Advice Needed - What Do I Want From Tomorrow's Vet Consultation?

[MattB]

I always go to pieces at the vet, get really nervous and stop thinking clearly. I wondered if I could describe my situation and ask what people would want from the consultation in terms of treatments or diagnostic tests. I'm not trying to self-diagnose, just asking how other people's communication with their vet would go in this situation. Obviously this is dependent on what the vet can see/feel.

 

Daisy (6y/o female ex racer) started with a very intermittent limp last week. I thought it was her front right leg although sometimes it has looked like the left. Typically she will limp for 3 or 4 strides, when she gets off the sofa or when we first go out on a walk. She will limp for a few strides then back to normal, she's been galloping around the garden showing no signs of any limping, she's been her usual enthusiastic self asking to be taken out for walks and dragging me round (which I've been making very short). She hasn't at any time whined or yelped or done anything to indicate pain. I thought that the limping had stopped but yesterday noticed it again so made an appointment at the vet for tomorrow afternoon. Daisy had licked her front right paw a bit and I checked and checked for anything stuck in there and then I thought her pads were a little dry and cracked and have moisturised for a few days but I don't think this is it any more.

 

I just wondered what people's thought were on what would be a reasonable suggestion from the vet. My only experience with a greyhound at the vet was our first and they had a lot of difficulty diagnosing the cause of limping and pain and took many weeks.

 

I hope it will be something non-serious and simple to fix, but if nothing is obvious:

 

Do we want an x-ray at this point? Or would I expect the vet to give anti-inflammatories a try first?

 

Daisy is due a dental in the near future so I thought that would be an opportunity to have an x-ray - this could be brought forward - or alternatively put back if it would be sensible to try something else first.

 

Usually the vet gives me options which I find a bit overwhelming so going forearmed with any thoughts or advice you could offer would be very much appreciated.

 

 

 

 

 

 

 

 

[MP_the4pack]

First,take a deep breath. I just went thru the limping thing with Emma. Let the vet exam Daisy first after telling him/her all the symptoms. They may find a very obvious reason why she's limping. When it's not obvious like with Emma, I asked them to do the Lymes because I found several ticks on Emma lately and we live in a high tick area. When the SNAP test came back negative I then asked for xrays. This was done all on the same visit. They had no problem with the requests as it was a logical order. If you get nervous and tongue tied....write it down now and bring the questions with you.

[Guest FordRacingRon]

What MP said. When I was diagnosed with cancer 12 years ago I knew what I wanted to ask the doctor adn the logical way I wanted to go with my treatment,,but I also knew I would just sit there an drool and get my "mords wixed up" when we started talking so I made a list and took it with me. Make a list. Check it twice.

 

When I thought Leia had CCD I went about it all wrong and didn't have her tested in a logical order and I mad the leap right too, she must have CCD. Had I written down what I should have done I probably would have saved a few $$$$.

[tbhounds]

Usually--lameness resolved with activity point towards arthritis. I would ask to run a 4dx (heartworm, tick test) to rule out Lyme disease. Perhaps a trial of an NSAID may be a good idea.

Don't be nervous--write your questions down before the appointment.

[ramonaghan]

Wow, this is *exactly* what I have been going through with Sweep since August--same age/sex, same intermittent limp upon rising that resolves quickly and no yelping/whining, same difficulty determining which is the affected front leg. I do hope you'll have a resolution sooner! When Sweep's limp started and didn't resolve in a couple of weeks, we had our vet examine her but he couldn't elicit a pain reaction and didn't see/feel anything abnormal, so we went ahead with x-rays at that first appointment. I would have obsessed about it if we didn't check then and there, which is something to consider since you've said you're the nervous type too. Long story short, in our case we've now had three sets of clear x-rays (both legs checked) and the limp resolves completely with NSAIDs but comes back after stopping them--it's been super frustrating! Re: which leg is affected, our regular vet thought it was the right front leg while the specialist we saw last week is positive it's the left, so it's challenging even for the pros, apparently. The specialist said watch for the head bob--"down is sound," so whichever leg the head goes down with is the good leg. I'd highly recommend getting a video if you can, since it sounds like they probably won't be able to see her limp in the office, and you can slow down the speed in YouTube to get a better look.

 

Is Daisy on any joint supplements? A lot of people have mentioned that to me with our current situation. Sweep was on them already, but I amped them up when all this started. One of those "can't hurt, might help" ideas.

 

Best of luck, and please keep us posted. I am an absolute wreck at the vet too, so I understand where you're coming from. Hopefully it will be a simple fix.

