Dog of the year competition 2009: Inka

Alison Williamson, 4th December 2009 (Re-printed with the kind permission of DTW)

Healthwise, Inka, my GSD, has not been the luckiest of dogs. She was born in June 2001, and by the start of 2009, she had accumulated over £15,000 in veterinary fees. I bought her at six months old from a show kennel who had decided she was not of sufficient quality to breed from. Before I bought her I paid for her hips to be x-rayed – which were excellent at that time. I had received advice from many sources (including professional) that if a dog has good hips at that age they are unlikely to become very bad hips....

We had to work very hard together to overcome Inka’s nervousness caused by poor socialisation and exposure to ‘every day’ events during her early months. Then, when she was x-rayed/ scored at 2 ½ years old, I was shocked to discover her hip score was an appalling 81 (39:42), although thankfully her elbows were clear (0:0). Clinically, she exhibited no symptoms whatsoever, and veterinary advice was to ‘carry on as before’. So we continued with our lovely long walks, as well as obedience, agility and breed shows.

Sadly, Inka’s health was always causing set-backs. She had a nasty on-going skin complaint for many years, which largely ‘disappeared’ after she was spayed. She has also had several benign skin tumours. More seriously, in spring 2004 she very nearly died from splenic torsion – a rare and usually fatal condition. If that wasn’t enough, in summer 2007 Inka bloated three times in two months. Referral to specialist vets at Langford revealed chronic inflammation of the stomach wall caused by megaoesophagus. On further advice she had gastropexy surgery to ‘tack’ her stomach wall to prevent future torsion, and is now on a prescription tinned diet for life.

In 2008 we had a great year. Apart from two great walking holidays, she competed in the Special Prebeginner Stakes Final at Crufts, won her Pre-Beginner and won one of her Beginners, had some great places in agility, and qualified for Crufts 2009 in breed!

We started off well in 2009. We went on another lovely walking holiday to North Wales in mid-March, and Inka had more successes in breed and agility shows. However, by the spring things were starting to go wrong. Not only had I found out I was being made redundant, but it was also apparent that Inka’s hips were quite suddenly deteriorating. I had done everything I could to keep her fit and comfortable, but she was slowing significantly on walks, struggling with the stairs, could no longer jump full height at agility, and kept ‘clipping’ the back of the car as she jumped in. The day she just looked in the car and looked back at me I knew I had to take her to the hip specialist.

Inka went to the specialist on 7th May. He concluded that she needed to have her right hip replaced ASAP. Since there was no real alternative, other than watch her suffer until she would have been PTS, I agreed and the vet operated that day. I picked her up the next day. She was very lame and confused, and so unsteady she needed help when rising, whilst she ate and to go to the toilet. She had to do four 10-minute walks a day, and right from the start she seemed to walk reasonably well, although would never weight-bear on her new hip when standing. The first weeks were a constant worry in case she slipped, tried to rush somewhere (such as if the doorbell rang) or tried to have a game with my other dog! I knew if she slipped in the first six weeks there was a very real risk of dislocation. I devised a system of ‘baby gates’ and room exclusions to try to minimise the risks, but suddenly life seemed fraught with potential dangers!

Five weeks after surgery she still wasn’t weight-bearing when standing, even though she was apparently walking reasonably well. I took her back to my local vet who confirmed that he could feel vertical and lateral movement in the new joint on manipulation. I obtained an emergency appointment with the specialist the next day. He found that the metal pin was luxating in and out of the metal ball joint to which it should have been tightly secured. After it was fixed under further anaesthetic, Inka improved straightaway. There had been massive muscle loss during those five weeks, which now made her recovery and return to fitness much slower. However, six weeks later Inka was walking seven miles a day again. Following a further checkup Inka could start hydrotherapy, which we did twice a week for twelve weeks. This made a real difference to her overall strength. She also had physiotherapy to help release the locked muscles in her back and hips, which had gone into spasm to compensate for her joint problems.

In August we did our first Open Obedience Show of the year at Bath, where she won the Special GSD class – I was thrilled to bits! In September, knowing her passion for agility, I took her to my local Open Agility show, and ran her in the NFC anysize (micro height) class. To curb her speed and enthusiasm I just ambled along behind her. By jump four she realised I wasn’t ‘with her’ and looked around and gave me a very concerned look of “Oh well, if you’re not feeling too good, I’ll slow down and go at your pace then”. She happily ‘pottered’ around the rest of the course at a very steady pace, being very careful to measure her strides so as not to get ahead of me! It was a truly touching moment and the memory will always be with me.

To prove her Bath obedience win wasn’t a fluke, she even managed a second at BAGSD Birmingham in late September. However, by then, erated hip. This was partly the result of excessive load-bearing and joint

wear caused by the problems with her first hip replacement. Although only about 25% of dogs which have one hip replaced need both replacing, it looked as if Inka was going to be unlucky.

In late October, having achieved maximum possible fitness, I took her back to the specialist. Although she moved/ gaited well, on examination he found she wasn’t putting much weight on her left hip, and that there was a lot of noise and ‘grinding’ within the joint. Although the optimum period for canine bilateral hip replacements is one to two years between surgeries, Inka needed surgery now. When he operated the vet discovered that the left hip was much worse than the right hip he had originally operated on, with several ‘joint mice’ apparent. These are small pieces of bone which had broken off the damaged joint and had become lodged between the femur head and socket. Here they were grinding away inside the joint causing pain and accelerating the deterioration. It was no wonder poor Inka had been much better on some days than others - depending on where the joint mice were in her socket that day.

