Nick's Lower Back Injury - help?
Posted 06 January 2012 - 01:30 AM
2nd opinion on Nick from another orthopedic vet. Some good news! You can read it further down the thread, here:
EDIT 21 JANUARY:
I have a diagnosis for Nick: Cauda Equina. I've pasted the orthopedic vet's report (and my remarks) further down this thread, here:
A second opinion and another set of x-rays are definitely on the menu.
Dear Sheepdoggers ~
First, I apologize in advance for what is going to be probably the longest, most rambling post I've ever made. But I'm struggling with panic, here, so I hope to hear from people who've had experience with back injuries in border collies.
Here is Nick's story. In the latter part of October, I was doing yard work while the dogs were free to play around the place. At one point, Nick ran down to the bottom of the property with his sister, as they often did. He came back up a while later, walking like a 90 year old man. He was visibly in pain, and it appeared to be in his hips or lower back.
Scared to death, I got him in to the vet the very next day. As best my vet could figure, he'd suffered an injury to the base of his tail, right at the bottom of his spine. My vet's guess was that he'd either tried to jump up somewhere and missed and fell back on his rump, or someone ran into him.
I'm inclined to think his little sister, Gael, probably collided with him from behind.
For whatever reason, the vet didn't prescribe X-rays, but we laid Nick up for about 3 weeks, and put him on some Rimadyl. With that rest time, he seemed to recover and his movement looked normal, including leaping lightly into the truck.
But then I ran him at Dunnigan Hills and at the end of the day, (after two good runs on those big hills) I went to put him in the truck ... and he didn't want to jump up. He was hurting again. When I got him home about 4 hours later, he was kind of hitching on one hip.
Of course, I laid him off again. During that time, I got him to a local holistic vet who does chiropractic. She adjusted him and while doing so, she showed me how an off-kilter tilt to his hips revealed that his back was out. When she had done the adjustment, it really seemed to help him.
A couple weeks later, I put him back to work and tried to go easy on him. There was one day of practice when we got home and he again got out of the truck seeming a bit ouchy and stiff. But some more time off, and he seemed good as gold. I finally put him back on the work roster and he seemed sound.
Well, last weekend, I spent 2 days at a friend's house, building fence and working on her arena, and the dogs just ran around and played. When I got done on the 2nd day (this past Monday) ... once more, Nick couldn't jump in the truck. There had been no wreck, no collisions, no wild leaps, just ordinary running around on a flat field, but two days of that was clearly too much.
I got him in to the vet for X-rays today.
We still have no real answers. What I do have is a whole lot of fear.
The X-ray was indeterminate. What it seems to show is that the disk-space between the last vertebra and the base of the tail (I can't remember what L this is) may be a little bit wider than the others, which may indicate there is swelling pressing the bones apart. But my vet said she did not think the disk was herniated or ruptured. (He can walk and trot normally, it just hurts him to perform any upward lifting movement, and his lope looks a bit tucked-under at the rump.)
Another odd thing, on the X-ray, there seems to be a ghostly image of what could be some calcification, a "flaring" at the bottom of the last vertebra and also the first bone of the tail. My vet said this could be Nick's body's attempt to compensate for an injury, by creating this calcification. But she said that if so, that bone would not be smooth, it would be rough, like granite, and that could cause him pain.
However, she's unable to diagnose any further, so she's referring me to a vet in Sacramento, Dr. Bob Richardson. - (EDIT: He is an orthopedic surgeon.) - She's sending me with Nick's X-rays, both the "before" image from when we OFA'd his hips and the "after" image of his lower back that we took today. And she said I might want to get an MRI done, but anyhow, to consult with Dr. Richardson, because he's handled this sort of thing for years and has more expertise than her.
This ... is where I start to panic. Since my vet can't pinpoint just what is going on, all we have are maybes. And those maybes range from Spondylitis to Spondylosis to arthritis to surgery to ... we don't know what.
People, I am scared. to. death. I made the appointment to see Dr. Richardson next Thursday, but his office said the visit and consultation will be $130, and an MRI runs from $1,000 to $2,000 !!!
I don't HAVE that kind of money! I just don't. God help me, I work part time in a liquor store and make $93 a week. My husband is self-employed, so he gets paid for when he works, but this time of year ... things can get slow. Plus his old corgi boy is sick and we need to get HIM in to the vet, because it looks like he's either suffering a return of his bladder infection or maybe something worse.
So ... I'm panicking. I'm terrified. I'm looking at this beautiful dog who isn't even 4 years old, yet, and who carries all my hopes and dreams in his gallant and loving heart, and I'm scared. The unknown scares me. The uncertainties scare me. And the financial aspect simply devastates me. An MRI will wipe out my bank account - and that's if it falls on the lower end of the quote range. There will be nothing left if this vet recommends further treatment.
But I'm trying to be useful and think how to help, in at least some small way. I've got rimadyl for Nick. He's already on MSN, and I've got a big tub of Synovi G3 that I've started him on. He'll be laid off for at least the next 2 months, no running, no playing, no nothin'.
