Gsod And Limping

[Guest Energy11]

I am very happy she is doing better! Having a sick girl myself, I KNOW how stressful this is!

 

HOPING for continuing good news!

[Guest sweetpea]

Oh, I opened this thread with dread in my heart, but it looks a bit more promising now.

 

I will keep thinking good thoughts for all of you!

 

Buzzy and da 'Pea

[Guest MorganKonaAlex]

A potential course of action with inconclusive xrays is to wait a few weeks. If the limp returns, repeat the xrays. If it's osteo, there can be changes in just a few weeks. In the meantime, I would send the first set to OSU.

[Guest JillinMichigan]

Hi, I am the one who fostered Butters (WW Quick Ramone) a year ago, and I got an e-mail from his family that he had a cyst removed from the muscle wall in front of his thigh this past summer. PM for Jeri's (Butters' mom) e-mail address if you don't still have it. I hope you are able to get the cyst removed without incident and Lucy feels better soon.

[TheFullHouse]

Everything sounds positive! Hope you get a good report from OSU also.

[RedFawnMom]

Hi, I am the one who fostered Butters (WW Quick Ramone) a year ago, and I got an e-mail from his family that he had a cyst removed from the muscle wall in front of his thigh this past summer. PM for Jeri's (Butters' mom) e-mail address if you don't still have it. I hope you are able to get the cyst removed without incident and Lucy feels better soon.

 

Very good to know, thank you! PM coming your way.

[carronstar]

Continued good thoughts and prayers for Lucy. The news sounds promising and you have nothing but good advice from everyone on here.

 

Love Lucy's picture!

[RedFawnMom]

Argh. OSU said they don't really know - they said it's in an unusual location for a tumor and doesn't look typical for a tumor, and she's only 4, which makes it more unusual, but the people who looked at the images have never seen a bone cyst, so they can't really differentiate. They suggested we see a local orthopedic specialist for additional imaging and to let him/her decide if a FNA is indicated. So, I have been on the phone for a few hours trying to find an ortho. The one I could get through to isn't loved by my vet's office, but no one else is calling me back, so I'm sort of torn. And, the ortho that my vet's office does recommend is not board certified. I E-mailed the images to the ortho I could get through to, and am waiting to hear back on what he thinks.

 

To further complicate matters, the greyhound OSU program is essentially temporarily shutting down until the beginning of 2011, starting Wednesday, so they will not be able to provide additional guidance past tomorrow.

[NeylasMom]

Argh. OSU said they don't really know - they said it's in an unusual location for a tumor and doesn't look typical for a tumor, and she's only 4, which makes it more unusual, but the people who looked at the images have never seen a bone cyst, so they can't really differentiate. They suggested we see a local orthopedic specialist for additional imaging and to let him/her decide if a FNA is indicated. So, I have been on the phone for a few hours trying to find an ortho. The one I could get through to isn't loved by my vet's office, but no one else is calling me back, so I'm sort of torn. And, the ortho that my vet's office does recommend is not board certified. I E-mailed the images to the ortho I could get through to, and am waiting to hear back on what he thinks.

 

To further complicate matters, the greyhound OSU program is essentially temporarily shutting down until the beginning of 2011, starting Wednesday, so they will not be able to provide additional guidance past tomorrow.

Well crap. I just sent Dr. C an email about Neyla - I hope he reviews it before then.

 

Back to your issue, I'm sorry you're having so much trouble getting an answer. Are you calling the orthopedist's offices during business hours? I'm not sure why a receptionist wouldn't be answering the phone if you are.

[RedFawnMom]

Argh. OSU said they don't really know - they said it's in an unusual location for a tumor and doesn't look typical for a tumor, and she's only 4, which makes it more unusual, but the people who looked at the images have never seen a bone cyst, so they can't really differentiate. They suggested we see a local orthopedic specialist for additional imaging and to let him/her decide if a FNA is indicated. So, I have been on the phone for a few hours trying to find an ortho. The one I could get through to isn't loved by my vet's office, but no one else is calling me back, so I'm sort of torn. And, the ortho that my vet's office does recommend is not board certified. I E-mailed the images to the ortho I could get through to, and am waiting to hear back on what he thinks.

 

To further complicate matters, the greyhound OSU program is essentially temporarily shutting down until the beginning of 2011, starting Wednesday, so they will not be able to provide additional guidance past tomorrow.

Well crap. I just sent Dr. C an email about Neyla - I hope he reviews it before then.

 

Back to your issue, I'm sorry you're having so much trouble getting an answer. Are you calling the orthopedist's offices during business hours? I'm not sure why a receptionist wouldn't be answering the phone if you are.

 

Dr. Couto might continue to check his personal Email, but I do think the woman I spoke with said he would be out of the country after Wednesday, so you may want to try to call him by tomorrow.

 

As for orthos, there are not many in the area (I've found 4), and a couple of them aren't associated with a specific clinic, they work with different clinics on a referral basis. So, they don't have receptionists.

 

Part of me thinks I should just cancel my surgery to give us more time to get some answers...but at the same time...I am going to be home for 6 weeks after my surgery, which could be a good thing if she does end up needing treatment of some kind.

