|Diagnosing Hind Limb Pain|
There are four main diseases that cause weakness, pain and stiffness in the hind legs of dogs. Often more than one of them is occurring at the same time. X-rays are necessary to determine which diseases are present in a particular pet. Taking proper X-rays of the hips requires sedation or anesthesia, but we can usually diagnose other diseases without sedation.
Once X-rays have diagnosed which disease or diseases are present in your dog, we can set up a treatment protocol to help your pet. This may include medication, change in exercise routines, nutritional support, surgery, or a series of injections to improve joint function or spondylosis.
Your pet will also need periodic blood testing to check for problems that will affect the treatment plan or the medications recommended. Any anti-inflammatory medication, including aspirin, Rimadyl, Deramaxx and the many other drugs classified as NSAIDs – non-steroidal anti-inflammatory drugs - can cause liver and kidney disease, especially with long-term use. Arthritis and spinal disease are generally treated for the lifetime of the pet, so it is important to monitor kidney and liver function. If there are underlying problems with these organs, treatment may make them worse. Most older dogs have at least minor changes in these organs. Blood testing should be done when starting a pet on lifetime medication, and at least annually thereafter.
We will also need to monitor your pet, and adjust our protocol depending on the response to treatment. Most dogs slowly worsen with age, and adjustments will need to be made over time. With appropriate care and medication, your dog will live longer and far more comfortably.
There are several diseases which may be diagnosed in the manner described above:
1) Intervertebral Disc Disease, or slipped discs, is common in dogs, as it is in people. Dogs with short legs and long backs are most prone to this disease, but it can happen in almost any dog. Discs can slip suddenly, causing acute disease, or slowly, leading to chronic lower back pain and pinched nerves. If we see signs of disc disease on your pet’s X-rays we may prescribe steroid or NSAID medications, surgery or changes in exercise and daily activity.
2) Discospondylitis can occur at any age, but it is most common in older dogs. It is an infection of the bones and intervertebral discs of the spine, usually in the lower back. The infection is most commonly bacterial, though it is occasionally caused by fungal or protozoal infection instead.
The infection typically comes to the spine via the bloodstream, from some other area of the body. Infected teeth and gums are often the source, but these bacteria can also come from skin or wound infections, urinary tract infection, infection of a surgery site or elsewhere. The kidneys, heart and joints are other organs also damaged by this type of infection.
Once they reach the spine, the bacteria cause a smoldering, low grade infection which gradually damages the vertebrae (the bones of the spine), the jelly-like discs between the vertebrae, and eventually the spinal cord and nerves.
Once damage is severe, even aggressive treatment for the infection cannot restore normal function and the dog will be permanently disabled. Early and proper treatment with antibiotics is essential.
3) Spondylosis also involves the vertebrae of the spine but it is not caused by infection. With spondylosis, the vertebrae develop outgrowths that slowly grow larger and larger, eventually fusing the spine. The bony outgrowths can press on the muscles running under the spine or trap the nerves coming off from the spinal cord, causing pain and inflammation. At this time, the cause or trigger of the disease is unknown.
Anabolic steroids may be used to help slow the progress of the spondylosis, improve muscle tone and maintain function longer. Pain medication may be needed. Sometimes surgery to remove some of the bony outgrowths and free trapped nerves is beneficial.
4) The last of these diseases is osteoarthritis, the typical hip arthritis of older, large breed dogs. Smaller dogs can also get arthritis, however, and arthritis is not just an old age disease. Many dogs start with arthritis at a young age, especially if they have hip dysplasia, poor conformation or a history of injury to the joints. As many as 44 million dogs in the United States are estimated to have some form or degree of arthritis - about 1 in 5. Like discospondylitis, arthritis is caused or worsened by infection elsewhere in the body, especially the mouth.
In the early stages, most cases of arthritis are treated with anti-inflammatory drugs such as Rimadyl ©. (Never use Tylenol, ibuprofen or other human products in pets. These medications are not safe and can cause death or serious side effects.) Many other treatment options are available for arthritis as well, including nutritional supplements, medication injections, acupuncture, and sometimes surgery.