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Speaker 2: So for those of you that had joined us, and
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and don't be afraid. It's free and it's easy, and
we want to hear from you. We want to help you.
So just again eight seven seven three eight five eight
eight A two. That's how easy it is to get
to us. So last couple of weeks we've been talking
about skin allergies. We also started talking about vomiting, a
lovely subject. And what I realize is that there are
Veterinary medicine is not a one size fits all. You
can't bring a dog in with the history of vomiting,
for example, and expect that the treatment or the approach
to the case might be the same as when your pet,
saint pet was vomiting a year before, because there are
so many other factors that we have to take it
to consideration, some questions we need to ask, and then
have answered before we can determine is this a serious
vomiting episode or a not so serious And I realize
that there are a number of presenting complaints that we
see that also can vary from oh my gosh, we
have to do something now to something that can actually
handle on the phone with a little history and say,
you know what, this is not a problem, just sort
of like take to a and call me in the morning.
Not quite that, because we don't like to give necessarily
pets aspirin. But the key really is that we have
to evaluate the entire picture. We have to get a
good history. We have to know how the pet is
doing other than the presenting problem. We have to know
how it came on. Was it sudden or was it
a slow, insidious onset? And these are all the very
very important questions that need to be answered before we
can determine how are we going to approach this case.
And if there's one concern I have with you know what,
I'm allowed to say anything I want.
Speaker 3: This is my show.
Speaker 2: But I've actually been in huge forms because I do
a lot of speaking at the conferences. But the biggest
concern I have is the younger veterinarians are so skewed
to the types of cases they see in their teaching
hospitals when by the time they get out and go
into general private practice, they don't really know that there
are many many other types of problems in that same
genre of problems that they might see. Here's what I mean,
just to give you a little history of a teaching hospital.
Teaching hospitals, like university hospitals in medicine, are where all
the research, all the happening stuff is being done. The
typical problem that you might go to your doctor for,
or that you might bring your pet to the veterinarian for,
is going to be handled by your veterinarian. Now, what
happens when your VET is challenged by a case is
presented a case that is beyond the scope of a GP,
that needs that specialist, that needs that extra.
Speaker 3: Bit, or need that team of specialists. So what might
they do.
Speaker 2: They might send your pet to a recall, a referral
to a specialty group in your area, or if there
is a hospital, a university vet school hospital nearby, they
will send it to the hospital. When I was at
UC Davis, we will scale a lot of these cases.
Now understand, these cases are not your norm they're not
your typical. These are the really bizarre, challenging cases that
do happen.
Speaker 3: But it's not something that's Norman.
Speaker 2: It's it's something usually that your general practice veterinarian or
even I sort of hit that roadblock and now we
need the help of the experts in that respective field.
Ah So, now think about the veterinary students going through
the many of our veterinary schools in the US. They
are not seeing the vast majority of the basic cases
because they don't need to get to the university. Your veterinarian,
your private practice vet in your little hometown is able to.
Speaker 3: Take care of it without issue.
Speaker 2: So the cases that they see are actually these very bizarre,
challenging cases that need a tremendous amount of diagnostic workups.
Speaker 3: So what they've forgotten.
Speaker 2: The disservice that we as a profession have created in
our young graduates is that they don't really have a
grasp for your normal, run of the mill, typical, much
more common case and they go bonkers when they see
a case and they think, oh my god, I have
to do this test and this test and this test
and this test and before you know what, A thousand
dollars later, you have five tests that were done, you
only need one and your pet's fine.
Speaker 3: But didn't need all that.
Speaker 2: So I think getting that history is so critical to
find out how something came up and how long it's
been there.
Speaker 3: What's the rest of the pet?
Speaker 2: Like try to we always try to do, is I
try to eliminate for a minute the problem even in
my brain, in my eyes that I'm seeing before me,
and I want to evaluate the pet as a whole
the rest of the pet.
Speaker 3: If that rest of the pet.
Speaker 2: Is just fine, and I'm clearly then less worried about
whatever the presenting problem was. If, however, he is as
we use the term a lot, and you know that
ADR ain't doing right, so in general everything else is
kind of off, then obviously we have to take a
different approach. So this week, what I wanted to do,
and I mentioned it last week before the show ended,
We're going to talk about a very very common presenting
complaint that we're going to see all the time, your
veterinarian's going to see all the time, and to help
you determine when this is something that you need to
panic or something that you don't need to panic something
where I'm going to give you some clues where you
could actually say to your veterinarian, really want to I
don't think we need to take an MRI right now.
Why don't we wait and see what the X ray
show is? And this is limping, and limping can vary.
