My Grey Was Diagnosed With Thromboembolism In The Mid Right Femoral Ar

[Guest Artemis]

Early in the morning at 2:00 am on 5-19-08, my greyhound after having been given her medicine (Prednisone and Tramadol) for treatment of a flare up of an old racing injury involving a herniated discs at L6-L7 at L7-S1, suddenly dropped a biscuit and started whimpering in pain. She began pacing and thrashing about with noticeable right leg drop which in 15 minutes. On touching her right rear foot I found it to be colder in comparison to her left foot and she cried out in pain as I touched it. The obvious right rear foot had no weight placed on it and later she was hopping on three feet with no weight placed onto her right rear leg. The right rear leg for the past three years was the weakest leg most compromised by the herniated discs but entirely useable by her with less weight placed on it. After 10 minutes of being unable to quiet her down, we raced her to the ER where she was diagnosed with suspected thromboembolism vs. neoplastic emboli and give the differential diagnoses of primary cardiac or neoplastic disease process, hypercoagulability, and trauma. Doppler testing revealed no flow of blood into the right dorsal pedal artery with the left rear leg pressure detected at 90mm. Pain medications of butorphanol (0.2mg/kg) and buprenorphine (0.03 mg/kg) were given to her but she still continued to hobble and cry out loud in great pain.

 

We took immediately to her Vet and the following diagnostic studies were labeled as normal: EKG, ultrasound of the abdomen and x-ray of the right rear leg. Ultrasound of the right rear leg visualized a very small clot in the leg at the mid femur. Dipstick urine testing noted the presence of protein which has been submitted for further urinalysis with no results yet returned. The Vet believes he can rule out the presence of heart disease and Cushing’s disease but the protein in the urine may well indicate some kidney disease, which the urinalysis should confirm. Later on 5-19-08, the Vet gave me a report in which my greyhound is still in obvious pain despite the medications of aspirin, Rimadal, Plavix, Tramadol and IV bufonex (sic). Her right rear foot is still cold with no evidence of sloughing - which can occur in really bad cases involving blood clots. She is able to void and pass a bowel movement on her own but has great pain when walking. The Vet recommended ultrasound to the right rear leg which is to have started later today.

 

I saw my sweetheart this evening and I am very heartbroken. I understand that with the medications that she is not herself but her right rear leg from the ankle (dog leg joint) to her wrist (ball of the toes) is swollen up six times its normal size and she is hobbling on top of her toes in pain. Her toes are ice cold, dish rag limp and unable to straighten out on their own. I bought her favorite food treats and home cooked meals that she loves and she rejected these things and me. She did not appear to recognize me and was hyperventilating and trying to pace away from me.

 

When I spoke with the Vet he believes that she is a little less anxious but still in discomfort and pain. He was planning to readjust her medications. He related that these next few days are critical that she be rested and non weight bearing and that this time will determine whether she has the ability to generate the needed new blood vessels to supply her right foot with the nourishment she needs.

 

My greyhound is a rescue who is 9 years, 5-months old with a herniated L5-S1 disc injury and partially desiccated L6-L7 intervertebral disc. Because of a bacterial infection at age 7 1/2 yrs old to her left front index toe which did not respond to antibiotics, we had to amputate the toe with no complications nor did biopsy reveal any cancer. A month ago, April 2008, she without trauma to the left front leg developed the sudden onset of lameness and blood work studied ruled out Lyme's disease and other infectious processes. Her Vet took x-rays of the left front leg to see if there was evidence of osteosarcoma which were negative. He treated her for tendonitis of the left shoulder which required steroid injections. A repeat x-ray of the left front leg 3-weeks later noted no evidence of osteosarcoma and he gave her the diagnosis of tendonitis which resolved with the steroid injection and no pain was voiced by her on manual manipulation. The Vet recommended aqua therapy for the front left leg and right rear leg and we had two sessions before the blood clot was thrown. After the 2nd aqua therapy session, I did see some improvement in her ability to walk given her limitations discussed herein.

