Calling the Hive Vet-limping

[mmasc]

My 7(ish)year old heeler started limping right after Christmas. We had traveled to my in-laws house for the holiday and she had free access to the outdoors and ran and played much more than at home (but we normally go here and she runs and plays) We didn’t notice anything amiss. 

two days after getting home she started limping, especially when getting up from resting. No improvement after a few weeks so I took her to her vet about 10 days ago.  (We just moved here this summer so I have no relationship with this vet other than a well visit in Sept)

vet said she suspected either a tick born disease or possible soft tissue injury or maybe arthritis. Gave us gabapentin to try along with rest. 

1) my dog doesn’t really like to rest, and still wants to play. We’ve limited her playing and made her outdoor walks short. 
2)she’s still limping and possibly even worse

things that seem especially noteworthy:

1) it’s *significantly* worse after she has been lying down and resting and then gets up. She hobbles out of her bed like she can barely walk. Within 5 minutes, she’s chasing the kids and acting like she wants to run and play. 
 

2) it’s very hard to tell which leg. Dr suspected front right from the exam (said it felt stiff and didn’t have as good of range of motion), but she showed NO signs of limping in office. I showed the vet a video and that helped her confirm right front, but I’m positive it’s at least that one plus a back leg too. 

Could this be an acute injury?? Arthritis horribly flared from one overactive holiday??

dr did blood work to screen for tick disease and the screen came back clean. Dr also said her knees and hips seemed good.

I’m sure I will be taking her back in, but since I don’t really know this dr, I wanted to see what you all thought. The dr didn’t really say what’s next, other than limiting her activity for several weeks and giving gabapentin. 

 Thank you for reading this far. 

[Lori D.]

One other possibility, although probably not if running around fine after 5 minutes, BUT... Valley Fever is pervasive in the southwest -- southern CA, most of AZ and NM, and parts of TX, NV, UT, and CO. If you are in any of those states, or have visited any of those states a few months back, that might be something to test for and take off the table.

Valley Fever is caused by a fungus in the soil, that is inhaled, and can attack the lungs (cough), the bones (limping), and even the spine or brain. It is nasty stuff, and only meds will alleviate symptoms. Symptoms tend to be: limping, lethargy, "dry cough", or even in rare cases, persistent diarrhea. Diagnoses is very straight forward, from an (expensive!) blood titer test.

SO sorry to hear your puppy is not doing well, and hope you quickly get whatever is wrong fixed for her.

[mmasc]

@Lori D. thank you for the info. We did not visit those states that you listed. I do think the reason the vet suspected something tick born was because it seemed to be in different legs and also because during our travel I DID find a tick attached to her (which shocked me since it was December). They did offer the expensive blood test, however, the vet seemed to think the most likely culprit would be Lyme and the screen would have shown something. In that case, we would have moved on to the more expensive test. Does that sound right??

[Selkie]

Did the vet do X-rays? Since it has been going on for almost two months, I would want those done. X-rays will show you if there are arthritic changes or a bone tumor.

Did the tick borne disease screening include things like anaplasmosis and erlichia? Those are as common as Lyme here where I live in the midwest.

Did the vet recommend an anti inflammatory along with the Gabapentin, like Carprovet?

[mmasc]

24 minutes ago, Selkie said:

Did the vet do X-rays? Since it has been going on for almost two months, I would want those done. X-rays will show you if there are arthritic changes or a bone tumor.

Did the tick borne disease screening include things like anaplasmosis and erlichia? Those are as common as Lyme here where I live in the midwest.

Did the vet recommend an anti inflammatory along with the Gabapentin, like Carprovet?

I’m not sure. I guess I need to call tomorrow and see what the screening checked for. I remember she said she didn’t suspect Rocky Mountain fever, but I can’t remember why. When the screening came back ok, she did say we could go ahead and do the $300 extensive tick born disease test “just to be sure” but in the office she made it seem like the screening would be the first step and if it was positive, then we’d move to the more expensive test. If I’m going to spend another $300+ though, I really need to know if that should be on this test or X-rays or what, so I guess I need to call. 

She did not give a traditional anti inflammatory (like carprofen) because my girl only has one kidney. I do think X-rays are probably in order. Thank you for the info. 

