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Unclear Diagnosis, Opinions Welcome.


Guest bredlo

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I'll preface this by saying I'm not thrilled that this is one of my first posts here, but rest assured it has nothing to do with all of you. Life has been simple, easy and beautiful with our first two greys, and we simply haven't had the need for all the wonderful resources here. I'm asking for feedback from anyone who has seen something similar to our situation - not as an alternative to a diagnosis, but to help reassure us that we're not acting on bad information when it's time.

 

--------------------

 

Nell is our first, our best, our angel. 10 and a half, and we've had her exactly six years (five of those with her adopted kid sister, Nina.)

 

Nell came to us after a track fracture in her back lower leg. The bone was shattered and replaced with a pin, resulting in an awkward gait and rear legs that aren't exactly the same length. She's done extremely well despite this, until this past summer when her mobility began to decline.

 

- Around July, she developed a corn on the bad leg, which lasted a long time. We chose not to go beyond hulling it, instead treating with oils and other topical solutions.

 

- By October she was using it fairly well again with the aid of a soft boot.

 

- In December, she began favoring the leg more and more, even hopping through carpeted rooms. We hoped it was arthritis and began using Tramadol, then adding Rimadyl.

 

- About a week ago we watched the foot, and eventually the whole leg, begin to swell and the skin turn dark red. It blows up and shrinks to normal repeatedly, seemingly independent of elevation, etc.

 

- As of tonight, we have new x-rays, which our very kind and educated vet says is inconclusive for a tumor, and can't recommend further action.

 

We've scheduled an MRI tomorrow morning with a traditional surgeon, as well as a potential third, holistic-focused vet here in the Chicago area. That would be three opinions on what we're facing, here.

 

Rimadyl, Tramadol and Amantadine have been limited in their effectiveness, and things have steadily worsened. Unfortunately, the only way we've found to guarantee a whole night's sleep is a small dose of Acepromazine to assist in knocking her out. I'm now carrying Nell up and downstairs, out to the yard, and through deep snow. I also must quickly position her leg for her when she tries to squat, so she can do her business. However, I've tried my best to let her use it in any situation where she'll benefit from the exercise.

 

I'll attempt to attach the most recent x-rays of the relevant areas: hip socket which seems to show significant arthritis or bone loss... and the fracture further down the same leg.

 

I was hoping anyone who identifies something they've seen or read here, could let me know what we may be dealing with. So far have felt there's advanced bone loss and decalcification is certain, and that the swelling is some sort of unexplained Edema. We're inconclusive on Osteosarcoma, but would like to know so we can prepare to make a difficult decision, as at her age... she may not be a good candidate for the expense and recovery time of amputation / chemo.

 

Again, I'm not asking for a diagnosis... just trying to reinforce our decisions from this point.

Thanks in advance,

Brad

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Guest annickaandjef

same here- we're also in chicago and the snow can be brutal, even for hounds without the issues Nell is adjusting to. hope you guys figure it out and are feeling better soon.

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Thank you so much - we now have a tentative appointment with Barb Royal, and I'll certainly look into having Dr. Couto see Nell as well.

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I sure will, o_rooly. It looks like we'll be up with her all night, as the Rimadyl is the only thing that seems to work well --- but we can't give her any before the MRI. Terrible howling and pain, and there's nothing we can do.

Hopefully we'll have some answers in the morning. I appreciate your caring.

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Definitely agree with the suggestions to consult with Dr. Couto. Here's his website with more information if you need it:

http://www.coutovetconsultants.com/

http://www.coutovetconsultants.com/blog/dr-couto-at-metzger-animal.html


Why no Rimadyl before the MRI? Did she have a dose earlier today? Is the hospital where she's having the MRI done associated with an emergency clinic? If so, might be worth calling them (or another local e-vet) about pain management to get her through the night.

Jennifer &

Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On),

Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice

gtsig3.jpg

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JJNg, I think the no Rimadyl may be because it thins the blood? And thus, if they were to take a biopsy while she was anesthetized, it could cause problems or something. Not sure...

We've snuck her some Acepromazine (very little) in hopes of taking the edge off and helping her fall asleep. We'll see... but for now it looks like an all-nighter.

 

I'm not sure where the facility is where we're heading tomorrow; my wife made the appt. and I haven't asked... but will.

Thx for the suggestion and additional thumbs up for Dr. Couto.

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Sounds like the vet is being overly cautious about the bleeding risk. Rimadyl is commonly used prior to major surgery (such as spays and orthopedics) and rarely causes any issues with bleeding. Were they aware of how much pain she's in? Can't really call them to ask now, but I hate that she has to endure the rest of the night without anything to relieve her pain. :(

Jennifer &

Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On),

Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice

gtsig3.jpg

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Guest grey_dreams

Thank you so much - we now have a tentative appointment with Barb Royal, and I'll certainly look into having Dr. Couto see Nell as well.

 

I'm so sorry to hear about what is happening with your beautiful Nell. Also urge you to send the X-rays to Dr. Couto's email address. He doesn't have to physically see Nell, he only has to see the X-rays right now. He is the leading expert in cancer in greyhounds, and he is the one who needs to see Nell's X-rays. Then he can consult with your vets about moving forward. Sending lots of prayers for Nell.

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Another opinion that you should consult with Dr. Coutu. He is wonderful, loves Greys and has so much knowledge. The $120 for him pays for itself tenfold in my opinion. The pain she is experiencing sounds terrible and personally I believe she should be on stronger dose or stronger pain meds. I'm sorry you are going through this and know that our Charlie who also had a leg injury when racing developed Osteo in the very same spot, coincidence possibly but I have my doubts. I hope you are able to get some kind of diagnosis and that you can control her pain. Also 10yrs is not too old for amputation and sometimes that is the best decision because the pain is gone and they do great on three legs. Dr. Coutu may tell you this as well as he has performed this surgery mostly for Osteo but sometimes it's necessary for other reasons. Our Charlie had an amputation and he lived another 21mths very happy.

