Updates on baby squirrel Guro who started with both front limbs paralyzed

[olorin19]

This thread continues and replaces original thread by Jim8923 -

https://thesquirrelboard.com/forums/...-gray-squirrel

One reason to relocate thread is it does not need to be in Emergency / Life Threatening Forum.

Stay tuned.

[olorin19]

So, Guro was found on 9/6 and came to me on 9/7 with both front limbs paralyzed.

More details about first few days may be found on original thread:

https://thesquirrelboard.com/forums/...-gray-squirrel

Guro made nice progress, particularly in left front limb, during her three days on prednisone. Took her to the vet on 9/10 and was told the prednisone had done its job as far as neurological improvement. And due to probable hairline fracture on right wrist or forearm, it was best to discontinue prednisone due to inhibition of bone healing.

Guro continues to improve, and as of today is doing much more exploration when in her cage. I have her out with me most of the day, and at present she is happily crawling under and nesting inside my sweatshirt. Like most baby squirrels, she likes to either curl up on my neck/shoulder, next to my heart, or inside the sleeve near the elbow.

When taking formula, she grips the dropper quite well with her left paw. While her right paw is not yet gripping the dropper, she is placing the paw on or near the dropper. Guro is also putting some weight on that limb at times.

Yesterday, she spent some time chewing on a Henry's block. When in the mulch this morning, she managed to pick up a small piece. I have also given her small twigs to chew on. Beyond the normal reasons, I am doing this to encourage her to use the right paw.

I have dropper many squirrels over the years, and pretty much all of then eat in and upright position - either held by me or standing on their back legs. While Guro does both, she also likes to lie on her side and eat in that position. I do not remember any other squirrel doing this, but it makes a lot of sense, as it more closely resembles their position when nursing with their mama,

[olorin19]

Here is Guro in her litter box.

As far as I can tell, the left arm, paw, etc. is 100%., while the right is much improved.

[olorin19]

Here is Guro this morning, almost a week since her arrival.

She has been using her left paw normally for 4-5 days now but still favoring the right.

The last few days, I have been giving her fresh green twigs to chew, where I hold one end so she can get the hang of it. At first she only tried to grasp twig with left paw, but she eventually tried using the right paw a bit.

In this photo, Guro is wrapping both paws around my thumb and exerting pressure with right as well as left.

[CritterMom]

Aw, look at her! What a little trooper!

[olorin19]

Here is Guro chewing on a green twig. It is kind of her physical therapy or rehab, as it gets her using both paws.

She is getting more active when in the cage, although still spending most of her time napping and/or relaxing.

[olorin19]

Quick recap and request for advice / suggestions on further rehab:

Guro arrived 9/7 with both front limbs at least mostly paralyzed. She had prednisone for three days and the left front limb improved tremendously, the right front limb much less so.

Guro went to the vet on 9/10. The vet felt that the prednisone had done its job and that there was a probable hairline fracture on the right wrist or forearm and advised me to stop prednisone as it interferes with bone healing.

It is now a week later 9/17 and Guro's left front limb seems 100%. With the right, it seems like she is able to use the shoulder joint quite well, but I suspect that she might only be able to flex but not extend the elbow. Guro has the range of motion, i.e. I can extend her limb at the elbow, but when I left go it returns to a flexed position.

There does not seem to be any significant use of the fingers on the right paw either.

She is now moving around the cage and climbing one me, and for the most part does this with three legs. She will lean forward and put some pressure on her right forearm, but I have not seen her extend at the elbow. If my thumb is inside the crook of her elbow, she is able to apply pressure by flexing around my thumb.

As far as the right front paw, she does use it to apply counter pressure on twigs, etc. but I have not seen her really grasp anything with it.

Is there any sense in trying prednisone again?

Or is there anything else that can be done to help Guro regain as much use of the right front limb as possible?

If Guro ends up being an NR, she will always have a good home here, but I want to do everything possible to give her the best chance to be a free squirrel.