Edited December 14, 2015 by ramonaghan

[MattB]

Thank you I really appreciate all these responses, it's nice to have people understand my anxiety. I'll get started on my list. Great idea about the video - don't know why that never crossed my mind!

 

Re: joint supplements, not currently, we used joint aid since we got our hounds then suddenly they refused to eat their food if we added it. I've just ordered another brand to give that a try.

 

I will certainly keep you posted.

[juliemac]

Let me suggest that you take someone with you if that's at all possible ... someone who can listen to everything and HEAR it or take notes.

[PatricksMom]

Let me suggest that you take someone with you if that's at all possible ... someone who can listen to everything and HEAR it or take notes.

Yes, and if you can't do that, try typing up your questions and leave spaces between them to write the answers--for some reason that helps me focus and not skip stuff. Also leave yourself space to write down tests being run, what you've decided on doing, and what your next planned steps will be (assuming you don't have a definite solution when you leave).

[Guest peacehound]

My girl Peace had on and off limping her whole life, she had xrays different times but they never did find anything. I took her to the OSU vets and they started her on a regimen of Adequan shots, it made a big difference in her quality of life..good luck! one thing I did was video tape her limping around house so vets could see since she would be nervous and didn't do it at the office.

[greysmom]

Intermittent limping can be caused by lots of things, some of them quite benign and easily treatable, though some, of course, are not - arthritis, corns, TBD, strains/sprays, all the way up to osteo.

 

If you don't live in a tick region, or you're certain your dog has never been to one (I don't know what exposure is like in the UK where it sounds like you're from), and you can afford it, it's not unreasonable to just have them do a quick xrays of both complete legs (shoulder to toes). Xrays on greyhounds can usually be done without any anesthesia, especially for front legs. If she's been limping longer than a couple months, anything bad like cancer will probably already be visible on xray. And if they don't see anything (and a competent xray reader doesn't see anything) you can rule that out and move on to other causes. And you have a nice set of clean rads to compare to later on, if necessary.

 

Does she limp more on hard surfaces and less on grass? Is she touchy about having her feet handled or her nails done? This might indicate a corn. But your vet may not be familiar with them, as many vets are not. Sometimes dampening or moisturizing the pads, and then looking with a flashlight will help them be seen better. Try gently squeezing each toe pad to see if there's any discomfort in any particular one. There might be a corn forming that hasn't erupted yet.

[XTRAWLD]

Ryder's limp seems to only be noticed by me these days! I think I'm crazy LOL. Chiro helps him. Get pup checked out by the vet, listen to what course of action they would advise. At this point I would request x-rays just to put your mind at rest. Then, with a relatively "clean bill of health" you would be able to pursue something like chiro, as you wouldn't want them to manipulate something that they shouldn't! Add some supplements to help.

 

Greyhounds are notorious for these sorts of things...they are racing machines and high performance athletes. One chiro once told me that it made the most sense for the dog to be "more lame" on their left sides because they race around the track in a counterclock wise direction, thus creating a lengthening of the right side of the dog to compensate and extra pressure on the left side. When pain is alleviated on one side, often you'll notice the other side limping....par for the course with these guys. The chiro was the pres of American Veterinary Chiropractic Association for years and had a pretty extensive background so what he said made some sense. He works with racehorses also.....counterclockwise runners there too. It's treatable, but takes multiple sessions to see results.

Edited December 15, 2015 by XTRAWLD

[MattB]

 

If you don't live in a tick region, or you're certain your dog has never been to one

 

 

 

Although I know about Lymes disease I've never thought about ticks causing something like this - Daisy has had a couple of ticks when she's visited my mum in the countryside, lots of sheep and deer - I'll mention this to the vet though I'm not sure if it's different in the UK.

 

 

 

Does she limp more on hard surfaces and less on grass? Is she touchy about having her feet handled or her nails done? This might indicate a corn. But your vet may not be familiar with them, as many vets are not. Sometimes dampening or moisturizing the pads, and then looking with a flashlight will help them be seen better. Try gently squeezing each toe pad to see if there's any discomfort in any particular one. There might be a corn forming that hasn't erupted yet.

 

I'd say yes to more on hard surfaces - I've tried squeezing each pad and no reaction at all but I'll try looking with a flashlight - thank you.

[Guest LazyBlaze]

If she's worse on hard surfaces it could point to a corn, but it could also just be that the harder surfaces are more jarring for wherever her pain source is. We had this situation with Blaze and were convinced it had to be a corn as he did better on softer surfaces, but it turned out to be muscular and nerve related pain. The softer surfaces are just a little more forgiving.

 

Fingers crossed you get to the bottom of it with Daisy. I agree with those above who suggest writing down all your questions/concerns and taking some video of her limping to show your vet. Very best of luck, let us know how you and she get on.

