Thursday, 22 September 2016

Discospondylitis

“DISCOSPONDYLITIS” - sounds like a made up word doesn’t it? Unfortunately, it is a rather nasty infection. Not to be confused with spondylosis, this is an -itis; an infection. And it is not the easiest of ailments to diagnose as it initially presents like so many more common issues. 

Now meet Fletcher (named after the Ronnie Barker character in Porridge as he is such a comedian). It took multiple referrals and scans to actually find out what was causing him to lose muscle mass and his mobility. 


Despite its cheery name, discospondylitis is an infection of the bone and disc space of the spine which causes inflammation in the vertebrae pushing on the nerves and spinal cord causing acute pain. Not cheery at all. Typical symptoms include weight loss (Fletch went from 36 kg to 31 kg), lack of appetite (Fletch developed paralysis of the gut), depression, fever, back pain (Fletch became quite hunched) and overall loss of mobility. But most of these symptoms can also be seen in many other ailments including illnesses like meningitis. In Fletch’s case, he initially showed these symptoms back in June, appeared to recover before re-displaying them all again 2 months later. 


Fortunately, once diagnosed and treated with the appropriate antibiotics, improvement and recovery is quite hopeful. Fletch is only 3 years old and was a very strong lad running half marathons with his Mum. He has been on his antibiotics for only a couple of weeks now and is already making considerable progress. He is also on Gabapentin to help with his neuropathic pain. 


The reason I was called in was to help with his muscle wastage and to provide some safe exercises which he can do to build him up. He is still a big red Irish Setter but doesn’t have the muscle strength to get his body around with confidence at the moment. He walks like he is tired with small steps – understandable with all that he has been through. 

Fletcher is a wary dog despite being the comedian. He is all about “Ok…I like that, I like you but I’m still not sure so I’ll keep my eye on you if that’s alright?”. It took a few minutes to persuade him to fully lie down on the massage mat but once down the eyes slowly closed….and then opened every now and again just so I was put in my place. 

He adored work on his neck, he liked work on his shoulders, he was Ok with work on his hips and thighs but he was still very unsure about work along his back. The massage part of the session was all about getting those muscles full of the good stuff again (blood, oxygen and nutrients). There were clear limits to how far he could stretch with the passive movements which allowed us to make markers to monitor any progress over the next few weeks. The exercise routine was to help stretch his back safely and confidently. 

He sleeps on a sofa, of course, but it is quite high off the floor. I suggested he might benefit from a cushion to help his climb up and down. Almost immediately after his Mum put the cushion down he eased himself off the sofa, placed his front paws on the cushion, looked at us both with a “There…that’s what I’ve been needing” look, stepped on to the floor and gave the biggest stretch. First time he has done that in a while. Little things help so much. 

It will probably take a while to regain full recovery but hopefully he and his Mum can look forward to those long runs along the beach again in the New Year. 

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