This time Inka’s post-operative recovery was much quicker. Right from the start she was weight bearing on her new left hip, and even on the first day after surgery needed no help from me to steady her. Initially my biggest problem was trying to stop her from doing all the things she thought she should be doing!

Even this time though her recovery hasn’t been problem free. Three weeks after surgery, at the second attempt, she came off the pain-killers, but by five weeks she was so lame that we had to re-start them again. I was very worried that something may have worked loose in the joint again. However, a further check–up and examination confirmed that she has been suffering from prolonged muscle pain where they have been in constant spasm. Thankfully, the joint is good, and hopefully she should be able to come off the pain killers in a couple more weeks. We can now increase exercise, as well as re-start hydrotherapy – all of which should greatly speed up Inka’s recovery. I owe huge thanks to all the health professionals (vets, nurses, physiotherapists and hydrotherapists) who have helped (re-built?!) Inka.

Throughout all her ordeals this year Inka has remained happy and playful. She has been incredibly tolerant towards everyone and everything that has been asked of her. Her trust and faith in me has been entirely unmoveable, even when things weren’t going well. No matter what life throws at Inka, her truly lovely and loving character always shines through. She is a truly amazing dog.

Postscript

The above comprised Inka’s entry into the Dog Training Weekly’s (DTW) Dog of the Year 2009 Competition. This competition is for dogs working in competitive obedience who have shown courage and determination in adverse circumstances over the past year. Inka won DTW Dog of the Year and on a very special and memorable day we were presented with our trophy in the main Obedience Ring at Crufts in March 2010. Below I provide a brief update since submission of our entry in December 2009.

We had re-started hydrotherapy on 8th December and if all had gone well, Inka would have come off the anti-inflammatory pain killers around mid-December 2009. However, despite twice weekly hydrotherapy sessions throughout December, it was clear that this alone could not unlock months of accumulated muscle spasm in her back and hips, and the on-going associated pain this was causing. Therefore, on 4th January 2010 I took Inka for a session of physiotherapy, which turned out to be the very best thing I could have done. The physiotherapist was appalled at the extent of muscle spasm in her back and hips, which required intensive physical manipulation to encourage release. Inka struggled both to stand steadily or walk properly after the half hour session, and I momentarily doubted my wisdom in taking her. However, within three hours she was moving more freely than she had for months, and within two weeks, following a rapid increase in exercise tolerance, she was once more walking seven miles a day. Inka had once weekly physiotherapy sessions throughout January which really turned her fortunes around, and by February she was completely free antiinflammatory drugs for the first time in about 2 ½ years.

She had another follow-up appointment with the hip specialist on 26th February, who confirmed she had finally made the recovery he had been expecting of a fit dog sometime previously. However, the very next day Inka pulled up lame on her front right leg whilst chasing my other dog! I put her back on anti-inflammatories, and when she wasn’t quite sound after five days, took her back to my local vet. He has detected a little arthritis/joint wear in her right elbow. In reality, this could have been developing for months or even years, and has been masked by the treatment for her hips. The good news is that the antiinflammatories are now controlling the elbow inflammation, although it seems unlikely that she will ever be totally independent of them!

Just a year ago, with the antiinflammatory drugs no longer controlling Inka’s hip pain, replacement hip surgery was the only remaining course of action. One year on, Inka’s range of movement in her hips has increased considerably, and she now has pain free joints. It is just five months since her second operation, and her strength continues to improve. Despite having to re-start the anti-inflammatories to control her elbow arthritis, importantly Inka is now once more leading a pain free, fulfilled and happy life.

THE PHYSIOTHERAPIST

Sonya Nightingale MCSP ACPAT Cat A

Name: Inka Williamson DOB: 07/06/01 Breed: German Shepherd

I will not repeat Inka’s main history here as it is included in the article above but merely outline her physiotherapy interventions.

Inka was referred in mid 2005 for mild thoraco lumbar pain on extreme exercise. On examination the only findings were a decreased range of passive movement at T11 and 12. This responded well to mobilisations and resolved the reported symptoms of early fatigue and tenderness, with an associated kyphotic stance. Over the next two years she was seen a further four times with similar symptoms but the picture was complicated by the development of her abdominal problems during this period.

By Dec 2007 the findings had changed to a minor loss of proprioception and control of the pelvic limbs associated with a 20% loss of flexion in the left hip and extension in the right hip. The proprioception and stability in the pelvic limbs improved with taping over the abdominal group and sartorious. However, in spite of mobilisations the ranges in the hip joints continued to deteriorate slowly. Between September 2008 and her first THR in May 2009 Inka experienced an increase in the frequency of her thoraco lumbar pain episodes and gradual loss of the stability in her pelvic limbs resulting in a ‘plaiting’ gait with increased sartorious spasm. She tolerated her treatment, consisting mainly of soft tissue mobilisations, well and improved each time, but the effects were not long lasting.

Inka struggled with the recovery from her first THR as detailed in the article and was only allowed back for physiotherapy eleven weeks post op from her second THR. By this time her thoraco lumbar spine was extremely stiff and tender to palpation and the adductor muscle groups, quadriceps and sartorious were bilaterally in spasm. This resulted in a gait with very little spinal movement or swing phase in the hind limbs. Her treatment since then (Jan 10) has consisted mainly of spinal mobilisations and soft tissue work. She is now off her analgesia with no muscle spasm and only a slight drop to the right pelvis in trot.

I wish Inka well and congratulate her on gaining her dog of the year award. She has cheerfully put up with everything that has been thrown at her and is living proof that, with the right attitude, you can succeed.