My dog has been diagnosed with a slightly rougher/mishapen condyle edge in the back hock, the vet has given him some metacam and glyco-flex, and told me to keep him moving (lots of short walks) he doesnt believe in complete rest.... he's only 2.  I was wondering what I should now be expecting in the future?  will the problem go away at all, as it only appeared when he came a cropper on a walk and he has showed signs of great improvement since....  or do you think I should ask my vet to refer me to a specialist? or consider surgery?  as I said it is only slightly rougher.  I want to do the very best for him, so any tips are most welcome.... what complimentary treatments would be benificial and is there any special diet which can help as well?
please help!

Did you ask your vet if he thought it appropriate to see a specialist?  What did he say?  Perhaps he thinks conservative management is more appropriate first.

No I didnt ask about a specialist but thought about it afterwards..... 

I would take your vets advice for now, and see how he goes for a couple of weeks, if he is already showing improvement now. However, if he does not continue to improve, I would certainly request a referal to a specialist. vets are quite used to this now, and should be quite happy to oblige. This can be pricy, but should be covered if you have pet insurance. If not, get a quote first. Even the advice of someone specialised can be useful, and you will be given their guidance as to the future prospects of your dog, and any costs incured. never be afraid to ask. :)

Thanks for the advice, I am insured fully.
I was worrying a bit about asking the vet as I didnt want him to think I was insulting his judgement.... so you do think its best to see how he goes and not ask to be referred now?

Dont be afraid to ask the vet for a referal. You are not insulting his judgement, and if he feels this way then I personally wouldnt think much of him as a vet. You are paying the bill, both his and the specialist, and you have every right to request this. I know nothing about this condition, there could well be others on later that have had experiences with it, and can tell you what they have done, and how it worked out for them.

What would I do. Now, this is me personally, Im not a vet, but as to my opinion. I would want to know exactly what the condition was, and I would ring or go back to the vet for him to clarify the condition, and any treatments that may be necessary at a later date should it not improve. I would then do an internet search of vet based websites, to read about this condition myself. I would also request, as you have done, anyone on here, and collie websites, to see if anyone else has experiences of this condition and how they managed it. I don't know if what your vet has advised is the correct treatment, i would certainly hope so. :) If I found during my research that the opposite were true, I would want a second opinion, even if only from the senior vet at that practice. If, however, this way of treatment would be benificial, and it was simply a 'wait and see' for improvement or not, then that is what I would do. If no improvement, then I would consider the referal. I have been with animals all my life, and i know that sometimes vets do get it wrong, so I am never afraid to question, regardless of my being 'totally unqualified' to do so. :) It is not for me to dispute your vet or his treatment of your dog. This is a matter for you to decide, an informed choice is always a good one though :)

If you are feeling doubtful, make an appointment with the senior, more experienced vet at the same practice, who may be more reassuring.

You are not insulting his judgement if you ask his opinion on whether a specialist opinion will be useful.  You may find that he has conferred informally through his network anyway.  Obviously a lay person cannot judge for themselves as to the amount of relevent knowledge and experience their own vet has had but in my experience vets do not mind you asking anbd being intelligent, well educated peopel they have been trained to appreciate their own limitations :).

Sadly some vets do not know their limitations, and if the owner wants a second opinion there is no reason not to ask and for this to be forthcoming. Sadly vets make mistakes, which I have known personally, as have many others, and if a tricky surgery is to be performed, or advice given as to if this is necessary i would want someone who knows exactly what they are doing, who has trained in this area and has much knowledge and actual experience,  to give advice and guidance on it. As you have said yourself in other posts Isobel, no vet can be able to know everything about everything. I really dont know why you advise against specialists in given fields, against a general vet that does not have either the specialist facilities, staff or aftercare that a good specialist establishment will have. If I was going to have a delicate operation performed, I would want someone in that field to advise on if it actually was necessary in the first place, then if an op was needed I would want someone proficiant in that area to do it, not someone who may have done one or two a while back....maybe....or simply will do one because they were taught how too at medical school. I would want my animal operated on by someone who had done this proceedure a number of times and was good at it. No, I dont know how good the OPs vet is.....but can rest assured that a specialist will know what they are doing.......Thats the difference.

