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Theo GSD 06/17/22 Adopted 11/23/22
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Discussion Starter · #1 ·
Short summary: clicking sound from R knee, no limp or favoring. One week bout where it would falter slightly during longer hikes. Vet examined, was not overly concerned. Clicking improved then resumed. No hesitation for any activities. Just finished another week of choosing to do modified exercise as a caution for little signs. All looked good until today, stumbling returned during light "hike"/free sniff in woods. I'm unsure how to handle this, waiting to hear back from vets today.

Details: Clicking started roughly a month ago Could have been from a puppy trip playing with a dog, loading excitedly onto a car ramp, or something else not obvious. No yelp, no limp, or issue with exercise occurred before the clicking, which was more obvious if he was playing in the house. Over the following two weeks I noticed on our longer distance/time exercise days, after 30ish minutes that leg would give ever so slightly. I would end the activity at this point.

At his final follow up I explained all this to the vet. She examined his legs, said his range of motion and mobility in hips was great (fingers crossed this continues) and could not manipulate either knee or hip to create the click. No signs of pain from Theo. Advised it was likely soft tissue, one week rest with short walking. We completed that, and while I could still hear an occasional click it happened less and there was no more give of the leg. He ran with other dogs and his run was entirely different-beautiful full stretched strides and over a decent amount of time. It also helped that these were larger dogs (first one was small-medium) so less sharp turns. Something I am keeping in mind for future.

All was well until one walk a leaf blew and Theo leapt straight up for it, landed wrong and let out a small yelp. Got right up but held his right leg up (not close to body, maybe 4ish inches from ground). Next step he put weight on it and we completed the walk no issues, though I shortened it precautiously. Over next two weeks frequency of clicks increased, but there has been no giving to include on a hike that mistakenly went far longer than expected. Only other sign was a tiny yelp during jumping to greet me (which we are slowly but surely correcting), which I couldn’t discern was pain or an excited yip. Whether from this or his recent growth spurt, his rear is a little tight and I noticed it looks stiff walking if you pay attention. Legs will stretch back, but to me it looks like he'd rather hike his hip flexor then bend the knee to go forward. Running and trotting I did not see any issues.

I chose to take this week off to only do controlled walks, as well as introduce swimming (he loves water, and naturally swam straight back using all legs). All that went well, and he loves the water and swims very well. Yesterday he was allowed off leash at a park to explore and romp--most decent paced trots and some running. I saw no issues.

Sadly, today during long line exploring in the woods the leg started giving again. First it was a very subtle stumble, but went within 10 minutes to tipping over frontwards (not ever actually falling). No limp or yelp but I stopped us then.

I've contacted both the vet that looked at this before (who managed his illness) as well as the vet who took care of his limp that was misdiagnosed as osteoarthritis. My largest concerns are if this is related to ACL, luxating patella or something alike; as well as the mental toll exercise restriction and forced rest is having on Theo. Not to mention pain. It frustrates me as someone who is acutely aware of the stress of medical issues, and sees how weeks where medical isn't an issue his personality and drive erupts. I was, and still am, looking forward to working with and inquiring about his individual drives, impulse control, etc. But for now this is the challenge given to us, and it is the challenge we will face.
 

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Theo GSD 06/17/22 Adopted 11/23/22
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54 Posts
Discussion Starter · #2 ·
Vet said this could be a sign of hip dysplasia, but found no instability and he still had good range of motion in both knees and hips. She also mentioned it’s possibly he injured (I guess a small tear?) his meniscus, but didn’t find that likely. Because he shows no signs of pain or hesitation for activities, I opted to hold off on X-rays until roughly 1 year age because he’s been sedated twice in four months.

I let him run his heart out the day prior to the appointment, since the email I received had cautioned we may need surgery, and he was playing and bounding for close to 45 minutes with no issues. I haven’t seen the “give” happen again (though I haven’t been back to the same spot it happens), but I do hear clicking especially on certain turns during playing.

If anyone has had any experience or suggestions, I’m open to them. I am thinking of adding fish oil to his diet, but with GLM, cosequin, Orijen Six Fish, and Feed Sentials I feel that may be overkill?
 

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Theo GSD 06/17/22 Adopted 11/23/22
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Discussion Starter · #3 ·
Unfortunately we will likely be doing the x-rays sooner than later.

Theo has had some noticeable yelps since his check up, though no holding up the leg. Once during tug, when he went into a down (loud). Twice outside playing which I couldn’t tell was do to leg or a stick he had (loud). And third when he was playing with a dog we know but that was light so may or may not be related.
Then today during play he YELPED again, dropped and showed his belly tail tucked. Hiding the right leg underneath, then tried to get up and laid back down again (not collapsed, didn’t want to stand). A minute later he was up no obvious lameness and still wanted to play, but we went inside.
The pattern during play that I think causes a yelp is when he is going to tug or play keep away and moves his rear to the side first.
There are three distinct motions that elicit the clicking at any time:
-walking/trotting around the couch as he turns
-performing a proper square sit. This will be something that an upcoming basic obedience class would ask for.
-asking him to turn using his rear legs while performing a “touch” command or anything where he would be moving laterally
Based on all of that, I’m thinking it is likely to be meniscus(?), but the vet opened a slot Monday morning and we’ll likely image hips and knees. I’m a little worried about this being the third time he’ll be sedated in roughly 5.5 months but I think it’s a higher risk letting him do good exercise (which he really needs coming off his rough early start in life) and let him further injure himself or set him up for aggressive arthritis and pain meds.

