# On rear leg instability - knuckling GSD



## Nancy Jocoy (Apr 19, 2006)

Going through a diagnostic route with the 8.5 year old and am kind of at a crossroads...Another one of my rambling health things. Ah the joys of having older dogs.

He presented a few weeks ago with some stumbling, toe knuckling, and weak knees/hocks bilaterraly on rear slightly worst on left side. He did have a fall (caught leg flipped off deck landed on back) a few weeks before that with no apparent injury other than a skin infection.

Vet sent us to specialist [not neurologist but they do a lot and are associated with dog ER and have the equipment ans she says very good] - x-rays no issues, tick titers came back negative from NC State, DM test at U of of M came back as "Carrier" (as opposed to "Affected") but that has its own detractors (is it testing the right gene or not?). He also pushed pulled tugged and said no cruciate issues either.

Dog was given prednisone 20mg - he is now tapered down to 5mg and significant crate rest. They also gave him 300mg doxy while waiting for tick titers. He has improved some but is not 100%. BUT he has not gotten worse! Improvement on pred was not dramatic as the vet thought it would be with injury. He can now walk without stumbling and flip his toes better though and his hocks seem more stable. If we go for short walk I hear a toe scrape every 100 feet or so. He knows where his toes are though with steps and will retract them if I tickle his toe hairs...I am still keeping him way down on excercise. Walk in yard to potty, a short slow walk (no more than a quarter mile) just to get out, and crate rest.

FWIW after much talk and research with others, I made a decision to continue on bird doxy at the tick dose of 700mg / day for his weight. In part based on some blood test results this fall and his splenomegaly which back then which is now resolved...that is on my own because I am not convinced the tests are getting all the nasties and nobody has explained the enlarged spleen/low platelets from this Fall. He is tolerating the doxy well and I am giving probios with pumpkin 2 hours after each meal to keep his gut happy....not something I feel I can discuss with the vet.

I go in on Friday and they may want to do myelogram / MRI - but I have an appt Saturday with a holistic veterinarian who is also a chiropractor and acupuncturist.......

*I was talking with my veterinarian on the phone today (She called with condolences about another dog who passed away from hemangio over the weekend) and she was appalled that I would consider going to another vet for chiropractic care or acupuncture and that a chiro could really mess up my dogs back. Has anyone actually had that happen? *I would take all the medical records to her and her intake questionairre beats anything I have ever seen by even a human doctor. Really in depth questions on patient history. The myelogram is not without risks either.

Right now you could watch him walk and would not really notice the issues unless you had been seeing him walk day to day and were used to reading his body language over the years.

Damned hard decision. I figure Grim may never work again but I would like to make his remaining time good. Oh, FWIW he has not shown ANY signs of pain through all of this.


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## Terrasita Cuffie (Jun 8, 2008)

With the fall, he could have done something to a spine disc. What was his proprioception test result? I'd go with a good chiro/acupuncturist. With my dog, injectable dexamethesone is what knocked out the inflammation. Didn't see much with oral prednisone. I did a combination of chiro, acupuncture and swimming. On the TBD front, Merck is too low and given to relapses so correct to increase there if that's what it is. The best resource for TBD is Tick-L. I've used the bird doxy [doxycycline hycelate] and that was wayyyy more tolerable for my dog than the other form which made her vomit. 

Oh I should add, my holistic vet did not like crates. Opt for a gated room or x-pen. You want them to be able to move around. I took mine out for walks on a long line and on grass only for a long time. He was six when it occurred and almost a year later, he was back to herding. With a home made diet and his supplements, he never re-injured again. If you have one of those facilities with the underwater treadmill, those work wonders. I bought an 8 foot stock tank for mine during the warmer months and started out in the bath tub doing swimming, spine massages and range of motion. With a 30 pound dog, that's possible.

T


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## Nancy Jocoy (Apr 19, 2006)

The propioception is variable [if we are talking about the toe flip]. He does flip ... now if I do it when he is eating and focused on something else he flips it immediately- actually yanks the paw out of my hand when I touch it. If he is aware I am doing it, like in the hallway, there is a short delay before he flips.

Ok the Bird Biotic is what I am using. With food and water and some pumpkin to wash the whole thing down. 5mg/lb twice a day so he gets 400 in the am, and 300 in the pm. [70lb dog]. From what help I have received figure 8 week course for now. I just cannot let go of that enlarged spleen -- something was going on then --.

He really has had no issues on it. Guess I need ot get on the Tick-L list too. This will probably be a bumper year for ticks.

