Osteo Thread

[vjgrey]

She keeps telling me to put my pretend DVM away.

 

Wow. I would be looking for a new vet immediately.

 

Your vet may know medicine, but YOU know your dog, and your vet should be willing to give that some deference. If for no other reason than to put your mind at rest. Especially after three months of treating him "her" way hasn't worked.

 

I would tell her, point blank, that I want x-rays. If she refuses to do them and you don't want to change vets, I'd take him to another vet just for the x-rays.

[greysmom]

You could also take him to an e-vet or hospital just for an x-ray and reading.

 

IMO, if you say you want an x-ray, and are willing to pay for an x-ray, and there's no medical reason NOT to do an x-ray, your vet should do the dang x-ray!

 

Too bad they didn't do one when he was already anesthetized for the surgery, though Dude never had to go under for any of his, and Toni got one of her leg without it a month ago.

 

Good thoughts for Sam!

[NeylasMom]

Wow, I can only reiterate what others have said. Tell her point blank you respect her opinion but you want the x-ray to put your mind at ease and don't mind the cost to do so, end of story. There is NO good reason she should refuse an x-ray you want. One consideration - not all vets have digital x-ray equipment. I think it's very important to get digital x-rays when you're concerned about osteo - both because they have a level of detail/magnification that non-digital do not and because if you need a second opinion, it is much easier to transfer digital images. Especially given your vet's attitude thus far, I would think a second opinion to read the x-ray is probably going ot be in order so if she doesn't have digital and the ability/willingness to send them out at your request I would get the x-ray elsewhere.

[joejoesmom]

Wow, I can only reiterate what others have said. Tell her point blank you respect her opinion but you want the x-ray to put your mind at ease and don't mind the cost to do so, end of story. There is NO good reason she should refuse an x-ray you want. One consideration - not all vets have digital x-ray equipment. I think it's very important to get digital x-rays when you're concerned about osteo - both because they have a level of detail/magnification that non-digital do not and because if you need a second opinion, it is much easier to transfer digital images. Especially given your vet's attitude thus far, I would think a second opinion to read the x-ray is probably going ot be in order so if she doesn't have digital and the ability/willingness to send them out at your request I would get the x-ray elsewhere.

 

This!

 

Also I can't believe that a vet would not recommend an x-ray under these circumstances: a limp of unknown origin for 3 months that is not resolving in a breed prone to bone cancer AND an owner willing to pay for it. I know you didn't ask for this but if I had a vet say to me "to put my pretend DVM away" I would be asking for an apology. The vet may know animal science better than me, but I know my dog 10 times better than any vet. To not listen to my valuable input on my dog's behavior is to ignore one piece of the puzzle.

 

Jane

[djsgreys]

Thanks for the advice. I don't want to make my vet look bad - honestly we have a good relationship and with 10 hounds I really appreciate the deep discounts that she gives me. I just don't get why she is so insistent on not doing an x-ray - usually she starts any vet visit with "and what is your diagnosis of the problem" and ends with "well I really was hoping you were wrong, just once, but you are right again" So normally we do have a good relationship. I just made an appointment for Saturday. My vet is away and will see the other one in the clinic and insist on x-rays.

 

The limp, the panting - are there other symptoms I should be looking for to tell them about? Have I missed something really important that is making her think this way?

[NeylasMom]

No, unfortunately there often aren't many signs of osteo until the progression is quite far along. Swelling is the only other thing I would think you might see, but generally that's only once the cancer has progressed quite a bit imo. Quite a few dogs have been asymptomatic and then just one day fractured the bone. So the fact that you have unresolved intermittent limping and a sign of pain (panting) is more than reason enough to warrant an x-ray like Jane said.

 

Oh, one other thing that is not necessary but might be a good idea if you don't mind the cost would be to take the same view of the opposite leg (so if it's left front that's painful, also x-ray the right front) for comparison. It may be useful, especially if you are dealing with the earlier stages of osteo where it can be harder to see the damage from the lesion to have healthy bone for comparison. Multiple views are ideal, but we were able to diagnose Neyla's osteo with just a lateral x-ray and we never went beyond that because I didn't want her leg manipulated too much or to have to anesthetize her.