 

Update: The one ortho I was able to get ahold of looked at the images and said he can't tell what it is, at all, that it could be one of many things. He suggested waiting 2-3 weeks, repeating Xrays and sending to a board-certified radiologist. He was not interested in repeating the X-rays now/getting the additional images OSU requested, he said it would not reveal any further information. He said if it's osteo, it will spread within 2-3 weeks and then we'll know. ???? That does not sound like a good approach to me.

Edited December 13, 2010 by RedFawnMom

[tbhounds]

Oh boy---nothing is easy. How is she feeling--sounded like she's responding to the pain medication well. As you well know if it's a bone cyst it's not going to hurt to wait for further treatment but, if it's .... I would hate to wait. I'm guessing that your veterinary clinic that you have been going to won't do the FNA?? How far is Angell Memorial or Tufts from you?

[RedFawnMom]

Oh boy---nothing is easy. How is she feeling--sounded like she's responding to the pain medication well. As you well know if it's a bone cyst it's not going to hurt to wait for further treatment but, if it's .... I would hate to wait. I'm guessing that your veterinary clinic that you have been going to won't do the FNA?? How far is Angell Memorial or Tufts from you?

 

She seems to be feeling fine. If I look closely, I see her favoring that leg a bit, but she's definitely not limping and doesn't hesitate with stairs or anything.

 

Our vet could do the FNA, but they preferred having a specialist review the images and make the call on what diagnostic tools to use. Tufts is 2-3 hours away; I called to try to get a consultation with an orthopedic surgeon there (I wanted to send them the X-rays, get their feedback, and then make an appointment for whatever testing will need to be done, rather than go in with the X-rays and then potentially have to come back for more testing if anesthesia is required, etc) but I found them to be a bit difficult on the phone, actually. The receptionist insisted that Lucy needed to see a soft tissue surgeon since that is the specialist who would treat osteo...I explained we actually need someone who is familiar with bone cysts, and that an osteo specialist had suggested we see an orthopedic surgeon, and she insisted that a soft tissue surgeon would be the best person to see for a bone cyst, which is just flat out not true. It also annoyed me that twice on the phone she said "Well, she has osteo, so...." even though I repeatedly explained that we do not KNOW what it is, and actually, our vet thinks it is more likely a cyst. I looked up the doctor she tried to make me an appointment with, and his specialties are gastrointestinal and nasal surgery. Um, yeah. I think that if we want to go to Tuft's, our vet is going to have to call them.

 

I did get a call back from a semi-local orthopedic surgeon who was very familiar with bone cysts and with osteo. I just Emailed him the X-rays...we'll go from there.

[NeylasMom]

Ah, I understand, that's the way my oncology team works, out of 2 hospitals. But they have an assistant since there's a team of them so I can contact her and I now have personal email addresses/cell phones. So I guess I wouldn't let that totally deter you from using one of them, although I agree it's frustrating.

 

I also agree that waiting is not the ideal approach if it may be osteo, but it's a pretty typical response I think. It was my own orthopedist's response (and he's wonderful), which is when I sent the x-ray to Dr. Couto, who dx'ed her.

 

I honestly don't know what to tell you. With Dr. Couto being uncertain, it's tough to say. I hope you get some answers soon.

[RedFawnMom]

Another update:

 

I just don't know what to do at this point. Perhaps I have too many opinions.

 

-OSU saw the images; suggested additional X-rays and consult with orthopedist to possibly do FNA

 

-The ortho who my vet doesn't really like saw the images and said he had no idea what it was and to wait 2-3 weeks and repeat the X-rays

 

-The ortho my vet does like (but not board certified) did not see the X-rays, but based on my description/her behavior/the fact that she quickly improved, said to wait 10-12 days then bring her in for a consult for him, where he'd examine her and re-do X-rays. He actually seemed to think it was a soft tissue injury causing the pain and that we just happened to find the lesion on the X-ray. He said subchondral cysts are very common but do not cause any symptoms.

 

-An ortho who was recommended by a friend (her vet recommends him and he is board certified) looked at the images and said it does not look like a classical bone cyst. The bone is reactive around it, which he said only happens if there is (a) injury (b.) infection or (c.) tumor. He wants to do a core biopsy (2 or 3 3mm biopsies). I asked about FNA and explained my concern about fracture; he said FNA will very likely be inconclusive and if so we'd need to do a core biopsy, anyway. He said the bone does not look fragile and he is not worried about possibility of fracture. I asked about additional imaging instead (MRI) and he said it would provide more information, but not enough for a definitive diagnosis.

 

I don't know what to do.

Edited December 14, 2010 by RedFawnMom

[tbhounds]

Tough call - I agree with the ortho vet that it might just be an incidental finding and perhaps she just hurt herself while she was playing. I would wait a week and re-radiograph that limb. Personally, I would not do a core biopsy. FNA's seem to work for OSU. Perhaps your vet could call and see how they approach the procedure. I don't think there is really. right or wrong way to diagnose this. Sorry, I know you are trying to do right for your girl.

