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Nick's Lower Back Injury - help?


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#41 amc

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Posted 08 January 2012 - 04:42 PM

So, I'll see what the MRI reveals next Thursday


Gloria, I thought you were going to have Dr Richardson examine Nick first, and then see if he recommends an MRI. I would certainly encourage this course of action...note well what Elizabeth wrote about investigations sometimes leading down a dangerous path.

In human orthopedic issues, many practitioners won't order an MRI if the patient is unwilling to have surgery.

Good luck with Nick!

Amy
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#42 Serena+Eluane B.C.

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Posted 08 January 2012 - 08:22 PM

Hi, just checking back and crossing my fingers for you Gloria! Let us know what you decide about the MRI from what AMC and Elizabeth are saying. I too hope that an easier healing will take place that takes away the need for the MRI too!

whoops Tea, I thought Wolftown's wildlife link would have the Wolftown contributions in there since it says Wolftown. Hehe, I had to giggle about the Saturday trials being a Red Riding Hood scenario bwahaha! :lol: (inside joke) but that is pretty funny! :)

#43 rac

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Posted 09 January 2012 - 12:07 PM

Just to mention my general agreement with Elizabeth and Amy...

It's generally not considered good medical practice to use lab tests or modern imaging to go on fishing expeditions. How these tools should be used is to confirm what the diagnostician already suspects based on the careful history and physical exams that were done. In my opinion you've been referred to a very good ortho specialist, you should consider learning what his opinion of your dog's condition is before you have the MRI. If Dr. Richardson wants an MRI then fine, he'll have a good reason for ordering that test, and he'll have something specific that he's looking for. Remember he is a specialist in this field and may have seen other cases like your dog. Your dog may yet need an MRI, but, just as easily, he may not need one at all. Good luck in whatever you decide.

Ray

#44 Gloria Atwater

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Posted 09 January 2012 - 07:02 PM

Hi again ~

My apologies if I misled anyone into thinking that I am already getting an MRI for Nick. I have a head cold that's stuffing up my thought processes terribly, so I'm probably not making the best sense. Of course, the decision for an MRI would rest in the hands of a vet, not me.

But the way my own primary vet reacted, so quick to pass me off to some specialist elsewhere, made me think it must be nearly a done deal. My vet was the one who referred me to Dr. Richardson, saying Nick should get an MRI. I've been preparing for it as something I should just expect to need done.

So, my apologies if I sounded like it was already scheduled. It's not. I'm scheduled to take Nick in for an exam with Dr. Richardson on Thursday, bringing his X-ray, and then we'll see what happens. My hope is that the doc won't see any need for an MRI, at all.
Cheers,

Gloria
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#45 Gloria Atwater

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Posted 09 January 2012 - 07:25 PM

A potentially stupid question for any folks in the know:

Is an MRI generally regarded as preparatory for surgery?

See, I took Nick (and his x-ray) to a second vet, and their thought was that my primary vet had been premature in referring me to an orthopedic vet to (possibly) get an MRI. If I'm not planning on surgery for Nick - and Vet #2 saw no need for that - why would I need an MRI?

My primary vet is not in the office today, so I plan to talk to her tomorrow. But I've realized that, in referring me so promptly to a specialist, she pretty much deflected any chance she'd be the bearer of unpleasant news. We've been with this vet hospital for years, so they know how important our animals are, to us. However, while she was tossing scary, multi-syllable words at me the other day, "surgery" was definitely one of the "ifs" she mentioned.

I'm hoping some of you may be able to 'splain more about this, because surgery is simply not an option for Nick. Not gonna happen. Granted, Dr. Richardson may not even ask for an MRI. He may look at Nick and say, "Yup, he's tweaked himself, go home and stuff him in a crate for 6 weeks. By the way, here's a prescription for some NSAIDS." Who knows?

But I'm hoping my vet isn't looking in a direction that I don't plan to take. I'll know more when I talk to her tomorrow, but I'm just curious to read any responses from folks, here, regarding the purpose(s) of MRIs.

