art of a ct-scan of a big dog's left front leg yet another section

Diagnosing a limping dog with a ct scan

This blog is the sequel to two preceding articles in which I explained how my Berner boy Pasha developed a chronic limp and how I took him to a specialised Pet Hospital for a CT-scan in order to get a more clear diagnosis on him. We left off at the point where Pasha had just come out of the scanner and I was duly dispatched because I made very clear I would raise all kinds of hell if he would wake up without me near him. It’s the type of dog owner I am… The Doctor, an assistant and yours truly were just all installed in the computer room to look at his scan when Pasha woke up in my arms…

Diagnosing a limping dog with a CT scan

While Pasha happily slipped back into a nap to my petting and stroking, the doctor showed me the scan and gave me his analysis of the imagery. To my astonishment, he said he’s seeing a ‘rather good’ set of shoulders and elbows (!), nothing in the way of arthritis (!!), and basically nothing in the way of elbow dysplasia (!!!). He did point to the same areas where our regular vet had diagnosed signs of elbow dysplasia and Fragmented Coronoid Process (FCP) out, but this doctor wiped them off the table as “nitpicking”. Well, insert dumbfounded look here. Our regular vet, who developed himself into a fine specialist surgeon for movement problems over the years, will probably still be on a well-deserved holiday break when I publish this article but I can hardly wait to discuss this scan with him! He’s the vet who made the x-rays in 2016 and last month and who called for arthritis/elbow dysplasia as a tentative diagnosis. I also still don’t have the radiologist’s second opinion at this point, which I’m equally curious about. Anyway, both the doctor and I swiftly moved on to this question: if Pasha has indeed good shoulders and elbows, than what is ailing him? The doctor reasoned it could very well be something in the softer tissues. Think a strained muscle or maybe a tear in a tendon or something. This sure sounded logical to me, but in the back of my head, I also thought about the back and neck hernias Misha and Bromley were diagnosed with during a previous life…

A proposed treatment plan for Pasha

The doctor proposed to give Pasha a cortisone injection. I quickly retorted Pasha already got one of those last month (it was prednisone but my gut feeling said it’s the same sort of “thing”) and that it gave him some relief, but certainly didn’t fix the problem. This remark made the doctor look a little surprised. “Hmm. I can’t remember reading that in Pasha’s medical files, let me check…”. Sure enough, a couple minutes later, I got confirmation my memory for this sort of thing still serves me reasonably well. “Pasha got indeed an injection last month, but that was in the joint. I propose to give him a cortisone injection the traditional way, into the bloodstream. That way it should be able to reach any problematic soft tissue better.” And then I remembered how the regular vet had taken a little liquid out of pasha’s elbow joint out of the joint, remarking “that’s good looking engine oil” and then proceeding to essentially replace it with a dose of prednisone. Yeah, so we’re going to put more chemicals into my dog, wonderful.

Cortisone injections for limping dogs

In spite of having lived with big dogs for 11 years (and counting) and having taken three out of five of the Bernese Mountain Dogs I owned so far through major medical procedures, I really don’t know all that much more about vet practice and canine medication as the next dog owner. Still, long before I even became a dog owner, I developed a strong aversion to chemicals, as far as those going into living beings are concerned. Whether it’s in the water we drink, the air we breathe, our food or as medicine, I don’t like it. Regardless of whether we’re talking humans or animals here, personally, I’d rather go natural. So, what I do know is that Cortisone is basically a stress hormone. Alarm bells. It’s actually the stuff that slowly kills a lot of people because they live lives full of stress (pot-kettle moment). And that’s pretty much all I could reproduce from the top of my head. So, why would we shoot a limping dog up with stress-hormones, I wonder? I mean the mantra I run this pack with is: “stress is the enemy”, so yeah, questioning looks at Herr Doctor at this point. Well, the reason it’s a medical treatment is of course that as a side effect, cortisone also boosts tissue repair processes. Dogs release this hormone themselves as part of the whole fight-or-flight deal (got stress much?) so there you have it. Or is that the main effect of these hormones and the stress a side effect? What even is canine stress exactly? You tell me. Then the doctor said this: “Either give cortisone another go for two tenners with an in my estimation 60-70% chance of success or make a 1000-euro MRI scan.” Well, so much for principles I’m afraid, pragmatism won the day again. Hey ho. In the same discussion, the Doctor agreed with a second opinion most gracefully. No surprise there. As I said in my previous blog, worked with the chap before, he’s experienced and not an idiot and he actually offers this as a service on his website as well.

