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Motor or Motion Problems
Difficulty walking with back legs
Movement problems in Sheltie
Exertional Hyperthermia
Exertional rhabdomyolysis
Trembling in rear legs
Hind leg weakness in Maltese
Osteoarthritis and nerve damage
Weakness in rear legs
also see Arthritis
also see Lameness
also see Neurological Problems
also see Orthopedic Problems
Difficulty walking with back legs in English BulldogQuestion: Hello,
I have a four year old American Bulldog who has paresis in his hind legs
that is progressively getting worse. The best way to describe his
condition is that his rear end looks drunk. We had his spine and hips
X-Rayed and looked at by both a neurologist and radiologist. In both
cases they didn't see anything that might be causing this. We ran tests
for Neospora Caninum and Toxoplasmosis , the Neospora Caninum test came
back negative, but the Toxoplasmosis test came back with a slightly
elevated levels. However my veterinarian feels that this may have been
from a previous exposure and is not causing his current condition. To be
on the safe side my vet prescribed Doxycline and wants to test him again
in a few weeks to determine if these low levels are declining or
increasing.I have been sending email to all American Bulldog breeders I can find
and have received plenty of replies, with suggestions ranging from a
pinched nerve to meningitis. Also I have contacted the breeder who I
purchased my dog from and he has seen this in my dogs Uncle and Aunt. He
has not been able to get a diagnosis and may put his dog (the Aunt) down
to have an autopsy performed (she is really doing badly). This has led
my veterinarian to believe that this is a hereditary based disease and
feels we won't be able to diagnose this until we can get a spinal biopsy
from one of the dogs. However I received a reply to an email from a
person in Washington who's American Bulldog has the same condition that
they were unable to diagnose as well.My veterinarian has been very receptive to any suggestions and has
encouraged me to continue to find out anything I can. So that's why I'm
writing you.
Is it likely that this is genetically based or possibly even meningitis?Do you have any suggestions or ideas?
Thank you....
Dennis
Answer: Dennis-
For a condition like this that is affecting primarily the rear limbs, a
problem with an intervertebral disc, instability of the lumbo-sacral
junction (cauda equina syndrome) or other spinal cord injury seems likely.
The most reliable test for documenting these problems is an MRI, based on
work done at Colorado State University and the University of Washington.
Disc problems are often inapparent on plain X-rays and are even inapparent
when myelograms (X-rays with dye around the spine) are done in some
instances based on the work at the two universities. The lumbosacral
instability problem is also more likely to show up in MRI or CT scans than
on plain X-rays.We have seen one or two patients that we really thought had spinal cord
disorders that actually had bilateral cruciate ligament ruptures. We missed
the first one of these because we were just convinced that the problem was
spinal. This was in a German shepherd and she got weaker and weaker for
about three weeks and then began to gradually get stronger (the owners
refused surgery) and was doing well about three months later.There was a literature reference to canine myotonia, a degenerative
muscular disorder that was reported to have a higher incidence in chow
chows and Staffordshire terriers (Kortz, 1989) which caused progressive
muscular weakness and stiffness but this is reported to show up pretty
early in affected dogs, as early as 8 weeks of age. If you were not seeing
any evidence of problems until recently, this is probably unlikely. The
American bulldog is one of the breeds that is sometimes mentioned as
susceptible to this condition but I do not have any idea what the
prevalence in the breed might be.I will try to check to see if there are any other neuromuscular disorders
that are peculiar to this breed but found none on the initial search
through the literature I have here. In the meantime, if the neurologist
only saw the X-rays and not the dog, it might really be worthwhile to get
your vet to refer you to the neurologist for an initial examination and
then decide what sort of work up is necessary from there.Mike Richards, DVM
6/12/2001
Question: My nine year old Sheltie is having problems, probably arthritis, rigid movement. Rough shedding coat (I have him on a oil internally Lenten), tongue sticks out 1/2 to 1" at times. Think he is getting cataracts.
I am a naturopath and looking for natural help for him. Thanks.