Thanks!

[SamtheSquirrel2018]

Quick recap and request for advice / suggestions on further rehab:

Guro arrived 9/7 with both front limbs at least mostly paralyzed. She had prednisone for three days and the left front limb improved tremendously, the right front limb much less so.

Guro went to the vet on 9/10. The vet felt that the prednisone had done its job and that there was a probable hairline fracture on the right wrist or forearm and advised me to stop prednisone as it interferes with bone healing.

It is now a week later 9/17 and Guro's left front limb seems 100%. With the right, it seems like she is able to use the shoulder joint quite well, but I suspect that she might only be able to flex but not extend the elbow. Guro has the range of motion, i.e. I can extend her limb at the elbow, but when I left go it returns to a flexed position.

There does not seem to be any significant use of the fingers on the right paw either.

She is now moving around the cage and climbing one me, and for the most part does this with three legs. She will lean forward and put some pressure on her right forearm, but I have not seen her extend at the elbow. If my thumb is inside the crook of her elbow, she is able to apply pressure by flexing around my thumb.

As far as the right front paw, she does use it to apply counter pressure on twigs, etc. but I have not seen her really grasp anything with it.

Is there any sense in trying prednisone again?

Or is there anything else that can be done to help Guro regain as much use of the right front limb as possible?

If Guro ends up being an NR, she will always have a good home here, but I want to do everything possible to give her the best chance to be a free squirrel.

Thanks!

First of all, Olorin, thank you so much for the love you have bestowed upon little Guro and for your willingness and enthusiasm for providing the means for a release if that seems reasonable and for becoming Guro's NR parent if release seems riski or impossible. Also, thank for your excellent, informative, concise and very useful posts in behalf of Guro!

1) There is no "one way to go" with steroids. I would not recommend them, however, for Guro's reluctance or inability for move his right front paw from the elbow distally (beyond the the elbow). Also, the Vet felt that there may be a fracture in the wrist or forearm this formed part of the basis for your Vet recommending the discontinuation of steroids. There is some evidence against using steroids when a fracture is present and the probably most Vets and physicians would avoid these medications if possible when there is a fracture present. I'll post some evidence at the end of comments so you and other who might be interested can take note of this. Steroids even when they might be the nly appropriate treatment for a condition always have risks associated with using them.

2) If your Vet had not done such a great job of evaluating Guro and also obtained the x-ray films,tis would be one of the recommendations I would give now as it appears that while Guro's original issues were quite extensive, his current issue is localized to his right front extremity from the elbow down. It may be worth getting another x-ray to reassess whether or not there is indeed a fracture or check to see if there is another unrecognized fracture. Your Vet could now focus on that one extremity. One very useful tool to use in reevaluating the status existence of a fracture if there was some uncertainty is to perform another x-ray to look for signs of healing. The sign used most is to look for the presence of Callus which is new calcification that has begun around the fracture site. Unfortunately this does not usually become evident on repeat films until about 2 weeks post-injury. I feel that a repeat x-ray study of the entire right front extremity would be worth doing to check for callus and tocheck for fractures that may not have been evident on the prior films (this does occur!). Another option is CT but this may not be readily available and is certainly more expensive than plain x-ray films!

3) the actually problem may have a number of causes but taken individually, they may include problems in the brain (similar in many ways to a stroke), in the spinal cord, in the nerves, muscles, tendons, ligaments or bones of the right front extremity. One of the commonly utilized treatment is veterinary and human medicine is Physical Therapy. This must be very focused or not utilized if there is a fracture, especially if the fracture is unstable (continued alignment is not assured) and in fact, if that is the situation, the fracture should be stabilized with a splint or other means. BUT, physical therapy, especially in a localized region and with a young animal (new nerve cells and the connections are still being made) can potentially be very beneficial. This would entail you gently extending and flexing and also rotating such rolling the wrist several times per day. I am not a physical therapist but what I would recommend, if you would like to try PT (I would encourage this!), would be to do this with his entire right front extremity. I know he is moving his shoulder but I would start there and move down to his other joints including all of his fingers. This sounds like a lot but just 5 or 6 hopefully full movements of these joints 2 or 3 times daily. This will help keep the muscles, tendons (the cords that attach muscle to bone), and ligaments (the "cords" that hold the bones together and stabilize the joints) loose and help prevent development of contractures of the muscles (where they may permanently become tight and cause the joint to loose function. Doing this will also "pattern" the brain and hopefully if there are damage nerves, other nerve cells will take of the job or in young animals, new nerve cells may actually be stimulated to grow!

