Sussex bravest pet

Sapphie - The Bravest Pet in Sussex

Sapphie on red ball

Clinical summary: Orthopaedic
multi-trauma

The veterinary surgeon’s viewpoint

“In 2007 I treated a delightful but unfortunate little dog called Sapphie, who had bilateral hip dislocation, a dislocated right elbow and cruciate rupture of her left stifle. Surgery to stabilise her hips was unsuccessful and she had to have a femoral head and neck excision on both her hips.

“After some time, I began to lose confidence that Sapphie would be mobile again and called Julia for advice.

Sapphies Hip xray

Internal fixation of both hip joints, before the bilateral femoral head excision arthroplasty operations

Sapphies Elbow xray

External and internal fixation of right elbow joint

“Julia’s thorough treatment and commitment from Sapphie’s owners rapidly turned Sapphie around and I was astounded how much was achieved with physiotherapy.

“I have no doubt that all Julia’s hard work has hugely affected Sapphie’s recovery and look forward to using physiotherapy on future cases with Julia.”

Peter Haggis BVM&S, Cert SAO, MRCVS
Partner, Wilbury Veterinary Surgery

Sapphie learning to stand in a dogmobile

Sapphie’s owners are Ali Kochnari and his daughters Kate and Millie:

“When Sapphie, our seven-year-old border collie, was involved in a devastating road traffic accident, we thought the worst,” says Ali. “We prayed that she would survive the horrific accident.

“There was nothing we could do apart from wait for her injuries to be assessed by the professionals who could tell us what our next step would be.

“A few days later Sapphie’s condition was stabilised and we were told the extent of her injuries. We were referred to Peter Haggis, an experienced orthopaedic surgeon, to start operating on her.

“We were so excited that there was hope of our lovely dog being saved; however, we were aware that anything could happen during and after the operations. We were called by the vet’s surgery to discuss the operations and the likelihood of her surviving, and at that point there was still no guaranteed outcome for our dog.

“Several operations later, Sapphie was getting better although she was still immobile and could not walk or even stand. Despite all of this, we persevered with all the exercises the vets recommended us to do.

“Although we were very pleased, and indebted to Peter Haggis, that Sapphie had survived the accident and the operations, we were still upset and concerned that she was unable to walk.

“When Sapphie had her next check-up we raised our concerns, and the vet suggested that she might need some kind of physiotherapy as there was nothing else that could be done via operations or medical treatment. The vet arranged for a Chartered Animal Physiotherapist, Julia Martin, to come to the practice and discuss Sapphie’s condition.

“The following week I took Sapphie to meet up with Julia. After an in-depth discussion with Peter Haggis, Julia wasted no time in beginning physiotherapy treatment, and giving us very specific instructions on handling and supporting Sapphie.

Sapphie sitting and walking unaided

“That was exactly what we needed at that time – we were all emotionally stressed and exhausted; however we were motivated by someone as experienced as Julia who knew how to deal with Sapphie’s delicate case.

“Julia monitored Sapphie’s progress very closely as she was very keen to get daily feedback alongside the other physiotherapy appointments. If there was a concern, she wanted to know about it.

“From the moment Julia was involved, Sapphie got better and improved every day. There came a time in Sapphie’s recovery when hydrotherapy was indicated. We were happy to take up this advice from Julia and Peter Haggis.

“It is now 18 months since Sapphie’s accident. Julia’s careful step-by-step treatment and observations resulted in Sapphie’s full recovery. She is now walking normally, but we still choose to take her to see Julia regularly for continuing management.

“Sapphie and Julia have bonded so well together, and we feel we could not have achieved the same results with any other physiotherapist. Now, whenever we take Sapphie for a walk, people watch her in amazement and often comment: ‘Is that the same dog that was in that horrific car accident?’

“It’s not very often that you come across a professional who carries out his or her work with such conviction and dedication. We were touched by Julia’s commitment to Sapphie’s wellbeing, and we will always be indebted to her for giving us back our playful and lovely dog.”

Ali, Kate and Millie Kochnari

Sapphie walking well independently

Julia Martin describes Sapphie’s story as a profound example of multi trauma:

“Peter Haggis, an experienced orthopaedic veterinary surgeon, phoned me when all six operations had been completed. He said that despite very strong internal metal wiring, the hips had been very difficult to stabilise.

“Unfortunately both hip joints redislocated. This was due to extremely weak muscle tone in her hind quarter (gluteal) region. The only option was to remove the femoral heads of her hip bones in an operation called femoral head excision arthroplasty. The right elbow joint was stabilised into its normal position with a metal external fixator.

“Peter and I discussed the physiotherapy plan in conjunction with the veterinary treatment. Within two days, we met up with Ali and Millie Kochnari for a joint consultation; this was about six weeks from her last operation.

“When I first saw Sapphie she was unable to sit or stand on her own, so there was extreme disability, weakness and non-function. However, I could also see the level of total commitment from the Kochnaris. I knew that if there was to be any chance of making progress with Sapphie, I would need them totally on board.

“This was to be an awesome and hugely demanding path for any owner to tread, but from the initial diagnosis through surgical operations and post-op physiotherapy to rehabilitation, these exceptional owners showed phenomenal and unfaltering commitment, care and compassion.”

Julia explains the Physiotherapy Treatment Modalities used to progress Saphhie’s recovery. They included:

  • Pain Management, in precisely graded stages:
    “With a very bright, neurally ‘hyper-wired’ collie character, it is so important to be at least two steps ahead of them in acknowledging exactly what you are asking of them at every level, and what they will actually be experiencing. This is so you can build a positive association with the intricate treatment handling required in physiotherapy rehabilitation. Remember, animals usually have wonderful memories in that they never forget a bad experience so, particularly with collies who are highly intelligent, they are always ‘clocking’ anything they experience. Maximising positive experience is essential.”
  • Manual Therapy:
    • Joint and soft tissue mobilisations
    • Joint and soft tissue manipulations
    • Myofascial release techniques
    • Massage
    • Passive movements
    • Stretching
  • Electrotherapy:
    • Laser therapy
    • Ultrasound therapy
    • Neuromuscular electrical stimulation
  • Exercise therapy:
    Advanced neuro-orthopaedic rehabilitation techniques
    regarding:
    • Balance, postural tone and proprioception exercises,
      including the use of a precisely fitting and supportive
      dogmobile for standing practice – for a few weeks
    • Flexibility exercises
    • Strengthening exercises
    • Stamina-promoting exercises
Sapphie with her family

Sapphie with her family Photo courtesy of Toni Tye

Kate Kochnari describes the outcome of Sapphie’s long road to recovery:

“Despite the severity of Sapphie’s injuries, her recovery has been nothing less than miraculous.

“The operations at the veterinary surgery saved Sapphie’s life. However we believe that if it were not for Julia’s precise understanding and careful treatment, Sapphie would not today be mobile and would not have the life she is going to have, for which we are so grateful.

“Throughout all of the emotional suffering and heartbreak our family have gone through due to Sapphie’s accident, Julia not only gave us hope but also gave us back our mischievous and happy little dog.”