Frances
Answer: Frances-
It is a good idea to try to get an accurate diagnosis of the cause of the movement problems. Arthritis
is an easy assumption because it is the most common cause of problems in older pets but there are
lots of causes of arthritis and the treatments vary some. In addition, there are other disorders that can
lead to movement difficulties, such as spinal problems, hyperadrenocorticism, hypothyroidism,
cruciate ligament injuries, bone cancer, heart disease and polymyositis. Arthritis can occur due to
degenerative joint disease (the typical arthritis that people think of), from Lyme disease, from immune
mediated disease, bacterial infections, systemic lupus erythematosus and other conditions. If a
specific cause for the problems can be identified through examination, X-rays, aspiration from
affected joints or other diagnostic tests, it is possible to tailor the treatment to the specific problem.For arthritis, the combination of glucosamine and chondroitin helps many dogs. This is a
"nutriceutical" and is usually dosed at 500mg of glucosamine and 400mg of chondroitin for every 25
pounds of body weight. (1 of the standard tablets per 25 lbs. of body weight). Accupuncture is
reported to help dogs that have arthritis. If there is a veterinarian in your area well versed in the use
of herbs, it is possible that there are herbal treatments that might be helpful. I like aspirin a lot for the
treatment of arthritis but that might not fit into your treatment philosophy.I can't really think of many causes of a tongue sticking out a lot. This occurs in some dogs with
hydrocephalus or other brain disorders but it seems unlikely that is the case. If the canine teeth are
missing it is hard for dogs to keep their tongues in their mouth entirely. Those are the reasons that I
can think of for this problem but there may be others and it might just be a behavioral thing.I couldn't understand what was happening with the hair coat. Is shedding occurring in clumps or just
not occurring normally?Mike Richards, DVM
12/27/2000
Exertional hyperthermia (sometimes exertional myopathy) in Labrador
Question: I don't think I've spelt Azoutura correctly.
But I wonder if you have any information on this condition in dogs?
Our bitch Tilly, Labrador, 4.5 years. Fit condition
Taken for a walk between 3-4 pm
Fed at 5 pm
Left in bed for evening 6-10 pmWhen we returned at 10 pm Tilly did not get up to greet us and was barely
able to walk with her hind legs. We had to lift her onto her legs to get
her to stand.We visited our vet immediately who diagnosed azoutura or muscle bind and
gave her an anti-inflamatory injection and glucose and electrolyte drinks.
He told us to massage her when we got home which we did with Arnica, Rhus
Tox and Ruta cream. Also to take her for a short walk tomorrow morning and
afternoon with massage before and after.Our vet tells us that this condition is quite common in greyhounds and can
lead to kidney damage.Do you know what can be done to stop this reoccuring? She had a lot of
exercise Monday and Tuesday, a light day on Wednesday and a light day on
Thursday, although on each day she was out for about 20 minutes with a
mixture of running and heeling exercise.Usually she has free run of the house in the evenings, but on two evenings
we are out and she is shut in their bed area.
Answer: Elizabeth-
Azoturia is the term I think you are looking for. I don't actually know
hat azoturia is, though. I have to admit that up front because I don't
have any of my reference books that might possibly define it at home with me.