Thanks, everyone, for putting up with me. I'm really good at handling crisis situations - except when they're my own! :P
Cheers ~

Gloria
You ask of my companions. Hills, sir, and the sundown, and a dog as large as myself that my father bought me. They are better than human beings, because they know but do not tell. ~ Emily Dickinson

To sit with a dog on a hillside on a glorious afternoon is to be back in Eden, where doing nothing was not boring - it was peace. ~ Milan Kundera

#46 Blackdawgs

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Posted 10 January 2012 - 09:39 AM

Long story, I do have a dog with back issues. She was origionally diagnosed with a "soft tissue injury" by her primary care vet. After months of conservative treatment, we wound up seeing a rehab vet/orthopedist at a vet school. At the time, I was worried about a bad disc. I was told (that at least at this vet school), they do NOT perform MRIs unless surgery is being considered and surgery is really only considererd if the dog is acutely neurologic.

We are now working with another rehab vet (the previous moved to another state), not associated with a vet school. We took more xrays. My dog has radiographic evidence of spondylosis, arthritis in some spinal facet joints, and arthritis in her SI joint (and hip dysplasia and elbow arthritis). The vet suspects lumbar-sacral stenosis, but that diagnosis would only be confirmed with an MRI. However, the changes on the xrays are consistant with stenosis. The vet said that in her experience, the outcome of stenosis surgery is not good, so she does not recommend it--the dogs are usually back where they started 6 months after surgery.

My dog is doing very well with stretching and strenthening exercises, and NSAIDS as needed. Her agility career is over, but she is currently comfortable with conservative treatment only.

#47 Chesney's Girl

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Posted 10 January 2012 - 03:19 PM

Gloria,

Nothing new to really offer other than a hopeful ending based on an experience that sounds similar to what happened to Chesney. Only difference is I saw what caused Chesney to hurt his back, and part of me is glad and the other part wants to forget the image of my dog not being able to walk.

Chesney on Easter Sunday 2009 was at search and rescue training with me. The dogs get some run/play time before and after training. Chesney was running after the other dogs (full tilt, as is typical Border Collie fashion) and went to run through a patch of pretty tall grass. Well the grass was taller than the rest because there was a very large rock keeping the grass long around it. Chesney hit it square in the chest, flipped head over tail and landed screaming. All he wanted to do was come to me for security but his back end lay limp on the ground with him only able to prop himself up on the front legs. I think I lost about 10 years on my life that moment since I'm sure I didn't breath for like 5 minutes.

I ran over to him telling him to lie down, when I got to him he still couldn't use his back end. I carried him to the truck and laid him in the back seat while I got numbers and directions to an emergency vet (because it's Easter Sunday of course) and I wasn't familiar with the area. The whole time I'm driving to the vet, all I can think about is my just turned 4 year old dog is going to be crippled for the rest of his life and I am a fresh out of college student with $0 to my name.

Once at the vet we did x-rays and a full body check with no sign of a fracture or damage other than a little bit of fluid on the front of his chest (from the impact causing a bruise). It took him about 2-3 hours to actually be able to stand and "walking" by the time I got home 3 more hours later. I rested him for almost a month of nothing but potty walks or slow walks on leash. He was sore for a long time.

3 years later I have seen him come up sore a handful of times mostly from jumping after boucing balls thrown by other people who think its cool to see my dog jump :angry: And if I see him a little sore I just keep him low key for a few days and he seems alright.

I take him to the Chiro which seems to notably help him and it's something I would recommend (as others have) once the soreness is lessened.

With all that rambling, I wanted to offer you a bit of hope, Nick is still young and dogs (if rested properly) have an amazing ability to heal. I won't say that he won't have any residual effects from whatever happened to him, but he should still be able to do what you plan to do with him... ;)

*sending good vibes from California*

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#48 Gloria Atwater

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Posted 11 January 2012 - 12:38 AM

Danielle and Blackdawg, thanks for sharing your stories. These dogs can make us grey-headed, can't they? Danielle, your Chesney in particular must have taken years off your life! I think I would have been almost out of my mind. :blink: I'm glad to hear your respective dogs are doing well, or at least well as possible.

For my part, I've spoken to my primary vet, and again to my 2nd-opinion vet, and I think I feel pretty good about where we're going, for now. I'll see Dr. Richardson on Thursday and ... just see what he has to say. My vet says he may or may not request an MR: she just wanted to send me to someone who had that option available.

So, any fears that my vet was trying to "herd" me in one direction or another are allayed, and I feel encouraged that we're all on the same page. We just want Nick restored to his old athletic ability. Even if it does mean he's laid off for a while.

