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Old 01-23-2013, 10:15 PM   #31 (permalink)
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I don't have any suggestions but I wish you all the best for your baby and my thoughts are with you!!
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Old 01-23-2013, 10:21 PM   #32 (permalink)
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I am not sure about philly at all. I am by Pittsburgh, so I am kinda clueless. But If you do find a place, your vet that your going to right now; does not even have to find out you got a second opinion. I just think it might help satisfy you on if this vet is going the right direction.
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Old 01-23-2013, 10:23 PM   #33 (permalink)
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Quote:
Originally Posted by lilLostduckie View Post
Does anyone know of a good place in Philadelphia area for a second opinion? The only place I can think of is UPenn, suggestions more than welcome. Preferably within a one to two hour drive, money isn't an issue - we want the best for our baby.
I'd head for UPenn. They did well for Jamie. Not sure what is in NJ or Maryland that would be close to you.
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Old 01-23-2013, 10:32 PM   #34 (permalink)
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Does anyone know of a good place in Philadelphia area for a second opinion? The only place I can think of is UPenn, suggestions more than welcome. Preferably within a one to two hour drive, money isn't an issue - we want the best for our baby.


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Old 01-23-2013, 10:36 PM   #35 (permalink)
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we took her into the ER for severe lethargy and no appetite,

The more I read about this, the more it sounds like it sure could be HOD. I've not personally dealt with it.

Hypertrophic osteodystrophy

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Clinical signs of hypertrophic osteodystrophy include fever, anorexia, and depression. Lameness is always seen with this disease and may vary from mild to severe. With multiple limbs affected, the patient may be reluctant to stand or walk. Typically, the ends of the long bones become thickened (see photo below left). The radius, ulna and tibia bones are most commonly affected; however, the ribs, jaw bone and the bones in the paw can also be affected. Other clinical signs may include diarrhea, discharge from the eyes, tonsillitis, thickening of the footpads, pneumonia and abnormal development of the enamel of the teeth. This condition is commonly seen in rapidly growing large and giant breed dogs from 2 to 6 months of age. Common breeds affected include Great Danes, Boxers, German Shepherds and Weimaraners.
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Old 01-24-2013, 04:41 AM   #36 (permalink)
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Since several vets seem to feel it is an ok diagnosis, I would hold out for another 24 hours. There ARE ways to test for distemper... bladder wall aspirate to look for occlusions in the epithelial cells, etc... However this could be a number of things. And since none of us have seen the dog and the vet has, I would be much more comfortable following the vet's diagnostic for now. BTW metacam can cause tremors and muscle twitching. Although distemper may only show with neurological signs such as focal seizures, it usually presents with nasal and eye discharge, respiratory signs. keratosis on the nose and pads (that's why it's called hard pad disease).

It doesn't hurt to get other opinions. But don't completley disregard your vet because a bunch of strangers on a forum with very little medical training feel it doesn't sound like panosteitis. Panosteitis has been reported in cases as young as 8 weeks, and 20% of cases are reported in animals over 18 months. So a 10 week old pup can't be said to not have pano simply because of an average age of 5-7 months. Also, there is very little radiographic change in the limbs in the early stage of the disease (or in the late stage of the disease), even though severe pain may be present on palpation. Stress can also cause the disease to manifest. Such as the stress of being hospitalized for 2 days?

If after 24 hours she gets worse, I would look for a second opinion. Teaching hospital is going to be your best place. State of the art, specialists, etc... Even in my emergency and specialty clinic, we send patients up to the teaching hospital all the time.

That being said, this case seems strange. Correct me if I'm wrong, extreme lethargy was treated with hospitalization and after two days the pup was sent home on metacam? For pain from what...? Were simple in house tests run, such as bloodwork? Parvo test? I'm assuming so? Or did the pup exhibit leg pain and then put on metacam? THEN twitching was noticed? That would make sense.
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Old 01-24-2013, 05:04 AM   #37 (permalink)
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Couple corrections:

First, this is the THIRD time today I've told myself I need to keep reading the ENTIRE thread before responding, haha.

Second, I said Metacam can cause tremors/twitching. What I meant to say was I've seen a FEW reports saying there can be neurological side effects, but I've never seen anything definitive on that, nor is it in our drug book.

