Tuesday, March 8, 2016

Cookie's Muscle Injuries: What Else Is Going On?

Cookie has been rehabbing from her iliopsoas injuries since November and was progressing well. She looked good, her range of motion was improving, her physio therapist was very happy with things and so were we.

Then, first thing starting the new year she got a case of zoomies and hurt herself again.

It wasn't immediately apparent; she didn't get sore until the evening of that day. But her hind left leg looked quite sore. In a new way. Could she have aggravated the left iliopsoas? And if that was the case, why did it look so different? The sore iliopsoas came with very little signs if any. This was quite a severe limp. We went back to the vet to see what might have happened this time.

Examination didn't reveal anything other than sore quadricept.

The iliopsoas seemed happy and the joints seemed happy. We went back to more rest but that was not helping at all by the looks of it. After a week or so of not getting anywhere with rest we resumed short leashed walks and things actually looked better.



All along I was concerned about her knees but the limp looked more like a hip issue if anything.

But the joints kept checking out at every exam and last x-rays were showing the hips as being good. What was going on then? Perhaps just the quad muscle after all.

So we kept rehabbing.

First two weeks there was very little improvement if any.

Then it started to look a bit better, until Cookie got her next zoomies. She was usually sore at night, which too would implicate muscle(s) rather than joints.

Her physical therapist, however, was seeing continuous improvement.

It was well possible that the quad was still not fully happy and getting stiff.

Time kept passing.

What if there was something else going on besides the muscles? But nothing was being found. It's been two months in and we were still getting set-backs on that hind left leg.

I know that sometimes it takes a long time for a muscle to get well.

But my gut wasn't happy. I kept thinking that perhaps we ought to keep looking. We took some videos of what Cookie looked like walking, sitting, getting up, doing play bows and doing her cavaletti exercises. I kept thinking we should try to tape her night soreness but the time window to do that was always very short because she walked out of it quickly, which, according to her therapist, was again a sign of a stiff muscle. And it was dark, how much would show on the video?

So it happens that on the day we decided we were going to try to film it no matter what was the day Cookie's leg got quite angry again.

We ended up getting some very good footage of what was concerning us.






When Cookie's physical therapist saw that, she agreed that something else might be going on. Her bet was the hip. The knee wasn't presenting anything that could be seen or felt during Cookie's rehab appointments. And it did look more like a hip issue to me as well. Plus Cookie always sits nice and square, never kicks her leg out. Except that it being the hip didn't make any sense.

Cookie's chiropractor too kept finding the same issues, no new ones.

What I didn't want to do, though, was going through months of rehab, then finding out something else is at play and going through more months of rehab for that.

We decided it was time to take new x-rays and see what examination under sedation might show.




The x-rays looked quite good but under sedation, the vet was able to get some mild drawer sign as well as tibial thrust on the left knee. Not the news I wanted to hear!

Cookie has a partial CCL tear in her left knee.

Was the ligament weak all along, being the "true" cause of the injury to the iliopsoas? Did it happen during the zoomies first day of the year? The x-rays aren't showing arthritis in the joint ... Either way, that's what we have to contend with now.

To be continued ...

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 
Cookie's Iliopsoas Injury: The Symptoms 
Cookie's Iliopsoas Injury: Battling the Zoomies


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. I hope Cookie is doing OK. I will watch for your new posts with updates. I don't know what is usually done for a partial tear, but I know you are very familiar with all the options. She looks so happy in all the videos, despite the pain she must be having.

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    Replies
    1. Lots of treatments for partial tear are the same as for full tear. Conservative management is used more for partials than full. Other than that, surgery.

      But these days, with a partial tear, regenerative medicine might work so we're going to give it a shot.

      She certainly is a happy girly and very enthusiastic. And very very loved.

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