Big dog sleeps his narcotics off

Pasha sleeping his narcs off in the recovery ward.

How big dogs recover from narcotics

When the treatment plan and further steps were agreed upon, yet another vet tech showed up to help me roll Pasha’s table with the Pasha still snoozing on it to the recovery ward. A sizeable enough space with a lot of windows separating the adjacent corridor and the opposite wall fitted with kennels in various sizes. In front of the kennels a floor space of about 3 by 6 meters I estimate (I’m a metric person. Sorry.). The vet tech started steering the table towards a large opened kennel in the corner. “Oh we don’t need to put Pasha in that, let’s just lie him down on the floor here. I’ll stay with him and make sure he’s good.” Plenty of room for my big dog there and absolutely no room for argument. The last time there was some sort of argument about any of my dogs going in a kennel was in 2011 when Stockard ended up waking up in a kennel he had to share with a big hulking Dutchman (Cellmates for life Stockard! <3 ). Anyway, the vet tech and I lifted Pash (I always take the head side) off the table and gently onto the floor, after which she went to fetch the cortisone injection. As soon as Pasha was installed I sort of instinctively inspected him, got a whiff of an all too familiar smell, opened his right ear flap and promptly exclaimed: “Well! While we’re here anyway, have a look at this!”

Bloody stinking hotspots!

So, it turns out while the two vets and the small army of assistants on site didn’t discover much of anything, I sure did. Pash had budding hotspots on the inside of his right ear flap. Think Aubrey’s ordeal from a couple months ago but thankfully in a much earlier stage. Quite sure if I would have caught that much later and it had gotten a chance to fester overnight I would have had another dog with oozing & foul-reeking hotspots all over his head and running a fever on my hands. The assistant immediately went to fetch Il Dotore™ once more and at one glance of Pasha’s ear he knew enough. “What shall it be, Mr. H? Cream or antibiotics?”. “The latter” I promptly replied. “We understand one another Mr. H. It will be ready for you at the reception.” 😀 No, really, I’ve worked with worse vets than this one. 😉

Hotspots inside a big dog's ear. About to escalate.

I HATE hotspots!

Abandoned pets circus

I dare say my mere presence in the room put Pasha enough at ease to just take it easy and have another nap on the floor next to me. By this time I finally had a chance to take a closer look at the cages. I think all of them except the big one reserved for Pasha occupied, a range of dogs varying from small to small-medium size and one young looking cat. And get this dear reader, all of them wide awake! I made a little video clip of Pasha recovering from the narcotics and filmed this sorry lot too. If you turn the volume way up you can hear me whispering: “where are all your people?” in this video.

Why pet owners leave their pets alone at such moments and places I’ll never understand. I mean, your pet just came out of surgery, right? For Pete’s sake. Stuff is hurting, they’re probably still nauseous from the narcs, not feeling 100% at all, penned up in a kennel in a strange place, confused, scared, stressed (helloooo!!!!???)… where the effin hell are you, owner?! I’ve seen it happen quite a few times at the many vet clinics I ended up in during my ‘dog-career’ so far: people dropping Fido off early in the morning for a procedure that could take two hours max while saying: “righto, I’ll come collect him between 5 and 6. Be good now Fido!”. And off to work they go. Unbelievable. In one of the corners a doggy that looked like an older Weimaraner was particularly moaning about her current situation. She had one of those post-surgery collars on, her back sat up against the gate of her cage and moaning away. When the vet tech came back with Pash’s injection and after she administered it I asked her the name of the dog. I have forgotten by now but it started with a F. And there I sat with my left hand stroking my Pasha and my right through the bars of the cage petting this distraught dog I don’t know and talking to her. And I don’t even like Weimaraners as a breed! At all… Still, a dog is a dog, isn’t she. Pasha took about 10 more minutes before he indicated he’d like to get up on his paws. Floors in vet clinics and hospitals are always sterile (supposedly) and thus slippery and therefore I help any big dog up. Especially when I brought him in lame to begin with and he’s still groggy from narcotics. All of this is logical, yes?

