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Need To Make A Major Health Decision - Input Welcome


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The background:

 

I have a 4 month old puppy from working lines. Three weeks ago she came up lame - an intermittent tenderness in the right hind that included toe touching and sudden loss of stability.

 

Cursory examination by our regular vet suggested a sprain or strain and a few days of light exercise and extra rest was ordered.

 

Three days after that she sustained a minor trauma ( a large dog fell from a truck and winged her hip). To be safe, I had a radiographic panel done. Everything was fine and her lameness was not exacerbated. It was all but gone. She exhibited no other signs of problem. A few more days of light exercise and extra rest was ordered.

 

On the third day of the second extra rest (so three days after the dog fell on her) she came up lame on her left hind leg. Quite a bit worse than the lameness on her right leg had been.

 

Bloodwork, more xrays and an MRI was performed. She is too young for many things to show up - but her hips look perfect, everything seated as deeply and securely as it should be, her spine is straight and solid and all the bones in all her legs are perfect. Her growth plates look normal for a dog her age and size. No cartilage or ligament damage was evident. No bone density abnormalities were immediately evident (again, she is 4 months, many things would not be apparent at this age, even if they were causing pain or lameness).

 

There is no history of OCD or dysplasia in her lines.

 

No TBI was discovered. No infection or virus was indicated.

 

She displays tremendous tenderness on both hind feet to cold and wet. Some days she seems lame on one side, some days on the other. She is in discomfort and I have no trouble keeping her on her belly and she has begun to "skittle around" to get to things - the effort to get up seems painful. She has discomfort when urinating and deficating because of the requirement to support herself in a squat.

 

She gives NO verbal clues as to pain and great pressure on all her leg bones by the vet(s) yielded no pain response.

 

She has been seen by a regular vet and an orthopedic specialist. In total she has been seen by four vets.

 

There was no trauma - the only kind she could have possibly sustained was from jumping off a dining room table - but she jumped onto a chair and then onto the floor and it was 10 days after that when she first presented as lame. She is no more active than any other dog and all of our exercise, even longish walks, have been done in a leisurely way - I am very certain she has not been over-extended. She IS a very very very active, physical puppy who tips over crates, tries to jump out of cars (has never done so), plays very roughly with the other puppies (she does play with a few larger, older dogs, but they are all puppy-savvy oldsters who do not play rough).

 

She experienced a rather extreme growth spurt between 14 and 16 weeks where she gained more than ten pounds. She went from a 13 pound dog to a 25 pound dog in two weeks and is now only a few pounds lighter than her mother who is 7.

 

Two of the vets think it is Pano - even though the xrays were inconclusive as to bone density abnormalities. One sort of agrees but feels OCD may be indicated - even without any physical evidence. The other thinks it is a bad strain of the hips.

 

At the moment, four days into nearly total crate rest, she is still very tender on both hind legs and the lameness switches, but that seems to me to be because she is picking a leg to use "more". Other times, you would swear she is fine.

 

Before the crate rest, when she did get a little run, it was a bunny run - you know - both hind legs working together. I have not seen her in anything except a walk and an "I wanna run, why won't you let me" gait since the crate rest. Her walks looks, by times, completely stiff and unhappy, somewhat stiff, just a teeny tiny stiff and full on sound as a dollar bill.

 

Her intended future was not herding, agility or any other sport. She was to be trained as a SaR dog - endurance/persistence, intelligence and independence are the important qualities.

 

Okay. All of that to get to this:

 

I have to make a decison about treating this.

 

If I go with the Pano, then I am going to more or less let her self regulate. Obviously I would still exercise a little limiting control but no more crate rest, no more leash every second of the day, etc.

 

If I go with the possible OCD, it IS crate rest until we can find some evidence and then likely surgery.

 

If I go with the hip thing, it is crate rest for a little longer and then working up to full activity over several weeks.

 

Obviously I will grab the lowest common denominator and give her some more crate rest and light exercise - but the decision still needs to be made as to what to do after, say, the next 10 days.

 

Thing is, at four months, shifts in her personality are already ocurring from the pain/confinement, etc. The long, complex training program for her mapped out future is being seriously compromised and will be derailed, perhaps permanently, if she is confined for a whole lot longer. The underlying qualities that will help her be good at her work are formed now and cannot be recovered. She is showing signs of fearfulness and a wee bit of meanness, not understanding at all why she is in a cage.

 

I love this animal and could, frankly, live with it if she did not become a service dog. What is VERY important to me is that she is a happy dog.

 

I would very much like to hear from anyone who has an opinion or has dealt with anything like this or ... well, I suppose I am seeking opinions so I can form my decision with as much information as possible.

 

What would you do? Treat the Pano, treat the potential OCD or treat the "sore hips"? The wrong decision could lead to a permanently lame dog, a dog unfit for her purpose or ... um ... yeah.