And I'll pray. A lot. Fervently.
But people, can anyone offer me anything, on the dubious strength of what I've told you? I'm certain it's a traumatic injury - Nick went out hale and healthy and came back wounded. Until that moment, there had never been a bad moment with his back, ever, and though he's always hurting himself somehow, it had NEVER involved anything in his lower back. So the various spondi-whatsits don't seem to fit. Or at least I'm praying they don't.
But ... help? Anybody? I'll know more - maybe - after seeing Dr. Richardson. I've also got Nick scheduled for another visit with the holistic vet for acupuncture and to see if there's anything to adjust, though that's not until the 22nd, when she comes down here.
What else can I do? What should I be afraid of, or what can I hope for? Just ... please. Somebody. My world is wrapped up in this dog. It's probably pretty pathetic, but that's how it is. So the complete lack of financial resources is more frightening than words can express.
Thanks for listening, anyhow. Some prayers would be welcome, too.
I now realize I'm guilty of perpetuating this injury, by not laying him off long enough, in the first place. Belatedly, I know this. I just hope I haven't ruined Nick for life.
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
Posted 06 January 2012 - 02:08 AM
Does it flinch when you touch it? Would ice help?
Posted 06 January 2012 - 02:32 AM
Not sure about an orthopedic vet - maybe that's the guy I'm going to see? I don't think we have any here in this part of Nevada. Anyhow, my soon-to-be-flattened bank account will cut the vet thing short. (Hence the panic ...)
He doesn't seem particularly sensitive to the touch. If I kind of bear down, he'll turn his head and look at me, but it's not a flinch response.
Guess I need to learn about dog massage. Maybe there's some online info I can find. Plus I'll ask the holistic vet, when I see her about the chiropractic and acupuncture. Maybe she can demonstrate some massage things for me to do.
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
Posted 06 January 2012 - 03:26 AM
When I found myself having to do an MRI on a GSD years ago I was able to find a place via the local dogcommunity that was charging a hit less. It is scary that is for certain.
Blimpie, Belle and Thor! Nothing but trouble!
Good thing that I thrive on trouble!
Posted 06 January 2012 - 08:49 AM
I am so sorry to read this.
Is it possible that after your consultation with Dr. Richardson that they may offer a payment plan? What about CARE credit? That may help you with the cost.
Sending you and Nick lots of good thoughts.
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Posted 06 January 2012 - 09:07 AM
I'm so sorry to hear about Nick - what a nightmare. My heart goes out to you.
You already know this - but here goes anyway -
Rest him. Get him used to a sling and help him up and down stairs. I suspect a ramp wouldn't help his hind end.
Call the vet, find out what you're going to get for your money. Explain your situation. More information is a good thing.
Take some deep breaths.
Call UC Davis and see if they have a rehab ortho on the faculty/staff. It's not any cheaper, but an ortho vet may be what you need, and it's not that much farther than Sacramento.
There are probably some doggy massage books - TTouch comes to mind - that would be helpful. I'll poke around later today and see what I find.
There's an excellent ortho vet in Sonoma County, too. I know that's way further for you, but just in case you want another consult . . .
We're all sending good BC Board Mojo for you and Nick!
Posted 06 January 2012 - 09:17 AM
It sounds like Lumbosacral stenosis or Cauda Equina- my 14 yo girl Gilly has this. Border Collies are prone to this (many active breeds are). Essentially there are bulging discs that impinge on the nerve roots. Gilly had the MRI & CT to confirm (regular films are not going to tell you much) but her heart & kidneys would not have made the surgery so I opted for rest & steroids. 8 weeks of strict rest & good doses of steroids. She is better now but not the same. Even if you opt for surgery there is always the risk of another disc rupturing.
My best advice would be to see a neurologist. They can thoroughly evaluate Nick & give your best options/prognosis for conservative treatment.
Good Luck- I feel your(& Nick's)pain
Posted 06 January 2012 - 09:19 AM
Posted 06 January 2012 - 09:40 AM
I just googled Dr Richardson, looking at his website it looks as though you are going to the right place.
Metacam is similar to Rimadyl, but does not seem to have some of the side effects. But, they can NOT be given at same time. If I remember correctly, it is 72 hours off of rimadyl before you can give Metacam.
Posted 06 January 2012 - 09:57 AM
Posted 06 January 2012 - 10:19 AM
Posted 06 January 2012 - 10:46 AM
Poetry in motion with Sophie, Taz, Meg, Ike, and puppy Gus!
And Craig waiting at the bridge.
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Posted 06 January 2012 - 11:08 AM
Working Border Collies Zac, Bill, Zeke, Joe, Spot and Devin
Posted 06 January 2012 - 11:19 AM
I wish I had more to offer that what's already been posted but I'll add my kudos to a good chiro and acupuncture. It did wonders fo Mick. I want to also add that I could tell when I found a good one compared the the first one I tried. She was trying her best but didn't have that special thing we needed. Mick would cringe with the first chiro and not want to let her touch him. The one that did us the best he'd happily get ready for his adjustments and you could see him go AHHHH when she made him feel better.
