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OA Diagnosis, Pain Identification
 CAM Forum User
CAM Forum User
18 January 2022 at 4:14 pm

Do I need to take my dog to a specialist?

My 6 year old lab has shown signs of pain off and on for the past 2 years with occasional limping and growling when touched. My regular vet xrayd his shoulders and didn’t see any signs of arthritis so managed with Adequan shots which helped immensely and Rimadyl when needed. In the past 6 months his limping has gotten worse and the Adequan shots didn’t seem to help like they did. He also started showing lameness in his rear hind leg when he first gets up from sleeping.  My regular vet x-rayed his hind legs and hips and diagnosed no CCL issue but moderate Hip Displaysia in left hip and severe in the left hip which he said is causing the lameness on that side.  So now he is on Rimadyl daily which changed his demeanor completely and I only notice the slight limp after he gets up. He has been going for regular hydro, laser and acupuncture therapies for 6 months which help keep him happy. My question is do I need to take him to an orthopedic specialist to get a definitive diagnosis? My regular vet only took one xray and called and said he has HD.  I feel like he could possibly has CCL disease as well.  My regular vet recommended FHO surgery right away before he gets any older but my rehab vet said surgery not necessary if managing with treatment. I guess I’m confused because I have 2 different opinions on what to do.  I want to be able to give him the MOST pain free life going forward and if this will progress and get worse is a surgical option best now or wait until the therapies are no longer working??  I’m so confused. I’m in the US so I appreciate any advice!!!

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  • CAM Responded

    18 January 2022 at 4:14 pm

    Hey there. I think you are one of many owners that feel confused, so don’t worry you’re not alone. OA/ arthritis is a really difficult “disease” to manage because multiple joints can be affected to different degrees, they can have secondary complications such as tendon, muscle or fascia related pain. They can have co-morbidities such as neurological or hormonal diseases….your lifestyle together, their exercise quotient, their weight  etc etc can all influence how their disease is presenting. AND it will fluctuate between good days and bad days. It is very, very difficult to manage!

    The next complication is there is not a definitive path that you should follow. Having hip dysplasia and secondary arthritis doesn’t definitely mean you need surgery. Many dogs are managed well with meds, weight management, lifestyle change and rehab. If they are not being managed well with those interventions then joint injections could be pursued, or surgery such as hip replacement of femoral head osteotomy.

    In honesty the path is dictated by the dog and how they are managing, the owner and what they can afford financially and time wise and the availability of the service.

    Your current choice will likely be dictated by pain state – if your dog is having a thorough multimodal approach with great weight control, adapted lifestyle, medication and complementary therapies and the dog is excelling with a great or improving quality of life, stamina on exercise – then you’re winning, and if things change in the future then you can pursue other interventions (joint injections and arthroplasties can be done at any stage in the disease). But if your dog is just hanging on with your current thorough interventions and you have the abilities to do more then I would advise seeing a dedicated practitioner that can look at your whole dog  all at once, front end, back end and middle end, and list you their current concerns and what their long-term plan that addresses ALL the concerns would be.

    With regards your rehab practitioner and your vet – have you asked them to have dialogue with each other so they can share the findings and thoughts for the best of your dog – 2 heads are generally better than one.

    If you do not feel you will get the level of care you need from either then I would say seek referral.

    regards

    Hannah

    Please head to Hollys Army our community group Facebook page –  you will be looked after there. There are also many many many videos of Canine Arthritis Management interviewing specialists on your YouTube channel https://www.youtube.com/channel/UCrEu7TDzQDM-IK2LHwfdrkA

  • CAM Forum User

    18 January 2022 at 4:15 pm

    Thank you so much Hannah!  The therapies and pain medication are working and have improved his lifestyle by about 60%.  The issue is my regular vet said not CCL but definitely HD and surgery needed now.  My rehab vet said HD doesn’t warrant surgery and feels that there is definitely injury to the CCL and thats where his limp stems from and not his hips.  So they have two totally different diagnosis which is why I’m confused.  His X-rays do show arthritic changes but I’ve seem much worse X-rays on dogs with HD than mine has. I’ve also learned that you treat the clinical symptoms and not the Xray which is what my rehab vet is doing.  My regular vet just said he should have FHO right away which is what led me to the rehab vet to see if I could manage it without surgery. His limp is only visible at the end of the day after he’s been lying down for a few hours but he walks out of it and then is fine.  I have him tentatively scheduled for stem cell and PRP but given the cost is about the same as a surgery I dont know if repairing his CCL first would ease the strain on his hips or not.  I have another dog who tore his CCL and that was a definitive surgical repair required as he could not bear weight on it at all but my Lab’s symptoms are confusing as sometimes it looks like hip pain and sometimes it looks like knee pain.  It may be worth taking him to see an orthopedic specialist so I know for sure everything he’s dealing with front end, back end and middle end like you said. Maybe that will help me understand what to treat and how to treat it going forward.  Thank you for your quick response!  I do follow Holly’s Army and just want to thank you all for this site and that group as it has been SO extremely helpful!!

  • CAM Responded

    18 January 2022 at 4:16 pm

    Very complicated situation as it definitely could be both. The hips could have led to the cruciate because of adapted use… very difficult.

    Hopefully approaching each at a time will result in improvement.

    I agree with your rehab vet – there is no going back after a FHO so if you are managing well then be reassured that you can go back to the surgery at a later date as needed.

    I personally would hope your 2 vets can discuss the case together to save you the cost of another vet, but sometimes fresh eyes is needed. I would seek a referral centre that offers you an ortho vet that works well with a rehab team, so they share knowledge xxxx

    Thanks for the compliments – it’s more than a labour of love ha ha… I must admit I think I opened Pandora ’s Box when I started this. It has turned into a beast!

    If you would like to support CAM then please pop over the shop and buy some business cards and start handing them out for other folk to benefit from our independent support xxx

    Love
    Hannah

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