First chiropractor appointment since surgery

I worked from home yesterday so that I could take Spice to the chiropractor. He seemed not too bad in the morning when I walked him. Before I took him to his appointment he was limping more than he has for quite a while :(.

His chiropractor said he wasn't as bad as she expected. I gave her a copy of the report from the surgeon and she had also read the Jump Down Syndrome article. Spice doesn't want to extend his right leg completely (the surgeon mentioned this as well). It has been a while since has. She showed me how I could gently stretch his leg. She also suggested that I massage his leg (towards his heart) and ice him a few times a day. She did notice some heat/inflamation in his elbow. More towards the outside of the leg.

She also asked if I was giving him any supplements and what other exercises I was doing with him. She also mentioned that lifting each leg would be a good exercise. I remember this from one of the DVDs I have.

She thought that it would be best if I brought him back in a week. It would help him to heal faster. I took next Thursday off so that I can take him to his regular vet for another cartrophen shot and back to see her.

After his appointment I found him to be about the same as far as limping goes. Today I am seeing an improvement. His limp is not as strong. I also noticed this morning he was tight lipped on his walk. This evening he was not. He wanted to go faster but I held him back so he wouldn't go too fast. He doesn't appear to be quite a good as I thought he was before he started this more severe limping. I am not sure why he was worse yesterday. I wonder if he curled up too much in his crate. Normally he is in his X-pen when I am not home. I brought him downstairs and he slept in his crate while I was working.

I have been walking him 3 times a day and I was up to about 10 minutes but yesterday and today I haven't been walking him as long. I also was doing cold therapy about once a day but have since started doing it more often.

Belleville CKC trial

This past weekend I went to the CKC trials in Belleville. Taari was entered in JWW only as I am still working on retraining her contacts. I brought Spice along as well.

Spice seems to be doing well. Sometimes his limp is barely noticeable though this weekend it almost appeared to my eye that he might have been off in the rear. I will be taking him to his chiropractor on Thursday. I am very interested to hear what she thinks and what she can do for him. The last time Spice saw his chiropractor was few months ago.

The Belleville trial location is very nice and I always look forward to seeing some of the dogs and handlers that I don't usually see. Two members of this year's CKC world team were at the trial. I love to watch Lucie and Nitro and Suzanne and Copine in person. They are such fabulous teams. Nitro's son Scud was also at the trial and it was great to finally see him now that he has grown up and is competing.

I got to see my friend's young dog Brigs get his first Qs. He did really well along with his brother and sister, Casey and Flicka. Cathy and Casey are previous world team members (2004 & 2005).

Taari didn't want to hold her start line stays. Luckily on the first course she knew where to go with out me. I spent the first part of the run trying to catch up to her. There were some very wide turns but we managed to Q with only one refusal.

The second run was much better. I need to improve my timing in some spots but otherwise I was very pleased with the run. It was also a Q. She came a close second to Scud with a time of 24.52 (5.71 yds/s) versus his time of 23.81. The run was not perfect and sometimes the agility gods are on your side and this was one of them. She got her Intermediate JWW title with that run.

On Sunday we ran in Excellent A. I thought that perhaps Taari would be used to the environment and would give me a stay at the start line. That was too hopeful. Nitro and Myda ran before Taari. Both are exciting dogs to watch and perhaps too exciting for Taari. I did not get any sort of a stay on Taari's first run. Taari did not know where to go this time. The run had some great parts though.

On the second course I was determined to get ahead of her and indicate which end of the tunnel to go in to. I was successful in keeping ahead of her but we had a bit of a discussion at the tunnel entrance and got a refusal. I was very pleased with the rest of the run. I wished I would have had that run on tape both to figure out what went wrong at the tunnel and what went right. Her weaves were excellent all weekend.

Both Taari and Spice got to visit lots with people and had a great time.

Massage and Progress

On Sunday we went to the Spot On trial. It was cool in the morning but otherwise not too bad weather wise. Taari's jumpers run was fast and had some good parts. We have some things to work on (start line stays) and I need to make sure she is with me coming out of tunnels. I am retraining her contacts so we are only doing jumpers runs at trials right now.

Spice had good visits with his dog and human friends. He was moving really well while walking at the trial. I was walking him pretty slowly so I think that people thought he was really old. No obvious signs of limping. Andrea gave him a massage. That was the main reason for bringing him to the trial.

I had a good visit too with my friends and stayed longer than I had intended. Unfortunately it was pouring rain by the time I left. I was glad not to be running in it.

I did some more reading about stem cell therapy and found that they need about 2 tablespoons of fat (see Vet-Stem website). I am not sure how easy it would be to find that much fat on Spice. I keep him pretty slim.