 

I love this dog with all my heart but I am concerned that the outcome is not very good. When I saw her, she was strung out, hyperventilating and whining in pain. Her affected right rear foot looks as though it is withering on the vine, cold and in all respect a dead limb. I do not want to amputate the limb or cause this dog to undergo any invasive diagnostic testing or exploratory surgery given her poor disposition to confinement and medical treatment. If she can eat, walk and poop/pee without assistance I would like to bring her home but she cannot be in such pain and discomfort as this is too cruel and affects her quality of life.

 

Can anyone give me any prognosis or guidance as to the situation I have on hand and make any recommendations as to treatment options and whether I am too hopeful with keeping her alive and should consider putting her to sleep? The last thing I want is to have this sweetheart spend her days with me in pain and unable to enjoy her retirement. I work full time and cannot nurse her 24 hrs, 7-days a week.

 

Many thanks to all who respond.

 

Viki

 

[Burpdog]

I have no experience with this. sending many prayers.

[Guest Willow8]

I have no experience or knowledge with this condition - but I just wanted to say how bad I feel for you. And your sweet hound.

[RobinM]

I too know nothing of this. I am hoping some people on here who have, unfortunately experienced this or Dr. Bill Feeman of OSU comes on and helps you with some answers.

 

I will keep you and your sweet baby in my thoughts and prayers.

[CaliforniaGreys]

I'm so sorry, no experience with this. But just want you to know you and your girl are in my prayers. It's obvious how much you love her and will do what is best for her. I so hope you get some answers.

[feemandvm]

Was general bloodwork done? Was the albumin low? If she is losing protein in her urine then she may also be losing something called anti-thrombin III which helps to prevent the blood from clotting. If AT III is in too low of a level, it predisposes the dog to throwing a clot.

 

Treatment options are as follows:

 

1. Start anti-coagulant therapy to prevent additional clots. Options include: heparin, aspirin, warfarin, clopridogel

 

2. Treatment to break up the current clot: streptokinase/urokinase/tissue plasminogen activator. This treatment is not without significant risk. There is little research on these drugs in dogs and reperfusion injury is a signficant risk.

 

3. Surgical removal of the clot: likely going to be very invassive and may not even be possible.

 

4. Treat the underlying cause: kidney disease, heart disease, etc.

 

 

The size of the clot really dictates prognosis. I referred one of these down to OSU but the clot was smaller and only intermittently would block the blood flow.

 

 

 

Dr. Bill Feeman of OSU comes on and helps you with some answers.

I graduated from OSU but do not currently work there. Just didn't want anyone to get confused.

[Guest Artemis]

Thank you Dr. Feeman for replying as I have spent all afternoon and evening trying to find out information on the Internet on her condition and prognosis.

 

The Vet described her blood clot to be "very small" and lodged in the right mid femoral artery as depicted on ultrasound.

 

I will get the information on the blood work 1st thing tomorrow morning from my Vet. I do know that she has been placed on the following meds - aspirin, Rimadyl, Plavix and Tramadol with an IV infusion of some pain killer sounding like "Bufonix (sic)".

 

I saw her today and she is walking on her toes/knuckling and the right foot dangles limply and from the ankle joint to the thigh the forefoot is swollen at least six times the normal size from the clot. The foot is extremely cold to the touch and looks dead. She is very stressed out, hyperventilating and crying in pain. Does she need stronger pain killers to dull the pain so that she can rest and allow the clot to dissolve and the new vessels to regenerate?

 

Given her age and herniated discs at L6-L7 and L7-S1, I do not think she can handle invasive surgery and still have quality of life.

 

What is the usual prognosis of such injuries?

 

Many thanks,

 

Viki

[Trudy]

Clots can be very painful. Ryan had one that was about 6-8" long in his neck. Now that's a clot!

 

The boy who had a stick go through his foot and never even flinched was screaming any time he moved. I think his top speed during that time was 0.02 mph - he would get up for a walk so I had to harness him up and take him to the corner (one house away) and back again. He was happy to go for his very slow walk. Since he was still happy to eat and walk, but just in serious pain and no real prognosis other than "let nature take its course"

I promised to give him a week to see if we could get his pain under control, if not, then we'd put him down.

