September 01, 2015 / Issue 13
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A Well Adjusted Pet, Dr. Ilana Strubel
Wow! What an amazing couple of months! Dr. Ilana and team have been working flat out with new clients and old favorites alike and A Well Adjusted Pet is partnering with Ortho Pets to provide advanced custom Veterinary Prosthetics and Orthotics consultations in the Bay Area! Read on to learn about the exciting new world of canine orthotics and prosthetics and what they can do for pets!
Patient of the Month: Maggie!
Maggie and her custom orthotics

Maggie's Story:

When I first evaluated Maggie for a physical rehabilitation and pain management consultation, it was clear to me that she was dealing with a lot of pain from an ongoing injury to her knee. Maggie was in foster care at Muttville Senior Dog Rescue and had suddenly lost her ability to climb stairs at her foster home. From her physical exam, her posture, and her gait I thought it likely to be an acute injury on top of a past problem with her 'Anterior Cruciate Ligament' (ACL) - ouch! 

The ACL keeps the 'shin bone connected to the thigh bone' - as the old song goes - and, if torn, these two bones slip and slide on each other. This is really uncomfortable and causes heat, pain, inflammation, and swelling in the knee joint. Because a dog's rear legs are always in use and ligaments have poor blood supply, not regenerating well once damaged, if the ACL is fully ruptured, the injury never really heals.  Without the ACL ligament to hold the knee in a normal position, prolonged slipping and sliding of the bones causes the cartilage to be destroyed in the knee. With the breakdown in cartilage we see terrible cases of 'Osteo-arthritis' with bone spurs and joint inflammation developing and causing extreme pain for the patient every time they take a step.

Maggie is a very sociable girl who loves to interact with people and she doesn't know she needs to be careful on her 'old lady legs.'  By the time we met, she was already suffering from a bad flare up of arthritis from walking around on the unstable knee. In fact, it was so painful that she couldn't put full weight on this leg at all, instead shifting it to her other legs to compensate. And because she was unable to bear weight on both rear legs, she couldn't go up and down the stairs. The muscles in the affected limb had begun to atrophy and she was indeed headed towards a steady downward spiral.

From the outset, we knew she needed help and wanted to save Maggie from a future filled with pain! Luckily Muttville was willing to go the extra mile and have a Custom Stifle Orthotic (also known as a 'Knee Brace') made which was exactly what she needed! Soft 'knee wraps', 'ace bandages', or other 'off the shelf' solutions don't limit the abnormal motion in the knee and often make problems worse by causing pressures sores and associated soft tissue injuries. A recent study at the University of Kentucky has shown that the Ortho Pets custom knee brace is extremely effective in normalizing the biomechanics of the knee in patients with a ruptured ACL ligament!

I proposed that we design and build a custom knee brace that would provide rigid stabilization for her knee in two of the three planes of motion. This brace would prevent the bones from slipping and sliding against each other and also prevent twisting and grinding when she walked. However the device would still allow her to bend her knee to sit, lie down, walk and to climb stairs. You can imagine that creating this is a specialized process! I think of it like designing a custom suit of armor to help stabilize her leg. Wearing it, she could regain her confidence in using the leg without being in pain.

As you may know, I have been working with Ortho Pets in Denver, CO, for the past 2 years, undergoing advanced training that's given me incredibly valuable expertise in the process of designing and creating custom orthotics (braces). When it comes to orthotics and prosthetics, Ortho Pets are the folks with the most medical knowledge and expertise, partnering with the Canine Rehabilitation Institute and the vet school at Colorado State University! And with custom orthotics I've enjoyed a huge amount of success with many of my beloved senior patients regaining full use of their injured limbs. Seeing a dog transition from partially mobile and in constant pain to fully functional and pain-free is one of the most rewarding parts of my job! 

And that's also why it's been great to work with Muttville Senior Dog Rescue and Maggie. Her new adopters have brought her for follow up visits to provide physical rehabilitation for her injured leg and to retrain her to walk properly in her brace. We're currently working with a custom exercise plan to help her regain strength and build up her muscles and balance. And seeing her improvement, I am confident that she'll be back up to full senior doggie speed and pain-free in no time!

Click on the image to watch the brave Maggie in action!

To learn more about Veterinary Orthotics and Prosthetic Solutions you can contact me directly or read about the solution at the OrthoPets website.
Partnerships in Colorado
Ready for some fantastic news?

After a few years of collaboration, A Well Adjusted Pet has been selected by Ortho Pets to become a U.S. “Partner Clinic" for the San Francisco Bay Area! Last October, Dr. Ilana was invited to participate in specialized training in Veterinary Orthotics & Prosthetics at the Ortho Pets United Center in Denver.  Dr. Ilana immediately fell in love with learning the biomechanics behind how the orthotic products work, the process for creating each custom device, and the possibilities for disabled patients of all kinds!

In addition to her two visits to Ortho Pets in Colorado this past year, Dr. Ilana has also spent time training with the Physical Rehabilitation & Sports Medicine Department at Colorado State University, Veterinary Teaching Hospital. Her time at CSU gave her a wonderful opportunity to learn additional rehabilitation techniques from some real experts in the field, as well as skills in assessing and planning custom devices for her animal patients.
So what does this mean for your pet?

This fantastic news means that we finally have a truly viable and highly functional alternative to expensive and often painful surgery. Orthotics and prosthetics are especially useful for helping with chronic, ongoing conditions such as degenerative myelopathy, spinal stroke, arthritis, traumatic injury, post-operative support, cruciate ligament injuries and other tendon or ligament injuries. And our aim with these devices is to improve the quality of life for our patients, decrease pain, enhance mobility, and assist in rehabilitation. From custom-made boots that protect paws to splints that provide temporary support to prosthetic limbs or wheelchairs, the variety of options is ever increasing.

Excited to see some of these devices in action? Check out the images below!
This device is excellent is for rear leg weakness caused by insufficient functioning of the Sciatic nerve. Patients like Wally with this kind of damage often walk with their rear paws flipped upside down, dragging their toes and knuckling the paw over as they go.
And if you'd like to see Wally in action in his custom toe-ups, click here!
This custom-made brace is a stifle orthotic and is commonly used for orthopedic injuries such as ACL tears or patella ligament luxations. It provides support and stabilization for the leg and enables increased weight bearing while limiting abnormal joint range of motion.
One of our favorite new patients is Emma, who is currently working with us to redesign her Tarsal Orthotic (ankle brace). This device helps her to maintain a normal standing position in her rear leg and will enable her to regain pain-free mobility. Emma suffered an unfortunate Achilles tendon rupture and ongoing infections after surgical repair and we are currently designing a newer, lighter brace that gives her better function over time. Right now, the tarsal orthotic allows her to bear weight and walk normally on her rear leg, and her independence has grown as her pain is greatly diminished when using it.
Dr. Ilana is excited to guide you into a whole new world of treatment and care options for your furry best friend. Following some detailed planning and precise measurements of your pet's body, Dr. Ilana will coordinate the development of your custom device and draw up a treatment protocol to maximize your pet's rehabilitation. She'll be there from step #1 to the final rehabilitation check out and will be your pet's greatest cheerleader! If you think an orthotic or prosthetic device would assist your pet, contact Dr. Ilana now!
Review us on Yelp!

We love your reviews! And we also love Yelp! So, let's combine the two! If you use Yelp and would like to write a review for A Well Adjusted Pet, we would be so grateful. If Dr. Ilana has treated your pet, why not let the world know?


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