I'll keep folks posted on what happens Thursday with Dr. Richardson! Thanks, everyone, for all your support, advice, encouragement and virtual hand-holding. What a wonderful border collie community we have! :D
God bless you,

Gloria (and Nick)
You ask of my companions. Hills, sir, and the sundown, and a dog as large as myself that my father bought me. They are better than human beings, because they know but do not tell. ~ Emily Dickinson

To sit with a dog on a hillside on a glorious afternoon is to be back in Eden, where doing nothing was not boring - it was peace. ~ Milan Kundera

#49 Serena+Eluane B.C.

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Posted 12 January 2012 - 11:38 PM

Thursday? Gloria? Am keeping fingers crossed for Nick! May the Good Lord bring future and fast healing for Nick. Hope there is great news from Dr. Richardson as well. It's such a relief to have a good vet do a good analysis and I'm sure Nick is in very capable and good hands too!

#50 Gloria Atwater

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Posted 13 January 2012 - 01:52 AM

GOOD NEWS!!! :D

I'm back from the wilds of Sacramento, and basically, Nick is okay! Dr. Richardson subjected Nick to perhaps the most thorough physical exam the poor guy's ever endured - including the cold, gelled-finger-in-the-rectum trick - but Nick bore it like a trouper. And the news is pretty good!

Dr. Richardson found absolutely nothing wrong with Nick neurologically or anywhere else. All his responses and reflexes are wholly normal. There were no pain or discomfort responses to anything, including the little rubber mallet to the knees. (I didn't know they used those on dogs!) No sign of any bulging or herniated disks, either. Just ... nothing. In fact, at one point Dr. Richardson looked up at me, from listing off non-symptoms to his technician, and said, "I guess you can tell that I'm not finding anything wrong with your dog." :P

Unfortunately, however, ... Nick's idiot mother forgot to bring his x-rays! :huh: (Where's that head-banging icon when I need it?)

So, a pretty danged important component of the exam was missing, and I have to either mail the plate to them or hand-deliver it if I'm over that way in the next while. I suspect I'll just mail it, since I don't think I'll be in Sacto within the next couple weeks.

This does leave us with one possibility, which we lacked the means to rule out, today. Dr. Richardson noted, as did my primary vet, that Nick's rump has a bit of a drop at the croup, which apparently neither vet entirely likes. And sometimes Nick lets his tail hang straight down, no curl to the tip, just wholly lax and straight down. Which again, Dr. Richardson didn't entirely like.

He said that these things, and the recurring ouchiness, could - could - be indicators of a condition called "transitional vertebral segments." A lot of you may already know what that is, (and it's apparently fairly common in GSDs) but in a nutshell, it's when the sacrum, that sort of pivot-point bone between the end of the backbone and the beginning of the tail, develops a defect. Instead of being a single, solid piece of bone that acts as a sort of shock-absorber at the end of the backbone, it sort of divides itself into a couple little mini-vertebra. This then can flex which cause the L7 vertebra, the last one, to impinge on the nerves inside the spine.

IF this is what's going on, then eventually Nick would need surgery to enlarge the tiny space through which the nerves pass. The injury Nick experienced, though unrelated, could have simply caused the disk and whatnot to inflame and thus get pinched, whereas the un-injured nerves had been able to avoid getting pinched. So far.

But you know ... I'm hoping - reeeeeeeeeeeally hoping - that the X-ray will dispel that worry. Dr. Richardson had a great time showing me all the fancy animated widgetry on their big-screen computer, and also example x-rays of dogs who DID have TVS. It was very interesting stuff.

However, to my very, extremely untrained eyes ... I don't think Nick's x-ray looks like the affected dogs'. I don't see the little mini-vertebra thing going on with his sacrum. But I'll send the x-ray to Dr. Richardson and see if he agrees, or if he thinks that when Nick gets older, there may be a problem, after all.

Meanwhile, I am very hopeful and I'm just doing to look forward to a positive outcome. For Nick, for now, it's just rest and more rest, and then back to work. Richardson actually didn't seem to think extreme rest was necessary, but dang it, I hurt my back last summer and I know how long it takes a back to heal.

If all that's wrong with Nick is that he got in a collision, got an owie, and I didn't give him long enough to heal, then this time, I'm giving him time enough to heal.

So, Nick is off duty until at least mid-February. If God grants it, he'll be ready to trial at Sonoma and Zamora, so whatever I do with him in the meantime will be with the goal of getting him sound, and keeping him sound. This dog carries my every hope, and it's on me to step and do the best for him.