[cleptogrey]

Usually--lameness resolved with activity point towards arthritis. I would ask to run a 4dx (heartworm, tick test) to rule out Lyme disease. Perhaps a trial of an NSAID may be a good idea.

Don't be nervous--write your questions down before the appointment.

 

also see if you vet manipulates all of your pup's limbs. if he/she doesn't than ask for it. most vets do look for mobility and stiffness when manipulating it. A week of NSAIDs and you should be able to note a difference if it's arthritis. a dog/human is never too young to experience it. supplements take at least 6-8 weeks to start to have any affect, that is if your pup responds to them. we just went thru this w/ our pups, and yes, of course i saw that gray cloud of osteo doom hanging low and close after loosing our first greyhound to osteo.

[MattB]

 

also see if you vet manipulates all of your pup's limbs. if he/she doesn't than ask for it. most vets do look for mobility and stiffness when manipulating it. A week of NSAIDs and you should be able to note a difference if it's arthritis. a dog/human is never too young to experience it. supplements take at least 6-8 weeks to start to have any affect, that is if your pup responds to them. we just went thru this w/ our pups, and yes, of course i saw that gray cloud of osteo doom hanging low and close after loosing our first greyhound to osteo.

 

Thank you - added to my list.

 

Does a positive response to NSAIDs negate the need for an x-ray or should arthritis also be diagnosed through x-ray? i.e. would a reasonable thing to do to try NSAIDs for a week or so and if no improvement then book in for an x-ray after that?

 

I noticed today that when Daisy does her stretches (the down-dog yoga one) there is an audible click which sounds like it's coming from one of her shoulders.

 

Only a couple of hours before our appt. Not much luck filming her limping so far, have got a little bit on camera phone I think - since I've started obsessing about Daisy limping it has become hard to tell when she's limping and when she's not.

[PatricksMom]

 

Thank you - added to my list.

 

Does a positive response to NSAIDs negate the need for an x-ray or should arthritis also be diagnosed through x-ray? i.e. would a reasonable thing to do to try NSAIDs for a week or so and if no improvement then book in for an x-ray after that?

 

I noticed today that when Daisy does her stretches (the down-dog yoga one) there is an audible click which sounds like it's coming from one of her shoulders.

 

Only a couple of hours before our appt. Not much luck filming her limping so far, have got a little bit on camera phone I think - since I've started obsessing about Daisy limping it has become hard to tell when she's limping and when she's not.

You can't always see arthritic damage on an x-ray, even when it's obvious from observation/exam/treatment response that's what's going on. I prefer to do the x-rays right away, just to rule out anything scary so I can stop obsessing, but I don't know that it's necessarily a bad idea to go with the wait and see approach.

[MattB]

Thanks so much for all your replies - we're back from our appointment:

 

A very difficult consultation as the vet, although lovely, was Italian and we struggled to understand each other at times. He said he specialises in oncology and sadly himself has a dog with osteo at the moment.

 

The vet spent a long time manipulating Daisy's leg (watched my video and agrees it's the front right) with no pain reaction at all. He said he's fairly certain it's arthritis but also her pads are quite dry and cracked which could also be causing it. He agreed the best thing to do was x-ray.

 

What has complicated things a little further is that the vet found a lump (I've been to see two different vets about this and the first one said leave it a while and the second said she wouldn't remove it as it was a wart) which he said he's concerned about which can be removed at the same time as her dental. We've got 7 days worth of NSAIDs.

 

The plan was to carry out Daisy's dental next Tuesday, remove the lump and take x-rays which I was happy with. When I got back I rang to double check that we were booked in for everything but they said that the vet we saw today couldn't do the whole lot until after Christmas. So I've provisionally booked in with a different vet which I feel less happy about after spending such a long time speaking to this gentleman.

 

What I'm wondering now is if it would be better to have an x-ray prior to a dental and lumpectomy? Would the outcome make any difference? I think I'm catastrophizing again! (Daisy is a spook so I'd thought the less visits to the vet the better).

So is my current plan - Next Weds we have dental, lump removal and x-ray done all at once with whichever vet is on at the time - a reasonable one?

 

And lastly - the vet suggested some boots to walk in to help with the dry cracked pads - can anyone recommend some of these?

