# Unusual swollen hock/ankle



## Kiersten Lippmann (Jun 5, 2011)

Thought I'd ask, in case anyone here has experience or suggestions. My dogs tend toward somewhat unusual health issues- 

My 5 year old GSD of unknown lineage- probably older American show line (adopted at about a year as a stray) has a swollen ankle/hock joint. The swelling is a round bump just next to the ankle bone. She's been a bit sore on her left leg most of the summer. Nothing major- I thought she'd strained her upper groin muscle. I noticed this swelling about three weeks ago and took her to the vet.

Photos Here: https://picasaweb.google.com/Tikkodog/TessaAnkleSwelling?authuser=0&feat=directlink

The vet aspirated a sample from the swollen area- didn't find a whole lot of white blood cells or much unusual stuff. Looked basically like joint fluid.

Tessa has a history of severe ehrlichia. We opted to treat with doxycylcine when I brought her in for the ankle swelling (200 mg 2X a day) as these tick diseases can come back in joint form.

No improvement on doxy after 2.5 weeks. If anything, she's showing more soreness. 

The other major medical history with this same foot/ankle is an infected lump that turned out to be an entry wound for some sort of thick spine (acacia thorn perhaps?) This pretty soon after I adopted her, about 3 years ago now. The vet tried treating with antibiotics, but had to go do exploratory surgery and remove the spine which was right next to the bone. 

The new swelling is in the ankle bone, right above the incision scar for removal of the spine.

My dogs are prone to unusual health issues- but I figure this is either another spine fragment in the joint or ehrlichia. The vet doesn't think it would be a spine fragment because the fluid didn't show a sign of infection.

My questions are:
Could this be a spine/foreign object irritating the joint without signs of infection?

If anyone knows, does this type of ehrlichia presentation resolve after a week, two weeks, etc. In other words, is ehrlichia still a possibility? (her blood work is normal, no other signs of illness).

Does it make sense for me to really push the vet into exploratory surgery? I worry about Tess and sedation/anesthesia because of the brain involvement when she was desperatily ill with erhlichia a year and a half ago (May 2010). 

I really like my vet, and I think she will be open to discussion- but I want to make sure I'm not overlooking anything and am doing what is best for Tess.

I'm thinking Occam's razor (fewest new assumptions) And looking at that scar right below that affected joint is leading me toward another piece of that same foreign object. I still have the thorn/spine the vet pulled out back 3 years ago, its about 1 inch long and very thick and broken at one end- there could still be a bit more spine in there...

Thought/suggestions? I see no point in waiting on surgery (if that is the best option) and continuing her pain/joint irritation.


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