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Case Studies

Arnhem’s Journey Managing Degenerative Lumbosacral Stenosis & Mobility Challenges

Arnhem, a 9-year-old German Shepherd, has faced increasing mobility challenges due to Degenerative Lumbosacral Stenosis (DLSS), first diagnosed in 2020. Initially managed with steroid epidurals, his condition has worsened over time, leading to significant nerve root compression and worsening hind limb weakness. Recent MRI scans also revealed moderate cervical spinal stenosis at C6-C7, which may be contributing to his balance issues and ataxia (wobbliness). Additionally, Degenerative Myelopathy (DM) is suspected, with genetic testing currently underway.

Given these complex neurological and orthopaedic issues, Arnhem’s rehabilitation programme at the Canine Fitness Centre focuses on maintaining strength, improving stability, and slowing disease progression.

Key Mobility Challenges

Arnhem’s main symptoms include:

  • Hind limb stiffness and weakness, particularly on the right side
  • Occasional offloading of his right hind limb
  • Intermittent dragging/scuffing of hind paws, especially on uneven surfaces
  • Reduced hind limb engagement, making turning movements difficult
  • Postural instability and weight shifts when standing
  • Pelvic sway and mild forelimb compensation due to lack of hindlimb control

Despite these challenges, Arnhem remains a strong, determined dog, responding well to structured therapy.

Treatment Plan: Physiotherapy & Hydrotherapy

Arnhem’s rehabilitation includes a combination of physiotherapy and hydrotherapy, focusing on nerve stimulation, strength-building, and postural stability.

Physiotherapy Sessions

  • Laser Therapy – Applied to lumbar spine, sacroiliac joints, and hips to reduce inflammation and pain
  • Massage & Soft Tissue Therapy – Focused on lumbar paraspinals, hip flexors, and triceps to ease muscle tightness
  • Balance & Proprioception Work – Using wobble cushions and controlled weight shifts to improve stability
  • Range-of-Motion (ROM) Exercises – Encouraging flexibility in stiff joints while avoiding excessive strain
  • Sensory Stimulation Techniques – Engaging hindlimbs with cavaletti poles and tactile stimulation to improve limb awareness

Hydrotherapy: Underwater Treadmill (UWTM)

Although Arnhem struggles with hind limb coordination, hydrotherapy helps by:

  • Providing resistance training while reducing joint stress
  • Encouraging correct weight-bearing and movement patterns
  • Strengthening core and hind limb muscles
  • Improving balance and endurance

Session adjustments include:

  • Water depth control to optimise support and muscle engagement
  • Guidance to prevent hind limb “plaiting” and medial collapse
  • Postural corrections during rest breaks to reinforce proper stance

Progress & Key Improvements

Over recent weeks, Arnhem has demonstrated notable progress:

  • Less frequent dragging of hind paws, with better foot placement
  • Improved stride length and hind limb coordination in the treadmill
  • Greater endurance before signs of fatigue
  • Stronger engagement in home physiotherapy exercises
  • More consistent weight-bearing in a standing position

While he still experiences periodic hind limb offloading and moments of instability, these have been less frequent and less severe.

Ongoing Care & Future Outlook

Given Arnhem’s complex condition, his rehabilitation will remain an ongoing process. The next steps include:

  • Adjusting hydrotherapy intensity based on fatigue levels and response
  • Continuing laser therapy and soft tissue massage to prevent compensatory strain
  • Implementing further sensory exercises to maintain hind limb engagement
  • Monitoring for changes linked to potential Degenerative Myelopathy (DM)

Arnhem’s dedicated rehabilitation team and committed owner ensure he receives the best possible support, keeping him comfortable and mobile for as long as possible.

Conclusion

Arnhem’s story highlights the importance of structured rehabilitation for complex neurological and orthopaedic conditions. With expert physiotherapy, hydrotherapy, and careful monitoring, he continues to enjoy an active and engaged life, despite his diagnosis. His journey is a testament to the power of proactive care and tailored therapy in maintaining mobility and quality of life.

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