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What additional tests were done and how did they decide there was a slight tear and it was insignificant? How did they decide there was lumbosacral stenosis? Without doing an MRI on each area you are really just guessing. Was this a specialist? A real specialist will have a Diplomate of American College of Veterinary Surgeons (or DACVS or ACVS) behind their name
Taking into consideration I have not seen your dog I would be very surprised if the arthritis in the ankles is causing the problem, the LS stenosis could be causing this but again without an MRI you can't say for certain. I'm not saying that the information your were given is not true- however it's pretty uncommon to have these things causing the lameness and it's really, really common to have a torn cruciate or two torn cruciates. As far as the treatment options you have been given- they are palliative in nature. I don't know of any specialist that advocates shock wave treatment and in fact I've never heard of anyone doing this- granted I don't stay current in these unproven treatments. The laser may help some but it's not going to "fix" the problem. Adequan may help some but again it's not going to fix the problem. You've been given a big bunch of treatments that may or may not help. I don't want to rain on your parade but that money would probably be better spent saving for the surgery for the insignificant cruciate tear that is going to be a problem in the future or surgery for LS stenosis if this is truly the cause.
Being that your dog is under 20lb you may be fine without doing anything but exercise restriction and NSAIDs- maybe some physical therapy +/- adequan. Personally for the costs I'd skip the shock wave and laser but I'm a skeptic when it comes to these alternative treatments without a lot of supporting evidence they work.
Can you post the x-rays of both knees, the ankles and the spine? You can post the mri images too but I'm not sure I can read them unless the problems are quite severe.
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Thanks for the reply.
The specialist who did the extended exam is the one who recommended the shock wave and she does have ACVS at the end of her name and actually taught abroad, at two highly acclaimed universities and even trained some of the other local vets.
To fix the problem would require more than one surgery which means she would have to be put out multiple times which is our concern.
Our primary care vet who received the results knew our concerns and suggested the cold laser treatment and Adequan to treat the back and both ankles. The shock wave would have only treated the back.
The cost is going to essentially be the same either way we go so we opted for the laser and Adequan.
She just started Dasuquin today.
When you mentioned NSAIDs, how much and what brand? Is this an OTC or prescription when it comes to dogs?
Although you mentioned this is palliative type treatment, is it one that could still keep her happy for what time she has left?
Oh, one more comment, the vet commented she is able to tell a difference between the two rear legs. The leg showing the limp has noticeably less muscle there. I am unable to notice but I don't do this on a daily basis.