Chilee the Chihuahua Overcomes a Stroke

Chilee the Chihuahua Overcomes a Stroke

Chilee's First SENSE Method Session

Alighting from the Cadillac, Marion Mitton placed the small bundle gently in my arms. I looked down to see a small tan head peeking out of the swaddling. Wrapped safely inside the blanket was Marion's precious companion, Chilee the Chihuahua, who had suffered a stroke 18 days before. The stroke left Chilee unable to move his right side.

Chilee had just been released from the care of the California Veterinary Specialists Critical Care Center in San Marcos, CA, where the team of veterinarians and support staff had fallen in love with this little dog.

Marion had read about my work with animals and hoped that the SENSE Method would help Chilee regain the ability to walk and joyfully engage in life again. Before his stroke, Chilee had served as a Delta Society therapy dog. Marion and Chilee had regularly visited hospital patients, spreading good cheer and helping people overcome disabilities and depression. Interestingly enough, Chilee's greatest contributions were with people who had suffered a stroke.

Chilee Lying on Side to Eat Strokes often cause an interruption in the flow of information from the brain to the muscles. In Chilee's case, this interruption resulted in paralysis of his right side. Unable to stand, Chilee would eat his meals while lying on his right side, moving only his mouth and jaw.

Thinking of the nervous system in simple terms, imagine a system of roadways. A stroke often interrupts the flow of traffic by shutting off some streets. With the streets that served Chilee's right side currently out of service, his brain's "body map" no longer included his right side.

My job would be to help Chilee find alternate routes that would allow nerve impulses to again reach his right side. His right legs themselves were not actually injured; the problem was in the signals not reaching them. Luckily for Chilee and the rest of us, the nervous system is an incredibly designed engineering marvel capable learning and improving. My intent was to help Chilee create a new body map that included his entire self.

But I fist needed to engage Chilee's attention in this learning process. So with Chilee lying on his side, I used my fingertips to gently lift the muscles along his spine, bringing them a little bit closer to his backbone. This slow, almost imperceptive movement served to bring his awareness to his spine and to help the muscles release their tension. But equally important, these nonhabitual movements were providing him with an unusual sensory experience, one that his nervous system was listening to. I was gaining Chilee's attention and engaging him in the process of change.

Habitual touch and movement are usually deemed "not important" by the nervous system and are simply tuned out, much as we tune out the sensation of clothes touching our skin. Novel, nonhabitual movements, on the other hand, produce stimulating sensations that engage the attention of the nervous system. With the nervous system no longer on "autopilot," it can process the sensory input to its advantage.

Keeping this concept in mind, I crossed Chilee's limbs, bringing his right legs over to the left side of his body. Again, this was an unusual sensory experience for him, so his nervous system was paying close attention. Even Chilee's demeanor showed that he was interested in what I was doing, with his eyes having a more alive look. I have found when working with individuals who have had a stroke, crossing the limbs like this can create amazing improvements in their functioning. It seems as if the brain confuses the left and rights sides, thinking that the right legs are now the left legs and vice versa. Consequently, the brain may now recognize neural connections to the right legs that it didn't before. It may not happen immediately (although I have seen that too), but if the correct sensory information is then provided, the nervous system may use this crossed-limb experience to create new neurological pathways (new roadways) to the formerly paralyzed legs. It's as if the confusion creates opportunity for change to occur.

I developed the SENSE Method after studying the work of the brilliant scientist, the late Dr. Moshe Feldenkrais. Dr. Feldenkrais taught how it was possible to evoke activity in a paralyzed muscle. He suggested that you cannot get a muscle to work by focusing on the muscle itself. But if you can provoke a function in the body and repeat it in different ways until you get a response from the brain that must use that muscle in order to respond to your stimulus, the function is integrated and the muscle works.