>I would want to know exactly what the condition was, and I would ring or go back to the vet for him to clarify the condition, and any treatments that may be necessary at a later date should it not improve.  I would then do an internet search of vet based websites, to read about this condition myself.<

By all means, talk more with the vet if you need more information, discuss possible action and use the internet but please bear in mind:

It isn't always that simple.  Orthopaedic conditions do not always lend themselves to a narrow, accurate diagnosis at the moment the animal is presented and it isn't always possible to predict the progression of a condition or necessary treatments.

Even a specialist, if consulted, may be giving only "the most likely" diagnosis of what the problem is and his "recommendation" for treatment, which might be hotly contested by another specialist in his department who has a different way of looking at things.  Some prefer early intervention, others take a more "wait and see" approach and there isn't one right answer clearly visible in every case.  It's not a question of right or wrong, it's a question of weighing up the evidence, reaching the most likely diagnosis and taking the most sensible course of action based on this.

>However, if he does not continue to improve, I would certainly request a referal to a specialist<

If the condition doesn't improve, then it's unlikely that your vet is going to continue with the current treatment regime.  Both you and the vet will be looking for the best outcome for this young dog.  :-)

I agree it isn't always that simple.  However, having been referred to an orthopedic specialist and a neurologist when Spends had his disc protrusion, I have to say I was very impressed with their knowledge, honestly, experience and professionalism.

They worked together as a professional team; the neurologist gave us a list of 5 possible scenarios based on a physical exam with a disc protrusion being top of the list.  They MRI scanned, found a protruded disc and operated.  Both spoke to us, explained in detail and suggested that surgery may be the best option to take the pressure of the cord but Spenders case was an unusual protrusion/exclusion and they couldn't give a prognosis whether surgery would be completely successful.  It would be a wait and see. 

They gave us the options, their opinions, we weighed up the pros and cons and made the final decision whether to go ahead or treat conservatively.  I have to say in my experience; both made my vets (2, I saw on that occasion) look like amateurs. (No disrespect to my vet or vets intended).  

I think it more likely that a vet will appreciate the situation than a layperson.
Obviously a delicate procedure may be best done by a specialist all I dispute is who is the best judge of what qualifies as a delicate, specialist necessary, procedure and, pardon if you take this personal, but I think a vet is better trained to appreciate that than you or anyone other layperson on a message board.

>>>>.who is the best judge of what qualifies as a delicate, specialist necessary, procedure and, pardon if you take this personal, but I think a vet is better trained to appreciate that than you <<<

I do not think only trained professionals can form an opinion as to whether or not a second opinion is needed & find that remark terribly condescending!

Believe it or not Isabel many many lay people are perfectly capable to make the decision of whether they want a second opinion for themselves :rolleyes:

They may be laypeople who believe themselves to be as well qualified as vets but as they have never been examined on the subject I am not sure they can ask the rest of us to believe it :)
The whole point of having professionals is they are carefully selected, extensively trained, examined, judged by their peers and regulated, most often by government legislation. That is really quite a lot up against what an unqualified board member can offer and if you think that is condescending I appologise :)

>I think it more likely that a vet will appreciate the situation than a layperson.

My vets were very appreciative, Isabel; so was I but I don't know if they were more so, but they were glad the specialist proved them wrong and my dog didn't have Degenerative Myelopathy (which is untreatable) as they diagnosed, and they were very impressed with the way my dog recovered. :-P

I think people are misunderstanding me :)  I am not saying we have no call for specialists, absolutely not!  It is the authority that posters are applying to the call for a specialist opinion that I question.

I think people are only stating what they either have done or would do if in similar circumstances Isabel - up to the OPs whether they follow up on that.

That's fine as long as it is clear that they do not speak with any authority or that the vets opinion is secondary to theirs otherwise I am afraid they will have to put up with my pennuth as well :)  For instance, asking the vet whether a specialist opinion would be appropriate is a far better suggestion to offer.

