Why can't my Doctor tell me why my dog is hurting?

What is causing my Dogs Pain?

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(link to beginning of article)The reason is simply that in many if not most of these cases the examiner is left guessing as to why a pet is suffering in the first place. If you and your companion have been through this you can identify with what I am saying. I have seen and  heard  the following scenario thousands of times over the years. A concerned family comes through the door of the clinic carrying or assisting their companion into reception. The conversation goes something like this, “we just called about our pet, he appears to be in pain, but we don’t know how it happened.” When they are subsequently ushered back to the examination room, stopping briefly to get a current weight, they explain to the Vet Tech one or more of the following as a rectal temp is performed: “when we came home today Sam here didn’t greet us at the door and we knew something was wrong when we saw he had trouble getting up.” Or, “we came home from a walk earlier and after lying for a while Betsy got up and was limping something awful.” Or, “we’ve noticed lately that Lilly is crying out when bumped or moved.” Or, “Rocco has been panting a lot lately and at night especially, he seems restless and uncomfortable. We think he is in pain.” Or, "Roger is having difficulty jumping into the car of late, like his back is hurting.” Or, “Thor is moving very slowly the last couple of days, his back is arched, and he seems like he’s in pain.” You get the picture.

 

After the owners explain the history to the doctor and the usual heart and lung auscultation etc are performed an examination occurs which involves what are called Orthopedic tests. Orthopedic tests are those that involve using force(s) applied to various parts of the animal’s body in various ways to attempt to cause enough discomfort for the animal to cry out or react in such a way that evidences that, “it hurts when the doctor does that.”  An orthopedic test is defined as a procedure designed to place physical stress or strain on connective tissue structures thought to be responsible for the patient's pain or dysfunction. Based upon my 35 +years of experience I am more than qualified to express the fact that these tests yield far too little information to justify the pain and stress they induce in our companions in most cases.

 

Over the years I have watched the doctors I work with gouging with their thumbs up and down the spine hoping to divine the locus of pain or injury by waiting for the animal to either "turn on them" or cry out in pain. Or twisting the head and neck to the extremes of neck motion in an attempt determine if the pet has neck pain. Pets of course many times do they're best to keep the Vet totally in the dark, stoically denying (thanks to instinct and adrenaline) the Vet any clue as to where they hurt. These orthopedic tests for the most part are too course to identify exactly where the problems is, what the problem is, or what might have caused it.  There is a better way which will be explained in this article.

 

The next step is usually  X-rays to see if there is anything on the radiographs that might give a clue as to what is ailing the Pet. Unfortunately, unless there is an obvious broken bone, dislocation, mass, or infection, plain X-rays for the most part yield limited information. Hence the need for MRI's or CT scans. X-rays may show a thinning disc or two, perhaps with some calcific inclusion. But I have found after examining thousands of patients that these findings only occaionally identify the actual source of a pet's malady.  I say this with 35 years of experience to back this up.  So as a pet owner you are told that might be a disc or a pulled muscle or arthritis, or Hip Dysplasia, but truthfully the results are inconclusive in about 95% of the cases at this point. But since this might be the pet's first episode, they hold off on the more expensive diagnostics like MRI or CT scans to see if a week or two of anti-inflammatory meds and Muscle Relaxers might keep the pain at bay and hopefully resolve itself before the prescription runs out. If you recognized this as you read this then you know exactly what I am saying.  What is frustrating to the pet owner and the Veterinarian is that more times than not the meds only give temporary relief and the underlying problem just rolls on unresolved.

 

This is the quintessential problem with patients who can't tell you where they hurt, when they feel it most, what makes it feel better or worse, or how it happened in the first place. Pet's instinctively do their very best to hide their malady from the perceived threat, in their animal mind, posed by the examining doctor. How does one overcome thousands of years of evolution that is hardwired into their animal psyche to hide their injury or malady from other predators or other members of their pack? Since time immemorial animals would find a place to hide out, lay low, and heal (hopefully) on their own. That is the very reason they resist being "messed with" or examined by some stranger.  Sadly this is only reinforced when a well meaning examiner relies on diagnostic procedures that induce even more pain in the animal patient.

 

So what can be done to "pull back the curtain," see through your pet's subterfuge to identify exactly what is ailing your companion and explain to you the mechanism of injury that yields a "light bulb going off in your head," moment? This is the Forensic aspect of what I have termed NMRT or NeuroMyofascial Release Technique. You as a pet owner really appreciate it when someone can give you an idea with a high degree of confidence, the location and mechanism of injury without exacerbating the condition during the examination. Not to put too fine a point on it but, that is the reason you sought help for your Pet in the first place!

 

Here are a few examples of this:

 

An animal patient presents holding their head low, unable to look up or to one side. The neck muscles are in spasm. Careful examination shows a sprain and instability at C5C6 (lower neck). Occiput/C1 (upper neck) are literally compressed axially.  You can do this with deft and skillful palpation if you know what you're palpating and the subtle but most evident signs. So you ask the owner the following questions: Have they recently collided head first into another dog or some immovable object like the sliding glass door, they thought was open?  If it were just the lower cervical sprain with instability without the upper cervical compression you would ask: Do you play Tug-of-War regularly with your pet? Have they had recent anesthesia prior to the onset (i.e. where they were lifted from the operating or treatment table with their head and neck unsupported and hanging down like "al dente spagetti" as they are moved to the recovery pad?

 

A Pet Patient comes in limping on one of the front legs and it seems to switch sides. You examine and find the upper thoracic vertebra compressed axially and with an additional flexion component.  You ask have they been charging and hitting the fence with their front paws aggressively, fence fighting or chasing a squirrel up the fence?  Do they hit the front door with their front paws lunging at the Mail person on the other side of the door?

 

A patient presents with the back arched up aka "roached back,"  tail between their legs and their rear legs seem weak and uncoordinated.  You palpate their ThoracoLumbar Junction (midback) and find the issue. You ask how often their companion jumps on and off the couch, bed, or window seat. Do they have a terraced back yard with their companion jumping down off of theses terraces frequently.

 

There are many more scenarios like these examples and getting you involved once I have determined the mechanism of injury gives you the pet owner relief because now you can understand what happened to your companion. But, more importantly you can help prevent recurrence by preventing similar injurious activities of daily living in the future. Nothing worse for a Pet Owner than being in mystery as to why their pet is suffering and just hoping that throwing drugs at it will somehow magically solve it!

 

In conclusion for the vast majority of Pet Owners who seek my help, their companion’s malady was not caused by some unanticipated accident but purely by years of cumulative micro-traumatic events that were part of their activities of daily living. The Dachshund who energetically leaps off of the couch or bed countless times per day causing shock and trauma to their spine with each impact. The pet owner who plays vigorous tug-of-war with his pup regularly, even holding his companion up off of the ground by his tug toy to impress friends and neighbors. How about the Golden Retriever who charges the fence, violently impacting with his front paws to fence fight with the neighbor dog numerous times per day or chase that pesky squirrel up that fence and out of the yard. How about that pup who wears one of those heavy choke chains 24/7 365 and the constant downward force applied to the lower neck yields over time an unstable lower cervical spine and painful neck pain episodes. What about that Springer who pops that heavy magnetized rubber dog door open countless times per day with his muzzle causing shock and trauma to his lower cervical spine. Then there’s that fuzzy faced Shih Tzu who runs her muzzle along the carpet, both sides, to wipe the residue from meals off of her whiskers day in, day out, month in, month out, and year in, year out.  Are you getting the picture?