Lameness & Muscle Spasms

[NeylasMom]

So Violet turned up a bit lame in Dewey in October in what appeared to be her left front leg. A week later we went camping and when she got up from the cold ground, she was lame on her right front leg. That persisted a bit into the next morning. Later that week we were able to see our orthopedist though by the time the appt rolled around she seemed almost better, no visible lameness in either leg. Her gait analysis showed some front leg off loading and he felt spasming in her bicep in her left leg. When he manipulated her right, she cried out. X-rays were pristine on both legs. He felt she probably had a strained bicep muscle and recommended either ultrasounding the shoulder or taking a more conservative approach of PT for 4-6 wks.

 

When I got home I remembered that she slammed her right shoulder hard into a sign post maybe a month or month and a half before the lameness appeared in Dewey. She cried out when that happened, but there was never any swelling or lameness so I forgot about it.

So we started PT and have been doing it once a week and then starting mid-Nov twice a week, for 2 months now and things are not resolved. She consistently has very tight, spasmy muscles behind her shoulders from up along her spine all the way down to her armpits and sometimes extending back to the muscles in between her ribs. We have periods where it improves, but the slightest bit of wilder activity (play with Skye mostly or spinning and pouncing around) causes it to return with a vengeance. She also for a while had a very stiff hind end, her right back leg in particular seemed really stiff and her gait would be really short (video here:

). We haven't seen that in 3-3 1/2 weeks. I really try to limit activity, but every once in a while she gets a real bug up her butt and gets in some craziness before I can stop her and usually immediately after that she won't fully weight bear on her front right leg while standing, but in a day or so she's seemingly back to normal.

 

So we have a recheck scheduled with the vet in 2 1/2 wks (soonest I could get in) and in the meantime are starting her on muscle relaxers and I'm going to go ahead with getting ultrasounds of both of her shoulders. I also shot an email off to the vet to ask if he wants us to do any more tests before the consult so he'll already have reviewed them.

 

My question is - any thoughts on whether this could be something other than an issue with either shoulder? Her PT is a bit concerned that maybe there's something neurological or something with her back, etc. that could be masking itself as a shoulder issue. I have the info for a good chiropractor and was thinking of having her see Violet, but I dont' think I can get it in before the recheck with the holidays. I also considered TBDs, but she shows absolutely zero other symptoms - she's completely healthy, and happy and frankly wants to be way more active than is good for her so I really think it would be a waste of money to test for them. She had a SNAP test reasonably recently, probably in the summer.

 

Just looking for suggestions of things to explore with the vet, or to hear if anyone has seen similar symptoms and what resolved them for your pet. Oh, Violet is 7 btw. And I am pretty positive we do not need to be concerned about osteo here. It doesn't present like it and there was NOTHING on her x-rays to be concerned about.

[MaryJane]

You've probably already done it but, have you checked for a corn ?

[palmettobug]

Would a nice heating pad help? Maybe just one of the self heating ones that has foil in the middle?

[ramonaghan]

Some of this sounds like Ryder's symptoms, which turned out to be a bulging disc. Hopefully XTRAWLD will see this and weigh in!

[smurfette]

I had something similiar with Paddy. He walkinto the bedpost, cried shortly but was fine afterwards. Days later i saw him favouring his right front leg and he started ĺimping on occasion. We saw the vet and she told me he bruised his bisceps tendron which needs time to heal.

We went to our physical therapy specialist and she told me that due to the limp Paddy cramped the muscels in his back. We did massages and carefully streched his leg. He was on pain meds for 2 weeks and a dose of arnica c200.

 

It's nearly 8 weeks now and he sometimes still favours the leg. We have physio every 2 weeks but he is much better and still improves.

[tbhounds]

She's moving like she's walking n eggshells. If it was me I would check cervial/back.

[MaryJane]

I wrote a post about something like this with my Lucy --

http://forum.greytalk.com/index.php/topic/318774-distal-axonopathy-long-nerve-disease/?do=findComment&comment=5957334

 

but, it might also be corns developing ...

 

one other note, if it is long nerve, it can also affect other areas of the body like the throat (LP) so you would need to watch out for coughing, trouble breathing and so on ...

