Saturday, May 12, 2012

When It's Looks Too Good To Be True … The Lameness Returns

Last week Jasmine suddenly started limping on her front left leg terribly. It was such a shock. She was doing so poorly that I was worried that she was going to hurt something else in the process. A physical exam led to a decision to do a stem cell treatment as soon as possible.

That was Thursday of the last week. The treatment was planned for Wednesday of this week.

Then, as suddenly as it came, the lameness disappeared.

It already looked better on Friday, and during the weekend the lameness was completely gone. Could it be that it was just something minor and two days of rest were enough for it to resolve? It surely didn't look minor when it happened. It didn't look minor to her vet the next morning either. On the other hand, there was no sign of a problem any more. Should we cancel the treatment?

After a long discussion with Jasmine's vet it was decided to put the treatment on hold.

I was very conflicted about this. I certainly didn't want to put Jasmine through anesthesia when I didn't need to, but I was worried that if we cancel the treatment the problem will come back with a vengeance. You know, it was one of those things that just looked too good to be true … Plus this was Jasmine—Jasmine doesn't do simple problems that quickly resolve on their own. It was very baffling to me.

Either way, the decision has been made and I was just sitting there, waiting for disaster to strike.

Through  Monday, things still looked good. Perhaps I was just being too paranoid?

Surely enough, on Tuesday night, the night before the day of the now canceled treatment, the lameness returned. Figures! It wasn't anywhere near as bad as originally, but it was back.

We had canceled the treatment by kept the appointment, because I wanted her vet to check her out to see what he makes of such sudden recovery.

But now we were some place else again.

He was checking her out thoroughly, and for a long time. He felt that the character of the lameness had changed. There was more resistance to flexion and this time he felt a grind. This was also confusing, since the first time it looked really bad, while this time it felt much worse.

It was time to get x-rays to get a better picture and rule out bone fragment(s), as now that seemed to be the likely root of the problem.

The radiology appointment was made for Friday. We were prepared for the possibility that Jasmine might need arthroscopy to get that fixed.

Jasmine, as always, was very excited to go to see her vet again. She just loves the guy. She wasn't, however, very impressed when hubby handed her leash over to him and turned to leave the room. “Hey, wait, where are you going? This is not how it's done! We come here, visit, and go home. You don't leave me here (again)!”


I was on pins and needles.

It didn't help that I knew that my worry was not rational. The last time we just took her for x-rays it ended up in the biggest medical disaster Jasmine had to face. Yes, it was a coincidence. Yes, it didn't have a whole lot to do with the procedure itself. Yes, it likely saved her life. Yes, she had other procedures that required anesthesia since. But she almost died!

That's how phobias are born.

Before the examination, and taking the radiographs, the vet spent half an hour observing Jasmine's gait as she walked and trotted. Her weight-bearing has now shifted towards the back end.

Typical weight distribution in a healthy dog is 60% on the front limbs and 40% on the hind limbs.

In a dog who suffered knee injuries it is likely to change to 70 : 30, in compensation for the weaker rear end. Before the knee surgeries, Jasmine was compensating with her front even more than that, which resulted in arthritis in her shoulders. Her shoulders were visibly broader than they would normally be.

After the surgeries and stem cell treatment it shifted more towards normal, and her shoulders slimmed down again.

Now, though, it seems to be the elbows that were paying the price and the distribution is changing once again, exerting more stress on the rear end—hence her sore iliopsoas.

The good news is, that the x-rays didn't reveal any surprises.

The bad news is that her joints are more of a mess than she was letting on. That doesn't really shock me so much. She has a spirit on a two-year old, and she expects her body to keep up with that. You can try explaining to her how to behave like a senior dog, she'll have none of that. She lives by a rule “live full throttle, or die.”

Taking that away from her would mean killing her spirit.

As she came home today, still groggy from the sedation, we got a glimpse of that. That is not something we can allow to happen as long as we can help it.

So now we need to help her body to be able to keep up with her spirit. This means going back to the original plan of the stem cell treatment, except now we'll be injecting all four joints (the elbows and the knees). Hopefully we can set it up for Friday.

Our other options for her would be cartrophen injections or getting her back on the gabapentin. I can't tell we've seen the gabapentin ever done much good to her, and it wouldn't deal with the problem. The injections are great, but she doesn't respond to them as well as some other dogs do.

Acupuncture would be an option also, but with the travel, and with Jasmine still having four doses of stem cells banked, by the time all would be said and done, it would not end up any cheaper. She is already receiving cold laser therapy after her physio sessions. She also already is on joint supplements.

NSAIDs are out of the question for Jasmine, as when she was put on them in the past, it was the first time she almost died. Steroids is something that we're keeping as a last resort option.

Stem cell therapy is our best bet.

Related articles:
Jasmine's Acute Lameness
Jasmine Doesn't Like "Doing Time"
Our Of Jail Free Pass
When It's Looks Too Good To Be True … The Lameness Returns
The Day Of The Treatment
 First Time For Everything: A Healing Crisis(?)


***

Meet Jasmine
I'm Still Standing! (Happy Birthday, Jasmine)
How Dogs Think (Well, Jasmine Anyway)
How The Oddysey Started: Jasmine's ACL Injury
Jasmine is Vet-Stem's poster child!
Rant About Quality Of Life Versus Quantity, And Differential Diagnoses
Jasmine Is Headed For Her Next Stem Cell Treatment
Jasmine's Stem Cells Are In
Arthritis? What Arthritis? 
Guess Who Is An Ever-Ready Bunny And Really Liking The Bit Of Snow We Got? 
Don't Knock It Until You Tried It: Animal Chiropractic 
Jasmine's Fur Analysis
Back At Chiropractic Care

Further reading:
Jasmine’s Story: Can Chronic Diarrhea and Soft Tissue Injuries be Normal?
Jasmine’s Story: An ACL Injury and a Cancer Scare
Jasmine’s Condition Deteriorates: Another ACL Injury and an Abdominal Abscess
Jasmine Recovers from Surgery and Jana Discovers TCVM
Who’s Minding Your Pet’s Health?
Pet Owner Perspective On Stem Cell Therapy
Difficult to Manage Lameness Treated with Physical Therapy
Our Journey to Traditional Chinese Veterinary Medicine

6 comments

  1. Poor Jasmine,

    I'm sending her massive hugs for a speedy recovery…..

    Your pal Snoopy :)

    ReplyDelete
    Replies
    1. Thank you so much, Snoopy. Jasmine really enjoyed the hugs you sent!

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  2. I don't blame you for not wanting to unnecessarily put her under anesthesia. Any time Elka has had to go under, she's come home spacey and miserable.

    I've heard that acupuncture can do great things for dogs! That might be a great option for you.

    ReplyDelete
    Replies
    1. Well, now when we are fairly certain we know what's going on the stem cell treatment makes most sense. She still has some banked and we had very good results with it in the past.

      She was such a good girl for the x-rays that there is a chance that she'll just need to get sedated for the injections, rather than getting full anesthesia.

      Acupuncture is certainly great also. But we think that this will help her body to catch up with her spirit the best and the fastest.

      Delete
  3. Oh, wow. That's a lot to handle for both you and Jasmine. We're sending lots of healing thoughts your way!

    ReplyDelete
    Replies
    1. Thank you so much, seems that fate can always come up with new challenges for Jasmine.

      Delete

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