Here is the chart with some evidence pertaining to steroid use in the presence of fracture:

Year/ Study /Model used /Medication /Outcome
1951 / Blunt ll Rabbits Cortisone • Oecreased callus formation
1951 ISissons Rabbits Cortisone • Retardation of healing • Abnormal histological appearance
1952 Ke Rats Cortisone • No inhibitory effect encountered
1964 Weiss Rats Cortisone • No inhibitory effect encountered
1966 Murakamiu Guinea pigs Cortisone • Retardation of bone healing
1972 Ehrlich Rats Prednisone • Inhibition of collagens synthesis
1986/Sato Rats Oexamethasone • Retardation of mineralisation
1972 Hogevold Rats Methytprednisolooe • No inhibitory effect encOlXltered
2000 Waters Rabbits Prednisone • Lower callus size and mineral content • Chronic administ ration resulted in weaker bone
2001 Sawin Rabbits Oexamethasone • Inhibition of bone graft incorporation in spinal fusion
2002 Luppen Rabbits Prednisolone • 25% lower callus area and 55% inhibition of torsional strength
2005 Aslan Rats Prednisone • No inhibitory effect encOlXltered

Regards,
SamtheSquirrel

[olorin19]

First of all, Olorin, thank you so much for the love you have bestowed upon little Guro and for your willingness and enthusiasm for providing the means for a release if that seems reasonable and for becoming Guro's NR parent if release seems riski or impossible. Also, thank for your excellent, informative, concise and very useful posts in behalf of Guro!

1) There is no "one way to go" with steroids. I would not recommend them, however, for Guro's reluctance or inability for move his right front paw from the elbow distally (beyond the the elbow). Also, the Vet felt that there may be a fracture in the wrist or forearm this formed part of the basis for your Vet recommending the discontinuation of steroids. There is some evidence against using steroids when a fracture is present and the probably most Vets and physicians would avoid these medications if possible when there is a fracture present. I'll post some evidence at the end of comments so you and other who might be interested can take note of this. Steroids even when they might be the nly appropriate treatment for a condition always have risks associated with using them.

2) If your Vet had not done such a great job of evaluating Guro and also obtained the x-ray films,tis would be one of the recommendations I would give now as it appears that while Guro's original issues were quite extensive, his current issue is localized to his right front extremity from the elbow down. It may be worth getting another x-ray to reassess whether or not there is indeed a fracture or check to see if there is another unrecognized fracture. Your Vet could now focus on that one extremity. One very useful tool to use in reevaluating the status existence of a fracture if there was some uncertainty is to perform another x-ray to look for signs of healing. The sign used most is to look for the presence of Callus which is new calcification that has begun around the fracture site. Unfortunately this does not usually become evident on repeat films until about 2 weeks post-injury. I feel that a repeat x-ray study of the entire right front extremity would be worth doing to check for callus and tocheck for fractures that may not have been evident on the prior films (this does occur!). Another option is CT but this may not be readily available and is certainly more expensive than plain x-ray films!

