We've just returned from our consult with an orthopedic specialist at the OVC in Guelph.
Tal has been doing so well, she seems so improved, that I think many people would have cancelled the appointment. But remembering the kind of pain she was in two weeks ago, and how long it took to go away, we felt there was probably something simmering - that rest was a relief, but not a cure. Plus it's not easy to get appointments at Guelph - this was on a cancellation - so we planned to go anyway.
An excellent orthopedist examined Tala, then asked another doctor do the same for a second opinion. They believe the problem is not in her knee, but in her spine.
The orthopedist explained a condition similar to sciatica in humans, in which a disc slips, then the body builds up fibrous tissue around the out-of-place disc, and that tissue presses on a nerve. In dogs, the affected nerve can either be the sciatic or femural nerves, so can present as lameness in one leg. It's known as cauda equina syndrome, and it's chronic.
It's likely that Tala has had some persistent lower back pain for a long time. She sometimes yelps in pain when being towelled off (after rain or mud), or when someone touches her belly in play. We've always thought that was her sensitive GI tract, but now know it's from spinal pain. Similarly, sometimes at night she's been extremely reluctant to walk stairs. Also a sign of back pain.
There's surgery to correct it, but just as in humans, it pretty high-risk and considered a last resort. Unfortunately for Tala, the first treatment is rest. We're to continue on the total exercise restriction we've been doing. (In fact, we've relaxed her restrictions a bit, letting her come upstairs at night, and we have to cut that out.) If she continues to improve after another two weeks, we can give her more on-leash walks, gradually increasing her walk time in two-week stretches. After two months, if she's doing really well, we can gradually give her some off-leash time. Maybe. We hope. Plus we'll have pain meds and good old prednisone to relieve the inflammation.
The other possible diagnosis is a tumour. It's much more likely to be the compressed spinal nerve; the doctor said for every spinal tumour they see, there are seven or eight dogs with compressed nerves. If it is a tumour, obviously, rest won't help, and we'll go back to Guelph.
The diagnosis isn't definitive; it's based on two manual exams, and our reports of her activity. For a definite diagnosis, we would need an MRI. At $1,000 a pop, you don't leap into that, especially when every possible sign points in one direction.
Naturally, we're very sad to think of our little girl being in pain, not having fun at the dog park, not zooming around the yard chasing squirrels. The doctor said that the must to avoid is "explosive" exercise. But Tala is an explosive!
She's so stoic and accepting of her situation, that's how dogs are. But she can't understand why Allan takes Diego to the park and leaves her behind, or why she is kept in a pen outside.
We're investigating to see if there are larger pens (plus now that this is long-term, we should return our friends' equipment). And at least she gets to be outside. When we lived in an apartment, a dog on exercise restriction was stuck inside all day. But still.
So we'll take it one day at a time and see how it goes. Thanks in advance for your support and good wishes.