 

Will be keeping my fingers crossed that in this case, as snotty as she was your vet is right.

[Charlies_Dad]

I'm with the others are what to say to your vet. I just can't believe a vet would say no like that but you have a good relationship and that is important to keep. I hope it's not Osteo, I really do and will be thinking good thoughts for Sam.

[krissn333]

I've never had a vet refuse to do xrays if I've asked for them...that's just nuts. Why would a vet refuse to take your money? I agree that you need to get digital xrays

[45MPHK9]

Oh, one other thing that is not necessary but might be a good idea if you don't mind the cost would be to take the same view of the opposite leg (so if it's left front that's painful, also x-ray the right front) for comparison. It may be useful, especially if you are dealing with the earlier stages of osteo where it can be harder to see the damage from the lesion to have healthy bone for comparison. Multiple views are ideal, but we were able to diagnose Neyla's osteo with just a lateral x-ray and we never went beyond that because I didn't want her leg manipulated too much or to have to anesthetize her.

 

This is exactly what we did with Bee Wiseman, one lateral view of each leg for comparison. I'm sorry that your Sam is hurting, Deb.

[BauersMom]

Everyone's already given you good advice, so I'll just send good thoughts to you and Sam!

[TwiggysMom]

Reiterating what everyone else said. It is odd that a vet would reject a request for xrays. Especially for an undiagnosed limp in a greyhound!

 

I was going to second Chris' suggestion to go to a specialty clinic or evet for xrays, but it sounds like you'll be able to get some this weekend, so that's good.

 

As far as what to look for, Twiggy's only signs were first more panting than usual (but it was summer and we were having a heat wave), and then a sudden, unexplained limp. With her, there was no soreness, swelling, limited range of movement, anything.

 

I just demanded xrays when on day 4 of limping (1 day after starting pain meds) her limp was worse. They showed what my vet obviously didn't expect, but I already knew.

 

One word on encouragement, though - 3 days later (so total 7 days of limping), there was a visible lump. Hopefully since there isn't any lump, and the limping has been intermittent for some time now, it might just be arthritis or something equally benign!

[Guest snakes]

I hope Sam gets the all clear when you have xrays taken. I think it is worth doing just for your peace of mine, the worry and anxiety will take far more toll than anything else when caring for a pet!

FedX had no symptoms prior to diagnosis, he was running one day, suddenly shrieked and held the leg up. We went straight to the vet (he was supposed to have surgery the next day for an unrelated condition) to have it checked out in case it postponed his surgery. FedX was limping when he shrieked, by the time we got to the vet (maybe 20-30min) it was starting to swell. The vet wanted to try NSAIDS for a week but i pushed a bit on "shouldn't we do xrays?", he basically said it was up to me, so I did it and glad I did. I had that gut feeling of what it would show. Now we continue to fight the beast, 14+ months later....

[djsgreys]

Thanks again. Its strange how a limp can put terror into your heart. I have had dogs all my life, and never thought twice about a limp, until I had greys. I also saw a couple of replies where the poster said the vet just confirmed what they already knew. That is what happened with Suzy - I knew from the first time I saw her pull up while running in the yard and limp a little. And I know there is something wrong with Sam. There is a visible swelling - and I pointed that out to the vet as well.

 

I did think of going to the E-vet but the three clinics here are so NOT greyhound savy and so ridiculously expensive that I advise people against going. I really like my vet, and her prices are the most reasonable around but I also know that she has missed making an osteo diagnosis after x-rays on at least one hound. They do digital though so will ask that they be read by a radiologist.

 

Will check back in and let you know the results after we get the x-rays tomorrow

[joejoesmom]

Thanks again. Its strange how a limp can put terror into your heart. I have had dogs all my life, and never thought twice about a limp, until I had greys. I also saw a couple of replies where the poster said the vet just confirmed what they already knew. That is what happened with Suzy - I knew from the first time I saw her pull up while running in the yard and limp a little. And I know there is something wrong with Sam. There is a visible swelling - and I pointed that out to the vet as well.