3) the actually problem may have a number of causes but taken individually, they may include problems in the brain (similar in many ways to a stroke), in the spinal cord, in the nerves, muscles, tendons, ligaments or bones of the right front extremity. One of the commonly utilized treatment is veterinary and human medicine is Physical Therapy. This must be very focused or not utilized if there is a fracture, especially if the fracture is unstable (continued alignment is not assured) and in fact, if that is the situation, the fracture should be stabilized with a splint or other means. BUT, physical therapy, especially in a localized region and with a young animal (new nerve cells and the connections are still being made) can potentially be very beneficial. This would entail you gently extending and flexing and also rotating such rolling the wrist several times per day. I am not a physical therapist but what I would recommend, if you would like to try PT (I would encourage this!), would be to do this with his entire right front extremity. I know he is moving his shoulder but I would start there and move down to his other joints including all of his fingers. This sounds like a lot but just 5 or 6 hopefully full movements of these joints 2 or 3 times daily. This will help keep the muscles, tendons (the cords that attach muscle to bone), and ligaments (the "cords" that hold the bones together and stabilize the joints) loose and help prevent development of contractures of the muscles (where they may permanently become tight and cause the joint to loose function. Doing this will also "pattern" the brain and hopefully if there are damage nerves, other nerve cells will take of the job or in young animals, new nerve cells may actually be stimulated to grow!

Here is the chart with some evidence pertaining to steroid use in the presence of fracture:

Year/ Study /Model used /Medication /Outcome
1951 / Blunt ll Rabbits Cortisone • Oecreased callus formation
1951 ISissons Rabbits Cortisone • Retardation of healing • Abnormal histological appearance
1952 Ke Rats Cortisone • No inhibitory effect encountered
1964 Weiss Rats Cortisone • No inhibitory effect encountered
1966 Murakamiu Guinea pigs Cortisone • Retardation of bone healing
1972 Ehrlich Rats Prednisone • Inhibition of collagens synthesis
1986/Sato Rats Oexamethasone • Retardation of mineralisation
1972 Hogevold Rats Methytprednisolooe • No inhibitory effect encOlXltered
2000 Waters Rabbits Prednisone • Lower callus size and mineral content • Chronic administ ration resulted in weaker bone
2001 Sawin Rabbits Oexamethasone • Inhibition of bone graft incorporation in spinal fusion
2002 Luppen Rabbits Prednisolone • 25% lower callus area and 55% inhibition of torsional strength
2005 Aslan Rats Prednisone • No inhibitory effect encOlXltered

Regards,
SamtheSquirrel

Thanks so much for the lengthy and informative post.

Guro is actually a girl - she is named after Guro Reiten, a Norwegian football player. All my squirrels have been named after athletes, rock stars, or fictional characters - Dustin Pedroia, Mookie Betts, Iggy Pop, Ziggy Stardust, Arya Stark, Amy the Girl From Nowhere, Harry Bosch, Huckleberry Finn, Samwise Gamgee, etc.

Okay, so no to resuming prednisone.

The vet did not take x-rays, but spent a few minutes examining and moving the limbs. Her conclusion was that there was no more neurological issues but quite likely a hairline fracture.

I have already been doing some PT stretches, mostly focusing on the elbow, wrist, and paw. Given the probable hairline fracture, I have been extremely gentle, but wanted to try and maintain some range of motion.

Huckleberry was overwintered last winter, and despite a broken wrist that never regained a full range of motion, Huck was released in May and is doing just fine. The paw and fingers work fine, so no issues eating, and Huck manages to climb and run around quite well. While I worried prior to his release that he might have a tough time out there, Huck has done just fine.

https://thesquirrelboard.com/forums/...-spinal-injury

In Guro's case, my concern is that if she does not manage to use the paw and fingers to eat, climb, etc. that she will be an NR. May is a long way away, so no such decisions need to be made any time soon, and I am prepared either way.

In the meantime, the focus is on doing whatever will help her improve the most. I work from home, so I am in a good position to do PT, etc. for Guro.

I did ask the vet whether there was any need for a splint, and she said no need. So I would say there is very low likelihood that there is an unstable fracture. And when I have been doing the gentle stretches, Guro has never indicated that there was significant pain or discomfort. She was not at all happy when the vet did her examination, but that was a new person in a very bright room.