 

Thoughts?

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crate rest or even just hanging out quiet with no rough housing, jumping or going up and down stairs other then a few to go in and outside, just in case you have a home with a lot of stairs. Reduce her dog food to a lower protein to slow growth and to help keep her more peaceful on crate rest and wait it out a few weeks to see if symptoms resolve themselves.

 

Also, don't make any big deal about what you see is lameness to her, observe but don't make a fuss about it, sounds silly but these dogs are smart, if you reward them for a behavior they will continue to offer it regardless of if they are truly lame or not.

 

 

Also, you mentioned training and having to delay it, have you been doing anything training wise or exercise wise other then just letting her be a pup and asking her to exhibit self control with easy obedience requirements such as sit, lie down, wait and come?

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Any pain control being used?

 

And yeah, I agree with Debbie--what is involved with the extensive training that she is already doing?

 

But I still get back to pain control. If it is panno, then helping control the pain could go a long way to helping her weather her situation both mentally and physically. It seems that the preponderance of opinion points toward panno as well, and given the absence of anything to prove OCD, that's the diagnosis I'd lean toward.

 

And if all dx result in rest and pain control, then it can't hurt to start with that. But I wouldn't worry yet about a 4 month old puppy being ruined for any future activity because of physical problems now. I'm sure there are SAR dogs that started much later in life than from the moment they were taken from their dams and taken home by their new owners.

 

J.

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Years ago I had a pup with similar symptoms. Even a very highly ortho vet could not find a cause. It turned out to be giardia!! The gas was causing deep stomach pain but displayed as alternating rear lameness. A fecal may be worthwhile

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Thanks for your reply.

 

Yeah, I am going to go the crate rest route, for sure, a little more of it to see what happens will not hurt - my concern was more in the case of several months of crate rest.

 

Training : it's all mental at this stage - all about patience and obedience and decision making and what not. There is no physical training beyond sit, down, stand, stay and various forms of recall and some nose work. Our play is very gentle, very controlled.

 

Good advice on the food. I did reduce her protien intake, but it was not high to begin with - her diet was puppy kibble with a mixture of cooked chicken & veggies, rice and salmon oil - pretty carefully modulated so that her total protien intake was appropriate to her age and activity. It is the exact same diet as they feed to the puppies who will be sheepdogs on our farm and they get about the same amount of activity. That said, as a precaution I removed the chicken and veggies and increased the kibble slightly. Kibble is Purina Puppy.

 

I did remove all the other things - bananas, apples, carrots and real bones - just as a precaution and because there are so many unknown factors - can't hurt to start reducing possible irritants/causes.

 

I need a magic wand :(

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Meds: yes, she was on metacam - every 24 hrs for two weeks - now reduced to every 48. Also I added Juvita mutlivitamin.

 

Yes, a fecal is next.

 

Speakina, as my mother said this morning when we had this same basic convo, the little lady better start fecal-ing out some gold. All this is NOT cheap.

 

I do not mind the expense in the strictest sense, of course - she is my dog and I am bound to do deal well with her - but yikes ...

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The long, complex training program for her mapped out future is being seriously compromised and will be derailed, perhaps permanently, if she is confined for a whole lot longer. The underlying qualities that will help her be good at her work are formed now and cannot be recovered.

 

I wish I had something to offer in terms of helping with the decision, but I don't. Sorry. (I'd probably opt for some more limited activity for a while if it were my pup, though, working at the same time on low key training activities to keep her mentally stimulated so the behavioral issues don't intensify.)

 

I do have some serious misgivings about the statement you make above.

 

I have a friend who started her English Shepherd in SAR training at a year and a half old. She had no previous experience in SAR and did nothing to prepare the pup for it. She actually started training because he was a handful and she felt she needed to do something with him.

 

Very quickly he was doing better than many of the other dogs with much more training behind them, with experience in SAR and no doubt raised their pups for (and some were bred for) future SAR work. So I don't see how an interruption in her "complex training program" is going to hurt at this stage in her life.

 

Best wishes getting your pup through this and on with her life.

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To me, the major clue is that sudden growth spurt. That could be a trigger for everything else. Purina puppy chow wouldn't be my first choice of food. I'd put her on a good quality adult food, and if anything, I'd do the opposite to what you're doing and keep the fresh meat, etc., and lower the intake of kibble, especially if you're planning to stay with the puppy food. Generally all my pups go straight on to adult food. I'd ask the vet about added vitamins--sometimes you can go overboard there and just end up causing more problems. If she's on a balanced diet, she shouldn't need extra vitamins.

 

J.