 

I did think of going to the E-vet but the three clinics here are so NOT greyhound savy and so ridiculously expensive that I advise people against going. I really like my vet, and her prices are the most reasonable around but I also know that she has missed making an osteo diagnosis after x-rays on at least one hound. They do digital though so will ask that they be read by a radiologist.

 

Will check back in and let you know the results after we get the x-rays tomorrow

 

Please send the x-rays to the OSU Greyhound Health and Wellness Program as soon as you get the files:

 

https://greyhound.osu.edu/consultationservice/

 

They are short staffed until the end of April but are doing their best to keep up with demand. Either Dr. Marin (from her parents house in Columbia) or Dr. Couto will respond. Dr. Marin is currently on extended leave to take care of an ill parent, but she is responding to requests 3 days a week. Dr. Couto is handling the remaining 2 days.

 

I sure hope that Sam is OK. I will be anxiously looking for an update.

 

Jane

[Charlies_Dad]

Thanks again. Its strange how a limp can put terror into your heart. I have had dogs all my life, and never thought twice about a limp, until I had greys. I also saw a couple of replies where the poster said the vet just confirmed what they already knew. That is what happened with Suzy - I knew from the first time I saw her pull up while running in the yard and limp a little. And I know there is something wrong with Sam. There is a visible swelling - and I pointed that out to the vet as well.

 

 

Deb, I know exactly what you mean. Never had a concern about limping until I had a Grey. I really hope the x-rays are all clear today.

[NeylasMom]

Any news?

[djsgreys]

Sorry to be late in getting back here. We did NOT get x-rays this morning but only because another dog arrived just before we did that require emergency surgery and they asked if we could come back. As I have been in the same place as the people that brought their dog in, how could I possibly say no. So we are now scheduled for Wednesday - first time I can do it with my schedule for next week. Sam is doing okay, I am being wimpy and overprotective and won't let him run in the big yard until we have the x-rays but with some metacam on a daily baisis we will make it through till Wednesday..

[dmswartzfager]

Passing through briefly - Symbra had her second round of chemo on Thursday, and seems to be suffering very few side effects - appetite is a *little* off, but her attitude is great. I did start her on Cerenia as soon as I saw her bloodwork results when I picked them up from my clinic Thursday morning and knew she'd be able to get chemo that day. The chemo vet also put her on Clavamox as a prophylactic measure, since she did get an infection last time.

 

We'll repeat a CBC next week to see if she should stay on antibiotics a few more days. The nice thing is that I was able to easily do her blood draw at home Wednesday night with Brian's help, so I don't have to stress her out by taking her in to work (the scary ceiling fans are turned on in the reception area again! ). So we'll keep doing her draw at home so she only needs to go to the specialty vet for the chemo, and then our clinic for the chest rads.

Edited March 25, 2012 by dmswartzfager

[TwiggysMom]

I'm so glad to hear that Symbra is doing well, and it's great that you can do the blood draws at home. That must be much easier on her!

 

 

It's too bad that Sam's x-rays had to be delayed, the waiting must be hard for you.

[tornadosgirl]

Sorry, I don't want to hijack this thread. But is there anyone who I could PM with or

phone? We learned on Friday that our Finn probably has osteo in his left front shoulder.

I don't want to get into a debate with anyone about treatment choices. If anyone

is on now and recalls our Penny history, they may understand why.

Finn is a cousin/half-brother to Penny. He is nine years old. My main

concern is spontaneous fracture. Thanks.

[krissn333]

We're not in the business of debating things regarding treatment here...some choose amp and chemo, some choose varying degrees of palliative care. There's no wrong choice here.

 

This is a place for support and sharing of information...so please feel free to post questions, etc...

 

I'm so sorry you've joined the osteo club

[tornadosgirl]

We're not in the business of debating things regarding treatment here...some choose amp and chemo, some choose varying degrees of palliative care. There's no wrong choice here.

 

This is a place for support and sharing of information...so please feel free to post questions, etc...

