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Lisa
Lisa, Certified Vet Tech
Category: Dog
Satisfied Customers: 13229
Experience:  AAS Vet Tech. Bully breed rehab & Behavior modification
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I have a two year, 3 month old chocolate lab who has been under

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I have a two year, 3 month old chocolate lab who has been under the doctor's care for over a month for a limp and swollen wrist. She had xrays and I was told she probably has panosteitis. She has been on two different types of antiinflamatory/pain medications and it is more swollen and she is limpiing and in more pain now than when I first brought her in. Any suggestions as to what else it might be? Also, what can I do to relieve her pain? Ice? Heat? Wrap? This really came about out of the blue.
Submitted: 8 months ago.
Category: Dog
Expert:  Lisa replied 8 months ago.
Hello! My name is XXXXX XXXXX it will be my pleasure to help you with your dog today.

May I ask what state you live in?

Did they do any blood work on her?

Has she ever had a tick on her?

Did they test for tick borne illnesses?

Do you know what antibiotics she was on when she initially started getting better?
Customer: replied 8 months ago.

Hi Lisa, I live in New Jersey. They did do blood work and tested for lyme disease, which they said was negative. The antibiotic was Metronidazole 500 mg - 20 tablets. She also was given CeRENia to stop vomiting and a Proviable kit which all helped with the vomiting and diarreah, but she never has stopped limping, and the swelling has progressively grown. The Metacam seemed to work better and be better on her sensitive stomach than the Rymadyl, which didn't seem to do anything but make her lose her appetite. I also remember a time toward the end of the summer when she was running around the edge of our pool and slipped and fell hard, but seemed to be alright at the time. The vet showed me the xrays and explained why she thought she might have panosteitis, and I could see the fuzziness in the bone area, but there was no marked swelling then, like there is now. She is not putting weight on it at all and is limping on 3 legs.

Expert:  Lisa replied 8 months ago.
Thanks for the additional information Wendy. I really appreciate it.

If the vet only checked for Lyme disease, then I would suggest asking him about testing for other tick borne illnesses such as Anaplasma and/or Ehrlichia. Both of these can present just like Lyme, but don't show up on a Lyme test. We find it most commonly on the 4DX test.

If that comes back negative, then it is possible that it really is Pano going on...with most dogs, we do see a worsening of symptoms before they get better, so it would be completely expected for her to get worse.

There's a great website about Panosteitis here: http://www.petmd.com/dog/conditions/musculoskeletal/c_multi_panosteitis

One thing that doesn't make sense to me is why your dog would suddenly have this since we most commonly see it in dogs under the age of 18months... if your vet is unable to figure out what is going on, you may want to ask for a referral to a veterinary orthopedic specialist...these are the guys who deal with bones all day, every day, so they'll absolutely be able to figure out what is going on with her.

I'll keep my fingers crossed for good news!!
Customer: replied 8 months ago.

Thank you Lisa! I also was wondering if that was the correct diagnosis for the same reason you mentioned. Is there anything that can be done to drain the fluid around the joint? It seems the more swollen it gets, the more painful it is. Also, I am not for from the University of Pennsylvania Veterinary Hospital (Ryan). Do you think I should try to get an appointment there, or would you know of a good veterinary orthopedic specialist in my area? I live in Mullica Hill, NJ, outside of Philadelphia, PA. Thank you, XXXXX XXXXX the website you referred me to.

Expert:  Lisa replied 8 months ago.
I would absolutely try to get into the U of Penn and see if they can figure things out.

You can definitely talk to them about options of draining the fluid around the joint...I think they may decide against it, only because they don't want to risk introducing bacteria/infection into the joint, but it never hurts to ask~!
Customer: replied 8 months ago.

Thanks again! Last question... What is the proper protocol? Should I make another appointment with my vet and let them know I'd like her to see a specialist so that the records can be transferred, or just make the appointment on my own and let the specialist start from scratch? I appreciate all of your help.

Expert:  Lisa replied 8 months ago.
At our clinic, we make the phone call to the specialist to let them know about the client/patient, and then the specialist generally calls the client to set up the appointment...however, every place has different protocols, so since she already has an appointment with her regular vet tomorrow, I'd just ask your vet to make the call.
Lisa, Certified Vet Tech
Category: Dog
Satisfied Customers: 13229
Experience: AAS Vet Tech. Bully breed rehab & Behavior modification
Lisa and other Dog Specialists are ready to help you
Expert:  Lisa replied 8 months ago.
Hi Wendy,

I'm just following up on our conversation about Addie. How is everything going?

Lisa
Customer: replied 8 months ago.
Hi Lisa, thanks for checking back with me. I took Addie to the Univ. of PA Thursday. She has osteosarcoma. Her leg was amputated today and will have chemotherapy to follow. As you probably already know, the prognosis is not good. We have her enrolled in a clinical study which could prolong her life. Needless to say, the future is uncertain with our girl but hope for more good days ahead. Only two short years old!
Expert:  Lisa replied 8 months ago.
That's horrible news Wendy...I'm so sorry that you and Addie are facing this. I'll keep my fingers crossed for her to have a good quality of life!!

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