It can present in so many different ways, so many
different onsets. A one year old who comes up limping
lame that was playing at the park the day before,
it's going to be a lot different than the ten
year old who has not going to the park and
then the last couple of days has a little lip
that's getting worse and worse, all right, which one of
my more concerned about the one year old or the
ten year old, and clearly the ten year old because
the one year old who was doing fine and Saturday
and then Sunday goes to the park and comes up
the lame Sunday evening. Obviously, that's like you or I
turning an ankle, twisting, pulling whatever. So is it dog
weight bearing meaning is it able to put weight on
the leg? Is it still happy?
Speaker 3: Is it eating?
Speaker 2: Is it wagging its tail when you come in? Is
it thrilled to see you. Then that's really not much
of a problem. That's one where I might just say
to an owner if they called me on the phone,
you know what, he's able to walk on it. Yeah,
so clearly pretty much. I'm obviously not one hundred percent,
but if they can put weight on it, even though
they're favoring it, it's not broken. Usually if there's a
broken bone, even so much as a broken toe, they
really are protecting it worse. Obviously not every dog is
this way, but certainly to not panic, I will tell you,
don't panic. Give it a day if you have any
certain nonsteroridals around the house, things that we've given before,
even if the case is right, and ask in a
very much lower dose than we take them, and rest.
Speaker 3: If something looks swollen.
Speaker 2: If there may have been what appears to be maybe
a bite stepped on a b I mean, there's so
many different reasons for a dog to come up limping
that is impossible to think that every limping dog needs
an X ray or worse, I mean, or a CT
or bone scan. I mean, that's ridiculous because most don't.
The expression that I've used many a time again it's
a California expression.
Speaker 3: But I'm sure you guys can get it.
Speaker 2: You're running along the beach in Malibu, hear the hoof
beats chasing you from behind. You're not gonna think zebras,
You're gonna think horses. You're gonna go with the obvious.
So when we see this a limping dog, the things
that I would have you do at home, first of
all is evaluate the rest of the dog. Forget the
limp for a second. Some questions that I'm going to
ask you, some questions that you should ask yourself that
will help you determine is this something that I need
to panic or is this something that you know what.
Speaker 3: I'm going to give it a day or two and
just see how things go.
Speaker 2: First of all, is there any swelling or pain to
the touch, like and you hit a spot where, oh
my god.
Speaker 3: If so, you have.
Speaker 2: To think of some especially if it's on the foot,
some sort of insect, be a spider, some sort of bite,
a thorn, something actually got in the pad.
Speaker 3: Turn the foot.
Speaker 2: Around, look inside, check in between the toes themselves.
Speaker 3: We call it the webbing.
Speaker 2: Check underneath by the pads, kind of spread the pads.
If there's hair, in the way, try to try to
get the hair and actually inspect the toe, toenails, the foot,
the pads, etc.
Speaker 3: See if you can find something.
Speaker 2: If the area is swollen and tender to the touch
so he doesn't want to really put weight on the
foot because of it. You can also fill up a
baggie with some ice water, stick the foot inside the
baggie and crympt the baggy over the wrist for ten
minutes and let's see if we can help bring down
the swelling. And lastly, and you might want to check
with your veterinarian. I am okay with a script in,
which is an aspirin with an ant apt in it
and at about I usually give one aspirin for fifty
to sixty pounds, So if you have a fifteen pound dog,
it's going to be a quarter of an aspirin only max.
Twice a day every twelve hours. Usually I'll just give
it once. Do not use a cedamnifen or ibuprofen or
any of the others in a dog without first consulting
a veterinarian, and never one more time. Never use a
cedamnifn tail and all in a cat. It will kill
your cat. So If all is well from that perspective,
then what you want to do is think about watch
the dog walk and see is he putting weight on
it or is he not putting weight on it? How
animated is he or she is still running around, still
wanted to play, just has kind of a glitch, you know,
a little limp. Then if that's the case, then again
it's probably nothing to worry about. So now let's look
at to the history. Where was your dog the day before,
the day before that?
Speaker 4: Right?
Speaker 2: Was there exsessive play? We're playing with another dog, doggy, daycare,
dog park. Any did you go to the park and
throw a ball or a frisbee? Any potential that he
twisted something, turned something, etc. And is it a front
leg or back leg? Because if it's a back leg
and give a big dog and there was a lot
of running or pivoting, there might be a concern of
accruciate tear, which is the injury a lot of football
players and the basketball players get called the crane accruciator
or the anterior cruciate ligament. Typically, however, when a dog
will tear a cruciat or tear not even completely. Even
some of the fibers. It's often associated with an acute yelp.
Speaker 3: You will hear.
Speaker 2: Them give a cry, and that is important to note.
And if certainly your veteran's going to ask.
Speaker 3: You did you hear? Were you there? Did you witness
what happened?