It's so heart wrenching when it's our go to dog, Any dogs is bad but that "special" dog just tears your heart even worse.
Sending MOJO Nicks way.
You have brains in your head. You have feet in your shoes. You can steer yourself in any direction you choose.
Posted 06 January 2012 - 11:34 AM
Posted 06 January 2012 - 12:05 PM
Minnie (the dog in my avatar) had an incident that was somewhat similar, and she recovered without any long term consequences. Forgive me, but it's been several years and my memory of specifics is a bit cloudy. I remember waking that morning with Minnie standing beside my bed staring ruefully and with urgency at me, and the look on her face told me all I needed to know--sheer distress. I got her right in to my vet and Xrays showed a spinal issue. Unfortunately I can't recall with certainty the diagnosis, I believe it was an enlarged disk pressing on her lumbar spine. She was treated with a course of steroids, several weeks of rest (6 maybe), restriction from all off leash activity, no jumping up or down from anything-I had to lift her in and out of the car, and a series of acupuncture treatments from a holistic vet. It may be that a series of Adequan injections (or the less expensive pharmaceutically compounded PSGAGS) would be helpful as well. They wouldn't hurt so you may want to ask your vet if it 's worth a try. I hope that Nick's issue turns out to be transitory as well. I will be keeping you both in my thoughts.
Posted 06 January 2012 - 12:22 PM
Good luck. It's such a heartbreaking process to go through.
"Do or do not. There is no try." -Yoda
Posted 06 January 2012 - 03:02 PM
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Posted 06 January 2012 - 05:25 PM
Through diet I got the weight off him. By watching him closely when he exercised we have prevented a reoccurrance. While he is not 100% even now two years afterwards, he is able to run again and work. And I would add he continues to improve in his agility and speed as time goes by.
My vet and I choose the conservative treatment plan, no surgery or expensive specialists. While I was very alarmed by his sudden weight gain due to the steriods, I have to say they did the trick in his treatment. He only requires a daily half dose of Novix with an occasional Tramadol when he over does it now. Of course I still keep a close eye on him outside the house.
Give him a chance to heal up and be prepared for the long haul. He may come out of this with little or no lingering harm, only time will tell.
Posted 06 January 2012 - 05:30 PM
Dr. Richardson took what I consider to be the most thorough history that I've ever seen or heard from a vet. After this I told him that what I wanted out of this visit was a diagnosis and a plan. He started examining Sally and his first instinct was to see if she'd react to pressure behind her knee. He hit the nail right on the head. He took her for x-rays just to confirm his suspicion. She had what's called a gastrocnemius fabellum fracture. It wasn't full blown yet, none of the fabella were broken/shattered but the gastrocnemius was beginning to tear away from its origin.
I had my diagnosis and plan. There was room for hope, but the condition was certainly in both legs even though only one was hurting at the time. The visit cost me $200 including the x-rays. I tried to rest this out of her per the 'plan'. 3 months crate rest then slow reconditioning. It came back the following winter. Surgery would have meant 6 months crate rest to recoop with no guarantee of success. Long story short.... it was the beginning of the end for her trialing career. The good thing was I went forward with eyes wide open. I finally knew what was wrong and could make better decisions for Sally. Dr. Richardson is the real deal, good luck there.
Another of my older dogs hurt her back when she was about 8 years old. Peggy went out in the side yard with the other dogs and when she came back a minute later she couldn't walk up the steps of the porch. Local vet gave her steroids and 'rest'. Something was really wrong though. 3-4 weeks later I was beginning to witness the decline of my dog. I took her to a neurosurgeon and he said that she was certainly a surgical candidate, but he wanted to apply some more "tincture of time" just to see if there'd be any improvement. I went home and Peggy's decline continued. Again... long story short.... I found a chiropractor that had experience with dogs and had some good reports about his work. I made an appt and went to his office to see him the next day. She improved at the first visit and he wanted her to start working again after the second visit. She had likely subluxated one of her vertibrae (in her lower thoracic/upper lumbar region). His exam was with his fingers, he doesn't even do x-rays (if he needs a film he sends people to a local radiology practice). The initial regimen was moderate exercise followed by a massage of her lower back. She needed periodic adjustments for the rest of her life. I was able to get her back on the trial field a year or so after her injury and she won some places at trials after that but no more wins. So this was a dog that could've had a back surgery (again with no guarantee for success), and was saved from going through that by chiropractic. She lived to be 15.
Both of these doctors did well by me and my dogs. You will meet Dr. Richardson, and if you'd like the name of the chiropractor you can PM me. His practice is actually with humans. He went to Palmer and began working on dogs when he was in school. He's very good. I'm naturally skeptical of chiro because I was trained in the medical model, but no more. When I saw how Peggy was helped I began to have him work on me at our visits after he saw my dog. I know it sounds funny, but it's true. BTW his rates are very reasonable
Good luck with your dog, and PM me if you want the name of that chiropractor.
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