Laurie's Blogs.

Last week I had a big hole in my schedule one day, and I was asked if I might consider seeing a neuro dog, whose owners were really hoping to get in, sooner than their appointment the upcoming week.  I said yes.

The case was complicated.  The dog was a passenger in a motor vehicle accident and had both cervical and lumbar involvement resulting in quadriplegia which was beginning to resolve in ‘bits and pieces’.  While the case itself is extremely interesting, it’s not the main point of this blog.

The owner had plenty of questions… but most importantly wanted to know prognosis.  The dog is older, and the owner wondered if it is unfair or unreasonable to persist with rehab if the prognosis was not good.  So, the rest of this blog is really just about how I talk to owners of neurologic dogs when I first see them.

Here are three phrases / points of conversation that I always bring up when doing an initial assessment of a neuro dog.

1.   “I’m going to think out loud for you, but you can’t hold me to anything until we get to the end.”

I use this phrase a lot whenever I do initial assessments.  I find that owners really like to know what I’m doing and what I’m thinking as I assess their dog.  It also helps me to think, and it lets the owner know how many things I am actually thinking about and factoring in as I’m palpating and testing their dog.

2.  “Neuro is always a ‘crap shoot’.  We don’t know how things are going to progress without giving it a little time to see how fast the body will heal with the right kind of stimulus.  I would hope to see signs of progress within two weeks.”

This is honest.  We can’t say with full certainty how a neurologic dog is going to progress. So this statement sets the stage for realistic expectations, and gives me and my team a chance to work with the dog for a while.  Additionally ‘signs of progress’ does not mean ‘full recovery’… it means a progression in the right direction.

3.“These are the things that give me hope…”  “These are the things that concern me…”  “These are the things that are normal for this type of injury / stage of healing…”

As medical professionals, we take for granted what we know of the nervous system and the fact that we have seen other neurologic cases and how they progress. I like to share some of this information with my clients.  So, when I explain what I am finding with my examination, I lay things out in these categories.  It gives them hope.  It gives them perspective.  It gives them things to watch for.

I’m sure I’m missing other aspects of what I talk about with clients during an initial neuro assessment, but these three things I feel are very important.  I find that they help to establish a rapport and ‘therapeutic alliance’, they begin to build trust, and they set the stage for moving forward with a rehabilitation plan.

So, this is my message for you this week.  Maybe it is of use to a handful of those who read this.

Until next time,

Cheers!  Laurie