There are a lot of (relatively) painless conditions that can keep a Yorkie from using a leg. My theory is that the left back leg has one of these conditions, and the right leg has a more acute, painful injury (like a sprain or muscle tear) because Loki has been forced to use it in order to compensate for the left leg issue. Definitely keep Loki as calm as possible until the vets have been able to figure this all out. That means no running or jumping. If it were me, I'd confine him to a crate, except for eating, drinking, and pottying, until the problem has been diagnosed. Keep us posted!

This may sound *way* crazy but are you absolutely sure the limping is happening on the left side.... Although you did mention earlier one vet on palpation of the right knee noticed a *slippage* or another term is LP.


Pstinard (Phil) has a reasonable theory. Usuage / overusage of the right leg has cause a muscle strain or some other painfull condition.


My next theory is that the lumbosacral area and their nerve roots are somehow affected, and lifting up the left leg actually relieves the nerve root pressure, but lifting up of the right leg increases the pressure on the nerve root so that the dog is reluctant to lift or have palpation done on the right leg.


I think that as hard as it is to wait, Thurs is not so far away, and hopefully their clinicians will find the answer!

So if it is his nerves (lets just play the what if game) what does this mean?

Just read this-Lumbosacral Syndrome in Dogs

WOW- could be- could be.. so is this common in Yorkies?

No it is not common - and all his symptoms do not match - (as far as I am aware of those symptoms). DLSS is most common and thought to be hereditary in German Shepherds and a few other large breeds. With daschunds as one of the small breeds affected. But a dashunds spine is very very different to a Yorkie spine....


There could be discal herniation somewhere in the lowback spine. There could be a boney outgrowth, cyst, osteophyte entrapping and or a narrowing of the vertebral canal of one of the spinal nerve roots.


When you get into the spine there are a multitude of conditions it could be.


You also could have two different things going on side to side. For example there could be a muscle tear (common one is iliopsoas muscle) on the right side, and on the left side LP co-committant with a mild ACL tear.


I know you want to research and try to be really well prepared for Thursday. Are you seeing an orthopaedic specialist? Does this clinic have a number of specialists on staff? That would be handy to have a neuro on staff as well.

I got nervous and had his apt shifted to tomorrow at 10:00am vs Thursday at 8:30am.

Now I am seeing a Dr. Howard. Not sure about him.. this is their website-http://www.cascadevrc.com/ and they got a great reviews.

More running around. but I won't stop until I know his not in pain. At least I have him on 2 different pain meds, and that gives me piece of mind.

When I read about the "popping" of the right knee, I was thinking luxating patella as well. OP, are you certain that the popping was in the right knee, and not the left? LP is one of those "relatively" painless conditions that can cause a dog to favor a leg. Two more days, and hopefully you will find your answers! And don't panic about the possibility of lumbosacral syndrome. We're all speculating at this time. Only a vet will be able to tell you for sure what is going on.

From the website, it looks like that clinic has excellent diagnostic capabilities. Although they have extensive surgical experience, the website doesn't explicitly mention whether the surgeons are Board Certified. Dr. Howard has experience performing orthopedic surgery, and the biography states that he was one of the first doctors to perform TPLO surgery, so that's a plus as far as diagnosing Loki's problems goes. I think this clinic will be able to provide you with the answers you are seeking, but if surgery is recommended, you might want to get another referral to a clinic with board certified surgeons for a second opinion.

Edit: Some of the internal medicine specialists are board certified, but the web page doesn't mention whether Dr. Howard is board certified.

So the weird part is that during yesterday visits- she stated both of his knees were not popping out of place, and shes just stump. Shes stated "this is beyond my level of expertise"

Okay some folks here are much much better than I at google searching, if Phil is still around, I am pretty sure he will look up this doc, and let us know what he finds. There is no neuro on staff as far as I could see.


I do hope he is on an anti-inflammatory too as one of those pain meds.


Just make a list of questions to ask. Most important stay calm, and focussed.
THink of the basic questions: Like what is it? Have them explain in plain English. Why are you *certain* it is this?
What are the risks of this treatment? What is the overall success rate - then your success rate, and based on how many surgeries?
Beyond this treatment that you are advising, are there different treatments options? If yes then why did you not consider a less invasive and or different approach?
Have you done and excluded any neuro signs? (BTW one such one is tail lift beyond 90 degrees and they watch for signs of distress). Have you reviewed the hip Xrays and concur with Banfield vets that there is no Hip Dysplasia and or evidence of Leggs Calves Perthes disease?


That s it for now, if I think of more questions I will post them




Also as a note MRI's are very expensive, and some conditions are best diagnosed via an MRI. CT's are less expensive but still pricey.

Dr. Michael Flynn at the clinic is a board certified soft tissue, orthopedic, and neurosurgeon:

"He became board-certified by the American College of Veterinary Surgeons in 1995. Dr. Flynn left the university to enter private referral practice in Michigan in 1996, and later moved to Portland in 1999. Dr. Flynn’s surgical expertise encompasses a wide range of soft-tissue surgery, orthopedics and neurosurgery. He has particular interest and experience in the areas of oncologic and reconstructive surgery."

Hi Gemy-

I do have petplan for him. And I went in yesterday got all medical records for Loki, along with his x-ray on a disk. Received a letter form Loki primary that he never had any per-existing issues, and all treatment should be covered for him. His plan covers this..