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Agreed, Roxanne. That's the point I was trying to make regarding SAR dogs and starting training as pups. I am quite sure there are plenty of superior SAR dogs who started their training as adults, and some of those were dogs who were rescues, which means they may not have even had a decent start on training before their owners decided to try SAR with them. It's a bit of a stretch for me to believe that crate rest and restricted activity for a four month old is going to ruin the pup's potential to be a great SAR dog.

 

J.

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My dog was diagnosed with OCD in both right rear and left front when he was 15 months old. The diagnosis was based on X-rays taken by and read by a general vet - but very experienced and a good surgeon. He suggested 2 surgeries ~6 months apart. I got a 2nd opinion from a rehab vet. Her diagnosis was iliopsoas strain. Appropriate rest and strengthening exercises for 4 months was the treatment. [Note: Dr. Canapp at VOSM also saw the X-rays and agreed that it was NOT OCD.]

 

What I am trying to say is: is the vet who thinks it is OCD qualified to diagnose the problem? General vets can be well-intentioned, but not as expert at reading X-rays. So I would have to think carefully about who gave me the OCD diagnosis before I went in that direction - based on my past experience.

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*sigh*

 

You are all right, of course - as to the whole concern about her being "ruined" for her future work. It is very likely a perception on my part due to my emotional attachment - but I can see a sort of mistrust and timidness sneaking into her personality. To be honest, I am an unreliable narrator in this story.

 

Thanks for everyone for their thoughts and opinions. I am immensely grateful to have folks who have experience to chime in - there is no such thing as too much information, in my mind.

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Diet:

 

We're a Purina farm - always have been and have never had problems. That said, I undertsand that opinions on food are pretty diverse.

 

The change is diet was on the vet's recommendation - the vet that treats our working dogs. We're trying a process of elimination. The vitamins were on his recommendation as I am removing some natural sources of beta-carotene and Vit C. I personally agree with you and wanted to remove the kibble ... but was convinced this was the most sound method to determine if it is diet based.

 

The four vets also did not agree on diet and recuperation.

 

So ... meh ...

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I can see a sort of mistrust and timidness sneaking into her personality.

 

That's why I suggested doing some other kids of low key training.

 

But at this age, it's really impossible to know whether this may have developed in her regardless.

 

Since it does seem to be there, why not do some of the confidence building things that you'd do for a fearful dog? Maybe the restricted activity has taken a bit of a toll on her puppy exuberance and she needs to have things to do that can increase her self confidence.

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Hello CMP,


Your puppy's extreme growth spurt would really raise a red flag with me. You mentioned that the kibble you feed is "Purina Puppy", and I imagine that you mean Purina Puppy Chow. If so, that kibble is rated very poorly by the Dog Food Advisor website (it received their lowest rating of one star out of five). You mentioned that your puppy's intake of protein was "not high to begin with", but the Purina Puppy Chow is 31% protein and then you added other ingredients that may have further increased the protein level. Also, if the kibble is of good quality, it isn't necessary to add all of the other things that you have been adding. I feed my puppies a good quality large breed puppy food that is formulated for a slow and steady growth rate, and I would suggest that you do the same.


Regards,

nancy
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From my observations - people usually aquire one of two types of dogs for SAR. Either a well bred pup or a second hand/rescue young adult that needs a job. My own first SAR dog was a young adult that was not raised right but did have all the genetic pieces. The 3 pups currently on my team are all learning with an emphasis on on the basics. It's all fun, puppy stuff. IMO, as long as they're learning how to learn and work with a person then the SAR stuff can be plugged in fine whenever.

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That's why I suggested doing some other kids of low key training.

 

But at this age, it's really impossible to know whether this may have developed in her regardless.

 

Since it does seem to be there, why not do some of the confidence building things that you'd do for a fearful dog? Maybe the restricted activity has taken a bit of a toll on her puppy exuberance and she needs to have things to do that can increase her self confidence.

 

Yeah, this is what we're doing. Lots of exercises to help her have successes - learning silly unnecessary stuff like having her touch her nose to various (my) body parts and working on her grammar (heh, I mean having her understand verbs combined with nouns as in "touch ball" "get ball" "push ball"). She was just very used to a choice based system with rewards that were never food in the "learn a task" sense - the rewards were always physical - and she is getting cranky at having a treat shoved in her face instead of a good session = go swimming in the pond or play tug with me or go visit grandma and get a carrot)...

 

Which is all just a "woe is me, it's not going like I want" whinge, I know. People work through way worse things all the time.

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Hello CMP,

 

Your puppy's extreme growth spurt would really raise a red flag with me. You mentioned that the kibble you feed is "Purina Puppy", and I imagine that you mean Purina Puppy Chow. If so, that kibble is rated very poorly by the Dog Food Advisor website (it received their lowest rating of one star out of five). You mentioned that your puppy's intake of protein was "not high to begin with", but the Purina Puppy Chow is 31% protein and then you added other ingredients that may have further increased the protein level. Also, if the kibble is of good quality, it isn't necessary to add all of the other things that you have been adding. I feed my puppies a good quality large breed puppy food that is formulated for a slow and steady growth rate, and I would suggest that you do the same.

