Seeking second opinion - shoulder pain

[INU]

Cooper has been limping on his front legs on and off. He usually does this the day after he worked really hard and/or when he gets up. It goes away quickly but it comes back again. It's been going on for a month or two - not really bad enough for me to take him to the vet.

 

We were supposed to go to a search in heavily wooded area tomorrow a.m. so I took him to the vet to get some x-rays done to make sure he can work in such a condition. My vet (whom I am starting to like) did not even touch him but asked me several questions like - when does it happen, how old he is, how often etc. He's a little over 4 years old and he said that his muscle probably get inflamed so he prescribed him 200mg Zubrin for after heavy run or rubble work. He said that it could be the early stage of arthritis or calcis (?) built up but we couldn't do much about it if I found out about it now or later... He suggested increasing the omega 3 and adding glucosamine (over the counter so that I wouldn't spend 90 bucks per bottle). I like him because he is more conservative as far as treatments go but I sure wanted to find out what was causing him the soreness. I did my own research before hand. I read that there were many cases like him where they couldn't figure out what was causing lameness or limping after x-rays, fluid test, MRI. Those dogs were usually put on pain killer.

 

My husband wants second opinion from his family vet who lives an hour away. My team vet has seen him and she didn't notice any displaysia type of symptoms. Has anyone experienced this kind of conditions? Would you still have x-ray done?

[Mojo]

I experienced something similar earlier this summer! Mojo is also about four years old, and he suddenly began limping slightly on his left front leg in late May, always bearing full weight on the leg. It first occurred during agility practice (weaving), and went away within minutes. I could not find anything on examination, and decided to restrict his activity for a few days anyway, but there was no recurrence of the apparent injury. Two weeks later at a full agility practice (including jumping), he began to limp much more dramatically on the same leg, while still bearing full weight on the leg, but this time, the limp did not go away right away--he continued to limp when we got home, and for several days afterwards. I checked him over very carefully, and it was only with very close scrutiny that I could feel the tiniest amount of swelling at the back of the left front leg at the wrist (i.e., the carpal flexor tendon), and it was really only through comparison with the normal, right front leg that I could discern any swelling at all--on the right front, I could clearly feel the nice, tight cords of the tendons running down the back of the wrist, but on the left, the cords seemed covered by a very slight, soft swelling of tissue. I also noticed that when he stood, it seemed as if the pastern was looser than usual (i.e., the slope was greater and the pastern was not as upright as usual on the affected side). Now thoroughly worried about a tendon sprain or hairline wrist fracture, I took him to a vet that specialized in orthopedics, but we could not get an appointment until nearly a week later, since it was not an emergency. By that time, the swelling and limping had entirely disappeared and the pastern was tight and upright once again. Since I had no background health history on Mojo (rescued stray), we did go ahead and take x-rays. We found the tiniest little bone spur (arthritis) on the left front leg, just where I had felt/seen the swelling, but the spur was so small that it could only be seen by zooming quite far into the digital x-ray. The vet said that this would not affect any future performance career Mojo could hope to have whatsoever, and that the second limping episode was likely much worse than the first because a few days of restricted activity (but not total inactivity) likely hadn't been enough rest the first time around. So, I restricted his activity for a full two weeks, and for the future, the vet recommended stretching before activity, wrapping Mojo's legs like a horse (pony polo wraps or v-trap flexible bandages) if we are going to be doing a lot of heavy jumping at full height, icing if he limps again, plus omega-3s (in the form of fish body oil, not cod liver oil) and glucosamine for prevention of future worsening of the arthritis (I use human capsules for cost efficiency--I just break them open and sprinkle on food, and a bottle of 180 glucosamine sulfate 500 mg capsules only costs $28, and at 1.5 capsules/day, it will last four months--I think it probably is a higher-quality supplement than one manufactured just for dogs, but Mojo will eat anything. If you have a picky eater, I would see why a more palatable, dog-friendly chew might be needed. If you are not using a canine all-in-one, don't forget that you will need to supplement vitamin C, as well, since glucosamine is not absorbed as readily without vitamin C). The vet and I agree that painkillers are not necessary at this time.