After-effects of the narcotics

Like most Berners and other big dogs, Pash doesn’t do very well with narcotics and I could clearly tell by how I had to support him as he made his way back into the waiting area. Pash was still rather weak and groggy. A young man sitting in the waiting area saw us coming in and exclaimed: “That’s a beautiful dog sir! How old is he?” That’s why I wrote Pasha is a show dog earlier. Even when completely whacked out of his head and walking like a drunk he’s still a stunner. -proud face- I thanked the chap for the compliment and told him Pasha is four. Meanwhile Pasha sighed down in front of the counter for another quick nap while I collected the anti-biotics for the hotspots. If I recall correctly he slept a good deal in the car and only became a little livier again about halfway on the road to home.

Big dog waits in vet clinic until he can go home

Too drugged to check all the new people and their pets in the waiting area out.

Conclusion on the expedition

So, in hindsight, this CT scan looks like it’ll be a grand waste of money I could have put forward to Pasha’s treatment plan instead. But yeah, not easy to draw up the perfect plan when you don’t have a clear diagnosis. And when the patient can only tell you so much about what’s wrong with him bless his soul. Woof. Maybe, in hindsight of course, I should have gone for an MRI scan instead. I honestly don’t know. It would have cost me about €300 more than the ct scan for one thing… See? I may have come across as Mr. Awesome Dog Owner in these three blogs (didn’t really mean to if I did), but down to the core, I’m just like the next person who falters and missteps at times. With Pash and this CT-scan I think I’m hoping our regular vet and the radiologist draw the same diagnosis as this vet in Friesland did. I mean, to know that at least Pasha’s front propulsion system consists of proper hardware is some sort of progress, right?

Where to go from here I’m not entirely sure yet. That will largely depend on the outcome of the second opinions. I also opened communications with an animal physiotherapist, should be interesting what he might have to say when he sees Pasha. And the other boys as well for that matter. In short: to be continued!

Anesthetized Bernese Mountain Dog

Making a CT scan of my big dog – further diagnosing a limping dog

On Friday the 17th of August 2018 I took my 4-year-old Bernese Mountain Dog Pasha to a specialised clinic for his CT-scan. This blog is a sequel to this one, in which I outlined the leadup to this event. 

Arranging  and preparing for a CT scan

There are only a handful of vet clinics in the Netherlands that are equipped with the scanners required to CT-scan big dogs. Thankfully, the nearest is Pet Hospital Drachten up in the province of Friesland, a 40-minute drive away. I was there in 2012 with my second Berner Bromley (2008-2015), when he got diagnosed with the hernia that eventually became fatal for him via an MRI scan. An appointment for Pasha on Friday the 17th of August 2018 was duly made, though I had to gulp at the expense of these scans. As it turned out, well over 700 euros. Having already spent more than a 1,000 euros on medical costs for all three of my dogs in the leadup, including the rabies shots, I was quite relieved to learn upon my inquiry that it’s possible to pay for this in ten monthly instalments, at the cost of a 10% fee. I personally feel that’s a steep fee but what can you do.

