All week the dog has been having thunder fright, and he is observably reacting to thunder generated as far away as 200 miles distant. This could really be a problem!

On the other hand, it’s also interesting as it provides a mechanism for the observed dog-based early-warning earthquake alert system. Getting him in his thundershirt clearly helps. He also seems to like having the harness on. It’s somewhat amusing how he reacts with the harness on when I have to pull out a leash to keep him out from underfoot in the kitchen during these fear times – he’s scared out of his mind and unable to obey verbal commands but he sees the leash and starts wagging his tail because “walk!” apparently.

Viv ended up going to California on her own after Logan’s apparent injury while I stayed here trying to work through what to do about it. I noted it here in a one-sentence entry on the day it happened.

Here’s what I wrote about it on August 2 in an email to family and neighbors:

Logan came down from a ball toss a week ago today with a yip. We were concerned as when this had happened to Rocket it was bone cancer and both expensive and futile to stem the tide via surgery.

On Monday, we took him to Value (up on 99 in Shoreline) because we are dissatisfied with the cost of Northgate Vet, the provider who took care of Rocket during his illness. The quality of care there is great but our annuals + shots this year for the dog and the cat came out to $800, and that’s just too much, even if it’s market rate for Seattle, something I am not yet convinced of.

They diagnosed a CCL tear, the canine equivalent of an ACL tear in humans, and suggested surgery to the tune of $2.2k, later corrected in estimate to $2.6k. Interim treatment was anti inflammatories and pain meds. Overnight Monday he was whiny and wanting the meds.

By Tuesday, after the meds were metabolized and worn off, he displayed no further evident pain and we scheduled a second-opinion visit with Northgate (who, on the phone, were audibly sniffy that we’d gone to Value). That visit went well in terms of quality of care but less so in terms of diagnosis, and they confirmed the CCL tear diagnosis and seconded surgery.

Looking into this, it seems that lab-like dogs have a high rate of this, like over 70% of older lab-like dogs will experience this injury. Surgery is indicated because they compensate by shifting the work to the other leg, which then also has the same injury, leading to a situation where both legs need surgery at the same time.

Pre-surgical care involves activity restriction: no running, jumping or climbing. There is no way into our house without a full flight of stairs.

I built a 14 foot ramp on Tuesday. He doesn’t want to use it and it’s too steep if I put it all the way to the head of the stairs. I figure something is better than nothing and have been training him on it with a partial coverage tilt. He’s accepting of it.

All of that said, he shows no interest in activity restriction at all, and if we had waited a day to go to the doctor would not have built a ramp or changed travel plans.

I had a long conversation with the diagnosing doc and she endorses my proposed view that keeping the dog in the car for six days (three days down and back to Laguna Beach) constitutes acceptable activity restriction.

Since we had to make a snap decision about Viv’s travel, she bought a plane ticket on Monday and left on Saturday as previously scheduled. If I drive, we think she’ll just drive back with me.

So at the moment, I’m exploring dog sitters but expecting to leave on Tuesday with the dog. It’s important within Viv’s family to get the dog to California due to advancing Alzheimers. My own view is that he should stay here, and so should I.

A bit later I reiterated in an email conversation with an interested party.

We took him in the day after he yipped and he was diagnosed with this (apparently extremely common in his size and breed) injury. We went to Value up in Shoreline partly because we are dissatisfied with the cost of Northgate and partly because it’s walk-in and we could just get him looked at immediately.

They did not do x-rays or sedation. They diagnosed CCL tear and provided a surgery estimate of about 2.2k later corrected to 2.6k. We were concerned about the lack of x-rays (which were included in the surgery estimate). They explained that since their orientation is to minimize consumer expense, they did not want to do it unless required (as for surgery). They provided us with anti-inflammatories and pain meds (Tramadol). We only gave him the meds on Monday night; he was audibly whimpering. The next day he did not appear to feel bad or to favor the leg at all and we decided to defer meds.

The next steps would be either or both x-rays and a sedated exam. The determination of need for a sedated exam is the dog acting defensive or pained during a non-sedated exam, where the vet is manipulating the leg bones to check for a diagnostic mobility indicating damage to the ligament.

We then went to Northgate for a second opinion despite our desire to move on. They confirmed the diagnosis based on a defensive reaction in a non-sedated exam and performed a non-sedated X-ray that was inconclusive but which did NOT show characteristic bone damage that can occur from an injury of this nature. It was not clear to me if the damage they were looking for was something that was common in a fresh injury of this nature or if it was more along the lines of a long-term consequence of an untreated injury of this nature.

By the day we got him in, he was not exhibiting any apparent symptoms and was instead exhibiting impatience with his activity restriction. This behavior has increased since his Northgate appointment.

Nothgate gave us a surgical estimate and has requested a second non-sedated exam as well as a possibility of a sedated exam. Their surgical estimate was 4.8k. They will not negotiate on price. The (second) doc there who requested another non-sedated exam sounded totally flabbergasted that Logan is not displaying any notable symptoms and that we had not been using meds. He is clearly suspicious of his employee doctor’s diagnosis.

The orientation to surgery for this injury is because there is a possibility an animal who has developed this condition will shift the workload to the other leg and require surgery on both legs at the same time or in close succession, depriving the animal of independent mobility for upward of two months. Obviously this is a concern for a dog of Logan’s size, especially in conduction with our home’s architecture, which requires him to use a full story staircase in order to go to the bathroom.

Currently, we do not want to go to Northgate for another round of expensive examinations when we know we will not be using them as a surgical provider. I am concerned that if I take him to yet another vet and tell this whole story they will immediately diagnose for surgery despite what I perceive to be no symptoms. If we had not taken him in the day after his surgery, I don’t think we would have taken him in at all, although his whining overnight that night challenges this assumption on my part.

So we are still deciding what to do. My preference is to maintain activity restriction for another month or so and then assess. I think this response is exactly what the vets are trying to prevent on the assumption it will cause a dual simultaneous injury.

Since these were written he has continued to display no apparent symptoms and to prefer using the stairs over the ramp. The game plan at present is to keep him on activity restriction for 3 months and to gradually reintroduce daily walks and moderate ball tossing. We have reduced his food slightly.

Interestingly (well, to me) even though our daily walks were only about a mile long and I have been relatively consistent in running 2 two four miles a day recently I am clearly gaining a little bit of weight back, up to 165-167 from 160 at the time of my tendinosis. My BP is up as well. I’m not really sure I can attribute this to missing a mile of low-impact activity, though.