[olorin19]

Update -

Still doing squirrel PT stretches with Guro.

Guro is quite agile running around and does some climbing. As far as I can see, she does not use her right forelimb for either. When she is running along, the right forelimb below the elbow is parallel and fairly close to the ground.

There does not seem to be much (if any) use of the fingers. She will use the right front paw somewhat when grasping things -while the left paw does the actual grasping, she does use the right paw to kind of push against. The photo with the branch shows her doing this, and Guro also does this when eating HHBs.

The left forelimb, paw, etc. seems to be 100%.

Since I am working from home, she is out of the cage much of the time. She naps inside my hoodie, and often climbs out and sits on my shoulder or the back of my chair. When out on the porch, she runs back and forth along the top of the couch. When inside her cage and not napping, she is active, particularly enjoying chewing on and playing with oak and maple branches. She now has a hammock near the top and she does climb up to get inside that.

[Chirps]

OMG that second pic with her little hand on the side of her face . . . Too cute!

[olorin19]

Here is Guro eating a block. She mostly holds it with the left paw, but uses the right paw or wrist to press against it while she is eating.

This is an old couch cushion that has been a climbing wall for many young squirrels. This morning was Guro's first time on it, and she climbed around on it quite nimbly. She does not use the right front paw at all, so when she turns it is always clockwise (which requires hanging from left front paw) but never counterclockwise (which would require hanging from right front paw).

For you Zoolander fans, so far Guro is not an ambi-turner.

[olorin19]

Update -

Guro is now about 10 weeks old. She runs around fairly well and is quite acrobatic climbing, but basically does not use the front right limb at all for movement. She does use the paw a bit when eating as something to apply counterpressure. And if chewing on a twig, she might be using that paw slightly, although hard to tell.

We built a squirrel tower over the weekend with a frame of wire shelf panels then some outdoor carpet to cover. (My wife is an ace with the hot glue gun!) The outdoor carpet works really well for Guro, and she flies all over the place, hangs upside down, etc. Both sides of the main upright are covered, so she is able to circle around and practice her evasive maneuvers.

It is time for me to get a larger cage ready. I have overwintered six squirrels, and usually build something that can either be taken apart or else repurposed as the outdoor release cage.

Before I build anything, I am asking for any experience anyone out there might have with releasing squirrels who are only able to use one front limb.

While I do not need to make any decision on whether to release Guro until next May, if I did know she was an NR, then I would build something larger and more elaborate for her. (I could fit something 8'H x 8'L x 6'W in my office if needed.)

So, if anyone has any input, it would be much appreciated, thanks.

[Lighten-Up]

In Guro's case, my concern is that if she does not manage to use the paw and fingers to eat, climb, etc. that she will be an NR. May is a long way away, so no such decisions need to be made any time soon, and I am prepared either way.

Such a sweet little girl!

I have a large male squirrel in my yard who two years ago showed up with a bloody left wrist, all the white tendons exposed. He was too big and wild and not friendly to catch, so I prayed for him.

His wound healed such that it closed over, but he has no use of his fingers or wrist really. His elbow and shoulder work fine. He runs up and down trees and uses his left stiff fingers as a support to eat nuts and anything he needs to hold in place to eat.

He has been out there two years post injury. And has finally felt I am safe enough to come as close as 10 feet for a nut toss. Just giving evidence of one squirrel who has not let a paw injury keep him from a relatively normal life.

He does not live in my yard, he appears about every other week, so he is really getting around without a working front paw, and he has been doing that for two years.

Your girl is a unique creature, so only you and she will know what is in her best interest.

[TubeDriver]

I don't have any experience with 3-legged squirrels that I have released but I have had a couple wilds with similar deficits. One yard wild, Spaz, had a badly damaged front paw, basically all the fingers except one were missing. Spaz was one tough squirrel and visited for several years.