Exchanging Pasha’s medical files and talking to the boys

By my request, our regular vet shared Pasha’s medical files after I sent all his X-rays myself.  The clinic in Drachten responded in agreement with CT-scanning both of Pasha’s elbows and shoulders. Very shortly after I informed them the appointment was made, our regular vet clinic phoned me to suggest requesting a second opinion by a radiologist when the scans are made. I think that’s called “due diligence”, big thumbs up for our vet there. The appointment was a week away, which gave me ample time to prepare my pack of dogs for the ordeal. I usually start talking to them about this upcoming event some five days in advance and explain what will happen to each and every one of them on ‘the big day’. And why. Very important that you explain a Berner the why’s… It gets all rather adorable when the bi-daily “talk” has become a part of the daily routine with the dogs. “Oh, he’s doing the talk again. Better gather round for a lookie & a listen. Maybe he’ll hand out treats when he’s done blabbing again.” 😀 And then they all come sit looking at you, listening to you and cocking their big dogheads trying to understand every word you utter.  🙂 <3 <3 <3

The boys listening to one of my 'talks' in preparation of Pasha's CT-scan.

The boys listening to one of my ‘talks’ in preparation of Pasha’s CT-scan. At this point they figured out it was Pasha who had the most difficult tasks so he was shoved to the front so he could pay really close attention. 😀

A slight change of plans

The day before the appointment the Pet Hospital phoned inquiring if I would be alright with them moving the appointment two hours later, due to an emergency MRI being requested. Though this somewhat compromised my projected schedule for delivering Pasha sober for 8 hours without him missing any meals, I won’t deny an animal the medical attention it needs of course, so I agreed to show up with Pasha at lunchtime the next day. Additionally, I made arrangements with a close friend for him to doggysit Stockard and Aubrey while Pash and I were out.

Travelling with Pasha

The day started very early with a breakfast at 5:00 and a woods walk with all the boys two hours later.  It’s so funny when you work with these big dogs in a pack, they can be quite challenging, loud and at times obstinate even. But as soon as you single them out and work one-on-one with them: little angels, hahaha. Pasha, usually the most troublesome of the lot by far, proved no different. The second we stepped out of the front yard and he fully realised it was just going to be just him and me on this outing, complete focus on me, quick to obey commands and a little glint of excitement and anticipation in the eye. Pasha was determined to be a very good boy for me indeed. The drive itself was uneventful. Not much traffic so far up north this time of year and the scenery on offer is less than inspiring to me. Flat, open and dull for the most part. Pasha performed several “Parrots” though. That’s when he sits down right behind the driver’s seat and lies his head on my shoulder. He does those on the daily drives to the woods as well, it’s a cute little habit of his.

Funnily enough, within the hour he met a real parrot and a white cockatoo in the waiting area, of whom he befriended the latter. The big white bird chattering at the big dog and the big dog carefully approaching the cage for a face-to-face was just another example of how magnificent these dogs are with other animals. Even fidgety doofuses like Pasha strongly display this trait. It must be said, it made the wait for Pasha to be called into the hospital all the more pleasant. Let’s just declare parrots the theme of the day…

Anaesthetizing Pasha

Before we got to sit down for a chat with the big birds, however, there were some further arrangements to be made at the counter upon entering the clinic. It has always been a policy of mine to remain and be with my dogs for as long as they’re conscious when I take them through medical routines. So, in practice, that means I help vet tech staff sedating my dog and that I shall enter recovery rooms or wherever my dog may be before he comes to again. Crucial with anaesthetizing big dogs, or any dogs for that matter, in my opinion, especially with the ones that are dispositioned on the nervous and insecure side like Pasha is. At the reception counter an assistant issued us their Terms & Conditions of Treatment and requested me to sign it. I promptly replied with my demands and after brief counsel with staff at the back a mutual understanding was established and documents were signed. Pasha got an opportunity to show what an exceptionally good boy he can actually be when I took him to the weighing scale. Pash grabbed the opportunity with both paws and after I tapped on the scale once while telling him I would like him to step onto the slightly raised from floor level scales, he did so without hesitation and held still right at the time I requested him to. Good boy, Pash! Pasha weighed in at 56.5 kilograms. If these scales are similarly calibrated to the ones at our regular vet, we managed to slim The Pash™ down by over a kilogram in a timespan of 2.5 weeks. I’m by no means an expert in this field, but that seems healthy and sustainable weight loss to me.  After the weigh-in we sat down with the cockatoo for a while and then we were called in.