This is not a vet based nor a board for professionals, its perfectly clear its a forum of lay people with a lot of experience in the canine world.

And some who have just joined the world of dogs who maybe need advice & that can be given by those members.

Its common sense that any advice given here is by non professionals cos we are all lay people. (Sorry to any that professionals that might be lurking)

I doubt very much if people need reminding of this by you or anybody else Isabel :rolleyes:

The vet may be 'more qualified' but in many cases that dosent mean they are right or all knowing, and as we are paying the bill its up to us to do what we think is right for the dog, and as vets specialise in orthopeadics there is obviously a need for this, otherwise general vets would see to all operations. Its not simply the fact the vet may be able to give advice on something they may have little knowledge in, its all the experience the specialist has gained over time dealing with these things, knowing the subject intimatly rather than constantly having to refer to books to find the answers. I prefer experience every time, and without the strains of running a busy surgery the specialist vet has time to talk to the owner, explain all the ins and outs, take time over the operation in conditions that are well set up for this with the up to date equipment and nursing staff for aftercare whilst there. My opinion would be that any operation involving joints etc is delicate, as if done incorrectly the results could be devestating.

People come onto message boards as laypeople. They give their experiences of things that have actually happened, and things that have gone wrong through bad vet advice, and give their opinions on what they would have done could they turn back time, or what was actually done. It dosent mean those that turned to specialists fell out with their vet, but they did find using a specialist exceptionly rewarding and more importantly exceptionally good for the dog. Why do vets specialise if there is no need for it. Breeders are not (on the whole) vets or have formal qualifications in any vet field, but if experienced they have wonderful knowledge of their subject, and it seems from reading the posts here over time they are very often right when they say something relating to the subject when the vet may have not been so knowledgable, or even wrong. I'v not seen a post where anyone has actually said don't consult your vet, or don't take this advice, many of get a second opinion, or get back in touch with the vet, no one has ever tried to take over, but all experiences count as a background info for those that want to ask.

I think you will find vets have surgery hours and operating hours much as the specialist has consultation hours and operating hours.  As specialist will take from a wide area so I am not sure that your supposition that they will be less busy is correct :)
However I am all for using specialists when the referral is appropriate and if individuals cannot be happy but to see a specialist regardless of whether a professional has advised it appropriate that is up to them but I think advising others to do so over and above what the posters vet might advise is a different matter.  Vets do many invasion procudures that could cause damage if done incorrectly but their qualifications give them much more basis to decide what is within their scope than a layperson who has none.

>I am all for using specialists when the referral is appropriate and if individuals cannot be happy but to see a specialist regardless of whether a professional has advised it appropriate that is up to them.

Indeed, it is up to them.  In my case, my vet didn't refer me to a specialist, never even mentioned it.  He was adamant my dog had DM and that was that.   I disagreed, put my foot down and told him I wanted referral to a specialist ASAP. 

I am sure you are not saying that you were better qualified to judge than your vet :) so really it was just down to luck that you were right on this occasion.  Nor do we know that the vet would not have referred when their process of trial and elimination was complete and the dog did not improve.  Whatever individual stories there may be the fact remains the vet is a better judge than any of us as to the appropriatness of a referral.
You might say well what does it matter, every one could trail of to specialists and the dog would not suffer for it but listening to a programme on Radio 4 last week on medical ethics I was struck by one of the speakers comments which was "we should think very carefully before we do anything to damage the trust between a doctor and his patient" and I think that also applies to vets.

Obviously she was better qualified to judge than her vet on this occasion!  If as you say the vet had decided to refer to a specialist at a later stage, who is to say that the condition might not have deteriorated further by that time making specialist treatment unlikely to be successful?  Sorry Isabel, I can't agree that the vet is always a better judge than us as to the appropriateness of a referral - other factors besides expert knowledge can also play a part.  I also believe that if a client has a good working relationship with either their vet or their doctor, nothing that is said on here is likely to damage that.  Maybe we should also stop sidetracking this thread. :)

What other factors are more relevent that expert knowledge?

