Marion I. Coffman
It was morning, July 22, 2013. Our boy Barney (GCH Cariad Elgin’s Barna Medve CD RN), [Winner’s Dog, Vizsla Nationals, 2012; Grand Maturity Winner, 2013; and titled in Obedience and Rally – all before the age of 2 1/2] — was an active, bossy, noisy, enthusiastic Vizsla, when everything changed.
Determined to be first off the porch and into the yard, Barney slammed the soft area inside his shoulder into the metal frame of the porch door.
“That had to hurt!” I thought.
Later at obedience class, when Barney yelped taking a jump, I became concerned. Despite several days of crate rest, Barney began to display changes in movement. His front legs had started to cross over; he was out at the elbows and his back was roached.
At our local vet’s office, I described Barney’s porch door incident. Although his pain was evident, his x-rays revealed no physiological reason for the changes.
Our vet prescribed acupuncture, which did nothing to alleviate Barney’s pain. Now he was unable to take more than a few steps without having to lie down for relief. His favorite position became the “prairie dog” –sitting up on his rear to take pressure off his front legs.
Because his rear appeared unaffected, Barney could get onto a bed or a chair, and with help, negotiate the porch steps, but his front legs were fast becoming useless. Our local vet referred us to the University of Florida’s Small Animal Hospital in Gainesville, Florida.
It was well into August when we arrived at our first appointment at The University of Florida Small Animal Hospital, Orthopedic Unit. Barney’s front limbs were useless, requiring the use of an animal transport wagon to wheel him in for his appointment. I described the July accident, but to rule out possible conditions, the hospital conducted a battery of tests – a CAT scan, spinal tap for fluid evaluation and blood tests for possible tick-borne diseases.
When the orthopedic-related testing came back inconclusive, Barney was referred to a Neurologist for further evaluation, including an MRI. Still, nothing explained his progressive crippling. Biopsies of nerve and muscle from under his armpit went to California for evaluation. Biopsy results would come in 2 weeks.
We waited. Barney had lost almost 8 pounds; his shoulder muscles had atrophied and retracted. He had numerous shaved areas over his body from his biopsies. The biopsy incisions were healing, but slowly. Barney was on a regimen of Prednisone in high doses, pain medication, high-protein, high-fat puppy food, and multiple vitamins. Although his appetite remained good, he was wasting away.
He had little strength in his front legs or feet; his weak lower left front leg doubled under when he tried to walk, forcing him to walk almost on the top of his foot. He wore a boot brace to help prevent a broken leg and possible limb amputation. He could barely move.
I filled the time with Internet searches: articles about Polymyositis, Muscular Dystrophy, Myasthenia Gravis, and Multiple Sclerosis filled my computer screen. Dr. Berry, from the University’s Veterinary Medical Department, provided reassurance as I named off these terrible diseases. “Is it this? Could it be that?” I asked. Her answer was always, “No, he doesn’t follow that pattern.”
The biopsy report finally came – no disease present – and Neurology discharged Barney with a prognosis of poor and a prescription for time in their Rehabilitation Service unit.
I was worried. I had no diagnosis. Barney’s medical bills were into the thousands of dollars, and rehabilitation services would deepen the pit. How far could I continue to go?
Meanwhile, Ed Foster, Barney’s co-owner and long-time family friend had been busy – he knew of a charity, Friends and Vets Helping Pets. He completed paperwork requesting financial aid for Barney, and when news came that Barney had been accepted by Friends and Vets Helping Pets into their assistance program, we moved ahead.
I scheduled Barney’s first appointment at the Rehabilitation Unit, alleviated from the worry about the costs; but I was beginning to face the idea that I might lose Barney. He was so thin, and he’d been getting steadily worse. Ed came from Ohio, and the three of us – Barney in his transport wagon – went to Barney’s first appointment at the Rehabilitation Unit with Dr. Justin Schmalberg, (Clinical Assistant Professor – Integrative Medicine; Associate, Small Animal General Practice, Gainesville, FL).
Dr. Schmalberg examined Barney. He listened as I recounted Barney’s July accident and his consequent symptoms, and he offered a diagnosis. He had seen this before. Finally, the trauma to Barney’s shoulder and subsequent paralysis had a name… BRACHIAL PLEXUS NEUROPATHY.
Brachial Plexus Neuropathy is a condition which often evades diagnosis because its evidence is difficult to detect with imaging. Treatment is challenging, prognosis poor.
Dr. Schmalberg drew a diagram of the brachial plexus, a network of nerves servicing almost the entire upper body region. Arising from the spinal cord at the back of the neck, these nerves branch into to individual nerves which supply the pectoral muscles and forelimbs. When the nerves are traumatized or torn from the spinal cord, the results are severe weakness and paralysis, inability to support weight, and loss of sensation in the leg below the elbow. Barney could not control his front feet, thus the turning and dragging. With the loss of the radial nerve, Barney’s paralysis had taken over and produced the atrophy of the primary flexor muscles of the shoulders, elbows, feet and toes. At last, things were making sense.
Dr. Schmalberg started Barney’s treatment course: electro-acupuncture, laser treatment, and twice-daily radial nerve stimulation with a Trim-Stim machine. He warned us that complete recovery was rare and that any improvement would be slow – it would probably be 8 months or more before any nerves might regenerate. He also reminded us that, along with having supportive owners, Barney was a Vizsla – a breed with “heart” – which might help him to recover at least partial movement and feeling in his legs.
In conjunction with his nerve stimulation treatments, Dr. Schmalberg prescribed swimming to maintain muscle tone. He emphasized the need for persistent, daily, concentrated effort, and for patience. Dr. Schmalberg referred Barney to the Sanctuary, a local facility designed to provide sports therapy and rehabilitation for horses. After the Sanctuary accepted him as a “special dog” in need of therapy, Barney began swimming 3 times a week in mid-September utilizing their 90-foot long equine rehabilitation pool. At first Barney swam in a life vest with a therapist walking on each side of the pool, but as soon as he learned the routine, he swam in a dog harness. Two months later with the improving muscle mass in his front legs he started to increase his swims until he started to actually walk a few feet each time he went out for exercise. He gradually started to increase the use of his front legs and he started to walk again and gain strength and confidence.
Two months later in mid November, we took Barney to Dr. Schmalberg for follow-up and re- evaluation. For the first time since his initial visit, Barney entered the office on his own four feet. He received a rousing greeting as the news spread among the staff: Barney’s walking!
No one was more pleased than Dr. Schmalberg. Out of 10 cases of Brachial Plexus Neuropathy he diagnosed by that time, only 2 dogs had recovered – Barney was his #2.
Barney walked out of Dr. Schmalberg’s office on Dec. 16th, 2013, with the only recommended therapy to use a water treadmill. We returned to the Sanctuary for 8 water treadmill exercise routines and watched as strength continued to return Barney’s legs.
Today, Barney’s legs are straight, his topline perfect. He is the strong, healthy, bold, noisy, bossy boy he was before his accident. He is enthusiastic about everything–everything that got him in trouble in the first place. He is competing in Obedience and loves to jump and retrieve the dumbbell. We are planning his return to the Conformation show ring.
We have acquired many friends along the way during Barney’s recovery – wonderful vets, aids, and therapists. Without the financial assistance of Friends and Vets Helping Pets, Barney would never have had the opportunity to pursue the rehabilitation service leading to his recovery. This charity made it possible to hope and continue to press on – they have inspired us all. And every time Barney charges out the door, Ed and I remember that, although life-changing accidents can happen in a split second – that care, concern, and love can’t cure all – and as Dr. Schmalberg said “Vizslas are a breed with heart”.