Thank you to Angela Griffiths and Greyfriars for their valuable input on swimmers syndrome and these included images.
Swimmers syndrome is a poorly understood, poorly characterized disease that affects puppies and kittens. It is usually noticed 15 to 21 days after birth, when the difference between an affected puppy or kitten and its litter mates becomes apparent. It will usually affect one animal in a litter, but has been reported to affect a whole litter in some cases (Dumon, 2005).
Most of us will rarely see swimmers syndrome; it tends to be a once- or twice-a-career event. Nonetheless, it is a good idea to have at least an idea of what to expect, and how to treat this unusual condition. Angela Griffiths and the team at Greyfriars have treated two puppies with swimmers syndrome recently, and share their story in this month’s Hydro Case Study. After watching it, I decided to get a better understanding of the condition – hence this blog.
What to expect
Swimmers puppies or kittens seem to have a delayed physical movement capacity (Fossum, 2007) that usually affects the hind limbs and occasionally also the thoracic limbs (Dumon, 2005). They will present with a continuous abduction of the hip joint and hyperextension of the stifle and hock joint. When the forelimbs are affected they will present with abduction of the shoulders, extension of the elbow and flexion of the carpus. The pups or kittens will have an inability to support their weight, and the limbs will move in a lateral, cyclical pattern that looks like swimming.
The condition seems most often present in chondrodystrophic or brachiocephalic breeds, although not always – as we see in the Greyfriars Case Study. In cats, the condition has been reported in a Devon Rex, as well as in mixed breeds
What can go wrong?
The continual compression of the chest and abdomen, together with the position of the limbs, can lead to the development of a flat thorax, skin lesions, milk regurgitation, cyanosis, dyspnea and aspiration pneumonia (Dumon, 2005).
The condition can also present with a number of concurrent conditions, including thoracic dorsal deviation, dorsoventral compression and sternal malformation, medial patellar luxation, malformation of the articulations of the long bones, and an innocent systolic heart murmur (Linde-Forsberg, 2010).
So what causes swimmers syndrome?
At this point there are only theories, and they remain difficult to prove. Some of these theories include hereditary factors, environmental factors, an excessive amount of protein in the mother’s diet, maternal metabolic disorders, musculoskeletal development problems, obesity, inadequate or delayed myelination of peripheral motor neurons or functional alterations in neuromuscular synapses (Linde-Forsberg, 2010).
Cerum creatine kinase levels in the bloodwork of some puppies have been shown to be significantly higher than in healthy puppies, and can give an additional clue into the effect of swimmers syndrome on the muscles. Since the muscle metabolism is affected, muscle hypoplasia or atrophy may result. This is not especially useful for a diagnosis of the disease, but can give an indication of the efficacy of treatment and the prognosis (Korakot, 2012).
Diagnosis
We expect puppies and kittens to start walking 10 to 15 days after birth. For this reason, we may see clinical signs as early as the first week after birth, but usually around the second week. A diagnosis is generally made from a history, clinical signs and radiographs. This condition usually affects only one puppy or kitten in a litter, but can affect multiple or the entire litter.
Treatment
Although a treatment protocol hasn’t been developed, it is agreed that the sooner treatment starts, the better. Traditionally, hobbles or bandages have been used to hold the limbs in adduction at the hip joint with a promotion of flexion in the tarsal joint. Together with daily physical rehabilitation – including exercise, heat, hydrotherapy and PROM, a return to normal function can be seen is as little as seven days (Cardilli, 2013).
Without guidelines in terms of treatment, and with a risk associated with the use of hobbles or bandages over a period of time, developing a treatment plan can be daunting. In this month’s Hydro case study on the members’ platform, Angela Griffiths and her team follow the progress of two swimmers syndrome puppies from beginning to end, describing the treatment protocols and techniques used for these pups, and how they regained normal function.
It’s amazing how little is known. I had an Abyssinian kitten from a litter of four that I noticed around the 10th day. I went to several vets who said put her down. Not one had any other suggestion. I had to try. I did PT several times a day along with holding the legs properly. Two weeks later it was hard to tell she ever had an issue. I do like that there is treatment ideas on the web now. There was nothing years ago when I was doing it on my own.
Hi Debra, that is really sad, and I am glad you stuck it out!! A condition that is so treatable, I don’t even want to think about how many have lost their lives because of our lack of knowledge! And we still know so very little… but at least we know they respond WELL to treatment!
There is a special place for all of us who TRY, without knowing what lies ahead – well done!
Years ago the only dog I ever had (I’m a cat person 😻) had this problem with his hind legs and no one we could find even had a name for it. So I just did the best I could and in time he was running around like a rabbit.
Over the years I’ve encountered it quite a few times with different species, actually. Turns out possums are susceptible too. I have a young rescue possum right now who was starving because he had so much difficulty climbing up to the food everyone else was eating.
I wish more was known about it and that strategic treatment guidelines could be developed for all critters, because it’s not so easy to use bandage-hobbles on a young possum! 😳 😅
Thank you so much for sharing your experience!!
It does seem to be something that occurs in different species, including rabbits! Good luck with managing the possum!!
I first learned about this syndrome on Pit Bulls and Parolees with a Pit Bull puppy. They weren’t fully successful with their therapy, which didn’t include any hydrotherapy, since, if I recall correctly, the pup had permanently bowed front legs and walked on the outside of his feet.
But what I most wanted to point out was two interesting cases that were on the show The Zoo on Animal Planet, which follows zookeepers at the Bronx Zoo.
The zoo had a Snow Leopard—which typically give birth to two to three cubs, sometimes four—who gave birth to a single cub, twice, back to back; both of them had Swimmers Syndrome.
The show followed their therapy (One of them was quite feisty and did a lot of hissing and such at the keepers and therapists. The other one was much more passive and easier to deal with), and it mostly involved hobbles and a lot of walking between narrow paths made from boards. They were successful to the point where it was unnoticeable once they became adults.
Both cubs were very large at birth, and continued to be up until and beyond when they realized something was wrong. I think it’s interesting that obesity seemed to play a bigger role in their syndrome than genetics did, despite coming from the same mother, considering the unusual nature of both being single cubs. The cubs just were not lifting themselves up as early on as they should’ve been, and as a result, they didn’t seem to be developing the necessary muscle strength to do so due to their large sizes.
One of my Dachshunds was from a single pup litter—if you can call it a litter. He was so rotund, I took him to the vet very early on because I was concerned about it. It ended up just being that he received all the nutrition, both before and after birth, which seemed to be the case with the aforementioned cubs, as well. My Dachshund is nine years old and still very large—much larger than his parents. I always joke that he ate his littermates. While, thankfully, he didn’t have Swimmers Syndrome, in retrospect, he did seem to have some difficulty lifting himself up and was a little late with walking. I definitely think there’s a connection.
Thank you so much for sharing that, the is such an interesting observation, and definitely something worth considering!
I recently rescued a 3 week old kitten with swimmers syndrome and hind leg paralysis. all x-rays show that her spine is intact and fine, her bones are growing as they should and there’s no evidence trauma. we are hobbling and doing therapy multiple times a day, and she’s in a special diet. So far, nothing has changed. euthanasia was suggested, but we can’t give up on her. The acupuncturist said she’s in no pain…..so we are trying everything we can to correct her legs and get her to use them. any advice anyone can offer would be greatly appreciated!!!
It sounds like you are doing everything you can.
Trust your team, and give her the time she needs.