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Doctor I have a 12 year old Maltese with the same conditions

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as described above. He also...
Doctor I have a 12 year old Maltese with the same conditions as described above. He also has hip dysplasia in the left rear leg and the abdomen seems bigger ie rounder than the rest of the body. What could this be?
Submitted: 1 month ago.Category: Dog
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Answered in 4 hours by:
10/14/2017
Dog Specialist: Dr. Michael Salkin, Veterinarian replied 1 month ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 30,741
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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You're speaking with Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

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Dog Specialist: Dr. Michael Salkin, Veterinarian replied 1 month ago

I'm sorry that your question wasn't answered in a timely manner. Regretfully, I can't see what you're referring to as "the same conditions as described above" and so I'll need you to describe what you're seeing in your Maltese. If his abdomen appears swollen, it's either distended by gas in his intestinal tract, organomegaly (enlargement of his vital organs), or an abdominal effusion (free fluid in the abdominal cavity) which can occur from heart, liver, kidney, or bowel failure; or neoplasia or infection in the abdominal cavity.

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Customer reply replied 1 month ago
Hi Doctor sorry I had replied to a page above. I thought you would be able to see it.My 12 yr old maltese is a bit wobbly on his back left leg. His front shoulder bones protrude a bit and i feel that the hip bones at the back also are extra bony and can be felt. His weight is 4.15 - 4.25kg but his spine on the lower side can be felt and his tummy is round
Dog Specialist: Dr. Michael Salkin, Veterinarian replied 1 month ago

Thank you for the additional information. His back left leg (including his hip) may be osteoarthritic at his age or perhaps he has suffered a knee joint injury such as a ruptured anterior cruciate ligament. Conservative care involves the use of a prescription nonsteroidal antiinflammatory drug (NSAID) such as carprofen or meloxicam. Aspirin dosed at 10 mg per pound of body weight (22 mg per kg of body weight) with food at 12 hour intervals or acetaminophen (e.g., Tylenol) dosed at 7 mg per pound of body weight (15 mg per kg of body weight) thrice daily can be helpful if the prescription drugs aren't available where you live. Acetaminophen isn’t antiinflammatory as is aspirin, however. You must avoid the toxic ibuprofen and naproxen in dogs.

His tummy appears to be "pulling away" from the rest of his body making those bones appear more prominent. I would thoroughly examine such a patient and include X-rays of his abdomen as part of my examination. Please continue our conversation if you wish.

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Customer reply replied 1 month ago
Hi doctor he has had meloxicam before but doesnt seem to be in much pain. Is the aspirn anti inflammatory or for pain. He is still active up and down stairs and plays for a little while with our other maltese every day. Can i send you a picture or is xray the only way to diagnose. What is the meaning / significance of abdomen pulling away and how can this be treated.
Dog Specialist: Dr. Michael Salkin, Veterinarian replied 1 month ago

Aspirin is analgesic by its antiinflammatory action. An abdomen that is filled with fluid or has enlarged organs inside it will sag ("pull way from the rest of the body") and when it sags the spine, shoulders, and hips become more prominent. I'd like to see a photo(s). You can upload photos by using the paperclip or add file icon in the toolbar above your message box (if you can see those icons on your particular device) or you can use an external app such as dropbox.com/

Please check that the photo(s) is in focus prior to uploading it.

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Dog Specialist: Dr. Michael Salkin, Veterinarian replied 1 month ago

Thank you. He's actually ataxic ("drunken sailor") rather than lame. That's usually due to degenerative disk disease (a "slipped disk") in his spine although I need to consider fibrocartilaginous embolism (an interruption in the blood supply to his spinal cord) and a tumor in or around his spinal cord as well. I don't see abdominal distension in these pics or videos. You mentioned that he eats ravenously. Is he also drinking excessively?

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Customer reply replied 1 month ago
No he doesnt really drink a lot. He is drunken sailor indeed his back legs sway. I had considered tumor but hadnt been able to find any lump. His pain also doesnt seem to be markedly noticeable.Is there another view for a picture you would like. How do we rule out interrupted blood flow or tumor.And what is the treatment for slipped disk.
Dog Specialist: Dr. Michael Salkin, Veterinarian replied 1 month ago

Thank you once again. Only an MRI could "see" an embolism or spinal tumor (unless the tumor were so large it could be seen in an X-ray). Acute treatment involves a drug such as meloxicam, a skeletal muscle relaxant such as methocarbamol, and a narcotic analgesic such as tramadol. His ataxia isn't acute, however, and so it's unlikely that any of those drugs would be of value. As long as he isn't painful...and there's no indication that he is...treatment isn't necessary. No, you were thorough with your pics and videos. I don't need addition ones. Please continue our conversation if you wish.

There's likely to be geriatric muscle wasting around those bones which makes them more prominent. We can't make him younger!

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Customer reply replied 1 month ago
What would be the indication to give him meloxicam or not. Is he fine without medication? Should he be going for daily walks or is his walking around the house sufficient. Some days he jumps up onto the sofa and most days he is happy to climb up and down the stairs. Is there a hind leg brace / harness like orthodog that would give him relief.
Customer reply replied 1 month ago
Do you rule out hip dysplasia?
Dog Specialist: Dr. Michael Salkin, Veterinarian replied 1 month ago

I would consider meloxicam if he were painful but there's no evidence of pain (inappetence, shaking/trembling, vocalizing) and so he'll do just as well without medication. Yes, he should be allowed to move about uninhibited; he's not in the acute phase during which he movement should be restricted. No, bracing is contraindicated. A harness rather than a leash makes sense because his back problem could also be in his neck. He may be dysplastic as well but hip dysplasia doesn't cause ataxia. It does cause lameness, however.

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Customer reply replied 1 month ago
a forced walk for about 10 minutes every couple of days and the rest moving around the house is ok. He also jumps off the bed a lot whereas he has stairs to climb up on it which he doesnt always use. These are different from the house stairs which he also does as i mentioned on occassion
Dog Specialist: Dr. Michael Salkin, Veterinarian replied 1 month ago

Yes, all of those activities should be considered good physical therapy for him.

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Dog Specialist: Dr. Michael Salkin, Veterinarian replied 1 month ago
Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin
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Customer reply replied 28 days ago
His condition is chronic so some days are good and some slightly worse.
Dog Specialist: Dr. Michael Salkin, Veterinarian replied 28 days ago

I understand. Chronically affected dogs don't respond to medication as well as acutely affected dogs. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

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Dr. Michael Salkin
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 30,741
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Experience: University of California at Davis graduate veterinarian with 45 years of experience

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