Tuesday, April 15, 2008

Looking for a Third Opinion

Sooner than later, my husband and I will be looking for the opinion of a veterinary orthopedist regarding our dog's back and knees. That will be opinion #3 as our vets in Chicago and Boston don't seem to agree on the next course of action for her. One would think her treatment path would be close to black and white, but somehow it's really not. Poor pup's probably sick of seeing vets so much lately, but I'm hoping opinion #3 will shed some more light on her situation.

Sam had X-Rays of her spine taken while she was at our vet in Chicago last week having her procedure. Our Chicago vet thinks she should have a prophylactic surgery on her spine that would make a future spinal problem unlikely. It's called a fenestration. He has identified calcification in two of the spaces between her vertebrae. Our vet in Boston, who did her post-op follow-up yesterday, only sees calcification in one of the spaces on that same X-Ray and sees where there might be a case for some narrowing in the other - but not really. He doesn't recommend any prophylactic surgery on her back at all. Basically, he says that even if a dog has calcification between her vertebrae, that does not mean she will ever have a problem with her back. In fact, the absence of calcification or narrowing in a dog's X-Ray doesn't mean that the dog won't have a back problem. So - one vet thinks she should have preventive surgery for her back and the other doesn't think there is enough basis for any surgery at this time. In fact, he doesn't think a surgery should be done unless she has major symptoms of spinal issues. Could they be any further from one another in their opinion? They both have reasonable points of view and are both very good vets. It makes it hard for us to know what to do next.

When it comes to her rear knees, it's the same situation. Sam has luxating patellas. Basically, her kneecaps float and sometimes, they stay out of place & off to one side. When this happens, her leg seems to lock up and she kicks it out and the kneecap snaps back into place. We've known about this condition since she was a puppy. Our vet here in Boston doesn't think that she needs surgery on them until they bother her regularly. If she's pulling up lame frequently as a result of her knee condition, then he thinks we should revisit the idea of knee surgery for her. He feels that there are always risks involved in surgeries and that if surgery can wait, it should. Our vet in Chicago says that her knees aren't going to get better - just worse. So, if they're not getting better, she should have them fixed sooner than later. So, no agreement there either.

If you're wondering why our dog has two vets, it's because we split our time between Boston and Chicago. Her primary vet is in Boston, as it's our primary residence - but she has required the care of a vet when she's been in Chicago more than a few times, and thankfully, my family is well-acquainted with a very good vet there as well.

So - I guess we're going to find a veterinary orthopedist for yet another opinion. We'll be reading up on her situation and our options and see what yet another vet has to say on the matter before we do or not do something about her back and knees.

1 comment:

Michael said...

Just my $0.02, but if it's not a clear case of Sam needing surgery, it's probably not worth it. Although I can appreciate the concern of waiting too long, I would hate to put one of our dogs through unnecessary surgery, anesthetic, and recovery.

A few years ago one of our pups was diagnosed with torn ligaments in her left hind leg. (She couldn't put *any* weight on it.) One vet recommended immediate surgery, another suggested leaving it alone and letting it heal on its own. We chose to leave it, and two weeks later she was back to normal. If we had chosen the surgery, she would have spent 4+ weeks crated just trying to recover.

Again, just my $0.02. I'm obviously not a vet :)