But I do think that I can give you a list of possible problems for what
might be wrong with your Labrador retriever, so I'm hoping that will make
up for not knowing how to define azoturia.Labrador retrievers have a condition that is known as exertional
hyperthermia (sometimes exertional myopathy), that occurs most commonly in
Labs, although it is seen in other breeds. If this is the problem, there
should be a high temperature, usually over 106 degrees Fahrenheit, during
the exercise period that precedes the clinical signs. Affected dogs get
weak in the rear legs, may have stiffness and difficulty walking, may
seizure and may have myoglobinuria, which is the presence of myoglobin in
the urine. Myoglobin is red, so the urine is said to have a "port wine"
appearance when myoglobin is present. There is an odd thing about this
condition. Dogs that are affected by it are often only affected when they
are engaging in a specific form of exercise. A dog may be able to hunt all
day but then gets exertional hyperthermia as soon as a Frisbee is thrown a
few times for it -- or any other specific exercise that affects that
particular dog. Sometimes this problem can be avoided by figuring out what
the inducing exercise is and avoiding it. There is some disagreement about
how to treat this. Fluid therapy and administration of oxygen seem to be
consistent recommendations. Anti-inflammatory medications are frequently
recommended. Cortisones are recommended less commonly. Muscle relaxants
seem to be out of favor at present. I am not sure what the current thinking
is about glucose administration but your vet is likely to know something
about this that I don't. Most Labs recover with or without treatment but
seem to feel better much faster with treatment. The condition will recur if
the inducing exercise is engaged in again. Finding out if there is a high
temperature that triggers this is a big diagnostic clue.There is a condition in Labs known as Type II muscle fiber deficiency. It
is supposed to show up in young Labs, so the fact that Tilly is over four
years of age seems to make this a little less likely, unless you have
noticed that she has an abnormal gait but it didn't seem like a major
problem until now. Labs with this condition get weak when they exercise
and if they continue to exercise they will get stiff and the back legs
develop a "bunny hopping" gait. This is a lifelong problem.Anaphylactic shock, which can occur with insect bites or a reaction to
vaccinations or medications can cause most of the symptoms you are seeing,
too. Unless there is a reason to suspect this, it is also an unlikely cause
of Tilly's problems. However, if she was vaccinated in the last few days or
if she is on antibiotics or other medications, it is something to consider.There is a condition, exertional rhabdomyolysis, that has been reported in
some very athletic dogs. It is a life threatening condition brought on by
very heavy exercise. This is a condition that can be induced in any
species, I think --- Discover magazine had an article about people getting
this after extreme exercise contests (like who can do the most squats in a
row). It is a rapid breakdown of the muscle tissue and it does lead to
kidney damage and can lead to disseminated intravascular coagulation.
Extremely aggressive therapy is sometimes necessary to reverse this
condition. This doesn't seem to fit the case history but has to be
considered, too. I think that this is the condition that occurs in
greyhounds. It also occurs in sled dogs.Sometimes we see signs like this when dogs have hip dysplasia. They get
sore and just don't want to move around much. This tends to show up as dogs
age. It often seems to come on suddenly, even though the damage has been
accumulating for years. In this case, it is the pain that interferes with
activity and response to anti-inflammatory analgesic medications is usually
very good at first.Disc problems and lumbosacral instability are also conceivable problems.
These problems can cause pain or weakness or both. There is usually a good
response to anti-inflammatory medications at first with these problems,
too. If weakness is the major feature of the clinical signs there is likely
to be some nerve damage and medications have a less obvious effect in that
case.Once in a while we see a dog that develops cranial cruciate ligament
instability in both stifles at the same time. These dogs are often very
weak in the rear legs and move with such difficulty that they can easily be
mistaken for dogs with disc injuries or myopathies.These are the things that I can think of. I'd tend to think that the
exertional hyperthermia or hip dysplasia/arthritis type problems are the
most likely problems, just based on the history. Over time, it will be easy
to distinguish between these, if one of them is present.If the exertional hyperthermia problem does seem likely, I think that Dr.
Shelton at the University of California at Davis has developed a test for
the condition. Your vet could contact her lab for details on how to submit
samples.Hope this helps some.
Mike Richards, DVM
9/24/2000
Exertional rhabdomyolysis, exertional hyperthermia, and azoturia
Question: It helps a lot. Thank you very much for replying so promptly.