So, with Chilee's legs crossed, I placed a small, hardcover book against one paw, in effect creating an "artificial floor." Using the book, I gently moved each toe, one at a time, until I could feel response, however small, in the muscles of his leg. When the nervous system detects something firm and flat under the foot, the brain recognizes that as standing. Even though Chilee's current condition only allowed him to be lying on his side, my movements were giving Chilee the sensory experience of standing. This could stimulate his brain to evoke the physical functions that would actually allow Chilee to stand. And the crossed legs could help create new neuromuscular connections to his right side.

Even when muscles are at rest, there is a certain amount of tension present, which is called muscular tone. This muscular tone is the result of nerve impulses being transmitted to the muscles. Chilee had no apparent muscular tone in his right legs when we began our session, and even tickling the space between each toe with my finger did not elicit any increase in tone. Now, as I delicately coaxed each paw with my little "artificial floor," I felt the right legs begin to awaken with increased muscle tone.

I slowly uncrossed Chilee's legs and gently supported his tiny ribcage, bringing it ever so lightly toward his head. The Chihuahua seemed to be enjoying the SENSE Method work, and Marion said she hadn't seen him so relaxed since before his stroke. By gliding Chilee's ribcage slightly forward, I was reversing the usual relationship of the shoulder blade sliding along the relatively stable ribcage. Dr. Feldenkrais taught that moving the ribcage instead of the shoulder blade enhances awareness of both the ribcage and shoulder and can assist in releasing excess tension in the area, preparing the shoulder blade for full, comfortable movement. Reversing the usual relationship of body parts appears to give the nervous system the opportunity to substitute a more comfortable, efficient organization for the habitual one.

With Chilee still lying on his right side, I slipped my fingers underneath his trunk and moved his right shoulder blade in tiny, easy movements. I then crossed his front legs and again introduced the sensation of standing by using the small book against his right front paw. The tone in his right front increased.

Mary doing gentle movements around Chilee’s shoulder blade.

With Chilee's legs now uncrossed, I held the artificial floor delicately against each paw, one at a time, as I moved the corresponding leg in the gait sequence of walking -- left hind, left front, right hind, right front, left hind, left front. As I slowly moved the top-lying legs, I made sure that they were the width they would be if Chilee was actually walking. At this point Chilee began to have nice tone in both right legs. I also added movements of his back, pelvis, neck and head -- movements Chilee would do if actually walking. I wanted him to have as complete a sensory experience of walking as I could simulate.

I gave Chilee a rest and then simply supported his torso with my hands so he could begin to explore how to move his right legs on his own. Suddenly Chilee began to move both the right front and right hind legs, pushing against the floor with them. Chilee then rolled over onto his left side, crossed his right hind over the left and used it to push against the floor! Marion and I were both thrilled.

I had been with Chilee about one hour and thought that this milestone was a good place to end our session. His nervous system had received good-quality information, and now it was time for Chilee to rest and let the sensory information "percolate."

It's important when doing the SENSE Method that you allow the time for the animal's nervous system to process the information you have provided. During a session, I will sometimes stop and just allow the animal to rest. This allows for integration and consequent improvement in functioning.

Marion reported that when she took Chilee home that day, he slept soundly, and the next day he began walking! Marion said he also began lying on his left side, which is important to avoid pressure sores and other problems. This also demonstrated that he no longer felt so vulnerable that he had to lie on his right side to protect himself.

Chilee's Second SENSE Method Session

Just one week after our first meeting, Chilee came for his second SENSE Method session. Boy, could he walk! In fact, now that he had regained his mobility, he was a very active little dog. I observed him as he explored my office, sniffing the carpet and trying to document all the other dogs that had been there that day. Even though he sometimes listed to the right as he walked, he didn't let that slow him down. Trying to keep him still today would be a challenge.

Chilee standing up!

I needed to find something that would engage Chilee's attention to the SENSE work. So, sitting on the floor, I placed Chilee on my leg, with his sternum and abdomen resting on my thigh and his little legs dangling to either side. With Chilee straddling my leg, I slowly moved my foot away and toward me. The slow movement served to get his attention and have him realize that his base of support (my leg) was unstable, necessitating an increase in his attention to his immediate environment and eliciting a response of Chilee using his four legs and paws to get a foothold on my leg. This was a wonderful moment, because Chilee clearly used his four legs and paws in a very functional, equal way.

