Pain

An 11-year-old MN Yorkshire Terrier presented for a second opinion for a 4-week history of back pain; an L2 lesion is suspected. Previous treatments were Gabapentin and Tramadol, but the patient showed no improvement. The patient was still very painful, reluctant to move, and baring teeth when owner tried to pick him up. The area of L2 appeared normal on radiographs. CBC was WNL, blood chemistry found an Alk. Phos. of 187 and a PSA lipase of 528. Urinalysis showed 2+ protein. A left medial liver nodule, likely lipogranuloma or benign lesion with minor renal mineralization was seen on ultrasound. The sonographic findings were not contributing to this patient's pain and there was no evidence of visceral disease that could be contributing to the clinical signs. A CT of the spine with contrast was strongly recommended given the patient's symptoms.