Viva's long road to rehabilitation: the work-out

The shelter passed along to us from the former owners that Viva loved long walks. They probably meant measured in time, not in distance. Viva hardly ever stepped up in pace, let alone take a run. As we soon where to find out, every step was painful for her. Caused by spondylosis and a continuously infected paw.

She already lost a lot of muscle with this inactive lifestyle, and she was in a negative downwards spiral. After we cured the infected paw and managed the spondylosis, we guessed it would be easy to build up some muscle again. We were looking forward to getting started. We could not have been more ignorant.

The mind

What's wrong with a couch-potato?

Viva was in better health and pain free, but the mind still told her to spare her legs and back. We could notice her being more happy and playful, but the walks were like before. The first thing she had to learn was that it was alright to use her legs again.

We adjusted our walks and made sure to do a lot of uphill walking and swimming. Preferably on the beach, plowing through sand and dunes.

How to outsmart a smart dog

Building up muscle is hard work. For Viva, but even more so for us. We came home exhausted from our work-out walks - which are more like runs to us humble humans. But that is by far not good enough for a dog. Therefore we tried bicycling, but that was just to stressful for her as a fearful dog. We also tried with toys, luring her into going uphill or climbing a sand dune.

But Viva is not that easy to lure. Once up on a hill, she didn't come down anymore and enjoyed her toy by herself. Or find out a less steep slope to reach the toy. Throwing another, more valued toy, didn't help getting her down either. Walking away would get her down though. But we had to find a new hill to throw the toy. Throwing it up the same hill again, she would only look at me and think "You must be stupid ...". When I asked Kenzo's help to get the toy back he was happy to oblige. But Viva thought it was very annoying he was getting "her" toy and waited for his return downhill with an attitude. Not a good idea if we wanted to keep the peace. I had to climb up and get it myself. In the end, it was me getting the exercise instead of Viva.

The water walker

The water walker was absolutely key to make any substantial progress. Walking this underwater treadmill once or twice a week forced her to use her legs. It was also a great way to follow her progress. Not only could we increase the time for each couple of sessions, we also could get a good picture of what she could cope and put a time on it. As soon as her steps became smaller, we knew she had reached her threshold. We found the water walker to be a great and absolutely necessary addition to our daily work-out schedule.

Viva started with a five minute session. Then we slowly build this up into multiple short sessions with a break in between. Today she can do a 13 minute non-stop session without getting tired. Pretty good Viva! To compare, a healthy dog could do a 30 minute session. But I am not sure if that would be realistic for Viva because that would certainly be too stressful for her back.

Stretch those legs

Slowly, very slowly, we can see her make progress. The biggest progress we saw was when her mind made the switch that it is cool to use both of her hind legs. Her gait improved into a more dog-like style, instead of using her hind legs as bouncers. She could accelerate and stop quicker. You could see her really stretch her legs to make big steps, meaning she was using her muscles.

Diary

To keep a good track of her progress we made a simple diary with videos and pictures of Viva doing the same things on the same places. That way we could track difference better. See this video here comparing Viva walking up stairs after one month of training. The two pictures above to the left and right also shows how she is able to stretch her legs now.

Because progress is so slow on a daily basis, the diary helps us to notice improvements being able to compare over a longer time. It is a mood booster too, that keeps us going.

Finding balance

We learned the hard way that work-out is more than just working out. Viva missed one of her acupuncture treatments. It was rescheduled twice postponing it in all for 3 weeks. As she needs acupuncture for her pain management and keeping her back flexible I was such a fool to wait and not give her NSAID's instead. We kept on training, and disaster struck. When she miss-stepped it indicated something was wrong. She was rapidly going downhill once more instead of improving. We had to start all over again with step 1, convincing the mind ...

There should be absolute balance between her medical treatment AND the work-out. We learned it the hard way. We have some NSAID's around might we miss an acupuncture treatment and I will not hesitate to use it next time.

When enough is enough

Ha! you make it sound like you can keep up with me ... not!

The question I struggle with now is how far I can take this. Viva will never become as agile as she once was, and I must take care not to overdo it. I am very happy with where she is now. She can do a one hour "work-out walk" with no signs of stiffness or pain the next day and fresh for a new work-out. The way she positions her legs, turned inside to better support her body, has improved a lot but could be better. When she can position them straight it will be a great indication that her muscles are strong enough. So we continue with the work-out and the water walker. Just taking it slowly, and giving Viva a chance to show how far we can take this.

A big thank you to the awesome people of the vet clinic "Københavns dyrehospital" and the love they have given to Viva: Lea, our water walker trainer and coach, and Charlotte, a great vet with a magic pair of hands.