I have two questions if anyone has any thoughts.
-is it possible this could be pano? I would almost think due to the on and off cycle but the clicking and distinct motion of turning doesn’t
-I’ve attached pictures of patchy fur on his legs (both) that I can’t figure out the cause. I have never seen him groom it so I thought it could be separation anxiety, but now am wondering based on its location if it is related?
 

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Theo GSD 06/17/22 Adopted 11/23/22
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Discussion Starter · #4 ·
So to finish this post off (hopefully) the good news is Theo’s right knee all looked good on the X-ray. I’ve attached pictures for reference. The patches of fur could be from anxiety, environmental allergies, or this; so I’m going to keep an eye on it.

The vet said if it really bothered me we could do an orthopedic surgeon referral if I really wanted to push to find the reason for his pain. It does bother me, in the sense that is been 2ish months and it has been the rear right involved in every incident, but I trust the assumption that it could be a strained illiacus or some other muscle vs torn. In the past the one week rest did improve clicking, but then it came back, so hopefully 2-4 weeks strict rest and then a careful transition back into what type of exercise we do for the following weeks with maybe aquatic treadmill does the trick. By that time GA may be hot again to swim, as he was a lot more lively during the week we did get a few days in the water. The worst thing of this all is he has been on more weeks of rest than he has exercise since I brought him home, but overall I’m still glad he doesn’t need surgery.
 

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Theo GSD 06/17/22 Adopted 11/23/22
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Discussion Starter · #6 ·
Unknown pains are the worst..I went through that in 2022. If you have insurance you may want to consider an MRI scan, maybe you can talk to your vet about it.
They are certainly frustrating. Like glad it's not xyz but still would like to know -what- it is since it's the same leg same issues. Being an impatient person probably doesn't help...
Yes to insurance, such a lifesaver. An MRI/Ultrasound is likely what the vet thought an orthopedic surgeon might do, but she didn't seem to push it and I do trust her in taking things seriously enough. If it reoccurs without reason after resting I will request it
 

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I would have an ortho evaluate the dog as soon as you can get him an appointment -- so much doesn't show up on xrays that they can spot with different exam and diagnostic techniques (e.g., muscle and ligaments tears -- partial ligament tears it can cause intermittent issues until they completely tear through, and they don't heal without surgery). The xray likely ruled out pano (that would have shown up), the logical conclusion you've got an injury....so I think there's probably an ortho visit in your future.
 

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Pippin Golden Retriever 2/6/14, Theo GSD 3/26/22
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I agree with seeing an ortho who can hopefully pin point what’s going on
 

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Theo GSD 06/17/22 Adopted 11/23/22
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Discussion Starter · #9 ·
I would have an ortho evaluate the dog as soon as you can get him an appointment -- so much doesn't show up on xrays that they can spot with different exam and diagnostic techniques (e.g., ligaments -- partial tears it can cause intermittent issues until they completely tear through, and they don't heal without surgery).
Thank you for this comment, I’m going to do some research today into which ones nearby I can see faster without loss of quality and give my vet an email for that referral. The partial tear (meniscus) is what I was worried about, I think it is so odd that a square sit causes the click more reliably than other things. The x-rays performed today the vet said we’re for evaluating a partial tear—which from reading prior to I know aren’t end all conclusive.

Greatly appreciate the feedback (you too Debbie!). For understanding, obviously I’ll follow the specialists lead but is there a type of radiology (mri etc.) that would be more specific to this?
 

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Theo GSD 06/17/22 Adopted 11/23/22
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Discussion Starter · #10 ·
Alright so everyone in the area around us sends out to a University Vet Clinic nearby as a few clinics have ultrasounds but nothing beyond that. That is also who my vet recommended, their earliest available is 2 weeks 2 days (which is 2-4 weeks earlier from when my vet thought) which I took, though I’m going to peruse if something quicker is available if I drive a lot longer.

Until then, we will continue rest and stop things from getting worse. I’m a little sick and frustrated over how this has been handled from the start (including myself not ramming the issue), but it’s at least getting thoroughly looked at now.
 

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For a non-emergency, 2 weeks out to see a boarded specialist isn't bad at all. I've had waits longer than that for an opening with vet cardiology and oncology -- where there were life threatening issues!

Don't beat yourself up. Mystery limps in youngsters are fairly common, and waiting a bit for them to self-resolve is common among vets. When there's nothing on the xray, it's often hard to get an easy answer.
 

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Theo GSD 06/17/22 Adopted 11/23/22
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Discussion Starter · #12 ·
For a non-emergency, 2 weeks out to see a boarded specialist isn't bad at all. I've had waits longer than that for an opening with vet cardiology and oncology -- where there were life threatening issues!

Don't beat yourself up. Mystery limps in youngsters are fairly common, and waiting a bit for them to self-resolve is common among vets. When there's nothing on the xray, it's often hard to get an easy answer.
They are a teaching hospital well regarded for non-ER cases and have all the imaging options (CT, MRI, etc). The paperwork they sent reads promising; it seems when you come in it’s a 1.5-3 hour appointment, they do imaging right after, and if surgery is required it happens the next day.

Yes, and he’s had a lot for the vet to work with so I feel for that. His mystery limp/click started on the tail end of his mystery illness too and the worst of it has been hard to catch on video. Started wishing we had that implant from a Black Mirror episode that lets the doctor see what the patient sees/feels…
 
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