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Dr. Gary
Dr. Gary, Dog Veterinarian
Category: Dog Veterinary
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Experience:  DVM, Emergency Veterinarian, BS (Physiology)
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If you had a 4 year old Rhodesian mix come in with signs of

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If you had a 4 year old Rhodesian mix come in with signs of arthritis, what would you think? Let me explain her history...

We got her from an animal shelter when she was about 2, and she had recurring ear infections. She also tended to throw up a lot so we put her on famotidine and that helped. Then, a year or so later, we moved from AZ to WA and she also developed frequent allergy symptoms and, after doing my own research, I decided to see if going gluten-free would help her. I now believe she is gluten allergic, or at least intolerant, as she often breaks out in hives and/or swells up (typically her eyelid or a foot) when she eats things other than her gluten-free food (we have a 2 yr old daughter, so food inevitably ends up on the floor). Switching her to a gluten-free diet a year ago has helped a lot - no more stomach problems and no more famotidine, only infrequent allergy symptoms that clear up with benedryl. However, she started showing signs of arthritis about 14 months ago, when the allergy symptoms seemed the worst. ---- On a different note, before we left AZ, she was bitten by ticks - 5 that we know of. We have done at least two, maybe 3 lime titers (I can't remember because there were so many vet visits) and all have been negative. Her multiple vets have done blood work, xrays, she gets regular vaccinations, etc. but no one can determine the cause of her arthritic symptoms as nothing has been abnormal. The biggest symptom is that she has trouble getting up from laying or sitting, especially when she's been napping for a while. Once she gets up, she's rather spry, and she still loves to go on walks, though we don't take her often as we're afraid of over-exercising her. (Last year we took her a park and she ran all over and the next day began a series of shifting lameness from foot to foot that lasted over a week. She couldn't even get up to go to the bathroom so my husband and I had to carry her (70lbs!) out and hold her up to go potty. Her doc gave her doxycycline, I believe, and she got better in about a week. Thankfully, we have not had a repeat of this, but we certainly don't let her run much anymore!) We now have a 2-story house and all of the bedrooms are upstairs, and she manages to get up and down, but not with the ease she should have. She goes up and down the stairs typically once a day (night and morning) as she is a very loving and sensitive dog and she would not stand for sleeping in a room away from her mommy and daddy :)

Since her arthritic symptoms appeared last year, she has been on 75mg of Rimadyl 2x/day, and this seems to keep her comfortable. As the weather started to cool a few months ago, we got her heating pads for her 2 beds, and that also seems to help, but it would be really great to know what the problems actually is and not have to have her on medication for the rest of her life, let alone something that could eventually affect her organ functions. We can't afford to do a ton of diagnostic testing as we've already spent a few thousand on it, so we've just been in maintenance mode over the last year. But she's so young and I want her to be able to thoroughly enjoy life and be comfortable and happy so I really wish we could help her more.

Anyway, I stumbled across this site and thought I'd take a stab in the dark and see if you might have a suggestion. I realize I put a lot of information in here, and I apologize if it is confusing; I just know that sometimes the symptoms you think aren't related actually are, so I didn't want to leave anything out. Let me know what you think. Thanks in advance!
Hello, I'm Dr Gary. I've been practicing veterinary medicine since 2007. I look forward to helping with your questions/ concerns.

This is pretty young for a dog to develop arthritis. It is very possible that she's older than 4 and they had her age wrong at the shelter. I could see them having a 4 or 5 year old dog and calling it 2 if they didn't know any better. Just one thought.

I would guess that she had some hip dysplasia that has now turned into hip/ pelvis arthritis. If you could get the x-rays on a disc and save them as jpeg images, you can post here and I'd be happy to look at them for you. I bet there is some bone remodeling that is consistent with hip dysplasia and secondary arthritis.

If this is due to arthritis in the pelvis, then we can do surgery to make these guys more comfortable. We do an FHO (femoral head osteotomy) procedure. We basically remove the head of the femur (thigh bone) so that there is no more bone on bone contact in the hip. We do the one is worse first. Some dogs need both sides done. They will then have what is called a "false joint." There is no ball and socket anymore, but the large thigh muscles hold the leg in place. They usually have a good prognosis and they are getting around pretty well within a day or two of surgery. They are in less pain immediately post operatively than they were with that bone on bone contact.

If it's arthritis in the knees and ankles (hocks) as opposed to the hips, then we have to manage it medically. Dogs can be on Rimadyl lifelong. We prefer to monitor kidney and liver enzymes every 6 months, but it's an option. You can also drop down on the dose to 50 mg twice daily or 75 mg once daily for the days that she is feeling better.

You can also add other pain meds like Tramadol or Gabapentin or Amantadine as needed if Rimadyl is not enough. I also like to put them on a joint supplement like Glucosamine/ Chondroitin to help with joint health.

I hope this helps give you some ideas, let me know if you have any other questions.

Customer: replied 3 years ago.

Two separate vets have viewed the xrays (we moved and had to change docs) and both agreed there was nothing on the xray that was abnormal. As you might imagine, they specifically looked for signs of hip dysplasia and arthritis. I do have the xrays on a dvd somewhere, but I'm not sure where... And I just don't think they'll help. Her current doc said we could take her to a diagnostic clinic and have her see a neurologist and an orthopedist and whomever else might be able to find something, but we don't have a ton of money to do all of that. No offense, but I didn't really think I was going to get any new suggestions, I just wanted to try.

If the x-rays are normal, then it's probably spinal disease. With spinal or neurologic disease, we don't see anything on the x-rays. The only way to diagnose those dogs is with an MRI of the spine. It could also be Degenerative Myelopathy where there is degeneration of the nerves and how quickly they fire signals. Being a Rhodesian, we would also have to put Dermoid Cysts on the list. This is where there is a tract from the spinal cord to the skin. This can lead to meningitis and pain/ weakness in the hind limbs. Again, x-rays are not helpful and an MRI is needed.

If you want to go the route of an MRI, a neurologist consult would be ideal. They do typically run ~ 1500. It's a lot, but you would get a final diagnosis.
Customer: replied 3 years ago.

Okay, these are definitely new ideas. If it was 1) spinal or neurologic disease, or 2) degenerative myelopathy, or 3) dermoid cysts, what would be the prognoses and treatment options? I am almost positive my husband wouldn't agree to $1,500 for an MRI...

1. If it's a disc herniation and compression on the spinal nerve roots, we treat similarly with pain meds and rest. There is a surgery option to remove the disc. That runs ~ 5000-7000.

2. Degenerative Myelopathy is managed with steroids- Prednisone. It's not curable, but we can help slow down the progression. Eventually it moves to the front legs and these dogs are euthanized due to poor quality of life.

3. Dermoid cysts are removed surgically. Secondary meningitis is managed with pain meds (Tramadol, Gabapentin) and antibiotics (Baytril or Clindamycin).

Dr. Gary and 4 other Dog Veterinary Specialists are ready to help you
Hi Shena,

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

Dr. Gary