Penny might be limping

Once again, we're wondering whether Penny is limping.

Because of the hot weather, we have taken shorter walks lately, which could be a good chance for Penny to rest a sore limb.

When I went out with her yesterday, I think I finally established that she is nodding her head as she steps on her left front leg, which would mean the pain is in the right front leg, according to this site.

Usually a dog will come down heavier on his healthy limb and avoid putting substantial weight on the limb that is bothering him. You can identify this by observing your dog's head when he walks. The comfortable limb will be placed on the ground and his head will go down at the same time. His head will tend to come up when the uncomfortable limb is on the ground.

She'll go to one of our favourite swimming spots, today, because in the water she can exercise without stressing a sore limb.  

When she comes home, we'll examine her nails and see if they are longer on one leg, because on this site I read:

Pets with rear leg pain often cary those legs father forward than normal and their hip on the affected side a bit higher. Pets with front led pain are often reluctant to move. When pets favor a leg over time, the toenails on that limb tend to be longer than on the others. That may be enough to identify the limb that is causing its abnormal walk.

Penny is still keen to go for walks and hurries in and out to the backyard when we go outside. She's been chasing toys in the park eagerly for the last few months, a practice we cut back after her surgery for a cruciate tear four years ago. (We throw the toy only a short distance, and along the ground, so that she runs straight with no swerving or sudden stops.)

She's been taking daily doses of Glyde joint supplement for eight years, so here's hoping the limp is only a temporary problem. A friend suggested that sometimes it's a good idea to give a dog a course of pain relief for a week and see if her behaviour changes. If the limp doesn't go away, we'll go to the vet and discuss options.

a dog enjoys the lovely autumn weather

With the mild weather we're having at the moment, Penny took the opportunity yesterday to relax on the swing on the back patio. It's lovely that her limp is gone. Perhaps the four injections of Cartrophen did the trick. Who knows?

We do still put a little table in front of the swing so Penny won't jar her joints jumping from that height, but otherwise she seems to be enjoying life.

Penny and the limp

Penny's limping once more. Or still limping, to be more exact.

After a month of seeing her limp when she gets up from lying down, and having tried complete rest; partial rest; massage; icing her front shoulder, swimming, we decided it was time to go back to the vet.

Of course she had no limp at the vet surgery. It was pretty difficult to assess Penny's gait, seeing she loves her vet so much that she throws herself at his feet all the time for a tummy rub, but he did his best, and of course he did all that disturbing limb manipulation, trying to find the soreness. Penny, like so many other dogs, is incredibly stoic, but the vet concluded that it is indeed her left front shoulder that is giving her trouble. Probably arthritis, sigh...

So she's having a course of cartrophen. One injection each week. She did have this once before, after her cruciate surgery, so we know she can tolerate this medication. The information on the site says it has no side effects, and our vet said the same thing, but I'm cynical enough to think that NOTHING has no side effects. But we'll settle for 'minimal side effects'.

The difference this time is that the vet suggested continuing with 'moderate exercise'. He used to advise resting a troublesome joint, so it was a pleasant surprise to be encouraged to keep her active. Given that in human medication the doctors and physios generally suggest keeping active after injury, I'm glad to get the same advice for Penny.

It's easy to restrain her from over-exercising, because the weather is awful lately. Hot, hot, hot every day. I've never known an autumn like this. Seeing we've just had the hottest summer ever recorded in Australia, it's frighteningly like what the climate change scientists have been predicting.

Good weather for swimming, though, and there's a nice little beach on the Yarra river up at Warringal Parklands.

And another swim at Kepala Canine Resort wouldn't go amiss.

Penny's feet

Two days ago, when we were bathing Penny's feet in cool water - as we currently do after every outing - we noticed the skin of one pad was peeling back.

Of course we didn't freak out and wonder if our current regimen of cleaning twice daily for ten days with Malacetic wipes and applying Elocon once a day for three days has wrecked her skin completely, or given her some dreadful skin-destroying disease - of course we didn't...

But, just in case, we thought a re-visit to the vet might clarify things.

He said the peeling skin is a sign that something was wrong with it and it is peeling back to healthy skin. Phew! When I think about it, she's had a horrible hard patch on her paw (it looked like callus) since last November. And that's the paw that is causing the limp. BTW, he found a similar development on the other front foot, and suggested something in her gait may be causing this.

