Limping Getting Worse

[Guest mrs]

Hi everyone. I'm not really sure why I'm writing this. Maybe I just need to write out my thoughts and feelings. Smitty is 10-1/2 years old. Always been very healthy. On Christmas Day we noticed him limping and favoring his right front leg. Took him to my vet, tried some medications, but eventually took him to an orthopedist where they did an ultrasound. That showed supraspinatus tendinopathy in both the left and right shoulders plus arthritis in his right shoulder. He started physical therapy with ultrasound and cold laser therapy and after 6 weeks was progressing along nicely. All this time he wasn't allowed to run around our backyard and was only going out for potty breaks. We were starting to increase his walks a little and things were looking up.

 

Then one day he fell in the kitchen. He also has a bad right rear leg from a previous broken leg which is why he came off the track. He has a collapsed ankle and arthritis in that leg. Anyway, a couple days later he started limping again on the same right front leg. Not too bad, but we decided to start from the beginning with limiting activity and physical therapy. After 3 weeks, there was absolutely no improvement and getting slightly worse, so he went back in for a follow-up ultrasound and x-ray. They said everything looked pretty much the same as his initial studies and suggested it could be a nerve sheath tumor. The only way to diagnose that is with an MRI and when I asked about treatment of that they said amputation. That's not really an option for us for a few reasons, but Smitty really only has 1 good leg so he wouldn't be able to go through that. The vet said we could try a cortisone shot and see if that helped at all, so that's what I went with. It took about 9 days, but he eventually got back to 90% normal and I was feeling so happy for him. For 2 weeks he was doing great, and then Sunday afternoon, almost like a switch, he started limping and limping bad. Today he's the worst I've seen him since this all started in December. I called the orthopedist and left a message. He was in surgery all day and I was unavailable to take his call in the evening, so I'll have to wait until tomorrow to talk to him.

 

I'm wondering if he does have a tumor if the cortisone injection he had somehow helped to reduce the inflammation a little and relieved some of his pain, thus no limping for almost 2 weeks. I want to talk to the vet to see if he thinks an oral steroid might help, but I'm starting to fear the worst for my boy. I don't want him to live in pain and I really don't think there is anything else we can do for him. I can't believe I'm preparing myself to let him go. His spirit, appetite, and everything else is just fine...but the limping is painful to watch. He's always been very stoic, so I'm afraid he's in more pain than it seems.

 

Sorry this is so long, rambling, and maybe not making sense. If you've read this far thank you. If not, at least I got to get some of this out. I'll try to get some sleep tonight but my mind is racing a mile a minute and I'm just not ready to say goodbye. Please hope for a miracle for him. That's all I can do right now.

[juliemac]

Gentle hugs.

[Busderpuddle]

Sending you positive thoughts and hugs

[tbhounds]

I would recommend repeating radiographs--perhaps sending them to a board certified radiologist. What medications is your houndie taking?

[Guest june]

So sorry. It is always hard when they start having problems getting around.

[Guest mrs]

The orthopedist wants to examine him again, so we have an appointment tomorrow. Will be good for him to see Smitty and have a face-to-face conversation. When Smitty's pain started on Sunday I gave him tramadol, but that doesn't seem to be doing much. Will update tomorrow. Thanks.

[NeylasMom]

I would recommend repeating radiographs--perhaps sending them to a board certified radiologist. What medications is your houndie taking?

Agree, repeat rads and send to either a radiologist or Dr. Couto.

 

When they did the first u/s, did they also do x-rays? What did they see that made them think he had arthritis?

 

How much Tramadol are you giving? You could quite safely give 50 mg every 8 hrs until you can get into the vet to try to help alleviate his pain.

[Guest mrs]

He's on 50 mg 2 to 2-1/2 tablets 2-3 times a day of the tramadol. He's had 1 x-ray at my regular vet on December 31 and 3 x-rays at the orthopedist's office from January to April.

 

Oh, I'm not sure what's in that tramadol but he HATES it. I've always wrapped pills in canned dog food. He picks it apart and spits it out. Won't even eat the canned food it's wrapped in. Geez, why don't they make these pills tasty to dogs. I've had to resort to the shoving it down his throat method.

Edited May 21, 2014 by mrs

[vjgrey]

I second sending the X-rays to Dr. Couto. My 10 year-old was diagnosed with Osteo via MRI two weeks ago after two vets and a head surgeon missed it on THREE sets of X-rays. We still feel we caught it early, but I think if I'd sent the first set of X-rays to Dr. Couto, he would've seen it immediately.

 

Tramadol apparently tastes AWFUL. I had some success with canned whipped cream with my first Osteo dog, but with Diamond, we can only do down the throat.

Edited May 21, 2014 by vjgrey

[Houndtime]

Tramadol tastes awful. I just shove it down their throat.

 

I have a limping boy since February. X-rays were clear. I was giving him deramax and tramadol, but there NSAID has now affected his stomach. He gets gabapentin and tramadol twice a day. He limps terribly and has a hard time to lay down. We don't walk him anymore. He is 12 years and 8 months. But, he eats, he plays a little, romps a bit and is still clean. Len says the dog is not ready, so he is still here. When I really see that the boy can take no more, then we will let him go. We love him so much.

[galgrey]

Sending good thoughts.

[Guest fastcasper]

I used Pill Pockets for my tramadol and it did the trick.

[Guest mrs]

Update: Smitty had his recheck with the orthopedist. They did x-rays (3rd time since January) and a repeat ultrasound. Nothing has changed as far as the tear in his supraspinatus tendon. His bones looked good so no cancer. So, the reason for his increased limp is still unknown. Because the first cortisone injection seemed to help, I opted to try a second steroid injection and he is now on tramadol and gabapentin. He saw the orthopedist yesterday for a recheck. Smitty is doing slightly better and at least seems less painful. As the last cortisone injection didn't start helping until about 10 days after it, we are going to give Smitty another week or so to see how he does. My options after that are to:

1) Do an arthroscopy to look inside the joint to see what's going on and do corrective surgery if needed to the tune of $5,000

2) Do an MRI to look at his neck, shoulder, and armpit ($1,800). I know one of the things they are looking for is a nerve sheath tumor. Doc already said treatment for that would be amputation which I'm not going to do as he has issues with 2 other legs, so it wouldn't be easy for him to get around on three legs.

3) Continue to manage his pain as best we could.

 

Not sure what I'm going to do yet, but will give it more thought over the next couple weeks. It's just so frustrating not knowing.

[DesiRayMom]

My heart goes out to you. There is nothing worse than watching an otherwise healthy, happy, hound suffer the pain of past injuries, arthritis, tendonitis, whatever.

And knowing that whatever symptoms of pain you're seeing.......what he's feeling is probably worse. If it were my decision, I would probably do pain management,

and lots of it. Different medications work different ways, and each hound reacts differently to each. I'd try to find the best combination to give him the best quality

of life possible, and take it a day at a time. Thinking of you & Smitty and praying for the best.

[Guest mrs]

Thanks DesiRayMom. I'm leaning toward pain management only for various reasons. If he was a young boy, I might consider doing everything possible, but he's 10-1/2 and I don't want his remaining time spent recovering from surgeries, having to be in hobbles for 3 months, etc. I've done that with older dogs and cats in the past. Tried everything possible only to have them deteriorate and end up dying anyway. I'd prefer him to remain as happy as could be.

[Remolacha]

It is a hard decision, but that is what I did with Molly. At 11 1/2, I wanted the time she had left to be as good as possible.