Saturday, May 2, 2015

Laddie's injury

This is not a training post. This is just a report on where things stand with Laddie's injury.

To review, two and a half weeks ago, I began to think Laddie wasn't carrying his trail as high as usual. By coincidence, we had an appointment with our holistic vet that weekend, and she said it might be cold tail. She said we should just watch to see if it got better in a day or two, and also suggested a homeopathic for pain. I don't believe in homeopathics so I didn't bother with that. But we didn't do a lot of work the following week, and nothing suggested to me he was injured.

But the following weekend, we began the seminar I had signed us up for, and Laddie's work was mediocre the first day. By the second day, I finally realized he was definitely injured. Whatever the problem was, it was not consistent with cold tail. I withdrew from the seminar, scratched him from the qual we were entered in for yesterday, and made an appointment for a sports medicine orthopedist to see Laddie. That occurred yesterday, instead of running the qual.  :0(

The appointment began with the doctor performing a thorough physical exam. From that, it seemed clear that one and only one movement was causing Laddie pain: extension of his right rear leg.

Next came an electronic stride test. That showed that Laddie was shifting his weight to the front a bit while also shortening and quickening his stride a bit.

Next, the doctor spent some time with me explaining the possible causes of Laddie's symptoms, but I didn't understand them well enough to report them here. Meanwhile, Laddie was getting xrays.

Next the doctor showed me the xrays and explained what he was seeing, but again, I didn't understand what he was saying well enough to report it.

The doctor then laid out a series of possible next steps, beginning with an ultrasound. On his recommendation, I made an appointment for the ultrasound in a couple of weeks. He also gave me a bottle of muscle relaxants for Laddie to begin taking twice a day. He said Laddie should not do any running or jumping up on furniture, much less retrieving, at least until our next visit.

The doctor said he would speak to my holistic vet and I guess he did, because I got a call from her this morning. She has been seeing Laddie all his life and I regard her as a good friend. She was frank.

She said she felt the orthopedist was being too aggressive. She said it wouldn't do Laddie any harm, but to her it seemed like overkill. Very expensive overkill. I thanked her of course, and said I would get back to her.

Later in the day, I called her back and left a voicemail, saying I would like her to do another physical exam as soon as possible. Although I feel she was incorrect about the cold tail, I have great faith in her. Assuming she will be able to see Laddie in the next day or two, I will be interested to hear what she finds. I will make a decision about what to do next after that.


JodyB said...

Personally I don't believe you were told overkill. It's been my experience and what I've seen that way too often people do under kill for various reasons, usually the person is anxious to be playing the "game" with the dog. They seem well, yet something is still not right. Dogs hide things well.

Lindsay, with Lumi & Laddie said...

I'm sure everything you say is true, Jody. Of course you have much more experience than I do with dogs and dog sports. Certainly Laddie is stoic, and certainly I am anxious to get Laddie training and competing again.

However, Laddie's type of injury (iliopsoas strain) has an extremely wide range, from very mild, requiring a few days rest, to very serious, requiring months of rest and PT. The fact that Laddie has this type of injury does not of itself indicate that it's automatically in the very serious category.

A reasonable question is, if Laddie has some underlying condition that caused it, as the orthopedist is prescribing expensive testing to discover, how did Laddie get thru eight years of continuous year-round training and competition without ever having any symptoms before, despite being thoroughly examined by a sports-oriented holistic vet every six weeks his entire life?

So even though SOME iliopsoas strains do require a great deal of rest and therapy, that doesn't mean necessarily that Laddie's injury does in this case.

Since the doctor who has seen Laddie only once immediately decided that we needed to spend hundreds, and possibly thousands, of dollars at his facility, and a different highly respected doctor who has seen Laddie all his life thinks that's overkill based on what we know right now, I have to make a choice as to which doctor's advice to follow.

Given the fact that the two doctors have reached opposite conclusions, I can't help having lost some confidence in the doctor who's seen Laddie only once and stands to bring in hundreds or thousands of dollars in fees with his recommendation, and will therefore put my faith in the doctor who's known him all his life.

It would be easier if both doctors had given the same recommendation, and I realize some people would go with the doctor who had seen Laddie only once rather than the one who has seen Laddie all his life. But I don't think my decision is entirely unreasonable.

JodyB said...

Had an interesting conversation this past weekend about injuries to dogs. Right now in the Agility world in the US it seems everything that goes wrong with a dog is illopsoas strain. Lots of articles have been written about this.

It's probably true in many cases, that this is what's wrong. And the majority of the dogs seem to be Border Collies (this is just from reading, have no idea if it's true or not).

What made the conversation so interesting to me, is what someone from England wrote. She/he was wanting to know what on earth an illopsoas strain was, ro this person's knowledge dogs in England didn't get them.

When did you learn this is what it's called? Have you been back to your regular vet?

Lindsay, with Lumi & Laddie said...

Hi, Jody. The orthopedist probably used the term "iliopsoas strain" during our talk but I didn't understand it nor remember it. But I saw it later in some of the paperwork that he provided.

I brought Laddie to our holistic vet again yesterday. She manipulated his joints the same way as the orthopedist had, and found no pain whatever in Laddie's rear quarters. Apparently the iliopsoas attaches high on the dog's back, and as she continued her exam, she found he needed an adjustment at that attachment. After the adjustment, Laddie had no pain anywhere.

She wants Laddie to rest for another few days, then begin light land training, but no water work at this time. She reduced the muscle relaxant to 50% and wants Laddie to continue that for another week. She'll see him again a few days after that. According to that schedule, when she sees him, he'll have had a small number of light training sessions on land (we don't usually train on successive days and haven't for years) and will have been off the muscle relaxants for a few days.

If at that time she sees no issues, we'll attend a three-day seminar the end of the following week, possibly followed by a competition on Saturday, and she would like us to resume use of the muscle-relaxants during that period.

The current plan is for Laddie to have no water work until the seminar, so if the seminar includes long swims, I plan to modify Laddie's participation. I now think that this injury probably occurred because of the very long swims during the first seminar we took, after going many months with no swimming at all followed only by a little swimming in the early spring before the seminar. Swimming involves the dog pushing back hard into the same extension where Laddie's injury occurred, and I guess those muscles weren't quite ready for the demands of the first seminar.

The holistic vet also wants me to give Laddie T-Relief (previously known as Traumeel) three times a day. She knows I don't believe in homeopathy but urged me to give it to Laddie at this time anyway, as a favor to her. :0)

JodyB said...

Glad you made it in to Carol with Laddie, and have a program to follow. Hopefully he'll be fine and ready to go to the seminar and upcoming trial. I'm sending you the best of everything.

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