Lytic Bone Lesion, We Don't Know What's Wrong Please Help

[Guest onebigunicorn]

To see pictures go to this link please: https://www.dropbox.com/sh/drn22svwfrhhtz4/TD3PH9F3eU#/

 

Hello,

We need some advice with our 5-year-old greyhound. He started to limp sometimes at the beginning of last year (front right leg). We initially thought he injured himself when running or something like that. He stopped limping after maybe 2 weeks. Then he started to limp again approximately 6 months or so later. This limping went on and off. Sometimes it was better sometimes worse, sometimes it stopped etc. In January this year we went to see our vet because he started to limp again and it seemed worse than before. The vet took leg and chest x-rays. There was a lytic bone lesion present in the elbow area (pictures attached). Chest was clear, the vet diagnosed it as most probably some kind of bone cancer, he was thinking of osteosarcoma. He said we needed to do biopsy. We said that what if it was a valley fever presenting itself in the bone since our grey was originally form Tucson, Arizona. He said that he didn’t think so, that it’s very rare etc etc and that, in any case, if it was valley fever, it would also show with biopsy. He gave us pain medication – tramadol, and anti-inflammatory drugs – onsior. So okay. Biopsy was done. They took multiple samples even used Jamshidi to take a sample. Vet said he was surprised how hard the bone was he expected sponge-like consistency which wasn’t there at all. Biopsy results came – all negative. No inflammation, no malignant cells, nothing. But our vet assured us he took good and enough samples. Also, I forgot to mention the blood work. Also in norm (I’m attaching the results). So then our vet was confused. He consulted this with his colleagues, they weren’t sure what it was. We waited four weeks, our baby on tramadol, and went for an x-ray again, cause by this time there should be a change to worse if it was a cancer. No change. We decided to consult other vet he said it might be bacterial osteomyelitis, so we tried clindamycin treatment for 6 weeks with no pain medication to see if there was an improvement. We felt that our grey was cheery and playful, although it was hard to say if it was because of the antibiotics since he was considerably down after the biopsy, in pain and looked sad. So it might have been just the fact that he was healed now. After 6 weeks we went for another x-ray. No change. Not worse but not better either. So our vet said he didn’t recommend continuing on clindamycin. But he still doesn’t know what’s wrong. He says it might be some kind of non-malignant tumor or something, or maybe some pathological bone changes due to some old injury we don’t know about. We are very frustrated because we paid lot of money with no result and we know our baby is in pain and discomfort. Even though he is in very good mood he won’t step on his right front leg if he doesn’t have to, he is sensitive to the touch in that area if you put your hand in his armpit area. He is also sensitive if you would bend his leg in the elbow (although he keeps the leg slightly bended when he stands)

Other than that, he eats normally, he didn’t lose any weight and as I mentioned before, he is in good mood and wants to go for walks (because for example after the biopsy he barely walked of course and he didn’t want to go for a walk at all)

Please if you have any advice, we really don’t know what to do. Thank you!

 

To see pictures go to this link please: https://www.dropbox.com/sh/drn22svwfrhhtz4/TD3PH9F3eU#/

Edited April 19, 2014 by onebigunicorn

[BatterseaBrindl]

Sorry you are going through this.

 

Can't see the pictures...

[macoduck]

Please utilize Dr Couto's consulting service. Your vet can send all reports to him.

 

http://www.coutovetconsultants.com/

[Guest onebigunicorn]

Sorry you are going through this.

 

Can't see the pictures...

 

yeah, sorry about that, I added a link now

Please utilize Dr Couto's consulting service. Your vet can send all reports to him.

 

http://www.coutovetconsultants.com/

thank you we'll check it out!

[tbhounds]

Second the suggestion to contact Dr Couto. Did they rule out a bone cyst???

Edited to add-just saw the images-doesn't look like a bone cyst. Did they get a comparative view (the other leg)??

Edited April 19, 2014 by tbhounds

[duncan41]

Please utilize Dr Couto's consulting service. Your vet can send all reports to him.

 

http://www.coutovetconsultants.com/

 

YES. That' the best advice.

[Houndmommy03]

Third to recommend Dr. Couto. Our angel lucky started limping vet thought osteo but bone biopsy came back normal. Took xrays to our gryehound kennel vet for 2cd opinion but he couldn't confirm osteo. Mailed films to Dr. Couto and he dx'd osteo- it took us over 2 months to get that dx. Good luck. Crossing fingers it's not osteo.

