Quote: Betty Landercasp

What is the working diagnosis here? I don't see any arthritis. What is the differential diagnosis? What are they looking to see in the MRI?

Before you spend a ton I'd want to know what exactly will the MRI show us that will change treatment plan.

Oh Dr. Betty, that's exactly what I needed to hear. Some very specific questions.

I printed this off and while I was doing that, I thought, wouldn't it be wonderful to have someone knowledgeable like that talking to these people. Can I PM you this Dr's phone number. I'll pay for the calls, whatever it takes.

I don't have confidence or faith because I'm not getting any real answers but maybe I'm just not asking the right questions.

There's some spurry type looking things on the x-ray of lumbars (hey, how's that for a medical terminology start) that she says is arthritis. They're supposed to be flat???

And this prednisone, I fully understand what Joyce is saying and I'm prepared now for almost anything. In your opinion, based on potential neurological issues, should I get him off the meloxicam and onto this stuff?

I won't give him his pill tomorrow and start that process. She said she could order it into my nearest pharmacy.

I am certainly not a Vet, but my understanding is if there is any sort of inflammation that could be pressing on the nerves, that this protocol for a high dose of prednisone, would in fact help that situation and alleviate it, if that is the trouble.

I believe that Meloxicam acts more slowly, over time and therefore not the drug of choice when dealing with nerve issues involving more inflammation.

CJ, you and Vince are in my prayers.

Okay, since this was one of the recommendations, maybe I should I do the prednisone.

I will call her tomorrow and see if I can get an answer on the 48 or 72 hour detox.

She's done a lot a talking, most I can understand but some is a bit much. I've just done a lot of listening.

I will ask Dr. Betty's questions (unless of course Dr. Betty will call ) and see if I can get something more specific. I guess this is what I was hoping for with the written report.

From what she's said so far, they don't have a clear view. I think they're looking to pin point exactly what's happening between the lower lumbars, 7 and 8. She hasn't really said anything about a treatment plan, surgery, what have you. I need to ask that. It's been "alluded" to though. If we need to go in....

ETA: Thank you Ben.

Neat, didn't know we had a vet/doc on the board.

I know I implied this already, but I'd go for the pred too until the MRI shows anything more.

Hey if this makes you feel any more hopeful, Sport's pelvis and spine were both broken (and they didn't think she should have had surgery) so even though her injuries were severe, she was able to walk and run again (and did agility). It was a miracle really, the vet wanted us to put her down...said she'd never walk again.

CJ,

So sorry to hear about Vince. If you can see a specialist, I would do it. About 9 years ago (?), my dog had a similar problem but it was not due to an injury. She had "knuckling" (that is what you are seeing with the failure to replace the foot correctly), crouching when walking, and urine leakage. We saw an neurosurgeon at the Univ. of California Davis Vet school (these symptoms can all be neurological). It was indeed very expensive. But on the other hand, I did not feel that money was spent on procedures that were not going to help the situation.

Since it was so long ago, things may have changed and technology has probably improved. At the time, the specialist kept her for a few days to evaluate her problem with several departments (for one orthopedics) and be able to see the big picture. I don't remember if they did an MRI. But, the big test for our dog was a myelogram (sp?). However, the procedure used at the time required that we agree to spinal surgery before they even did the test. That was necessary because the myelogtam was done under anesthesia, and once the problem was found they went straight into surgery to fix it. The myelogram itself was not without risk from the injection into the spinal column. And, we went ahead with the procedure. In our case, they didn't find anything that could be fixed surgically on the myelogram. My dog's littemate however developed the same issue and did require two spinal surgical procedures and physical therapy (hydro too).

Our dog recovered with medication, extendive crate rest, and physical therapy. We never found out what the problem really was, but we were happy it eventually went away. The vet school had cautioned us that it might be and indication of DM later in her life. That never happened ... thank God.

There is hope. Ask as many questions as you can. You can only make a decision with all of the information. My prayers are with Vince and your family.

 Quote: CJ Barrett

I don't have confidence or faith because I'm not getting any real answers but maybe I'm just not asking the right questions.