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Ok, I am not fond of the crate either and have been concerned about too much down time in it. My home office is kind of like an x-pen though - only problem is if I am working he is constantly trying to solicit play. I am really concerned about muscle loss / weakness from this prolonged lack of excercise...and not really that impressed with the conventional vet.


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## Terrasita Cuffie (Jun 8, 2008)

Conventional didn't do anything for me either and that included a trip to the university neuro for a consult. However, the biggest conventional thing that I learned from this is the injectable Dexamethesone is worth its weight in gold as far as shutting down the inflammation and releiving pressure on the nerve. I knew of warm water therapy with people from work and decided to try it so started swimming him in the bath tub. That was huge in terms of bringing him back. There is Dr. Clemmons that does nutritional treatment for DM and I added some of those supplements. The vet/chiropractic did two treatments and told me to continue whatever it was that I was doing. She didn't like the crate because of the huge loss of muscle mass. When I took him back a month after going to walks on a line and keeping him in an x-pen she said he was much improved and almost normal. The chiro adjustment was minor and she showed me exactly where the problem was. My dog just woke up one morning in his crate paralyzed and dragging his rear legs. No proprioception but he had deep pain sensation. Based on what you've written, it sounds like disc involvement.


T


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## Nancy Jocoy (Apr 19, 2006)

Interesting--I was terribly frustrated today because the specialist kept holding me back until the DM test came in --and I was getting very frustrated at warehousing the dog, not knowing what was going on -- and they had messed up and not sent their email for the results to be returned. I finally contacted U of M yesterday and found out the test had been run on Feb 22nd and got the results. I should have done it myself through OFA for half the price and quicker results.

Of course there is some controversy with whether or not the test for the gene is really testing for susceptibility to DM, which it *could* be but the relatively rapid onset also says maybe not. 

Very interesting the pred not so much because he said it would be "dramatic" improvement if it was a disk injury. And I would imagine they would want to operate if they found anything, but that myelogram really scares me...especially on an older dog.


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## rick smith (Dec 31, 2010)

you mentioned doing an X-ray,,,,,,,,did you also do a thorough UT scan ?
i had a dog who ended up dying (hemangio) and the first symptom was stumbling....multiple X-rays showed nothing but a very detailed scan showed the beginning of tumors on the spleen....of course by the time it became even more developed, there wasn't much that could be done

not trying to add any unnecessary fear factor here, but i am a big fan of UT. non invasive and they can show conditions which might be missed with radiographs


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## Nancy Jocoy (Apr 19, 2006)

I know it is a possible sign of hemangio. He had an ultrasound in September that was negative, the VDI test in November that was 2.5 or "normal", and unremarkable spleen noted on the recent x-ray (realizing x-ray not diagnostic for hemangio). I realize hemangio is fast and brutal (just lost one to it this Saturday)

What is "UT" scan?


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## julie allen (Dec 24, 2010)

Nancy I had an old GSD that began having joint instability. This was years ago, I can't remember exactly now if is was blasto? It started in her lungs, then moved to bones. Ugh I can't remember. ,anyway she had a dislocation of her hock, the new vet had never seen, said was very uncommon. After that she appeared to have back problems, then was diagnosed. I don't remember the drugs we used to treat her, but was around $600 for a month, and it didn't help, she was euthanized not long after. 
Don't think that helped much, I'll see if I can find her old records.


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## rick smith (Dec 31, 2010)

the Ja vets just refer to ultrasonic as a "UT scan" over here since they read out on film or the monitor as they "scan around".....just didn't read that you had done that also

but hope it can be diagnosed as well as treated


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## Bob Scott (Mar 30, 2006)

I had a GSDxDane some yrs ago that was diagnosed with DM at about 9 yrs old. With him it went fast but the good news was there was no pain involved. 
At the time (late 70s) I don't recall any treatment being available.


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## Kellie Wolverton (Jan 16, 2009)

I am sure the holistic vet will check the psoas muscle...but just in case: http://www.ivghospitals.com/specialty-services/ilio-what-keeping-your-dog-off-of-the-dl/

Good luck. I hope you get it all figured out for your pooches sake 

Kellie


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## Nancy Jocoy (Apr 19, 2006)

Right now he seems pain free -- I am more inclined not to spend more money on diagnostic testing just because what am I going to do with the results and see if alternative approaches help. Particularly since there seems to be no real change except for slight improvement.

It could also be an FCE which would resolve (or not) over time.


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