[XTRAWLD]

I have lamented over Ryder's limping for years. The video of Violet indeed shows that she looks very tight and tense (to me anyway) and somewhat similar to how Ryder would sometimes walk, although at times his limping was significantly pronounced. I don't see limping per say, but I can see she's not walking right. X-rays only showed some potential mild bicepital tenosynovitis for Ry. I put him on methocarbomol and we went to chiro and it was recommended to do a steroid injection at the site in the shoulder (because it was a suspected soft tissue injury) the next time he came up lame. (He didn't so we didn't). Any time he had exercise more than the "norm" he could barely move off his bed. I would run my hands down his back and he would often have muscle spasms, I'd stretch out his legs and often he would refuse to give me paw even though he knew the command and wanted that treat. In hindsight, his whole behaviour was starting to change, and he was becoming more shy and very careful around the house. Turns out we were chasing the wrong thing.

 

We went in for an MRI last week and discovered bulging discs in his neck in 2 areas and am treating him now with Gabapentin. He's back to being spunky after only a few days on meds. One area is mildly compressing the spinal cord, the other thankfully is not but meds are now making a difference. While I don't think I can fix his neck, and thankfully we caught this early, I can only make him comfortable and prevent further damage. He's A-OK with that.

 

Try this test:

Walk her with a treat in your hand in front of her nose but up so that she needs to carry her head to walk. Is she following the food or refusing to keep her head up as you walk? Is she trying to look down when she's walking and not following the treat?

When standing, take the treat in front of her nose and make her follow it to her hindquarter on her left, and then to the right. Is she going for the treat? Does she get it when it's just out of her reach and you know she can?

When standing, if you take up a right front paw and force her to move in one direction, does she readily hop to counterbalance? How about the other side?

 

These tests were done to Ryder by the neurologist which helped lead her to believe something was wrong with his neck. You mention she hit a post hard with her shoulder, perhaps there was enough of a shock there if she was carrying her head the wrong way to have put something out of whack. I'm not saying she may have the same issue, but we chased the wrong thing (muscles) for a very long time. Good luck and I hope you are able to figure it out.

[cleptogrey]

have you considered a tic borne disease? it can travel from joint to joint, it doesn't necessarily manifest in one area. a simple antibiotics regime and i personally do not trust the lab work. once a dog has been exposed their work will show up positive.

 

has her lower spine been checked for LS, manipulation not a $$$ MRI?

 

have you tried a regime of metacam for a week and looked for improvement? if it improves, then reduce the dosage to the every other day or every 3 days and see if you can keep her moving at the "good" weekly dosage point. eventually i did start felix who was on metacam on adequin injections, loaded him(annie too, she was sore/stiff/begining of ls) with the 6 shots /3-4 days apart and a booster since. that has cut down on the use of metacam drastically. i just hate giving intramuscular injections, a good friend whose a retired vet did it for me.

 

felix whammed into a fence post and a concrete table with his shoulder at different times. i was amazed that he didn't break something, but ice and rest and he was fine.

 

i would look into all of the above before going to a neurologist, she's not dragging her leg, it looks stiff/sore. also if you have a Therapaw bootie, try it. one never knows....a lot cheaper than a neurologist.

Edited December 13, 2016 by cleptogrey

[Remolacha]

I think the chiropractor might help, Conner is much better after his sessions. His limp(s) is/are based on his gait being off because of his bad foot (racing injury that healed "off"). BUT, make sure it is not a spinal/disc injury first. A good chiropractor would check on that, but a bad one could cause more harm, and you don't want to take chances.

 

Edited to add, she reminds me a bit of my first greyhound, I told the vet she walks like she is trying to limp on both back feet at the same time. Turned out in her case to be a disc thing. For her, acupuncture was a life saver. Literally, as she had gotten so bad she couldn't walk.

Edited December 13, 2016 by Remolacha

[BatterseaBrindl]

If Violet was a horse I would say the issue is in her lower back.

Have rads been taken?

Have you tried chiro?

[NeylasMom]

Thanks for all of the feedback!

 

For those of you suggesting back issues, are you basing that primarily on the video? Because we didn't have that at first (started only as front leg lameness), and we haven't had it for 3-4 weeks (now it's primarily the muscles directly behind her shoulders spasming). Not arguing that you're wrong, just making sure we're on the same page.

 

I had something similiar with Paddy. He walkinto the bedpost, cried shortly but was fine afterwards. Days later i saw him favouring his right front leg and he started ĺimping on occasion. We saw the vet and she told me he bruised his bisceps tendron which needs time to heal.