CJ, you are in a tough situation because this Dr. is new to you; no relationship to fall back on. Communication is probably stilted at best, but will improve as you become more comfortable with her.

Prednisone is an excellent anti-inflammatory. I would probably pursue that option too.

 Quote: CJ Barrett

There's some spurry type looking things on the x-ray of lumbars (hey, how's that for a medical terminology start) that she says is arthritis. They're supposed to be flat???

Lumbar....very fancy word; are you a vet? I am glad Vince is showing some improvement. That is a very good thing. And Thor and I will continue to send healing thoughts and prayers.

Thank you Tresa, I do believe in miracles and know that we are all humans and vets can make mistakes too. I guess it concerns me when we’re dealing with our "pets", which of course they are but Vince's back and legs and butt and ears are just as precious to me as my own. And I guess I'm just so scared to make the wrong move. We’re not millionaires and are at the disposal of people we hope know what they are doing.

It's funny, I get pelvis and spine and would even go so far as hips, but this vets into the lumbar and sacrum and vertebrae and invertebrae.

I feel a bit wiser today after yesterday's study session but I have no idea how to cure any of this or what will or will not bring down inflammation or if that's right or wrong.

We have to advocate so hard for them sometimes and when it comes to these complicated medical things, I just feel so helpless.

But it's okay, I have to believe these things happen for a reason. We’ll get through it.

And Sheila, you're just too funny, love it! Check out those words in paragraph 2 up there and get this, I actually know what they mean now. And you're pretty intuitive. One of the big things (on my mind) that I did today was make sure everything was getting sent to my vet. He makes sense.

Mary, thank you for sharing that.

And I’m just wondering about the antibiotics now. He's got a couple days left on those. Are these going to react at all with the prednisone?

My last dog went through a few courses of prednisone. Once for erhlichia (auto-immune suppression) with doxycycline (an antibiotic) and a couple times for severe neck pain. It was a miracle drug for the neck pain. He'd be on full dose for three days, then we'd wean him off it over the course of a week or so. Not a big deal.

On the pred, he drank more, peed more, was hungry all the time, and lost some muscle tone, but it was a wonderful solution to his crippling pain/inflammation. I would not hesitate to go this course with Vince.

One thing I've learned after desperately throwing money at vets to help my last dog in his final months, is NEVER do a test/procedure that will not give you information that will either change your treatment options, or give your dog a better quality of life. If it is just to satisfy your vet's curiosity, or to get a definitive diagnosis, don't do it. I know I wanted to do everything I possibly could for my boy. I think overall, I made some bad decisions.

I would find out exactly what benefits an MRI would have. How it would or could change your treatment options. And how successful those treatment options would be versus a less invasive course of rest/anti-inflammatories/course of prednisone/physical therapy.

With a humans, an MRI isn't a big deal. We can lie still for it. A dog must be sedated, and if I remember correctly even completely anesthetized. It is therefore a more major procedure. One I would hesitate to do unless some good would come of it.

I think antibiotics are important to give a full course of because you don't want antibiotic resistant infection in Vince on top of everything else. Your vet can tell you for sure if it would interact with prednisone, but I don't think they are generally eliminated in the same way by the body and don't have compounding effects on liver/kidneys. Maybe Dr. Betty knows?

Any chance cortisone shots would help Vince? Dr. Betty?

I think gradual improvement is a great sign. Nerve/spinal issues can be weird. One of my friends just had a surfing accident and 'bruised' his spinal cord. He is getting the best treatment and tests available, but the doctors can not tell him anything other than that he may never have feeling below the waist or even full upper body strength, or he may recover 100%. These things are really iffy.

Improvement for Vince, already= super.

I think you may be looking at a case where you give the predisone, then anti-inflammatories, you make Vince rest (so hard, I know), and then gradual strengthening exercises and physical therapy and he may improve and get back to his old self on his own.

If he were getting worse I would advocate getting him to a teaching hospital ASAP. From what I'm hearing, you may be looking at a slow return to normal.

I am by no means a veterinary professional, but I've seen people and dogs beat the odds many times.

Keep positive. I feel encouraged by your updates.