Osteo?

[Guest KaraBearNC]

I've had my guy a year. He limped some off and on when I got him and some months later he broke that leg doing nothing more than starting to run. Vet said his knee looked somewhat congenitally compromised so he shored it all up in surgery. I've noticed him limping on another leg. I've preemptively decided if it is osteo that I would not treat (no amputation or chemo). I see nothing wrong with his pads and his limping comes and goes. Thoughts?

Edited April 23, 2014 by KaraBearNC

[45MPHK9]

Get X-rays. Don't wait.

[RaineysMom]

Get X-rays. Don't wait.

double this. And get in contact with Dr. Couto if needed, with the xrays.

[KF_in_Georgia]

Agreeing with the previous posts: get x-rays. Osteo is massively, extremely painful.

 

But your boy could have arthritis. He could have a tweaked back or neck. He could have something not fatally wrong that would respond well to an anti-inflammatory.

 

But if it's cancer, he's in a lot of pain and you need to know what's going on.

[Charlies_Dad]

There could be multiple reasons for a limp. To discount Osteo, x-rays are required, that should be your first plan of action. Good thoughts for your pup.

[macoduck]

http://www.coutovetconsultants.com/ This is Dr Couto's consultation service. Definitely worth the money to have him review your boy's case files and images.

[a_daerr]

Here's my quick and dirty rundown of OSA. In osteosarcoma, the cancer pretty much eats through the bone, resulting in what's called osteolytic lesions. If the x-ray is clear (and you have a good, savvy vet to interpret them), osteo can be diagnosed from the shadowy, black areas on the films. From there, it's a fast spread first to the lungs, then to other systems of the body. After time, it can pop up in another leg. By the that time that happens, there are other obvious symptoms (lameness, pain, swelling, decreased appetite, abnormal bloodwork, etc.) Now, I say *generally* because there are a lot of different factors at play. Sometimes, the dog's limp isn't long or severe. Sometimes it takes multiple x-rays before a diagnosis can be made. Sometimes the metastases is a slow progression. You get the picture.

 

Just based on your description, though, it doesn't really sound like osteo to me. Here's why I say that. Your vet had to have taken x-rays at the time of the original break, and then he then did surgery to repair the bone. If it was osteo, I'd find it a little odd that he didn't notice any abnormalities during the surgery or post-op. It would be unusual that your dog could have osteo in two legs without any other symptoms. I've heard of osteo dogs going several months of limping on and off, however (if I'm understanding correctly), you're saying your dog has been limping on and off on two legs for over a year. Even dogs who have been treated aggressively amputation and chemo generally only live 6-12 months after diagnosis. It would be very rare for an osteo dog to live over a year without any treatment. Long-term limping is more indicative of a balance/gait issue (in greyhounds, these are often the result of old racing injuries).

 

With that being said, I would take the advice of others here and have x-rays done for your own piece of mind. If you're still worried about it, get a consultation done with Dr. Couto. This is really the only way you'll know for sure.

[Guest KaraBearNC]

The broken leg was a rear one. The now limping one is a front one. I would have thought the surgeon only xrayed the rear one. Yeah, not that I'm a vet, but I would have thought there would have been some progression, (regression), by now if it were osteo. I'll see if he improves with an anti inflammatory. I only have a part time job right now. Thank you ObamaCare

[PrairieProf]

Whatever is going on now, if his broken leg healed it wasn't osteo there.

[greysmom]

Just because it's a different leg, does NOT rule out osteo causing the current problem. It might be the same cause or it might be completely unrelated. Cancer is so prevelant in greyhounds that anyone's first course of action for just about any noticable limp should be an xray, IMO.

[Guest KaraBearNC]

Finish this sentence:

 

I need to get X-rays asap to rule out Osteo because if it is then _________

[greytpups]

...I need to manage the pain

[Guest KaraBearNC]

Are you saying that pain cannot be managed without an xray?

[45MPHK9]

...I need to manage the pain

Amen, sister. And quick.

[greytpups]

If your pup is limping he's in pain and I'd want to know the cause so I could treat it. I'd also want to know if it's OS because I'd be restricting activities such as jumping in and out of cars, or on and off furniture to reduce the risk of breaking the leg.

[45MPHK9]

Are you saying that pain cannot be managed without an xray?

Wiithout an X-ray, you have no idea what you're dealing with. Get X-rays. Don't wait.

[Guest KaraBearNC]

Ah I see. Getting an X-ray so I know whether or not to restrict the activities part makes sense. Thanks everyone

So is it difficult to discern osteo from an X-ray?

Edited April 24, 2014 by KaraBearNC

[NeylasMom]

Are you saying that pain cannot be managed without an xray?

