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The
Martha's Vineyard Times is a weekly publication.
January
20 - January 26, 2005 Edition
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VISITING
VET Dear Vet, January 20, 2005 By Michelle Gerhard Jasny, VMD I feel like Dear Abby. I'm getting letters from my readers. The first, which was anonymous, went as follows: “This letter is meant to inform, not to offend. In your last The Visiting Veterinarian article you declared that you are a feminist, which is very admirable. However, later in the same article you used the harmful saying “an old wives' tale.” This statement perpetuates the stereotype that old wives are an uneducated bunch, that believes in superstition nonsense. This saying is offensive, and is in the same category as referring to a female over the age of 18 years as a “girl,” or calling a black American man a “boy.” Such words are meant to oppress a specific group of people. I am sure that in your rush to meet a deadline you overlooked this offensive stereotype, and that your editor is not herself/himself feminist. A gentle reminder from a fellow feminist, and an old wife.” Dear fellow feminist and old wife, Perhaps I should have used the Yiddish word “bubbemeiser” instead. It means a Grandmother's Myth…but I suppose that is oppressive to Bubbes. If I call something an urban legend, does that imply city-dwellers are gullible fools? If I call someone a country bumpkin, is that oppressive to rural residents? Maybe it is. How do we achieve political correctness without removing all poetry and folksiness from our language? I am truly a feminist and I believe my hard-working (female) editor is as well. I am also an old wife, who doesn't mind being referred to as a girl as long as it's another old wife doing so. Seriously, I am sorry you found my choice of words offensive. It was not my intent and in the future I will try to be more thoughtful. Growing pains or serious problem? My next letter went as follows: “Dear Sirs: I wonder if you could forward this question to the vet. Can a puppy have intermittent rear-end troubles without it being serious? We adopted our eight-month-old terrier/spaniel mix four months ago. Occasionally, he has trouble getting out of the sit position. He appears stiff in the rear legs and once up has a strange gait. Sometimes, he scooches his butt on the floor because it looks too difficult to raise the hind quarters. This has happened twice when we went on long, active walks - off leash for over an hour. He can walk around all right, but after a nap, getting up is difficult. The vet checked his anal glands which were negative. Then he ranged the legs and noticed nothing wrong with the hips, knees or ACL's. He said to have him X-rayed the next time it happens. Any ideas? Thanks. Sincerely, Mary Anne Kackley, Upton, Mass. Dear Ms. K., Sure, a puppy can have intermittent rear-end problems without it being serious. Puppies get sprains, strains, charley horses, bruises, and non-specific “growing pains, “ just like kids. One of my daughters frequently complains about leg pains. It took much reassurance on the part of my experienced daycare provider, and our family doctor, to put my mind at ease, not to mention a couple of mother-requested Lyme tests and radiographs of her ankle. The majority of limping puppies I see have minor problems that will heal without treatment. That said, the symptoms you describe are a little worrisome. Forget about his anal sacs. These normal structures may fill with discharge and be uncomfortable, causing him to scoot his hind end on the ground in an attempt to relieve the “full” feeling. They can also become impacted or infected. Occasionally an owner is confused when a dog keeps sitting down suddenly because his tush hurts, but anal gland problems do not cause true difficulty raising the hindquarters or walking. Your veterinarian checked the glands and found nothing wrong, so we can move on. Medium to large breed dogs are prone to panosteitis, a disease in which the long leg bones become painful. No one knows for sure what causes it, but because German Shepherds and Shepherd Mixes are most commonly affected, it is thought that there is an inheritable component. It usually affects dogs between five and 18 months old but can occur as early as eight weeks and as late as five years. The lameness can shift from leg to leg, which can confuse owners (and doctors.) Radiographs reveal a characteristic patchy appearance of affected bones. Tincture of time and pain medications is all that is usually needed to cure panosteitis. What about the ACL you mention? That's short for anterior cruciate ligament, an important stabilizing structure in the knee. An ACL rupture usually results in a more obvious, ongoing limp. Your veterinarian checked each joint for popping, clicking, grating, pain, limited flexibility, or excessive laxity. Normal range of motion lessens the likelihood of serious problems, but doesn't rule them out. I once saw a young bullmastiff, Beast, who was continually off in one hind leg or the other, and having trouble getting up. She had normal range of motion but tested positive for Lyme disease, which we at first assumed was the problem. After months of unsuccessfully trying various treatments, we sent Beast to an orthopedic specialist. He found she had partial ACL tears in both knees that were too subtle to diagnose on a range of motion test in an unanesthetized dog. The tears might have happened during birth, accounting for the early onset of problems. Dysplasia needs early action Other possibilities? Fifteen years ago, a client brought her golden retriever puppy, Belle, in for routine vaccinations. An observant owner, she commented that she sometimes heard a click in Belle's hip when she ran. I checked range of motion, watched her walk and run. Nada. Like your vet, I reassured her there was probably nothing seriously wrong. When Belle was nine months old, we decided to take X-rays. Although she didn't even limp at this point, we found she had severe hip dysplasia, an inherited malformation of the hip in which the “cup” of the “cup and ball” socket is too shallow, causing an unstable connection that leads to degenerative joint disease. We sent Belle to the orthopedist to be evaluated for a triple pelvic osteotomy. Optimally done at 8 to 10 months, this surgery involves restructuring the pelvis so that the hip socket, technically called the acetabulum, is angled to form a more stable connection. But Belle's dysplasia was too severe and the damage already too extensive. “You must get these dogs that are [severely] dysplastic at early age of about four to six months,” the orthopedist wrote. “I see some that I can't do a pelvic osteotomy on at 5 to 6 months because they virtually have no acetabular coverage left at all. They are not the common ones, but they do occur, so you have to be aggressive about radiographing them when they are very young.” The surgeon advised a femoral head osteotomy. In this surgery, the end of the thighbone is removed, so the shaft floats freely, eliminating the pain. Dogs do remarkably well with this procedure but obviously a functional painless hip socket is preferable. Nowadays, painful dysplastic dogs also have the option of total hip replacements, just like people. Belle's owners opted to manage her case medically (which is a whole other column.) Now not every puppy needs to have radiograph, but what X-rays can do is diagnose a wide range of congenital and developmental orthopedic problems and alert us to those uncommon cases that would benefit from early surgical intervention. An abnormal gait that persists for any length of time is worth evaluating, especially if you would consider major corrective orthopedic surgery. If you would not pursue surgical treatment, there is less urgency, but getting a diagnosis is always a good idea. Most awkward puppies are just awkward puppies and grow out of it, but you don't want to be an ostrich with your head in the sand and miss a serious problem. No offense intended to the ostriches. |
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