Tuesday, January 26, 2016

Cookie's Iliopsoas Injury: The Symptoms

After all the medical challenges we've been through with our dogs, I thought that I could tell whenever ANYTHING was wrong.

I've seen it all, what could surprise me?

We've been through various soft tissue injuries, busted knee ligaments, hip problems, elbow problems, spine problems, infections, stings and cuts ... I've seen about every kind of lameness there is. I could tell if a dog was having a problem with a leg just by hearing how they got up and how they walked; didn't have to see anything. Or so I thought.


Cookie's sore iliopsoas eluded me.

It is true that every now and then I didn't like her gait when running. I fact, I never really liked her gain when she was running. But given the state of her pelvis and one hind leg being shorter than the other it seemed to make sense that it would reflect in how she moves.

And since her back end often needed a chiropractic adjustment, when I saw some discrepancies, I figured it was time for another one. Even though we've been doing those regularly, sometimes Cookie needed an additional appointment. Or so I thought.

Not that her spinal alignment wasn't messed up at those times.

I think there was only one or two times when Cookie didn't need [much] of an adjustment.

And then, somehow, at some point, she messed up her iliopsoas. And apart from the weird scary events, there wasn't anything to see.

There wasn't anything I saw.

So much for my all-seeing eye, huh? I still don't understand it.

Sure, in retrospective, there were some subtle things. But unfortunately, those could have been chalked up to any other ol' reason.

In the summer, sometimes Cookie would go for a walk a bit, play around and hunt her critters a bit, and then she'd decided to lay down. This could be half hour or two hours into the outing. Could that mean something? It was hot. Was that all that was?  That's what I thought at the time.

Couple of times, after she went running through the bush chasing critters, she'd come out slowly instead of her typical happy, rambunctious self. But she was running hard for quite a lot time and it was hot. Did that mean more than than?

There was some reluctance when jumping out of the truck some of the time. But we too figured it would have been from the pelvic region.

She didn't offer her belly for rubs as often. We figure she outgrew it. Ha, such a rookie mistake, wasn't it?



There was no lameness, no stiffness, no favoring of any leg a human eye could see.

Cookie's first scary event happened at home when she was resting in the afternoon. Nobody had any idea what that was all about. It came and went quickly and that was that. Everything was back to normal after that. No lameness, no stiffness, no nothing. Cookie was back to her active self.

Was that when the iliopsoas got initially injured?

Were they sore the whole time since? Were they sore ever before that? There was no way of telling.

All was perfectly fine until the next event in October. And right after that everything was normal again. Cookie's vet didn't find anything other that some pain response in the pelvic area. Cookie got an adjustment and the chiropractor's findings confirmed that there was indeed a problem there again.

Nothing else was amiss. Cookie was playing, running, jumping and hunting her critters as always.

Nobody was any wiser. I have seen all kinds of limps. There was none. After the event was over, it was over. The next event came sooner, a month later. That's when I decided that we have to get to the bottom of this and see what we can do to prevent these things from happening. We were all still convinced that the pelvis and the lower back were the culprit.

Nothing was found wrong with Cookie's knee or hips. No neurological issues were found, though the events surely did look like a neurological problem.

We decided to get a consultation with an orthopedic specialist.

And that's when she diagnosed this as iliopsoas injury.

Now, the day after the last event, Cookie's back muscles were in spasm. And after the exam she did exhibit visible issues. The exam was rather painful and I wonder whether it actually made things worse. It sure looked like it.

That all lasted about couple of weeks and after than she again seemed perfectly normal.

Only on her underwater treadmill it was apparent that some things are going on. Only with gentle stretching and manipulation resistance could be felt.


But how come things weren't way more obvious than that?

The typical signs of iliopsoas injury include:

1. Difficulty or stiffness when rising

Cookie never showed any of that.

2. Crying when rising or laying down

Cookie never showed any of that

3. Outward rotation of the leg when walking

I saw outward rotation of the leg when she was running, shortly before the last event. As I mentioned I did have issues with her gait when running in general but it was assumed that the pelvis was the reason.

Depending on the degree of the injury, other signs might include:
  • Decreased performance
  • Avoiding lifting leg when urinating, not squatting all the way down, avoiding full defecation position
  • Decreased extension on affected side
  • Changes in weight bearing
  • Pain behavior; painful lumbar region
  • Decreased activity level/performance
  • Pain with stretching of the hip
  • Pain with stretching into abduction
  •  Pain and spasm in groin and lumbar region
Sometimes, though, the only thing one might see is the lack of a smile after performance, which in Cookie's case is return from critter chasing.

That's how subtle this mess can be. Which brings me back to those times when Cookie came back from the bush slowly and looking tired, rather than bouncing back happily.

