Lots of updates

Flash has now been on Rimadyl and Gabapentin for over two months. He is doing so much better, his pain is definitely much decreased, he is walking better (not as roached), trotting more and also playing more again both with toys and with Skye. I am carefully monitoring his exercise levels as too much does cause him problems, so he gets the occasional rest day which is very helpful.
I have also added Aktivait to his regime. Although it won't do anything for the pain, it might help with maintaining nerve function better in his back.

This picture was taken 14th May.


And 21st May, on Hinderclay Fen


27th May, chilling in the garden



In addition, when his fur on his back didn't grow back (where they took the spinal fluid from) and due to him still being quite slow on the way back on walks, Rachel (vet) and I thought of testing him for thyroid (especially also as his last test 4 years ago showed him to be low borderline). The results came back as him being hypothyroid. So he has been put on 0.8g Soloxine  (and once I have finished with that Thyforon, as soloxine is not available anymore).

30th May, going off track more again
Since then he has even made more improvements. He has more energy (still a bit slower on walks than he used to be, but that'll never be 100% again), he goes more off track on walks now, trots even more often, and he is also a bit less grumpy with dogs I have noticed. The hair on his back is still not growing loads, but I have noticed that his bold tummy is growing some fluff again... yippee!

So overall, Flash is doing great. He will never be 100% again as the facet subluxation won't ever go away now, but he is doing much better than I thought he would. And once we have started acupuncture, he will hopefully improve even more.

Chilling after chiro treatment on 16th June


He is due another thyroid test this week just to check whether he is on the right dosage.

He is also getting better with Blake... or shall we say, Blake is getting better at respecting their space and backing off when told to do so by the dogs. But Flash rarely grumbles at him now, though I wouldn't let Blake push it too much just yet.

29th June


5th July, with Blake, waiting for their dinner

Update! Further back trouble

Here's a couple of lovely picture first of all taken end of March.

Well, Flash had xrays to see what is causing the pain. Rachel thought it was arthritis in his hips, so we first put him on Metacam. However, although it did help a little, it didn't make a huge difference,  so we went for the xrays, but it turned out that all his joints look absolutely fine.


Our next step was a referral to The Grove Vet Centre in Fakenham. So Flash had an MRI and fluids taken from his knees (and from the spine, but the vet couldn't get any from the spine) as well as blood tests. All the scans and test results came back fine - and there was no sign of degenerative disc disease either. So it was all a great puzzle.




Here's Flash on 27th April home after the MRI:

It was only when the referral radiologist that found the possible problem: articular facet subluxation. In other words the tiny facet joints in the spine dislocate and cause pain because of that. Here is a copy of the report I received:

Diagnostic interpretation:

Lumbosacral vertebral column

There is subluxation of the cranial articular process of the first sacral segment in relation to the

caudal articular process of L7. The cranial articular process of S1 has moved forward into the dorsal

aspect of the intervertebral foreman. By doing so it attenuates the L7-S1 foreman bilaterally reducing

the space of the exiting L7 nerve roots. However this subluxation is static between the flexed and

extended views and between both series the nerve roots can be observed exiting the cranial aspects

of the foramina surrounded by perineural fat signal. There is very little associated osseous

remodelling and only very mild degenerative change is present within the L7-S1 intervertebral disc.

The spinal cord and cauda equina run centrally along the vertebral canal without attenuation. The

other intervertebral discs demonstrate some mild dehydration however no significant protrusion or

extrusion is evident.  

Conclusions:

1) Static L7-S1 articular facet subluxation and attenution of the intervertebral foramen bilaterally.

2) Nodular splenic and liver changes.

3) Intrapelvic urinary bladder.

 

Additional comments:

In all images there is evidence of subluxation at the L7-S1 facet joints. The cranial displacement of

the cranial processes of S1 attenuate intervertebral foreman. Despite the static appearance of this

subluxation on these images I am concerned that with aggressive action this process will move

further cranial and be a cause for L7 nerve root entrapment and injury. This could account for the

pain is described in this patient. If this is the case on rest and at inflammatory therapy should result in

a clinical improvement have a repeat concussion of these nerve roots is likely to occur with normal

exercise in the future.  It was the first time Simon Gilbert (referral vet) had come across this. So today I have now started Flash on Gabapentin and from tomorrow also Rimadyl (as the metacam didn't help greatly). I really hope this will help him! He looks so uncomfortable on walks, particularly on the way home. He is better after a day's rest, but still slows up considerably on the way home. I will then also add acupuncture to see whether that will help. For now there will be no further hydrotherapy as I feel that is making things worse at the moment.

On the sofa next to me on 2nd May:

Incident with Blake and back troubles

At the weekend, when I let Flash and Blake play together, Flash caught Blake's skin (he still hasn't learnt to play nicely obviously) and Blake screamed blue murder (which then made Jesse attack Blake...). No physical harm was done, but Blake was terrified after that. I managed to pull Blake back to his happy self over the afternoon, but the relationship between Flash and Blake has gone back to square one after it was going so well. They are ok together, but not best friends yet... Here's a picture from last week when they were more comfortable together. :-)

Flash has also started showing pain in the water treadmill, and he is still slow on the way back on walks. I have booked him into the vet's for Thursday to discuss pain management with Rachel. It looks like it is time to finally put him on conventional medication. And if he is uncomfortable, which I think he is now, then that won't help with accepting Blake either.

Improvements

Flash has improved greatly with the hydrotherapy and physio and no longer has any problems at all with his shoulder. He is still doing hydro at the moment, but phasing it gradually out now.

Today, Blake joined our family and Flash has been great. Apart from a couple of grumbles when Blake got right in his face, Flash has been brilliant. :-)