Monday, April 29, 2013

Bella's boo-boo

I've mentioned in passing over the last few months that Bella is dealing with an injury. Today, I'll fill you in on what she did, what we've done, how she did and how she's doing. Tonight, we'll start with the timeline.

Back in September when we had our first fabulous family vacation in a number of years, Bella spent much time doing zoomies on the beach. The first night we were there, we noticed she had a limp when she stood up after resting for a while.

We didn't think much of it at the time. She had injured her left shoulder when she was a little more than a year old and on occasion ever since would show just a slight limp when rising after a good night sleep. But she would shake it off after a couple of steps and never really seemed bothered by it. In cold, wet weather, maybe she would limp a couple of times in a day but it never persisted longer than that.

So when she started limping on vacation, we gave her a couple of aspirin and thought nothing more of it.

Only this time, it didn't go away in a couple of days. And after a few days, it didn't ease up after a couple of steps. She started limping more consistently. Sometimes slight, sometimes considerably more pronounced.


So we called our vet. (October 15, 2012)

Here's something we learned about Bella through this: she's a pretty damn good little actress. And capable of being much more stoic than I'd ever imagined. Our little, limpy girl at home didn't even flinch at the vet's office. She didn't limp, she didn't grimace at the pulls and tugs. Of course, she's afraid of people so basically, she shuts down when the vet handles her. But in this case, it made it much more difficult to identify and treat the issue.

Anyway, the vet found nothing wrong and told us to rest her for awhile - no running, no jumping, definitely no zoomies. So we cancelled Agility class for a couple of weeks and waited.

And called the vet - again. (November 1, 2012)

At home she was still limping even after no exercise for a couple of weeks. The vet ordered x-rays. Her blood work was checked. Thankfully nothing notable there. No indications of Lyme, cancer or arthritis.

We scheduled an exam with a visiting orthopedic specialist (November 16, 2012).

Luckily, by this time we had wised up to her "Nothing to see here" routine and sent a video of her at home in to our vet before the appointment with the specialist.

They couldn't believe their eyes. The specialist actually said, "It's a good thing you sent the video. She looks like a completely different dog."

Next up, an ultrasound. (December 12, 2012)

The specialist said at the time of his examination, he thought Bella had the equivalent of a human's torn rotator cuff and he wanted to do an ultrasound because she didn't react to the examination. That didn't show anything either. Apparently, there are some muscles/tendons/ligaments that they can't really get a good view of even when they have a dog under sedation.

We were sent home with a two-week dose of carprofen (Rimadyl) and instructions for "strict exercise restriction". I will have much to say about Rimadyl in another post, however, the bright side is, she did show improvement while she was on the drug. But the very day she came off it, she was limping again.

As for the exercise restriction, if you're keeping track, Bella hadn't been allowed to exercise at this point since September and we were working our way into January. With any other dog, this might be an inconvenience, a cause of mischief. In Bella's case, it can lead to bad behavior much more severe.

And it didn't help anyway.

January 2013 had us investigating rehab as an option and I've got some amazing video of Bella in the underwater treadmill tank to share coming soon. But, while that was providing a semi-controlled environment to get her the exercise she needed to not flip out on us, it didn't seem to be fixing anything either.


Finally, in March, we set up an appointment with a renowned neurologist in Boston to see if he could tell us what was wrong and what to do. He was a bit confused because to him, the injury was obvious: Left should biceps tendon tenosynovitis. (As noted earlier: the equivalent of a human's torn rotator cuff.) And he didn't know why we had been made to wait so long to do something about it.

He gave us a couple of options - steroid injections or ultrasonic shock wave therapy. Since he wanted to aspirate the shoulder joint anyway to confirm the diagnosis and degree of injury, he recommended we start with the steroid injection and he would draw the fluid at the same time.

Confirmation came on March 27, 2013.

We went with Dr. Sisson's recommendation of having the steroid injection and aspirating the joint at the same time and his diagnosis was confirmed: Bella had "moderate, chronic inflammation in her left shoulder joint". The effects of the steroid treatment were real but not long-lasting (as had been explained to us as a possibility) and a second treatment was performed on 4/16/2013.

