Dog with Intermittent Back Pain and Pyrexia

RE: Dog with Intermittent Back Pain and Pyrexia

niamhjl — Wed, 03 Mar 2021 17:32:04 GMT

[quote userid="9179" url="~/001/veterinary-clinical/small-animal/neurology/f/discussions/29681/dog-with-intermittent-back-pain-and-pyrexia/228869#228869"]pyelonephritis or PCKD doesn't always have azotaemia and some pancreatitis cases still eat, though that's a bit odd.[/quote]

This is a good point, I have had a kidney infection once in my life, and my most obvious symptom was crippling back pain!

RE: Dog with Intermittent Back Pain and Pyrexia

Neil Wheadon — Wed, 03 Mar 2021 16:56:26 GMT

[quote userid="3094" url="~/001/veterinary-clinical/small-animal/neurology/f/discussions/29681/dog-with-intermittent-back-pain-and-pyrexia/228885#228885"]One cause of persistent pyrexia and pain that I missed for a short while as embarrasslingly simple! ASevere anal sacculitis and developing abscessation! It explains, probably, the pain on defaecation as well! Only when it burst through the skin did I see what I had been missing. [/quote]

That's interesting isn't it. I see quite a few clients who come in with a burst anal gland abscess and my impression is that it is getting more common. Most say 'he/she was a bit quiet a few days before'

I do wonder if checking the anal glands should be added to any exam of a dog where they aren't right but you can't find anything

Neil

RE: Dog with Intermittent Back Pain and Pyrexia

Julian Earl — Wed, 03 Mar 2021 15:49:53 GMT

One cause of persistent pyrexia and pain that I missed for a short while as embarrasslingly simple! ASevere anal sacculitis and developing abscessation! It explains, probably, the pain on defaecation as well! Only when it burst through the skin did I see what I had been missing.

Ifelt silly, but the dog felt loads better, that was clear!

Other than that I agreed with discospondylitis and the suggestion for a CSF- tap?

If in doubt, just keep looking and you will find out the cause sooner or later! Good luck with this case...

RE: Dog with Intermittent Back Pain and Pyrexia

Chris Milligan — Tue, 02 Mar 2021 22:47:02 GMT

Just want to check if you did a cPLI? - can be super hard to tell back pain from abdo pain sometimes. Did you take urine? The pyrexia with neutrophilia suggests inflammatory - pyelonephritis or PCKD doesn't always have azotaemia and some pancreatitis cases still eat, though that's a bit odd. Otherwise i'd be going after something spinal. My mates dog had a spinal autoimmunity that presented similarly but is a little bit off piste!

RE: Dog with Intermittent Back Pain and Pyrexia

Anthony Todd — Tue, 02 Mar 2021 18:47:22 GMT

[quote userid="2457" url="~/001/veterinary-clinical/small-animal/neurology/f/discussions/29681/dog-with-intermittent-back-pain-and-pyrexia/228864#228864"]Eh? [/quote]

I guess we've all had pain, and so do our patients. Sometimes there really is something which can be identified and demonstrated or shown by some test, image or measurement.

Sometimes [like my current back], or the dog that jars it's back when it awkwardly jumps off the sofa, there is pain but I doubt if any test available will show anything, ie no pathology, despite certain and obvious pain.

I say alleviate the pain, and only if no improvement, only then look for pathology, not look for the pathology 'cos it doesn't help my,back, and the dog off the sofa 'cos there isn't anything to find!

I'd better add that if there is obvious "pathology" then obviously.......................

RE: Dog with Intermittent Back Pain and Pyrexia

Gillian Mostyn — Tue, 02 Mar 2021 16:57:45 GMT

[quote userid="5904" url="~/001/veterinary-clinical/small-animal/neurology/f/discussions/29681/dog-with-intermittent-back-pain-and-pyrexia/228843#228843"]I used to find that moving both hips to their"comfortable" limits in all planes slowly and carefully probably would identify the pain source even before any X-ray evidence[/quote]

Finding the pain is the easy bit. Let me reassure you, Tony, that most vets are still able to carry out a thorough clinical exam.

Figuring out why it hurts is the tricky bit.

[quote userid="5904" url="~/001/veterinary-clinical/small-animal/neurology/f/discussions/29681/dog-with-intermittent-back-pain-and-pyrexia/228843#228843"]I suggest that this would tend to differentiate pain from pathology which is, I suppose the aim [/quote]

Eh?

RE: Dog with Intermittent Back Pain and Pyrexia

Anthony Todd — Mon, 01 Mar 2021 17:59:49 GMT

[quote userid="11308" url="~/001/veterinary-clinical/small-animal/neurology/f/discussions/29681/dog-with-intermittent-back-pain-and-pyrexia/228837#228837"]pelvic rads thinking it was hips[/quote]

I used to find that moving both hips to their"comfortable" limits in all planes slowly and carefully probably would identify the pain source even before any X-ray evidence

. Similarly for the various sections of spine too. [used to alarm owners though!]