You were the first person (after our vet here) who we contacted and we did
some other research on the Internet, particularly in the horse area. We
found a load of horse information on Azoturia, and also a very interesting
site about a grayhound.Azoturia, it turns out, is another name for exertional rhabdomyolysis and
there is an excellent article about the problem in a greyhound at
http://www.abap.org/azoturia.htm.The article indicates there are three different types of extertional
rhabdomyolysis and I wondered if the third type (which fits Tilly best)
would also go under the name of exertional hyperthermia? They seem very
similar.We saw from our research that it can be brought on by low levels of sodium
and potassium. Tilly has been on a low sodium diet for some time owing to
urinary incontinence problems (she is spayed). Our vet also thought she
might have some crystals in the bladder, hence the low sodium. She is also
extremely fit, and apart from her work as a trialling retriever, she also
has plenty of free running exercise and can frequently be off running for
quarter of an hour or so (probably longer than a grayhound would run in a
race!)The exertional hyperthermia is an interesting one though. She didn't have a
temperature on arrival at the vet, but she did lie down while waiting for
another dog being trained while we were out on our walk. She normally sits.
We didn't think too much of it at the time. Would her temperature have gone
down 6 hours afterwards (when we took her to the vet) do you think?The Anaphylactic shock is a possibility. She was vaccinated on Monday
morning (3 days before this episode). She has had AS before, when stung by
a bee at 10 weeks old. Is there any more information on that?We think that hip dysplasia is very unlikely since she has a 4/4 hip score
so we will concentrate on the three above.
Is it possible that the muscle problem (be it exertional hyperthermia or
exertional rhabdomyolysis) and the urinary incontinence might be related?
Regarding future avoidance - we have put her back on a normal salt diet
(chicken and vegetable nuggets) and we're going this morning to get a blood
test for her. Is there anything else we can do?Having said all this, Tilly is a lot better this morning (Friday). She is
still having her electrolytes and we are going to do the massage again today
a few times.Answer: Elizabeth-
I looked at the article that you included the link to. I think that the
disorder seen in Labradors is actually different from what is described,
but it is hard to be sure of this since few vets get to see a whole lot of
these cases.There are three important clinical signs that it is going to be necessary
to look for, if a future episode occurs.The first is temperature at the time clinical signs appear. Any normal
rectal thermometer will work for taking a dog's temperature. The
hyperthermia in Labs is reported to be transient but consistent. So the
high temperature should occur but is likely to disappear by the time the
patient gets to the veterinarian's office.The second sign is myoglobin in the urine, which produces the reddish
discoloration seen. This is a sign of rhabdomyolysis and it should be
present if this condition is the cause of the muscle soreness seen.The last thing to look for is when the muscle soreness occurs. In
rhabdomyolysis the clinical signs usually occur after a delay of several
hours from the exercise episode. In exertional hyperthermia the muscle
soreness normally occurs at the time of exercise, or very close to the time
of exercise.In re-reading the original note, I am not actually sure if either of these
conditions really seems all that likely, based on what you saw.I think that I misused the term anaphylactic shock in the reply I sent to
you, too. While I think that a reaction to medication or vaccination is
possible, and that it would be an immune mediated reaction. However,
anaphylaxis is an immediate reaction to a toxin, medication or vaccination
which usually occurs within minutes of the administration of the offending
substance. Muscle weakness, salivation, breathing difficulties, vomiting
and hives are all possible signs of this.What I would have to include in the list of possible problems is a
condition that I should have referred to as delayed hypersensitivity
syndrome. This is a reaction to a toxin, medication, vaccination,
infectious agent or other stress to the immune system. Typically, it occurs
at least five days after administration of the substance but can occur in a
shorter time on subsequent exposures, according to Kristen Bernard, in the
"Handbook of Small Animal Practice" (Morgan). This syndrome can produce a
lot of different clinical signs, including joint soreness and muscle
pain. I do continue to think that this is a possible problem in Tilley's
case. If it has occurred, there will likely be reactions to future
vaccinations. I know of no way to be sure that this is what happened,
unfortunately. Although if it does happen in the future it will obviously
be more likely.My understanding of exertional rhabdomyolysis electrolyte levels is that
the sodium level may be low but that the potassium level is usually high,
during an episode of this condition. This is one of the things to consider
when planning fluid therapy.I would be really surprised if the incontinence has a relationship to this
problem but can't be certain that it does not.I think that you are going to need to depend on the advice of your vet,
after evaluating the labwork, to advise you on necessary dietary changes.