I liked this vet and she seemed knowledgable, but I just hate using someone new when we have a problem because I need to have that trust relationship built to feel confident in our course of action 😔

Edited February 15, 2022 by mmasc

[thewellerman]

Our dog was on carprofen for a limp (known injury) for a while, and it did seem to help him.  Towards the end of the treatment, he developed severe vomiting and diarrhea, though we can't be certain carprofen was the cause. 

Apparently, it can be quite serious, and we didn't know to watch for symptoms.  He seems fine now, but do read up on it if you decide to use it for your dog, and do the necessary monitoring.

[mmasc]

2 minutes ago, thewellerman said:

Our dog was on carprofen for a limp (known injury) for a while, and it did seem to help him.  Towards the end of the treatment, he developed severe vomiting and diarrhea, though we can't be certain carprofen was the cause. 

Apparently, it can be quite serious, and we didn't know to watch for symptoms.  He seems fine now, but do read up on it if you decide to use it for your dog, and do the necessary monitoring.

I don’t think the vet will use it unless it’s absolutely necessary due to my dog only having one kidney. They have to be very careful on what she takes. I appreciate the info though. Thank you. And I’m glad your pup is ok now!

[itsheresomewhere]

My elderly dog is on carprofen during the winter for arthritis.  It does wonders for her.  She started limping like you described and the vet suspected Lyme at first and did the blood test and X-ray . Lymes test came back fine so we knew it was just her arthritis.  During the summer, she hardly limps. Unless she is attempting to relive her glory of squirrel/chipmunk chasing. 

[MercyA]

My first thought was arthritis. I'd have those x-rays done to be sure. It'll help determine the best course of action going forward. 

Hope your pup feels better soon!

[MercyA]

11 minutes ago, thewellerman said:

Our dog was on carprofen for a limp (known injury) for a while, and it did seem to help him.  Towards the end of the treatment, he developed severe vomiting and diarrhea, though we can't be certain carprofen was the cause. 

Apparently, it can be quite serious, and we didn't know to watch for symptoms.  He seems fine now, but do read up on it if you decide to use it for your dog, and do the necessary monitoring.

Yes, my dog also had a bad reaction to carprofen. It made him terribly ill every time we tried it. But, it works very well for those who can take it! 

[mmasc]

Your replies are making me feel better about pursuing the X-rays. I was worried they wouldn’t help since the doctor didn’t suggest them and thought it might be a soft tissue injury. My understanding is that that wouldn’t show on an X-ray. But arthritis definitely would, so it seems logical to me for that to be next. I will call tomorrow and see what she thinks. I just feel like if it’s arthritis, we can walk my dog and play with her and she will let us know when she’s done, but if it’s a soft tissue injury, then she needs rest and no activity to heal—those are vastly different! And we need answers because she wants to play!

[mmasc]

3 minutes ago, MercyA said:

Yes, my dog also had a bad reaction to carprofen. It made him terribly ill every time we tried it. But, it works very well for those who can take it! 

I’m so sorry for your pup. I hope he’s ok now. 
 

my other dog is on daily carprofen for hip dysplasia, and like @itsheresomewhere ‘s dog, it works wonders for him. He’s on a pretty low dose for his weight, and he’s a very large dog, so I’m sure that all helps him tolerate it. He’s been on it for 5 years.

[Selkie]

6 minutes ago, MercyA said:

Yes, my dog also had a bad reaction to carprofen. It made him terribly ill every time we tried it. But, it works very well for those who can take it! 

Poor pup! I hope you found something that works well for him.

My dog with hip dysplasia has been on Carprovet (carprofen) for years and it has helped him so much. Our vet requires bloodwork every six months to make sure it isn’t affecting his liver or kidneys. So far, so good.

[mmasc]

6 minutes ago, Selkie said:

Poor pup! I hope you found something that works well for him.

My dog with hip dysplasia has been on Carprovet (carprofen) for years and it has helped him so much. Our vet requires bloodwork every six months to make sure it isn’t affecting his liver or kidneys. So far, so good.

Same with us! Night and day difference within a few weeks. I’m so thankful it works. He gets checked every 6 months as well.

[MercyA]

11 minutes ago, mmasc said:

I’m so sorry for your pup. I hope he’s ok now. 