Edited by Charlies_Dad

Kyle with Stewie ('Super C Ledoux, Super C Sampson x Sing It Blondie) and forever missing my three angels, Jack ('Roy Jack', Greys Flambeau x Miss Cobblepot) and Charlie ('CTR Midas Touch', Leo's Midas x Hallo Argentina) and Shelby ('Shari's Hooty', Flying Viper x Shari Carusi) running free across the bridge.

Gus an coinnich sinn a'rithist my boys and little girl.

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I second/third/etc/ sending your xrays to Dr.Couto ASAP. When 2 vets couldn't give us a definite answer as to what was causing our hound's leg pain, Dr. Couto was able to confirm the DX just by looking at the xray. Good luck and hugs .

<p>Kim and the hound - Rumor
Missing my angels Marlow, Silver, Holly and Lucky

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Even to an untrained eye, that hip looks miserably painful. Bless her sweet heart, I hope you can find some kind of relief for her soon.

I also encourage you to email those xrays to Dr. Couto. I was lucky enough to have him consult on my Desi's case when he was in

intensive care at OSU throwing clots. His opinion/advice is worth its weight in gold.

Blessed is the person who has earned the love of an old dog.

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Thank you all.

It took me a few replies before I realized Dr. Couto can identify these without seeing her in person. That sounds like the confirmation we need at this point... we made it through the night and ironically the biggest yowls and howls seem to be when she needs to pee. Not that it's any less uncomfortable, but it felt absolutely euphoric for me to put a temporary end to her pain out in the snow. Letting an animal suffer isn't in my DNA - I've wrapped up squirrels and rabbits on the side of the road, and this is just about tearing me apart.

 

I understand this may not have spread and that we can keep her a bit longer -- but with an extreme tightness in my throat, I'm preparing to say goodbye, here.

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Just sent everything off to Dr. Couto and paid for his services. I've used the internet since the beginning (I just turned 40) but it's still beyond incredible that we can access an expert like this with such immediacy.

Thanks again, everyone, I will update. It's providing me a great deal of strength to know we all go through this and - somehow - come out okay each time.

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You may also want to peek in on the osteo thread in health and medical. Lots of good pain management advice there. You want to give enough med to stay ahead of the pain, instead of playing catch up when a dog is in major pain. Hope your baby is feeling better. I've done the crying all night thing ( me) while holding and trying to comfort a dog screaming in pain. Hope something can be one to increase her comfort. Hugs!

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I have no advice from a personal standpoint. I, too, would have suggested reaching out to Dr. Couto but I see you have done that. When in doubt, on here, take member JJNG's posts to heart as she is a vet.

 

I hope the terrible tight feeling in your throat is wrong, but it it isn't, we are all here with you.

 

You girls are gorgeous. Holding them, and you, in my prayers.

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Hi again, new friends.

After a very difficult night, we went this morning to meet with a new surgeon, for a new opinion. We presumed we'd have an MRI, learn Nell's fate, and move forward.

 

But today hasn't been quite that simple.

 

By 7 AM, I'd contacted Dr. Couto, and he responded right away with what he would do in our situation. That's about the most comforting thing one can hear in a confused, grieving state and it was wonderful to hear a voice of confidence and compassion. He was very confident it is indeed bone cancer, and virtually no chances it could be anything but. "Textbook" is the word he used, from the hollow looking joints to her bruised, swollen leg which is four times its normal size.

 

A few hours later we'd obtained chest x-rays locally (which appear to be clear) and Dr. Couto more or less implied that Nell could have a pelvectomy.

 

Yet, Melissa and I spent the day crying and hugging our sweet girl; we'd decided we weren't going to put Nell through a series of biopsies, amputations, drugs, chemo, etc. Maybe if she'd been 6 or 8... but we felt it wasn't right to inflict this onto our very tired pup. Mostly we wanted to do what is best for her, vs. succumbing to our resistance to let go.

 

Fast-forward to a final family photo - much, much sobbing - and the rare event of Nell and Nina wolfing down McDonald's for lunch. We discussed putting Nell to sleep by the end of the week, while she's still somewhat herself and to avoid weeks of dull, aching dread.

 

Then, around 3 this afternoon, we received a call from a different well-respected Chicago vet whom I'd reached out to last night. She has zero financial interest in our situation, and technically isn't allowed to give advice at all so everything was simply discussed as friends. She felt we weren't giving amputation an honest look - and that we didn't have to do biopsies, the repeated anesthetics, the chemo. In short, she felt we could simply remove the leg and see if Nell can adapt quickly and live happily. She then put us in touch with a surgeon who happens to have a cancellation first thing tomorrow morning. He has an outstanding reputation here in Chicago, and we feel we'd be walking into a very safe environment.

 

So it has been an incredibly volatile emotional roller-coaster the past few days, and I hope what we decided next won't come off as flighty or flaky. We decided we'd regret not finding out if Nell might've had another joyful chapter in her life, and took the appointment. We're still adamant about not letting her languish, and will euthanize her quickly if we get the sense she's suffering. The best part is, she'll be giving up the leg with the god damned pin she earned at a track 8 years ago. Our hope is that this will be a head start in her recovery; learning to live without the pain she's bravely hid for so long.

 

Thank you all for your support, and especially your suggestion to contact Dr. Couto. I'll update you when we're out of surgery sometime tomorrow.

For now I'll leave you with what we now hope will not be our last family portrait, after all.

 

 

family.picture.jpg

Edited by bredlo
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