And .... that's that, for now! Thank you, everyone, for all your well wishes, advice, shared experiences, good vibes and prayers. All of it has meant ever so much.

Thank you, Border Collie Forum! Y'all rock! :D
Sincerely,

Gloria and Nick
You ask of my companions. Hills, sir, and the sundown, and a dog as large as myself that my father bought me. They are better than human beings, because they know but do not tell. ~ Emily Dickinson

To sit with a dog on a hillside on a glorious afternoon is to be back in Eden, where doing nothing was not boring - it was peace. ~ Milan Kundera

#51 urge to herd

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Posted 13 January 2012 - 08:53 AM

WooHOOOOOO! Glad to hear some good news - you must be breathing a lot easier!

Might see you at the Wine Country trial - hope Nick's 'spa break' goes smoothly.

Ruth

#52 Serena+Eluane B.C.

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Posted 13 January 2012 - 03:49 PM

FANTASTIC and Wonderful News, Gloria!!!! Uh, I don't think you need a headbangin' emoticon. You need this instead as cheers from everyone on this great news...Posted Image Posted ImagePosted Image What a huge relief, and you need to give yourself a break. Things are very stressful and I'm sure you were busy trying to prepare and pack for the long road trip to see Dr. Richardson.

Well, it's looking like a real solid trip to healing :D I too am expecting the last final ok with those XRays as well. Yes, I agree about the "taking it easy" because this speeds up healing. Heheh about the human back, plus, unlike humans, border collies keep goin' and motorcyclin' way past their limits....They don't know how to stop, so I'm glad you're giving Nick that extra break. Cheers to a wonderful recovery for Nick!

#53 Sue R

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Posted 13 January 2012 - 05:05 PM

Sounds fabulous!

Transitional vertebrae? I have a friend with a natural bobtail Aussie. He has what the vet called a transitional vertebra but the way she described that one to me is that natural bobtail is a mild form of spina bifida (like the ridgeback in Rhodesian Ridgebacks is a mild for of SB), and one of the manifestations can be a transitional vertebra - which in his case is a partly-fused pair of vertebrae, where they are fused on just one side of the spine. That causes, for him, a asymmetry.

So her dog always, while very active, was more comfortable moving on a circle in one direction rather than the other - in other words, he favored one lead over the other as his sacrum could flex more naturally in one direction and not in the other. This seemed mostly to affect his stock work in that he was less comfortable moving on one cast than the other since he either had to counter-canter or mix his leads up (am I being totally confusing?).

He did very fine, taking the occasional lesson on sheep or cattle, doing agility for fun, and other normally active dog pursuits. But when he reached the age of 9 to 10, he began to slow down noticeably as arthritis finally began to take its toll, due to his uneven gait.

It sounds like something a bit different from what you are describing, and it sounds like Nick has an excellent chance for a full recovery. Very best wishes!
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#54 Gloria Atwater

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Posted 21 January 2012 - 02:19 PM

Though I posted this elsewhere, I should probably include it here. This is Dr. Richardson's official diagnosis, for Nick:

"He does appear to have some mild expression of Transitional Vertebral Segmentation as evidenced by what I believe is a small vestige of soft tissue at the juncture of S1 and S2. The LS (lumbosacral) Spondylosis is also evident and I would correlate that early development to this transitional aspect of the L-S anatomy. Consequently, ruling out the hips as you have his radiographs and my evaluating his knees by physical exam, we are left with a clinical diagnosis of Cauda Equina, with episodic expression by his bursts of activity.

I have informed Ms Atwater that this will likely worsen in time and thereby prepared her for possible surgical intervention when deemed necessary. I have had more success than not in helping such patients by dorsal decompression, guided by an in house CT scanning immediately before entering the OR. Many of our law enforcement dogs have returned to work, and I would expect an athletic outcome for Nick, providing neurologic damage does not ensue before decompression
."

Repeating what I said in my other post/thread, it looks like he's saying that the early onset of the spondylosis is due to the TVS in his sacrum, and that Nick's physical exertions (he uses himself like an Abrams tank!) trigger his painful physical symptoms. And apparently he feels surgery will halt the whole nasty mess.