5 minutes ago, Selkie said:

Poor pup! I hope you found something that works well for him.

Thank you, my friends. He passed away years ago. Due to his very sensitive stomach, we were never able to find a really great medication for him although we tried many. His heating pads and soft beds helped. 

[Storygirl]

I don't want to add to your worries, but I would recommend asking the vet about x-rays. My parents' dog started limping, and the vet's first thought was some kind of sprain or injury, but when it didn't improve, they did x-rays and found bone cancer. I hope that something serious like that is not the case for your dog, but it can happen, unfortunately.

[Tanaqui]

My vet told us that animals often get so hyped up about being at the vet's office that the adrenaline stops them from feeling pain and, therefore, limping. It's very annoying when you came there so they could see the limp!

Definitely ask about x-rays. It may have been reasonable not to get one when you first went in, but as it's not improving....

[Pawz4me]

9 hours ago, mmasc said:

Your replies are making me feel better about pursuing the X-rays. I was worried they wouldn’t help since the doctor didn’t suggest them and thought it might be a soft tissue injury. My understanding is that that wouldn’t show on an X-ray. But arthritis definitely would, so it seems logical to me for that to be next. I will call tomorrow and see what she thinks. I just feel like if it’s arthritis, we can walk my dog and play with her and she will let us know when she’s done, but if it’s a soft tissue injury, then she needs rest and no activity to heal—those are vastly different! And we need answers because she wants to play!

I'd want x-rays, but with a middle aged medium sized dog I'd almost expect some arthritis to show up, and just FWIW -- the vet (now retired) that I'd trust with my own life tells me that x-rays are weird with arthritis. He says some x-rays look absolutely horrendous and yet the dog seems fine, and for another dog the amount of arthritis showing on an x-ray will look very minimal and yet the dog will seem to be in quite a lot of pain. I'd still want to know, and to rule out a tumor or an old fracture.

With only one kidney I'd very very, very hesitant to put a dog on carprofen or any other NSAID. My guess is that for additional pain control your vet would consider something like Tramadol. I'd be very leery of giving an NSAID unless you're running blood work every couple of weeks, then if all goes well for awhile maybe extend it to once a month. A few days to see if an NSAID works? Probably fine, depending on her kidney function levels. More than that w/o very frequent blood work -- no, I wouldn't do it. I know it's a bad spot to be in. DH only has one kidney and we've had to deal with the pain control issue for him. All of his doctors are absolutely adamant that he only take the smallest amounts of NSAIDs, and only for very short periods of time. Tramadol can work well, but it is a narcotic, so sleepiness can be a side effect. That's not always a bad thing for some dogs, though.

Edited February 15, 2022 by Pawz4me

[mmasc]

@Pawz4me I appreciate the info and thoughts on this. I do not think an nsaid will be used at this time. They did blood work and her kidney function is already at the lowest numbers on the “high end”. (Does that make sense??). It is definitely a tough place to be in for when she will need pain medicine. I’m sorry your dh is in that position. I personally love anti inflammatory medications for myself and don’t care for things like Tylenol.

The odd thing is, I know dogs are super good at hiding pain, but she isn’t acting like she’s *in pain*. Slower and more cautious, sure, but once she gets moving she brings us her ball. All.day.long. Drops it, stares a hole through us, and waits. Like, well, are you gonna throw this thing or not?! 😂 Of course we don’t right now, but she definitely wants us to. She also still tries to chase the kids and herd them, which is her other favorite game. 

We need more answers for sure. Hopefully the X-rays will give us something. Thank you for the info on X-rays and arthritis, too, as I didn’t know how well or not well it might show up. 

[Pawz4me]

2 minutes ago, mmasc said:

@Pawz4me I appreciate the info and thoughts on this. I do not think an nsaid will be used at this time. They did blood work and her kidney function is already at the lowest numbers on the “high end”. (Does that make sense??). It is definitely a tough place to be in for when she will need pain medicine. I’m sorry your dh is in that position. I personally love anti inflammatory medications for myself and don’t care for things like Tylenol.

The odd thing is, I know dogs are super good at hiding pain, but she isn’t acting like she’s *in pain*. Slower and more cautious, sure, but once she gets moving she brings us her ball. All.day.long. Drops it, stares a hole through us, and waits. Like, well, are you gonna throw this thing or not?! 😂 Of course we don’t right now, but she definitely wants us to. She also still tries to chase the kids and herd them, which is her other favorite game. 

