Front lameness can be challenging to diagnose and treat. There are straightforward causes and daunting ones too.
The causes of front leg lameness include anything from:
- nail injuries
- paw injuries and foreign bodies
- insect bites and stings
- snake bites
- elbow injuries, arthritis or elbow dysplasia
- carpal injuries
- shoulder injuries
- neck and spinal injuries
- Lyme disease (shifting lameness)
Shoulder injuries are particularly are particularly a complicated matter.
It came like lightning out of a blue sky. In an unsuspected moment, Jasmine went from a prancing puppy to a dog who can barely make it from her bed to a drinking bowl.
We still have no good idea of how it could have happened.
We went for a regular walk, everything was perfectly fine, and nothing happened on the walk that we could suspect as a source of the sudden lameness. The onset also doesn’t add up to trauma from the walk. When she did hurt herself outside, there has always been a usual chain of events. She’d come in just fine, then lay down to rest. Getting up from the rest, boom, that was when you would see something has happened.
No clue how it happened
But that’s not how it happened this time. She got up after her rest and everything looked normal, except some mild soreness in the rear from the iliopsoas that she had hurt some time back. She had her dinner, everything was fine. When she came into the kitchen for her dessert, everything was fine. Then she walked into the office and when she returned she wouldn’t put her foot down.
My heart jumped into my throat.
We examined the foot, and toes and the pads … didn’t find anything. At one point, when hubby was examining the foot, she cried a little, so we searched the foot further. But there was nothing we could see, feel, find, or get a reaction to. So we figured it must be something further up and it hurt as hubby was manipulating the leg to get a better look at the foot.
We examined the whole leg but found no swelling, no hot spots. Just from observing the way Jasmine was babying the leg we were convinced it must be the wrist.
Is it the wrist?
It really looked like it was the wrist that was hurt.
We didn’t want to manipulate it too much, as it must have been hurting a lot; she wouldn’t put the foot down and didn’t even want to lay down, as she would need to put some weight on that leg while doing so.
I was perfectly ready for a trip to the emergency.
But our last experience with them was less than positive and meanwhile, Jasmine did lay down and started bearing some weight on the leg. So we decided to wait till morning to see her main vet.
Worst limp ever
She looked so bad—the worst I’ve seen Jasmine limp, even with all her past injuries and trouble (except the big horror with her hyperthermia). It was so scary and heartbreaking to watch.
It does underline the point that the front legs are so much more important for overall function than hind legs.
The past day and a half was spent watching her every move so I could be there to help her if she wanted to go anywhere She was favoring the leg so badly that she almost fell a couple of times; I wanted to be there to make sure that she doesn’t fall and hurt something else on top of things.
Was it better to let her rest at home or risk the long ride to the vet?
I figured that this needs to get looked at and we changed the trip.
At the veterinarian
First thing in the morning, we’re at the vet’s office, waiting for him to arrive. He took us in right away and examined Jasmine thoroughly. His findings are that she messed up her elbow and really made it very angry. He said she’s telling him the elbow is the problem. He knows Jasmine inside out and really cares about her. And he earned our trust in the past three years. So we trust that if he says that it is aggravated “dormant” arthritis in the elbow, then that’s what it is.
He said the pain and signs are inconsistent with any fragments, luxation or cancer.
So that was the good news.
Limited options for pain management
Jasmine cannot have NSAIDs, since the first time we tried them it almost killed her. She got a bunch of painkillers and also a topical treatment containing DMSO (dimethyl sulfoxide), lidocaine and morphine. I wish they worked better than they seem to, though.
Her vet said that we could take x-rays but that he believes they wouldn’t tell us anything new. It is a leap of faith for us to take his word for it, but he knows Jasmine literally inside and out, cares about her, and earned a lot of trust.
Is it crazy to put so much trust in his experience and diagnostic touch?
Of course there is some seed of doubt deep inside me; on the other hand, our experience with him does tell me we can take his word for it. I know that if he had the slightest suspicion something else is going on he’d be the first one to bring up further diagnostics. When we first brought Jasmine to him with her injured knees, he wanted x-rays not only of the hind legs but other areas also, to get a really good picture of what is going on in her body and treat it all. That’s how it was discovered that she had arthritis in her shoulders and other places also.