>I am sure you are not saying that you were better qualified to judge than your vet  so really it was just down to luck that you were right on this occasion.

No... I'm not better qualified than my vet Isabel...... and no...nothing was down to luck.  The difference between me and my vet is - I know my dog, I live with him, I know every inch of his body and I listen when something feels wrong.  I watch, listen and learn.  I knew by his attitude, the way he moved, the look on his face that it wasn't DM.  That wasn't to say he didn't have DM as a secondary issue at the time.  He didn't BTW.  Vets are human and only see the dog occasionally; as one vet said to me; she would love to have a crystal ball.

We know our dogs but we do not know all the possible orthopaedic conditions and their presentation unless we have had veterinary training. 
A crystal ball would be nice and would speed things up but a proper diagnostic procedure is the next best thing :)

The difference in orthopaedic symptoms compared to DM is quite notable.  But on looking back, it's was  an easy one to get confused with based on a physical exam.   Spender didn't exhibit any signs of pain when the vet examined him.  DM is common in older GSD's and he had the neurological deficits in the hind legs that matched the symptoms of DM.   DM can be a rule in after everything else is ruled out and I guess the vet may have thought it wasn't fair putting the dog through invasive testing just to rule in DM.  So I can see the vet's point of view.  I'm not expecting vet's to be super human or have a crystal ball.  But I'm aware that sometimes things are not quite what they seem.  I'm also fully aware that us humans are far from perfect.  Vets and me included.  :-D 

So tell me, what is the use of information message boards then. Breeders had also better stop giving advice, as had breed clubs because they don't have the training or medical knowledge of a vet that has spent years training. :rolleyes: Advice regarding feeding should be passed to the vet, no one should give advice regarding training unless qualified to do so. :(

I agree that message boards can have the idiots posting that may know nothing and give advice for the fun of it, but CD is exceptionally well regulated, and the members that post regulate it also, should anyone start the sillyness or give stupid advice they would be well stamped on. The wealth of experience in here is immense, it has helped many in the past and long may it continue to do so. :)

Specialists have time slots given to whatever the situation is, be that consultation or surgery, they don't have to dash off suddenly because the local farmers calf is stuck, or Joe Publics dog has been hit by a car. As I have said before, many vets dont know their limitations, unless they have done a proceedure before they dont know how successful they may be, and I for one dont want them practising on my dog! Its not simply the op itself, although that is important enough in itself, its the specialist having the knowledge to know if that is essential, if something else may work, and if the condition the general vet has diagnosed is actually the condition the dog is suffering with in the first place! :rolleyes: I may have no qualifications, but i do know that things can and do go wrong, spaying although put forward as an easy safe proceedure is not always the case, but vets dont say what the possible complications could be. No surgery is safe, but if its something that is not 'run of the mill' I would want specialist advice, firstly to ensure the condition is as said, that the op is necessary and nothing else will do, and that someone skilled in this will do the op so that I can feel assured that my dog is having the very best of care before, during and afterwards with follow up care and advice, that I can provide. I don't need to be qualified for this, simply a caring owner.

I suppose single handed vets might be on call as well as holding surgery but my single handed vet reciprocates with another local vet so as not to do this.
We could go round in circles discussing on what basis you are able to judge that "many vets dont know their limitations" but there does not seem much point as we have already done that.
There is a wealth of experience here but I don't think we should forget that for every breeder, multiple dog owner here it is unlikely that many have owned more dogs in a lifetime that a vet will see in just a couple of months of general practice and as most of us would hope that those dogs are generally healthy the possibilities of us meeting a faction of the conditions they deal with in the at time is minute so even our experience cannot compete with theirs let alone their training.  To me the best use of this message board is to urge veterinary opinion or to offer suggestions to be put to a vet that is working through a diagnostic process but at the end of the day the vets opinion will be of far more value not just on their training and experience but on the vital evidence of a physical examination and full medical history.

