Bone and joint problems
An honest story
Go directly to the OCD-diary
A breeder who is not critical to his own dogs and very critically those of others,
a breeder who prefers gossiping rather than analysing studies,
a breeder who does not understand that knowledge can change over the years,
a breeder who only enunciates black & white idle talk and follows no nuanced line of thinking
a breeder who smiles in your face and laughs behind your back,
a breeder who, entirely free of self-criticism, thinks that he is all wisdom and no longer need to learn,
will never reach the level of Beate Konstad
And we are very grateful to her that such a sweet dog as Noor, with such a great character and also so beautiful may live with us.
Why do we start this web page with such a text? That is explained below.
Joint problems. With a large breed like the Pyrenean Mountain Dog you can face this. And it happens to us, unfortunately.
But before we can write a lot about this we are warned to not to do so. And even more when it is uncertain what the definitive diagnosis will be. Noor will be judged and that will never go away. Because now that we have a dog with a pedigree, we end up in the world of the breed club, the NVLPH. And it appears to be a battle scene of breeders. NVLPH stands for Dutch
Association of Lovers of the Pyrenean Mountain Dog. Better would be: Never-ending Vendetta around the Life of the Pyrenean Mountain Dog. This is a world where people do not want or dare to be honest. A world where an incredible amount of mud-slinging is blemished. (Unfortunately, this applies everywhere. I have never heard someone who said: "With us it is very nice.") Very, very much is left out when it comes to health problems. But what you deny or ignore, you cannot learn from and improve. Nobody gets better from that attitude.
By a breeder link on the website of the NVLPH for example I find on a website of a Dutch breeder with photos of dogs from their previous litters, cheerful smiling in your face. But it does not say how many pups where born in those litters. And I miss two dogs of which I have read their sad story on other
websites. One with a happy ending, the other not. The breeder link from a breeder who does write what is going on is suddenly removed. Apparently there are unwritten rules that we do not understand.
We will never deny the existence and the essence of our beloved Noor. Never! So here it is:
Noor had OCD!
Fortunately, we are in the Netherlands (and Belgium) assisted by two very caring and compassionate breeders. So Marina and Karin, thank you so much.
Fortunately, or rather of course, we are also supported by Noors Norwegian breeders Berit and Beate who have a lot of knowledge and a big heart for the breed.
In June though, right after I had written in Noors diary that she does NOT have OCD (because that was the diagnosis then), there is plenty of twaddle of the fact that she does have it. And we are accused of not raising our dog properly. And all is based on her diary in which they read things that are not there. Well, that's great! Our dear Noor is already abused by people who like to twist everything for their own benefit. How on earth can you call yourself a lover of the breed and so-called expert if you write off such a very beautiful and sweet dog immediately and "take" her to use in your own little quarrel?
I am at that time looking for information. And I learn that joint problems are not that clear and straightforward.
So if you hear in this context from someone that OCD is hereditary then he is basically right. But if he praises himself and claims that, with certainty (?!) there is no OCD in his lines it would be worth to see if Alta Colina - jealousy could play a role. Or does a person tell you that it is entirely our fault that Noor has OCD because we let her run or jump too much? Then look in the pedigree of their dogs if there is Alta Colina. This person has every interest that it is not hereditary. What a pity that it goes like this.
But if you can find someone who says that it is a complex condition, which is not all clear, which may have multiple causes and/or a combination of causes you have at least found a qualified person who tries to look beyond self-interest .
The orthopaedist has told us that it is a recessive genetic condition. Several studies have shown that the condition is multifactorial and polygene hereditary. It's just a very complex story. Because it is so complex I have tried to write down the information that I have gathered together. Click here for the file on a multi-factorial polygene recessive hereditary disease.
At the moment that Noor starts limping, we are looking for information. You get a lot of websites of breed clubs of all kinds of breeds and websites of veterinary surgeons, where you can read (often literally the same) very general information about joint disorders, causes, symptoms and treatment. But no dog seems to have it. However, now we own a dog with bone and joint problems, we hear much whispering. That this dog has this, that dog has that, etc. A quick inspection of the policy of Noors health insurance shows that even in the most expensive package handling hips and elbows in dogs over 10 kg is excluded from compensation. In the Netherlands, at no animal health insurance is it possible to ensure treatment of hips and elbows. And that will not be because it is so rare.
With any luck someone puts a lower HD result in a pedigree but that's it. HD results should be public if you want a to breed with your dog, because of specific rules. Same with PL results. But further? There are no specific health rules, so do not talk about in public.
Because what one doesn't know, one doesn't care. And that is my problem. For does care me if I am not sure what is happening to Noor going on and how I should handle that, or what I can expect.
So for all normal individuals, that lover their dog and are looking for information we write our experiences on the Internet.
Our questions to the orthopaedist and his answers:
On August 4, the day of the surgery we asked a lot of questions. We will copy them here so readers don't have to go scrolling down so much.
What is OCD?
A bone in a joint has a thin layer of cartilage. If a bone is growing this is because the cartilage becomes bone and there comes/stays another layer of cartilage. That thin layer of cartilage is needed. If the orthopaedist draws this than it looks a bit like the rings of a tree. (But in a bone no rings remain visible like in a tree.) In a dog with OCD that layer of cartilage does not become bone quickly enough. This becomes therefore a kind of dent in the bone. The earlier in life this happens, the deeper the dent is. That dent is filled with a thick layer of cartilage. On X-rays it is seen as a dark spot and the bone is not nicely rounded. As this cartilage is thick, it can crack more easily and breaks it off. This may (but need not always) be caused by a fall or a jump. The loose piece of cartilage is floating in the joint. Also, the body respond to it with an inflammatory reaction and for both reasons this causes pain.
What creates this and is it hereditary?
Studies in other breeds have shown that it is a recessive hereditary disease. So we can assume that this also applies to the Pyrenean mountain dog. Environmental factors can affect the development. Good exercise and good nutrition can limit the development and wrong exercise and nutrition can make it worse.
You cannot turn it around. If a dog has no genetic predisposition to OCD than it is not created only due to poor exercise, poor diet or trauma. (My own conclusion, not said by the orthopaedist: you've got to have that thick piece of cartilage before it can break off.)
What is good nutrition and good exercise?
Good exercise is not too much and not too little. And especially not jumping and walking stairs.
Good nutrition is a complete diet of high quality of a good brand with less than 1% of calcium in it.
What happens during surgery?
They will make two holes in her shoulder. One in order to go inside with an arthroscope (literally joint viewer) and one for the fluids. First, the loose piece of cartilage will be removed and then the "gap" will be scraped to stimulate blood flow. Here should then grow new cartilage. Also, the edges of the "gap" will be polished to ensure that the new cartilage will join the existing cartilage as good as possible. This new cartilage will always be of inferior quality and the connection with the old is not always good.
Noor has walked well all the time in between and responded well to painkillers. Does this mean that she therefore has pain from the growing pains and not of the OCD? It was also better after rest and that seems to be not the case with OCD.
OCD is not always better after resting. Furthermore, we speak of pain killers but a significant effect of the painkillers, the anti-inflammatory that is in it. This reduces the inflammation and makes it thus less painful. Also, the loose piece of cartilage can shift. Sometimes it can sit in a place where it is not so painful and then it shifts back to a painful place.
Will she get osteoarthritis sooner than average?
The osteoarthritis process has already started. This is a process that cannot be stopped. But the operation is supposed to have make the process go much slower. The first six weeks to give an indication on how Noor will cope with this in the future, both mentally and physically.
What is growing pain and why is that gone as they mature?
Growing pain is caused by the "tubes" in the bone which contains the blood vessels. They do not grow as fast as the blood vessels themselves. They get "jammed" by which fluid starts leaking. This hurts. As dogs grow older the bones and hence the "tubes" grow further, if all is going well, and it all comes back into balance.
How should we go on from here?
When we get home the bandage from the infusion may be removed.
Noor has had sufficient moisture. Tomorrow morning she may eat and drink again and then also start with the medication.
Noor, must be put in a box or cage, for the first weeks, in which she can move around freely. (Later I ask the assistant to explain what "freely" means. A bench where she can turn around, stand, sit and lie, and make a few steps is the best. Better than a small room where she can jump against the doors etc.)
Furthermore, she most go out 6-10 times per day, for a 3-5 minutes walk on a short leash. Not running, not jumping. But in between she must rest for the shoulder to heal. This structured motion also contributes to the healing process.
And also much Love, Care & Attention will help.
The first day she can still limp. That is normal. But then that should be over.
She receives antibiotics and Rimadyl. And Cosequin is also recommended.
Luckily she does not need a cone because she cannot reach the wound with her mouth. A T-shirt makes sure that she cannot directly scratch the wound.
After ten days the stitch-staples may be removed by her own veterinarian.
After two weeks we have to call to discuss the situation further.
After six weeks we have to get back to the clinic for a check-up.
Any physiotherapy or hydrotherapy should only start after six weeks as the shoulder is completely healed.
You hear often: 'Let the dog do what he wants. He knows himself to what he can and can not do. "
A dog knows only the present. He has no idea that what he does today has bad consequences for the future. (Personally, I had already thought that a dog does not have a natural instinct to something so unnatural as a surgical procedure with medication by which you don't feel pain.)
For further instructions see the diary notes on August 17 and September 14.
OUR STORY
November 7, 2009
Noor may be free in the house since about ten days now. Here she can do whatever she wants. And one or two times a day we let her on her field of 15x15 meters.
Sometimes she can play there for half an hour without being too wild. There is a plastic chain there of about six meters long. She loves to pull that or run around with it. She has wrapped it around every tree and moved it into every corner. It's so cute to see her playing there. She has so much fun now that she may be free again.
But sometimes we hold our breath. Then she flies around for about 60km per hour. And if she is really full of energy then she will remain running around in laps. Along trees, across the hump and sometimes slipping in a corner. Luckily she makes a soft landing in the leaves. And fortunately she quickly comes when she is called with a treat and comes to sit with us. For we are really frightened still for this behaviour.
Noor is not afraid, she dares to do everything. This way she recently hurt herself (with a hip I think) to an iron box that is there. And that evening when we awoke her for her last walk she was completely unstable. At first she seemed to have all four legs crippled and soon she only limped with just the right leg. But that was gone already after two minutes. So whether it was the aftermath of the surgery and now she has really done too much? Or is she just completely drowsy. This we see more often with her. In the evening Noor is in a lovely deep sleep. And when she is wakened, she is just like a little child. Still half asleep and tottering. So, well? And even if it is because of the operation. Two minutes, what is that?
For a few weeks now she eats Carnibest (complete meal wit raw meat) every day. And with that the freedom and the movements. Whether this has something to do with I it I don't know but it seems as though she is more beautiful every day. She is really improving, now that the three months of cage-rest are over. Physically she is slowly getting much stronger and more impressive. And mentally she is again completely at rest. After one day outside of the cage she was already the old Noor. Unfortunately, she has a substantial "hole" in the coat around her throat. This is because we only dared to walk with her using a choke chain collar. She slipped out of every other kind of collar. And surely the final month or more she has tremendous pulled on her leash during walks. But funny enough that is gone now. We can just go walking with her with a loose hanging leash. Only the proximity of other dogs is still very difficult for her. For they challenge her and she still may not go to them. Then she is still completely crazy on the leash and it is very hard to hold her. That we'll practice soon.
Last Wednesday was the intake for Noors hydrotherapy. Hydrotherapy is not really necessary for her but swimming is always good. But in a post-operation situation
there always has to be an intake to determine the program. And the therapist saw nothing at Noor. All tests she did were good. The muscles were also good. Only the trapezoid muscle or something like that could be a little better. She said: "I have to right, just good, good, good, on my checklist even with the right front leg".
She thought that they did a very good job in Almkerk. And I suppose we also have earned a compliment. She had rarely or never seen a dog that looked and felt so good three months after having an operation. And she sees many post-operative dogs. So she said that for her part this is not rehabilitation but fun swimming, also called fitness swimming. For the next weeks Noor goes swimming every Saturday and Wednesday. I wonder how she will like this because she has never swum before. Last Wednesday she could sniff as much as she wanted. She did this for one whole hour. She found the swimming pool very interesting but did not go in there. She has soften the therapist by hugging, kissing and being naughty, as she can do so well. She immediately loved her and found her very beautiful and well built.
October 28, 2009
Today we have to visit the orthopaedist again. Mr. van der Peijl is doing this consult again. We are in his office for one hour while a consultation lasts only 30 minutes. They really take much time for their patients.
Noor has been without Rimadyl for three days now. First she has to run. That is good. If you know that she has been operated there is sill a little bit to see. But basically you do not notice anything on her. Then he asks me how it goes. It goes very well, we don not notice anything. It is just that we really cannot keep her calm. Especially when other dogs are around she goes nuts. And we are surrounded by dogs. Every neighbour has at least one. But two is quite normal and the nearest neighbour has six dogs. Since Noor is on the leash all the time she became much more snappy to other dogs. When they bark at her, challenge her and she cannot go to them (as is always the case at the moment) then she is mad with frustration.