We went to our physical therapy specialist and she told me that due to the limp Paddy cramped the muscels in his back. We did massages and carefully streched his leg. He was on pain meds for 2 weeks and a dose of arnica c200.

 

It's nearly 8 weeks now and he sometimes still favours the leg. We have physio every 2 weeks but he is much better and still improves.

Thanks, this is good to hear. You posting this actually made me think that I did something similar to my leg. I fell and my leg slammed down into a rock. I had actual swelling and bruising and a LOT of pain right off the bat, but it took forever to heal and it still hasn't returned completely to normal. So with that in mind it may not be so unreasonable that its taking a long time. And I had nerve involvement for a while from the swelling. So I'm still inclined to think this is the most likely thing and the rest is compensatory, but will definitely continue to explore other options.

 

I'm still waiting to hear back grim the vet to get the ultrasound scheduled. By the way, a couple of people mentioned a neurologist. There's one on staff so they can consult with him if need be, we wouldn't need a separate consult. This is a specialty facility that does surgery, rehab and PT for orthopedic issues.

[smurfette]

Thanks for all of the feedback!

For those of you suggesting back issues, are you basing that primarily on the video? Because we didn't have that at first (started only as front leg lameness), and we haven't had it for 3-4 weeks (now it's primarily the muscles directly behind her shoulders spasming).

Exactly the same with Paddy. When I touched his back directly behind the shoulders, his back rippled? - I don't know the exact word to describe it. You know, like the feeling when someone touches a nerve point on your back.

This showed how cramped his back was just from favouring his right front leg.

[NeylasMom]

Exactly the same with Paddy. When I touched his back directly behind the shoulders, his back rippled? - I don't know the exact word to describe it. You know, like the feeling when someone touches a nerve point on your back.

This showed how cramped his back was just from favouring his right front leg.

Yes! That's the perfect word to describe it! Okay, I feel a lot better knowing you saw similar symptoms from the same type of injury.

[XTRAWLD]

Yes! That's the perfect word to describe it! Okay, I feel a lot better knowing you saw similar symptoms from the same type of injury.

For what it's worth, Ryder did this too......

[NeylasMom]

For what it's worth, Ryder did this too......

Yeah, but in our case I actually saw Violet slam her shoulder into a metal pole.

 

I'm not ruling anything out, but I heard back from the vet and he confirmed the shoulder ultrasound is the next step so I'm working on getting that scheduled. They're dragging their feet so I hope I can still get her in before I leave for Christmas.

[smurfette]

Oh - and I forgot. I work with hypericum because it is known to help with nerve damages. It is a homeopathic remedy (those little round things - globuli in german).

[Walliered]

Lady had several of her disks replaced with bionic ones. The surgery was done by Dr. Jason King in Savannah, Ga. A couple of years ago he was the only neurologist doing this type of surgery in the southeast. Great Dr.

[Guest LazyBlaze]

Blaze had pain originating in his front right leg (where he'd suffered a fracture and irritated a nerve). Him compensating for this wound up his pain in very much the way you describe with Violet: muscle spasms and trigger points around his tricep, shoulders, saddle and eventually all the way down his back, ending up in real tightness in the muscles on his back left leg (the opposite side to the problem at the front, due to him throwing his weight back the way).

 

I think it's very likely that Violet's injury to her front leg from slamming the sign is at the root of all these problems with wind-up pain/spasming. The best thing for Blaze has been his chiropractic treatments, which really help keep him balanced and have helped immensely with his nerve issue. Allied to this he gets physio and acupuncture to help with any muscle pain. Going on what you've said, I'd say that the best thing you could do for Violet is to keep her muscles as loose as possible (massage, lasering, heat, embrocation) until you have her see a chiropractor. It could just be a soft tissue injury taking a while to heal, or it could be that she has bumped something out of whack that needs adjustment. All of this is of course going on your reports of her perfect x-rays. If x-rays look good I'd have a chiro be her first port of call, followed by physio.

 

But in short, I think her front leg injury is likely at the bottom of it rather than anything neurological or more sinister. You may, as we did, spend a lot of time and money to confirm this!

 

Fingers crossed for the lovely Violet.

[NeylasMom]

Thanks LadyBlaze! I am sending an email off to the chiropractor Violet's physical therapist recommended today to see when we can get into her. I almost did that yesterday and then got sidetracked.