I would like to point out that I moved my leg very carefully and slowly, making sure that Chilee was never anxious about it. Causing anxiety in an animal would not only be unkind, but it would also defeat the value of the session, since learning and improvement cannot happen in an environment of fear. Keeping the animal feeling safe is one of the basic concepts in the SENSE Method. Using the environment (in this case, my moving leg) to stimulate improvements in the functioning of the nervous system is another concept of the work. Once Chilee's attention was engaged, he relaxed and "got into" the session.

Since they may have an impaired body map, many individuals who have suffered a stroke lose the feeling of having a center around which to organize. As you can imagine, this will greatly impair their balance. Since Chilee would often lean to the right as he walked, I wanted to let Chilee experience how he could move from side to side relative to his center, his spine. Being able to comfortably move his head and neck from left to right is important for maintaining balance. So, with Chilee lying on his sternum and abdomen, I asked Marion to wave her hand from side to side. Chilee followed her movements with his head and neck. His range of motion gradually increased as my hands lightly supported and assisted his movements.

Then with Chilee resting comfortably on his back between my bent knees, I passively moved his shoulders in an alternating sequence. I gradually enlarged the movement, so that he began to reach in front of himself with his forelegs. Initiating the movement from the shoulders is a different experience than moving the legs by holding onto the paw. The shoulder is closer to the middle of the body; it's the proximal part. The paw is more distant, hence it's referred to as the distal part in this relationship.

Imagine for a moment that I have taken hold of your hand, and I am gently stretching your arm. Can you imagine what that would feel like? Now imagine that instead of your hand, I have molded my hands around your shoulder blade and have begun delicately moving it in circles, coaxing your arm to reach forward as I do so. Can you imagine that that would be a different experience for your nervous system? It certainly is, as we all have particular patterns of action that revolve around reaching with our arms and legs. Again, if I were to take the distal end (your hand) and lengthen your arm, your habitual patterns would be invoked. It is common for these habits to include tightening around your shoulder blade as your arm reaches forward, which can inhibit the movement and cause strain and tension. But if I were to support the proximal part (your shoulder blade), your nervous system would not be inclined to invoke the same habitual response, since the movement itself is unusual and there is no "built-in," habitual response to it. I have found that moving the proximal part relative to the distal one can stimulate the nervous system to pay attention, release tense muscles and create more comfortable and efficient ways of moving the arm. Supporting and moving the proximal part gives the nervous system the opportunity to come up with a new approach to moving the limb.

As I continued moving Chilee's shoulders in this way, at times I gently coaxed his head and neck side to side. There is a strong neuromuscular relationship between the neck and the forelegs, and I have noticed that improving the movement of one will often improve the movement of the other. I wanted Chilee to feel how easy it had become to move both his forelegs and his head and neck. At times, I also added the artificial floor, so that when Chilee reached with his forelegs, he would contact the "floor," stimulating an increase in muscular tone.

At this point I still had Chilee fully supported and lying on his back, so that he didn't have to worry about bearing weight on his legs and balancing over them. I frequently work with improving animals' movement when they are lying down, since the nervous system is more attentive and available for improvement when it doesn't have to contend with the challenges of weight bearing and balance.

Whenever I gave Chilee a break to allow his nervous system to integrate his improvements, he jumped up on his hind legs to reach Marion, who was sitting on a chair in my office. Chilee, who hoped that Marion had treats hidden somewhere, would use both forelegs to scratch at her chair. I noticed that he was using all four legs very well, with muscular tone in all of them.

Again taking the little dog into my lap, I carefully suggested movements with my fingertips, seeing if Chilee could move his head a little to the left, a little to the right. I alternated between moving just his head with moving his head and neck as a unit. I also alternated with moving his head, neck and ribcage separately and together, letting him experience that he could move them together or separately at will. This distinction allows for finer control and would give Chilee more movement options.