I see Vets as GPs.  Good at daily 'run of the mill' stuff, with obviously more knowledge than the average pet owner.;)  In the case of Vets as opposed to GPs, then they also carry out routine operations.  Castrations, spaying, simple fracture repairs make up their bread and butter.  Anything more than that, IMO needs specialist advice.

A bitch that I bred fractured her hock joint a couple of years ago.  I advised the owners to ask for referral to an Orthopaedic Surgeon.  They declined as they had great faith in their Vet.  He operated and the bitch was in great pain for a week (despite daily visits to the surgery) before the pin protruded out of the skin!  He operated again.  This time the flesh went black and he was talking about amputating the leg!  I insisted that the owners asked for a referral.  The bitch had a 3rd operation at the RVC and took 3 months to recover.  It should never have happened. :(

Veterinary medicine has not developed in the same way.  For instance all veterinary practitioners in the UK are qualified surgeons which is not the case with human General Practitioners.  Perhaps this is why the entrance requirements and training is higher for vets :)
Your would have to audit outcomes of all the operations carried out in specialist departments and compare them to those attempted in general practice to be able to say if there were poorer outcomes.  Anecdotal evidence is not much use really.

If they are all qualified surgeons, capable then of conducting all surgery, why do vets specialise? there should be absolutly no need to specialise, if what you say is correct. Maybe the newmarket horse hospital had best shut its doors, in fact any specialist hospital because, if that be the case, none of them are needed as all vets can carry out all proceedures. You would only need the tutors and a few cases of whatever needs to be operated on or treated to train the students on, when they qualify they can do it all. Makes me wonder why any vet specilaises at all.

I think I have already said I think there is a definately a role for specialists.  But general vets are trained in surgery so every operation does not need to go to a specialist and when it does they have sufficient training, certainly more than you and I, to judge that.

What makes you qualified to make that statement isobel?

You dont have to be a single handed vet at a busy practice to get multiple call outs! :D

Yes, vets will see more animals in their lifetime than any of us here will see, but that does not mean they will have seen and successfully dealt with every condition with evey animal they will have seen. Nor operated on every one. That is impossible. We have to remember, although this is a dog thread, that vets treat all animals, not just dogs, although i do realise that some vets within a practice will have a preference for larger or smaller animals. Whilst people in here may not have the full scope of knowledge for every animal and every condition, also impossible, if they have had a similar condition diagnosed, and can pass on what they have learned, why is that a bad thing? In their opinion they recommend a specialist because that worked for them, and the reasons why. To my mind, personal experience makes them more qualified to make that point than you who has not been there so don't know. As you too are unqualified, a layperson, it could be said that you are also not qualified to make the comment that a specialist is not required. Unless at the consultation, how can you know that the vet is correct in the diagnosis in any paticular case, even so you are not qualified, so just maybe your advice to stay with the vet could actually be wrong too :) See, with the greatest respect, it works both ways too. :)

I have never known my vet to leave the surgery but then specialist teams may be called to a emergency too for all I know :)

>but that does not mean they will have seen and successfully dealt with every condition with evey animal they will have seen. Nor operated on every one. That is impossible.

I'm not saying they have but I would say say the probabilities of them having had experiences are very much higher than ours.  In addition they will have regular journals, professional intranets, networks of other vets both general and specialist that they can refer to before they are obliged to the take the opinion of a layperson.

Just because your vet hasnt been called out during surgery does not mean it dosent happen Isobel. i know it can and it does, personal experience again.

Isabel, by saying that we should take the vets opinion in every case, leaving them to suggest a specialist, you are in fact saying that a vet has experience and knowledge of each case, be that from updates or hands on.

I'm saying the are far more likely to have that knowledge or access to it.

>As I have said before, many vets dont know their limitations,<

I think this is an unfair comment.  The vets I know are generally well aware of their limitations.

I would say that the use of information message boards is to trawl for information, ideas and suggestions.  I value enormously all three as given on this board but view them as just that.  I very much appreciate advice but reserve the right not to follow it and to disagree with it.