The initial problem may still seem more important after this is all over
and can be evaluated in retrospect.I am glad that Tilley is feeling better. That is a very important sign no
matter which of these conditions turns out to be the culprit.Mike Richards, DVM
9/24/2000
Question: We have an 18 year old mixed Samoyed female about 50 lbs - looks mostly like
Samoyed with maybe a little bit of golden lab and terrier background colorThis is a long story because she is a long dog
She came to us from the pound at about 8 months old
She has been spayed - when younger probably as a young puppy before getting
to the poundTwo years ago she was found to have reduced thyroid and has been tested and
stabilized on Levoxin synthetic at 4.5 mg per day
Her back end seems to be gradually failing - this is the problem
About a year ago she was started on Anapril - this was to help maybe with
her going outside for business - she is an inside dog who has always been
well mannered and always asked to go out - can't say much good or bad for
Anapril - changes if any are subtle - she now has degenerated to regularly
hitting the floor solid and liquid - even sometimes when we are right there
in front of her - and failing to indicate she needs to go out - almost like
she is not connected front to rear - we take her out on her regular
schedule and she will go outside but sometimes has accident just as we walk
back in the door - changing timing and special trips outside have not fixed
things - diet is NutraMax for older dogs and does not seem to be a factor -
we have tried variations of diet but same pattern occursBridie is still her normal joyful self - she is not gahgah or losing mental
function or general interest - again can't say Anapril good or bad - same
before and afterShe has always carried her bushy white plumed tail high over her back
About 8 months ago she gradually stopped doing this and now keeps it low
between her legs except when she is really happy when a few wags occurIncreasingly she has shown unsteadiness on her back legs especially after
just getting up - she will occasionally stumble or lurch to the side in the
rear when walking - this is the problem we are really worried aboutShe has been on Joint Care condroitin / glucosamine for 2 years just as a
preventive measureTried Rimydil about a year ago starting when needed and then on a regular
dose ( idea was that maybe she wasn't going outside because it hurt to walk
) - seemed to help comfort wise when running in the back yard etc but not
with the messing - but high liver blood test numbers 2 months ago had our
vet saying we should go immediately to a liver specialist for ultrasound and
should be prepared for the worst - we fixed this problem by just stopping
the Rimidyl after reading on the net that some people had dogs dying of
liver related Rimydil toxicity - her liver numbers 1 week after stopping are
back in normal or high normal ranges and stabilizedArthritis range of motion testing has been and continues to show good, with
and without Rimidyl - no protest or apparent pain when moving her legs as
per a much younger dog - now we have Etogesic but have not had a chance to
try it out - we are a bit afraid of the liver connection - we do give her
buffered aspirin when she acts like she is sore - but this is not oftenMuscle mass on back legs and over her rear end seems to be diminishing
(visual impression to us who are watching her closely) but her weight
remains overall normal - skinny rear end - front normal - both rear legs
have same apparent problem, neither is favoredSome trembling in rear legs - rapid buzzing of muscles - will come and go -
gets better after walkingJust had X-rays of spine suspecting some type of degeneration - vet came
back amazed - spine looks great, like young dog - no disk bulges - vertebrae
spacing even - no spurs or missing spots in the bone - hip joints normal
with maybe slightly small femur heads but no degenerative changes can be
seen - no evidence of tumor or cancer showingSlightly tight abdomen - some gas - so vet says maybe Cushing's - but vet
says Anapril is typical treatment for Cushings - can you get negative
Cushings from too much Anapril?Vet says rectal exam feels normal and organs seem to feel about right except
for the abdominal tightness - she did a reflex test where the back paw was
turned under - regular dog should immediately turn back up when released -
Bridie just left it there three out of four timesUrine test normal density, no infection (she has had a few bouts of urinary
infection in the past)Hair growth has almost stopped - she is getting bald patches and the tip of
her tail is now baldAlso, with just a little bit of cold she starts chattering her teeth - very
fast again like a buzz - she is off Anapril for the last week - and the buzz
seems better - can Anapril cause too much nerve activation? Can rear end
degeneration be caused or aggravated by Anapril?Vet has recommended Cholodin for trial - just see if it does any good
We are now looking at doing an ACTH stimulation test
If this is Cushings and Anapril doesn't affect it what then?