Luckily, daily pain injections and butt loads of tramadol and some gabapentin as well got him to where he wasn't yelping with every movement.

 

It's been 8 months and he still has odd issues pop up and we still don't know what is causing it all. Now we just treat what pops up and have pretty much given up trying to actively find the cause.

 

 

Good luck - I'd focus on getting her pain under control and then go from there.

[Guest greybookends]

:hope :hope :hope

[Guest vahoundlover]

No advice, just wanted to add my prayers.

[Guest Artemis]

Many thanks to all posters offering prayers and words of support. Despite not knowing each of you personally, your kindness and generosity of spirit has help to ease my emotionally fragile state as we try to get my sweetheart comfortable and treat her condition. My husband and I are meeting with her vet later this afternoon to discuss her situation and I am still hopeful that she will be able to come home with me. Please keep her in your thoughts and prayers as I will the health of your grey sweethearts too.

[Guest paulamariez]

Your poor precious girl! I will keep her tender heart in my prayers for a quick resolution to her clot problem and a quick recovery and healing. Tiger, Bueller and Domino are sending her some healing get well doggie kisses too.

[Burpdog]

Sending lots of prayers. Do you have acupuncture vet close?

[Guest Artemis]

My husband and I met with our Vet yesterday and the discussion on my sweetheart was not very good. While she appeared in better spirits that when I saw her on Tuesday, the urinalysis results were in and she had an extremely elevated creatinine level of 17 which was suggestive for chronic renal failure in addition to the small blood clot/thrombis still lodged in her right femoral artery. This will seriously complicate her recovery and her swelling on the right rear leg is even larger than it was on Tuesday. My Vet said this swelling of the leg to increase in size is expected when a dog throws a blood clot and she has been started on Levenox (some derivative safer form of heparin), in addition to aspirin, Plavix, Tramadol and an IV opiate for pain. After an intense Q&A session on her prognosis for quality of life, we are willing to try treating her pain, clot and renal failure with medications provided she continues to keep those "intoxicating high greyhound spirits" and that she visibly wants to be with us. I know we will have to face the issue of putting her to sleep because her renal failure is progressive and not curable.

 

Can anyone with any of these health issues tell me of their treatment and quality of life they were able to give their greyhound how ever long or short lived? I feel like I am operating in a haze and I want to make the most informed but humane choice for my angel without letting my selfish needs of keeping her outweigh God's plan.

 

Many thanks

[Guest Artemis]

We just got back from the Vet after receiving the news that our angel took a turn for the worst. Our precious Artemis was sent to heaven around 5:30 pm today. It was the hardest decision for us to face but we know she is at peace.

 

Thanks to all on the website who offered words of encouragement and support. It made the road traveled less painful.

[LuvEarsies]

I am so sorry

[Guest Scouts_mom]

I am so sorry for your sweet girl is gone. Your family must feel that there is a major hole where she once was. But I am glad she had a such loving home for her retirement years, and now she is painfree.

[Guest jerrybird]

Viki, We are a loving bunch here on Greytalk and feel deepest sympathy for you. I'm so sorry for the loss of Artemis.

[Guest jurishound]

I am so, so sorry. We went through something very similar with our beloved Cricket, and despite many diagnostics, never had a clear DX. Finally she began throwing multiple clots and we knew what we had to do. There was much heartache on our part and in the end, I wondered if we waited too long to release her from her discomfort. Jack did not suffer long and knew he was loved - that is what is important. My sincere sympathy to you and your family.

[Guest nerak254]

I am very sorry.

[Guest FullMetalFrank]

Oh, no, I am so sorry. I was hoping for a better outcome. Run free, sweet girl.

[Guest Ohiogreymom]

I'm so very sorry.

[iluvgreys]

My heartfelt condolences to you and your husband for the loss of your precious girl. She's free of pain now, in the best of company at the Bridge, and will live on in your heart forever.