***

"Viva's long road to rehabilitation" is a series of updates how Viva is doing almost one year after her adoption:

• the work-out
• reactive behavior

Viva showing remarkable improvement in health

I admit. I am a very happy person. Although we knew Viva was neglected and in poor condition, it was still a shock to discover her many health issues. Now, five months after we adopted her, we can see how much she improved. It is so much more then we could have hoped for.

Viva the Hovawart

A small recap of her issues: Viva has spondylosis, a form of osteoarthritis, food- and dust mite allergies, and was overweight.

The easy part was the overweight. Viva is now on 86 lbs. Perfect for her size and body structure. She lost 14 lbs with a strict diet balancing everything from her meals as well as her treats and a daily exercise program. She must enjoy not having to drag along all those extra pounds on her already sore back.

Spondylosis

The gravest of her conditions gave us a lot of worries. Spondylosis cannot be cured. It leads to pain, stiffness, lameness, restricted mobility and muscle weakness. Possibly also incontinence and an inability to coordinate placement of the feet. Dawgblogger wrote a very informative article about the disease: The Many Faces Of Arthritis: Viva Has Spondylosis.

Viva having acupuncture
We were so fortunate to find an excellent vet that studied Traditional Chinese Veterinary Medicine (TCVM). She suggested a treatment based on acupuncture, physical therapy, and a food supplement consisting of glucosamine, organic anti-inflammatories and Omega 3/6.

The acupuncture had an immediate effect. And after a month also the physical therapy and the glucosamine supplement started to pay of. Viva is today clearly in less pain. She enjoys long walks and playtime with Kenzo. And she likes playing rough. Where at first she sometimes whined and squealed because of (the anticipation of) pain, it is now Viva that initiates playtime and wrestling is her favorite. Her back is more agile. Where it first only moved up/down when she walked, it is now noticeably also moving left/right. This means she has become able to use the spine in her back!

Our daily work out (Viva is the darker Hovawart)

See also this video that show progress in her muscle build-up after one month of training.

We could have done better though, as Viva's muscles are not strong enough yet. A daily work out is limited in its progress. When Viva becomes tired on the walk she adjusts her level of activity, meaning progress is slow.

We did join an underwater treadmill program, but were not able to carry that through on a regular weekly basis. Viva stepped into something sharp and hurt her paw. Twice. Meaning a set back in the training program as we had to start over. But hey, it is great there is still room for improvement.

Allergies

To treat her allergies Viva is only getting low-allergy kibble and for her dust mite allergy we administer monthly shots of an allergy vaccine that is specifically developed for her. We also bath her regularly with a special dermatological shampoo.

Although progress was slow the allergies bother her a lot less. From a state of obvious discomfort, reddish skin, biting, itching and almost inflamed paws she now only has slightly reddish paws left. Biting and itching only returns incidentally and not so intense as before.

The vaccine is first fully active after nine months and we therefore still expect to make more progress. Her skin has such a beautiful pink color and the dandruff has disappeared.

The years to come

Today we visited the vet for her regular acupuncture treatment. She was very pleased to see Viva. The stiffness in her back is completely gone. Her muscles are not tensed anymore. We can stop now with the regular acupuncture appointments and just see when we would need it again might the pain return. The vet added that she was especially happy with Viva's progress, and that she has a completely different aura now. Viva is one of her patients that made the most remarkable progress.

What will happen in the years to come we don't know. But we are so hopeful for Viva's future. We cannot win the battle with her spondylosis. But we can enjoy each day we are allowed to spend with her. In good health.

Viva adopted: adressing her health issues in the first two months

The first time we noticed Viva was a half year ago. When her first family had left her in the local shelter. As a dog lover with a weak spot for Hovawarts I followed what happened with her. She got quickly adopted, but things went wrong and she returned to the shelter again after some months. That's when me and my wife decided to adopt her.

Viva in the shelter, 5½ years old
She had issues. She was overweight, flea-infested and had a poor skin condition.

We took her to the vet to look at her skin condition. The vet gave us some Hill's prescription low-allergy dog kibble as she guessed it was probably a food allergy. We also ordered blood work to investigate further for other possible allergies.

Unfortunately Viva couldn't cope the low allergy kibble and went down with some severe diarrea. We changed back to the original kibble to stop the diarrea. The vet got us some new, this time very-low-allergy, kibble. At least she could digest that but the whole thing made me uncomfortable. I don't know for sure if Viva suffers from food allergy as the other allergy test results hadn't come in yet. And not knowing what ingredients she would react upon, what would be safe for treats or snacks? The ingredients listed on the bag looked like something from which each living molecule had been removed. At the end I went along, better safe then sorry at this point in time. But I still have a bad taste in my mouth of getting pushed a Hill's sales pitch without a proper diagnosis.