To demonstrate to Chilee what other movement was possible, I delicately touched the space in between each rib. This served to outline his ribs for him and remind him that they could move freely. I then gently lifted each vertebrae a tiny amount, working my way from the base of his skull down to the end of his tail.

I ended the session by lightly pushing through his ischium on each side. I could clearly see a wave of movement travel from Chilee's pelvis all the way to his head. This was an opportunity for Chilee to feel how all his parts could function harmoniously, allowing this free-flowing, comfortable movement. After this second SENSE Method session, Marion reported that Chilee began running around the yard and climbing the stairs!

Chilee's Third SENSE Method Session

I saw Chilee for a third SENSE session about one week later. I wanted to help him refine his ability to maintain his balance as he walked and ran.

As Chilee lay quietly in my lap, I delicately slid his right front paw up and down his left front leg. Not only did this novel movement serve to gain the attention of Chilee's nervous system, but it also created an unusual feeling -- evoking different responses from the dog's nervous system compared to how the animal usually makes contact with the paw. These new sensory stimuli can evoke a different use of the legs and back.

With Chilee's right front paw lying on top of his left front paw, I placed my artificial floor against the left paw, coaxing first each toe and then the entire foot as a whole. It was interesting to see how both legs gained tone in response to this unusual simulation of standing. The strategy of moving two or more of the dog's body parts (in this case both front feet and legs) can serve to enhance awareness of the parts themselves and also how the parts work in efficient coordination with each other.

Then, with the legs lying next to each other, I again introduced the artificial floor, this time to both paws simultaneously. It was exciting to see how the tone in the right leg was now matching the tone in the left leg. I repeated this approach with Chilee's hind legs. I used slow, delicate movements, so Chilee could SENSE differences and detect changes in comfort and ability.

With Chilee comfortably lying on his side, I touched his spine and pelvis in a way that induced rounding (flexion) and arching (extension) of the back. I helped clarify these movements for Chilee by touching and gently suggesting movement in his sternum and ribs, since allowing the sternum and ribs to move slightly down in the direction of the pelvis will assist in rounding the back. Conversely, the sternum and ribs can move up toward the head when the back arches. Including the movement of the sternum and ribs makes the movement of the back freer.

I also touched his ribs on the abdominal side while my other hand supported the movements of his back. This helps coordinate the movements of his spine and abdomen, while including both in his neurological image of the movement.

I then coordinated rounding the back with flexing Chilee's hind legs gently underneath him. I alternated this with slightly straightening the hind legs when his back slightly arched. These movements simulated what Chilee would do when running. Coordinated, balanced movement requires that the spine and pelvis move in harmony with the legs. To provide additional sensory information, I added artificial floor while repeating these movements.

I gave Chilee a little rest. Then, with him lying on his back, held safely between my hands, I gently rolled him side to side, crossing his legs as he did so. He began reaching to each side with his forelegs. He gradually was able to support weight on the foreleg closest to the floor as he rolled from side to side. We then graduated to rolling over to each side and completely coming to standing, with my support.

Breaking down a function such as rolling or walking lets each small piece of the movement be taken apart and explored, allowing for discovery of new options in movement. In addition, we remove any anxiety caused by anticipated pain, since we lead slowly up to the full movement, only adding more when we see that the animal is relaxed and ready. Many animals (and people too) have inhibited movement due to the threat of anticipated pain.

With Chilee now rolling freely from side to side, I ended our third and final SENSE Method session. Chilee then began running happily after Marion. As I smiled at the vision of the two beloved friends, I thought back to the first day I met Chilee, just a short time ago. He had not walked, had in fact barely moved, for 18 days. Now he was running and playing with abandon. I was filled with gratitude that this brave former Delta Society therapy dog was still helping others overcome adversity -- this time by providing us with his own dramatic demonstration of the incredible plasticity of the nervous system. Bravo and thank you, Chilee!

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