In all honesty, if my dog was facing orthopaedic surgery, I would ask if it required referral to a specialist.  But I would not assume that I knew the answer to that question in advance because someone with very special and important experience about other dog matters had "told" me it did or didn't.

You may think it unfair, but i stand by it from personal experience. gained over my lifetime, of living with all manner of animals whilst a growing up child, large and small, working with horses for many years as well as owning them, in all parts of the country, so I have met and have experience of a great many vets. Some I have found fantastic, some I wouldnt touch with a bargepole.

yes, I have said before in another post, information boards are just that, the passing of info and for each and every person to take from it what they will, and do with this info what they will. If that makes them ask questions from the vet then I dont see a problem with that, neither would a vet worth his salt. If, because of info received here I found out more about the condition the dog was suffering with and because of what I had read felt it more approprite to seek a second specialist opinion then I would ask for that. Obviously politly, but if it was refused I would then make my request a bit stronger, if I felt it was correct for the dog. I would also want a good explanation of why it wasnt deemed necessary. Same as I would if it was my child and I was consulting my GP. And I'm not a doctor either ;)

You may not wish to touch them with a barge pole and are probably better moving on but we have no basis to assume you are right, some people argue with their doctors over having antibiotics for a cold.
To claim that "many vets do not know their limitations" I would say you would have to be of a similar qualification.

This is your opinion Isobel, and as a layperson also, one you are entitled too. As I am entitled to mine, based on years of experience with many animals, not just a few dogs. Maybe if we shared the same experiences, you would be more open minded. :) Likewise, to claim that vets do know their limitations you would also have to be qualified to say this......:D

Owning animals may teach us good husbandry and observation of symptoms but it cannot teach us veterinary science and most importantly it does not examine us on the subject to demonstrate that we understand.
I don't have to be qualified to judge vets fortunately the professional system has evolved over centuries that all such highly qualified people are judged by their peers on behalf of us all not able to do so.
I think we are best leaving the debate over which view is the close minded one ;)

I think lots of us know our own animals.  I knew how poorly my dog was when he suffered his adverse reaction to his booster (sorry to go off topic) and the vet didn't.  He was out of his depth, which he admitted afterwards when it was too late and Spangler was dead. 

It's similar to children, when they are young we know by instinct when they are really poorly, regardless of what GP has advised.
That's the reason it's always best to speak your mind before it is too late - get a second opinion.

By asking for a second opinion you have nothing to lose, and a life could be lost if you don't!
Maria

Isobel If you are going to make observations over the competance of vets, as I have and you have critised me for, then you should also be a qualified vet. You put your thoughts over as if they are true and accurate, and put down everyone elses, yet in the way you put forward you are no more qualified than we to make these comments.

I accept that vets are highly trained, but with a full life having been spent I have seen both sides of very many things, and one of those is vet incompetance. If you don't wish to accept that this happens simply because this is not in your experience, then so be it, but to say others are not qualified to give an opinion based on their experiences, to which they don't have to be qualified, is a very closed viewpoint.

We will just have to disagree.  I am not saying it is impossible for vets to be wrong only that you are I are not able to judge whether they are.  For instance when they make a wrong diagnosis we can only really know if that is unreasonable if we can understand how difficult it is, what all the probabilities were and how many vets out of a hundred might have made the same diagnosis but the owner of that animal will, quite naturally, say that vet is a poor one.

I agree calmstorm.

I think maybe some vets know their own limitations, but there are certainly some that don't!  Again like you calmstorm I know this through experience.

I think the majority of people know that it's best to have a second opinion when you have no confidence in the opinion which has been given.  Lets not be under any illusion that all vets are god - there are good and bad in every practice, as with GP's!

 

Ditto C/S :D

>>>>but we have no basis to assume you are right,<<<

And by the same token we have no basis to assume you are right either Isabel ;):D

Right about what?  That they are best judged by their peers?  It's a system that has been in place for centuries for many professions supported by acts of parliament in many cases.