Referral dilemma

[Allyson]

Could it be IOHC? That does need x rays done at completely different angles I think than ED?

My friend had a dog with this and was operated on by Noel Fitzpatrick, he still bobs.

[arwesa]

Probably because it's a young labrador. There is also a test you can do manipulating the elbow which is quite specific for ED. But it's a good question to ask because not all vets are good at examinig joints and muscles (I forget sometimes as it's so much a part of my day to day work).

Which is why i was suggesting to try at least talking to mm. She would want the background info from vet and could rule out soft tissue issues from gait anaylsis etc and palpation hence potentially saving money. Unless its a known orthapedic issue it seems silly to me to spend hundreds on xrays and scans without ruling out soft tissue .. My point was my springer had intermittent lameness after working...it was muscular..

[Rookie]

Unless its a known orthapedic issue it seems silly to me to spend hundreds on xrays and scans without ruling out soft tissue ...

Even though the dog first showed signs of lameness 18 months ago when it was 12 months old..?

I be going down Vicky's suggested route, having x-rays done by my own vet and sending them off for the opinion of an orthopaedic specialist.

s incomplete ossification which is suspected to be hereditary and I'd love to look for some patterns in pedigrees.

I've seen a mother/daughter combo and pair of litter brothers with IOHC so there's not much doubt in my mind that there's at least some hereditary component. Those particular ones were springers but we're seeing more and more affected cockers, the last few we've had have been cockers.

Allyson, CT scanning is the best way of diagnosing IOHC. It can be found on plain x-rays, and I have found it, but it is very easily not picked up and that's not the fault of the person taking or even reading them.

[arwesa]

Unless its a known orthapedic issue it seems silly to me to spend hundreds on xrays and scans without ruling out soft tissue ...

Even though the dog first showed signs of lameness 18 months ago when it was 12 months old..?

I be going down Vicky's suggested route, having x-rays done by my own vet and sending them off for the opinion of an orthopaedic specialist.

Forgive me for suggesting a course that was going to help confirm orthapedic without costing, which was what i took to be the OPs main concern here ... What else could be done is what i believed was being asked.

Of course a 12 month old dog can hurt itself. I know my youngster had strained muscles at 12 months. And gemmas pec injury was diagnosed before 2 with scar tissue so had happened before then....having seen what mm is capable of doing i was merely suggesting there are other cheap things to do to rule out first..

[t jack]

alpha, feel free to say no but could you pm your pups pedigree? I take it yours has incomplete ossification which is suspected to be hereditary and I'd love to look for some patterns in pedigrees. Also there are some vets studying it if you would be happy to pass pedigree onto them...
http://www.vet.cam.ac.uk/news-and-events/iohc/
http://www.andersonmoores.com/services/ ... _research/

I dont have it as he is one of my Pre triallers but will pm you the Parents if that helps

Is this condition proven to be hereditary and are there any tests available for adults to conclude whether they have it/can pass it on to offspring?

[vicky payne]

Statistical pedigree analysis of affected cockers strongly suggests IOHC is hereditary. There is no reason to believe it would be any different in ESS and Cambridge are working on it right now. IOHC is, I feel, the biggest health problem facing ESS and cockers at the moment. Sadly there is no test for it. The KC/BVA elbow score will rule out other elbow dysplasias but does not include a view for IOHC. The correct view is VERY hard to take on plain x-rays and when the fissure is visible it can be more from luck than skill! CT scans show the problem up much better but are more expensive.
Luckily for Labradors their ED is easier to see on plain xrays (which are quite cheap). That said I usually refer them to a specialist to be looked at as they look at rads all day long and can see things I miss (subtle changes in subchondral bone).
You can of course go straight down the physio/massage route and I have no doubt there will be muscle damage in this dog...but is it the cause of the problem or is it secondary to another problem (ie the joint). In a different breed or a different age maybe I wouldn't suggest x-rays....but in a young lab there will be a question mark over ED for me.
Good luck!

[MarstonMarauder]

keirk, If the Xray doesn't bring any light onto the lameness i am more than happy to palpate and treat as a case study.

Vicky, I respect and work alongside vets and will refer cases back to them if i don't think soft tissue damage is the cause. I am
trained to look out for orthopedic conditions as-well and not to treat unnecessarily .
I sense a little defensiveness in you posts which there is no need as i am not an anit-vet therapist.

[vicky payne]

Sorry, I don't mean to sound defensive but I believe in getting a diagnosis before treating with any therapy. I upset many of my potential holistic clients by telling them they sometimes still needs bloods or x-rays before I can treat with herbs, physio or acupuncture! At the end of the day legally only a vet can diagnose an animal and the buck still ultimatley rests with the refering vet, so my cautious attitude is only so that both the vet and non-veterinary therapist are protected if things go wrong. Personally I'm happy to work with other therapists and regularly share cases with a pyhsio locally ( I soften things up with the acupuncture making her job easier!).

[cornishbirdabroad]

Now I don't know what we are talking pricewise for a MRI/X-Ray etc but ... I'm guessing £1000's? I really can't afford £1000s for potentially fruitless investigative scans, but on the other hand ...What do I do?

My cocker has elbow dysplasia, in both elbows, diagnosed at 6 months which the specialist vet stated was hereditary. First we had x-rays at our vets, then more at the specialists. We didn't go down the route of MRI scans etc because we didn't have enough insurance cover, fortunately we didn't have a vet who was pushy. He was very understanding of this fact and said the MRI would have only been to reassure himseld of the diagnosis because the x-rays were clear enough. Herbie had the key hole surgery straight away.
Our vet also suggested water therapy as a means of recovery, but we didn't go down that route.

He's now 4, touch wood no real difficulties since other than a touch of arthritis which we were told to expect. None of this stops him from doing what he wants!!

So in short, inform the vet from the outset what your insurance cover is / what you can afford (if you're paying yourself).

[MarstonMarauder]

Sorry, I don't mean to sound defensive but I believe in getting a diagnosis before treating with any therapy. I upset many of my potential holistic clients by telling them they sometimes still needs bloods or x-rays before I can treat with herbs, physio or acupuncture! At the end of the day legally only a vet can diagnose an animal and the buck still ultimatley rests with the refering vet, so my cautious attitude is only so that both the vet and non-veterinary therapist are protected if things go wrong. Personally I'm happy to work with other therapists and regularly share cases with a pyhsio locally ( I soften things up with the acupuncture making her job easier!).

I am just curious from a learners prospective as how the vet got to the conclusion that it was orthopedic and in the elbow without X ray, ROM test maybe?

I think if vet read the course i have nearly finished and the high level we have had to achieved (degree level) they would hopefully be reassured,
One year of studying the insides of a dog before i was allowed near one!
I also got top mark for refusing to treat a dog that had been given permission by a vet as i believed that massage would be a contraindication to it's condition and referred the dog back to the vets. Two years of hard slog and the lack of a social life but the end is near.