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Need Help With Limping--Did We Miss The Mark With The Xrays?


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My boy Seamus is 10 years old and has been on pain meds for three years for hind end pain. He takes 300 MG gabapentin and 50 mg tramadol twice a day. About three weeks ago, he started limping on his front right leg. It was the worst when he got up off his bed, but after walking a bit, it was not as bad. It still looked like he was hurting, but he didn't limp so severely. Since he could walk it off somewhat, the vet thought he had pulled something and that we should watch it for a bit. Unfortunately, it didn't improve so we went back to the vet, who thought the pain was in the shoulder. Xrays were done, and the vet said they were clean with no signs of cancer. He went back to thinking Seamus must have pulled a muscle or strained a ligament. He recommended cold laser therapy as well as adding another medicine, amitriptyline.

 

I haven't given him the third med yet since I wanted to see if the laser therapy made any difference. Well, he had his second laser treatment today, and things have gone from bad to worse. He was okay right after, but a few hours later, he could hardly walk and was clearly in pain, limping severely on the front right leg. I called the vet who now seems baffled and unsure what to do from here. He said he would have another look at the xrays and call again tomorrow to see if Seamus is any better.

 

In the meantime, Seamus really hurts, in spite of being on both Gabapentin and Tramadol. There are no lumps or swollen spots that I can see or feel. He has not lost any weight, and his appetite is still good. He pants frequently both night and day.

 

 

My questions are: how likely is it that there is cancer in his shoulder that can't be seen? Is there something else very painful that could be happening in his shoulder? Could he have bone cancer further down in his leg without any signs of swelling? Should they xray his leg and foot? Is there anything else that we may not have thought about? It kills me to see him in pain and feel like we aren't helping him or getting to the bottom of it. Any insight or advice would be appreciated. Here is my sweet boy:

 

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It is so hard when they can't tell us where it hurts. I am sorry that your sweet boy is feeling poorly.

Irene Ullmann w/Flying Odin in Lower Delaware
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We've been having a similar issue with Cecil. Seems to be shoulder and at first very pronounced limping that tapered off with no meds, but then he started crying out and yelping every time he got up from lying down. Vet visit who said he suspected soft tissue and gave him Rimadyl and that seemed to help, but after 4 days on meds we took him off and pain came back. Back to the vet for an Xray and it was clean. We stopped meds 3 days ago after about a week and a half and no crying out or limping so far so we're hoping it was soft tissue. I have an appointment for him next Monday with a doggie chiropractor just to get him checked out (similar to Seamus, it seems shoulder/neck related and works itself out once he's up and moving around, so maybe something is out of place and pinching a nerve?).

 

All that said, if he continues to have issues, my next step will be sending the X-rays to Dr Couto to review. My vet said flat out that the X-rays look perfect, but he's NOT a radiologist and if Cecil wasn't feeling better with treatment and time that he'd want someone else to take a look at the X-rays, and who better than Dr. C. If your handsome boy isn't feeling better soon, I'd send the X-rays to Dr Couto to review and consult a chiropractor. Hope he's feeling better soon.

 

http://www.coutovetconsultants.com

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I just wanted to ask if it could be about corns in their feet? I had a bunch of tests done on DaVid a while back ($3000.00 worth) and everything came back clean. Just by chance I checked his paws and he has corns on both of his back feet that were causing his pain.

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My questions are: how likely is it that there is cancer in his shoulder that can't be seen? Is there something else very painful that could be happening in his shoulder? Could he have bone cancer further down in his leg without any signs of swelling? Should they xray his leg and foot? Is there anything else that we may not have thought about? It kills me to see him in pain and feel like we aren't helping him or getting to the bottom of it. Any insight or advice would be appreciated. Here is my sweet boy:

 

 

It is possible that there is cancer in the shoulder that your vet didn't see on the x-ray. Multiple views using HD x-ray equipment is the way to go to ensure that you've got the best images. Then have Dr. Couto and/or a radiologist review them. I would not rely on your regular vet to be able to spot bone cancer (my own is a fabulous vet, but she missed Neyla's despite me being quite sure she had it because something on the image got in the way because of a weird angle - my ortho immediately spotted it, took better x-rays and it was obvious). It is also possible that it's elsewhere in the leg.

 

I would not do any further cold laser until you've figured this out as ,at least according to my vet it's not a good idea to cold laser an area with cancer (I think it could promote growth). I also wouldn't use Amitriptiline at this point. I did some research into it's use as a pain medication, but it's primarily used as an anti-anxiety drug. The better choice would be to add in an NSAID if there isn't any reason he can't take them. I would also, if your schedule allows, space the Gabapentin out so you're giving it more frequently - maybe 200 every 8 hrs instead of 300 every 12. You can do the same with Tramadol.