After reading everything, I would think it could be the pain. Muscle tremors can be a sign of pain in an animal, along with a sign of anxiety (imagine trying to walk and feeling excruciating limb pain and not knowing why).

Severe worm infestation could be the cause of the lethargy and hospitalization earlier.

And NSAIDs can DEFINITELY upset the GI system, so that could cause vomiting on an upset stomach.
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Old 01-24-2013, 06:28 AM   #38 (permalink)
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"However this could be a number of things. And since none of us have seen the dog and the vet has, I would be much more comfortable following the vet's diagnostic for now."

No worries, I take anything on the internet with a grain of salt, and anything posted by people with at least two. We are more interested in a second opinion because, a we continue research on Pano, we don't think it "fits" if that makes sense. It definitely would explain some stuff, but there are just a few things going on in addition that don't seem to. Perhaps there is more than one thing, but it never hurts for a second opinion. We are hoping to forward over everything diagnostic, and that way she woulddn't need more diagnostic testing, just see what another expert thinks based off of the tests and a simply physical exam.

She definitely has found her appetite this morning, and has been begging for food, though I am holding out until her rice and chicken is done, which is hard! Those puppy dog eyes get to me every time! Her pain medicine wore off about an hour ago, and we can tell she is in discomfort, she keeps nibbling and licking her back legs. Again, we are trying to hold off on her morning pain meds and antibiotic until after she eats a little, as she had some bbaadddddd diarrhea last night.

Our GS mix was diagnosed with pano and was on treatment for almost a year before showing improvement, though he now suffers from some awful knee problems. So we are somewhat familiar with it, the presentation, and the treatment, and Thor NEVER acted like this, though he was older when the onset occurred.

So, like I said before, we don't want to over stress her with unneccessary things, but we don't want to ignore or have her worsen. I think our plan at the moment is to contact UPenn when they open and inquire as to seeing someone there, preferably a specialist of some sort, and having them do a cursory examination and giving them access to all of her diagnostic testing from the last few days. If they come to the same conclusion, I will definitely sleep better at night (and stop googling the crap out of puppy ailments!!), and if they don't we will progress from there.

I know I say this every time I post, but I really do mean it. THANK YOU ALL SO MUCH! I would have been so lost these last 24 hours without all the help and support, even if just because it gave me an initial line of questioning with the vet. I like to be involved in her care, and sometimes questioning is the best way to open up a new line of thought.

PS I am a microbiologist, and I took some of her worms and am growing them in my lab, got those suckers up to over a foot at this point! Gee-whiz, can't even IMAGINE what it's like to have those living in you!
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Old 01-24-2013, 07:21 AM   #39 (permalink)
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Good to hear! Trust me, I am a VERY frantic owner, and I know WAY too much about illness to not freak out over every little thing, haha. I am getting a new pup in March, and I have convinced myself that he is going to get parvo AND lepto AND distemper AND then die... just because I am a giant disease fomite, lol (Actually... I'm living... would I be a vector? Everything on me is a fomite! Clothes, shoes, entire house)

Zeke was diagnosed with panosteitis when he was 9 months. Him and my ex's husky got out, were found about 5 miles away the next morning by a nice couple that called us. When we picked them up, Zeke was limping so bad he could hardly walk. Of course, I thought he was hit by a car, and it being a Sunday I rushed him to the ER vet. After 800$ of diagnostics (now that I look back on it, WTF did they do for 800$?!?!?) it turned out he had Pano that was aggravated by him being out all night running. Nothing you can do about, it'll go away when it goes away, here's some Rimadyl, have a nice day. If he never would of ran away and been out all night over-exercising and irritating his limbs, we probably NEVER would of known. 2-3 days on Rimadyl and he was back to normal
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Old 01-24-2013, 07:47 AM   #40 (permalink)
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I think giving her age and how severe the symptoms are, it's well worth your while to get a second opinions. I am also suspicious about the pano diagnosis.

It's expensive, I know, but well worth it in the long run if they get a proper diagnosis, quickly. Pups don't have a lot of reserves, so they can go downhill fast.

Please keep us posted, poor little baby.
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