He once again checked her limbs completely, trying out every joint and reassured us that this latest limp is not likely to be joint-related. (Always a relief, given her previous cruciate repair.) He suggested we continue to work on getting rid of the hard, peeling skin, and gave us some chlorhexidine to use. We're to wipe the two paws every couple of days, working deeply to wipe or pull the loose skin off. When he did it she didn't seem to find it painful. But I do know that, like other dogs, she doesn't readily admit to pain.

PetPlace says of this medication:

Overview

Chlorhexidine is classified as a disinfectant or cleanser. It is used both to treat environmental surfaces, and in less concentrated forms, to treat the skin, ears and oral cavity. It is effective against bacteria, fungus, yeast and viruses.
Chlorhexidine is an OTC (over the counter drug) but should not be administered unless under the supervision and guidance of a veterinarian.
Chlorhexidine is used in veterinary medicine for the treatment and prevention of dermatological (skin) conditions and for the management of ear infections (otitis externa) and gum disease.

And

This drug can be used in the treatment of superficial skin infections, irrigation (cleansing) of wounds and as a medicated shampoo for the treatment of certain skin conditions (hot spots or acute moist dermatitis).
Chlorhexidine is not effective against infections caused by parasites (such as worms and mites).

Okay, that sounds like a good plan.

But then I remembered I hadn't told the vet I've been wiping Penny's paws with aloe vera gel. I simply break off a piece of leaf and gently rub it into the underneath of her foot. She didn't seem to mind this at all, even when the paw was quite sore.





PLEASE NOTE: Saturday 10th March 2012 - I have a subsequent post that looks at the pros and cons of use of aloe vera in terms of its possible toxicity.

I'm going to continue with the aloe vera, as well as the chlorhexidine, as I don't see that they should counter each other. In looking around to check this, I came across this informative answer at AllExperts to a query about paw problems. I like this answer because although it talks about alternative therapies, it doesn't dismiss modern veterinary medicine. I thought it had a good balance.

The query was about an akita who was licking her paws. Here's part of the answer:

Allergies can cause constant licking and swelling of the paws and accumulation of debris, creating a moist, warm environment that can cause an overgrowth of bacteria, yeasts, fungi and demodectic mites. Chewing and superficial infection allow deeper penetration of these organisms into the skin, creating a very itchy, and hard to break cycle.

The problem is really two fold: If the suspected allergy is treated but not the skin infection, it is unlikely that your dog would have complete or lasting results.

So you see, because your dog is chewing at her paws, she's at risk for developing secondary infections on her skin, which can quickly get out of hand. That is why your vet told you to keep your dog's feet clean, and why you should strictly follow that advice.

Gently wash your dog's feet with peroxide, at least once a day. Dry your dog's feet very well. If your dog will allow it, a hair drier on the low setting would work well. If it's possible, wash your dog's feet when she comes in from outside too, since grass or pollens might be aggravating or causing the itch.

If you can't wash your dog's feet each time she comes in from being outside, simply soaking her feet for 5 or 10 minutes, four times a day, in cool water can help control licking. For additional relief, add a sprinkling of Epsom salts to the water (1 teaspoon in 2 cups of warm water). Again, it's really important that you dry the dog's feet well after a soak.

Your vet asked that you get back to her in a week, you need to do that if you haven't done so. Treatment for an allergy is a long term and complicated thing, it might take months to get it under control, and the first course of treatment might not work, so other medications would be needed.

Since the problem is continuing, your vet may want to run tests for fungus, bacteria, or parasites, or take a skin scraping sample. In addition, she may prescribe medications such as steroids (Prednisone) which quickly relieve irritation and break the "lick cycle."
These drugs have the added benefit of putting the brakes on the immune system, which produces the allergy symptoms. Finally, pets with severe allergies may undergo a series of shots to help desensitize them to whatever they are allergic to.
In some cases, the vet simply isn't able to find anything physically wrong, but can still treat for the symptoms.

And

Aside from the medication your vet prescribes, the following suggestions might help control the itching, but these are not a substitute for vet care, and you should tell your vet exactly what supplements or over the counter remedies you are using on your dog.

Along with washing your dog's feet with peroxide (which is important that you do), also try this:
Brew a cup of tea as you normally would (regular black tea, that you can drink), then soak a clean towel in the cooled tea to make a compress and apply it directly to your dog's paw for three to five minutes, up to five times a day. Tea can discolor fur, so don't be surprised if your pet seems to be wearing socks when you are done. Tea contains chemicals called "Tannins", which help dry rashes and ease irritated skin. Dry the paws well when you're done- with a hair drier if possible.


