Spine radiographs

Re: Spine radiographs

james herriot lied — Fri, 20 Jan 2012 23:10:55 GMT

Mark

First off, nice x-ray - as someone who has to work with a pre-NHS behemoth, I'd love to get rads like this. I think there are times when we forget just how variable our diagnostic capabilities can be.

When you say polyarthritis, are you finding issues in all four limbs, or just hindlimbs? Any neuro issues at the back end, including toilet problems? Any change in appetite or weight? Calcium levels? Have you sent the toe off for histopath? That might just be the best fifty quid you spend for the owner.

I think if - like most of us - you come to a sudden stop in the investigative pathway, then pain relief becomes a matter of tweaking. I'd second gabapentin as a trial for the forcibly-undifferentiated caudal spinal cases, but it can knock come dogs off their legs (as with my head nurse's mother's dog - not my finest moment, perhaps). I'm also a tramdadol-steroid fan for certain patients, when further investigation is impossible (and yes, I've read extensively on how tramadol is the devil's spawn).

Re: Spine radiographs

Nicola Lawlor — Fri, 20 Jan 2012 21:50:25 GMT

Have you questioned them on diet at all. I wonder if hypervitaminosis A might be a factor here???

Re: Spine radiographs

Dagmar Steele — Thu, 19 Jan 2012 09:21:50 GMT

another vote here for hyperthrophic osteopathy, especially when looking at the toes... any blood work, Ca-levels?

Re: Spine radiographs

Utlendigur — Wed, 18 Jan 2012 21:16:46 GMT

[quote user="David Beattie"]

Don't see a mass on the thoracic/abdo films, but as an 11yr old Retriever could hypertrophic osteopathy be worth considering as well?

[/quote]

Beat me to it - I was just wondering about that too having diagnosed a case recently (middle age springer with primary lung tumour).

Re: Spine radiographs

Anonymous — Wed, 18 Jan 2012 21:08:11 GMT

Don't see a mass on the thoracic/abdo films, but as an 11yr old Retriever could hypertrophic osteopathy be worth considering as well?

Re: Spine radiographs

Judith Joyce — Wed, 18 Jan 2012 14:58:33 GMT

Ankylosing spondylosis in dogs is often not associated with pain and the only significant ambulatory abnormality is down to spinal stiffness. The radiographic signs alone are not enough to implicate the spine or justify any medication. These abnormalities are very long-standing - are the clinical signs similarly chronic?

The toes are certainly abnormal with bony proliferation along the diaphysis of several phalanges. There appears to be some symmetry or at least left-right similarity. This is an unusual pattern and I am not confident about diagnosis on the basis of this evidence. There is not enough here to support a diagnosis of polyarthritis - I would want to see consistently abnormal joint fluid from several joints. If you are amputating the toe, I would be keen to see histology.

Malcolm N

Re: Spine radiographs

Mark Lowrie — Wed, 18 Jan 2012 14:08:51 GMT

I must apoalogise - I saw the spinal radiograph and got a bit over-excited that this was a neuro thread! I'll let others comment on managment of arthritis. For what it's worth, gabapentin IMO is excellent for neuropathic pain but I would rarely use it for an arthritic dog. Having said this, there is no harm in trying it as it has few side-effects and if struggling to get pain under control it would seem appropriate to add it to the regime and corss everything!

Re: Spine radiographs

Mark Rowland — Wed, 18 Jan 2012 13:14:37 GMT

Thoracic spine

All done concious (mild sedation) so no DV as yet.

Re: Spine radiographs

Mark Rowland — Wed, 18 Jan 2012 13:11:54 GMT

11 yo me goldrn retreiver, history of progressive lameness on left fore. Swelling of digits on left and right fore with severe periosteal reaction, Biopsy of skin and connective tissue revealed a severe nutrophillic reaction and sinus tract formation. In today to amputate the affected toe on lf (lower one on rad) as it is much worse and very sore. However general gait deteriorating and I opted for further rads to start with.

Re: Spine radiographs

Mark Lowrie — Wed, 18 Jan 2012 12:53:22 GMT

Hi Mark, do you have more details? Signalment, presenting signs, results of joint fluid cytology etc??