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. :-)

Flash's first hydro session

Flash had his first water treadmill session last night. He did brilliantly and got used to it very quickly. He already managed 3 x 1 minute walks in it. Great stuff.

More physio

Flash has been doing really well since having the physio treatment. He had another session last week, and tonight he will start with the hydrotherapy.

Here are a couple of pictures of Flash's session last week with Flora.

Flash, the stooge dog

This morning, I brought Flash along to a client to work as a stooge dog for their lead-reactive dog. Flash has helped me before as a stooge, but not for a long time and not since his back issue that made him reactive as well. Well, he did a great job. He was pretty relaxed, showed good body language, nothing threatening and lots of sniffing. This way the other dog was able to relax and it all went really well. Very proud of Flash.

Flash also went for another physio session on 30th October, and chiro two days before that. He was getting quite "ploddy" on walks at times, but since the treatments he is back to normal again. Later this month he will start with hydrotherapy (treadmill) as well, I think that will make quite a big difference.

Happy birthday, shoulder problems, lipoma removal and horse training

Various things have happened since my last update about Flash.

First of all, Flash celebrated his 10th birthday on 30th August! Wow, I can't believe that my crazy boy has reached that amazing mile stone! He got a lovely birthday chew on the day.

He has settled in incredibly well and is really enjoying the country life. There is also a couple of areas where I can let him off lead now and he is very responsive!

However, he has had a problem with his shoulder. A few times he yelped when he hurt himself. At first I didn't think anything of it as that's the sort of thing that happens if you place your foot wrong by accident and you hurt yourself. But when it happened about the third time within a few days, I grew concerned and got him checked out. The vet couldn't find anything major other than some pain response in his shoulder.

I then took Flash to a hydrotherapy center (www.meadow-farm.com) where the first thing to be done was a thorough assessment and treatment with physio therapist Flora. She also found that there was a problem in the shoulder area, but not sure what exactly.

So when a couple of weeks later, Flash needed to have a lipoma removed that grew very close to his hock joint, I requested to also have x-rays done.

The x-rays came back clear other than some very minor wear and tear that wouldn't have any impact. So we now know that it is a soft tissue issue of some sort. Looking at chiro reports as far back as 2010, Susan even then reported a tight shoulder, so this is a longer standing issue.

Oh, and he also had titre tests before the physio and they all came back as fine. Parvo and hepatitis showed very high levels of antibodies and distemper was just borderline.

This is is when Flash came home from the vets. Unfortunately once the bandage was off, he had to wear a buster collar as he wouldn't leave the stitches alone otherwise. But last weekend I took the stitches out, so he is now back to normal.

Anyway, as Flash has not had any further incidents with his shoulder since the physio treatment, I have decided against further investigations with CT/MRI as I don't think it will help any further. So Flash will go back for physio and hydrotherapy soon - as soon as I have sorted out Dylan's oncologist appointments.

I am very glad that Flash is fine and the shoulder is not a major issue and hopefully can be strengthened up with physio and hydrotherapy so this doesn't happen again.

Here's a couple of recent pictures of Flash

 

 Flash spying on the left here.

The whole gang!