 

From your post, however, it sounds like Cooper is limping on both front legs, or possibly one and then the other intermittently, but not just on one leg, as Mojo was. Limping on both legs could indicate a degenerative (arthritic) problem with his spine, his elbows (dysplasia), anything bony (arthritis, calluses, tumors) or soft tissue-related from the elbow down, an injury to any of the aforementioned parts, or something neurologic. You have said that your team vet did not suspect dysplasia, though, so that is very good! Does anyone think tick-borne disease is likely (i.e., is Cooper feeling otherwise well besides the limping? Any known tick exposure)? I am quite surprised your vet did not touch Cooper when you took him in for an exam...although it is great he asked you a lot about Cooper's history, someone needs to feel for swelling, joint mobility, and tenderness in the joints and spine. I didn't see if you had said his paw pads had been checked for soreness/cuts, particularly if he is working on difficult surfaces. In your case, it seems unlikely that BOTH front legs would have been injured at the same time, and instead suggests a more chronic problem affecting both front limbs, which could also include the spine [disclaimer: I am not a vet!!!]. I take it that you are considering not getting x-rays based on the likelihood of it being arthritis, which is a reasonable concern, since even if the x-rays do show arthritis, the treatment will be exactly the same, regardless...the problem would be if it is not arthritis, but that is a gamble we all take when we consider passing up diagnostic exams in favor of the most logical outcome!!! You can always try reverse-diagnosing--i.e., doing the treatments for arthritis and then seeing if Cooper improves (rest, supplements, icing, stretching, etc., which are often more helpful than painkillers alone). If he doesn't improve in a short period of time, maybe then you should consider x-rays again, as there may be something else going on. I have to be honest, though--I personally always prefer to have definitive diagnoses on paper rather than speculation, and if I can afford it, I get the tests done for my own peace of mind. I hope that helps!! In response to your other concern about going through the workup and not finding anything, I will say that the angle at which the x-rays are taken matters a tremendous deal in picking up ortho pathology, which means that the vet and his techs need to be experienced in taking these kinds of films, or nothing will be seen. The interpretation is just as vital, if not more so. So, if you do end up getting films, I highly suggest going to a vet that specializes in orthopedics, if you have one in your area....we are lucky in that Los Angeles is overflowing with animal specialists. Best of luck!!! I hope your boy feels better soon.

[kelpiegirl]

My suggestion is to rest the dog, and then, once he has had some rest, bring him to a phsyiatrist for a full eval. If you can get the inflammation reduced, you should then be able to start to figure out the root of the issue. Dogs can get what's called bicepital tendonitis- and that can be a long recovery- think of tendonitis in dogs. Also, when you all are chilling out at home, lay your hands on him, and see if you can find any trigger points, and areas with heat. Basically got to know him, and see if when you touch any areas, if he gets squirmy or his skin shifts. It may be something that he is doing repetitively is bothering him.

Julie

Cooper has been limping on his front legs on and off. He usually does this the day after he worked really hard and/or when he gets up. It goes away quickly but it comes back again. It's been going on for a month or two - not really bad enough for me to take him to the vet.

 

We were supposed to go to a search in heavily wooded area tomorrow a.m. so I took him to the vet to get some x-rays done to make sure he can work in such a condition. My vet (whom I am starting to like) did not even touch him but asked me several questions like - when does it happen, how old he is, how often etc. He's a little over 4 years old and he said that his muscle probably get inflamed so he prescribed him 200mg Zubrin for after heavy run or rubble work. He said that it could be the early stage of arthritis or calcis (?) built up but we couldn't do much about it if I found out about it now or later... He suggested increasing the omega 3 and adding glucosamine (over the counter so that I wouldn't spend 90 bucks per bottle). I like him because he is more conservative as far as treatments go but I sure wanted to find out what was causing him the soreness. I did my own research before hand. I read that there were many cases like him where they couldn't figure out what was causing lameness or limping after x-rays, fluid test, MRI. Those dogs were usually put on pain killer.

 

My husband wants second opinion from his family vet who lives an hour away. My team vet has seen him and she didn't notice any displaysia type of symptoms. Has anyone experienced this kind of conditions? Would you still have x-ray done?

[Lenajo]

xrays are cheap compared to a lot of things. I'd get the pics done, see if it's anything bony and rule that out. 4 is really too young for a well structured, healthy BC to have arthritis unless he's been worked absolutely into the ground on a regular basis (which I doubt you do)

 

Don't automatically assume shoulder - a lot of hard working dogs get arthritis of the feet and wrists. Have you been over every joint, doing full rom (range of motion) and felt for the telltale crunching of arthritis or for heat?

 

2-3 weeks of crate rest and hand walking can work wonders.

[INU]

Thank you all for taking the time to share your experience and information. We will remember to strech him before working then make sure to rest him. I did a quick search on specialist in my area but could not find one. I'm sure other vets in my area would know one or two. Thank you.