We need more answers for sure. Hopefully the X-rays will give us something. Thank you for the info on X-rays and arthritis, too, as I didn’t know how well or not well it might show up. 

The vet is probably monitoring her creatinine, GFR and urine albumin. Those are the main tests that indicate how well (or not) kidneys are functioning.

I have very minimal experience with dogs and tick borne diseases, but what you describe isn't what I've seen. The dogs I've known with TBD have shown muscle/joint stiffness, but they've also seemed "off" all around--more lethargic, less willing to move over all, wanting to sleep all the time, etc. But tick stuff is weird. I think what you're seeing could be just a bit of arthritis--she stiffens up when she's resting and then the stiffness works out after she moves around a few minutes?

It might help if you could get a video of her when she's limping to show the vet.

If it is arthritis I'd check into a good quality fish oil (a high enough dose acts like an anti-inflammatory) and a joint supplement like Cosequin Max, if your vet approves those. I don't think there's anything in either of those that would be contra-indicated for her, but I'd want a vet's opinion. And if the vet okays those I'd want some advice as far as dosage of fish oil. There's all sorts of ranges on the internet about how much EPA/DHA is therapeutic for particular conditions, so it's hard to know what to trust.

[mmasc]

@Pawz4me Thank you for that. It’s very encouraging. She’s currently on Dasaquin chews (has been for a couple of years though), but there might be something better. I’ll definitely ask the dr about fish oil. I hadn’t thought of that. I hope I can find something chewable or tasty to pour on her food (if that exists) bc this girl will NOT take a pill nicely. She’s waaaaaaaay too smart for her own good. I could tell stories about the pill thing! 😅

The doctor did ask me to catch a urine sample to bring in, so I think she is trying to cover those three things you listed. She also mentioned putting her on a special diet food that’s better for kidney function. And that’s all good, but I do need to know about this limping. She doesn’t seem lethargic and she didn’t have fever, so those things might point away from tick born diseases too. 
 

eta: I didn’t answer your questions. Yes, very limpy and stiff and awkward-looking walk when she gets up. Loosens up within 5 minutes and is trying to chase boys. 😁

I’m planning to get a really good video to take in. Thanks!

Edited February 15, 2022 by mmasc

[Pawz4me]

Dang it. I was going to say that if it's arthritis another possible treatment for her might be Adequan injections. I don't pretend to understand a lot of the science, but it's sort of like a super duper version of glucosamine. I used it with a young Rottie with very bad hip dysplasia a long time ago and it was a miraculous thing. But I looked at the safety precautions, and -- "It should be used with caution in dogs with renal or hepatic impairment." So maybe not, or at least not unless she gets worse.

[mmasc]

I was very much hoping for any kind of injection when I took her in the first time because again, I’m serious when I say this girl has BIG issues with pills.😔

Thanks for looking into it for me. I truly appreciate it!

[Pawz4me]

5 minutes ago, mmasc said:

I was very much hoping for any kind of injection when I took her in the first time because again, I’m serious when I say this girl has BIG issues with pills.😔

Thanks for looking into it for me. I truly appreciate it!

I am certainly not a vet, but if it's some arthritis or inflammation type thing then I'm thinking a cortisone injection (or some type of steroid) might be a possibility? DH's docs seem to think short term steroids are okay for him when needed (but even though he only has one kidney it's functioning just fine, so . . FWIW).

[itsheresomewhere]

If it is arthritis-  cbd oil can help some.  We have our permanent foster on it for hip dysphasia and some other issues.  We get a gel that I rub on his ear.  It seems to work well for him. 

[mmasc]

30 minutes ago, itsheresomewhere said:

If it is arthritis-  cbd oil can help some.  We have our permanent foster on it for hip dysphasia and some other issues.  We get a gel that I rub on his ear.  It seems to work well for him. 

Another thing I would have never thought about. Thank you!

You all are so helpful and I’m feeling encouraged about possible treatments IF it’s arthritis. Now we need to find out if that’s what it is...

