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Topic Dog Boards / Health / Undiagnosed after 6 weeks, and still in pain
- By Susie72 [gb] Date 04.09.11 12:04 UTC
Nellie, my 4 year old patterdale, injured herself 6 weeks ago (careered across the rug and crashed into the fireplace, doing the splits front and back).  She's seen 4 GP vets, had x-rays, seen an orthopaedic specialist and 2 physiotherapists, and we still do not have a definitive diagnosis.

She hasn't had an MRI scan as yet - the specialist wanted to hold off to see if she improved first, as he found no evidence of structural defect/damage to bone or cruciate ligaments, and all but ruled out a spinal/disc issue as there are no neurological symptoms.  He even examined her for abdominal pain.  He felt it was possible this is simply soft tissue damage ( a muscle tear around the sacro-iliac junction, maybe) which will resolve on it's own.

All we know at the moment is that she is favouring her right hip, and after 6 weeks is now showing significant atrophy on that side of her quarters, and is building up muscle in her shoulders.  She has made some limited progress - initially she was unwilling to move around or even stand up, now she is virtually "normal" indoors, other than not being able to jump up/down or step backwards. 

The physio has encouraged us to exercise her gently - I do some stretching and balancing work with her - and I also try to walk her a little.  But even 6 weeks after the original injury, she is unable to maintain a regular pace for more than a few minutes.  She can walk enthusiastically at first, beginning with some excitable skipping around (and yelling her head off) when leaving the house, and even pulling on the lead a little at a brisk trot.  But she fades after 8-9 minutes, slowing into a pained walk. Her back roaches up, her head and tail goes down, and she throws all her weight onto her front paws and paddles her hindlegs feebly behind her.

I scoop her up and carry her home as soon as her gait starts to change, where she'll head directly to her bed, and lay down in an awkward position (presumably the only way she feels comfortable).  She'll stay there like that, sometimes panting in pain, with her eyes open and pupils dilated, for anything from 10 minutes to an hour.

Once rested/recovered, she'll revert back to her old self, and after a while will even pester me to take her out again.

I suppose I'm posting to see if anyone recognises these symptoms or has any inspiration as to the problem!  We are disputing an exclusion in her insurance policy which would prevent an MRI scan being covered - we aren't really in a financial position to pluck £1,800 out of thin air - so if the insurance company are feeling reasonable, we may be able to have her scanned in the next week.

But the specialist AND physio seemed sceptical that anything would show up. :(  What are we supposed to do?  I'm frightened she'll never make a 100% recovery.
- By Nikita [gb] Date 04.09.11 15:41 UTC
I still think a visit from a chiropractor might help.  If nothing else, it'll help keep her a bit more comfortable - if she's favouring her hip so much that there is atrophy in her muscles, then it's going to be putting significant pressure on her body in an unnatural way which could be causing pain/discomfort in itself. 

Even if it is a soft tissue injury they can help - my boy whacked his should a good one years ago and it took him 6 months to recover, no evidence of any damage anywhere but he was lame for a long time - had the chiro look at him and he'd knocked one vertebra slightly out of place when he did it, the vet didn't realise after an x-ray and two very, very thorough exams, but having it set straight made a big difference to his recovery.  Sometimes the misalignment is very small and easily missed but very painful - my own probably wouldn't show on x-rays but I tell you, when it pings it's agony (did it last weekend - couldn't move for half an hour and needed tramadol just to move around for 3 days).

McTimoney chiropractors are very gentle - it's not like people with all the violence and crunchy popping noises!  Just gentle tweaks and flicks.  Next chiro I go to will be a McTimoney (I can pop my back myself lol!).

I do hope you get some answers soon for her :-)
- By PennyGC [gb] Date 04.09.11 16:32 UTC
I agree a chiropractor would be a good idea - it sounds like it may be a sacro-iliac issue.  I had a fall (from a horse) and couldn't bear any weight on one leg and nothing apparently showed on an x-ray but visit to chiropractor and I was good as new.  He couldn't believe they hadn't noticed the sacro-iliac out - it's like a rib, only attached one end and it was pushed out of place.  People can do it kicking a step - they don't have to fall 5' at 25mph apparently!  I blame the branch which pushed me off. 
- By Susie72 [gb] Date 05.09.11 19:00 UTC
Thank you for those replies. :)

I have steered clear of chiropractors for now....Nellie very much dislikes being touched, and the physio hasn't been able to do much with her (other than deliver laser treatment), so I doubt a chiro would be able to exert much pressure anywhere - at least, not at the moment.

I have, however, just had a very interesting discussion with her vet.  6 weeks from the original onset of symptoms - which we have assumed to be due to her little accident - she is now virtually normal at home, but still shows some muscle atrophy, a stiff/stilted gait and exercise intolerance.  The next thing they want to rule out is a muscle disorder - specifically one of the variations of myositis (polymyositis, I think - affects many muscle groups and could be due to auto-immune disease).

So depending on whether the insurance company agree to cover her, our next move is a muscle biopsy and steroids. :(

I have found some info on the net (in vet articles/manuals etc), but as yet have found no-one with personal experience of polymyositis - only MMM, which is the one that affects the jaw.......
- By PennyGC [gb] Date 06.09.11 10:57 UTC
interesting about muscle, good luck with that. Going back to chiropractors as someone said earlier if you find a McTimoney they don't use pressure at all, it's like a flicking action which your dog may be able to tolerate.  I had a collie who was very touch sensitive and when we went to a physio he was fine as long as the physio told him exactly what he was doing - if he tried to sneak anything in the dog objected.. he couldn't do everything but enough to make a difference.  The other treatment that this dog found ok (objected initially) was a magnet therapy wand - he went from running at the sound to lying down and holding up the poorly paw!  You can get them online, mine cost about £95 but believe there are cheaper - but they're worth it!
- By tohme Date 06.09.11 21:14 UTC
Have the MRI if you can afford it/if insuance covers it.

There are several conditions that do not show up on x rays, neurological testing and cannot be diagnosed by chiropractics etc.

You will then KNOW hopefully what is wrong with your dog and whether or not a chiropractic will be of benefit, no benefit or even contra indicated.

I use a physio and chiro for my dogs, but some conditions are only revealed by MRI.
Topic Dog Boards / Health / Undiagnosed after 6 weeks, and still in pain

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