[sweetdogs]

I don't know what to do.

You're doing all the right things - you are ALL over this & it will serve you well in the next few weeks.

I wouldn't do the biopsy - too painful & too risky. I'd also eliminate that last ortho: "He said the bone does not look fragile and he is not worried about possibility of fracture." Um.

 

Keep in mind that greyhounds present with osteo differently than other breeds (which is why we love OSU). Even if, maybe especially if an ortho told me they see lots of greyhounds, I'd be skeptical. Some things don't matter breed-wise but osteo does.

 

I'm so glad Lucy is feeling better. I hope this is not anything serious - I have a soft spot for little red fawn girlies.

[TheFullHouse]

Holy cow, what a range of opinions! If she's responding so well to the pain medication, would it hurt to wait a couple of weeks and then redo the x-rays to see if there is any improvement? At that point you could take her to see the orthopedic specialist. Did you vet tell you why he didn't like this particular doctor? It could just be a personality conflict between the two and have nothing to do with the Ortho's abilities. I'm not telling you what you should do, heavens I would never do that. I think that would be my course of action if it were my dog.

 

Whatever you do, I'm praying for the best results possible for your sweetie.

[RedFawnMom]

Holy cow, what a range of opinions! If she's responding so well to the pain medication, would it hurt to wait a couple of weeks and then redo the x-rays to see if there is any improvement? At that point you could take her to see the orthopedic specialist. Did you vet tell you why he didn't like this particular doctor? It could just be a personality conflict between the two and have nothing to do with the Ortho's abilities. I'm not telling you what you should do, heavens I would never do that. I think that would be my course of action if it were my dog.

 

Whatever you do, I'm praying for the best results possible for your sweetie.

They didn't say why they didn't like him - it could certainly be a personality conflict; I didn't really like his personality based on the brief phone call I had with him.

 

I have a call into OSU to give them an update on all of this and see if they can give me any guidance. I am really not comfortable with doing a core biopsy based one one opinion, especially when she is doing well and doesn't seem to be in pain.

 

I think what we'll probably do is see the orthopedist that my vet recommended, sometime toward the middle of next week (which would be about 10-12 days after the first X-rays were taken). I'll ask him to repeat the X-rays (they also have better equipment) and get his opinion on an FNA/next steps. I am a bit worried that he was the least concerned of everyone I've spoken to so far and hope I'm not "picking" him because of that (however, he did not see the X-rays, so I can't really compare his opinion to that of people who saw the X-rays)....but he is the most local and at the very least can probably get us some better X-rays. I am very much not a "wait and see" person, but I also don't want to put Lucy through any tests just to ease my mind sooner, if they could be avoided by waiting to see how it goes.

 

I've just gotten so much conflicting information, I don't know what to think. On one hand the odds are in her favor (not a typical image of osteo, not in a typical place for osteo, it's uncommon at her age, her pain has improved), but at the same time, she's a greyhound with a bone lesion.

[NeylasMom]

No help on the decision, just hugs. I know how incredibly frustrating it can be to make decisions like this, especially when you are getting conflicting information. Give yourself a day or so to sit on it and I think the answer will come to you.

[robinw]

Maybe the thing to do is to wait a little bit (ankle allowing ), have a second set of x-rays taken, then send them off for further evaluation.

 

Good luck with your surgery!

[Guest MorganKonaAlex]

I put my Alex through a core biopsy and I will *never* do that again. It was extremely painful. He was

maxing out NSAID, tramadol and gabapentin and still wasn't comfortable. A FNA is not a painful procedure and I wouldn't hesitate to do that if needed.

[tbhounds]

Had a thought-- how far are you from Cornell? Also, I may be mistaken but, they might have a satellite center in Conn.

I can find out tomorrow.

[Guest LindsaySF]

Have you tried anyone at Angell Memorial? They are in Boston. Sophie's neurologist is there, but they might have an orthopedic specialist for consult. The drive is not bad.

 

Because her pain seems better, and the lesion is atypical for osteo, I think I would wait a little while and then repeat the x-rays, rather than do a potentially invasive procedure now. Best of luck in your decision!

 

 

 

~Lindsay~

[RedFawnMom]

Had a thought-- how far are you from Cornell? Also, I may be mistaken but, they might have a satellite center in Conn.

I can find out tomorrow.

 

Cornell would be further than Tufts, but I'd love to know if they do have a satellite center in CT.

 

Have you tried anyone at Angell Memorial? They are in Boston. Sophie's neurologist is there, but they might have an orthopedic specialist for consult. The drive is not bad.

 

Because her pain seems better, and the lesion is atypical for osteo, I think I would wait a little while and then repeat the x-rays, rather than do a potentially invasive procedure now. Best of luck in your decision!

 

 

 

~Lindsay~

 

I haven't looked into Angell Memorial, I'd actually never heard of them, but I will, thank you.

[NeylasMom]

 

I haven't looked into Angell Memorial, I'd actually never heard of them, but I will, thank you.

I am pretty sure we've used them for our NE chapter of our group and had good experiences with them. So a very vague second on that rec.

 

How's your girl feeling lately?