Bloody, stinking catheters!

Pasha and I walked through a corridor with sliding doors into the prep room, where he once again stepped onto a raised platform, a surgery table this time, without any trouble. Fitting Pasha with a catheter proved very troublesome however. A total of 4 members of staff tried on three of his legs, while he just held as still as possible in my arms. He’s a true darling… In the end, the senior vet had to come in and he managed to get the little hollow needle and tube into one of Pasha’s veins in one go. To the mock annoyance of the junior staff who had just spent 10+ minutes collectively clobbering the job up and the 100% genuine, pure and increasingly growing annoyance of Pasha’s owner, who also managed to pull a muscle in his back while keeping his 50+ kilo dog as comfortable as possible during the bloodshed on a table not quite raised high enough for a gent of his size.


By the time the narcotics were finally applied and Pasha sank down for the big nap I had been telling him about, an unusual amount of blood was shed, only adding to my already foul mood. And I could tell my dog was getting a little disgruntled as well. Pasha was the best and sweetest boy though, bless his heart. If he would have chosen to protest more than he did I wouldn’t have blamed him. The weird thing is that this is standard procedure at the regular vet in our hometown as well and it’s always bingo in one go, regardless whether a vet or one of the vet techs perform the task. I don’t know nearly enough about this stuff to tell whether this was incompetence, bad choice of materials, both or just sheer bad luck. I know this for sure though: few things get me as hellish as having one of my dogs bleeding on me. “Oh dear! I’m afraid I may have soiled your nice trousers with his blood, sir!” – “I really don’t care about the trousers.” -shoots bolts of lightning from eyeballs-

Pasha taking his big nap

After I gently let Pasha sink down and ease him into a comfortable sideways sleeping position, all the while talking to him and praising him, the all too familiar big Berner snore rang out soon enough. I probably uttered a small sigh of relief, quickly did the eyelid test making 100% sure Pasha was unconscious and then announced that I would leave the room now and repeated my demand that I wanted him back before he woke up again. I’m sure this clinic dealt with more complacent and less demanding clients than me but hey, I don’t care about the trousers, nor about what the staff of a vet clinic somewhere in Friesland might think of me. Yeah? Oh, of course Pasha ended up being shaven on three of his legs as well. It was almost funny that a vet tech actually asked for my permission. I mean, yeah, how else are you going to do this? And it’s not like Pash is some kind of show dog or something. Well, he is actually, but I have issues with dog shows so nevermind. -huge bunny trail averted-

Anesthetized Bernese Mountain Dog

Finally, after several attempts to get the catheter in, my Pasha is fast asleep and snoring away, oblivious of everything.

Background info on this pet clinic and the founding vet behind it

The cockatoo and a cup of ghastly machine coffee in the waiting area managed to calm Pasha’s owner down a bit and the 20 minutes it took to CT-scan Pasha’s elbows, shoulders and a section of his spine flew by thanks to our white feathered new friend. I made some additional video of him or her.  Anyway, very happy indeed to report my policy worked it’s magic once again for lo and behold: aforementioned senior vet pops in to collect me in person. This is the same doctor whom I worked with when Bromley’s MRI had to be made. We’ve been connected on LinkedIn since, he’s 10 years my senior and in my personal experienced-amateur assession, certainly not the worst vet around. He’s the founder of this clinic and let me tell you, growing a business like his in this thinly populated part of the country to the extent that you can afford to put a few cool millions’ worth of scanners in the joint takes some doing! I’d say he’s half a head taller than me and looks very slim and fit. I’m mentioning this because while he guided me to Pasha I noticed he had no difficulties in keeping up with the speedwalking pace I tend to punch out in situations like these. People usually complain when they walk with me so kudos to the old doctor! I might as well add that he was jokingly referred to as “the antique furniture” by his younger staff while they were desperately trying to apply a bloody stinking catheter on my Pasha. -insert a witty remark here-