[Guest MnMDogs]

Your pup is very handsome! I'm sorry you're dealing with this- definitely consult Dr. Couto- he's very helpful and amazingly responsive for such a busy man. Good luck.

[Guest onebigunicorn]

Second the suggestion to contact Dr Couto. Did they rule out a bone cyst???

Edited to add-just saw the images-doesn't look like a bone cyst. Did they get a comparative view (the other leg)??

 

yes they did a comparative view, the other leg looked completely healthy with dense bone.

[Guest onebigunicorn]

Your pup is very handsome! I'm sorry you're dealing with this- definitely consult Dr. Couto- he's very helpful and amazingly responsive for such a busy man. Good luck.

 

Thank you, that's nice to hear. We could definitely give it a try

 

Third to recommend Dr. Couto. Our angel lucky started limping vet thought osteo but bone biopsy came back normal. Took xrays to our gryehound kennel vet for 2cd opinion but he couldn't confirm osteo. Mailed films to Dr. Couto and he dx'd osteo- it took us over 2 months to get that dx. Good luck. Crossing fingers it's not osteo.

 

They kind of ruled out osteo since it is a very aggressive cancer and his leg x-ray is the same for almost 3 months now and his limping is not getting worse either.

 

Does anyone have experience with latent valley fever that would present in lytic bone lesions in bone years after initial infection? Even though the biopsy was negative it could still be one of the possibilities...

Also does anyone have or knows someone who has a grey that has bone loss due to a degeneration as a result of old injury? If yes what are the options?

[silverfish]

Please utilize Dr Couto's consulting service. Your vet can send all reports to him.

 

http://www.coutovetconsultants.com/

 

Definitely do this.

 

There are other types of bone cancer and diseases of bone. I would definitely seek the advice of an expert. If Dr Couto can't help you (unlikely!) then please ask for a referral to a specialist veterinary hospital since your own vets seem to be a bit clueless on this. You've waited plenty long enough already.

[NeylasMom]

 

Thank you, that's nice to hear. We could definitely give it a try

 

 

They kind of ruled out osteo since it is a very aggressive cancer and his leg x-ray is the same for almost 3 months now and his limping is not getting worse either.

 

Does anyone have experience with latent valley fever that would present in lytic bone lesions in bone years after initial infection? Even though the biopsy was negative it could still be one of the possibilities...

Also does anyone have or knows someone who has a grey that has bone loss due to a degeneration as a result of old injury? If yes what are the options?

Unfortunately no change in the xray in that timeframe doesn't rule out osteo. Neyla had bone cancer and we saw virtually no change on her X-rays for about 5 months. While osteo is known to be an aggressive disease, I strongly believe and I think the anecdotal evidence supports that it grows very slowly in the body for some time, even long periods and that sort of explodes at the end.

 

I also strongly suggest the consult with Dr. Couto. And isn't there a blood test for Valley Fever? If so, I would get that done ASAP.

[Guest onebigunicorn]

Unfortunately no change in the xray in that timeframe doesn't rule out osteo. Neyla had bone cancer and we saw virtually no change on her X-rays for about 5 months. While osteo is known to be an aggressive disease, I strongly believe and I think the anecdotal evidence supports that it grows very slowly in the body for some time, even long periods and that sort of explodes at the end.

 

I also strongly suggest the consult with Dr. Couto. And isn't there a blood test for Valley Fever? If so, I would get that done ASAP.

 

okay thank you. yes there is but even the blood test can be false negative and it can be confirmed by biopsy and there was nothing although I keep getting this feeling that because our vet didn't expect for the bone to be so dense he didn't take proper samples =(

 

 

Definitely do this.

 

There are other types of bone cancer and diseases of bone. I would definitely seek the advice of an expert. If Dr Couto can't help you (unlikely!) then please ask for a referral to a specialist veterinary hospital since your own vets seem to be a bit clueless on this. You've waited plenty long enough already.

yeah, I know there are. And yes, we were frustrated with our vet who really seems somewhat clueless and keeps asking us to pay for the same tests over an over with no results! >=(

We will contact Dr. Couto

[NeylasMom]

Yeah, at this point I think you are correct to doubt the biopsy results and I absolutely would not do another one as they are generally not recommended when osteo is suspected because the biopsy can weaken the bone and lead to fracture. Normally I would say that in all likelihood you are still dealing with osteo, but given the history in AZ Valley Fever is a real possibility so I would want to try to rule that out. Otherwise given the X-rays and symptoms I'm afraid osteo is the most likely answer, although its not impossible that its something else and I will certainly keep my fingers crossed that its not osteo.

