So in our last episode, I was very excited to go to the physical therapist so I could be equipped with strategies that would make my pup feel better and return to his old puppy self, before the injury or whatever it is that has him off his game.
I went to the physical therapy appointment Saturday. It was a great space, filled with people who genuinely love dogs. There was a low futon for him to lay on, which he liked very much. When the doctor came in, she sat on the futon for the interview. He wanted to play with her, but she was writing on a clipboard, so he started bugging her for attention. I offered to come over and sit on the futon with him, and give him attention while she worked, but she declined. When I reprimanded him for mouthing her, she reprimanded me, and told me that she was bonding with him and this was a place for him to be himself.
Let me stop here and say that although I appreciated a lot about her, I did not appreciate this, and not just because it was a snappish response to my behaving appropriately. To be clear, I sat five feet away from him, and said his name quietly but disapprovingly and said “no” firmly. I didn’t yell, scream, threaten, or seek to terrify. With a big dog like he is, mouthing is the sort of thing that could get us both in real, lawsuit-style trouble, done to a small child, someone who’s afraid of dogs, or who just isn’t particularly understanding. It’s the sort of thing that could get him euthanized against my will, if it were a pattern of behavior. One of the big things I believe about the way I am training him is that it’s about setting him up for success. Her sitting on the futon instead of on the available chair told him she was going to pay attention to him, and then ignoring him while he begged for attention meant he was going to escalate. And then not letting me correct him verbally when he did something that will certainly get him in trouble, in his behavior with strangers— it’s not a great plan. She said “this place is an exception to the behavioral rules you establish,” but everything I hear and read and experience about dogs is that exceptions are confusing to them. “Is this a place where it’s okay to mouth someone until they pay attention to me? Let’s find out!” is not setting him up for success.
She took a while assessing him, petting him and playing with him, feeling all his bones and muscles. She had him walk a little for her, and then told me she thinks he has a disorder of the growth plates called Hypertrophic Osteodystrophy (HOD), and suggested that I see an orthopedist. She admitted that it is something she’s never seen in practice (and it looks like she’s been in practice for the better part of 20 years) but that she read about in vet school. She came up with a treatment plan, but said that she’d let her plan be entirely subject to what the orthopedist said. And then she suggested some tools— harnesses, etc., to support my supporting him, with mobility issues. I declined until I know for sure what we’re up against.
I was left to Google the condition, which appears to resolve itself without incident sometimes, result in bone deformity of the long bones sometimes, and sometimes come with fatally high fevers. It’s also painful enough that even though it’s transient, some owners opt to euthanize their puppies rather than have them fight through the condition to the other side.
The idea that my pup has been fighting through serious pain like this (and I’m somewhat resistant to pain medication, so I’ve been giving it to him sparingly), breaks my heart. I’ve been much more aggressive with early morning pain relief since then. And the idea that I could lose him to it tears me up inside. But the more I read about it and thought about it, the more I wonder. It appears to mostly resolve itself by eight months of age. We’re not precisely sure of his age, though we should be accurate to within a month or so, since the rescue had him since last April and his growth is tracking accordingly, but I celebrated his birthday on Valentine’s day, so we think he’s a year, give or take, and we didn’t start seeing problems until he was 11 months, give or take. Also, we’re not seeing a lot of the symptoms (high fever, loss of appetite, hunching, multiple limbs afflicted with similar severity) of the condition. And he’s consistent where this is periodic— he’s consistently reluctant to walk in the mornings, he’s consistently more motivated for walking at night, and he’s consistently favoring one paw, when he limps, (which is less consistent.)
Leaving your patients to Google the “so what does that mean,” is not my favorite approach to medicine. To be clear, I’m doing that either way, but my vet is really good about supporting me with information and helping me understand what I’m up against, and I’m finding less of that, the more that I encounter other vets. Whether they mean to or not, they suggest a dramatic diagnosis and leave me in tears, sure that I’m going to have to make a horrible decision for someone I love. That’s not really responsible, in the case of my mostly-healthy animals. There are other growth plate disorders that it could be, most of which have better outcomes, and that track better with his age, and she didn’t mention them. Maybe because she was able to rule them out, but that would have been something worth sharing with me. Also, left to my own devices, I could make really unhelpful leaps. There are sites that suggest grain-free food is anti-inflammatory, and other sites that suggest that a diet too high in protein could be a trigger for conditions like this. If I were less responsible in my research, I’d have gone headlong down a road with very little scientific support.
So I’m going to go to the orthopedist, but I’m not sure that I’m going to say that I think it’s HOD. I think I’ll say that I was referred by the physical therapist, that my regular vet thought sprain/non-structural, the physical therapist thought it might be more structural and perhaps involving the growth plate, and see what he/she says. My experience is that if you say you think it’s x, up front, someone will try to solve for x. I’m not sure that makes sense, so I might just ask for a broader-based opinion, and provide supportive details on demand. It could be something else entirely. I’d like a clear picture of what he’s up against, and how I can help him.