[NeylasMom]

I would say do it all in on fell swoop, whether that's sooner with a different vet or later with the vet you saw today, whichever makes you more comfortable. The only urgency imo would be if you are concerned osteo is a possibility and would consider amputation. In that case, you really want to minimize the delay. Otherwise, I don't think waiting until after the holiday is such a bad idea. One thing I will offer, I did a dental right before the holidays last year on Violet, who we knew might have issues iwth anesthesia. Though we did everything we could to minimize risk, things did not go completely smoothly and she had to be hospitalized overnight. She's fine, but adding that stress in right before Christmas was probably a bad call. On the other hand, if bone cancer were on the table, I'd want an answer *right now* one way or the other. It doesn't sound to me like osteo is likely here though so to me it seems reasonable to wait if you want this specific vet. So basically I am no help, except to say I agree with not stressing her out by spreading things across visits.

 

For the dry pads, you may want to try a topical treatment as well. There are a couple of products geared mainly toward dogs who have cracked noses, but the products work on paws as well. I ended up with Snout Soother for Zuri based on Amazon reviews: http://www.amazon.com/SNOUT-SOOTHER-Natural-Dog-Company/dp/B00IEDA5S2/ref=sr_1_2?ie=UTF8&qid=1450203748&sr=8-2&keywords=snout+sootherbut there is also Bio Balm and Bag Balm (and probably others).

 

The only other thing I will add is in response to your earlier question about NSAIDs as a diagnostic tool. The only thing that a trial of NSAIDs will tell you is whether your dog is in pain from something. But you can't really assume what if your dog responds to them. Many a story on here about people who didn't x-ray for osteo because their dog responded to anti-inflammatories only to find out later that the dog had cancer. So I would do the x-rays regardless, and still start on the meds in the meantime as prescribed.

Edited December 15, 2015 by NeylasMom

[MattB]

Thanks NeylasMom,

You are right - we'll do everything at once. On reflection we will keep out appointment for next week as we have some time off before Christmas (my gf approaches Christmas with to-do lists and Gantt charts so we're fairly on track with everything). Yes re: NSAIDs the vet said the same that this won't help diagnostically - just that he thought it would help initially. I guess we'll reassess meds after the x-rays.

[Guest xengab]

Its best to do it all at once. My boy had to have an xray on his toes to rule out dislocation, but he wouldn't stay still so they had to sedate him. (this is what happens when your dog wants cuddles..LOL)

It will also make it rather quick for the vet to do them.

 

Can you call the new vet and speak a little with them before the dental?

[JohnF]

All at once would be the best way I think.

Tip to find corns: Use toothpaste on the pads.

 

That's how they found what was wrong with Lola on the supervet tv show

[MattB]

Its best to do it all at once. My boy had to have an xray on his toes to rule out dislocation, but he wouldn't stay still so they had to sedate him. (this is what happens when your dog wants cuddles..LOL)

It will also make it rather quick for the vet to do them.

 

Can you call the new vet and speak a little with them before the dental?

After thinking about it, I probably got a little hysterical about it. They're a nice practice and they've got Daisy's notes. I'm worrying about the lump now too!

[MattB]

I just had another quick thought.

 

I'm trying to stop thinking the worst - however one think I was wondering after reading some other posts on this page:

 

If they do an x-ray and saw something suspicious - would the next thing to do a biopsy? As Daisy would already be under GA would/could this be done there and then?

 

Is this something I should speak to the vet about prior to the surgery? I've found out that we have a consultation with the vet when we drop Daisy off in the morning.

 

On another note Daisy hasn't limped since we left the vets - she is taking the pain meds as prescribed but yesterday I got home and I couldn't stop her from doing laps of the garden and jumping on our other hound.

 

I see why people advised to get an x-ray asap - it's all I can think about now.

[JohnF]

Certainly have a chat with the vet prior to the procedures. They can't ever be definite about the 'what-ifs' until there is more data. Sometimes X-Rays have to be sent to experts for evaluation, the same as in human medicine. You don't want a biopsy done unless it is necessary.

I know how hard this is, so just keep fingers crossed for a favourable outcome. Try to look at it this way: diagnostics are the start of the process of managing any illness your dog might have. Try to think happy... it helps keep the dog happy.

[MattB]

We're back post surgery and I'm relieved - very clear x-rays looked at by vet + specialist and couldn't see any signs of osteo. Daisy has worse arthritis than expected for a dog her age affecting the elbow and wrist so we're going back next week to talk about management - I'll have thoroughly checked this forum prior to this! I know arthritis isn't great but more manageable than alternatives.

 

Re: suspicious lump, this was a cyst which has now been squeezed - they think it might come back but definitely isn't anything to worry about.

 

Three teeth extracted and a lovely set of white teeth

 

After spending a week thinking of nothing else I'm very happy. Daisy is sleeping and has a rumbling tummy so I'm going to make her something bland soon. Took her in the garden on a lead for a wee and she was eager to check out the bushes where she saw a cat a few days ago.

 

Thanks so much everyone for your advice, it means a lot.