 

It's possible this is a muscle injury or some arthritis, but given his age and the presentation I think you are right to be very suspicious that it may still be osteo. I would get better x-rays and have someone more experienced review them and go from there. If something does turn up on the images and he's ever been in the southwest, Valley Fever is also something to keep in mind. Sincerely hope that osteo is not what you're dealing with.

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Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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I just wanted to ask if it could be about corns in their feet? I had a bunch of tests done on DaVid a while back ($3000.00 worth) and everything came back clean. Just by chance I checked his paws and he has corns on both of his back feet that were causing his pain.

Seamus has corns on one of his back feet, but I don't see or feel any on that front paw, and he doesn't show signs of tenderness with the pads.

 

NeylasMom, There is an orthopedic vet that he has seen a few times through the years. I will contact him tomorrow and find out if they have HD xray equipment for new film.

 

I was hestitant on the amitriptyline too--I think he prescribed it because Seamus does have some neurological based pain but it sounds like it can have some dicey side effects. I have some Deramaxx that I could give him but it tends to upset his stomach. Perhaps with Pepcid he will tolerate it. I will talk to vet about it. Thanks for the suggestion about spacing the other meds.

 

Seamus has never been in the Southwest. He came to me from Florida. I pray that it is not osteo or some other cancer. It just feels like something is very wrong.

 

Thank you!

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He probably wouldn't have side effects from the Amitriptiline. Anti-anxiety meds are generally pretty safe. Violet actually takes it for her anxiety. It's just a really uncommon med to use for pain. Like I said, I did look into it and we almost put Neyla on it, but that was around the time that I was growing desperate and it became apparent that I just needed to let her go. But I think I'm probably the only dog owner in history to ask her vet about prescribing Amitriptiline for pain. :lol

 

Not saying you shouldn't try it, either now or down the road, but if it is osteo, it's generally good to use that triple combination (Tramadol, Gabapentin, and an NSAID) if the dog can tolerate all 3.

 

Good luck. Your ortho should have good quality x-ray equipment. Most places now do, at least in more urban areas. My vet has since upgraded hers, this was 4 years ago that Neyla was diagnosed so I guess she was on the cusp.

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Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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That leg should be xrayed from toe to shoulder and even up into the neck area. Not saying it *is* cancer, but it could be hiding anywhere in the leg. Hopefully it's more of a neck/soft tissue injury than cancer. Also, Jey is correct in that gabapentin needs to be dosed more like every 6-8 hours instead of every 8-12. Greyhounds tend to metabolize it faster than other breeds. The same with the tramadol. If he can tolerate a higher dose without panting or making him anxious it could be beneficial.

 

Make sure to give the nsaid AFTER food if it upsets his stomach. Even a substantial snack will do the trick.

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My Chellie had a limp and the vet missed a lesion on the x-rays. The radiologist is the one that spotted her osteo. She has swelling in her shoulder, though. I hope you get some answers soon.

 

Andy

"Human beings, who are almost unique in having the ability to learn from the experience of others, are also remarkable for their apparent disinclination to do so."

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It took 3 sets of x-rays from 3 different vets(the last being an orthopoedist), to diagnose osteo in the shoulder of my friends grey last month. So the answer is yes, it is possible. Hoping that it is something less serious in your baby. She was also 10 years old.

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Guest iconsmum

seconding the advisability of scouring those pads for a tiny round mark that is a corn starting. They can hurt like hell. Eight years ago I spent some money having a dog xrayed also. Pictures turned up clean. I went home with 2 day's worth of metacam and a $400 bill. Guess what I found that the vet had never even thought of? It was a tiny corn that I eventually zapped with murray hill corn cream I changed vets because I think that's a ridiculous oversight, even if greyhounds weren't common here at the time.

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It took 3 sets of x-rays from 3 different vets(the last being an orthopedist), to diagnose osteo in the shoulder of my friends grey last month. So the answer is yes, it is possible. Hoping that it is something less serious in your baby. She was also 10 years old.

I guess this is what I am afraid of. I called the orthopedist this morning and am waiting for him to call me back. Did your friend's greyhound have shoulder swelling?

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I guess this is what I am afraid of. I called the orthopedist this morning and am waiting for him to call me back. Did your friend's greyhound have shoulder swelling?

My two cents on swelling - osteo can be there for a long time without the swelling although I do think you tend to see it sooner when the cancer is in the wrist simply because there's nothing for it to hide behind so to speak. But as many people have reported on here over the years, often their first indication that their dog had osteo was a fracture. So don't let the fact that you are not seeing swelling deter you from pursuing the dx. Neyla lived for 6 months after her dx with palliative care only and I only saw her shoulder swell at the very end when the cancer seemed to be growing (and getting more painful) exponentially.

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Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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Also, sometimes stuff doesn't show up on the xrays until some time after the limping has started.

