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Bicipital Tendernitis


Flaves
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Yep my 3.5 year old BC has been battling it on and off for the last 12 months - she a few months short of her third birthday. She first started limping back in December 2010. We have been on restricted exercise, done rounds of chiro vets, physios and ortho specialists. We went the conservative management path. 50% recover without needing surgery 50% of dogs end up needing surgery. She was continuing to get better so I figured it just needed time and was happy enough until I found a new specialist who is recently over from the states and has dealt with plenty of performance dogs.

Kenz is now going to have platelet rich plasma treatment (PRP) in a final attempt to avoid surgery otherwise the specialist will go in and transect the biceps tendon. The results are mixed as to whether the PRP will help but its a lot less invasive then surgery with minimal side effects so while there is little data I thought I had nothing to lose at this stage. If she was only going to remain a "pet" and lived a fairly sedate lifestyle then her level of lameness is not worth looking further but given she is also a very active performance dog I guess I wasn't satisfied that we had got to the bottom of it.

Surgery has a 95% success rate but I have found enough evidence to suggest the PRP is worth a go before going to surgery.

There will be extensive rehab regardless but it beats 4 weeks strict crate rest.

Our specialist is confident that either way she will regain full function and be able to resume agility post extensive rehab. He cited plenty of performance dog examples where they have got back to full training and trialling so long as you are careful and don't try and rush it.

Edited by ness
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So do I - having a tough day she is back on no heavy activity and I am convinced she was worse today as a result. All she got were two short leash walks :(. Not even sure I am starting to doubt that surgery is the only solution and thats scary as its not something I can really afford :(.

Edited by ness
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My first Vizsla had this diagnosed at about 3.5 years old. I was told he'd likely never compete in agility again and that walks on a halti was all the exercise he'd be able to do. He had several months of rest with regular chiro and physio and went on to compete in agility and obedience until he was 10 years old when another condition forced retirement.

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Just a question- has this caused any muscle wasting in the dogs front end? Is there any muscle increase in their rear to compensate. Also when they were jumping pre diagnosis did it look like the dog was trying to land softly?

I was looking at a dog in competition and I am sure it has a should injury of some description but their vet hasn't found anything so I am looking for more unusual problems.

Hang in there Ness!

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Kenz has muscle wasting over her right scapula. The only real "symptom" she has most of the time is she can be a little stiff when she wakes up but its quickly resolved. Its normally only later on in the evening that she has issues but its very much blink and you will miss it the majority of the time. Sometimes we have days of obvious lameness but mostly not. Even 2 days of solid exercise post her last specialist appointment i.e. run at the beach and a couple of frisbee sessions and at the appointment she wasn't sore in the slightest until he started applying pressure to her biceps tendon and then took her back outside for a walk and she was subtly lame.

I haven't noticed any change in her jumping style hmmm I misunderstood him and jumped her Saturday and she pulled up 100% after that. Just straight grids. She drove as hard as she normally did and had a good jumping style. We had our last agility trial a couple of weeks prior to her injury so she hadn't been jumping in the few weeks prior to when she was diagnosed. We have done some random agility sessions this year - maybe 2 or 3 max at varying points and there has been no noticeable difference other than the last session when she came up not weight bearing her rear leg and that is what triggered me to investigate further.

Kenz has had some intermittent hind end lameness in the opposite back leg.

Edited by ness
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Flynn did not show muscle wastage in the front end or increase muscle in the rear. I could not tell you if he was'trying to land softly' pre diagnosis, it was 10 years ago now and I certainly didn't notice at that time, but may have missed it.

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I wish you all the success Ness.

Flaves, Dyzney has BT on both sides, one slightly worse than the other.

Sadly it was the original lameness popping up after a bike run a few years ago, that prompted me to pop along to the vet (won't do that ever again, go to the vet for lameness I mean) and Dyz was put on Rimadyl.

Next thing we knew we nearly lost her to IMT which we believe was brought on by the Rimadyl.

Anyway, long story short, many months later when we Dyzney became well enough to desex, Pete Rafferty x-rayed her shoulders whilst she was under anaesthetic (as we had never got to the bottom of her original complaint being busy treating the IMT)... and voila, that is when he diagnosed the BT.

Nowadays, it is mild. Most of the time you would not even know she had any soreness. After a couple of kms on the bike she looks a little proppy, that's all.

We manage it. She still herds, still goes out on the bike, goes swimming and had a wee go at agility yesterday... pulled up fine and was so happy to get back into it.

Keeping her mind and body active is keeping her happy and gives her fitness and will to live.

Dyz has magnetic therapy each night, herbal remedies, homeopathics, Power Blend and myotherapy (as you know). For a nearly 9 yo Rotti that competed at Masters level agility, I reckon she is doing OK.

I have toyed with plasma and other treatments, and maybe I would, but with her IMT risk, I am a bit scared to even go there.

Whilst she is still going so well, I will continue as we are going.

I did consider the surgery when Pete first diagnosed, but there was no hurry as she was not lame at the time and it is so invasive.

Now she is the age she is, I do not think I would even go down that path, even if she became quite sore.

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Thanks all

His was caused by an injury - when he was loaded on the plane he fell forward onto his shoulder - a friend and i saw it happen as we were watching them load the plane.

When i got him off the plane in melbourne he was lame :cry:

He is on crate rest and has just finished his course of cortisone, i have just started acupuncture and he is already having myotherapy....he has his own personal myotherapist :rofl: ;)

So i am hoping that rest, restricted exercise, light swimming and acupuncture and myotherapy that he will heal and be able to be shown

I am taking it easy and slowly as i want him to heal and heal properly with no long term issues

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All I can say Flaves is the recovery can take forever so take it really slowly. The specialist recommendation for biceps tendonitis if you want to opt for conservative management is 8 weeks strict crate rest. Then gradual rehab - building up 5 min of leash walking at a time. You can then add back in swimming but the higher drive the dog the greater the risk of reinjury at any stage during the course of rehab. 4-6 months or even longer rehab isn't uncommon so just don't rush the process. Any sign of soreness is to much activity.

You can also opt for a steroid injection into the tendon which can assist the inflammation to settle if coupled with strict crate rest.

I would also look into the PRP (PM Inevitablue she was the one that put me onto it) - its a very low risk and relatively cheap alternative to anything more invasive, basically they take blood from the dog, prepare it and then reinject it into the tendon. Its suppose to help settle the inflammation.

Edited by ness
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Hi Flaves, it will be interesting to see how Ness' Kenzie responds. Joe Sulyok at Heathcote Vet and we did a GSD bitch with chronic bicep tendonitis who has made a 90 - 95% recovery within 2 weeks.

The PRP is predominantly a human treatment at this stage, but rapidly growing into the veterinary medicine. Your own vet can do a crude PRP treatment by simply separating the plasma from red blood cells and injecting into the area. Kenzie is getting a more advanced method, so fingers crossed it gets her back into the agility ring. :thumbsup:

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Actually on the subject of PRP, when I first mentioned it to the chirovet I take my girls to back in May as a suggestion he said many many years ago when he did a locum with a Vet they regularly injected blood into injured joints to promote healing with such things as cruciate ligament rupture. So its not even a relatively new process.

Edited by ness
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Agreed Ness, the greyhound people have utilized it a fair bit, and its great for ulcerated corneas.

We have also treated a star post fence injury on a horse, making the PRP into a paste and applying it topically. The wound healed in half the time! Would be a nice adjunct addition to wounds on dogs (ie dog fight bites)

It's simply amplifying the work platelets would normally do in the body.

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