And I explain that up till now we had her in the cage for a lot of the time. If she is out we cannot keep her calm. She never lies down somewhere. She keeps on walking around and jumping up or against something. She simply cannot lose her energy.
Mr. van der Peijl gives the redeeming word. Noor may return to a normal life. The cage is no longer needed for rehabilitation. And she may walk of the leash. In our case we still will not do that. She still is a Pyrenean mountain dog, of course. So we let her loose on an enclosed piece of property of about 15x15 meters. I explain what she will do: running, and jumping on a hill, digging and playing. But she may do that now. After five minutes we have to say that she should be calm. In Noors case this means that we put her back on her leash and go walking with her. Calm down when she is loose, is not possible for her at this moment.
Furthermore I tell him that Noor will occasionally jump on and therefore also of the kitchen counter. But we do not have to worry too much about that.
For now, she may still not play with other dogs. And if she wants to play with us then we should simply not react so she will stop. These movements of the leg in all directions as it is like when dogs are playing, are still bad for the recovery.
From now on we just need to observe. If she is limping again than she needs Rimadyl for a few days and cut back on the activity. We need to find out what she can and cannot do in the next months. She does not need to come back but we still occasionally have to call to discuss the situation.
So we assume that there will be a moment that she starts limping again and that we do not have to be afraid of that. This is normal since the cartilage is not fully grown back yet. The entire healing process will be 6 to 12 months to complete.
He also examines her shoulder. She shows no signs of pain. Even without the Rimadyl. Mr. van der Peijl explains that he does not use Rimadyl much as a painkiller. The analgesic effect of it is only important in the beginning when the wound needs to heal and still hurts. The inflammatory effect is much more important. The growing back of the cartilage actually causes inflammation and this is slowed down by the Rimadyl. Therefore the healing process improves. (I hope I recite this correctly.)
I also ask why it took so long in Noors case while I hear of others at home and abroad that they only have to be calm for a few weeks (Apart from that her breeder Beate is an exception. She also recommended this long rest.) Dhr. van der Peijl suspects that abroad, but perhaps also in the Netherlands, these opinions come from ordinary non-specialists and veterinarians who have less experience in this specific disease. And there are also studies showing that it goes well with less rest. In these studies, the dogs are not inspected for a lot of years. Mr. van der Peijl would like to see studies where the dogs are inspected for at least five years and preferably more, because only then the problems arise and you will see if the rehabilitation was good or not. Therefore they would rather take the safe side. And also the removed piece of cartilage from Noor was larger than normal. With Noor it had the diameter and thickness of a one-euro coin.
We are now just the happiest people in the world. And Noor is of course the happiest dog. At home, the first thing I do is let Noor loose in the small enclosure. But not before I quickly grabbed the camera to film the first five minutes of her regained freedom. And then I immediately set the cage aside. I am not sure if I interpret that but it's like she understands. The way that she is looking at me moving the cage out of the living room ....
By clicking on the picture you can watch the movie of the first five minutes off leash. It is not of very good quality but I did not cut it on purpose. It is touching to see how happy she is. She doesn’t know what she will do first: run, dig, jump, play, roll?
MOVIE:
September 14, 2009
Today we went back to Almkerk with Noor for a check up. Noor was examined by Mrs. Schaeffer this time. She is really nice and explains everything well. As she earlier also told over the phone the defective in Noors shoulder is very large. The hole in her bone is very deep and a such a big recovery lasts six months.
So unfortunately Noor may still not run loose. She may still not make wild movements, no jumping and no running. But she may now be taken out on a long leash rather than a short one.
It is very good with Noor. Actually too good said mrs. Schaeffer. For she is far too wild and energetic. That is the frustration of a animals orthopaedist she said. At a certain point you just can not keep an animal calm anymore. So that is why she would like to think along about how the balance could be between losing energy and resting.
Noor may therefore walk six times a day on a long leash. More often is also good but absolutely no longer than 20 minutes of walking. Playing with other dogs is of limits for the next six weeks really is not.
Hydrotherapy is not recommended. She did not see the point in putting such a large dog in an "aquarium". That was not necessary in the case of Noor. But she may swim. That is actually good for her. But well, Noor has never swum before and how we should do that on a leash I cannot imagine. And it really is too cold to dive in a lake with her.
Mrs. Schaeffer still sees an irregularity in her walk. She no longer limps, but at every step she apparently makes a movement with her head. But we do not see that. And the examination on the left shoulder Noor shows some pain. But not as much as before. Noor is gasping of excitement all the time. But at a certain movement in the shoulder she stops gasping which indicates pain. But that is all.
We still need to continue with the Rimadyl and Cosequin. But she will not need them for the rest of her life, because that was one of our questions. In five weeks we need to call again if needed and depending on the situation perhaps come back for check up. But we say that we want to come back anyway, just to be sure. That is fine. Noor then needs to stop the Rimadyl three days before the check up, so she can see how it goes without this medicine.
There is also a new drug on the market. This time you only give it once a month instead of every day. But we are afraid we might just forget that then. And for us it is important to know what the side effects are. This is from a newer generation of medications by which the side effects to the stomach and kidneys are less. This new drug is supposed to take up the substance in the cells and then gradually release it.
We have heard that the side effects of Metacam are less than of Rimadyl. But she says that this is not true because Metacam is from an older generation of medicines.
September 6, 2009
Each week we think it is impossible for us to keep her quit, only to find out one week later that it is even more impossible to keep her from playing and jumping.
We will be so glad if we do not have to correct her for just being happy, because it really comes down to that. And that we no longer have to put her in her cage just because she is too playful. Because that is really awful.
But there are still some moments (only a few per week) that she is tired. For example after she has been at her daddies office all day. It is a kind of vicious circle that only ends when the veterinarian says that she can run and jump again. She still may not run and jump and so she must regularly be in her bench. In her bench she cannot loose her energy and she becomes frustrated. So when she finally is allowed out of the bench, she must act extra playful to let off steam so she must return to the bench because we cannot keep her calm this way. That is so frustrating and heartbreaking at the same time. We now have rediscovered that new impressions can get her tired, but you can't do that every day.
And then, for the first time in her life, she is shedding now. We had already noticed that her coat looked a bit dull. But we did not groom her for over a month now because it invites her to playful and challenging behaviour. Noor doesn't like to be groomed on every party of her body. And since she is not allowed to make wild movements we did not groom her to avoid that. But the fur is starting to get a bit greasy and tangled in places. (And showering/bathing is of course not at all possible because the risk of slipping.) So we have nevertheless begun combing and brushing. And she is really shedding because there is no end to it. With each comb you pull out hair. But we do it always for a short period and only when she is lying down because she otherwise she really likes to start a game of wrestling. And we do enough grumbling already. We take the stand that we will have enough time left to correct unwanted behaviour. But there is just very limited time for her shoulder to heal, so that comes first.
And during walks she mainly wants to play, run, roll around and sniff. If we notice that she wants to jump against us then we will quickly go on our heels and then she will usually sit down. And then we start to do some obedience training. She does that very well mostly as you can see in the movie. But during each walk there is one or more time that she suddenly makes a strange move or jumps on our shoulders. That is really unstoppable and you will not even see it coming.
MOVIE:
September 1, 2009
Things are getting better with Noor. On August 22 we talked about that she is more playful. And that is getting more and more. She clearly has no pain and prefers running. If she is free inside and she sees a toy she dances around with it. But, dancing is not allowed. And just playing is not enough anymore. She wants to dance around! And you don't want her to eat only snacks. So we try to give her something to play by which she does not want to run around. Fortunately we had (with the emphasis on had) some cushions left over from the Flea market.
Furthermore, her hair starts to grow a bit now. The first on her upper arm, then the chest. But the flanks are still very bald, while the operation is already one month ago. The pigmentation spots are quite dark so she looks like a Dalmatian. It looks weird.
And how better she gets, the more wanton she becomes. Now we can not leave her alone for other reasons. We found an empty mint wrapping in her bed. And one empty shell of a paracetamol (as if she doesn't have enough painkillers already) and yes, a broken box of fountain pen refills. The blue tongue betrayed the culprit. Further suddenly a picture frame falls on the ground. And Noor has nothing to doh with as she tries to tell with a roguish smile.
But otherwise there is nothing more to tell. We're already four weeks long in the same daily routine.
MOVIE:
August 22, 2009
We are now 2,5 weeks after surgery and we feel that things are improving with Noor. It is not measurable but we believe that since a few days she is more vivid, brighter and more playful. Once she is out of the bench she has to play. That can be because she is bored to death by now in that bench. And that will also be party the case. But we also have the impression that she no longer has pain. For although she still may not trot she does that more now and then we no longer see her limping. But we do not trot long stretches with her. These are always just a few steps before her leash is tight. Also she just seems to walk faster than before.
But that only makes it harder for us to keep her quiet. If she wants to play then we do a little obedience training. She likes that. And in the bench she is regularly bored. All the chew bones are not nearly as nice than they were before. So we have consulted the vet and now she gets "Sanal Relax. This is a remedy to calm her a little. The vet advised not to use anything heavier. Of than she can go stagger with all the bad results for her shoulder. So now we try "Relax". We start with the lowest recommended dose but for now it has zero result. We'll see if it's still going to have a desired effect.
Funny to see the website statistics of this year. These were very constant. Then suddenly a dip since we didn't write anything (as explained above) and than at the publication of her decease you see the peaks shoot up. So anyone with a healthy and compassionate interest, thank you. And if they soon return to normal, it means that Noors situation is normalized again. How symbolic ....
August 17, 2009
The operation is now a little two weeks ago. And that means that a telephone consultation is at the state. I called Mrs I. Schaeffer. Fortunately, it goes very well with Noor but that does not mean that she just may do everything. I told her that in trot it is better than before the operation but that she now gets painkillers. Also mrs. Schaeffer says that it is more likely due to the anti-inflammatory function of the medication. The pain-relieving effect is small.
Mrs. Schaeffer explained that the first six weeks, at least, are very important to build the cartilage. The cartilage cells in this period must work hard to do their best to grow back. The inner and outer edges must grow against eacht other as much as possible. If this does not happen you will notice the effects only later in life. So in the first six weeks after surgery she can not jump and run and can not play. Each time she does this she accelerates and decelerates. And that is very bad for the cartilage-building. But by normal movement, there is also wearing instead of building.
But a controlled reduced movement is needed to keep the joints flexible. So that is why she has to walk regularly. We started with a schedule of 6 to 10 times per day, 3 to 5 minutes. We are now at 10 times per day between 8 and 9 minutes. Now we in the next four weeks we may slowly build that up to 20 minutes at a time. But 20 minutes is the absolute maximum and may not be achieved until the end of the 6 weeks. That may be just up to 6 times per day. And still on a short leash. So with the building up of the duration, the number of times has to go down.
For rest, rest, rest remains very important. By resting the new cartilage will be of better quality. In the first years you will not notice the effect of the quality of the rehabilitation. But you will notice that when the dog gets older.
According to her Noor does not have to stay in a bench but they may be loose in the living room. Large dogs do not run around the house like small dogs and they are much quieter. A little walk around the house does not hurt, But she may not jump or run. And jumping around on the sofa is absolutely taboo. Well, we can not guarantee that with Noor. Noor can get crazy in a split second. Especially now that she is always in the bench or on the leash. This means that we are still need to be very close to her and that we better let her free in the evenings when Noor is tired. She is allowed to sleep on the couch but no jumping on and off. (Furthermore, Mrs. Schaeffer has also some concerns about this behavior, dominance, etc., but not for physical recovery.) She adds that you want to hug and spoil her more now. But you really should not do this because later you'll suffer from it. For the dog there is nothing going on, so she doesn't need to be cuddled more. You are better of doing obedience training with her, especially she has to be on the leash anyway It is also provides more for all parties.
The first 6 weeks are especially important for the cartilage to grow. But then it is not ready yet.
The building up of the cartilage takes up to 6 months before the entire process has been completed. How we need to go on after these 6 weeks we will hear on September 14 when we need to return to Almkerk. But I don't think that she will immediately be allowed to run, jump and play. At that moment she will be on a schedule of 6 times per day up to 20 minutes easy walking.
Hydrotherapy may only begin at a later time, certainly not in the first 6 weeks. Hydrotherapy is a movement without any pressure but it is still too much for the joint to handle in the first recovery period.
She adds that really need to unlearn Noor to explore the kitchen counter for food or to lay on tables. This is not because of the OCD but sooner or later this will go wrong because these surfaces are sllippery. And then she breaks a bone or tears a knee.
Somewhat about the hair growth. That will indeed still be a while before it all grows back. We have to watch the sun, especially now the weather gets warmer, the coming days, because the skin does not contain pigment. And as the sun shines on the skin the hair grows slower.
