Strange case

[lehughes]

I wonder if I can pick your brain about a strange case I have been dealing with over the past couple months. Her name is Nika, she is a 3 yr old husky. She was diagnosed with iliopsoas mitosis in February. Presenting complaint is screaming when she has a BM. Palpably along the back I can not elicit pain, she does not loke deep palpation into the groin, quads or adductors. The leg shakes when she lays at rest. Wen she walks she drags and exorotates ( the right hind only) when she is really sore she can not tolerate a belly rub. She growls with palpation of the quads and adductors.

We have be performing laser into the groin, massage ( as much as she will let us) hydortherapy - slow walk ( initially she has a very springy gait) better now. We explored E-stim but that didnt seem to change much. I feel like I could be doing better for her but I am a bit at a loss. I am wondering if there is some squeezing of the sciatic happening when she has a BM and then lingering nerve signs follow.

Sorry for the long message.

Bad video I was taking it my self.
https://youtu.be/tJ2lMw-VUik
(NOTE: copy and paste the link into your browser bar.)

LDF

[lehughes]

Okay... so the first thing that comes to mind is lumbosacral disc disease. It fits with both the neuro signs, pain with pooping, iliopsoas pain...
Second choice is degenerative myelopathy but this doesn't make sense with pain on pooping.
I have one dog that I've treated that had screaming with pooping and his issue was internal... fistula, growth, something (sorry, not at the clinic to lookup the chart and remember exactly what it was.) Anyways, it required surgery. However he wasn't wobbly / neurologic.
So... I go back to lumbosacral as my first guess and the only thing that would make sense. She may a two part problem... so if working on the L-S doesn't change the scream to poop issue, then perhaps an Internal Medicine Consult would be in order... and if you don't get anywhere with the neuro stuff... then maybe a neuro consult.
It's a good question / good case to ask about, because it is NOT straight forward.
I'll also post this on my FourLeg Members Forum. Maybe someone else will have ideas as well.

[lehughes]

Thank you so much for your insight. She did have a neuro consult but is was minus any really diagnosis. No MRI or CT. They came up with Ilopsoas Myotitis. Is lumbosacral something you would see in a 4 yr old dog?

Thank you also for posting on your forum. The more insight the better.

L

[lehughes]

I think the iliopsoas myositis if your 'red herring'. It doesn't fit with all of the other symptoms.
And, yes, I think you can see it in a young dog. I have a 3 or 4 year old Shepherd right now that we are working with. The owner is trying to avoid surgery.
-Laurie

[lehughes]

I also agree with the red herring thought. This is persistent and the neuro aspect is strange. I don’t think the owner realized that until I recorded her gait.
Here is my problem the neurologist said it is iliopsoas myotitis so who Am I to say different...
LDF

[lehughes]

Doesn't make sense. Go with your own evaluation then... and try treating the L-S junction as a test of that diagnosis.

[lehughes]

I will thank you so much. I appreciate your time