Reunited with Pasha: waking a big dog from narcotic sleep

We thus reached the holy grail of Scanners & Computers of the Vet Hospital in good time and as agreed on forehand, there was the surgery table with my snoring Pasha on it rolled into the computer room. The table was raised a little above my waist height this time, enabling me to lean over Pash as if hanging at a bar. I grabbed him immediately, placing my right hand in between his front legs in order to stroke his chest and my left right against his shoulders and upper neck for a good head scratch. The doctor sat down behind his PC, turned the monitor my way a bit and opened up the file of Pasha’s CT scan. Before he could start playing it I felt a little movement in my arms telling me Pasha had come back to life. Of course I immediately told him “hi sweetie!” and that I was here and that he’s a good boy and that he can just stay put, rest and take it easy. With a gentle thrashing move of the right front paw he told me: “I’m still a bit sleepy but give me many pets please”. Pasha-thrashings for attention are usually much more violent so I could tell he still had some drugs left in him to sleep off.

In my next blog, I will give as much detail as possible about the diagnosis of Pasha’s condition, how he recovered from the narcotics and the second opinion on his CT-scan.

Strips of Tramadol and Previcox for limping dog Pasha.

Diagnosing and medicating a big limping dog – through the eyes of a large breed dog owner

On Friday the 17th of August 2018 I took my 4-year-old Bernese Mountain Dog Pasha to a specialised clinic for his CT-scan. Pasha has been periodically limping with his front legs for approximately two years due to what his vet and I perceive to be arthritic problems and forms of elbow dysplasia such as Fragmented Coronoid Process (FCP). Pasha’s condition is comparable to what his one year younger brother Aubrey suffers from in a stronger degree and which Aubrey was operated on two years ago. Pasha’s other packmate, 7-year old Stockard, was also diagnosed with a lighter variation of elbow troubles (very mild case of Fragmented Coronoid Process) 5 years ago. This blog describes how Pasha became a chronically limping dog and how the vets and I arrived at the conclusion that a CT scan should be made.

Living with limping dogs

Practically speaking, living with three big dogs that have arthritis and elbow dysplasia means that from time to time, one of them will inevitably limp, be lame and/or display stiffness for a few days. Especially when the weather changes. It’s very comparable to human arthritis in that respect. A change to cooler and damper weather usually makes this condition flare up. With some proper management and a bit of rest, these limping episodes are usually short-lived and not overly problematic. Focussing on Pasha now, a telling sign that something isn’t quite right with his front propulsion system is his gait. When Pasha walks, he turns his elbows outwards, which turns his paws in. If we’d use a human analogy, we could say Pasha walks O-legged. As far as I can recollect, this started ever since he reached his full grown size, which these dogs reach in both an incredibly fast but at the same time very slow rate. But that’s a whole other topic for a different article some time. Let’s just say: “it’s complicated” for now… 😀

Three big Bernese Mountain Dogs

My three boys. From left to right: Aubrey, 3 years old, Pasha 4 years old and Stockard, 7 years old. And yes we know, dirty floors. Time to clean them. Again. 😛

Having a pain-fighting strategy in place

Ever since Stockard broke his hind leg in the backyard in the spring of 2011, and we were very lucky that I happened to have Novacam on hand, an almost over-the-counter NSAID (Nonsteroidal anti-inflammatory drug – Wikipedia, basically painkiller/anti inflammatory drugs) and I swiftly softened the initial pain he suffered from this accident with it, I make sure I always, always, always have this in the house. My vet supplies me this on request but without prescription and over the years we developed this working relationship that enables me to independently diagnose minor movement troubles in my dogs and apply the Novacam at my own discretion. For anything more serious or dubious-looking I always phone the vet for consult before I take further action. The vet and I follow a policy of continuing the Novacam for seven to ten days, provided there’s a marked improvement after three. This arrangement enables me to recover my dogs from most of their limping episodes without any veterinary interference. As I deal on average with 3 dogs times 2 to 3 limping episodes each per year, this has become a standard routine in the care of my dogs over the years.