It will therefore be difficult for us in the weeks to come. Because no matter we do our best, Noor jumps. From frustration, to let the energy out or to try to get free with playing. Even with a short leash, even if hold her at the collar, then she just suddenly jumps on us in a split second. That is so frustrating for us. On the other side you can see that she is mentally suffering from that bench. She sometimes behaves so frustrated in that thing. Especially when she hears other dogs bark outside or when we have visitors. Then she reacts so weird.
We try now to accept that we do our absolute best and cannot do more. And all this is also in her character. And we do our best for sure. We cannot make it better than we are doing right now.
August 16, 2009
Yes spoiled, that is how you can call it. Noor will need to kick this later. To give in to her mental needs she may be out of the bench more. Especially in the weekend if we can take time for her. Because we dare not to leave her alone for one second when she is outside the bench. Noor simply jumps on the table, to lie down like a real mountain dog. And on the kitchen counter to see if she can steal anything, on the high window still to look outside. Or at doors to see if she can open them. And when she hears the neighbor dogs she runs like crazy on the porch and tries to take to the barricades to break out. Or she jumps on and even over the couch, in a crazy mood. At 99% of the time she is just quiet. But those crazy 5 minutes or getting in her head that something needs to be done now, happens in a split seocnd.
And so we are at her side at every "free" minute. We come to nothing. I haven't been out of the house for two weeks now, except to go to work. The house is a big mess.
August 13, 2009
Tonight, the stitching-staples were removed. It looked just like two staples. At one place there was nothing to be seen anymore. And the other had a bit of a scab. And that was the size of a pee. But that was probably more because of taking the staple out. Now Noor has to wear a T-shirt for one more day since she may not sratch. She will be happy if that T-shirt may be removed. Although she doesn't think that it is too bad. But it's getting warmer and when she is going to be in the sun a lot we still let her wear a T-shirt to avoid sunburn. Although there is now a little bit of a fluffy hair, she is still very bare.
Furthermore, she is examined by the veterinarian. She had to trot a short piece. In trot she is still limping but less than before the operation. That was without painkillers than and now with painkillers, but it looked very good for a dog that had surgery just a week and a half ago. The examination on the shoulder was no problem for her. She is still recovering well.
And at the scale she was 38,5 kg. That is 600 grams more than 3 weeks ago and 1300 grams more than 6 weeks ago. That is fine because she is still in growing. And the amount of extra treats doesn't seem to be too much.
August 11, 2009
Peace is back in the house again. Because we have started the second week and it goes well with Noor we decided to let her free a little more. She may wander around the living room in the evening. But she don't want to move for so long. Because she loves to lay down on the couch to sleep. You can see that she missed that and it is fully enjoyig it. But Noor is simply a white tornado. And from one second to another she can have "the mad five minutes" and then fly over the back of the couch if necessary. So for us it is very exciting to let her free.
After the walks she may cuddle a little on the outdoor couch. And of course after dinner playing on the grass. You can see that she is having fun. We, but especially Noor, can't wait until she may walk free again. Only if it is just on a small fenced field.
I put the videos of Noor on YouTube, just to be sure.
August 10, 2009
It is now a week that Noor has to stay in the bench. And today we see that the effect of this. That is how I interpret the behaviour. She now regularly heard the dogs of the neighbours barking. Then she barks back but she is in the bench and can not get out. She is so furious then that the bench starts to wobble. Correcting her scarcely helps. Today during our training walk, the neighbours dogs were outside and ran to the fench. Normal Noor wants to go there but can be hold back, and it's more of a game for her. But now she started a big fight with me. I think it took less than half a minute but it took me an hour before I stopped shaking. The idea of what could happen if she really had broken loose! Fortunately there was nothing to see at her leg afterwards but still, it was horrible! I had only one type of protection instinct: whatever happens, do not let go but try to fixate her!
She was not aggressive to me but to angry at the situation. I have never seen her like this. Raised lips and growling, and at one time they seemed to want to bite my arm to make me let her go. But she instinctively did not bite me, because as I said she was not aggressive to me. But three times she almost slipped out of her collar and that should not be possible, this is a slip collar and normally she cannot take it of by pulling. (But from now she may go out with the slip the chain on.)
I tried to push her to the ground and even lie down on her but I did not succeed so soon because I wanted to save her foreleg. And tan I tried to keep her in the air. That seemed the least damaging to her leg. She was already jumping on me all the time to try to push me away so that was not so difficult. I believe that I finally pushed her right standing on her hind legs with her back against a tree. The neighbourhood dogs were quickly called back and then she was quiet.
My feeling was that she totally looked like a frustrated farm dog who is always on the chain. And I do not think there is anything that we can do to take the frustration away as long as she should be in the bench. Chew Bones, toys, cuddling, evenings on the leash on the couch with me, cannot take away this growing frustration. This makes you feel so very powerless.
August 9, 2009
There is not so much to tell. It is still going well with Noor. We ask ourselves how long the T-shirts will last. Madam usually thinks that the sleeves are too short and the cleavage not deep enough. So she refines that herself. And we have discovered that Noor is training better if we are singing Marching Songs.
Her life at this moment can be summarized in three videos. The movies are just randomly filmed. But they show accidentally
very well how well it goes with Noor and how difficult it sometimes is. You can beautiful see how she distinguishes "peeing and pooping (Uitlaten)" and "Training". The "free uitlaten" two times a day, she just needs psychological but because of that freedom she sometimes thinks that she can afford more and coincidentally she jumped a little while filming this. (The movie does not show the rolling on her back which also is part of this free walk but she needs that as well, just let the body move freely. She is than swinging her hind legs in the air so we don't see a problem there.)
It seems that it can take a bit long before the movies load, so you must be patient. If the complaints continue then I will put them on YouTube. We can however quickly play them via the Internet, so I do not know what the problem can be. We use Windows Media Player 11. But then we first are asked whether we want to download. So perhaps it is the security level. If you have a yellow bar above your window then you need to click on it.
August 8, 2009
It is already much better with Noor. And that means that she no longer wants to stay in the bench. in the bench she is regularly barking
and crying and trying to push the door open. And if we exercise with her then she refuses to walk. So we called the orthopaedist. What is better, walking for 4 minutes and then walk back very slowly. Or shorter walks because now she is out of the bench for 15 minutes in total.
He is glad to hear that it goes well with her. Therefore, she may walk slightly longer, 5-10 minutes each time. He says it is not the intention that she is boss. No, we do not want that either but every breed lover knows that independence and independent thinking are part of to the breed standard of the Pyrenean mountain dog so that stubbornness and obstinacy are in their nature. The challenge is to deal with it creatively so that you still remain the boss.
The orthopaedist gives us a few suggestions that we can work with. It is not good for us to pull her leash but we may lift her butt
as she sits down. And he suggests to make a difference between peeing and pooping and training.
So now we always walk up and down to the gate. This is training and then she has to walk. Each time she sits down it's "no" and we lift her butt. And then we show a nice treat. And daily, half an hour after the meals, we go "play" on the grass and poop behind the pond. That playing of course is no more than just a roll on her back. Because she really needs to do that.
So far, this approach works. However, in an unattended split of a second she slipped from her collar. Freedom! She made a couple of little skip jumps and ran 8 meters away where she lay down. Normally she runs away hard if we approach her but she now seemed to hear the panic in our
voices because this time she stayed put with keen ears. So it was not so much and not so wild, but still, it may not happen. We hope she didn't do too much.
As predicted. This is the most difficult. Keeping her calm throughout the day.
August 5, 2009
Yesterday evening Noor was regularly whining very hard and strange and was sometimes very restless. In the letter they gave us it says that this is normal because of the effects of opiates during anaesthesia. At the end of the evening she was so deeply asleep that we left her in the bench. During the night she regularly was crying and whining and at 4.00 am it was much. So I got up to let her go pee but I was too late. Once I switched the lamp on she did a huge pee in the bench. If I take her out she greets me with 1000 licks. Our Noor is back from her anaesthesia.
This morning, she may eat again and then starts the rehabilitation regime. I turn the cooking timer each time at 75 minutes and then take here out of the bench for a walk of about 4 minutes. In the beginning, she still does it but after a couple of times they thinks "I am not taking one more step." And then she falls on her butt. She knows very well that turning back means bench and she really does not want that. And so she sits down. Pulling her leash is not good so I should be patient and wait and be patient. Yes, our Noor has definitive returned from the anaesthetic. I really want her to walk continually for a few minutes. Because the frequency of this brief quiet movement promotes recovery. So I try treats. That works three times and then she thinks "I don't want your treats. That weighs not up to the fact that I should go in the bench." And so she does not want them anymore. Every time another kind of treat helps a little. Once inside she doesn't mind to go into the bench. Today she is still sleeping the whole time.
But when she walks you hardly notice anything. She is not limping, just a little stiff. As far as I can tell it seems that the swelling in her shoulder is already a lot less and it is not really warm.
We hope and keep our fingers crossed that this continues and that this is a predicts a good prognoses.
August 4, 2009
The day of surgery. We have to be in Almkerk at 9 in the morning at the Specialists Clinic "Het Binnenhof".
We are welcomed by Drs. van der Peijl. He takes time to explain what is wrong with Noor, how it occurs and what to do.
He examines her again because there will only be surgical intervention as X-rays and symptoms support each other. But Noor shows clearly that her right shoulder hurts. Not the other joints. Yet he wants to be sure and take some more X-rays from the shoulders from different angles. Often it happens that both shoulders are affected. Then we leave Noor behind with pain in our hearts.
At 5.45 we may come to pick Noor up. She has just left the OR. First we have a conversation with Drs. van der Peijl. The second set of X-rays shows that Noors left shoulder is " suspicious ". But because she does not show symptoms and no pain indications it is not operated. Her right shoulder had a large piece of loose cartilage with a diameter of about an inch. It is very sturdy and it means that there is now a large hole this gap will always remain. They have tried to scrape and clean the hole, to provide good "corners" and to stimulate blood flow so that new cartilage will grow better. But unfortunately only for 90 to 95% successful because the unfortunate place. The body will also have to resolve itself. She is operated by arthroscopy and the "tube" can not be used around a corner. But with a full operation it would not have been possible as well. It was also behind the muscle. He is not really making a statement about the prognosis. The next six weeks should show how Noor handles this, both mentally and physically. The fact that it is one shoulder is actually a bit negative. If both shoulders were effected than it would be more in balance. We are really afraid of this. You would just like to hear that she is operated now and that everything is good from now on? But perhaps this is not reality.
Then we go to get Noor. She is still half "drunk" from the anaesthesia but she wags her tail, makes her Chinese smile as good as she can and she licks my nose. She has really been suffering today. We can see that. The most notable thing is that it looks as if she was at the dentist. Her tongue seems to be quite rigid and does not what she wants.
And so I'm back with her in the backseat on the way home. Like on December 6. But now everything is different and that hurts.
Our questions to the orthopaedist and his answers:
What is OCD?
A bone in a joint has a thin layer of cartilage. If a bone is growing this is because the cartilage becomes bone and there comes/stays another layer of cartilage. That thin layer of cartilage is needed. If the orthopaedist draws this than it looks a bit like the rings of a tree. (But in a bone no rings remain visible like in a tree.) In a dog with OCD that layer of cartilage does not become bone quickly enough. This becomes therefore a kind of dent in the bone. The earlier in life this happens, the deeper the dent is. That dent is filled with a thick layer of cartilage. On X-rays it is seen as a dark spot and the bone is not nicely rounded. As this cartilage is thick, it can crack more easily and breaks it off. This may (but need not always) be caused by a fall or a jump. The loose piece of cartilage is floating in the joint. Also, the body respond to it with an inflammatory reaction and for both reasons this causes pain.
What creates this and is it hereditary?
Studies in other breeds have shown that it is a recessive hereditary disease. So we can assume that this also applies to the Pyrenean mountain dog. Environmental factors can affect the development. Good exercise and good nutrition can limit the development and wrong exercise and nutrition can make it worse.
You cannot turn it around. If a dog has no genetic predisposition to OCD than it is not created only due to poor exercise, poor diet or trauma. (My own conclusion, not said by the orthopaedist: you've got to have that thick piece of cartilage before it can break off.)
What is good nutrition and good exercise?
Good exercise is not too much and not too little. And especially not jumping and walking stairs.
Good nutrition is a complete diet of high quality of a good brand with less than 1% of calcium in it.
What happens during surgery?
They will make two holes in her shoulder. One in order to go inside with an arthroscope (literally joint viewer) and one for the fluids. First, the loose piece of cartilage will be removed and then the "gap" will be scraped to stimulate blood flow. Here should then grow new cartilage. Also, the edges of the "gap" will be polished to ensure that the new cartilage will join the existing cartilage as good as possible. This new cartilage will always be of inferior quality and the connection with the old is not always good.
Noor has walked well all the time in between and responded well to painkillers. Does this mean that she therefore has pain from the growing pains and not of the OCD? It was also better after rest and that seems to be not the case with OCD.