On Monday I noticed Spice limping a bit more when he went for his walks. It is too bad he doesn't like to walk on the grass. He prefers the sidewalks which is probably harder on him.

Today (Tuesday) he seemed worse (head bob and limping when walking) in the morning and got better later on (less limping). We started going for longer walks since it has been two weeks since his surgery. He seems to want to go fast on the walks and I am slowing him down. I am still massaging his leg 2-3 times a day and I have been icing it as well.

Spice does seem to be more lively which is a good sign. He is still spending the day in an X-pen when we are at work and no stairs.

Stem Cell Therapy

Using stem cell therapy to heal orthopedic issues (osteoarthritis, orthopedic soft tissue injuries) sounds very promising from this news report and from Vet-Stem's website.

I found that there is stem cell research being done on horses in Canada.

http://www.uoguelph.ca/news/2008/02/ovc_testing_ste.html

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20080415/stemcells_horses_080415?s_name=&no_ads=

Not sure if it is available in Canada yet though for pets.

It was mentioned in the Jump Down Syndrome article as well.

Recheck with the surgeon

Today we went back to the clinic to have the surgeon check Spice. It has been 10 days since his surgery.

The surgeon was happy with Spice's range of motion. The small incision healed well and the bruising is gone. Spice is still sensitive at his elbow joint but there is no swelling. The surgeon could not detect crepitus in the joint. One thing that he noted was that Spice does not want to extend his leg completely. I am not too surprised as I think that it will take some time.

No stairs for 2 more weeks and then he can be allowed to do the small set of stairs going up to the bedrooms. Going up is easier on the joint than going down. We will have to wait longer before he can go down the larger set of stairs to the basement. One thing that the surgeon suggested was to use a harness (tracking harness or seat belt) when Spice is going down the stairs and lift him a bit to take some weight off and reduce the impact.

I told the surgeon that I used a physioroll before to help strengthen Spice. I have the Get on the Ball DVD. He said that we can start ball work twice a week to start and see how he does. I will wait about a week before trying this and will be starting slowly. Yesterday I did some ball work with Taari and Spice was getting excited in his X-pen thinking that he would get a turn. He got cookies instead.

Another good passive exercise is having Spice give me his paw. I will have to review my other DVDs to figure what other exercises would be good.

Up until now I have only been walking Spice about three houses down the street for his bathroom breaks. We can start walking more (6 houses) but it will be a meandering walk. He is not ready yet for 10 minutes of continuous walking but we could just go out for 10 minutes - visiting with neighbours and enjoying the spring weather.

I am at a trial this weekend with Taari and it is okay for Spice to come along and get a massage.

It will take 6-8 weeks for cartilage to form. How Spice is doing will tell us how well things are progressing with his joint. There is a danger of damaging the scar tissue if the surgeon went in again so he will only do it if necessary (i.e. Spice gets worse).

I may find that Spice gets sore during his rehabilitation and if he does then I rest him for 2-3 days. I asked about his cartrophen shots and Spice can continue to get them on his regular schedule (he doesn't need to have them more frequently). I stopped giving him Metacam today. If he gets sore again later today can give him Metacam again for 2 or 3 more days.

He doesn't think that Spice's elbow will get bad enough that it will require more drastic measures - fusing the elbow joint, amputation or elbow replacement. I was glad to hear that.

The surgeon also said that Spice looked good for his age (12 years old).

We will go back and see the surgeon in two months unless he gets worse. Until then we will continue with his physiotherapy. I am feeling more positive about his prognosis.

Diskless

Spice no longer has to wear his e-disk to prevent him from licking his legs. I think that he will be happy about that. He doesn't like being left in the X-pen at times and lets me know. Especially when I come home and want to do a few things before letting him out.

To prevent him from going up the stairs I have taken parts of my hoops (Taari's contact training hoops) and created a barrier. I have a baby gate that I use on the stairs that go to the basement. This is one of these times I wished I lived in a bungalow.

I will have to figure out a way to categorize Spice's limping so that I can see if he is improving.

Tomorrow he goes back to the surgeon for check up.

Update on Spice

Wednesday: I picked Spice up on Wednesday (his surgery was on Tuesday). His leg was very bruised which is to be expected. He has a "poodle" cut on his leg as they shaved part of it. He also missing some fur on his left leg from the surgery. His leg was quite sore.