Pasha’s previous limping episode

Since the spring of 2018 Pasha’s limping episodes became more frequent and more severe.  The routinely administering of painkillers/anti-inflammatory and moderating exercise just didn’t seem to do the trick for Pasha anymore. By mid-May 2018, Pasha suffered a sudden and severe crippleness in his right front leg.  This rather freaked me out at the time, enough to call the vet on their emergency line on a Saturday afternoon. We eventually didn’t decide to take him in that day, but try the routine treatment first.  It was all really rather curious. Pasha walked as if the leg was actually broken, poor boy. But he was totally fine with me touching it, bending it and carefully testing it. And he was still almost as lively and active as ever in spite of this limp! Dogs. They never fail to amaze me… Additionally, Pash had nothing in the way of a fever, his appetite was well up like a proper Berner ought to have, there was just that dreadful looking limp… And get this: it lasted for only 12 hours! I think the shortest limping episode I’ve ever seen with any of my dogs was like three days. Until this one, that is. Anyway, within 12 hours, it was completely gone. Very strange indeed!

Pasha’s current limping episode

Pasha started limping again a couple days after he and the other dogs got their Rabies shots late July ’18. This only occurs as an afterthought to me but there are studies out there suggesting there’s a correlation between vaccinations and limping. I certainly didn’t make the connection at the time. But here’s an article describing vaccinosis, which is what we’re talking about here. I honestly don’t know what to make of all this yet. But in future blogs I will try to gradually formulate my personal take on alternative and homoeopathic treatments for dogs versus traditional canine medicine.

From intermittent acutely limping to chronically limping

When I noticed that Pasha was limping again, with his left front leg this time, I assessed this limp as ‘severe’ as well, but not as bad as the previous 12-hour one. It worried me a great deal, as it was only two months since his previous limping episode was averted. Moreover, as an additional complication, the weather had been, was and showed every sign of continuing to be exceptionally hot. Bernese Mountain Dogs generally don’t tolerate the heat very well, so, keeping my three Berner boys comfortable & happy was already challenging enough. Last thing you’ll want is a bloody limp under such circumstances… Not that you’d ever want one but with all that heat and dry toasty air blowing about you don’t expect it to flare up either. One blessing though was that the dogs and I were already swimming more than we walked and swimming is usually the prefered mode of exercise for limping dogs.

Initial response to Pasha’s limp

I always respond to a limp with the Novacam routine I outlined above, along with filming the limping dog in question and sharing those videos with our vet and on Facebook, where I’m fortunately connected to a group of fellow-big dog owners with centuries of experience in living with big dogs between them. This is another routine I employ when one of my dogs is limping. Get a whole bunch of experienced and smart fellow dog owners to help you diagnose and put their thinking caps on for your sick doggy. 🙂 It’s truly great and helpful and certainly gave me a few eye-openers on occasion. And as usual, a couple hours of focussed commenting and chatting left me with plenty of input on possible diagnosis and treatment for my Berner boy. Meanwhile, my instinctive first reaction is always to kill or at least minimise any pain my boys might experience and Pasha was duly taken off the Novacam and put on Previcox instead when I saw no improvement on the former and the phone call with the vet was made.

NSAID upgrade: Novacam replaced with Previcox

If it hadn’t been for the 35 degrees Celcius weather around that time I would have taken Pasha in for an examination at this point. Thankfully the vet had enough to go on with my own observations and video’s in order to go ahead and prescribe the Previcox. As I discovered, Previcox is a stronger and more advanced NSAID. Along with the Previcox, I picked up Tramadol as well as an optional medicine at the vet’s. I gave Pash two doses of this and then noticed it was making him weird in the head. Both the vet and the big dog facebook crowd urged extreme caution with this medicine. Reason I decided to give it a go anyway was Pash still giving clear indications of pain. I sincerely hope I’ll never have to use Tramadol again. Here is an article on how inefficient and generally bad Tramadol is. Besides the NSAID upgrade, I also introduced Devil’s Claw and Glucosamine as supplements to Pasha’s diet by my own initiative (sanctioned by the vet and facebook support crowd though). This package of measures certainly seemed to give him a fair amount of relief after a couple days, manifesting itself in a happier and livelier Pasha who walked slightly better than before. My uneducated guess is that it’s mostly the Previcox that should be credited for this improvement.