We are worried about her comfort and about losing her rear legs more than
anything else - we can always clean the messSince we will be going in for more blood tests soon - what else beside the
regular stuff should we look at? Any leads to try? I have read your online
info - didn't see anything that was a really close fit to these symptoms
thoughThanks for the interesting news letter and we appreciate your service - its
been a big helpAnswer: Turq-
The symptoms of the more recent problems with the rear legs sound like a
neurologic disorder. The most likely diagnoses are degenerative myelopathy,
a spinal tumor or a herniated disc in the spine. There are other possible
problems.The best approach to a diagnosis is probably to have a neurologist examine
Bridie and to have an MRI done of her spine, if possible. In many areas of
the country this is hard to arrange. An alternative is a myelogram, in
which dye is injected into the area around the spinal cord to outline any
areas of pressure on it. This is a good test but not nearly as good as an
MRI, based on recent reporting of a high percentage of disc problems in
dogs undergoing MRI exams who were previously suspected of having
degenerative myelopathy based on a inability to see the disc problem on
normal X-rays and with myelograms.Anipryl (Rx) is not likely to cause Addison's disease (I know of no reports
at all of this and it doesn't seem likely with the way that Anipryl is
supposed to work). Some vets use if for the "old age shaking" syndrome
seen in older dogs. We have tried this with one patient, for a month, but
it didn't help in that time. It didn't hurt, either, though.4.5 mg of levothyroxine would be a really large dosage. I am hoping that
you mean 0.45mg. The current thinking is that even big dogs do not need
more than 1mg of levothyroxine per day very often. If you are really using
that high a dose, I would have to be suspicious that the levothyroxine
could be a problem.The most sensitive test for naturally occurring Cushing's disease
(hyperadrenocorticism, HAC) is a low dose dexamethasone suppression
test. However, an ACTH response test is still a reasonable choice. The
hair loss is a common sign of HAC and some dogs do seem to get sensitive
about the cold with this condition.It would be worth rechecking the T4 levels, even if you are using 0.45 mg
of thyroxine rather than 4.5 mg --- but if you are using 4.5mg, it is
really important to check the T4 level to see if it is elevated.I know that proposing even more testing doesn't sound inviting, but if
there is a neurolgist or internal medicine specialist with an interest in
neurology near your area, it could really be worthwhile to get a second
opinion on Bridie's condition from a specialist.Mike Richards, DVM
4/15/2000
Question: We have a one year old Maltese.He suddenly experienced weakness in hind legs,difficulty
raising himself on these and is extremely fatigued.Vet suspected lyme and prescribed
tetracycline but western lyme test came back negative,Vet then suspected joint problems and
gave anti inflamatories.No improvement.Exrays done showed no joint problems.Dog placed
back on tetracycline and more general blood screening done for tick borne diseases.waiting for
results.Dog does not want to walk,can't jump on or off couch.Some slight improvement so far
although todaystanding with right hind leg held off floor.At one point dog was struggling to
walk down hall facing forward with hind quarters angled off to the right and slighthly
forward..Any ideas?
Regards, J.
Answer: J.
I am not going to be able to help much with this one, I'm afraid.
I would worry about spinal disc problems even in a dog this young. If this has not been considered, it may be worth checking into. Most of the time there are neurologic signs but some dogs only have pain, weakness or lameness. Radiographs are often helpful and they would also help rule out other problems, like Legg/Calve/Perthes disease (affects the hips, usually).
I think that Maltese dogs are more prone to portosystemic shunts than other breeds and fatigue or weakness is sometimes associated with these, but things like siezures, "spacing out", incoordination after eating and other signs related to central nervous system irritation are usually evident with this.
If luxating patellas are present, which is pretty likely in a small breed dog, they will sometimes cause significant weakness in the rear limbs. This would be something else to think about.