For the next two weeks he is to be kept quiet. Only going out on leash for bathroom breaks. No stairs, slippery floors, jumping, running, etc. He will need to be kept in a small room or crate when we are not at home. I have an X-pen that I set up in the living room. He also should not lick his incision. I don't like the cones (typical e-collars) and neither to my dogs. So I am going to try the craft foam disk that I made for Taari. I just need to cut a larger hole in it for Spice since he is bigger. This is quite flexible and should prevent him from licking himself. It is Christmas colours since I bought the foam on sale (red and green with some yellow duct tape). As well as ice therapy for the first few days I should wash the incision with warm water. Home physio consists of massage and flexing and extending the joints. I will probably continue with the ice therapy as well.

After two weeks I can start short walks with Spice and gradually increase the time to help build muscles. They recommend 3-5 walks a day which will be a challenge on days in which I work. I think that I can get three walk in (one before work, one when I come home and one before sundown). I will also do some strengthening exercises.

Wednesday night Spice and I didn't get much sleep. He was very restless which I believe was due to pain from the surgery and possibly an upset stomach. They most likely gave him something to eat while he was at the clinic.

Thursday: I worked from home so that I could keep and eye on him. Thursday night we both slept better. I gave him some Slippery Elm to help with his stomach.

Friday: I went to work but came home early since I was worried about him. It was actually Friday when I started using the e-disk on him.

Saturday: His bruising is continuing to decrease. He seems to be in less pain.

Sunday: Again I noticed that bruising is less. I tried not using the e-disk but caught him licking his leg. Not where the incision is but where he was shaved. It is a bit red there so I am wondering if it is irritated. There is also some scabbing on his skin and I wonder if it is because he was shaved or perhaps due to the arthroscopy.

Spice has for the last couple of days wanted to go for more than a bathroom break when I took him out front on leash. I think that he is expecting a walk.

Sunday night when I got home from the trial (Taari was entered in a nearby trial) he seemed to be moving better when he went for his bathroom break. It is good to see an improvement.

Jump Down Syndrome

When I was going home to visit my family I took some Clean Run magazines to read on the plane. While I was reading the Jump Down Syndrome article I thought is this what Spice has?

Spice has been limping for a while and he wasn't putting full weight on his front right leg. Initially I thought that perhaps it was a soft tissue injury or arthritis. I took him to his chiropractor and she could feel heat in the joint and noted crepitus. When it wasn't getting better my vet started cartrophen injections. They seemed to help a bit. I was of the opinion if it was arthritis there wasn't much that could be done other than what I had been doing. Spice is on a variety of supplements - Vitamins B, C, E, Sashas blend, Joint Complex (Glucosamine and Chondroitin Sulfates with MSM), and salmon oil. I feed him a raw diet (Urban Wolf and Healthy Paws).

When Spice was due for another cartrophen injection I took him and the Clean Run article to my vet (Wednesday). I wanted to know if there was something more that could be done. My vet referred me a specialist. She called to let me know on Friday that Spice had an appointment with a surgeon on Monday. Spice had arthroscopic surgery on his elbow on Tuesday. When I picked up Spice on Wednesday I asked the surgeon if I could call what Spice had Jump Down Syndrome. He said it was likely that was what Spice had.

From the Clean Run article by Sherman O. Canapp Jr., DVM, MS, DACVS and Donald Hulse, DVM, DACVS (April 2008 p 78)

"Jump down syndrome" or traumatic fragmented medial coronoid process is a condition in the elbow joint of dogs that appears to occur commonly in performance dogs. Unlike the classic condition of fragmented medial coronoid process (FMCP) affecting the elbow joints of skeletally immature large to giant breeds of dogs, jump down syndrome (JDS) appears to have no age or size limitations.

They say that the cause isn't well understood but suspect that abnormal repetitive loading may cause microfractures of the bone. Landing from a jump, hitting contacts or a flyball box are given as examples. They also discuss other factors.

The treatment according to the authors is multimodal - medical, surgical and rehabilitation.

Arthroscopy - diagnosis and removal of bone fragments
Medical - pain killers, joint protective agents, etc.
Rehab - ice therapy, manual therapies, home exercise program, etc.

Basically as I understand it the bone fragments and pieces of it end up in the elbow joint. When the surgeon examined his right elbow manually it was sore. They took X-rays and found that Spice's right elbow joint didn't look right - possible fragments - fuzziness. His left elbow looked fine. During the arthroscopy the surgeon found pieces of bone in the joint (which he removed). We will have to see how Spice recovers since a fair amount of damage (moderate to severe osteoarthritis) was seen but the surgeon did what he could. I got to see the video of the surgery when I picked Spice up.

My goal is not to have Spice compete again but to make him more comfortable with every day life. If his recovery goes really well we may do some jumpers runs at his double drop height of 6". They do mention in the article that recovery is typically 2-3 months and "return to sport" 4-5 months.