 

Regards,

nancy

Thanks for your thoughts.

 

Yeah, I've had the Purina discussion a lot of times with a lot of people. But I have watched so many BC puppies be raised on exactly what she is eating that I would be very surprised if this was diet based, at least in the sense of nutritional composition. Could be so, but I would be surprised. The replacement of some of the suggested amount of kibble with rice, chicken, veggies is not to supplement it nutritionally but to provide texture and taste variation.

 

I have given thought to switching her to an adult food but I have to be systematic about how I approach this, I think, and will wait to see what effects the current set of changes have.

 

SO much to consider.

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FWIW, I have nothing against Purina (my parents used to be part owners in a Purina feed store), but I do have something against foods that encourage rapid growth in pups, which is what puppy chow (generally no matter what the brand name) does. Yes, lots of dogs can be raised just fine on a particular brand of food, but dogs are individuals, and it may be that the particular food you've chosen, because it's worked for all your family's other dogs, isn't the best food for YOUR pup.

 

I'll stop beating that dead horse now, but just wanted to point out that my objection is to the formulas that encourage rapid growth and not so much the brand.

 

J.

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Others have given you great advice. Having been through a major orthopaedic experience this past year, I cannot stress the total rest part enough. I found an x pen in the living room worked better than a crate when I was at home. My pup felt more part of the family, not quite so isolated, but was still confined. He dealt with it. He went on a leash out the front door to potty and then back to the x pen. After some months, we were then instructed to do limited leash walks, slowly building up to more time and distance. We started at 7 minutes and built to over an hour (both morning and evening). He was 7 months old when he first had to be restricted.

 

I have no guess as to the cause of your pup's lameness, but the huge sudden growth spurt seems to be a factor, I would think. But all possibilities say rest at this point. As for ruining the dog for future work, my pup is as intense, balls-to-the-wall kind of guy as I have ever had (mine are all cowdogs, so they are pretty intense to begin with, and this guy is at the extreme end of the scale). I, too, was stressed, as I felt I was seeing personality changes in him from being so restricted for so long. Not to worry--he is now fine. When we see his Dr. mid Sept, he wants him up to 80% of normal activity by then. This guy has been been restricted since LAST OCTOBER, but now that he has a bit more freedom, I find he is the same booger-head he was always meant to be.

 

Hang in there--I hope they find a definitive diagnosis soon. But there is definitely hope.

A

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Stockdogranch: That was good to hear :)

 

Well, crates have been an issue. Thankfully we pretty much have a crate warehouse here so I have lots of options. I am using a very large open wire crate set up, like you, in the middle of the living area for *supervised* non sleeping time. I get in it (the top was removed) with her and we hang out. A television, a garden door, the kitchen, the back door, etc. are all visible and it sits more or less where we used to hang out, anyway. She can have toys and food and water and what not.

 

Her sleeping crate, which she loves, is a nylon collapsible and has been set up like a bedroom with access from the wire crate's door. She goes in there for quiet time and when she is sleeping, I close the door and try to get all the things done that need doing so I can afford all this :/

 

I also move her large bed/cushion around the house when I am doing something (and outside sometimes) and leave her in a down/stay with a few chew toys (and on a short tether, just in case, when outside). Thankfully the two things she does VERY well and which are very nearly proofed are recall and down/stay. I also allow some down/stay time in the kitchen, before bed on the living room floor where we do the nightly grooming, etc. So she is getting out and around without walking.

 

I also try and get her out once a day or so for a car ride (in a crate) and we go places and I open the back of the truck and she enjoys observing new things and we have picnic lunches. Yes, I know :/

 

I am very appreciative to hear of your experience. Thanks for that.

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re: iliopsoas

 

That was an early thought except she can fully extend both legs upwards and backwards and displays no discomfort on any diagnostic flex so far performed. The only discomfort she ever exhibits are during a rise from a down and while urinating/defecating and we have been unable to duplicate the stress sufficiently to cause her to respond during examination. One vet is holding out for an undetermined soft tissue injury in the hip area.

 

It's bloody perplexing, is what it is. :/

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It can be soul destroying when one of your dogs is sick especially when it's a pup.

 

I agree with others about the need for good pain control . Also that prolonged enforced rest at this stage of her life will not have long term detrimental consequences on her personality or ability to learn.. Consider all those rescue dogs who have a troubled start and then bounce back.

 

Although it probably is something like pano has a urinary tract infection or giardia/ other gut problems been checked for and ruled out.?

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