On Oct 11, 2007 - I finally had the appointment with the Orthopedic Specialist in the US. Dr. Engen is a highly respected surgeon that came heartily recommended to me. It was an early AM appointment, so Ella (and Jazz) and I left the night before and stayed in the RV at a good friend's house. Dr. Engen was extremely thorough, very approachable, and most importantly knowledgeable. He decided after reading thru her (lengthy) medical history notes and looking at the x-rays I brought with me - that it would be best to have him take more rads. Ella was x-rayed from stem to stern; hips, elbows, knees, ankles (hocks) and feet. The good news is that Dr. Engen said she is perfect!, except of course for the OCD lesion in her right hock. However, according to this vet - he felt that surgery would NOT be a good option for Ella - the lesion is very small- and he could see no flap/chip of cartlidge from any angle he looked at -- not to say there isn't something there- but because it is so tiny - it would not be worth it to go in a do a surgery on her to clean it up. In fact, Dr. Engen felt that surgery would not help Ella, period. In his opinion, he felt she would be the same as she is now, and possibly worse after the surgery -from the invasion of the instruments into the tiny joint -which could quite possibly accelerate the arthritis in her joint. So.....in Dr. Engen's view - he felt I should continue to do what we've been doing- the underwater treadmill therapy, ice, rest, and high dose Arnica when she's overdone it. Also to continue with the Adequan maintenance and whatever oral joint supplement we have been using. I was also pleased that Dr. Engen seemed to really like Ella -- he also made a point of telling me that she is a VERY happy girl, and that in his opinion, she's living a very good life! And that I should just accept the fact that she won't be able to do the highly strenuous performance venues; herding and agility - but that I could and should continue with obedience, tracking, and carting (all things that we both love to do together). So, that's the upshot --- I've decided that, at this point, and after seeing EIGHT different vets - that we're going to leave things for now. I won't be seeking out any more opinions on what to do with Ella- and/or trying to cure her. She's most likely as good as she's going to get -- and I'm OK with that. I love her to bits, no matter - the entire family loves her to bits - she will continue to live a very good life - and continue to be the totally spoiled princess that she already is. I will continue to update her story - if anything new develops.
Ella's Story....
We brought Ella home from our breeder at just over eight weeks old. As you've seen from her pictorial, she was a very lively puppy. Ella comes from strong working lines on both sides of her lineage; this was one of the big selling points for me - I wanted another dog that was versatile enough to work in several venues, including herding, agility, and obedience. Ella seemed pretty darned perfect; she was a very pretty puppy (we also had aspirations of showing her in the breed ring) AND she had a lot of drive, both prey and play. Her breeder is very involved in herding - and had Ella and her siblings on live stock from the time they were 5 weeks old. Ella seemed to have a ton of drive and interest in the stock right from the beginning.
We brought her home and everything seemed perfect. She was a very quick study with toilet training and learning house manners came very easily for her. We were in heaven.
I brought her a half dozen times to the herding facility where her breeder works. After a few times I noticed that she seemed to favor her right rear leg after chasing the sheep around the pen. She was about 12 weeks old at this point. In fact, Ella was already exhibiting the classic symptoms of OCD at this age. I took her to the vet; he could find nothing wrong with her. I had x-rays taken at 16 weeks, this particular vet still couldn't determine anything was wrong and suggested she might have Pano. I was not convinced; I had seen an OCD in the left hock in a puppy already. In fact, Ella's half sibling had an OCD at about the same age as Ella. But this pup apparently became asymptomatic within a few months of initially becoming lame. I was concerned, but because I'd seen another pup seem to recover I wasn't too worried at this point. I took Ella to another vet - one that specializes in ortho issues - and had more x-rays taken, including her prelim OFA's (just to rule out HD. Her hips look good to excellent, elbows clear, fyi). This vet confirmed the OCD in Ella's right hock. The lesion, he said, was quite small and he recommended a conservative course of action; Ella was to be rested for at least 6 weeks. She was 16 weeks old at this point and as I mentioned, a very lively puppy - but OK - we could do this. He also recommended she get on some type of supplement, like Recovery or Syno-flex (a Chondroitn/Glucosomin type of product). Ella also got her first injection of Cartrivan during this visit (she's had several since that first injection - Cartrivan is similar to Adequan, fyi). Six weeks came and went - and Ella did seem much better with the rest. However, as soon as she became active - the soreness and limping returned. In the meantime - I started researching OCD on the internet - and I was utterly shocked and disheartened with what I discovered. OCD is a very debilitating disease that generally affects the quality of life of the dog, often for it's entire life (depending on where it presents). At the very least, dogs with OCD will most likely develop arthritis far sooner than they would with the normal aging process. The worst part of all for me was to see my puppy suffering. It broke my heart.
The lameness continued - and I started looking for a solution that would heal Ella's lesion. In honesty, it was a pretty frustrating search - if you read many of the medical journal's on OCD - most will tell you that if the OCD lesion is on the shoulder (which is most common) surgery is the best and most successful option. The hock, on the other hand, is the worst place for a dog to have ano OCD - surgery is generally suggested ONLY as a last resort - and ONLY if the dog is in so much pain their quality of life is being affected. I took Ella to see several more vets, to get more opinions, and all of them said that surgery would not be a good choice for my puppy, as it may in fact make her worse.
I then decided to try the homeopathic route. I found a credible practicioner within driving distance. Ella was examined by the homoepath and her veterinary partner - and she was prescribed a series of remedies. In addition, they recommended a chiropractor and swim therapy for Ella. We stayed on this program for almost a year. And what I noticed, after spending close to $5,000.00 in remedies, therapies and rehab treatments is that Ella would be much better when she she was on limited activity. The lameness, soreness and pain would return after she was active. I decided after a year that we weren't getting anywhere. I wanted to try Adequan, and did. I also started acupuncture with Ella. We tried that for 4 sessions (once a week). The upshot? Ella was really just the same as she was prior to embarking on this healing journey.
Fast forward to now -- it has been over a year since I aggressively started trying to find a way to heal my puppy. At this point, I am now seriously considering surgery - I have found a very reputable surgeon in the US and I'm waiting to get an appointment to see what he thinks. I've had more x-rays taken in the last couple of months, and I guess the good news (if there is anything that could be considered good news with this disease), is that the lesion is no bigger than it was when she first presented with symptoms. In fact, it does look like it has shrunk somewhat. But Ella is still telling me her leg hurts, so she is still curtailed, to some degree, in all her activities. And the heartbreaking truth for me has finally sunk in. Ella will not be participating in herding or agility venues. She may not even be able to surpass novice obedience, as the jumping may prove too much for her; For even if she does become asymptomatic at some point - I wouldn't want to risk putting strain on her joints and exacerbating the arthritis (which has clearly started - you can see it on her x-ray).
So, for the time being, Ella is continuing with her water therapy (on an underwater treadmill); she is also still on the Recovery, and wild salmon oil. We also found that high dose Arnica (1M) if used in conjunction with ice does a lot to calm down the swelling in Ella's ankle, when she's overdone it. At this point, I'm not keeping Ella from playing and running; we are now in management mode with her condition. In addition, she will be on an Adequan maintenance program for the rest of her life (she just turned 18 months old on September 15/07). And the possibility of a surgery looms in the future.
Wish us well - I'll keep you all updated on how we're doing.
