So we started with Lily, a 6 year old female neutered Boxer…. awww!
So, "walking funny"… the first things that spring to mind are musculoskeletal problems and neurological problems…
Well done guys! Now, lets get some more questions going!
So we came up with these:
Nice one! But don't forget your general health questions too, such as prior health, medications, diet and travel history…. could be major clues in there!
Anyway, some answers to our questions….
We pretty much all agreed that a general clinical exam should be done before focussing on a neurological or MSK exam….
Nice one…. so now some Clinical Exam findings:
So our thoughts were these:
Pyrexia – nervous consult or infection/inflammation? Most people leaned towards infection/inflammation here!
Resenting rectal- painful or just nervous/grumpy? Most people decided resenting rectal was common with or without disease, although we need to bear in mind here that it might not be normal for this dog.
I continued to request an orthopoedic exam (I didn't want to be caught out!) but with no joy:
Oh well, there goes my vote for a bit of arthritis! Next we're looking to do a full neuro exam. Joe threw a bit of a harder one our way at first:
So here are our results:
Eeeeek! That's a lot of information!
Ok… well the first one should be easy enough to answer… she's abnormal because of her slow postural reflexes (proprioception). Localising the lesion proved a little more difficult!
A quick question from Claire for those of us who were getting tangled (I know I was)!
Ah ok! Another quick question from Sarah just to help us all out:
So, onto the problem list… again we all had pretty similar ideas here (spinal pain, lameness, proprioceptive deficits, pyrexia, hunched posture), but we wanted a nice conscise list so:
Great. Onto some differentials. Again, fantastic answers here folks- we were on fire! 🙂
Hahaha! It's a good point Claire, it's a very good grade! Right, let's move on as we're supposed to be finishing in 4 minutes!
Nice one! We all wanted to go to MRI but unfortunately were told we were in a first opinion practice and couldn't do that…. So onto the x-rays…..
Well done both! The radiological diagnosis is as follows:
So what are the causes of discospondylitis?
Great. We've diagnosed the dog with discospondylitis, which is most commonly caused by staphylococcus…But don't forget she still needs treatment!
And in the meantime, which antibiotics should we use?
Ok, so we're going to go with co-amoxyclav (Noroclav/Clavaseptin/Clavudale etc) or a cephalosporin (like cefovecin:Convenia or cephalexin:Therios/Cephacare/Rilexine etc) for several months.
Remember: for exams we need to name the drug, not the brand name. However, given that in a few small months we need to know what we're actually picking off the shelves I thought I'd add some options.
So, a quick summary!
And that's that! Thank you all for coming and an especially big thanks to Joe, who is now a Twitter expert! See you all next week!