The Remarkable Journey of Miso: How PainTrace Provided Hope for a Staffordshire Cross
“If we had not had the PainTrace to confirm that there was sensory nerve activity in the hind limbs, we very likely would not have Miso with us today.” – Dr. Christina Rock
In the world of veterinary medicine, breakthroughs continue to emerge that change the lives of our beloved animal companions. Miso, an eight and a half-year-old Staffordshire cross, found himself facing a life-altering challenge after a serious injury. His story is one of determination, compassion, and a cutting-edge solution that saved his life. PainTrace® – a non-invasive pain monitoring device played a crucial role as it was used to detect neural sensory status, providing a more objective prognosis compared to traditional methods.
Miso’s life took an unexpected turn one fateful evening when a crash echoed through his home. Following the incident, he experienced a rapid onset of paraparesis in his hind limbs. While the exact cause was not immediately apparent due to limited access to advanced imaging, the prognosis looked grim as Miso exhibited no deep pain response, leaving his veterinarian, Dr. Christina Rock, deeply concerned.
Miso’s stoic nature only added complexity to the diagnosis. Like many SPCA Staffordshire-cross dogs, Miso didn’t show an overt reaction to traditional tests like toe pinching, even prior to his injury. This challenge left Dr. Rock and Miso’s owners grappling with a difficult decision – contemplating the possibility of euthanasia due to the lack of encouraging signs.
In the midst of uncertainty, PainTrace emerged as a beacon of hope. A non-invasive wearable device, PainTrace is equipped with skin-mounted sensors that directly detect neural signaling within pain pathways. This innovative technology offered a glimmer of clarity for Miso’s situation, and Dr. Rock decided to take advantage of it.
To their delight, PainTrace revealed a repeatable deflection in response to stimulation of specific dermatomes on Miso’s hind limbs. This critical discovery provided much-needed confidence – it indicated that sensory nerve function was still present. Armed with this newfound insight, Miso’s medical team, led by Dr. Rock, embarked on an intensive rehabilitation regimen with renewed determination.
A Journey of Recovery…
Miso’s journey towards recovery was a collaborative effort. His veterinary nurse owner, alongside a team of specialists, dedicated themselves to helping Miso regain his mobility and independence. Through a combination of rehabilitation techniques, including neuromuscular electrical stimulation (NMES) and underwater treadmill therapy (UWT), Miso’s progress was slow but consistent.
A Triumph of Will
With each passing milestone, Miso’s resilience shone through. He gradually regained tail wagging, took his first steps, and even achieved the remarkable feat of voluntary urination. PainTrace had played a pivotal role in confirming his sensory nerve activity, leading to a transformed prognosis. Miso’s journey is a testament to his owner, Dr. Rock, and a team of specialists who worked tirelessly to ensure his success, proving that innovation, unwavering determination, and compassion can save even the most challenging cases.
Although his Treibbal days might be behind him, Miso’s story is one of hope and triumph in which he is sure to become a cherished couch cuddler and regain his independence. As technology continues to advance, stories like Miso’s inspire us to believe in the boundless possibilities of healing and hope for our four-legged friends.
Miso’s full story as described by Dr. Christina Rock at Happy Hound Vet Limited:
Miso is an 8.5year old staffy cross with prior history of mild hip dysplasia, and active in Treibball. Miso was engaging in evening zoomies in his house when a crash was heard. We don’t know for sure what he might have run into, but following this he experienced acute and rapidly progressive onset of paraparesis of the hind limbs with accompanying Schiff-Sherrington syndrome developing indicating T4-L4 myelopathy with panniculus absent from L1/2. X-rays at the time were clear for visible abnormality and he had no deep pain response. Reflexes were intact but he had no voluntary bladder or bowel function and required expression or catheterization to empty his bladder.
Findings were unchanged at the first rehabilitation assessment with him. As advanced imaging is not readily available in our region (10 hour round trip to access CT/MRI) and surgery was not a viable option for Miso’s family, we elected to implement intensive conservative rehab treatment. The lack of focal spinal pain suggested that this may have been a massive FCE, which would be non-surgically managed, anyways. A team was assembled including Helena Akesson (his vet nurse owner who has some additional rehabilitation training), Green Island Veterinary Clinic (his primary care provider where his owner is employed) and included a veterinary acupuncturist (Jennie’s Pet Therapy), Aqua Paws Canine Hydrotherapy + Rehabilitation (our local hydrotherapy provider who was also able to provide additional laser therapy while we awaited suitability for underwater treadmill therapy) and Happy Hound Vet Limited (Dr. Christina Rock, rehabilitation coordinator for Miso’s care team).
While his Schiff-Sherington resolved within the first week, there were no other significant changes and no overt deep pain response was noted on standard testing of hind limbs. Interpretation of deep pain testing was somewhat complicated by the fact that, like many SPCA Staffy-cross dogs, he is highly stoic and pre-injury the most he would do if you pinched his toes would be to slowly kick or withdraw his foot with no other appreciable behavioural acknowledgement.
His owner was well aware of the poor prognosis given the lack of overt deep pain response to nail bed testing over this week and we were seriously contemplating euthanasia.
I offered that we could perform a PainTrace to give us some potential additional clarity on Miso’s neurologic sensory status. To our joy we did see a repeatable deflection for stimulation of the plantar metatarsal and caudal foot dermatome of the hind limbs that was similar to that generated when we pinched his forefoot webbing. This gave us confidence that there still was nerve function available and that with intensive rehab we would potentially achieve his goals of being able to walk and toilet independently. We then trialed NMES of the caudo-medial thigh muscles and noted some acknowledgement by Miso. This gave us confidence to continue with his intensive rehabilitation regime, which he has quite frankly relished. He has become the clinic mascot at his owner’s employer where he gets to hang out every day getting thoroughly enriched watching all the goings-on at the clinic and getting extra pats and attention from everyone there. He has delighted in the extra 1-on-1 time with his owner and enjoys being treated like a minor celebrity when he attends dog sport events with her and her other dogs. While progress on all his key milestones has been slow it has been steady since we made the decision to continue his conservative treatment.
By this time Miso was able to be assisted to stand for up to 5 seconds.
Some acknowledgement was noted on pinching of toe bones.
Tail wagging returned, which is a key feature of his personality!
We started UWT for gait training and endurance in standing continued to improve and consistent yawn response noted to pinching of tail bones.
Miso was taking steps on the floor with tail stimulation. Ongoing progress in number of steps both in UWT and at home continued over the following weeks and he even demonstrated ability to get himself into standing on occasion. Foot placement continued to improve with less knuckling.
Miso succeeded in a major key milestone of achieving independent voluntary urination, likely partly due to his improved confidence and endurance in standing.
While he is unlikely to return to Treibball, he now has a very good prognosis for being able to be a champion couch cuddler (his favourite activity!) and being able to walk and toilet independently. It has been a long road and he still has progress to make, but his owner’s and care team’s dedication have paid off.
If we had not had the PainTrace to confirm that there was sensory nerve activity in the hind limbs, we very likely would not have Miso with us today.