Original Question: "About 3 months ago my Bernese Mountain dog (6.5 yeas old) sprained her back leg. We treated it with Metacam and she got better. Two weeks ago she injured it so we are continuing with the Metacam (35 kg daily) resting her and limiting her walks. She has the foot lifted about 50% of the time. What advice do you have? I listen to you on the radio and value your opinion." - Anne
Thanks for your question.
The first thing I'd like to say is that when I get a question like this I’m basing my opinion without a final diagnosis. It sounds as though a physical exam was the only test performed, which is fine, but without X-rays we truly don't know what the diagnosis is so my first recommendation is to perform X-rays. I also want to give a very stern warning about another common problem in the hind legs of dogs that can cause lameness. This is an anterior cruciate ligament rupture. Please make sure your veterinarian performs something called a drawer test to assess the integrity of that ligament. Often this test needs to be performed under sedation to assess it properly. Without diagnostics, we are left making assumptive conclusions as to the diagnosis.
The simplest explanation is that the leg is sore or painful from injury. It sounds like this is the current assumption. By giving anti-inflammatories such as Metacam and letting them rest, if the injury was simple and uncomplicated, this should be sufficient. However, we know that the symptoms are persisting so we have to consider other possibilities.
If it is a cruciate rupture, which permanently changes the physical structure of the knee, the joint becomes unstable and as they use it, it will become inflamed recurrently. With this condition, we often see the patient improve temporarily on treatment, but the instability persists and it becomes re-inflamed and lame. This seems to be the case here so I would recommend your next step to be a visit to your veterinarian where they would sedate your dog, examine the knee physically and take radiographs to assess it. The best treatment for this condition is surgery, which is expensive, but if it is not performed you often end up spending much more money on lifetime anti-inflammatories and they achieve the improvement and quality of life that the surgical option can offer.
So now let's assume the diagnosis is arthritis. There are very critical things you can do to control or improve arthritis in your dog. We have a really terrific article on our website that goes over these different issues to address. You can use medication, one of them is traditional anti-inflammatories but I do review other ones in the article that are healthier and may have great benefits, such as polysulfated glycoaminoglycans. You can also use painkillers to help alleviate some of the symptoms and discomfort that your dog is experiencing.
In the article, I also discuss weight management. This is one of the most important features for preventing arthritis and reducing its progression. Over 50% of dogs are overweight and this really contributes to arthritis. I've actually seen cases where dogs with arthritis have been removed from anti-inflammatory therapy once their weight reduces down to a healthy amount.
Exercise is key to control as well. You mentioned it in your question. Do you want to do a level of exercise that does not stimulate lameness, pain or a flare-up of arthritis? So you'll have to experiment by doing a level of exercise consistently for a week or two and judging the response. For example, you could leash walk your dog 10 minutes twice a day for two weeks and monitor how much lameness that creates. If there are no symptoms, then you could increase the duration, frequency, and intensity of the exercise to a small degree and reassess after another two weeks.
Glucosamines are a great supplement to use as well. The research is largely anecdotal but many clients have noticed an improvement with their dog’s arthritis. There are all sorts of different glucosamines you could try and the dose can arrange quite a bit. In the article on this website, it discusses those products and how to dose them properly.
Lastly, I want to mention a very important concept. Arthritis is progressive. Waves of inflammation that occur in a joint will slowly break that joint down. It's called degenerative joint disease. So what I always tell clients is that if you see your dog limping, then that means there is pain in the joints, which means there's inflammation in the joint and that the joint is being destroyed. So the goal is to never see lameness. Any lameness means that you're contributing to degenerative joint disease. So use the four concepts mentioned above and implement proper treatment and management to control the condition. This will improve your dog’s function and quality of life in the future.
To summarize, I recommend that you follow up with your veterinarian and discuss sedations and radiographs as the next diagnostic step to attempt to achieve a diagnosis.
Best of luck,
Dr. Clayton Greenway
Disclaimer: healthcareforpets.com and its team of veterinarians does not endorse any products or services mentioned. Advice presented by our veterinarians is not meant to replace a regular physical exam and consultation with your primary veterinarian. We always encourage you to seek medical advice from your regular veterinarian.does not endorse any products or services mentioned.
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