 

We just had another PT visit and Courtney reported that Violet feels much better than last time. Granted we are back to 2 sessions a week, but I also started her on the Robaxin 2x/day Monday night. Courtney said she was able to get much deeper with the massage as a result and frankly, Courtney's massage has probably been the most helpful out of anything (Violet sees 2 different PTs who both do massage, ultrasound and cold laser, but Courtney gets much deeper with the massage and we always see the best result when she does that). So it's encouraging to me as I wasn't sure the Robaxin was doing anything.

Part of me is inclined to set up the chiro visit and hold off on the ultrasound and follow-up consult, which will be a lot of time and money, but we'll do it just to make sure we rule out other shoulder things. I doubt we'll be able to also fit in the chiro before we leave town, but hopefully we can see her the week we're back.

[Guest LazyBlaze]

Fabulous NM. Amazing the difference a good massage can make isn't it! Hopefully Violet continues to feel the benefit and to improve, and that either the chiro can help or whatever soft tissue damage there might be heals by itself.

 

Keep us posted about how she gets on - I'll be thinking about her. I know how sore Blaze was with the myofascial pain for a long while under we got things under control, poor soul. We now massage him ourselves twice daily before walks to keep him loose and it seems to help, though the chiro was really the biggest turning point for him. We are knackered but he is on great form !

[NeylasMom]

Fabulous NM. Amazing the difference a good massage can make isn't it! Hopefully Violet continues to feel the benefit and to improve, and that either the chiro can help or whatever soft tissue damage there might be heals by itself.

 

Keep us posted about how she gets on - I'll be thinking about her. I know how sore Blaze was with the myofascial pain for a long while under we got things under control, poor soul. We now massage him ourselves twice daily before walks to keep him loose and it seems to help, though the chiro was really the biggest turning point for him. We are knackered but he is on great form !

Yeah, I do massage and stretches on an almost daily basis. Sometimes I feel like all I do is take care of my dogs, but it's a labor of love.

[Guest HOMEFORHOUNDS]

Has any one used any natural remedies? I have seen a post but cannot find it. I saw one about Fresh Factors. And what were the results of the euro exam. We have not done that. We have done the cold therapy and physiotherapy. What a bout acupuncture?

[NeylasMom]

Has any one used any natural remedies? I have seen a post but cannot find it. I saw one about Fresh Factors. And what were the results of the euro exam. We have not done that. We have done the cold therapy and physiotherapy. What a bout acupuncture?

I started another thread about a month ago. We had been progressing slowly with her PT and chiro when after a short bout of play she ended up incredibly painful (crying out in pain repeatedly). Fast forward and the neuro suspects an issue with a cervical (neck) disc. We started additional pain meds as well as acupuncture and discontinued the chiro. The acunpuncture has been a HUGE help, as has continued visits from our physical therapist.

 

The PT also gave us a new device called an Assisi Loop that is intended to reduce inflammation and I think it may help. We also started Curcumin and Duralactin for inflammation - no idea whether they are helping or not. I went with the get as much on board as we can that might help and sort out what is or isn't working later once she's feeling better. I actually removed the Curcumin about a week ago and I'm on the fence about whether it was helping or not.

[MerlinsMum]

Has any one used any natural remedies?

 

There is virtually no solid clinical evidence (other than small, statistically irrelevant trials conducted with dubious methodology) that these "natural remedies" (aka "alternative/integrative veterinary medicine") work. The few studies that do show a benefit beyond placebo are trials funded by companies trying to sell a product, and they very clearly set out to prove something they already believe (or want to believe) works. I understand the wish to choose "natural" (whatever that means) alternatives to surgical or pharmaceutical options that will deliver a cure without side effects... But the promise of no side effects whatsoever, considering the physiological complexity of the body and its organs, should generate skepticism in itself. Most of these alternative "therapies" are based on pre-scientific (and mostly pseudo-scientific) concepts, and are therefore - unsurprisingly - extremely weak on clinical evidence; they are promoted on the basis of a few in vitro studies and a LOT of anecdotal evidence.

 

Homeopathy is not medicine - it's just water. My two cents: save your money for evidence-based veterinary medicine...

 

ETA A new study published in the American Journal of Veterinary Research shows no benefit from Cold Laser Therapy in dogs having surgery for disc problems.

Edited May 24, 2017 by MerlinsMum