Pain management for osteo is different than pain management for other issues, ie. arthritis, muscle injury. The pain from osteo can be very severe and we often cannot determine how much pain our dogs are in just by observing them. End of life pain management is also different than pain management that is not because you don't worry about side effects like you would if the dog were not at the end of his life. If it's osteo, you treat for the pain aggressively without worry of long term side effects. Get the x-rays. It is always better to know what you're dealing with. And I would suggest a consult with either Dr. Couto or an experienced oncologist and/or radiologist to read the x-rays (both this set and the old ones), not just your regular vet. Same with who to consult on pain management if god forbid it does turn out to be osteo.

[45MPHK9]

It wasn't a difficult diagnosis for my vet when Bee Wiseman had her X-rays done. It was quite obvious in her case.

Edited April 24, 2014 by 45MPHK9

[NeylasMom]

Ah I see. Getting an X-ray so I know whether or not to restrict the activities part makes sense. Thanks everyone

So is it difficult to discern osteo from an X-ray?

It can be. It depends on who's reading the x-ray and where the cancer is in its progression. Other factors can also come into play. With Neyla, my regular vet completely missed it because of the way she was positioned and the lesser quality of her x-ray machine. When I took the films to my orthopedist, he saw something fishy, got HD x-rays and it became obvious that that's what we were dealing with. And still, the oncologist wouldn't officially diagnose her on the x-ray only because hers didn't progress on x-rays over time, not because he didn't believe she had it but because he couldn't *definitely* diagnose it. On the other hand, Dr. Couto took one look at her x-rays and called it. FYI, it was 5 months before we saw any progression on her x-rays, and then the oncologist called it.

 

Point being, there are a lot of factors. But if the osteo is progressed, it should be obvious. The bone will look moth eaten and you may also see new bone growth that will appear as bright white spots or areas on the x-ray. It's often very helpful to have film of the other leg for comparison purposes so if you can swing it financially I'd recommend that.

Edited April 24, 2014 by NeylasMom

[Riverhound]

Ah I see. Getting an X-ray so I know whether or not to restrict the activities part makes sense. Thanks everyone

So is it difficult to discern osteo from an X-ray?

 

 

Even if it isn't osteo, you are likely looking at seriously restricting activity. We had Joe on about 12 weeks leash walking, limited stairs & no running for an unknown soft tissue injury a few years ago. In our case, the x-rays ruled out osteo, but didn't give a real answer. Joe is still funky sometimes. I monitor him, medicate as needed, and hope to hell he doesn't blow out a knee when he plays with Brees.

 

Get the x-rays. Go from there.

[Guest LindsaySF]

I would restrict activity and get X-rays.

[a_daerr]

I didn't mean for my first post to sound like I was recommending a 'wait and see' approach. Although it doesn't sound like osteo to me, it could be. Or it could still be something else very serious that needs surgery, activity restriction, and the right type of medication. There's such a wide range of pain meds out there- it's hard to know what's appropriate unless you know exactly what you're dealing with.

 

If you can swing it financially, I'd get the x-rays and send them to Dr. Couto ASAP. He can look at the films and tell you in two minutes if it's osteo or not- many vets aren't able to diagnosis as efficiently as he can.

 

One other thing I want to mention if (God forbid) it ever does come to this. I know a lot of people don't want to put their dogs through lots of heroic efforts when it comes to cancer. They'd rather let them live out the remainder of their life peacefully and just let whatever's going to happen happen. I will tell you with honesty that osteo isn't the kind of cancer you can do that with. Not only is it one of the most painful types of cancer, it puts the dog in constant risk of fractures and broken bones. In the end, most osteo dogs will need a great deal of pain management and help getting across the bridge. I encourage you to at least get a diagnosis, then go from there.

 

I'm still keeping my fingers crossed that you're dealing with something else less serious.

Edited April 24, 2014 by a_daerr

[Guest KaraBearNC]

Thanks. Good advice. From the research I've done, treatment of osteo doesn't give that much more time, and the end is still painful just deferred. Of course I would not let it get that bad. Rest assured everyone, my guy is not in any such pain. He is happy and healthy and chasing balls. I've left a message with my vet to schedule a visit :-)

[NeylasMom]

Thanks. Good advice. From the research I've done, treatment of osteo doesn't give that much more time, and the end is still painful just deferred. Of course I would not let it get that bad. Rest assured everyone, my guy is not in any such pain. He is happy and healthy and chasing balls. I've left a message with my vet to schedule a visit :-)

Glad to hear your guy is happy and doing well right now.

 

FWIW, palliative care for osteo has come a long way in recent years. It depends on a lot of factors, including your budget as some of the "newer" options (IV pamidronate and radiation therapy mainly) can be very pricey, but people are seeing longer survival rates. Heck, Neyla had 5 good months with no progression on her x-rays without those treatments (although I was doing holistic supplements). I think some of that may also be due to the fact that people are diagnosing it earlier, but I believe that the therapies I mentioned do allow for the possibility of delaying the cancer's progression, unlike pain medications which just address the pain. Again why it's helpful to just know what you're dealing with so you can explore all of your options.