 

I'm so sorry you've joined the osteo club

 

Thanks krissn333. We are probably going to choose just pain control. But what we fear most is a spontaneous fracture. Is there any way for a vet to determine how likely that is? My DH is home all the time, but he doesn't drive, so if something happens, we would have to hope there is a neighbor who could get Finn and my DH to the vet ASAP. Since it may happen that no one is available, I would hate to see Finn suffer. Ugh, what to do?

[joejoesmom]

Sorry, I don't want to hijack this thread. But is there anyone who I could PM with or

phone? We learned on Friday that our Finn probably has osteo in his left front shoulder.

I don't want to get into a debate with anyone about treatment choices. If anyone

is on now and recalls our Penny history, they may understand why.

Finn is a cousin/half-brother to Penny. He is nine years old. My main

concern is spontaneous fracture. Thanks.

I would be happy to talk with you. I did choose amputation for my 7 year old Joe who had osteo in his right shoulder. He now has another osteo tumor in his left rear leg. So now my main concerns are keeping him as pain free as possible and a spontaneous fracture. Joe did receive radiation for his pain. He has not yet received any fosamax like infusions. OSU feels that the main reason for trying a fosamax type drug is to provide pain relief. They feel that the bone strengthening properties are not well studied in osteo patients, so are hesitant to recommend them solely for bone strengthening.

 

Although it may be more for my peace of mind, this is what I have done so far in regards to preparing for an unexpected fracture:

 

Created a "fracture box" which contains:

 

-a blanket to carry him

-a muzzle

-a spare car key

-a copy of my drivers license and credit card

-a list of all neighbors, in order of most likely to be available and able to help carry Joe and drive me to the vet. This list includes home and cell numbers

-a list of friends with home and cell numbers

-a shot of buprenex to inject (intramuscularly) to help the pain

 

Entered numbers into my cell and home phones in order of most likely to be available and set up speed dial (starting at #1)

 

Reduced the size of my yard. I normally have a 1 1/2 acre fenced area. I installed a fence to reduce this area to less than 1/4 acre. This way, a break couldn't happen 400 feet away from the house in the middle of the woods.

 

If I didn't live in a ranch house, I would have also blocked access to the stairs.

 

Perhaps others have more ideas. If you would like to talk to me you can call me at 614-523-0754.

 

Jane

[BauersMom]

Sorry, I don't want to hijack this thread. But is there anyone who I could PM with or

phone? We learned on Friday that our Finn probably has osteo in his left front shoulder.

I don't want to get into a debate with anyone about treatment choices. If anyone

is on now and recalls our Penny history, they may understand why.

Finn is a cousin/half-brother to Penny. He is nine years old. My main

concern is spontaneous fracture. Thanks.

 

No one debates here - just support. As has been said, there's no right or wrong decision and you aren't hijacking at all. So sorry that you may be facing this diagnosis. I would suggest sending the x-rays to OSU (link in the first post of this thread) for a second opinion.

 

This thread had a lot of advice of what to do in the case of an emergency. The risk of a break is always there, so best to be prepared.

http://forum.greytalk.com/index.php/topic/284087-need-some-input-please/

[krissn333]

It's very difficult, indeed. Unfortunately, no, there's really no clear cut way for a vet to tell how likely it would be for the leg to fracture. Sometimes they fracture even though the X-ray shows moderate bone loss, sometimes the bone DOESN'T fracture even though the X-ray indicates there is not even much of the bone left. It's a very difficult tightrope to walk-I have been there myself. My first osteo pup Sutra had it in his right shoulder. We did artemisinin, Deramaxx, and tramadol, along with pamidronate infusions (I'd highly recommend those). Others here have had good luck with gabapentin in addition to an NSAID like Deramaxx and tramadol.

 

With Sutra, I tried to keep him from jumping DOWN off of the bed or the couch-I got him trained to wait for me to lift him down. He also figured out he could run by adjusting his gait so that his good front leg always came down first, taking the brunt of the weight as he moved.

 

He was 3 days shy of being 6 months post-diagnosis when it was time for me to let him go. He had very few bad days, and im thankful for that.There are a few people here whose pups have passed our 6 month mark and then some with palliative care...I'm sure more people will chime in here as well.