Need for further diagnosis of limping dog arises

Still, on the whole, I observed some significant changes taking place in my big dog’s behaviour. Pasha never moved really well of course but a close friend who frequently walks with us pointed out how it’s more pronounced now. What I could clearly tell myself is that he would tire out on the walks sooner. Sure, there was a cracker of a heatwave going down, but that’s one advantage of living with three big dogs instead of one; you can always compare them to each other and thus more accurately assess how much the weather or any other circumstance might be impacting them. I’ll just reiterate that swimming is a really good idea when you’re living with big dogs here… At home, I found Pasha a bit more lethargic as well. This would manifest itself in him camping out under my desk more than usual and choosing to continue his nap on the floor or the dog sofa rather than venturing into the backyard with the other boys and me. Nothing drastic, but all these little things were certainly noticeable. That friend I mentioned earlier said she felt “Pasha had been a bit quiet lately”. It became most apparent a more thorough diagnosis should be made and fitting treatment pursued for Pasha.

Diagnosing and medicating a limping big dog

Pasha had his elbows x-rayed in 2016, when his limping episodes first cropped up. It made sense to redo those images, just to see how far the arthritis might have advanced and what the FCP looks like nowadays. Well, the x-rays we made on the 11th of August 2018 were a bit of a surprise. A double surprise actually. Firstly, it all didn’t look nearly as bad as we all anticipated! And secondly, the right elbow looked worse than the left! In a way, I was relieved to learn we have been successful at keeping the arthritis at bay. On the other hand, Pasha was still clearly sparing his left front leg for a week now and I really wanted the hurting to end and to know what exactly causes Pasha’s lameness.

Click on the thumbnails of Pasha’s x-rays to compare the state of his elbows in 2016 and 2018.

Prednisone injection into the arthritic elbow joint

Going on Pasha’s limping history and his orthopaedic observations mostly, the vet proposed to try a Prednisone injection into Pasha’s elbow joint. I knew Prednisone is serious painkiller drugs for humans and had heard from my online big dog support group it’s used in canine medicine as well. Anything to ease Pasha’s pain more I thought so gave the go ahead without much further thought. Pash was still unconscious from the narcotics for his x-rays so the vet immediately proceeded with extracting a little liquid from the elbow joint and injecting the same amount of prednisone solution. I did see some further improvement with Pasha’s limping the next day and no signs of pain anymore, which was quite the relief for both Pash and me of course.

Cartilage related or muscles and tendons?

Naturally, I shared the x-rays with the Big Dog gang on facebook later on and we ended up with two predominant scenarios: Loose cartilage or other cartilage-related problems (cartilage is not visible on x-rays) being the first line of thinking.The other theory was that Pasha was compensating his bad right elbow with his left and thus ended up spraining the latter. Pasha’s breeder, who is one of the best in her trade in my opinion, is always quick to react, think, comment and offer support whenever any of the pups she ever reared is in trouble, suggested a CT scan be made. After pain relief, getting the correct diagnosis for any of my big dogs is top priority when they’re ill or limping. So, seeing how the x-rays only left everybody still guessing (as x-rays quite often do when you’re trying to diagnose a limping dog), levelling up and getting Pasha ct-scanned only made sense. For the meantime, we would try to roll on with what our vet recommended: Previcox, controlled exercise (on lead at first and no walking on very sandy surfaces) involving a good amount of swimming (but once again ‘controlled’) and some weight loss if possible at all.

In my next blog, you can read how I took Pasha to Pet Hospital Drachten for his CT scan.