OCD is not always better after resting. Furthermore, we speak of pain killers but a significant effect of the painkillers, the anti-inflammatory that is in it. This reduces the inflammation and makes it thus less painful. Also, the loose piece of cartilage can shift. Sometimes it can sit in a place where it is not so painful and then it shifts back to a painful place.
Will she get osteoarthritis sooner than average?
The osteoarthritis process has already started. This is a process that cannot be stopped. But the operation is supposed to have make the process go much slower. The first six weeks to give an indication on how Noor will cope with this in the future, both mentally and physically.
What is growing pain and why is that gone as they mature?
Growing pain is caused by the "tubes" in the bone which contains the blood vessels. They do not grow as fast as the blood vessels themselves. They get "jammed" by which fluid starts leaking. This hurts. As dogs grow older the bones and hence the "tubes" grow further, if all is going well, and it all comes back into balance.
How should we go on from here?
When we get home the bandage from the infusion may be removed.
Noor has had sufficient moisture. Tomorrow morning she may eat and drink again and then also start with the medication.
Noor, must be put in a box or cage, for the first weeks, in which she can move around freely. (Later I ask the assistant to explain what "freely" means. A bench where she can turn around, stand, sit and lie, and make a few steps is the best. Better than a small room where she can jump against the doors etc.)
Furthermore, she most go out 6-10 times per day, for a 3-5 minutes walk on a short leash. Not running, not jumping. But in between she must rest for the shoulder to heal. This structured motion also contributes to the healing process.
And also much Love, Care & Attention will help.
The first day she can still limp. That is normal. But then that should be over.
She receives antibiotics and Rimadyl. And Cosequin is also recommended.
Luckily she does not need a cone because she cannot reach the wound with her mouth. A T-shirt makes sure that she cannot directly scratch the wound.
After ten days the stitch-staples may be removed by her own veterinarian.
After two weeks we have to call to discuss the situation further.
After six weeks we have to get back to the clinic for a check-up.
Any physiotherapy or hydrotherapy should only start after six weeks as the shoulder is completely healed.
You hear often: 'Let the dog do what he wants. He knows himself to what he can and can not do. "
A dog knows only the present. He has no idea that what he does today has bad consequences for the future. (Personally, I had already thought that a dog does not have a natural instinct to something so unnatural as a surgical procedure with medication by which you don't feel pain.)
For further instructions see the diary notes on August 17 and September 14.
July 31, 2009
This page has not yet been published on the internet, we do not even know exactly what is going on, but the rumour machine is already fully running. A dog of a somewhat rare breed, with a pedigree, leads no anonymous life. There seems to be gossip about us, by people who somehow believe to suffer any harm by Noors decease, and point to us as the gulprits. Damage Control at the expense of another. I don't know what and how exactly but it would not surprise me if it happens.
Someone supposedly said: "Who is going to walk for hours in Switzerland with a Pyrenean mountain dog a few months old?" Well, say it then. Who does that? We don't.
Actually we find that we do not even need to defend ourselves. We do not need to render an
explanation to the world. But I want to show how easily such bullshit is undermined. To begin with, Noor was not a few months old but 8,5 months. This means that according to the guidelines she can walk for approximately 45 minutes. And what does it actually say in Noors diary? She went limping on the second day in Switzerland. That was on the viewpoint "Stand" near Moosalp. A photograph of the sign on "Stand" shows that it is 30 minutes walk to the car park at Moosalp. There and back it's one hour. That is 15 minutes too much. Bad! But has anyone taken the trouble to see how many resting pictures there are in her album?
A day earlier we walked along the Bisse Déjore to an Alpine Meadow and back. A look at Google Earth shows that the round trip is 1 kilometer.
And if someone wants to see how "strenuous" the walks are that we make in Switzerland should look again at the movie in which Noor is limping in Switzerland.
And although we had walked two days with her for hours. It shows ignorance to suggest that OCD suddenly, out of the blue, is created on two days of walking.
The worst thing is that I myself have felt so guilty by whether we might have done something wrong. This is a thought shared by other people who have similar experiences and many people will recognize it. Noor is our first puppy and the balance between not too much physical exhaustion and not too much mental limitation, is the most difficult thing for me in the upbringing of the Pyrenean mountain dog. And we will have made a few beginners mistakes. Who doesn't? So at the time Noor begins to limp a huge feeling of guilt sets in and I wonder if maybe the balance has been wrong. It is the only question I can not to ask the vet without bursting out in tears: "Have we done something wrong?". (His answer was "No", but that does not remove the guilt.) And then there are people, breeders with a self-interest that spread these kinds of lies and point the finger at us. It does not matter how much they hurt the puppy-buyer of another, as long as they themselves benefit from this. Why is the world around dogs with such a great character, so rotten?
Meanwhile, we have remembered an incident in which we forgot because at the time it seemed so futile. About a week before we went on vacation, so a week before Noor began to limp, she slipped. We sat outside for diner and Noor was with us (of course). Then suddenly she heard the dogs of the neighbours and ran towards them like crazy. She flew around the corner of the house and then we heard her slip, and scream of pain. The only time in her life until then that we heard a sound of pain. A half second later we were there and there was nothing going on anymore. Later we read on the internet that this is a typical example of the beginning of OCD-symptoms. We have the feeling that this might be the cause. Some dogs slip and have nothing, others rip off a ligament. And at others a piece of cartilage breaks off and then it's called OCD and suddenly all hell breaks loose.
But what is the reason that in Noor a piece of cartilage breaks off and in others it doesn't, that is now before us the question. Hopefully, the orthopaedist can tell us something more about that.
July 29, 2009
Noor now has used Metacam for one week and she is walking like a ballerina, but soon it will all be over because then she will operated. It is bizarre that we now know that she has OCD and that she walks so beautiful at the same time. There is nothing to see at her. It is therefore again not the standard picture of OCD. We want to advice everyone with a (young) dog of a large dog breed to make X-rays soon as possible when they start limping. It can be really worse than it seems. We think that she is limping more of growing pain than of OCD.
July 22, 2009
We gave her no painkillers and Noor is still limping. At 1PM we should be at the veterinarian. He too sees her limping this time. She is put under anaesthetic. At 3.45 I return to the veterinarian. Pieter takes me to the office and shows the X-rays on the computer. She appears to have OCD in her right shoulder. He shows me a small dark spot seen on the X-ray. Click here for the X-ray. Not much, but still ... It also shows that she has growing pains in both her front legs. Luckily her hips and hind legs are fine. However, what I get to hear about her legs is a big shock. I had expected that there would be something because all together it was too much limping. But you still secretly hope it's nothing. And if something should be wrong than just growing pains. But growing pains and OCD. How could that be? Have we done something wrong? But Pieter wants nothing of it. He knows us for a long time and sees how well Noor looks, good weight, how we care for her and what we do (and previously did with Lot). We do not need to feel guilty. It can happen in a large breed like the Pyrenean mountain dog. He sends us to the best orthopaedic clinic that he knows, the Binnenhof in Almerk. Since they can tell us more about her condition and what to do. It is easy to operate. And they have very good facilities.
Then I go get Noor. She is still a bit woolly of anaesthesia. She greets me not as exuberant as usual. But of course she is very happy that she can go home.
July 16, 2009
Noor starts limping again in the evening. And now we know for sure. The next day we make an appointment to make X-rays.
July 9, 2009
In the evening, I think I see her limping. However, it is gone so quickly that I do not know if I looked well enough. But it is already for a long while that she licks her legs. She does that for months but now the leg becomes brownish from licking.
July 6, 2009
Noor has finished her three weeks of calmness. We are now one month after the limping started and expect for the first four days there is nothing noticeable. However, I would like to be sure again by the vet. The fact that she was not limping before but did cry is bothering me. So she has to trot again and is again examined. He is completely satisfied with her. Nothing to notice, nothing to feel. And this time she no longer cries. She only pulls back a little and sighs at the right shoulder but that's it. I am completely reassured.
June 15, 2009
Noor had a full dose of Rimadyl the first day. The next day a half and on Saturday a quarter. Then nothing anymore. It is now Monday and we are in the Netherlands. It actually was better with Noor very soon and since Friday there nothing noticeable anymore. But I still want the security of our own veterinarian. First, she has to trot in the car park and then he examines her legs. When trotting he cannot see anything unusual. At the examination of her legs she cries a few times. But this is no cause for concern. She now needs three weeks of calmness. The first week only short walks at the leash and then slowly build it up. Of course, without X-rays he cannot say with certainty but the probability that it is OCD would be very small. That does not go away so quickly, certainly not without painkillers. Growing pains could be because that comes and goes but usually not as fast. So for now there is no need to make X-rays
June 8, 2009
It all starts on Monday, June 8. Noor is almost 8,5 months old. We are on holiday in Switzerland and on a hill in a plateau. Noor is exploring the area and comes back. Suddenly we see that she is limping. Well, she's hopping. It is not that she no longer can stand on her leg. Immediately the fear grabs me by the throat. Since I know that her half-brother Giusto had surgery on both shoulders, I deepened myself in OCD. But as the most critical period begins to pass, I am less afraid. And now, suddenly she's limping. On top of a lookout point. It is not a big mountain but we need to go a bit steep down. Very gently we let her walk down. Because even though she is limping, it doesn't bother her. She is still just as energetic as always.
The next day it seems to be a lot less. But later in the day it gets worse again. But it doesn't seem too bad. We make a movie so that we can watch it in slow motion on the computer, to see which leg it is.
Click here for the video of Noors limping in Switzerland
We conclude that it is the right front leg, because she "falls" on her left leg. I try myself how I would run if I would have pain in one leg, and how it would look like. Because we are in Switzerland, we have little opportunity to find out what it can be. And so we worry all day long.
On Wednesday we go to a veterinarian in Visp for our own peace of mind. We find one in the Yellow Pages and make an appointment. Unfortunately, we can go late in the afternoon. Noor is examined by a veterinarian at the Animal Kleintierpraxis. She notices pain and "back pressure" in both shoulders and in the right elbow. This is worse than
expected. Noor gets an injection of Rimadyl and Rimadyl tablets and the advice to go to the veterinarian at home if the limping persists. She may only go out on the leash a few times a day. She may walk for 15 minutes, 6 times a day. We had hoped that it would be not so bad, but pain in three joints! According to the veterinarian it need not be so bad as it seems. Regularly you'll see that if a dog has pain at one joint that then the others are used more and start hurting as well. We still need to go shopping in the supermarket, but I can only sit in a garden chair there. I just can't concentrate on what we need for food and eating is already something I don't want right now.
We can now go on the Internet on our mobile so we look for information as good as gets. The most important thing we learn is that OCD gives severe limping, worse after rest and better after movement. And that at early diagnose there is proper treatment. With Noor it is not worse after resting, rather better. And it is not better but rather worse after activity. And we cannot call the limping severe. You can see it in trot, not in step and not in run. And it seems no burden to her because she has energy for ten and would prefer to run, climb and jump. But now that she can not do that, what it really is frustrating.
We also email her breeder Beate and Jukka, the owner of Giusto. They add that OCD does not go away with painkillers. And since Noor is soon better and after 4 days no sign of limping anymore, they both confirm that the risk of OCD is small. Beate adds that she is thinking of growing pains because she is hurting in the whole leg. That is a relief but the uncertainty continues to rankle and rankle.
DISORDERS (Needs English updating)
Below is a collection of general information that we encounter on the Internet:
HEUPDYSPLASIE (HD)
English Wikipedia
English Wikipedia
WHG Veterinarians
Rashof
of Metacam Folder
Board
Maarten Kappen
ELLEBOOGDYSPLASIE (ED)
This is a collective of four disorders:
Los Processus Coronoideus (LPC)
Los Processus Anconeus (LPA)
Osteochondrose Dissecans (OCD) OCD kan ook in andere gewrichten voorkomen
Incongruentie
Wikipedia Engels ED
Wikipedia Engels OCD
WHG Dierenartsen 1
WHG Dierenartsen 2
Rashof
Folder van Metacam
Folder van Pfizer ED
Folder van Pfizer LPC
Folder van Pfizer LPA
Folder van Pfizer Incongruentie
Raad van Beheer
Peter Vandekerckhove
Maarten Kappen
OCD IN DE SCHOUDER
Dierenarts Online
Rashof
Folder van Metacam
GROEIPIJN (ENOSTOSIS)
Folder van Pfizer
WHG Dierenartsen
PATELLA LUXATIE (PL)
Rashof
Dierenarts online
WHG Dierenartsen
..
A breeder who is not critical to his own dogs and very critically those of others,
a breeder who prefers gossiping rather than analysing studies,
a breeder who does not understand that knowledge can change over the years,
a breeder who only enunciates black & white idle talk and follows no nuanced line of thinking
a breeder who smiles in your face and laughs behind your back,
a breeder who, entirely free of self-criticism, thinks that he is all wisdom and no longer need to learn,
will never reach the level of Beate Konstad
And we are very grateful to her that such a sweet dog as Noor, with such a great character and also so beautiful may live with us.