Lyme or other tick borne diseases are possible and it is good to rule them out.
It is likely to take more than one visit and possibly even a referral to a specialist, in order to get to the bottom of a severe weakness or lameness in a dog of this age. Keep working with your vet to resolve this. If a significant change for the worse occurs make sure that your vet re-examines your dog within 24 hours of the change at the latest --- and sooner is much better.
Hopefully this is improving instead of getting worse, though.
Mike Richards, DVM
10/15/99
Q: My pomeranian-chihauhau is 12 years old. She wobbles and sways when she walks and her rear hangs low to the ground. A specialist diagnosed her as having a brain-related problem about 2 years ago (i.e. tumor). Some of her health problems that could be related are: disc degneration (she takes prednisone every other day), complete blindness, and diabetes. If taken off of the prednisone, it gets to the point where she cannot walk at all. She can still move fairly quickly, however, it seems that recently her rear hangs lower and her hind legs are pointed outwards. Do you know what this could mean or would any other information be helpful?
A: Weakness in the rear legs can occur with injury to the spine or with central nervous system problems if they affect the areas that control the rear legs. Diabetes can lead to diabetic neuropathy, an inflammation of the nerves that can also lead to weakness in the rear legs. In addition, prednisone can cause muscular weakness as a side effect. It would be hard to tell you which was the problem currently without doing an exam and it may be hard to tell even with a good physical exam and lab testing since there are so many concurrent problems. Your best bet may be to consider returning to the specialist for a recheck.
Sorry I can't help much with this problem.
Mike Richards, DVMOsteoarthritis and nerve damage
Q: I have a 13 year old golden retriever/collie mix...weight 110 lbs. He has been diagnosed with osteoarthritis in back right hip which, as expected, is getting worse. He has been on numerous drugs to help with the pain and stiffness and most recently is taking Rimadyl along with dexazone (cortisone). He had been doing fairly well but going up steps was becoming a problem (fortunately, I have a ranch style home) so I had a ramp built to get from the outside into the house after walks. But on Jan 1, he took a fall and since that time, he is severly lame. Some days are better than others but most days he needs assistance lifting his back legs up and then he needs support under him to walk (I use a towel supporting his belly and help him walk). However, the lack of mobility has caused the muscle in his right hind leg to atrophy. When he walks, his paw is bent over in half (ie., his "toes" are bent underneath the foot) and sometimes he drags his one hind leg. My vet has said that when the weather changes, this situation should improve. He has suggested that I do range of motion exercises and messages to his leg/hip which I am doing. Obviously, I love my dog, Brandy, very much and I want to make sure that I am doing everything possible to help him. His appetite is still good (on a prescription diet food to help reduce his weight); he is alert and attentive; he does not seem depressed. Your comments and suggestions will be much appreciated.
A: The "knuckling" of the one rear leg can be a sign of nerve damage, which would be a little different than the arthritic condition previously being treated. The nerve damage could be to the sciatic nerve or possibly to the nerve roots coming from the spine. If this is the case, recovery may occur but it becomes less likely the longer the signs remain. It is sometimes very hard to tell if nerve damage is present when there is chronic degenerative joint disease since the atrophy and sometimes even the posture can also occur over time from that problem as well. There is not much else you can do if nerve damage is present, unfortunately. Some people believe that Vitamin E is beneficial in doses up to 2000 IU/day for degenerative neurologic conditions of older dogs. It is not too likely to be harmful, so we do try it pretty often. I have to admit that I really don't know if it ever helps, but sometimes it seems to. This is also a time we consider use of the "nutriceuticals" -- food products like Arthroflex (Rx) or Cosequin (Rx) which may be beneficial in chronic debilitating conditions. Weight loss might help your dog. Keeping an arthritic dog thin is one of the best things you can do to alleviate the clinical signs of arthritis but it is also a very hard thing to do, especially in a dog in which you can not encourage more exercise and are using corticosteroid medications. If it is possible, it could be beneficial. I wish I had better suggestions for you.
Mike Richards, DVM
Last edited 08/30/02
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