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Sesamoid Bone Injury/Inflammation


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Yes - Tweed had prolotherapy for the sesamoid bones in one of his front feet last year. My vet injected a chemical compound in his toes where the sesamoids were deteriorating and then casted him for a few weeks, the idea being that fibrous tissue would build up around the bad sesamoids, and then when the cast was removed and he was allowed to run, the tissue would break down around them, but the sesamoids were still protected. It worked very well for that foot and he was on the podium at Regionals a few weeks later with no limping at all. It did take him a little bit to get used to using that foot, since it kills some nerve endings and he couldn't feel parts of his feet.

 

Sadly, the sesamoids are deteriorating in other feet as well, and I'm not sure how many times I'm going to subject him to putting put under, casted and crated as he is going on 12 now. However, the procedure was very successful with the one foot. Apparently this is a common treatment for racing Greyhounds as well.

 

RDM

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I am dealing with this issue right now....have 2 yr old with a fractured front lateral sesamoid. I will be meeting the ortho vet tomorrow for an appointment. He has already read her xrays on referral. Roughly the options offered to me were 1) amputation, 2) arthrodesis (fusion), 3) steriod injection and rest (triamcinolone).

 

I will ask him about prolotherapy.

 

This is a wicked fast and athletic bitch. I'm not inclined to consider arthrodesis, and would only consider amputation when other options have failed.

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The vet doesn't know what causes it, but says it is not uncommon in highly athletic dogs, like agility dogs. Tweed had an off again on again limp for quite a long time that other vets failed to diagnose ... I can't tell you how many times he was subjected to anti-inflammatories, crate rest, leash walks etc. My vet that I have now took one look at him and said "sesamoids" and xrayed to be sure, and they were visible on the xray.

 

Having said that, his feet have been xrayed before by other vets who failed to see the problem. My vet is a canine sport medicine vet, so he is maybe more accustomed to diagnosing these kinds of injuries.

 

Kim Collins' dog fractured a sesamoid at 7 months or something, the same vet did the prolotherapy for her, and it's been something like 5 years and she's sound as a bell so ...

 

RDM

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Thanks for the info. I took Rave in today and there was definitely something on the x-rays, but my regular vet couldn't tell what, so is referring me to the vet school ortho vet. I wish there was a sports vet in my area, but there's not. I may see if I can send the x-rays to a sports vet to have them read.

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A friend of mine is having trouble with her dog, too, and is on her third vet to try to get to the bottom of it. I suggested this issue to her, but in my research, it says mostly front legs are affected. Is that the case with y'all here who've had dogs with a sesamoid problem?

 

Edited to correct a boo-boo. I meant to say front legs instead of hind...

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I have been wondering if Pip'd persistent front leg lameness isn't sesamoid related. He gets better with rest, but starts limping when he's worked or gets wild running around. He's been diagnosed as arthritic (at 5!), but I wonder....

 

J.

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Elizabeth, what was the injury? Do you have pictures of the swelling and/or x-rays? Rave has an enlarged area on her wrist, but it appears if there's any fluid it's under the bone (i.e. the area doesn't feel soft and squishy).

 

Still trying to diagnose Rave, will have a copy of the x-rays later today. Here's what her wrist looks like:

 

photo.jpg

 

photo2.jpg

 

photo3.jpg

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Laura, there was no swelling in Tweed's foot / feet, which was part of the frustrating mystery. Over the the couple of years we dealt with this problem, before Dr. Bowra diagnosed it, I was told he had pulled his shoulder, had a soft tissue injury and had possibly dislocated one of his toes. Dr. Bowra had me trot him around for him and said that the problem was clearly in his foot, not his shoulder, from the way he moved, and that's when he said he was 90% sure it was the sesamoids.

 

Having said that, I am no expert on sesamoids and still not sure where they are all are in the feet ;-) (I did one of those things where he showed me the x-rays and I nodded sagely, but really I couldn't recognize squat as the problem).

 

I hope you get some answers soon!

 

RDM

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Thanks all. I was able to send the x-rays to a sports vet and he was 80% sure it's arthritis and the bony protrusion we're seeing is bone spurs. I'm still going to consult an ortho vet to make sure and to get a course of treatment started. We knew she'd eventually develop arthritis since she had previously broken a bone in that wrist, I just didn't think it would be this soon. As long as she can still run with Wick, I'm happy. Rave's a very good stable pony!

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  • 2 months later...

I know this is a bit of an old post, but Paula told me to take a look at this, as I've been having a problem with Charlie limping on his right front leg for some time now. I'm wondering if maybe this is his issue, too. Charlie will limp after he has run around. But, if I rest him for a few days, the limp goes away with regular walking and moderate activity. But, if he ups the activity, he'll start limping again. The vet diagnosed a soft tissue injury and put him on anti-inflamatories and restricted activity for 4-6 weeks. After 4 weeks, I started to let Charlie be more active (he was NOT diggin' the restricted activity nonsense). Everything was OK for a couple of days, but then he started limping again. I'm pretty sure that the issue is in his foot or with a toe(s). Do his symptoms sound similar to those of you who had a dog diagnosed with a seasmoid injury? Did your dogs limp all the time or just after some running/jumping?