Speaker 2: And if it's a back leg, especially if it's a
larger dog or any of those short squat dogs like
my friend Chees, then that is something we need to
put on our list of possibilities. And we may want
to obviously take an X ray. There's some things that
we can do and try to evaluate whether or not
that is a problem as well. Anyway, we're going to
come back. We're going to talk about some conditions that
are more serious. But it is that time halfway into
our show and it goes very quickly, so stay tuned,
don't move. If you have any questions about this about
a limping dog, a dog or a cat that's been
limping favoring a leg, I want to hear from you, because,
believe it or not, it might not even be a
leg problem.
Speaker 3: That's right.
Speaker 2: We have to think of the backbone and the neck
as well, So don't go away, get ready to call
me back. Eight seven seven three, eight five eight eight
eight two Look back in just a minute.
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Speaker 1: Radio, pet Life Radio dot.
Speaker 2: Com and welcome back to Ask the Vets with doctor
Jeff Here on Pet Life Radio and before the break
we are we were talking about limping just one of
the other conditions problems that you're you might notice in
your pet. And I want to give you some guidelines
just to when is it something you need to really
worry about, worry about just maybe a little, or really
pretty much not worry about it at all. So you know,
we talked about the swelling a dog that comes up
acutely means suddenly lame, usually after an episode of running
or playing, but still walking on it's just kind of limping.
Just before the break, we talked about if it's a
back leg, a knee issue, we might be concerned about
about a cruciate tear. But let's get into some things
that might require some intervention, some veterinary intervention, a call
or at least a visit to your veterinarian. And those
would be either that same minor problem.
Speaker 3: And you've done everything right.
Speaker 2: You rested, you gave some some medication that might help you,
maybe some glucosamine, you checked with the veterinarian, and you
gave a low dose aspirin with ideally with a little
an antacit in it as well. And yet despite all
that two or three days later still limping that now
it says, okay, we now we have to check it out.
Even though the rest of them is fine, even though
he's happy, he's eating, everything else is perfect. By now,
the limp should be slightly getting better every day, and
if it's not, we need to take a look at it.
Or the problem where it's not just limping, it is
non weight bearing, an injury, something that happens suddenly, something
that's insidiously day by day not getting better but actually
getting worse. And you really can't pick a time or
an episode that happened that brought this on. It just
all of a sudden it started happening, and you notice it,
and every day it's getting worse. A few days it's
getting worse, and now it's gotten to the point where
they don't want to walk it all on a leg
or more than one leg, or how about a dog
that you're noticing the leg is just getting large, more
and more swollen, and when you touch it it's either
hot or you know, like firm to the touch. These
are all the different scenarios that this could happen and
we need to go through because obviously they're even still
a little bit different. Now when you have any of
these situations, you definitely want to see a veterinarian. And
this is where some sort of study is going to
be in order, depending on again the rest of the pet.
If the pet is otherwise fine despite the leg issue,
the limb issue itself, then at least the X ray
and a good thorough manipulation palpation is in order.
Speaker 3: Blood work may not be in order.
Speaker 2: Let's take a cat, however, for example, or a dog
that you can see actually a wound, you can see
a puncture, you can see a bite, and the leg
is not only getting firm, but it's almost getting hot
to the touch. Temperature is elevated, so now you have
to think, oh my god, we have either a cellulitis
or an abscess. These animals one hundred percent need to
have blood work done as well. We need to see
if there's an elevated white cell count, do we have
an infection brewing? And if so, has anything else been
affected by this? And that where it's going to require
obviously veteran intervention. If you have the injury, for example,
the most obvious it hit by car, and not only
is the dog I'm.
Speaker 3: In pain, not bearing weight at all, and even.
Speaker 2: If you looked at the leg, or especially if you
looked at the leg and saw, oh my god, this
is not.
Speaker 3: A normal leg.
Speaker 2: Of course, straight to your vet, straight on the X
ray table. We have to evaluate for any kind of fractures. Now,
what about a case where you have an insidious onset
that seems to be getting worse. And again an absessed
brewing or cellulitis that's not being treated could be one
of them. But if you have an older dog, a
large breed especially and you could feel it's not necessarily
that it feels warm to the touch, but the bone,
especially near the joint, is starting to feel very firm
and clearly larger than the opposite end, the opposite bone
on the other side. Well, now we have to start thinking,
and I hate to say it, it does happen. It's
a drag and that is bone cancer or joint cancer,
something called osteosarcoma or chondrosarcoma. And we see this a
lot in larger dogs.
Speaker 3: As they get older.
Speaker 2: So again, this is something that's going to need work up.
It's going to need full panel of bloods and a
major discussion with you and your veterinarian to determine, Oh
my god, what are my chances?
Speaker 3: What are the options here?
Speaker 2: Because there are many, and most importantly, what is the
prognosis again depending on all these factors. I know some
people that just refuse to put a dog on chemon radiation.