More diagnostics or treat?
I feel we can trust him and spend money on treatment rather than further diagnostics from which we will not learn anything new. I pray I’m right!
Based on the situation, and the fact the treatment worked so well for Jasmine in the past, we initiated for her to get a stem cell treatment next Wednesday. She has a lifetime supply of stem cells at Vet-Stem, grown from her retaining sample.
Not that we have the money, but we’re really hoping this will get her back on her feet. It is so devastating to see her like this.
Things do get better when she walks around a bit, which would confirm the diagnosis.
Of course, at the vet’s office, with all the excitement of being there, she hardly limped at all. Fortunately, he really amazed us with how he can listen to what Jasmine’s is telling him when doing an exam.
The day of the treatment
Friday was the big day of the stem cell treatment. We had high hopes that it will fix Jasmine right up. Her lameness seemed somewhat controlled with the pain protocol we were using.
Somewhat controlled meaning Jasmine was moving without visible problems during the day, and only showing a various degree of lameness at night. Of course, she’d still want to do everything as she normally would. Getting her to take things a little easy is one of the hardest tasks. Holding her back is sad for her as well as for us.
All we want is to get her body caught up with her spirit once again.
Getting her to take it easy was even harder on Wednesday when son showed up on the walk with his Sharpei, Gambit.
Jasmine just loves that dog and wanted to play with him. How could we not let them play around at least a little bit? I was terrified but not letting her play at all just was not possible under the circumstances. Of course, she did pay for it that night …
We couldn’t wait for Friday, getting those stem cells in and letting them do their thing.
Since Jasmine was so good and cooperative getting the x-rays, her vet was hoping that it might be possible to inject the cells under sedation only as well.
Jasmine WAS a good girl, but couldn’t help twitching her legs. That was no good, as the stem cells needed to be injected into precise locations. So she ended up having to go under anesthesia after all.
The procedure went well and Jasmine underwent the anesthesia without any complications.
The areas of injection had to get shaved, in order to create a sterile environment. Unfortunately, Jasmine ended up with a bunch of other shaved patches, as they were trying to find a place to draw some blood. Drawing blood from Jasmine is always difficult because finding a vain on her is nearly impossible.
Hubby actually got to be there during the entire procedure; originally to help keep Jasmine steady with the sedation only, but he got to remain even after the plan had to be changed.
He was admiring how the vet and his team are a well-oiled machine.
When Jasmine came home she was still quite groggy and slept until dinner time. She wasn’t overly interested in food but I was able to coax her with a bit of turkey. Then she slept some more.
When she finally went to get up, her front left leg was very sore, and her rear left leg was quite painful also. In fact, in retrospect, it makes me wonder how much of her wobbliness, which we thought was from coming off the drugs, was from pain instead …
She had quite a hard time getting around again.
I guess the DMSO++ and all that was of much more benefit in terms of pain management than we would figure. Today, since she ended up off all those things, we got a true picture of what the situation really is. (Note to self: the DMSO++ concoction seems to be really good)
It was very disheartening for me to see that (again).
OK, clearly, I’m emotional. I do understand that the stem cells will need some time to work before we can expect to see a true improvement in those joints. Somehow, though, I was not expecting to see her that lame. So her poor vet can look forward to an early morning phone call from me. It would make sense, though, that the lack of pain management for the day would have done it. Half a kingdom for never seeing Jasmine lame again!
At least not this badly; at least not on a front leg …
Some dogs show almost immediate pain relief response, even the night after the treatment; we weren’t meant to be that lucky so we got to ride it out. We applied the topical treatment again and today she will be back on the original regime.
Come on, little stem cells, do your thing! Do it as fast as you can, please, for my little girl!
Not as easy as expected
Things remained quite horrible for four days. Was Jasmine going through a “healing crisis,” or was something else happening?
All is well what ends well
After the initial unexpected surprise, the treatment worked really well. Four days post-treatment, Jasmine was as good as new.
Resolution of the story: Stem Cells At Work: From Zero To Sixty In Four Days
Why Is My Dog Limping On The Front Leg