[krissn333]

Everything Jen said above

 

Osteo is awful. Get ahold of Dr. Couto ASAP.

 

Hoping for the best

[MP_the4pack]

I don't know where you are but Dr. Couto will be in Gettysburg this coming weekend. I heard he's going to be there all weekend. Maybe you can talk to him in person.

[a_daerr]

Sorry to say this, but it looks like osteo to me as well. Osteosarcoma is VERY common in retired racing greyhounds. Yes, it's fast-progressing, but you can't use length or severity of limp as a criteria for diagnosis. Bone biopsies are inaccurate a lot of the time too. According to our veterinary oncologist, the chances of an osteolytic bone lesion in a greyhound being anything other than OSA (or some other kind of cancer) are 10-1.

 

Your best bet is a consult with Dr. Couto ASAP. Keeping my fingers crossed for you .

[carronstar]

Another vote for Dr. Couto. As my own vet said when he had me see an internist for my girl's kidney issues "it is the best money you will spend."

[Guest onebigunicorn]

Everything Jen said above

 

Osteo is awful. Get ahold of Dr. Couto ASAP.

 

Hoping for the best

thank you!

 

 

I don't know where you are but Dr. Couto will be in Gettysburg this coming weekend. I heard he's going to be there all weekend. Maybe you can talk to him in person.

thank you for the info but Gettysburg is veeery far away from where we live.

 

Sorry to say this, but it looks like osteo to me as well. Osteosarcoma is VERY common in retired racing greyhounds. Yes, it's fast-progressing, but you can't use length or severity of limp as a criteria for diagnosis. Bone biopsies are inaccurate a lot of the time too. According to our veterinary oncologist, the chances of an osteolytic bone lesion in a greyhound being anything other than OSA (or some other kind of cancer) are 10-1.

 

Your best bet is a consult with Dr. Couto ASAP. Keeping my fingers crossed for you .

oh yes =( I know it's very common.... =(

 

Thank you all! we'll let you know how it goes!

Edited April 22, 2014 by onebigunicorn

[Guest onebigunicorn]

So it is indeed valley fever =( he has titer 1:32! anyway, how do you get fluconazole for cheap? We found RoadRunner Pharmacy but we are not sure how it works, also, we are in Canada, so we would need to get fluconazole somehow from them but not sure how? Can someone help?

 

thank you!

[NeylasMom]

Glad to hear that it is not osteo! Hope you are able to treat successfully without major side effects. I am of no help on getting the medication although I do know it's available as a generic here in the US, but thought you might find this website useful in general:

https://www.vfce.arizona.edu/ValleyFeverInPets/Default.aspx

[Guest onebigunicorn]

Thank you =)

and yes we know about the website.

It's really expensive here so we need to get it from somewhere else...Maybe I should start a new thread about it..

[Remolacha]

I am afraid it has become very expense recently, it used to be a cheap drug. I don't currently need it, so I can't help except to suggest you try several online compounding pharmacies. Glad it wasn't cancer!

[NeylasMom]

Thank you =)

and yes we know about the website.

It's really expensive here so we need to get it from somewhere else...Maybe I should start a new thread about it..

Probably a good idea, with the name of hte medication in the title. I don't really see much about VF on here, but hopefully someone will be able to help.

[Zachary]

I am so happy for you that you finally received a diagnosis and it was not osteo! Congratulations to your puppy and may he have along and happy life with you.

 

I understand your frustration and fear only too well as my Grey is experiencing the same symptoms. Did multiple x-rays, did a biopsy, results were inconclusive because of the extreme hardness of the bone -- which, as your vet said, was very unusual and unexpected. Redid x-rays, no change. Consulted with Dr. Couto and he doesn't know what it is!

 

I tried to view the x-rays of your pup but the images are no longer there. Would you be so kind as to reload them? I would love to compare the rads and see if there are similarities.

 

I have suggested Valley Fever to my vet, but because my pup raced in Kansas he thinks it very unlikely. I will push for it next appointment.

Edited June 2, 2014 by Zachary