I suggest that this would tend to differentiate pain from pathology which is, I suppose the aim [says he groaning after lifting a heavy plant pot.....]

This was common practice among dinovets AFAIK

I must revise my initial suggestion on here and say a week on analgesics before Xrays rather than the other way round.

RE: Dog with Intermittent Back Pain and Pyrexia

Anthony Dennison — Mon, 01 Mar 2021 16:08:35 GMT

I had a case like this spanning a few months at the beginning of last year. Dog seemed fine in consults, possibly slightly sore but very intermittent. Took pelvic rads thinking it was hips, but all fine. Eventually referred because he became paretic on HLs and it was found to be discospondylitis on MRI. It was early stages when we xrayed it so no evidence of it then.

RE: Dog with Intermittent Back Pain and Pyrexia

Thomas Johnson — Wed, 24 Feb 2021 08:24:31 GMT

[quote userid="5904" url="~/001/veterinary-clinical/small-animal/neurology/f/discussions/29681/dog-with-intermittent-back-pain-and-pyrexia/228716#228716"]Happy to become red-faced and silent if, and only if, the patient is not jumping on and off heights or the boot and is exercised only on a lead, and only walking.[/quote]

I've treated enough dogs with back pain over the years to hopefully not put a dog with a muscle strain through unnecessary investigations. I'll report back when I've had a report from the referral centre.

RE: Dog with Intermittent Back Pain and Pyrexia

Neil Wheadon — Mon, 22 Feb 2021 23:04:58 GMT

[quote userid="6297" url="~/001/veterinary-clinical/small-animal/neurology/f/discussions/29681/dog-with-intermittent-back-pain-and-pyrexia/228715#228715"]My thoughts were discospondylitis, toxoplasma, neospora, potentially an unusual presentation of steroid responsive meningitis.[/quote]

If you refer, this may be done, but it's something that you can do yourself, so I'd take a blood and go fishing.

[quote userid="6297" url="~/001/veterinary-clinical/small-animal/neurology/f/discussions/29681/dog-with-intermittent-back-pain-and-pyrexia/228715#228715"]I had a chat with the owner, and as advanced imaging will give significantly more information than radiographs it has been referred.[/quote]

I totally concur with this in this case.

Neil

RE: Dog with Intermittent Back Pain and Pyrexia

Anthony Todd — Mon, 22 Feb 2021 19:42:45 GMT

Happy to become red-faced and silent if, and only if, the patient is not jumping on and off heights or the boot and is exercised only on a lead, and only walking.

I wonder if there might be a good case for a shot of a short acting injectable Csteroid, now that it's come out of the dark ages?? I'll definitely shut up if it has had a jab and it didn't help!

Many is the time.....

RE: Dog with Intermittent Back Pain and Pyrexia

Thomas Johnson — Mon, 22 Feb 2021 19:13:41 GMT

[quote userid="5904" url="~/001/veterinary-clinical/small-animal/neurology/f/discussions/29681/dog-with-intermittent-back-pain-and-pyrexia/228709#228709"]This is a classic example of modern veterinary practice. Just watch how it develops.[/quote]

This has been going on for 3 months, and each episode has been worse than the last, the dog is very subdued despite Onsior and Pardale, I think we have already 'watched how it develops' and now is the time to try and find out what's going on. My thoughts were discospondylitis, toxoplasma, neospora, potentially an unusual presentation of steroid responsive meningitis. I had a chat with the owner, and as advanced imaging will give significantly more information than radiographs it has been referred. If it had stayed with us I would have taken radiographs and considered doing a CSF tap, though it has been a while since I've done one.

RE: Dog with Intermittent Back Pain and Pyrexia

Clive Ansell — Mon, 22 Feb 2021 18:40:36 GMT

As with the melaena thread, in most of my practices referral would not be an option as usually restrained by costs.

options:

1. Further examination including careful neurological exam and ideally urinalysis (quick, cheap, easy and could rule a UTI in/out), then treat symptomatically with nsaid's, and antibiotics given pyrexia and neutophilic, could be justified.

2. investigate in house; spinal radiographs, urinalysis. CSF analysis maybe if all other findings nad.?

3. Referral

My usual approach would be 1. and then 2 INB. Would discuss 3 at the onset, but 99/100 ain't gonna happen.

RE: Dog with Intermittent Back Pain and Pyrexia

Clive Ansell — Mon, 22 Feb 2021 18:30:07 GMT

What would you do?

RE: Dog with Intermittent Back Pain and Pyrexia

Anthony Todd — Mon, 22 Feb 2021 17:26:41 GMT

This is a classic example of modern veterinary practice. Just watch how it develops.

RE: Dog with Intermittent Back Pain and Pyrexia

Evelyn Barbour-Hill — Mon, 22 Feb 2021 17:20:45 GMT

Consider kidneys? Just a thought.

RE: Dog with Intermittent Back Pain and Pyrexia

Rob Davis — Mon, 22 Feb 2021 14:37:10 GMT

Discospondylitis? CT or MRI if available.