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MaryP,

I know that others are more expert in this area than me, but I would think that on-and-off limping could have multiple causes. If you are observant enough to know if the soreness is focused in the foot, you have obviously narrowed down the cause. BUT my dog limped off and on for 3-4 weeks -- the first 2 weeks I treated for soft tissue injury on the advice of a vet (anti-inflammatories and pain meds) and also leash-walked. After 2 weeks of medication and restricted activity, he would still limp when allowed to run (not all-out running, just a little running and we would go back to leash walking). At that point, the rehab vet thought it was something other than a soft tissue injury and further examination by her and a sports injury surgeon resulted in a diagnosis of a torn bicep tendon (narrowed down from several other potential diagnoses).

 

That is my experience with on-and-off-again limping.

 

Jovi

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Jovi,

What sports injury surgeon did you see? I'm looking at alternatives for Pip right now, though he's still undiagnosed. On-again off-again lameness for at least a year. Worse with extreme exertion. Usually will go sound or nearly sound with a good rest. Except that after the last two trials in which I had to use him for set out--he hasn't gone sound since. We've gotten as far as X-rays of his shoulders (only place we could get a reaction on manipulation). There appear to be some arthritic changes in one shoulder. The radiographs are being evaluated by a radiologist now.

 

The tentative dx by my regular vet is possible undiagnosed OCD, which seems a bit far-fetched for a 5-year-old dog, especially since I am quick to pick up even the most subtle signs of lameness, but never say never. (At one point I thought perhaps sesamoids, and I'm not ruling out other issues as well, since for a long time he did a lot of licking of that wrist as well <--due to pain?).

 

Anyway, I'm thinking of next steps and looking for recommendations of good sports injury vets who would be best able to diagnose lameness issues in working dogs.

 

J.

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Julie, Many sports people in the mid-atlantic and beyond swear by Dr. Canapp at VOSM in MD: http://www.vetsportsmedicine.com/about/staff_scanapp.html

 

A bit closer is Dr. Regina Schwabe in VA who I think is awesome and she's also very well-priced: http://www.wellpaws.com/

 

There may be others in NC now. Ask Pam!

 

 

MaryP, until you have a diagnosis "soft tissue" could mean just about anything. It's impossible to properly rehab without knowing what the issue is. It could be anything from tight muscles to a torn ligament. I've had the exact symptoms you describe with two of mine right now - for one it's just residual tight muscles from a previous injury, for the other it's arthritis.

 

Good luck to you both. Sucks when they're hurt.

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Thanks Laura. I take dogs to Regina for rehab, but as far as I know she doesn't have the capability to do X-rays and related diagnostics. Once I know what's wrong with Pip and have decided on a course of treatment (which could include surgery), I definitely plan to make her part of his aftercare/rehab. I have an appointment with her on Friday, though (Jill's going for a swim!), so will plan to ask her for recommendations.

 

J.

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Julie,

Yes, the dynamic duo is Regina Schwabe and Dr. Canapp at VOSM. If you are currently going to her, you know how awesome she is. I take Torque every 3-4 months for a well-check (since he is so pain tolerant it is hard to tell if he is injured) and a swim. He is very good at the 'bump game'. :D When she examined Torque for his bicep tendon tear, she kept saying in her sweet voice "Oh Torque, what did you do to yourself?" and other innocuous phrases. I kept thinking "Oh no, this does not sound good." She never came out and said "Wow, he is really messed up. I think he needs surgery." But she was very honest and told me that she did not believe that rehab would solve his problem. Then recommended Dr. Canapp.

 

You are right. Regina does not do X-rays, but a lot of people send them to her to read. VOSM has digital X-ray capability if needed, and Dr. Canapp is experienced in arthroscopic surgery (which I preferred over traditional surgery).

 

The way it worked for me was that both vets were pretty sure he had a bicep tendon tear, but until he had arthroscopic surgery, the exact injury and the extent of the injury was not known. The surgery was necessary for an exact diagnosis.

 

It is very common for Dr. Canapp to do the surgery and Regina will follow-up with rehab. VOSM and Regina seem to have a very good working relationship. I know of several dogs (and there are probably many more) that have had surgery at VOSM with follow-up by Regina.

 

Good Luck with Pip,

Jovi

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Unfortunately, although I will be at my regular vet today, I don't think they'll have the radiographs back from the radiologist. But if they do, my plan was to take them to Regina. If it is his shoulder and it is OCD, I suspect that as lame as he is now, surgery will be our only option, so I still need a surgeon. If I can find a good one closer than Canapp, that would be lovely. After all, I am self-emplyed and every time I make a trip to the vet, etc., it is UNPAID leave, so closer really is better (since the more time I have at home, the better chance I have of earning money to pay for what's likely to be a large vet bill), unless there's overwhelming evidence that Canapp is the only one who is suitable as a surgeon for Pip's problem.

 

Oh, and the reason I'm going to the vet today is because one of my guard dogs has developed a nasty tumor. It came up pretty quickly, which probably isn't a good sign. Sigh.

 

J.

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Oh, and the reason I'm going to the vet today is because one of my guard dogs has developed a nasty tumor. It came up pretty quickly, which probably isn't a good sign. Sigh.

 

J.

 

Bummer! It's never just one thing.

 

Mojo for your guard dog.

 

Jovi

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