Dog Insurance & Puppy Insurance | Find the Best Plan | Petplan

I got the bronze insurance. I pay $200.00 deductible, with 10% of the treatment.
Hereditary, congenital and chronic conditions
Prescription medications
Diagnostic testing
MRI, CAT scan and ultrasound imaging
Non-routine dental treatment
Alternative and holistic therapies
Surgery
Hydrotherapy
Specialist treatment, including cancer treatments and more

Well again, she is doing what she should do, recognizing when something is beyond her, and referring you to a specialist. I can only say, that knees especially in early stages of LP do not ALWAYS pop out of joint. I am not sure how long she has been in practice but knee examination is a very basic and relatively easy clinical skill to master.

At your clinic - here is the board certified that I found
 

Michael F. Flynn, DVM, DACVS
Cascade Veterinary Referral Center
11140 SW 68th Pkwy
Portland, OR 97223-8945
Phone: (503) 684-1800
Email: mflynn321@gmail.com




Richard Howard does not show up as a board certified surgeon.


www.acvs.org

Woohoo very good indeed! I was afaird that you were only covered at Banfield!


So MRI's and CT;s and ultrasound are covered yeah! Wow alternative and holistic too! How much? Particularly physiotherapy coverage.


This gives you a whole lot of financial room to manuveur to the best treatment options for your pup! Including the one that says rest, maybe physio etc!

Loki
10/28/2014 (start date)

$222.04 (policy amount for a year)

10/28/2015 (renewal date)

Pet name: Loki
Type of pet: Dog
Breed of pet: Poodle Mix
Inception date: 10/28/2014
Bronze plan Details
Veterinary fees $10,000
Deductible $200
Reimbursement level 90 %
monthly premium $21.50

Your detailed policy should reflect the coverage annual $ limit by type of service. BTW is that an annual veterinary fee $ 10,000 or a lifetime limit?

From the petplan website, it looks like an annual limit:

Dog Insurance & Puppy Insurance | Find the Best Plan | Petplan

That confirms what I found, but at least they have a board certified surgeon on site.

I am not able to see the page 6- wonder why..

Anyone else having this issues?

I am looking at page 6 right now. Maybe if you close and reopen your browser?

Just so everyone knows I am not able to view my thread past 5 pages.. Please note I am not ignoring anyone. It won't allow me to see page 6.

Bumping in the hope that the OP can read page 6 today, and also give us an update after Loki's appointment at the new clinic...

Thank you for bumping this as I can see now. I just got here at work from Lokis apt.

1. Arrived at 9:45 am sharp, they took me in. Dr. looked at his x-ray and confirmed loki has Hip dysplasia. Both of loki's knees move meaning loki has Luxating patella as well.

States Loki is very new(not enough a 1 year old) so would suggest we do hip surgery (by removing his ball joints) and then knee surgery as well.

He was shocked because hip dypslia is usually a big dog issues and not a toy breed.

I am moving forward with his surgery. I am getting a price quote today. I will upload- does anyone know how to upload on here? I haven't got the quote now.

Conclusion- this is sucks for us-- however loki is fully insured and therefore we are able to get the care he deserves. The doctor said if Loki was older then he wouldn't suggest this surgery (but pain management instead). Since loki is so young he will live a long productive healthy life.

oh no! I am so very sorry. Have you contacted the breeder? Is this considered hereditary? I have no idea, I would find out b/c that could affect insurance coverage vs. breeder responsibility.

anyone know the answer to that?

My insurance covers hereditary- doesn't cover per-existing. However my doctor indicated there is NO way to tell if this is hereditary--- so that is nothing he will be able to states. He states that by looking at all of Lokis records he DIDN"T have a pre-existing issues.

Thank you so much for updating us. I am just so sorry that your Loki has HD. So no Leggs Calves Perthes disease? Is the surgeon recommending Femoral Head Osteomy? Or some other surgical technique? Did the specialist give you a grading on the HD? Mild/Moderate or Severe?


I do know that FHO surgery is usually very successful in small breed toys!


I confess to some curiousity did you ask the specialist or did they comment that the Xrays taken by your vet were difficult to read, or the changes were very subtle? I am just wondering why the Banfield vets did not see that HD? As well as missing the diagnosis of the LP in both knees? What grade did the surgeon say it was?


Maybe your specialist can recommend a good experienced general vet for you and your Loki.


In terms of hereditary and or genetic diseases Hip Dysplasia is generally thought to be a polygenetic recessive disease that can be compounded by environmental factors.


I think you should let the breeder know of Lokis diagnosis - the specialist should be or already have done a written report - you can scan the report and send it onto the breeder. That breeder at the minimum needs to re-evaluate her breeding program.


Have you already scheduled a date for the surgery?

Sorry some more thoughts for your consideration


1. Will you seek a second expert opinion? This is not at all unusual with serious conditions and serious surgeries. Another expert can and may recommend a different surgical method, or timing of the surgery, etc


2. Did you ask the specialist about joint supplementation? I do have an article (which) you might like to read; I can send it to your private message box here.

He stated they would remove his ball joints (one surgery now, and one surgery about 6 months later) but during his first surgery of the hip he would want to operate on his knees at the same time.

He didn't have to redo the x-ray- indicated Banfiled did an excellent job but there not expertise at looking at surgery. Thus why I was referred over to them with their x-rays. He pointed things out to right away. Things that are clear now.

He indicated the surgery should be easy- but a heavy healing time about 3-6 months recovery period.

He did a exam, and then the board certified doc came in and did the exam as well. So there were two docs looking at him.

They are sending me the quote of this surgery. I am then moving on with a surgery date. For now keeping loki medicated (per docs request).

I imagine that you must feel relief at finding out for sure what is going on, but over-whelmed with all the information, and the worry that any major surgery carries with it.


There are more than a few members here that have had that surgery for their dogs, and some good threads on it.


Sending out some (((hugs to you))) and Loki just in case you both could do with a hug about now.