As if I needed any more excuses for seeing ghosts.

I think my only reasonable option is to learn how to palpate the iliopsoas and gently manipulate the legs to be able to find an issue that way.

Every other lameness, including Cookie's latest injury, was perfectly obvious, at least to me. The dog is either lame or not, right? Well, as I've learned, with the iliopsoas, not always.


Related articles:
From The End Of A Lead Line To Casa Jasmine: Meet Cookie, Our New Adoptee
And So It Begins Again(?) Our First Health-Related Heart Attack With Cookie 
I Didn't Know I Could Fly: Why Cookie Wears A Harness Instead Of A Collar
C.E.T. Oral Hygiene Chews For Dogs CAN Be A Choking Hazzard 
Our First Health-Related Heart Attack With Cookie: The Knee Or The Foot? 
Creative Solutions And An Incidental Product Review
Too Young For Pot: Cookie's Snack With A Side Of Hydrogen Peroxide  
Taming Of The Wild Beast: Cookie's Transition To Civilization  
Staying On Top Of The Ears: Cookie Is Not Impressed  
Putting The Easy Back Into Walking
Cookie's Ears Are Still Not Happy 
The Threat Of The Bulge Is Always Lurking 
Today Is Cookie's Three-Months Adoptoversary  
Cookie Meets The Electric Horse Fence And Her First Chiropractic Adjustment  
Why Examine Your Dog's Vomit? 
Why Is That Leg Still Not Happy? Cookie's Leg Keeps Getting Sore 
Cookie Too Is Insured With Trupanion
Does Being Insured Mean Being Covered? Our First Claim With Trupanion
Is Cookie's Leg Finally Getting Better?
Is Cookie Going To Be Another Medical Challenge Or Are We Looking To Closely? 
The Project That Is Cookie: Pancreatitis Up Close And Personal  
Pancreatitis: Cookie’s Blood Work   
Another Belly Upset: Pancreatitis Again Or Not?  
Happy Birthday, Cookie 
Incontinence? Cookie's Mysterious Leaks 
Who's Training Whom? Stick And Treat 
Don't Just Stand There, Do Something? Cookie's Mysterious Bumps 
Cookie's Mysterious Bumps Update
One Vomit, No Vomit 
Happy One-Year Adoptoversary, Cookie!
Cookie's Leaks Are Back: Garden Variety Incontinence Or Not?
Cookie's Leaks Update 
Don't Panic, Don't Panic: Know What Your Job Is 
The Continuing Saga Of Cookie's Leeks: Trying Chiropractic Approach 
Cookie's Minor Eye Irritation
Regular Wellness Exam: Cookie's ALT Was Elevated 
Cookie's Plantar Paw Pad Injury 
How Far To Take It When The Dog Isn't Sick?
Cookie Has Tapeworm Infection 
Cookie's Elevated ALT: The Ultrasound and Cytology  
Cookie's ALT Update
The Importance of Observation: Cookie's Chiropractic Adjustment
Sometimes You Don't Even Know What You're Looking at: Cookie's Scary "We Have No Idea What that Was" 
Living with an Incontinent Dog 
Summer Dangers: Cookie Gets Stung by a Bald-faced Hornet 
To Breathe or Not To Breathe: Cookie's Hind Legs Transiently Fail to Work (Again)
Figuring out What Might Be Going on with Cookie's Legs: The Process 
Figuring out What Might Be Going on with Cookie's Legs: The Diagnosis 
Cookie's Iliopsoas Injury Treatment: Trazodone  
Cookie's Iliopsoas Injury Treatment: Other Medications 
Cookie's Iliopsoas Injury Treatment: Laser, Hydrotherapy and Chiropractic 
Cookie's Recovery from Iliopsoas Injury: ToeGrips 
It Never Rains ... Cookie's New Injury 
Mixed Emotions: When What You Should Do Might Not Be What You Should Do for Your Dog 
Cookie's New Injury Update


Do you have a story to share?

Your story can help others, maybe even save a life!

What were the first signs you noticed? How did you dog get diagnosed? What treatment did/didn't work for you? What was your experience with your vet(s)? How did you cope with the challenges?

Email me, I'll be happy to hear from you!

2 comments

  1. Last week we were told that Sampson did a partial ACL tear in his 'good' leg. I'm not entirely convinced it's not that pesky Illiosoas. Like you I was watching him running and walking and thinking, I don't like the looks of that leg and his 'bad' leg (the one he already had ACL surgery on) turns out like you mentioned.

    I'm think a consult with an orthopedic might be in our future too. I hope Cookie is feeling better!!

    ReplyDelete
    Replies
    1. If they got positive or somewhat positive drawer test, they're probably right. But getting a second opinion is definitely a good plan. "Measure twice, cut once."

      Delete

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