I currently have a yard wild we named "Hurt Paw". She had some type of injury to the wrist that never healed. The paw is not stable and she cannot use that paw or really put a lot of weight on it. Her fingers have atrophied and are curled up. She gets around pretty good but does get chased by some of the bigger squirrels. I don't know how long she will survive out there but overall she appears pretty healthy.

I think a squirrel with a front paw deficit can get around and survive out in the wild but I would not expect them to live as long as a completely healthy/mobile squirrel, all things being equal. Still, for many squirrels, my guess is that they would accept a shorter time if that is what comes with being free and wild IMHO. Some squirrels are miserable in captivity, others do better. Only you can judge what might be best for your little one. I would see how she does over the winter but a decent size cage that allows her to climb and jump would be good. Reserve judgement until the spring.

[olorin19]

I don't have any experience with 3-legged squirrels that I have released but I have had a couple wilds with similar deficits. One yard wild, Spaz, had a badly damaged front paw, basically all the fingers except one were missing. Spaz was one tough squirrel and visited for several years.

I currently have a yard wild we named "Hurt Paw". She had some type of injury to the wrist that never healed. The paw is not stable and she cannot use that paw or really put a lot of weight on it. Her fingers have atrophied and are curled up. She gets around pretty good but does get chased by some of the bigger squirrels. I don't know how long she will survive out there but overall she appears pretty healthy.

I think a squirrel with a front paw deficit can get around and survive out in the wild but I would not expect them to live as long as a completely healthy/mobile squirrel, all things being equal. Still, for many squirrels, my guess is that they would accept a shorter time if that is what comes with being free and wild IMHO. Some squirrels are miserable in captivity, others do better. Only you can judge what might be best for your little one. I would see how she does over the winter but a decent size cage that allows her to climb and jump would be good. Reserve judgement until the spring.

Thanks TD, very helpful.

Like you, I am inclined to release if possible. I released Huckleberry last May after overwintering. He started with two paralyzed limbs and a broken wrist. The wrist healed so he does not have full extension, but the paw is fine. I worried all last winter as to whether he would be okay to release, and he has done just fine.

There is a wild in my yard we call Slash (large slash in one ear) who only has the pinkie and ring finger on one front paw, and he does fine - he is actually a bit of a bad ass!

[olorin19]

Here are a few Guro photos today -

Two of Guro eating a yam, with some use of right front paw although left front paw is doing the vast majority of the job.

Then one of Guro perched on my slipper. She does not really put weight on that right front paw, but holds it like you see in this photo so that it does bhit anything while running or climbing.

Guro likes to play fight either while standing or hanging upside down. I try to engage both front paws, but she really only bats at me with the left.

[olorin19]

Guro has moved into her new cage for the winter, and is enjoying more room to climb, run around, etc.

I am still adding things: large branches for climbing, perching, and chewing plus bins with mulch for digging, etc.

I have an extra 1' x 6' piece of the outdoor carpet from the squirrel toward, and put that on top of the cage so she can run around up top. Standing there on a step with her running around at eye level provides a close view of how Guro moves.

With Huckleberry last winter (broken right wrist that did not regain full extension), he ran around mostly on three legs but did use the right front leg, often pushing with the knuckles rather than the palm.

With Guro, her right forearm and paw are not used when she walks, runs, or climbs. While she does run around on three legs, I am fairly sure that she also has developed a gait I never saw with Huckleberry: Guro will jump using just her back legs, land on just the back feet, then jump again like a kangaroo.

Kanguro!

Anyone else ever see a squirrel hop a few times just using back legs?

[CritterMom]

What a smartie pants! You MUST get this on video!

[olorin19]

What a smartie pants! You MUST get this on video!

I will try and catch it on video. She really only does it when she is scampering about on top of the outdoor carpet on top of her cage while play fighting with me.

It reminds me of what I call the "helicopter jump" where young squirrels play fighting (or adult squirrels evading one another) jump straight up in the air, except Guro also does it with forward movement.

I added some thicker branches for Guro to climb and chew, and she likes to perch on top.