We are now a full two weeks out from that second treatment and Bella seems to have gained considerable relief from it. She even had a moment yesterday when both Jan and I cringed as she ran around the backyard. Much to our relief, she has not come up lame again yet as a result of her escapades. (Do not underestimate how difficult it can be to keep a crazy dog from doing unexpected zoomies.)

We start back in agility class on Wednesday and yesterday I started jogging with Bella on the path around the yard. (About 1/8 mile, maybe?) We did two nice, slow, deliberate and controlled laps to start working her muscles again and begin to get her toned. Good exercise for her, good exercise for me.

Cross your fingers and toes, paws and claws that Bella continues to show steady improvement as we gradually work her body back in shape. I do have some fun stories to share about our experiences during this whole ordeal and will later weigh in with my opinion on various canine health care issues ranging from pet insurance (positive) to the use of Rimadyl as the pain management drug of choice of many veterinarians (not positive).



I am proud to say Bella has been a real trooper through this entire ordeal taking vet visits, surgical procedures and even home improvement renovations right in stride. Even without exercise, her stress levels have remained controllable (although we're having some issues with her sleeping habits at the moment). She's been a champ through this whole thing and has barely raised her voice to Jan even when he has had some less-than-spectacularly-thoughtful moments like trying to offer her a massage while she's nomming on a bully bone. (Really, Jan? Doh!)


Mysterious illnesses and injuries. We've had more than a few here in Blogville. Have you suffered at the hands of not knowing what the heck was wrong with your dog? How'd you manage to keep your spirits up and keep pursuing answers? Did you ever feel like you were the only one who cared? Or have you worked with extraordinary vets who go the extra mile because they're driven to help? Let us know in the comments.




And thanks to Alfie, Snoopy, Luna and My Brown Newfies for bringing us the Monday Mischief Pet Blog Hop.

Make sure you hop on through to the other blogs and see what trouble our various critters can get into over the weekend.

22 comments:

  1. We dealt with Canine Cognitive Disorder with Lilac, and thought we'd lose our minds along with her. The only help our vet's office offered us was a very expensive drug that we simply couldn't afford and it only works part of the time. Finally, I found melatonin and it changed things so much for us! She finally slept through the night again and so did we.

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  2. Oh, poor baby, sending healing thoughts.


    We had more than our share of mysteries. The last one ended with Jasmine's passing :-(

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  3. Oh I am so glad to hear she's been properly diagnosed and getting better from the treatments! YAY!!! :D


    Waggin at ya,
    Roo

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  4. Wow, so glad you thought of the video tape to help in Bella's diagnosis. I'll have to remember that little trick.


    Looking forward to hearing your thoughts on Rimadyl. I didn't have an awful experience with it when it was prescribed for Agatha's arthritis. But I found she did as well or better on natural treatments prescribed by our naturopathic vet.


    I suspect that vets get a lot of Rimadyl samples from the drug companies. It's a very effective way to get drugs prescribed by human doctors so I doubt it would be any different with vets.

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  5. We feel like we are the experts in mysterious illnesses and injuries. Since September, R has had weird red and white blood cells that usually indicate hemangiosarcoma. Many tests later, no tumors were found. So, we have been watching and waiting ever since. Fortunately, we live near a world-class vet hospital (CSC teaching hospital) and have their advice. However, we just keep waiting for the other shoe to drop (although we try hard not to think about it).


    I'm so glad that you've finally made some progress with Bella. Exercise is so key to a dog's happiness and to mellowing them out. I can only imagine how hard it is for Bella not to get much of it. Our R (yes, him again) has obsessive-compulsive disorder, and when he can't exercise normally, it takes off. We're in a phase like that right now due to a flare-up in his elbow that had dysplasia surgery when he was a pup. He drinks and pees, and drinks and pees, and drinks and pees. You get the picture. Drinking water is his obsession.