100% pure Aloe Vera gel (not a blend!) can be applied directly on the paws. Aloe Vera gel comes from the Aloe Vera succulent plant and contains enzymes which break down inflammatory proteins and enhance healing. It really stops itching, and you can use it on yourself too. If you happen to own a plant, just crack off a piece and rub it onto your dog's paws. You can use Aloe Vera gel 4-5 times a day and after cleaning or soaking the paws, or whenever you see your dog chewing at her feet. It's safe if your dog licks it.

There's lots more advice in the post, and I'm saving the whole thing to my computer, because it's one of the best overviews of paw licking that I've seen.

We're going back to the vet in ten days, so here's hoping that the problem will be resolved by then.

a ramp to help a limping dog

We've been lifting Penny up and down the thirteen - thirteen! - steps out the back and the one big step out the front, and we're sure getting tired of it, so I thought we'd better set up a ramp. Living in a household where nothing is ever thrown out has its advantages; just a glance around the garden and there they were, three big planks of wood.

Set up a couple of warning posts, so humans don't go for a sixer on the front patio, and we're set...



Now to train her to use it... clicker, treats, yep, we're ready to go. But what is this? She doesn't need any training - looks like all those 'dog walks' at agility with Cindy have paid off.

Penny and cruciate ligament surgery

Well, after consultations with three vets, weeks and weeks of rest, and x-rays, it has been decided; Penny is to have surgery on her left knee. (One thing I've found out over the course of these stressful weeks is that dogs only have knees on their back legs, which seems logical, as we are so closely related and only have two knees.)

We took a video of Penny with us when we went to the specialist vet clinic today - Advanced Vet Care - but didn't need to show it to the vet. I thought I'd post it here as it might be interesting to other people who see their dog has a limp and would like to see the symptoms.

What I see in the video is that when Penny gets up, she slips on the floor, and I think that might be because she is stiff. When she gets up speed - which we've been doing our best to prevent, I might say - she runs with her two back legs together, like 'bunny hops'. She goes about her normal wake-up routine and, just as we do every morning, we get our hopes up and say, "Oh, it's a miracle, she's recovered during the night". But it never lasts...

By evening, after a day spent mooching around, with no walks except toileting outside, she is stiff and sore - and horrifies us by stumbling and falling over as she leaves the kitchen.



The vet surgeon was great, and spent over an hour examining Penny and talking to us, and then he explained the operation. It's a version of the TPLO, which should return her to full mobility, but not for some months.

Veterinary Orthopedic Sports Medicine Group has clear explanations of the operation and the recovery schedule, so we've printed it out and we'll prepare for the long haul.

Our surgeon told us we can expect Penny to return to full use of her leg - well, not completely full, but it should be so good that we won't notice the difference, and she won't be in pain. It should also prevent the onset of arthritis. Here's hoping!

I'll include a few links that I've found helpful in this difficult time:
Woodhaven Labs
Marvista Vet
Joint Pain in Dogs

Pet Surgery Topics
Dog Knee Injury
Practical Tips for Diagnosing and Treating Meniscal Tears - a discussion paper for vets

dogs are funny and unpredictable

Living with a dog demands that we see the funny side of life.

Today Penny had her first off-lead walk in two weeks, after a long rest to see if we could settle her scary limp. I took her up our back lane, where we weren't likely to meet other dogs and where she could walk on flat ground.



When she threw herself onto the ground and began to roll around, I was pleased to think that she was revelling in the freedom from confinement.



But wait? Why did she keep rolling in the same spot? And why was she rubbing the side of her head on the same spot?

Yep. Dog poo.

So home to carefully wash the stink off her. (We don't want to bathe her at the moment, for fear of her jumping around and undoing the good all the resting has done.)

Life consists of short walks at the moment, usually about ten minutes. So, when she set off later in the morning for yet another stroll, it seemed like a good idea to try to film her gait and see whether we amateurs could figure out whether she is favoring her left rear knee. On the video tutorial I referred to in yesterday's post, it didn't seem too hard to film a dog walking.

But Penny wasn't having any of it. Why was her human hiding in the street and filming her? She had to check it out.



We did let her walk - the plan was, quietly and sedately - up two little steps to see how she moved, but as the end of the clip shows, she took it at a fast pace, so we hope we didn't do any harm. I guess tonight or tomorrow we'll know how she's been affected.

It's exciting to see her almost back to her old self, but we do realise that if she has a cruciate ligament injury we'll have to deal with it. At the moment, it's just a matter of taking things slowly and seeing how she goes .