Why do we start this web page with such a text? That is explained below.
Joint problems. With a large breed like the Pyrenean Mountain Dog you can face this. And it happens to us, unfortunately.
But before we can write a lot about this we are warned to not to do so. And even more when it is uncertain what the definitive diagnosis will be. Noor will be judged and that will never go away. Because now that we have a dog with a pedigree, we end up in the world of the breed club, the NVLPH. And it appears to be a battle scene of breeders. NVLPH stands for Dutch
Association of Lovers of the Pyrenean Mountain Dog. Better would be: Never-ending Vendetta around the Life of the Pyrenean Mountain Dog. This is a world where people do not want or dare to be honest. A world where an incredible amount of mud-slinging is blemished. (Unfortunately, this applies everywhere. I have never heard someone who said: "With us it is very nice.") Very, very much is left out when it comes to health problems. But what you deny or ignore, you cannot learn from and improve. Nobody gets better from that attitude.
By a breeder link on the website of the NVLPH for example I find on a website of a Dutch breeder with photos of dogs from their previous litters, cheerful smiling in your face. But it does not say how many pups where born in those litters. And I miss two dogs of which I have read their sad story on other
websites. One with a happy ending, the other not. The breeder link from a breeder who does write what is going on is suddenly removed. Apparently there are unwritten rules that we do not understand.
We will never deny the existence and the essence of our beloved Noor. Never! So here it is:
Noor had OCD!
Fortunately, we are in the Netherlands (and Belgium) assisted by two very caring and compassionate breeders. So Marina and Karin, thank you so much.
Fortunately, or rather of course, we are also supported by Noors Norwegian breeders Berit and Beate who have a lot of knowledge and a big heart for the breed.
In June though, right after I had written in Noors diary that she does NOT have OCD (because that was the diagnosis then), there is plenty of twaddle of the fact that she does have it. And we are accused of not raising our dog properly. And all is based on her diary in which they read things that are not there. Well, that's great! Our dear Noor is already abused by people who like to twist everything for their own benefit. How on earth can you call yourself a lover of the breed and so-called expert if you write off such a very beautiful and sweet dog immediately and "take" her to use in your own little quarrel?
I am at that time looking for information. And I learn that joint problems are not that clear and straightforward.
So if you hear in this context from someone that OCD is hereditary then he is basically right. But if he praises himself and claims that, with certainty (?!) there is no OCD in his lines it would be worth to see if Alta Colina - jealousy could play a role. Or does a person tell you that it is entirely our fault that Noor has OCD because we let her run or jump too much? Then look in the pedigree of their dogs if there is Alta Colina. This person has every interest that it is not hereditary. What a pity that it goes like this.
But if you can find someone who says that it is a complex condition, which is not all clear, which may have multiple causes and/or a combination of causes you have at least found a qualified person who tries to look beyond self-interest .
The orthopaedist has told us that it is a recessive genetic condition. Several studies have shown that the condition is multifactorial and polygene hereditary. It's just a very complex story. Because it is so complex I have tried to write down the information that I have gathered together. Click here for the file on a multi-factorial polygene recessive hereditary disease.
At the moment that Noor starts limping, we are looking for information. You get a lot of websites of breed clubs of all kinds of breeds and websites of veterinary surgeons, where you can read (often literally the same) very general information about joint disorders, causes, symptoms and treatment. But no dog seems to have it. However, now we own a dog with bone and joint problems, we hear much whispering. That this dog has this, that dog has that, etc. A quick inspection of the policy of Noors health insurance shows that even in the most expensive package handling hips and elbows in dogs over 10 kg is excluded from compensation. In the Netherlands, at no animal health insurance is it possible to ensure treatment of hips and elbows. And that will not be because it is so rare.
With any luck someone puts a lower HD result in a pedigree but that's it. HD results should be public if you want a to breed with your dog, because of specific rules. Same with PL results. But further? There are no specific health rules, so do not talk about in public.
Because what one doesn't know, one doesn't care. And that is my problem. For does care me if I am not sure what is happening to Noor going on and how I should handle that, or what I can expect.
So for all normal individuals, that lover their dog and are looking for information we write our experiences on the Internet.
Our questions to the orthopaedist and his answers:
On August 4, the day of the surgery we asked a lot of questions. We will copy them here so readers don't have to go scrolling down so much.
What is OCD?
A bone in a joint has a thin layer of cartilage. If a bone is growing this is because the cartilage becomes bone and there comes/stays another layer of cartilage. That thin layer of cartilage is needed. If the orthopaedist draws this than it looks a bit like the rings of a tree. (But in a bone no rings remain visible like in a tree.) In a dog with OCD that layer of cartilage does not become bone quickly enough. This becomes therefore a kind of dent in the bone. The earlier in life this happens, the deeper the dent is. That dent is filled with a thick layer of cartilage. On X-rays it is seen as a dark spot and the bone is not nicely rounded. As this cartilage is thick, it can crack more easily and breaks it off. This may (but need not always) be caused by a fall or a jump. The loose piece of cartilage is floating in the joint. Also, the body respond to it with an inflammatory reaction and for both reasons this causes pain.
What creates this and is it hereditary?
Studies in other breeds have shown that it is a recessive hereditary disease. So we can assume that this also applies to the Pyrenean mountain dog. Environmental factors can affect the development. Good exercise and good nutrition can limit the development and wrong exercise and nutrition can make it worse.
You cannot turn it around. If a dog has no genetic predisposition to OCD than it is not created only due to poor exercise, poor diet or trauma. (My own conclusion, not said by the orthopaedist: you've got to have that thick piece of cartilage before it can break off.)
What is good nutrition and good exercise?
Good exercise is not too much and not too little. And especially not jumping and walking stairs.
Good nutrition is a complete diet of high quality of a good brand with less than 1% of calcium in it.
What happens during surgery?
They will make two holes in her shoulder. One in order to go inside with an arthroscope (literally joint viewer) and one for the fluids. First, the loose piece of cartilage will be removed and then the "gap" will be scraped to stimulate blood flow. Here should then grow new cartilage. Also, the edges of the "gap" will be polished to ensure that the new cartilage will join the existing cartilage as good as possible. This new cartilage will always be of inferior quality and the connection with the old is not always good.
Noor has walked well all the time in between and responded well to painkillers. Does this mean that she therefore has pain from the growing pains and not of the OCD? It was also better after rest and that seems to be not the case with OCD.
OCD is not always better after resting. Furthermore, we speak of pain killers but a significant effect of the painkillers, the anti-inflammatory that is in it. This reduces the inflammation and makes it thus less painful. Also, the loose piece of cartilage can shift. Sometimes it can sit in a place where it is not so painful and then it shifts back to a painful place.
Will she get osteoarthritis sooner than average?
The osteoarthritis process has already started. This is a process that cannot be stopped. But the operation is supposed to have make the process go much slower. The first six weeks to give an indication on how Noor will cope with this in the future, both mentally and physically.
What is growing pain and why is that gone as they mature?
Growing pain is caused by the "tubes" in the bone which contains the blood vessels. They do not grow as fast as the blood vessels themselves. They get "jammed" by which fluid starts leaking. This hurts. As dogs grow older the bones and hence the "tubes" grow further, if all is going well, and it all comes back into balance.
How should we go on from here?
When we get home the bandage from the infusion may be removed.
Noor has had sufficient moisture. Tomorrow morning she may eat and drink again and then also start with the medication.
Noor, must be put in a box or cage, for the first weeks, in which she can move around freely. (Later I ask the assistant to explain what "freely" means. A bench where she can turn around, stand, sit and lie, and make a few steps is the best. Better than a small room where she can jump against the doors etc.)
Furthermore, she most go out 6-10 times per day, for a 3-5 minutes walk on a short leash. Not running, not jumping. But in between she must rest for the shoulder to heal. This structured motion also contributes to the healing process.
And also much Love, Care & Attention will help.
The first day she can still limp. That is normal. But then that should be over.
She receives antibiotics and Rimadyl. And Cosequin is also recommended.
Luckily she does not need a cone because she cannot reach the wound with her mouth. A T-shirt makes sure that she cannot directly scratch the wound.
After ten days the stitch-staples may be removed by her own veterinarian.
After two weeks we have to call to discuss the situation further.
After six weeks we have to get back to the clinic for a check-up.
Any physiotherapy or hydrotherapy should only start after six weeks as the shoulder is completely healed.
You hear often: 'Let the dog do what he wants. He knows himself to what he can and can not do. "
A dog knows only the present. He has no idea that what he does today has bad consequences for the future. (Personally, I had already thought that a dog does not have a natural instinct to something so unnatural as a surgical procedure with medication by which you don't feel pain.)
For further instructions see the diary notes on August 17 and September 14.
OUR STORY
November 7, 2009
Noor may be free in the house since about ten days now. Here she can do whatever she wants. And one or two times a day we let her on her field of 15x15 meters.
Sometimes she can play there for half an hour without being too wild. There is a plastic chain there of about six meters long. She loves to pull that or run around with it. She has wrapped it around every tree and moved it into every corner. It's so cute to see her playing there. She has so much fun now that she may be free again.
But sometimes we hold our breath. Then she flies around for about 60km per hour. And if she is really full of energy then she will remain running around in laps. Along trees, across the hump and sometimes slipping in a corner. Luckily she makes a soft landing in the leaves. And fortunately she quickly comes when she is called with a treat and comes to sit with us. For we are really frightened still for this behaviour.
Noor is not afraid, she dares to do everything. This way she recently hurt herself (with a hip I think) to an iron box that is there. And that evening when we awoke her for her last walk she was completely unstable. At first she seemed to have all four legs crippled and soon she only limped with just the right leg. But that was gone already after two minutes. So whether it was the aftermath of the surgery and now she has really done too much? Or is she just completely drowsy. This we see more often with her. In the evening Noor is in a lovely deep sleep. And when she is wakened, she is just like a little child. Still half asleep and tottering. So, well? And even if it is because of the operation. Two minutes, what is that?
For a few weeks now she eats Carnibest (complete meal wit raw meat) every day. And with that the freedom and the movements. Whether this has something to do with I it I don't know but it seems as though she is more beautiful every day. She is really improving, now that the three months of cage-rest are over. Physically she is slowly getting much stronger and more impressive. And mentally she is again completely at rest. After one day outside of the cage she was already the old Noor. Unfortunately, she has a substantial "hole" in the coat around her throat. This is because we only dared to walk with her using a choke chain collar. She slipped out of every other kind of collar. And surely the final month or more she has tremendous pulled on her leash during walks. But funny enough that is gone now. We can just go walking with her with a loose hanging leash. Only the proximity of other dogs is still very difficult for her. For they challenge her and she still may not go to them. Then she is still completely crazy on the leash and it is very hard to hold her. That we'll practice soon.
Last Wednesday was the intake for Noors hydrotherapy. Hydrotherapy is not really necessary for her but swimming is always good. But in a post-operation situation
there always has to be an intake to determine the program. And the therapist saw nothing at Noor. All tests she did were good. The muscles were also good. Only the trapezoid muscle or something like that could be a little better. She said: "I have to right, just good, good, good, on my checklist even with the right front leg".
She thought that they did a very good job in Almkerk. And I suppose we also have earned a compliment. She had rarely or never seen a dog that looked and felt so good three months after having an operation. And she sees many post-operative dogs. So she said that for her part this is not rehabilitation but fun swimming, also called fitness swimming. For the next weeks Noor goes swimming every Saturday and Wednesday. I wonder how she will like this because she has never swum before. Last Wednesday she could sniff as much as she wanted. She did this for one whole hour. She found the swimming pool very interesting but did not go in there. She has soften the therapist by hugging, kissing and being naughty, as she can do so well. She immediately loved her and found her very beautiful and well built.
October 28, 2009
Today we have to visit the orthopaedist again. Mr. van der Peijl is doing this consult again. We are in his office for one hour while a consultation lasts only 30 minutes. They really take much time for their patients.
Noor has been without Rimadyl for three days now. First she has to run. That is good. If you know that she has been operated there is sill a little bit to see. But basically you do not notice anything on her. Then he asks me how it goes. It goes very well, we don not notice anything. It is just that we really cannot keep her calm. Especially when other dogs are around she goes nuts. And we are surrounded by dogs. Every neighbour has at least one. But two is quite normal and the nearest neighbour has six dogs. Since Noor is on the leash all the time she became much more snappy to other dogs. When they bark at her, challenge her and she cannot go to them (as is always the case at the moment) then she is mad with frustration.
And I explain that up till now we had her in the cage for a lot of the time. If she is out we cannot keep her calm. She never lies down somewhere. She keeps on walking around and jumping up or against something. She simply cannot lose her energy.