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  6. Jan K, Wag N Woof PetsApril 30, 2013 at 8:45 AM

    So glad to hear that Bella has been (finally) diagnosed and it's looking like she's on the mend! Hope it continues. We've had mysteries here too, one dog and one cat. Both are seniors, and sometimes it's hard to figure out how to much to put them through to solve the mysteries, or since they've ruled out all the bad things, if their quality of life is OK by just not pursuing it. It certainly is never simple. Also interested to hear your experience with Rimadyl since we've had two dogs on it short term and didn't have any issues. But our vet does not seem to give it out without being very sure it is needed.

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  7. So glad you did find someone that would help and things seem right on track with Bella.

    This sounds so familiar to us!! In January after a strenuous hike Teach came up lame on his left hind leg. We did rest, Rimadyl (not happy about having to be on that), x-rays and more rest. The vet said the only thing that he could see in his x-rays was his knee caps were riding high on his legs (he called it patella alta) and was going to send his x-rays off to a specialist. Sent us home with more Rimadyl and just wait to hear back from VA Tech (this was . Fast forward almost 3 months ... the x-rays were never sent, he seems completely fine now and stopped taking Rimadyl about a week after the x-rays. He is back in regular exercise and competing in Rally. Very aggravating the vet never did what he said he would, but at least things seem fine now. We're chalking it up to sprained ligaments/muscles.

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  8. If only they could tell us exactly what was wrong. I'm glad she seems to be on the mend.

    Sam

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  9. Two French BulldogsApril 30, 2013 at 9:35 AM

    Gosh, poor baby. The video was really a good idea
    Benny & Lily

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  10. Good for you for being such a trooper, Bella! Love that photo of you and the daffodil - just beautiful!

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  11. We all are keeping our fingers and paws crossed that Bella continues to improve! We have been very lucky in that none of the pack have experienced anything serious. Again, I am so glad that Bella has the two of you looking out for her. Be sure and keep us posted!

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  12. Glad you were able to find someone that could find the answer! Veterinary specialists are awesome! I have given Shiner Rimadyl before but it upset her stomach as it does in some dogs. I don't think it's for everyone... it's an NSAID so it's not without some degree of possible side effects. But, I have seen it work for many dogs.

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  13. When my traditional vet fails me, i go to the holistic vet and I find him to be incredible. I'm glad Bella is finally feeling better, it's been a long road for you.

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  14. Oh, jeez. What an ordeal! Thank goodness you finally have a diagnosis and a plan! I'm looking forward to reading about your experiences with Rimadyl because we're at a point with Lucas' hips where our vet has sort of said that's probably our next step. I'm super curious about your experience!

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  15. I'm SO glad y'all got an accurate diagnosis and good treatment! Our pups are fine, but we had a mysterious chicken issue. She cleared it up when she died in her sleep. She was just really old.

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  16. I'm so glad Bella is finally on her way to feeling better! It can be really frustrating just trying to figure out what is going on and not being able to help anything until you do.

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  17. Dontcha just love when they act like nothings wrong at the vet? It was really brilliant to do the video. See...she's faking (when she's in YOUR OFFICE.) LOL! Not that her injury is funny, of course. Especially after all the worry she's cased. I'm so glad to hear this newest treatment is giving her such a steady improvement. Hope she keeps on getting better. :-)

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  18. Wow! We have been through a similar chain with Brychwyn but still no clear diagnosis. It always helps to ask a vet about something specific so I may bring up the tendon tenosynovitis with the next specialist on our quest...

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  19. Sometimes it takes time to get to the bottom of an injury but usually we figure it out.

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  20. So glad she is feeling better ;) The mysteries are what drive us crazy aren't they? Our vet finally used the "c" word the other day, which did not make either of us happy :( So happy that Bella is doing better.

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  21. What a trooper Bella has been! I'm so glad you know whats at the source and you're getting back to real life.

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  22. oh gosh, bella. if it's not one thing it's another. what are we going to do with you? glad to hear things seem to be turning around!

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