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.