I've had clients that refuse to amputate, even though they're
catching it early in the course of the disease. The
dog is doing great. Otherwise to them, to the dog itself,
three legs means nothing. They do it so easily, and
yet owners have this thing in their own head that
I'm not going to amputate. So but that's something a
discussion you have to have with your family and you
have to have with your veterinarian. But options are out
there if you have the dog that has a continued
lameness and it can't be pinpointed. Everything on the X
ray is normal right as far as the limbs. Now,
as they mentioned just before the break, believe it or not,
there are disc episodes in the neck, the cervical spine
creating for limb lameness at the very end, creating hind
limb lameness that has nothing to do with the foot,
the hawk, the knee, the hip, it's all in the
nerve supply to the back leg in that case, or
has nothing to do with the shoulder or the elbow
or the carpass or the toes. In the case of
a fore limb lameness, it might be all because of
a pinch nerve or a disc something going on in
the neck. So this too, obviously is going to need
a certain amount of diagnostics to determine what the problem is. Now,
another area that we didn't discuss that we need to
bring apart. We talked about the older dogs, We talked
about the cancer, We talked about the knee, the stifle
injuries in some of these breeds. But what about the
ten or twelve month old golden retriever. No history necessarily
of any kind of injury, It wasn't running like crazy
at the park, and all of a sudden, it's really
favoring let's say a four limb, a front leg. Now, what,
what are some of the possibilities. Well, this is where
we get to talk about some of the growth related
diseases that we can see commonly in especially large breed dogs.
Large breed, rapidly growing dogs up until they're about two
years of age, and yes, it's going to need X
rays to determine the problem. And when you see a
dog presenting like this, this is what we need to evaluate.
And there are three major issues that we see on
a front lamp and pretty much two on the back.
But the three on the front of them are something
called pan osteitis that is an inflammation.
Speaker 3: Of growing bone. The bone hurts.
Speaker 2: Next is FCP fragmented coronoid process, which is a developmental
anomaly in the elbow we call elbow dysplasia. And lastly
is OCD and not obsessive compulsive disorder, but osteo chondritis desiccans.
It's a cartilage flap defect, typically present in the shoulder.
So fortunately, the panastitis is.
Speaker 3: The most common of the three.
Speaker 2: And the reason I say that is that it is
a non surgical condition. It is a medical Let's wait,
let's provide some pain relief, let's provide some anti inflammatories,
and we're gonna be fine. Versus the osteochondritis and the
fragmented cornoid which turned out to be surgical diseases. Now
they do great after surgery, but still you got to
subject your young, happy, healthy goofy retriever or whatever the
large breed may be to a surgery. Now I mentioned
the elbow displasia, obviously it brings to mind hyptasplasia. And
let's talk for a second. Because of hyptasplasia, it's extremely
it's a huge subject. As a matter of fact, I
see that our time is such that I don't even
want to start the subject of hypdasplasia because it's a
big I can give a whole show to hypdasplasia. And
as a matter of fact, I may next week, well,
actually next week, I'm going to be at the Central
Veterinari Conference and will most likely have a guest on
with me. Who that guest might be, I'm not so
sure yet, because I have to see who will be
the most interesting colleague to bring on our show next week.
From the conference itself, it's a great conference in Kansas City.
If you've never been to Kansas City, not a fun
place to be during the winter, but man, during the summer,
it is a great town, a lot of fun, a
lot of great.
Speaker 3: Places to go and eat.
Speaker 2: And this conference, called the Central Veternight Conference, has been
growing by leaps and bounds over the years. It's become
one of the Big three or four and it's a
great conference. So we're gonna be live broadcasting live from
the Central Veternight Conference next week next Sunday, but I'm
going to work on We'll do this piece on hip displasia,
hip problems and the wide gamut. It's one of those
things that to me is a practitioner, it's so frustrating
how much misinformation is out there about hips.
Speaker 3: So we're gonna have to clear that up.
Speaker 2: So anyway, for those of you that didn't call, the
number that you forgot was eight seven seven three eight
five eight eight eighty two. That's the number you can
actually call us the next week. We did get an
email which we will also deal with next week.
Speaker 3: A sort of a.
Speaker 2: Common problem about a woman who's neutered. Male cat seems
to get a little bit over aggressive out of the blue,
often when she's just lying in bed and starts to bite.
This could be an issue a displaced aggression. So we'll
talk about that as well. And other than that, we
get to see you next week, same bat time and
right here at Ask the Vets with doctor Jeff here
on Petlight Radio. And want to thank once again our sponsors.
Speaker 3: Pro Sense and Kong who are off the hook this week.
Speaker 2: Is none of you chose to call, And of course
Mark Winter my fantastic producer, and we will see you
live from the Central Vet Conference next Sunday.
Speaker 1: Let's talk pets every week on demand only on petlight
radio dot com.