Mr. van der Peijl gives the redeeming word. Noor may return to a normal life. The cage is no longer needed for rehabilitation. And she may walk of the leash. In our case we still will not do that. She still is a Pyrenean mountain dog, of course. So we let her loose on an enclosed piece of property of about 15x15 meters. I explain what she will do: running, and jumping on a hill, digging and playing. But she may do that now. After five minutes we have to say that she should be calm. In Noors case this means that we put her back on her leash and go walking with her. Calm down when she is loose, is not possible for her at this moment.
Furthermore I tell him that Noor will occasionally jump on and therefore also of the kitchen counter. But we do not have to worry too much about that.
For now, she may still not play with other dogs. And if she wants to play with us then we should simply not react so she will stop. These movements of the leg in all directions as it is like when dogs are playing, are still bad for the recovery.
From now on we just need to observe. If she is limping again than she needs Rimadyl for a few days and cut back on the activity. We need to find out what she can and cannot do in the next months. She does not need to come back but we still occasionally have to call to discuss the situation.
So we assume that there will be a moment that she starts limping again and that we do not have to be afraid of that. This is normal since the cartilage is not fully grown back yet. The entire healing process will be 6 to 12 months to complete.
He also examines her shoulder. She shows no signs of pain. Even without the Rimadyl. Mr. van der Peijl explains that he does not use Rimadyl much as a painkiller. The analgesic effect of it is only important in the beginning when the wound needs to heal and still hurts. The inflammatory effect is much more important. The growing back of the cartilage actually causes inflammation and this is slowed down by the Rimadyl. Therefore the healing process improves. (I hope I recite this correctly.)
I also ask why it took so long in Noors case while I hear of others at home and abroad that they only have to be calm for a few weeks (Apart from that her breeder Beate is an exception. She also recommended this long rest.) Dhr. van der Peijl suspects that abroad, but perhaps also in the Netherlands, these opinions come from ordinary non-specialists and veterinarians who have less experience in this specific disease. And there are also studies showing that it goes well with less rest. In these studies, the dogs are not inspected for a lot of years. Mr. van der Peijl would like to see studies where the dogs are inspected for at least five years and preferably more, because only then the problems arise and you will see if the rehabilitation was good or not. Therefore they would rather take the safe side. And also the removed piece of cartilage from Noor was larger than normal. With Noor it had the diameter and thickness of a one-euro coin.
We are now just the happiest people in the world. And Noor is of course the happiest dog. At home, the first thing I do is let Noor loose in the small enclosure. But not before I quickly grabbed the camera to film the first five minutes of her regained freedom. And then I immediately set the cage aside. I am not sure if I interpret that but it's like she understands. The way that she is looking at me moving the cage out of the living room ....
By clicking on the picture you can watch the movie of the first five minutes off leash. It is not of very good quality but I did not cut it on purpose. It is touching to see how happy she is. She doesn’t know what she will do first: run, dig, jump, play, roll?
MOVIE:
September 14, 2009
Today we went back to Almkerk with Noor for a check up. Noor was examined by Mrs. Schaeffer this time. She is really nice and explains everything well. As she earlier also told over the phone the defective in Noors shoulder is very large. The hole in her bone is very deep and a such a big recovery lasts six months.
So unfortunately Noor may still not run loose. She may still not make wild movements, no jumping and no running. But she may now be taken out on a long leash rather than a short one.
It is very good with Noor. Actually too good said mrs. Schaeffer. For she is far too wild and energetic. That is the frustration of a animals orthopaedist she said. At a certain point you just can not keep an animal calm anymore. So that is why she would like to think along about how the balance could be between losing energy and resting.
Noor may therefore walk six times a day on a long leash. More often is also good but absolutely no longer than 20 minutes of walking. Playing with other dogs is of limits for the next six weeks really is not.
Hydrotherapy is not recommended. She did not see the point in putting such a large dog in an "aquarium". That was not necessary in the case of Noor. But she may swim. That is actually good for her. But well, Noor has never swum before and how we should do that on a leash I cannot imagine. And it really is too cold to dive in a lake with her.
Mrs. Schaeffer still sees an irregularity in her walk. She no longer limps, but at every step she apparently makes a movement with her head. But we do not see that. And the examination on the left shoulder Noor shows some pain. But not as much as before. Noor is gasping of excitement all the time. But at a certain movement in the shoulder she stops gasping which indicates pain. But that is all.
We still need to continue with the Rimadyl and Cosequin. But she will not need them for the rest of her life, because that was one of our questions. In five weeks we need to call again if needed and depending on the situation perhaps come back for check up. But we say that we want to come back anyway, just to be sure. That is fine. Noor then needs to stop the Rimadyl three days before the check up, so she can see how it goes without this medicine.
There is also a new drug on the market. This time you only give it once a month instead of every day. But we are afraid we might just forget that then. And for us it is important to know what the side effects are. This is from a newer generation of medications by which the side effects to the stomach and kidneys are less. This new drug is supposed to take up the substance in the cells and then gradually release it.
We have heard that the side effects of Metacam are less than of Rimadyl. But she says that this is not true because Metacam is from an older generation of medicines.
September 6, 2009
Each week we think it is impossible for us to keep her quit, only to find out one week later that it is even more impossible to keep her from playing and jumping.
We will be so glad if we do not have to correct her for just being happy, because it really comes down to that. And that we no longer have to put her in her cage just because she is too playful. Because that is really awful.
But there are still some moments (only a few per week) that she is tired. For example after she has been at her daddies office all day. It is a kind of vicious circle that only ends when the veterinarian says that she can run and jump again. She still may not run and jump and so she must regularly be in her bench. In her bench she cannot loose her energy and she becomes frustrated. So when she finally is allowed out of the bench, she must act extra playful to let off steam so she must return to the bench because we cannot keep her calm this way. That is so frustrating and heartbreaking at the same time. We now have rediscovered that new impressions can get her tired, but you can't do that every day.
And then, for the first time in her life, she is shedding now. We had already noticed that her coat looked a bit dull. But we did not groom her for over a month now because it invites her to playful and challenging behaviour. Noor doesn't like to be groomed on every party of her body. And since she is not allowed to make wild movements we did not groom her to avoid that. But the fur is starting to get a bit greasy and tangled in places. (And showering/bathing is of course not at all possible because the risk of slipping.) So we have nevertheless begun combing and brushing. And she is really shedding because there is no end to it. With each comb you pull out hair. But we do it always for a short period and only when she is lying down because she otherwise she really likes to start a game of wrestling. And we do enough grumbling already. We take the stand that we will have enough time left to correct unwanted behaviour. But there is just very limited time for her shoulder to heal, so that comes first.
And during walks she mainly wants to play, run, roll around and sniff. If we notice that she wants to jump against us then we will quickly go on our heels and then she will usually sit down. And then we start to do some obedience training. She does that very well mostly as you can see in the movie. But during each walk there is one or more time that she suddenly makes a strange move or jumps on our shoulders. That is really unstoppable and you will not even see it coming.
MOVIE:
September 1, 2009
Things are getting better with Noor. On August 22 we talked about that she is more playful. And that is getting more and more. She clearly has no pain and prefers running. If she is free inside and she sees a toy she dances around with it. But, dancing is not allowed. And just playing is not enough anymore. She wants to dance around! And you don't want her to eat only snacks. So we try to give her something to play by which she does not want to run around. Fortunately we had (with the emphasis on had) some cushions left over from the Flea market.
Furthermore, her hair starts to grow a bit now. The first on her upper arm, then the chest. But the flanks are still very bald, while the operation is already one month ago. The pigmentation spots are quite dark so she looks like a Dalmatian. It looks weird.
And how better she gets, the more wanton she becomes. Now we can not leave her alone for other reasons. We found an empty mint wrapping in her bed. And one empty shell of a paracetamol (as if she doesn't have enough painkillers already) and yes, a broken box of fountain pen refills. The blue tongue betrayed the culprit. Further suddenly a picture frame falls on the ground. And Noor has nothing to doh with as she tries to tell with a roguish smile.
But otherwise there is nothing more to tell. We're already four weeks long in the same daily routine.
MOVIE:
August 22, 2009
We are now 2,5 weeks after surgery and we feel that things are improving with Noor. It is not measurable but we believe that since a few days she is more vivid, brighter and more playful. Once she is out of the bench she has to play. That can be because she is bored to death by now in that bench. And that will also be party the case. But we also have the impression that she no longer has pain. For although she still may not trot she does that more now and then we no longer see her limping. But we do not trot long stretches with her. These are always just a few steps before her leash is tight. Also she just seems to walk faster than before.
But that only makes it harder for us to keep her quiet. If she wants to play then we do a little obedience training. She likes that. And in the bench she is regularly bored. All the chew bones are not nearly as nice than they were before. So we have consulted the vet and now she gets "Sanal Relax. This is a remedy to calm her a little. The vet advised not to use anything heavier. Of than she can go stagger with all the bad results for her shoulder. So now we try "Relax". We start with the lowest recommended dose but for now it has zero result. We'll see if it's still going to have a desired effect.
Funny to see the website statistics of this year. These were very constant. Then suddenly a dip since we didn't write anything (as explained above) and than at the publication of her decease you see the peaks shoot up. So anyone with a healthy and compassionate interest, thank you. And if they soon return to normal, it means that Noors situation is normalized again. How symbolic ....
August 17, 2009
The operation is now a little two weeks ago. And that means that a telephone consultation is at the state. I called Mrs I. Schaeffer. Fortunately, it goes very well with Noor but that does not mean that she just may do everything. I told her that in trot it is better than before the operation but that she now gets painkillers. Also mrs. Schaeffer says that it is more likely due to the anti-inflammatory function of the medication. The pain-relieving effect is small.
Mrs. Schaeffer explained that the first six weeks, at least, are very important to build the cartilage. The cartilage cells in this period must work hard to do their best to grow back. The inner and outer edges must grow against eacht other as much as possible. If this does not happen you will notice the effects only later in life. So in the first six weeks after surgery she can not jump and run and can not play. Each time she does this she accelerates and decelerates. And that is very bad for the cartilage-building. But by normal movement, there is also wearing instead of building.
But a controlled reduced movement is needed to keep the joints flexible. So that is why she has to walk regularly. We started with a schedule of 6 to 10 times per day, 3 to 5 minutes. We are now at 10 times per day between 8 and 9 minutes. Now we in the next four weeks we may slowly build that up to 20 minutes at a time. But 20 minutes is the absolute maximum and may not be achieved until the end of the 6 weeks. That may be just up to 6 times per day. And still on a short leash. So with the building up of the duration, the number of times has to go down.
For rest, rest, rest remains very important. By resting the new cartilage will be of better quality. In the first years you will not notice the effect of the quality of the rehabilitation. But you will notice that when the dog gets older.
According to her Noor does not have to stay in a bench but they may be loose in the living room. Large dogs do not run around the house like small dogs and they are much quieter. A little walk around the house does not hurt, But she may not jump or run. And jumping around on the sofa is absolutely taboo. Well, we can not guarantee that with Noor. Noor can get crazy in a split second. Especially now that she is always in the bench or on the leash. This means that we are still need to be very close to her and that we better let her free in the evenings when Noor is tired. She is allowed to sleep on the couch but no jumping on and off. (Furthermore, Mrs. Schaeffer has also some concerns about this behavior, dominance, etc., but not for physical recovery.) She adds that you want to hug and spoil her more now. But you really should not do this because later you'll suffer from it. For the dog there is nothing going on, so she doesn't need to be cuddled more. You are better of doing obedience training with her, especially she has to be on the leash anyway It is also provides more for all parties.
The first 6 weeks are especially important for the cartilage to grow. But then it is not ready yet.
The building up of the cartilage takes up to 6 months before the entire process has been completed. How we need to go on after these 6 weeks we will hear on September 14 when we need to return to Almkerk. But I don't think that she will immediately be allowed to run, jump and play. At that moment she will be on a schedule of 6 times per day up to 20 minutes easy walking.
Hydrotherapy may only begin at a later time, certainly not in the first 6 weeks. Hydrotherapy is a movement without any pressure but it is still too much for the joint to handle in the first recovery period.
She adds that really need to unlearn Noor to explore the kitchen counter for food or to lay on tables. This is not because of the OCD but sooner or later this will go wrong because these surfaces are sllippery. And then she breaks a bone or tears a knee.
Somewhat about the hair growth. That will indeed still be a while before it all grows back. We have to watch the sun, especially now the weather gets warmer, the coming days, because the skin does not contain pigment. And as the sun shines on the skin the hair grows slower.
It will therefore be difficult for us in the weeks to come. Because no matter we do our best, Noor jumps. From frustration, to let the energy out or to try to get free with playing. Even with a short leash, even if hold her at the collar, then she just suddenly jumps on us in a split second. That is so frustrating for us. On the other side you can see that she is mentally suffering from that bench. She sometimes behaves so frustrated in that thing. Especially when she hears other dogs bark outside or when we have visitors. Then she reacts so weird.
