around T10-12, follows the underside of the lumbar vertebrae, until it gets to the pelvis, where it splits and attaches to the lesser trochanter of the femur. The secondary function of this muscle is core and back strength and stabilization. Therefore, it can be assumed that if the core is not engaging, the iliopsoas is likely not performing to its full potential, and then the dog will not be properly flexing and extending its back legs, as they may be hunching their back and guarding their back/abdomen. This results in a shortening of the iliopsoas, which results in increased flexion and decreased extension of the hind leg, resulting in a choppy gait. Then after a while, as the dog continues to hunch its back, its core weakens, it stops engaging their core, the dog decreases their hip extension and push off, and with time the dog starts dragging itself forward with their front vs pushing from their rear. Assessing early on if the dogs normal running function is abnormal is important at catching something early before it has a chance to progress.
We continued to work on shoulder exercises by performing a lateral side step with an elevation. You will notice watching the video that I used a different pair of mini FitBones. This pair is not over inflated. This makes them more stable and decreases their difficulty. For this exercise I did not want to insert another complicated factor, as the technique is already complicated. The goal of this exercise is to keep hind feet still while walking laterally (to the side) with front feet, stepping off the FitBone, and back on. This is difficult and likely more complex than she should be doing right now, but again I wanted to see where we were at. This exercise engages the core as a stabilizer, allowing the dog to step down and back up, while utilizing the abductor/adductors of the forelimb. This is definitely not an exercise for a lower physical fitness athletic with weak forelimb stabilizer muscles. Rainey did very well, and maybe became overly excited.
Side steps on the flat are next in the video. The important element with this exercise is trying to keep the head in neutral position (difficult with small dogs). Next, the goal is for the dog to actually cross their front feet and their back feet as the step sideways. In the video, Rainey is almost shuffling sideways, with some points she will actually crisscross her legs. She was very excited, and we had not performed these in a long time. Another project to work on! Again, this exercise focuses on hind limb and forelimb abduction/adduction, but in order to stay straight sideways, the dog must stabilize their core.
This week we returned to the land treadmill! The focus was a slow 2 minute warm up, followed by 3 minutes at a faster pace, with the goal being improving her cardiovascular fitness. With the weather currently being below 0 in Minnesota, we are not able to do this outside. However, Rainey thoroughly enjoys her treadmill! As the weeks progress I hope to work up to more HIIT training at 90 to 120 second intervals, which will aid in training her cardiovascular fitness for agility.
This week Rainey was able to return to something that resembled agility and training – wraps! I went down this path for three reasons – 1. To assist her mental stimulation and joy for training, 2. To assess her ability to control herself at speed, and 3. Continue improving her spine flexibility. I would say I am happy with her progress.
The last technical exercise of the week was a ‘Sit to down to sit’. This exercise requires a stronger core, and the ultimate goal is for the dog to ‘pop’ to a sit and ‘pop’ to a down. This means no walking with their feet. Initially, Rainey wanted her cookie, and did a half-effort down to sit. You will see that I correct her by luring her head to a higher seated position. This looks like I was trying for a sit pretty, and I can assure you I was not. Then after that first attempt, Rainey performs the sequence with better effort. She is still walking her feet slightly for the down to sit, but overall, her performance is pretty good!
This week we complicated our cavelletti’s by placing the bars at apposing angles. This further challenged Rainey’s proprioceptive input (the ability and speed at which her eyes communicated with her limbs and her brain telling them what to do when and where). As you can see in the video Rainey struggled a little bit to this challenge, which as with everything she does, was at speed. I wanted to continue the lovely patterned gait, but with increased complexity. Having a quick reaction time is important in the jobs Rainey performs (agility).
Lastly, Rainey finished the week out with scent work practice, at which she excelled!
And there we have it – all of Rainey’s exercises for the week plus some anatomical reasons why I chose these exercises. This week, I increased complexity and started to push Rainey past her comfort zone. She continued to exceed my expectations, especially as her willingness and love to train returns. It will be soon that Rainey returns to class at low jumps, as we continue to rebuild her core and overall strength. Next week I hope to write about her diet and expand on any new exercises we perform, and in the future, I do plan to expand on laser therapy, the Assisi Loop, and Tui-na massage. I also discovered that I would like to go more in-depth on anatomy and why things matter or why we recommend what we do for our sport dogs.
The road to recovery is long, and sometimes there are setbacks, but the time it takes to get there will always be worth it!
Take care and may the Qi flow freely for you!
Dr. Shantel Julius, DVM, CCRP, CVA, fCoAC, CVSMT, CVFT, CVTP, CVCH, CTCVMP
Xie, H., Preast, V. Xie’s Chinese Veterinary Herbology, 1st Edition. Wiley-Blackwell, 2010.
Millis, D., Levine, D. Canine Rehabilitation and Physical Therapy, 2nd Edition. Elsevier. 2014.
Evans, H.E., deLahunta, A. Guide to the Dissection of the Dog, 6th Edition. Saunders. 2004.