|In the waiting room chair, as it should be.|
I was very anxious about finding out the reality and truth behind Molly's limp because it meant facing the music and making decisions. I knew the toe was an issue, but I was also very concerned about her wrist - I was specifically worried it was a hyperflexion injury. I am really good at worrying! I didn't stop there! There is always medial shoulder instability, elbow injuries and bone cancer! Lots of things to be fretting about for no good reason!
We started by reviewing Molly's old foot x-rays from June of last year. Then we went into a large room and let Molly move around freely so that the doctor could observe her (Molly had been, to my eye, moving quite evenly as of four days prior to the appointment.) There was a very thorough clinical exam. Toes, wrists, elbows, shoulders, spine. Molly was cranked into full extension and flexion, I noticed the abduction angle of her shoulders was also tested. She tolerated it all with a "where the f**** is my f**** breakfast" stink eye and as soon as it was done she visited everybody and tried to kiss them. My heart burst with pride. Molly is so tolerant and accepting of handling. I had no food to pay her with since she had to have an empty stomach in case of any test or procedure requiring sedation. She is a Good Dog. Clinical exam revealed soundness in all joints except for a grudging pain response when the doctor pressed firmly on the toe that has been troubling Molly.
Next there were diagnostic tests. Molly's had the Gait4Dog gait analysis test, "It's a pressure sensitive walkway measurement system designed to capture and objectively analyze data in minutes." I have a super nerdy fascination with this test! What exciting technology! I was shocked to hear that Molly's gait is totally normal, no off loading. My eyes were not tricking me, Molly really was moving soundly again and not favoring her left front. There were also all new x-rays. Feet, wrists, elbows and shoulders. Frontal and Lateral (side views.) The shoulders looked great, no arthritis or other issues. The elbows also looked great with some mild arthritic changes on the left side. The wrists also looked great. The foot x-rays revealed some intense arthritic changes to the left medial toe in comparison with the opposite side. There was an ultrasound of these two areas of concern (the left toe and the left elbow) and it revealed a small bone chip in the joint, remnant of an old fracture (they said at least a year old - I cannot remember a time when Molly acted as though an injury of this sort occurred but that means nothing.) The joint has been trying to heal itself. Blessedly the tendon near this joint is quite intact. They also scanned Molly's elbow and it showed some mild thickening of the biceps tendon, which they feel is secondary to altering her gait to compensate for pain in the toe.
Molly was sedated and given steroid injections in both her elbow and toe. The doctor actually was able to drain fluid build up from the painful toe joint. That alone should give her relief, doubly so from the steroid injection. She was released a few hours later! Two weeks of leash walks only. After that I am to take her hiking and start reintroducing some uneven footing. He wants her back in a month for a follow up visit and would like me to do some very heavy activity with her before the visit. I think Molly and Mr ChuckIt Ball could make that happen. He asked what my plan is for this year's agility season. I told him I am prepared to retire Molly but I said that we both love playing the game together so it sure would be nice if we could keep doing that. He is optimistic that Molly can continue playing agility! He said at this point he is happy to do injections as Molly needs them - time will tell how much relief they give her and how often she might need them.
I feel so much relief at what we have discovered! Arthritis and old fractures suck but you cannot do much about them and there are much worse things in the orthopedic realm of possibilities. I believe that the warm weather will be easier on the arthritis in Molly's toe. I have made the decision to no longer participate in coursing activities with Molly. While I know that Molly's toe was arthritic before this past year's coursing aggravated it into lameness (browsing old photos I can see the foot deformity as far back as at least 2016 and perhaps 2015.), I think it is smart to avoid the things that triggered acute lameness. And that includes the blue mat footing for agility. If we get to return to agility, which I really feel we will!, we have to stick to turf, grass or dirt.