We try now to accept that we do our absolute best and cannot do more. And all this is also in her character. And we do our best for sure. We cannot make it better than we are doing right now.
August 16, 2009
Yes spoiled, that is how you can call it. Noor will need to kick this later. To give in to her mental needs she may be out of the bench more. Especially in the weekend if we can take time for her. Because we dare not to leave her alone for one second when she is outside the bench. Noor simply jumps on the table, to lie down like a real mountain dog. And on the kitchen counter to see if she can steal anything, on the high window still to look outside. Or at doors to see if she can open them. And when she hears the neighbor dogs she runs like crazy on the porch and tries to take to the barricades to break out. Or she jumps on and even over the couch, in a crazy mood. At 99% of the time she is just quiet. But those crazy 5 minutes or getting in her head that something needs to be done now, happens in a split seocnd.
And so we are at her side at every "free" minute. We come to nothing. I haven't been out of the house for two weeks now, except to go to work. The house is a big mess.
August 13, 2009
Tonight, the stitching-staples were removed. It looked just like two staples. At one place there was nothing to be seen anymore. And the other had a bit of a scab. And that was the size of a pee. But that was probably more because of taking the staple out. Now Noor has to wear a T-shirt for one more day since she may not sratch. She will be happy if that T-shirt may be removed. Although she doesn't think that it is too bad. But it's getting warmer and when she is going to be in the sun a lot we still let her wear a T-shirt to avoid sunburn. Although there is now a little bit of a fluffy hair, she is still very bare.
Furthermore, she is examined by the veterinarian. She had to trot a short piece. In trot she is still limping but less than before the operation. That was without painkillers than and now with painkillers, but it looked very good for a dog that had surgery just a week and a half ago. The examination on the shoulder was no problem for her. She is still recovering well.
And at the scale she was 38,5 kg. That is 600 grams more than 3 weeks ago and 1300 grams more than 6 weeks ago. That is fine because she is still in growing. And the amount of extra treats doesn't seem to be too much.
August 11, 2009
Peace is back in the house again. Because we have started the second week and it goes well with Noor we decided to let her free a little more. She may wander around the living room in the evening. But she don't want to move for so long. Because she loves to lay down on the couch to sleep. You can see that she missed that and it is fully enjoyig it. But Noor is simply a white tornado. And from one second to another she can have "the mad five minutes" and then fly over the back of the couch if necessary. So for us it is very exciting to let her free.
After the walks she may cuddle a little on the outdoor couch. And of course after dinner playing on the grass. You can see that she is having fun. We, but especially Noor, can't wait until she may walk free again. Only if it is just on a small fenced field.
I put the videos of Noor on YouTube, just to be sure.
August 10, 2009
It is now a week that Noor has to stay in the bench. And today we see that the effect of this. That is how I interpret the behaviour. She now regularly heard the dogs of the neighbours barking. Then she barks back but she is in the bench and can not get out. She is so furious then that the bench starts to wobble. Correcting her scarcely helps. Today during our training walk, the neighbours dogs were outside and ran to the fench. Normal Noor wants to go there but can be hold back, and it's more of a game for her. But now she started a big fight with me. I think it took less than half a minute but it took me an hour before I stopped shaking. The idea of what could happen if she really had broken loose! Fortunately there was nothing to see at her leg afterwards but still, it was horrible! I had only one type of protection instinct: whatever happens, do not let go but try to fixate her!
She was not aggressive to me but to angry at the situation. I have never seen her like this. Raised lips and growling, and at one time they seemed to want to bite my arm to make me let her go. But she instinctively did not bite me, because as I said she was not aggressive to me. But three times she almost slipped out of her collar and that should not be possible, this is a slip collar and normally she cannot take it of by pulling. (But from now she may go out with the slip the chain on.)
I tried to push her to the ground and even lie down on her but I did not succeed so soon because I wanted to save her foreleg. And tan I tried to keep her in the air. That seemed the least damaging to her leg. She was already jumping on me all the time to try to push me away so that was not so difficult. I believe that I finally pushed her right standing on her hind legs with her back against a tree. The neighbourhood dogs were quickly called back and then she was quiet.
My feeling was that she totally looked like a frustrated farm dog who is always on the chain. And I do not think there is anything that we can do to take the frustration away as long as she should be in the bench. Chew Bones, toys, cuddling, evenings on the leash on the couch with me, cannot take away this growing frustration. This makes you feel so very powerless.
August 9, 2009
There is not so much to tell. It is still going well with Noor. We ask ourselves how long the T-shirts will last. Madam usually thinks that the sleeves are too short and the cleavage not deep enough. So she refines that herself. And we have discovered that Noor is training better if we are singing Marching Songs.
Her life at this moment can be summarized in three videos. The movies are just randomly filmed. But they show accidentally
very well how well it goes with Noor and how difficult it sometimes is. You can beautiful see how she distinguishes "peeing and pooping (Uitlaten)" and "Training". The "free uitlaten" two times a day, she just needs psychological but because of that freedom she sometimes thinks that she can afford more and coincidentally she jumped a little while filming this. (The movie does not show the rolling on her back which also is part of this free walk but she needs that as well, just let the body move freely. She is than swinging her hind legs in the air so we don't see a problem there.)
It seems that it can take a bit long before the movies load, so you must be patient. If the complaints continue then I will put them on YouTube. We can however quickly play them via the Internet, so I do not know what the problem can be. We use Windows Media Player 11. But then we first are asked whether we want to download. So perhaps it is the security level. If you have a yellow bar above your window then you need to click on it.
August 8, 2009
It is already much better with Noor. And that means that she no longer wants to stay in the bench. in the bench she is regularly barking
and crying and trying to push the door open. And if we exercise with her then she refuses to walk. So we called the orthopaedist. What is better, walking for 4 minutes and then walk back very slowly. Or shorter walks because now she is out of the bench for 15 minutes in total.
He is glad to hear that it goes well with her. Therefore, she may walk slightly longer, 5-10 minutes each time. He says it is not the intention that she is boss. No, we do not want that either but every breed lover knows that independence and independent thinking are part of to the breed standard of the Pyrenean mountain dog so that stubbornness and obstinacy are in their nature. The challenge is to deal with it creatively so that you still remain the boss.
The orthopaedist gives us a few suggestions that we can work with. It is not good for us to pull her leash but we may lift her butt
as she sits down. And he suggests to make a difference between peeing and pooping and training.
So now we always walk up and down to the gate. This is training and then she has to walk. Each time she sits down it's "no" and we lift her butt. And then we show a nice treat. And daily, half an hour after the meals, we go "play" on the grass and poop behind the pond. That playing of course is no more than just a roll on her back. Because she really needs to do that.
So far, this approach works. However, in an unattended split of a second she slipped from her collar. Freedom! She made a couple of little skip jumps and ran 8 meters away where she lay down. Normally she runs away hard if we approach her but she now seemed to hear the panic in our
voices because this time she stayed put with keen ears. So it was not so much and not so wild, but still, it may not happen. We hope she didn't do too much.
As predicted. This is the most difficult. Keeping her calm throughout the day.
August 5, 2009
Yesterday evening Noor was regularly whining very hard and strange and was sometimes very restless. In the letter they gave us it says that this is normal because of the effects of opiates during anaesthesia. At the end of the evening she was so deeply asleep that we left her in the bench. During the night she regularly was crying and whining and at 4.00 am it was much. So I got up to let her go pee but I was too late. Once I switched the lamp on she did a huge pee in the bench. If I take her out she greets me with 1000 licks. Our Noor is back from her anaesthesia.
This morning, she may eat again and then starts the rehabilitation regime. I turn the cooking timer each time at 75 minutes and then take here out of the bench for a walk of about 4 minutes. In the beginning, she still does it but after a couple of times they thinks "I am not taking one more step." And then she falls on her butt. She knows very well that turning back means bench and she really does not want that. And so she sits down. Pulling her leash is not good so I should be patient and wait and be patient. Yes, our Noor has definitive returned from the anaesthetic. I really want her to walk continually for a few minutes. Because the frequency of this brief quiet movement promotes recovery. So I try treats. That works three times and then she thinks "I don't want your treats. That weighs not up to the fact that I should go in the bench." And so she does not want them anymore. Every time another kind of treat helps a little. Once inside she doesn't mind to go into the bench. Today she is still sleeping the whole time.
But when she walks you hardly notice anything. She is not limping, just a little stiff. As far as I can tell it seems that the swelling in her shoulder is already a lot less and it is not really warm.
We hope and keep our fingers crossed that this continues and that this is a predicts a good prognoses.
August 4, 2009
The day of surgery. We have to be in Almkerk at 9 in the morning at the Specialists Clinic "Het Binnenhof".
We are welcomed by Drs. van der Peijl. He takes time to explain what is wrong with Noor, how it occurs and what to do.
He examines her again because there will only be surgical intervention as X-rays and symptoms support each other. But Noor shows clearly that her right shoulder hurts. Not the other joints. Yet he wants to be sure and take some more X-rays from the shoulders from different angles. Often it happens that both shoulders are affected. Then we leave Noor behind with pain in our hearts.
At 5.45 we may come to pick Noor up. She has just left the OR. First we have a conversation with Drs. van der Peijl. The second set of X-rays shows that Noors left shoulder is " suspicious ". But because she does not show symptoms and no pain indications it is not operated. Her right shoulder had a large piece of loose cartilage with a diameter of about an inch. It is very sturdy and it means that there is now a large hole this gap will always remain. They have tried to scrape and clean the hole, to provide good "corners" and to stimulate blood flow so that new cartilage will grow better. But unfortunately only for 90 to 95% successful because the unfortunate place. The body will also have to resolve itself. She is operated by arthroscopy and the "tube" can not be used around a corner. But with a full operation it would not have been possible as well. It was also behind the muscle. He is not really making a statement about the prognosis. The next six weeks should show how Noor handles this, both mentally and physically. The fact that it is one shoulder is actually a bit negative. If both shoulders were effected than it would be more in balance. We are really afraid of this. You would just like to hear that she is operated now and that everything is good from now on? But perhaps this is not reality.
Then we go to get Noor. She is still half "drunk" from the anaesthesia but she wags her tail, makes her Chinese smile as good as she can and she licks my nose. She has really been suffering today. We can see that. The most notable thing is that it looks as if she was at the dentist. Her tongue seems to be quite rigid and does not what she wants.
And so I'm back with her in the backseat on the way home. Like on December 6. But now everything is different and that hurts.
Our questions to the orthopaedist and his answers:
What is OCD?
A bone in a joint has a thin layer of cartilage. If a bone is growing this is because the cartilage becomes bone and there comes/stays another layer of cartilage. That thin layer of cartilage is needed. If the orthopaedist draws this than it looks a bit like the rings of a tree. (But in a bone no rings remain visible like in a tree.) In a dog with OCD that layer of cartilage does not become bone quickly enough. This becomes therefore a kind of dent in the bone. The earlier in life this happens, the deeper the dent is. That dent is filled with a thick layer of cartilage. On X-rays it is seen as a dark spot and the bone is not nicely rounded. As this cartilage is thick, it can crack more easily and breaks it off. This may (but need not always) be caused by a fall or a jump. The loose piece of cartilage is floating in the joint. Also, the body respond to it with an inflammatory reaction and for both reasons this causes pain.
What creates this and is it hereditary?
Studies in other breeds have shown that it is a recessive hereditary disease. So we can assume that this also applies to the Pyrenean mountain dog. Environmental factors can affect the development. Good exercise and good nutrition can limit the development and wrong exercise and nutrition can make it worse.
You cannot turn it around. If a dog has no genetic predisposition to OCD than it is not created only due to poor exercise, poor diet or trauma. (My own conclusion, not said by the orthopaedist: you've got to have that thick piece of cartilage before it can break off.)
What is good nutrition and good exercise?
Good exercise is not too much and not too little. And especially not jumping and walking stairs.
Good nutrition is a complete diet of high quality of a good brand with less than 1% of calcium in it.
What happens during surgery?
They will make two holes in her shoulder. One in order to go inside with an arthroscope (literally joint viewer) and one for the fluids. First, the loose piece of cartilage will be removed and then the "gap" will be scraped to stimulate blood flow. Here should then grow new cartilage. Also, the edges of the "gap" will be polished to ensure that the new cartilage will join the existing cartilage as good as possible. This new cartilage will always be of inferior quality and the connection with the old is not always good.
Noor has walked well all the time in between and responded well to painkillers. Does this mean that she therefore has pain from the growing pains and not of the OCD? It was also better after rest and that seems to be not the case with OCD.
OCD is not always better after resting. Furthermore, we speak of pain killers but a significant effect of the painkillers, the anti-inflammatory that is in it. This reduces the inflammation and makes it thus less painful. Also, the loose piece of cartilage can shift. Sometimes it can sit in a place where it is not so painful and then it shifts back to a painful place.
Will she get osteoarthritis sooner than average?
