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Old 01-11-2013, 11:25 AM
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Default Anyone have experience with OCD; Piper's x-rays included!

I don't think I've ever mentioned this here, but Piper has been having some pain in her left rear leg since November. So far we've just been treating with Rimadyl, but haven't seen much improvement. Today she went back to my vet for x-rays of her knee. We were thinking it was a cruciate tear or something along those lines, but after looking at the x-rays, neither vet thinks that's what it is.

Based on the x-rays, my vet thinks it's OCD (pulled this up from a quick Google: http://www.peteducation.com/article....2+2084&aid=464). Reading over that, she does have those symptoms.. stiffness/soreness when getting up, limping after more activity, and not appearing to be that painful.

So here are her x-rays:

This one is where you can see the abnormality right below the patella..







We did her hips at the same time to make sure there wasn't something going on there. Surprisingly, they look pretty darn good.

Since she's not *that* painful and 90% of the time she seems okay, I'm opting to go a more conservative route at this point. We have a great canine rehab place near me that does laser therapy, acupuncture, massage, swimming, pretty much anything you can think of. So I think I'm going to get her in there and let them tell me what they think I should do. A couple of my friends recommended Adequan so I'll ask about that as well. My horses got Adequan regularly so I'm not stranger to it.

If I wanted to go the aggressive approach, I'd get her scheduled for surgery. But at this point no one thought that was the only option.. so I guess we'll see what happens.

Anyone else have experience with this?
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Old 01-11-2013, 11:31 AM
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No experience, but good luck!
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Old 01-11-2013, 11:32 AM
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No experience but I hope it doesn't get worse and she heals up nicely!
Poor Piper ---vibes---
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Old 01-11-2013, 11:37 AM
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Thanks guys She's a little trooper.. of course, being a Bully breed, she really has no clue that she's "hurt" so I'm constantly reminding her to slow down. Poor dog is SO pent up right now because I haven't let her run for a long time.
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Old 01-11-2013, 11:54 AM
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How old is she? Stifle's kind of a weird place for OCD IME, and usually the lesions I've seen have been right along the margin of the cartilage. You can see that the articular surface itself right above the lucency is pretty unbroken except for a tiny divot.

I'm not convinced that's an OCD lesion but I can't really say 100% sure "no", either. There's quite a bit of joint effusion in the joint space, if I were looking at this x-ray with that history I might be thinking about a partial ACR, honestly.

If I'm not sure, I ask the local radiologist or surgeon - although my preference is a radiologist as surgeons are usually looking for things they can surgerize. It's super easy to over-interpret x-rays, there are a lot of tendon attachments and other normal lucencies in bone that can really fool you if the angle is just perfect to see them, and the radiologist comes along and says "oh that's just blah blah blah totally normal structure" and you feel dumb. If that option is available to you it might be a good idea to have one review the rads.


ETA: Nice hips, though.
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Old 01-11-2013, 01:04 PM
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Quote:
Originally Posted by sassafras View Post
How old is she? Stifle's kind of a weird place for OCD IME, and usually the lesions I've seen have been right along the margin of the cartilage. You can see that the articular surface itself right above the lucency is pretty unbroken except for a tiny divot.

I'm not convinced that's an OCD lesion but I can't really say 100% sure "no", either. There's quite a bit of joint effusion in the joint space, if I were looking at this x-ray with that history I might be thinking about a partial ACR, honestly.

If I'm not sure, I ask the local radiologist or surgeon - although my preference is a radiologist as surgeons are usually looking for things they can surgerize. It's super easy to over-interpret x-rays, there are a lot of tendon attachments and other normal lucencies in bone that can really fool you if the angle is just perfect to see them, and the radiologist comes along and says "oh that's just blah blah blah totally normal structure" and you feel dumb. If that option is available to you it might be a good idea to have one review the rads.


ETA: Nice hips, though.
Can you.. speak in normal talk for me LOL? I can understand some stuff but a few of the things you mentioned went over my head.

She turned 3 in Nov., btw.

