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Dr. Andy
Dr. Andy, Medical Director
Category: Veterinary
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Experience:  UC Davis graduate, Interests: Dermatology, Internal Medicine, Pain Management
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I have a 5 1/2 female Shih Tzu/Beagle mix that has limped occasionally

Resolved Question:

I have a 5 1/2 female Shih Tzu/Beagle mix that has limped occasionally for the past year, and is no longer interested in taking walks (bascially refuses to, even when not limping). About three weeks ago, she began limping much worse, and continuously. One thing that seemed to make it worse was when she stepped into a mole hole, and went into the hole all the way up to her hip. She immediately began limping worse, and it has not gone away. Three vets have examined her, and she had x-rays, blood work, and urinalysis. She was tested for Cushings Disease. All tests were negative, except her thyroid function is low. The vet gave us medicine to give the dog twice a day for the thyroid condition. She still limps as much as ever. She sits to eat her food. When she goes out side, she sits down immediately. The affected leg appears to be the right hind leg. She holds it up sometimes when standing. She seems unable to put weight on it. I would like a recommendation.
Submitted: 4 years ago.
Category: Veterinary
Expert:  Dr. Andy replied 4 years ago.
Chat Conversation Started
Dr. Andy :

Hello. A few comments.

Dr. Andy :

The #1 injury to a hind leg is a partial or complete tear of the cruciate ligament. If the x-rays didn't include the stifle (knee) that must be done next. In addition, vets in a hurry or not paying careful attention will skip doing a very simple test to help rule-out a cruciate tear.

Dr. Andy :

This test is called a cranial drawer. I would ask your vet if they did it. If they say they did, and it was normal, find another vet and confirm it. If they didn't do it, ask for a courtesy exam because it should have been done.

Dr. Andy :

Next....treatment.

Dr. Andy :

Absolutely, it is time to try a good non-steroidal anti-inflammatory. Rimadyl, Deramaxx or Metacam will do. In addition, I would ask your vet for a pain medication called Tramadol to complement one of the other drugs.

Dr. Andy :

It will be trial and error. Let's see what the medications can do to help the comfort of that leg.

Dr. Andy :

So, to summarize:

Dr. Andy :

A follow up with your vet if they ever properly did a cranial drawer test (a simple manipulation of the leg) to rule-out a cruciate ligament tear.

Dr. Andy :

X-rays. Make sure knee x-rays were taken. Not to look for fractures, but to look for fluid accumulation in the knee joint.

Dr. Andy :

and the trial with the medications mentioned.

Dr. Andy :

That's it.

Dr. Andy :

Dr. Andy

Dr. Andy :

Please remember to click "ACCEPT", so JustAnswer recognizes me for addressing the question. It is greatly appreciated.


Thanks. XXXXX

Expert:  Dr. Andy replied 4 years ago.
Chat Conversation Ended

If you are still working with your Expert on this question, you can post additional replies and receive additional information on this page.  If you received a satisfactory answer in Chat, you can accept the chat conversation above.
Expert:  Dr. Andy replied 4 years ago.

The #1 injury to a hind leg is a partial or complete tear of the cruciate ligament. If the x-rays didn't include the stifle (knee) that must be done next. In addition, vets in a hurry or not paying careful attention will skip doing a very simple test to help rule-out a cruciate tear.

8:36 PM

This test is called a cranial drawer. I would ask your vet if they did it. If they say they did, and it was normal, find another vet and confirm it. If they didn't do it, ask for a courtesy exam because it should have been done.

8:36 PM

Next....treatment.

8:37 PM

Absolutely, it is time to try a good non-steroidal anti-inflammatory. Rimadyl, Deramaxx or Metacam will do. In addition, I would ask your vet for a pain medication called Tramadol to complement one of the other drugs.

8:37 PM

It will be trial and error. Let's see what the medications can do to help the comfort of that leg.

8:38 PM

So, to summarize:

8:38 PM

A follow up with your vet if they ever properly did a cranial drawer test (a simple manipulation of the leg) to rule-out a cruciate ligament tear.

8:38 PM

X-rays. Make sure knee x-rays were taken. Not to look for fractures, but to look for fluid accumulation in the knee joint.

8:38 PM

and the trial with the medications mentioned.

8:39 PM

That's it.

8:39 PM

Dr. Andy

8:39 PM

Please remember to click "ACCEPT", so JustAnswer recognizes me for addressing the question. It is greatly appreciated.

Thanks. Dr. Andy

Customer: replied 4 years ago.
<p>I understand. However, the dog (Gabby) was on anti-inflammatory and pain medications for a week. There was no effect. Although I realize the anti-inflammatory may need longer than that to take effect, one of the vets felt that since he was unable to diagnose her condition, it might be best not to give her a medication that could be inappropriate. The pain medication makes her very lethargic, to the point I was having to carry her outside and back in. Without the pain medicine, she will at least try to talk.</p><p>Also, none of the vets have been able to identify any sore spot when they manipulate her hind leg (either leg). The xrays show normal knees and hip. There was no obvious fluid build up.</p>
Expert:  Dr. Andy replied 4 years ago.

Okay. I would say time for an evaluation by a neurologist. I know this isn't necessarily a neurologic problem, but what you need is a specialist who can do a thorough orthopedic and neurologic evaluation of the leg.

 

This is a good idea anyway, because they will review all the records and x-rays as a seocnd opinion as well.

 

I don't agree with not giving the non-steroidal. Certainly, we can make some assumptions that there is probably some inflammation at the root cause of the problem, and to give nothing is not right. I would consider maybe switching NSAIDs to see if one is more helpful.

 

Dr. Andy

Dr. Andy, Medical Director
Category: Veterinary
Satisfied Customers: 28296
Experience: UC Davis graduate, Interests: Dermatology, Internal Medicine, Pain Management
Dr. Andy and 5 other Veterinary Specialists are ready to help you
Customer: replied 4 years ago.

By the way, I am satisfied with your responsiveness, and I will accept your answer, but I have one more question. How do I find a veterinarian who is both a neurologist and an orthopedist in Dayton, Ohio? This sounds like I will need to go to The Ohio State University. Is there any sort of online directory of veterinarian specialists? I have looked but I haven't found one.

 

Thanks you for the help. Gabby is an incredibly cute and lovable little animal. I really want to find the right medica help for her.

 

Mark

Expert:  Dr. Andy replied 4 years ago.

Yes.

 

 

Find Various Specialists

--> Under "specialty" select SAIM = Small Animal Internal Medicine

--> Or, you can search for a Neurologist, Cardiologist or Oncologist

 

For an orthopedist, you would want just a regular surgeon:

 

 

http://www.acvs.org/AboutTheACVS/DiplomateDirectory/

 

 

Dr. Andy

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