When we got results back from her blood work allergy test Viva tested positive on dust mites and fungus. The good news was that this was treatable with a vaccine that had no known side-effects, so we ordered that. Now we had the whole allergy picture laid out. And although not overly excited with feeding low-allergy kibble and allergy shots, it would do the trick. We decided to go for it also because we started to notice other issues with Viva that could be a lot more severe.

Viva (left) and Kenzo (right) playing
Getting to know Viva better, other things with Viva started to worry me. She didn't seemed as mobile/agile as Kenzo. When Kenzo would land on her lower back when playing she seemed to be in pain and she stopped playing immediately. Also I guessed that the pain could be a cause for her aggressive, fear-based, behavior with some other dogs we met on our walks.

We went back to the vet to have this looked at. The vet investigated Viva's back and noted something was there that caused pain. We went outside and I showed her how Viva walked. Viva drags her feet a little when she walks (sounds like walking with slippers) and she also moves slowly as if she is tired. And when she is running, I can keep up with here. The vet discarded that to be an issue, but wanted to have a closer look at her back. Again, like with the food allergy diagnosis that didn't feel right.

We agreed to take x-rays of her lower back and got very bad news. Viva had spondylosis, a form of osteoarthritis. Three discs in her lower back were affected and were growing towards each other. This caused inflammation and pain. When left untreated, other discs would follow, resulting in a back as stiff as a board. The vet gave us a glucosamine and omega3/6 food supplement which is good for the inflammation and prevents the spondylosis from spreading. So far so good, but when she also suggested pain-killers and possibly also steroids, we thought that now it was enough. The total picture of Viva on low-allergy kibble, treated with agressive medicine and some of her signs neglected just didn't cut it. It sounded like a future of side-effects and new problems.

Inspired by my Twitter pal @dawgblogger on the possibilities of traditional Chinese medicine (TCVM), stem cell treatment, etc. we went looking for another vet. I found a vet that studied Chinese medicine in China itself, specialised in joint problems and an advocate for alternative treatment giving seminars, teached on universities, etc. She got her Ph.d. on that subject and travelled the whole country to handle the difficult cases everybody else had given up.

So we visited the new vet. Her approach was completely different. When we arrived we started with going on a walk where she observed Viva. Without me telling her she quickly noticed the same issues with Viva's walk I noticed before which our own vet had discarded earlier. After that we went inside and she did a physical examination, with a lot of feeling and rubbing Viva over her whole body. She concluded that the problem was not only the spondylosis in her lower back but also that her weak muscles were not able to support the back properly and had to be strenghtend. It was probably a result of Viva over a longer period trying to walk in a position that would give her the least pain. She was not sure that even more could be wrong, also because the right hind leg reacted differently to some reaction tests she did. But we had to move the muscle problem out of the way first to be able to see if more could be hiding.

We agreed to start a treatment with acupuncture for the pain and an exercise program to start training her muscles. Involving swimming in a pool with a treatmill and do a lot of walking up hill. Viva got her first acupuncture right away and we started the exercise program. The vet suggested to do this for a couple of weeks and then to re-assess the situation depending on the progress Viva has made. She instructed me to be on the lookout for any change in behavior that might indicate Viva was in less pain. In the mean time we can also talk allergies and nutrition again, as she suggested there are other options then low-allergy kibble. And she wanted, like me, know what ingredient triggered Viva's food allergy. But she stressed to work on her back now first, as the allergies seem to be/get under control with what we were currently doing.

I liked this. She noticed a lot more of what was wrong with Viva. Without even looking at an x-ray or other info. One thing in particular I noticed which I thought gave a lot of hope. When she was examing Viva and pressed on the top of her back, it looked stiff as like you would press on a woaden board. She repeated the examination of her back after the first acupunctur treatment, and I it was clearly noticeable that Viva's back reacted with more movement and flexibility to her touch.

And that is where we are now. Will undoubtedly be continued. For more information on treatment of joint problems, allergies, Chinese medicine, stem cell treatment and a lot more, please visit @dawgblogger's blog. On these topics it is one of the richest and most clear sources of information on the Internet.

Kenzo (left) and Viva (right)
One thing is for sure. Even Viva is struggling with her health, she still enjoys every day with her new family, Kenzo in particular. We have been on a vacation, started training in obedience and tracking on our own and have already been on lots of dog walk adventures. And she enjoys it as much as her health will allow it. Probably even more then that.

For us it is an absolute joy to see her getting better mentally. We hope her health will follow soon. And that she will have a great "second part" of her life.

She deserves it.