Vet said it wasn't a definite diagnosis of OCD, but that's what she's leaning toward at this point. Will be interesting to see what the staff at the rehab place think once they see the x-rays.
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Old 01-11-2013, 01:38 PM
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Sorry! So, I'm assuming what your vet is concerned about is the lucent (dark) circle that the yellow arrow is pointing to. But then the actual margin of the bone above it (red arrows) is really intact, unbroken. When I've seen OCD, the surface of the bone itself is involved. What is throwing me a little bit is the tiny divot at the dark blue arrow.

At the light blue arrows, there is some sort of fluffy, irregular, greyish/whitish material. In a 100% normal knee, that whole triangular space is pretty uniformly dark grey to black. When you see that lighter material it can mean that there is joint effusion - fluid or fat leaking or sticking out from the joint. That can be seen with ACRs (even partial) because the cruciate ligament tends to hold that material in, and when it's compromised it can leak or pooch out.

Looking more carefully, there are a few irregular spots on the end of the patella and femur (green arrows) that could represent some inflammation where ligaments and part of the soft tissue of the joint capsule attach.

It would be unusual IME for a 3 year old dog to start showing symptoms of OCD. Most of them are painful by a year, and significantly. And I've only ever seen one in the hock, and all the rest in shoulders. BUT, any body can do whatever it wants, especially when you have a stoic dog. I'd be really curious to hear what the rehab thinks if you wouldn't mind updating, I always like to be double checked when I have a chance.

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Old 01-11-2013, 02:37 PM
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Quote:
Originally Posted by sassafras View Post
Sorry! So, I'm assuming what your vet is concerned about is the lucent (dark) circle that the yellow arrow is pointing to. But then the actual margin of the bone above it (red arrows) is really intact, unbroken. When I've seen OCD, the surface of the bone itself is involved. What is throwing me a little bit is the tiny divot at the dark blue arrow.

At the light blue arrows, there is some sort of fluffy, irregular, greyish/whitish material. In a 100% normal knee, that whole triangular space is pretty uniformly dark grey to black. When you see that lighter material it can mean that there is joint effusion - fluid or fat leaking or sticking out from the joint. That can be seen with ACRs (even partial) because the cruciate ligament tends to hold that material in, and when it's compromised it can leak or pooch out.

Looking more carefully, there are a few irregular spots on the end of the patella and femur (green arrows) that could represent some inflammation where ligaments and part of the soft tissue of the joint capsule attach.

It would be unusual IME for a 3 year old dog to start showing symptoms of OCD. Most of them are painful by a year, and significantly. And I've only ever seen one in the hock, and all the rest in shoulders. BUT, any body can do whatever it wants, especially when you have a stoic dog. I'd be really curious to hear what the rehab thinks if you wouldn't mind updating, I always like to be double checked when I have a chance.

Thank you for that!

She pointed out the areas with the green arrows to me, and did mention where you have the light blue arrows that it looked "irregular".

When you say ACR, do you mean ACL? Just checking. They checked her for anything involving her ACL & cruciate today while she was sedated and both vets there didn't think those were what was causing this. HOWEVER, she did tell me that the only way to really rule that out would be an MRI or surgery, obviously.

She is definitely stoic. Either that or she's really not in that much pain most of the time. It's worse when she first gets up, then she works out of it for the most part. When this first happened, we came home from the park (where she ran her butt off) and that night she was hopping around on 3 legs. By the next morning, she was fine, so I didn't think much of it. But then it kept happening every time we went to the park, so I knew something was up.. and here we are now.

But even now if she gets a wild hair up her butt in the house she spins on a dime and you'd never know anything was wrong with her.. so it's.. complicated?
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Old 01-11-2013, 02:26 PM
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I'd sent it off to a radiologist if possible. It seems kind of late for an OCD lesion, and as been said, that's a strange spot for one.
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Old 01-11-2013, 05:00 PM
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Hmmm, so odd. This thread interests me because we've been dealing with my dads dog, Lily, something similar for a while. My dad is not really as "up" on vet care so she only ever had one x-ray of her hips, I think, once and hips were fine.

She's a JRT mix, with short legs. And since I can remember, after bursts of exercise (like out in the yard running for more than 30 mins). She keeps SO super sore and stiff later that evening. Sometimes can barely walk. She ends up walking it off, or sleeping it off, but it always happens after some form of exercise.

I've never heard of OCD and it sounds VERY similar to what Lily goes through.
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