It's going to take time to get finances prepared for anything like that, so in the interim, I'm doing what I can. I am getting another set of X-rays, since quality of the single plate that was taken has come into question. And I will be getting a second opinion from another orthopedic vet. I doubt the diagnosis will change one bit, but I'd just like another set of eyes on the problem.

Meanwhile, Nick will continue laid off for at least a couple more weeks, though I am going to call or fax Dr. Richardson with a couple questions. Initially he seemed to think I could return Nick to work whenever I felt he was ready, and just monitor his activity. I want/need to know if this diagnosis has changed that, since right now, I feel as if Nick sneezes, he could fall apart! :huh:

And also in the meanwhile, I've had Nick cold-lasered, he's going to get chiropracted and acupuntured tomorrow, and I'm continuing to supplement him with Synovi G3 and MSM. Looking at some other supplements, too. So, we'll see what happens in the weeks ahead. I'm curious to see if the lay-off and treatments make any difference at all, or if Nick will continue to come up with episodes of discomfort.

So, that's that. I'll come back and post more as I know more.

Thanks again, everyone, for your input.

~ Gloria
You ask of my companions. Hills, sir, and the sundown, and a dog as large as myself that my father bought me. They are better than human beings, because they know but do not tell. ~ Emily Dickinson

To sit with a dog on a hillside on a glorious afternoon is to be back in Eden, where doing nothing was not boring - it was peace. ~ Milan Kundera

#55 Gloria Atwater

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Posted 24 January 2012 - 01:57 PM

FYI, if anybody wants to be FYI'd ... ;)

I'm taking Nick in for a 2nd opinion. Week after this, on Friday Feb 3rd, I'm taking Nick over to Dr. D. W. Griffin at Loomis Basin Veterinary Hospital in Loomis, CA. There I'm going to get Nick a set of digital x-rays, as well have Dr. Griffin look him over.

Suzy Applegate recommended him to me, as she's had dogs to him and is very pleased with his work. So, I'll get the digital x-rays I probably should have had in the first place, as well as another doctor's look at and opinion of Nick's situation.

Kind of interesting, in my reading around, it seems there are various causes of Cauda Equina, some being from injury or incident, and various ways to approach it. Anyhow, I just really want a second look at this.

Meanwhile, Nick is in Week 3 of his layoff and though he's a pretty mellow dude at home, he's starting to get bored. Prime symptoms being that every evening, he drags the dog toys out and scatters them around the house, with occasional rounds of barking at them - or us. He's such a giant dork. :P

And that's the news. He's doing great, feeling good, so I'll see how he looks whenever I start letting him do stuff again. Which won't be until late February, and also depends on what Dr. Griffin says.

Peace, out. :)

~ Gloria
P.S.
Dr. Griffin is versed in both orthopedic and neurologic matters.
You ask of my companions. Hills, sir, and the sundown, and a dog as large as myself that my father bought me. They are better than human beings, because they know but do not tell. ~ Emily Dickinson

To sit with a dog on a hillside on a glorious afternoon is to be back in Eden, where doing nothing was not boring - it was peace. ~ Milan Kundera

#56 Sue R

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Posted 24 January 2012 - 06:58 PM

Best wishes to both of you!
Sue Rayburn - Cleverly disguised as a responsible adult, but not the brightest firefly in the jar.

Celt, Megan, and Dan

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#57 juliepoudrier

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Posted 24 January 2012 - 07:55 PM

Good luck with the next appointment. Do keep us updated.

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#58 Gloria Atwater

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Posted 25 January 2012 - 12:10 AM

Thanks, guys. It helps having moral support. It's kinda pathetic how much this thing has taken over my brain! :huh:

~ Gloria
You ask of my companions. Hills, sir, and the sundown, and a dog as large as myself that my father bought me. They are better than human beings, because they know but do not tell. ~ Emily Dickinson

To sit with a dog on a hillside on a glorious afternoon is to be back in Eden, where doing nothing was not boring - it was peace. ~ Milan Kundera

#59 rushdoggie

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Posted 25 January 2012 - 12:29 AM

We totally get it. And it does sound hopeful. Thanks for the update, Gloria.

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#60 Serena+Eluane B.C.

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Posted 26 January 2012 - 01:22 AM

oh, craaaaap!!!! I just got back from a very draining weekend, and am still trying to process! give our hugs to Nick! The other thread is frightening me, but over here the Blessed boy is still trying to cheer up his Mama with his antics... I'll be back. My head is trying to sort out what's happening....


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