The osteoarthritis process has already started. This is a process that cannot be stopped. But the operation is supposed to have make the process go much slower. The first six weeks to give an indication on how Noor will cope with this in the future, both mentally and physically.
What is growing pain and why is that gone as they mature?
Growing pain is caused by the "tubes" in the bone which contains the blood vessels. They do not grow as fast as the blood vessels themselves. They get "jammed" by which fluid starts leaking. This hurts. As dogs grow older the bones and hence the "tubes" grow further, if all is going well, and it all comes back into balance.
How should we go on from here?
When we get home the bandage from the infusion may be removed.
Noor has had sufficient moisture. Tomorrow morning she may eat and drink again and then also start with the medication.
Noor, must be put in a box or cage, for the first weeks, in which she can move around freely. (Later I ask the assistant to explain what "freely" means. A bench where she can turn around, stand, sit and lie, and make a few steps is the best. Better than a small room where she can jump against the doors etc.)
Furthermore, she most go out 6-10 times per day, for a 3-5 minutes walk on a short leash. Not running, not jumping. But in between she must rest for the shoulder to heal. This structured motion also contributes to the healing process.
And also much Love, Care & Attention will help.
The first day she can still limp. That is normal. But then that should be over.
She receives antibiotics and Rimadyl. And Cosequin is also recommended.
Luckily she does not need a cone because she cannot reach the wound with her mouth. A T-shirt makes sure that she cannot directly scratch the wound.
After ten days the stitch-staples may be removed by her own veterinarian.
After two weeks we have to call to discuss the situation further.
After six weeks we have to get back to the clinic for a check-up.
Any physiotherapy or hydrotherapy should only start after six weeks as the shoulder is completely healed.
You hear often: 'Let the dog do what he wants. He knows himself to what he can and can not do. "
A dog knows only the present. He has no idea that what he does today has bad consequences for the future. (Personally, I had already thought that a dog does not have a natural instinct to something so unnatural as a surgical procedure with medication by which you don't feel pain.)
For further instructions see the diary notes on August 17 and September 14.
July 31, 2009
This page has not yet been published on the internet, we do not even know exactly what is going on, but the rumour machine is already fully running. A dog of a somewhat rare breed, with a pedigree, leads no anonymous life. There seems to be gossip about us, by people who somehow believe to suffer any harm by Noors decease, and point to us as the gulprits. Damage Control at the expense of another. I don't know what and how exactly but it would not surprise me if it happens.
Someone supposedly said: "Who is going to walk for hours in Switzerland with a Pyrenean mountain dog a few months old?" Well, say it then. Who does that? We don't.
Actually we find that we do not even need to defend ourselves. We do not need to render an
explanation to the world. But I want to show how easily such bullshit is undermined. To begin with, Noor was not a few months old but 8,5 months. This means that according to the guidelines she can walk for approximately 45 minutes. And what does it actually say in Noors diary? She went limping on the second day in Switzerland. That was on the viewpoint "Stand" near Moosalp. A photograph of the sign on "Stand" shows that it is 30 minutes walk to the car park at Moosalp. There and back it's one hour. That is 15 minutes too much. Bad! But has anyone taken the trouble to see how many resting pictures there are in her album?
A day earlier we walked along the Bisse Déjore to an Alpine Meadow and back. A look at Google Earth shows that the round trip is 1 kilometer.
And if someone wants to see how "strenuous" the walks are that we make in Switzerland should look again at the movie in which Noor is limping in Switzerland.
And although we had walked two days with her for hours. It shows ignorance to suggest that OCD suddenly, out of the blue, is created on two days of walking.
The worst thing is that I myself have felt so guilty by whether we might have done something wrong. This is a thought shared by other people who have similar experiences and many people will recognize it. Noor is our first puppy and the balance between not too much physical exhaustion and not too much mental limitation, is the most difficult thing for me in the upbringing of the Pyrenean mountain dog. And we will have made a few beginners mistakes. Who doesn't? So at the time Noor begins to limp a huge feeling of guilt sets in and I wonder if maybe the balance has been wrong. It is the only question I can not to ask the vet without bursting out in tears: "Have we done something wrong?". (His answer was "No", but that does not remove the guilt.) And then there are people, breeders with a self-interest that spread these kinds of lies and point the finger at us. It does not matter how much they hurt the puppy-buyer of another, as long as they themselves benefit from this. Why is the world around dogs with such a great character, so rotten?
Meanwhile, we have remembered an incident in which we forgot because at the time it seemed so futile. About a week before we went on vacation, so a week before Noor began to limp, she slipped. We sat outside for diner and Noor was with us (of course). Then suddenly she heard the dogs of the neighbours and ran towards them like crazy. She flew around the corner of the house and then we heard her slip, and scream of pain. The only time in her life until then that we heard a sound of pain. A half second later we were there and there was nothing going on anymore. Later we read on the internet that this is a typical example of the beginning of OCD-symptoms. We have the feeling that this might be the cause. Some dogs slip and have nothing, others rip off a ligament. And at others a piece of cartilage breaks off and then it's called OCD and suddenly all hell breaks loose.
But what is the reason that in Noor a piece of cartilage breaks off and in others it doesn't, that is now before us the question. Hopefully, the orthopaedist can tell us something more about that.
July 29, 2009
Noor now has used Metacam for one week and she is walking like a ballerina, but soon it will all be over because then she will operated. It is bizarre that we now know that she has OCD and that she walks so beautiful at the same time. There is nothing to see at her. It is therefore again not the standard picture of OCD. We want to advice everyone with a (young) dog of a large dog breed to make X-rays soon as possible when they start limping. It can be really worse than it seems. We think that she is limping more of growing pain than of OCD.
July 22, 2009
We gave her no painkillers and Noor is still limping. At 1PM we should be at the veterinarian. He too sees her limping this time. She is put under anaesthetic. At 3.45 I return to the veterinarian. Pieter takes me to the office and shows the X-rays on the computer. She appears to have OCD in her right shoulder. He shows me a small dark spot seen on the X-ray. Click here for the X-ray. Not much, but still ... It also shows that she has growing pains in both her front legs. Luckily her hips and hind legs are fine. However, what I get to hear about her legs is a big shock. I had expected that there would be something because all together it was too much limping. But you still secretly hope it's nothing. And if something should be wrong than just growing pains. But growing pains and OCD. How could that be? Have we done something wrong? But Pieter wants nothing of it. He knows us for a long time and sees how well Noor looks, good weight, how we care for her and what we do (and previously did with Lot). We do not need to feel guilty. It can happen in a large breed like the Pyrenean mountain dog. He sends us to the best orthopaedic clinic that he knows, the Binnenhof in Almerk. Since they can tell us more about her condition and what to do. It is easy to operate. And they have very good facilities.
Then I go get Noor. She is still a bit woolly of anaesthesia. She greets me not as exuberant as usual. But of course she is very happy that she can go home.
July 16, 2009
Noor starts limping again in the evening. And now we know for sure. The next day we make an appointment to make X-rays.
July 9, 2009
In the evening, I think I see her limping. However, it is gone so quickly that I do not know if I looked well enough. But it is already for a long while that she licks her legs. She does that for months but now the leg becomes brownish from licking.
July 6, 2009
Noor has finished her three weeks of calmness. We are now one month after the limping started and expect for the first four days there is nothing noticeable. However, I would like to be sure again by the vet. The fact that she was not limping before but did cry is bothering me. So she has to trot again and is again examined. He is completely satisfied with her. Nothing to notice, nothing to feel. And this time she no longer cries. She only pulls back a little and sighs at the right shoulder but that's it. I am completely reassured.
June 15, 2009
Noor had a full dose of Rimadyl the first day. The next day a half and on Saturday a quarter. Then nothing anymore. It is now Monday and we are in the Netherlands. It actually was better with Noor very soon and since Friday there nothing noticeable anymore. But I still want the security of our own veterinarian. First, she has to trot in the car park and then he examines her legs. When trotting he cannot see anything unusual. At the examination of her legs she cries a few times. But this is no cause for concern. She now needs three weeks of calmness. The first week only short walks at the leash and then slowly build it up. Of course, without X-rays he cannot say with certainty but the probability that it is OCD would be very small. That does not go away so quickly, certainly not without painkillers. Growing pains could be because that comes and goes but usually not as fast. So for now there is no need to make X-rays
June 8, 2009
It all starts on Monday, June 8. Noor is almost 8,5 months old. We are on holiday in Switzerland and on a hill in a plateau. Noor is exploring the area and comes back. Suddenly we see that she is limping. Well, she's hopping. It is not that she no longer can stand on her leg. Immediately the fear grabs me by the throat. Since I know that her half-brother Giusto had surgery on both shoulders, I deepened myself in OCD. But as the most critical period begins to pass, I am less afraid. And now, suddenly she's limping. On top of a lookout point. It is not a big mountain but we need to go a bit steep down. Very gently we let her walk down. Because even though she is limping, it doesn't bother her. She is still just as energetic as always.
The next day it seems to be a lot less. But later in the day it gets worse again. But it doesn't seem too bad. We make a movie so that we can watch it in slow motion on the computer, to see which leg it is.
Click here for the video of Noors limping in Switzerland
We conclude that it is the right front leg, because she "falls" on her left leg. I try myself how I would run if I would have pain in one leg, and how it would look like. Because we are in Switzerland, we have little opportunity to find out what it can be. And so we worry all day long.
On Wednesday we go to a veterinarian in Visp for our own peace of mind. We find one in the Yellow Pages and make an appointment. Unfortunately, we can go late in the afternoon. Noor is examined by a veterinarian at the Animal Kleintierpraxis. She notices pain and "back pressure" in both shoulders and in the right elbow. This is worse than
expected. Noor gets an injection of Rimadyl and Rimadyl tablets and the advice to go to the veterinarian at home if the limping persists. She may only go out on the leash a few times a day. She may walk for 15 minutes, 6 times a day. We had hoped that it would be not so bad, but pain in three joints! According to the veterinarian it need not be so bad as it seems. Regularly you'll see that if a dog has pain at one joint that then the others are used more and start hurting as well. We still need to go shopping in the supermarket, but I can only sit in a garden chair there. I just can't concentrate on what we need for food and eating is already something I don't want right now.
We can now go on the Internet on our mobile so we look for information as good as gets. The most important thing we learn is that OCD gives severe limping, worse after rest and better after movement. And that at early diagnose there is proper treatment. With Noor it is not worse after resting, rather better. And it is not better but rather worse after activity. And we cannot call the limping severe. You can see it in trot, not in step and not in run. And it seems no burden to her because she has energy for ten and would prefer to run, climb and jump. But now that she can not do that, what it really is frustrating.
We also email her breeder Beate and Jukka, the owner of Giusto. They add that OCD does not go away with painkillers. And since Noor is soon better and after 4 days no sign of limping anymore, they both confirm that the risk of OCD is small. Beate adds that she is thinking of growing pains because she is hurting in the whole leg. That is a relief but the uncertainty continues to rankle and rankle.
DISORDERS (Needs English updating)
Below is a collection of general information that we encounter on the Internet:
HEUPDYSPLASIE (HD)
English Wikipedia
English Wikipedia
WHG Veterinarians
Rashof
of Metacam Folder
Board
Maarten Kappen
ELLEBOOGDYSPLASIE (ED)
This is a collective of four disorders:
Los Processus Coronoideus (LPC)
Los Processus Anconeus (LPA)
Osteochondrose Dissecans (OCD) OCD kan ook in andere gewrichten voorkomen
Incongruentie
Wikipedia Engels ED
Wikipedia Engels OCD
WHG Dierenartsen 1
WHG Dierenartsen 2
Rashof
Folder van Metacam
Folder van Pfizer ED
Folder van Pfizer LPC
Folder van Pfizer LPA
Folder van Pfizer Incongruentie
Raad van Beheer
Peter Vandekerckhove
Maarten Kappen
OCD IN DE SCHOUDER
Dierenarts Online
Rashof
Folder van Metacam
GROEIPIJN (ENOSTOSIS)
Folder van Pfizer
WHG Dierenartsen
PATELLA LUXATIE (PL)
Rashof
Dierenarts online
WHG Dierenartsen
This is a collective of four disorders:
Los Processus Coronoideus (LPC)
Los Processus Anconeus (LPA)
Osteochondrose Dissecans (OCD) OCD kan ook in andere gewrichten voorkomen
Incongruentie
Wikipedia Engels ED
Wikipedia Engels OCD
WHG Dierenartsen 1
WHG Dierenartsen 2
Rashof
Folder van Metacam
Folder van Pfizer ED
Folder van Pfizer LPC
Folder van Pfizer LPA
Folder van Pfizer Incongruentie
Raad van Beheer
Peter Vandekerckhove
Maarten Kappen
OCD IN DE SCHOUDER
Dierenarts Online
Rashof
Folder van Metacam
GROEIPIJN (ENOSTOSIS)
..