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Guest Greyt_dog_lover

My boy Bart has had similar limping off-and-on for nearly 2 years. We go back each time and x-ray. Nothing over 2 years. We finally took him to a chiropractor since we have another hound that is getting physical therapy for a torn tendon and Bart now gets adjustments once a month. The chiropractor did say there was some tightness in his shoulders and he does seem better after the adjustments. My boy only limps after he does zoomies around the back yard. He will limp for 2-4 days after a good romp in the back yard.

 

Chad

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Guest hlpnhounds

Our boy Logan was recently diagnosed with osteosarcoma. He had a forelimb lameness that was first noted after a play session in the yard with our other hounds. This was on Tuesday July 15. I gave him a dose of tramadol and we went to bed. The next day the limp was improved but was still present. I made an appointment with one of our orthopedic specialists at work for July 17. He had a thorough exam which included radiographs of the shoulder and humerus. There was no proliferation of tissue (lump on the bone) there was also no moth eaten or web-like appearance to the bone. There was a small area near the very top of the humerus that appeared a bit hollow where it should have been solid. While he was on the X-ray table we went ahead and shot some chest films---thankfully they were clear. An appointment was made for the following day to have a bone biopsy done. He did well for the procedure. This was 7/18 and we got the results on 7/24. He does have osteosarcoma--very likely in the earliest of stages. It is our plan to get him started on chemo very soon in order to prevent the spread of the disease. We are planning for 8 months of quality time with him.

It was just a limp that improved after tramadol. It was just a limp.

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Thank you for sharing your story. We have shifted to a three doses per day of both the tramadol and the gabapentin (50 mg and 300 mg each time). There has been no improvement in the lameness with the extra pain med. I have spoken with his regular vet, but am still waiting for a call back from the orthopedic vet--I am wondering if he is on vacation or something. Will call again tomorrow. Seamus didn't eat his breakfast this morning.

 

I am so sorry about Logan's diagnosis. Sending positive thoughts your way and wishing you plenty of wonderful time together in the coming months--lots of spoiling and loving. Scritches to Logan. :heart

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Guest hlpnhounds

Logan's current pain management consists of 100mg Carprofen (Rimadyl) twice a day and 300mg gabapentin twice a day. He was also on 150mg tramadol 3 times a day for about 10 days after the biopsy. Once he stopped limping, we cut the tramadol back to 150mg once a day at a mid-day dosing. Now he is not on the tramadol at all. He eats well. He has had some zoomie moments in the yard that scare the crap out of me but if he feels good enough to do it I'm not going to hold him back. The biopsy site is healed. He will enjoy the time he has left with us.

Our goal with his pain management is to use the least amount at this time while still keeping him very comfortable knowing that we can increase the doses or add in something else when we need to. He will start chemo (provided by the good folks at OSU) this week in the hopes that we will be able to keep the cancer from spreading too quickly. So far so good.

 

As far as Seamus not eating.....

The tramadol can throw their appetite off a bit. I have taken to adding "goodies" to Logan's breakfast. For some reason, the chicken mash that they have been getting every morning on top of their food is suddenly a food that he will refuse. We feed Purina One L&R kibble as a rule. He will eat the kibble well. We have switched to adding the canned variety of the same brand to his food in the morning and he eats well now. There were days when he would refuse the food altogether at first but would then eat it all if we offered it again a couple of hours later. He's been eating pretty steadily for the past week or so. I think we've found his magic formula---at least for now.

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The limping showed up first. The swelling showed up later and when I saw her the day before she was diagnosed and euthanized the swelling was all the way down the leg into the foot. The second vet she saw the day before still told her it wasnt osteo and was going to schedule shoulder surgery for an injury. She called me and told me this and I went over to see the dog and told her she needed to be seen by an orthopoedist immediately and that the dog was in tremendous pain. She didnt even look at me when I came in and had no use of the leg. We took her to the ortho vet and they diagnosed the tumor and she was let go then. I don't have any vets by me that I trust right now but I know one that I definitely won't be going to!

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Have you been able to get in touch with the ortho? I'm concerned that with the amount of medication you're giving that the pain is not decreasing. I think an NSAID might be wise until you get this sorted out and I would press on getting those new x-rays sooner than later. Even if this isn't osteo and it's muscular, an NSAID would be a normal med to give to help with inflammation and pain.

The not eating is concerning as well. Is he back to eating his meals after skipping his breakfast?

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Jen, CPDT-KA with Zuri, lab in a greyhound suit, Violet, formerly known as Faith, Skye, the permanent puppy, Cisco, resident cat, and my baby girl Neyla, forever in my heart

"The great thing about science is that you're free to disagree with it, but you'll be wrong."

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IIRC Nube's chiropractic doctor said you should NOT do cold laser therapy if there's cancer :( hope your boy is doing better :(

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