[Selkie]

12 hours ago, mmasc said:

I’m not sure. I guess I need to call tomorrow and see what the screening checked for. I remember she said she didn’t suspect Rocky Mountain fever, but I can’t remember why. When the screening came back ok, she did say we could go ahead and do the $300 extensive tick born disease test “just to be sure” but in the office she made it seem like the screening would be the first step and if it was positive, then we’d move to the more expensive test. If I’m going to spend another $300+ though, I really need to know if that should be on this test or X-rays or what, so I guess I need to call. 

She did not give a traditional anti inflammatory (like carprofen) because my girl only has one kidney. I do think X-rays are probably in order. Thank you for the info. 

I liked this vet and she seemed knowledgable, but I just hate using someone new when we have a problem because I need to have that trust relationship built to feel confident in our course of action 😔

Re. the tick borne disease screening - I can see where you would be hesitant to spend $300. That seems very pricey.  

Our vet does a routine yearly 4Dx test that checks for Lyme, anaplasma, and ehrlichia as well as heartworm. It costs $59.50. Maybe that's the screening your vet already did? 

[mmasc]

11 minutes ago, Selkie said:

Re. the tick borne disease screening - I can see where you would be hesitant to spend $300. That seems very pricey.  

Our vet does a routine yearly 4Dx test that checks for Lyme, anaplasma, and ehrlichia as well as heartworm. It costs $59.50. Maybe that's the screening your vet already did? 

I think it is. That sounds right. 
 

We recently moved to a very HCOL area and *everything* seems crazy high here, so yeah, I’m not willing to do a $300 blood test unless the vet very, very strongly believes that the screen was wrong, and I don’t believe that’s the case. I’m sure this won’t be cheap, and I need to put the money towards X-rays or other avenues of diagnosis, imho. I appreciate hearing that you all would do the same. 

[mmasc]

I’ll take this down in an hour or so for privacy, but I wanted to show you all the sweet girl you’re so kind to be helping. 
 

Edited February 15, 2022 by mmasc
Eta: remove photo

[Tanaqui]

Aw, what a pretty girl!

[Scarlett]

4 hours ago, mmasc said:

I’ll take this down in an hour or so for privacy, but I wanted to show you all the sweet girl you’re so kind to be helping. 
 

I missed it!  Have you seen the vet today yet?

[mmasc]

2 hours ago, Scarlett said:

I missed it!  Have you seen the vet today yet?

We didn’t see her today. I called and she wants the urine sample brought in tomorrow and will test it, and then we will take it from there. Presumably another appointment with X-rays, but I’ll see what she says when I get to talk to her on the phone tomorrow. 

[mmasc]

well, the dr said her urine looked great, and based on that her blood numbers that were a little high probably were just due to dehydration that day. She said if the kidney was in trouble, the urine would’ve shown it for sure. So that’s good news. 

she recommended based on that info, that we go ahead and try a low dose of carprofen to see if the anti-inflammatory effect will get whatever is going on under control. She said 35mg twice a day for a week, 2 weeks at most, should be ok on her kidney. Her thought is if it’s soft tissue, then this could resolve it and we will see improvement that sticks.  If it’s arthritis, this might improve it, but then symptoms would likely return after we stop the medicine. 

I asked about X-rays. She said that yes, that’s an option of course and that they do them, but I’d likely just take those X-rays to an orthopedic specialist to analyze. This annoys me to no end! It’s one huge thing that I HATE about living here! It seems like it’s something a vet could look at and see if something was amiss, no??  Isn’t looking at X-rays likely covered in vet school?? Specialist seems like if it was a situation that required surgery or something. Ugh. I’m left wondering if this vet is any good, or if this area just operates this way, or what. Plus, I’d like to try the carprofen if it’s truly safe, but my dog isn’t even acting like she’s in pain, so do I risk it?

thanks for hearing my ramblings. I’m frustrated and conflicted. 😔

[Selkie]

2 minutes ago, mmasc said:

I asked about X-rays. She said that yes, that’s an option of course and that they do them, but I’d likely just take those X-rays to an orthopedic specialist to analyze. This annoys me to no end! It’s one huge thing that I HATE about living here! It seems like it’s something a vet could look at and see if something was amiss, no??  Isn’t looking at X-rays likely covered in vet school?? Specialist seems like if it was a situation that required surgery or something. Ugh. I’m left wondering if this vet is any good, or if this area just operates this way, or what. Plus, I’d like to try the carprofen if it’s truly safe, but my dog isn’t even acting like she’s in pain, so do I risk it?

thanks for hearing my ramblings. I’m frustrated and conflicted. 😔

That sounds odd to me. We've had X-rays done countless times over the years and have never had to take them to a specialist to be read, and our vet practice is a small one with only four vets. One of the vets specializes in orthopedic surgeries more than the others, but all of them are qualified to read X-rays and are competent to spot arthritis and other common afflictions. 

