Leg questions

[ahicks51]

Vague title, I know.

Hazer is a 12-1/2 yo cowdoggie, a big ol' boy that had a racing record with >260 races. Mid-December, he started having some problems with his right rear foot; X-rays didn't reveal anything terribly interesting. He was put on Rimadyl, and later gabapentin. Pain does not seem to be an issue with him, and I continue to deliberate as to whether even these are necessary.

His limp continues to get worse, although he still gets around and he's adapted to getting up and down. But on Saturday, the bottom 6-8" of his foot and leg swelled up, and the symptoms are consistent with lymphedema.

He continues to be happy, hungry, loves to go on walks (although they get shorter and shorter), and we're just making sure he stays happy. Although there are some recent problems in terms of defecation (they are small, soft, and he seems to have problems in that he paces and occasionally squats unproductively), he is otherwise healthy and on no medications.

With that in mind, is a hind limb amputation a bad idea with a hound of this age?

[greysmom]

Im sorry to say that an amputation isn't going to help with simple aging problems.

Given what you've described it's likely something like lumbosacral stenosis, or even just arthritis impinging somewhere in his sacrum or hips.  If you have the extra cash, investing in thorough xrays of his spine would be in order (or an MRI if you can afford it, though he'll really need to be sedated for it).

Nsaids, Gabapentin, and even a tolerated opiate are the most used combo for these symptoms, which are mostly related to nerve issues than skeletal ones (except for any impingement).  That and keeping him moving as much as possible.

And begin to keep a close eye on his quality of life.  {{{hugs}}}

[ahicks51]

Can lumbosacral stenosis be unilateral?

Honestly, I don't think painkillers are the answer- we're not seeing substantial differences with Rimadyl, I just keep giving it just in case.

[macoduck]

Aaron, the new almost 13 year old that I recently took in is also on Rimadyl and Gabapentin.  His owner's vet started him on that combo when he'd gotten to the point where he could not get himself off the floor. A mutual friend said that the improvement was remarkable. I can't ask the previous owner for any more details since she's in a nursing home now.

My thought on a hind end amp at your boy's age is that if struggling to squat and poop then he may struggle more without that leg to support him.

Yes, it can be unilateral. Spine xrays are recommended.  I found some info via Google:

https://wagwalking.com/condition/lumbosacral-stenosis-cauda-equina-syndrome

https://www.animalclinicofbillings.com/resources/orthopedic-surgery/spine-and-neck-surgery/lumbosacral-stenosis-spine-disease-ls/

https://www.physio-pedia.com/Canine_Intervertebral_Disc_Disease

[FiveRoooooers]

Your good boy is 12.6, a wonderful age. Agree with the above. My angel Pagliaccio had bilateral LS and for a good while we were able to manage it with Adequan injections that I gave at home and acupuncture, along with Deramaxx and something (multiple somethings) that I can't recall atm. 

What a great name, Hazer!

[Remolacha]

My Val was diagnosed with unilateral LS at 12.5. She was on gabapentin and metacam, but we stopped the metacam after awhile as it didn’t seem to help much, although I could tell a difference with the gabapentin. She also got acupuncture and cold laser treatments. She loved her walks and kept going (except in the summer!) until the end. She made it to 14.4. 
 

 Hazer

[ahicks51]

I'm going to try to get him into the vet, of course, but she is agnostic as to the value due to findings from X-rays taken ~6 weeks ago- some stuff on the pelvis that couldn't be identified by the vet nor the veterinary radiologist; it wasn't consistent with osteo (plus, it would be an odd location), there was some thought it could be "Valley fever" (cryptococcus) so we put him on diflucan until the blood tests came back- negative.

So- my dumb question: do the nerves for the distal portion of the hind leg leave the cauda equina same as in humans? I'm not understanding how a growth on the pelvis (if that's even what it is) is interfering with nerve transmission to that part of the leg.

I'm hoping we can get him in and give the Stack protocol a go, but I don't think our vet has ever administered it.

[greysmom]

This would be worth asking for a consult from Dr Couto.  He can help answer your questions re anatomy and treatment going forward.

[ahicks51]

How much does Cuoto charge for a consult these days? Last I checked a few years back it was $300, but his website doesn't seem to provide that information.

Hazer is at the point where his care is palliative. The X-rays and palpation tests suggest LSS is not an issue here. The data are suggesting it's cancer, probably somewhere in the pelvis, and with the pitting edema he has in his right leg (and, as of today, now his left), I'm guessing he's throwing mets in his lymphatic system.

One suggestion has been Pallida, but we got the last appointment of the day, and the vet's office is closed on weekends, so the soonest Chewy or any other online pharmacy could confirm the script is Monday, and then more time to deliver. None of the local pharmacies carry it, it seems to be unavailable in the entire metro area. Costco can get it maybe Tuesday-Wednesday (and for less than any online provider), and it's... very expensive. With side-effects and handling precautions that are not... encouraging.

But there are no signs he's in pain at this point.

[ahicks51]

Hazer's gone. He was starting to have a rough night of it, and after weighing all factors, we took him to the E-vet at 4 AM.

Not a bad run for 12-1/2, 260-some races and (apparently) no osteo, didn't even need any meds or anything up until 6 weeks ago. Last night for dinner, he was the same as always, shoving his head into our asses to get us to hurry up and feed him. But he decompensated quickly.

[FiveRoooooers]

I am so sorry. Hazer was a very good boy who lived his best and fullest life with you. 

Rest well sweet boy. 

[Remolacha]

I am sorry he had to leave, but at least it does not sound like he suffered for long. Sometimes they do go downhill very quickly.

[ramonaghan]

I'm so sorry for your loss. You did right by your boy and spared him any prolonged suffering. He was lucky to have you as his people.

Rest well, Hazer.

[EllenEveBaz]

I'm so sorry about Hazer.  

Sometimes greyhounds are just too fast for the speed of the medical diagnosis process.  

[macoduck]

Aaron, I'm sorry that Hazer had to leave you. He knew he was loved. I will add his name to the list of Bridge Angels here on GT. He will be in good company.

[Time4ANap]

I'm so sorry, Aaron.   Run pain-free, Hazer. 

[BatterseaBrindl]

Sorry for the loss of your boy

 

[Potomacpupsmom]

I'm so sorry it was time for Hazer to leave you, but you gave him the best gift possible.    Run free Hazer!  

[Houndtime]

I am so very sorry for your loss.

[JaimeL]

I am so sorry for your loss of sweet Hazer. Fly fast, high and free sweetie.

[ahicks51]

Thanks, everyone. He was one hell of a hound.

[MerseyGrey]

18 hours ago, Potomacpupsmom said:

I'm so sorry it was time for Hazer to leave you, but you gave him the best gift possible.    Run free Hazer!  

This is perfect. Sorry for your loss.