[mmasc]

3 minutes ago, Selkie said:

That sounds odd to me. We've had X-rays done countless times over the years and have never had to take them to a specialist to be read, and our vet practice is a small one with only four vets. One of the vets specializes in orthopedic surgeries more than the others, but all of them are qualified to read X-rays and are competent to spot arthritis and other common afflictions. 

I agree that I’ve never seen this before either. I’ve lived in so many towns and states with dogs over the last 20 years, and this is a first. But I’ve already noticed in living here in this huge metro area, that even though there’s MORE of everything, nothing is as simple.
When we first moved here, her gall bladder issue looked like it was maybe flaring up and I wanted to find a vet just to check her out and see about getting a refill on that med. I called FIVE vets and they all told me I would need to see a specialist. I was like “A regular vet just diagnosed and treated this at my last town 3 months ago” Nope, see a specialist because they don’t “deal with gall bladders”🤨 last time I checked, that was a pretty normal and integral part of the body. It’s crazy. I ended up calling her diagnosing vet in the state we had moved from and pleaded my case and she was kind enough to just refill the medicine. That fiasco is what actually made me choose this current vet because they were the only office that said even though I’d need to see a specialist for the gall bladder, that they’d be willing to at least look at her. 
 

Sorry for the ramblings. I need to figure out the carprofen decision, then take it from there. In two weeks, I might have to try a new vet. That of course will be a huge amount of money bc they’ll charge new patient fees on top of the exorbitant prices this area already charges. I guess I have a bit of time since she doesn’t seem to be in pain at least. 
 

[Selkie]

25 minutes ago, mmasc said:

I agree that I’ve never seen this before either. I’ve lived in so many towns and states with dogs over the last 20 years, and this is a first. But I’ve already noticed in living here in this huge metro area, that even though there’s MORE of everything, nothing is as simple.
When we first moved here, her gall bladder issue looked like it was maybe flaring up and I wanted to find a vet just to check her out and see about getting a refill on that med. I called FIVE vets and they all told me I would need to see a specialist. I was like “A regular vet just diagnosed and treated this at my last town 3 months ago” Nope, see a specialist because they don’t “deal with gall bladders”🤨 last time I checked, that was a pretty normal and integral part of the body. It’s crazy. I ended up calling her diagnosing vet in the state we had moved from and pleaded my case and she was kind enough to just refill the medicine. That fiasco is what actually made me choose this current vet because they were the only office that said even though I’d need to see a specialist for the gall bladder, that they’d be willing to at least look at her. 
 

Sorry for the ramblings. I need to figure out the carprofen decision, then take it from there. In two weeks, I might have to try a new vet. That of course will be a huge amount of money bc they’ll charge new patient fees on top of the exorbitant prices this area already charges. I guess I have a bit of time since she doesn’t seem to be in pain at least. 
 

The senior vet at our practice told me he sees that a lot with newly graduated vets these days - they have been taught in vet school that many common conditions need to be seen by a specialist, rather than treating it themselves. The example he used was that a client will bring in a dog with a run-of-the-mill rash and the vet will automatically say it needs to be seen by a dermatologist.

He thinks it's happening because the vet schools have a profit motive. Many specialists are located at university vet hospitals, so it keeps the patients and money flowing to those institutions.

[MercyA]

On 2/15/2022 at 7:21 AM, Pawz4me said:

My guess is that for additional pain control your vet would consider something like Tramadol.[...] Tramadol can work well, but it is a narcotic, so sleepiness can be a side effect. That's not always a bad thing for some dogs, though.

Yes. It was the one medication my dog with arthritis could take, and it did help. It didn't seem to cause sleepiness for him.