Dr. Williams came out this week to see Nixon on Tuesday.  He likes her and trusted her quite a bit.  She did things with him that he protests with me but I guess she knows how to ask nicely.  Nothing actually surprised us after the 2 hours of examining him was over but he's got a laundry list of things that are wrong.

1.  One of the sesamoid bones in his remaining front foot is out of place.  Not much can be done for this and it causes a lot of soreness.

2.  Hyperextension of the wrist.  He is going to get a custom brace from Therapaws for support but won't completely immobilize it.  His wrist was actually in much better shape than we had hoped!  He really isn't a candidate for surgery to repair it though. 

3.  Soreness in the neck and shoulder area.  This has been chronic since before the amputation but has been re-injured multiple times including when he ran into the deck.

4.  Mid-back pain from the FCE.  There is some neurological deficit in the right hind too.  We knew this prior to the amputation.  It was the number one reason we hesitated prior to amputation.  

He has maintained a lot of muscle tone in his thighs.  We'd love to get an ultrasound of his front leg but no one does soft tissue diagnostics in this area.  They rely on CT scans.  We'll probably do xrays of the front leg just to get an idea of what kind of changes we're seeing in it. 

He's got a busy week lined up.  Tuesday morning is the chiropractor and getting his nails done.  I will probably order blood work and urinalysis since he's been on NSAIDs for a month.  Dr. Williams will visit on Wednesday.  She'll be doing some exercises to strengthen his wrist and improve balance.  The better his balance is, the less accidents we hope.  He does have an impressive core.  We're also going to try acupuncture again.  I think if he gets it at home in his bed, he'll enjoy it.

He hasn't seen the chiropractor in too long.  So that will also help with the back soreness.  We knew when he needs an adjustment by how he poops.  If the hind legs are matching, he's good.  If right hind is behind him, he isn't.

I'm trying to take Nixon out and about with me so he isn't bored at home.  The more stimulated he is, the happier he is.  And this is the odd thing, if we leave the property in the car, even if he doesn't get out of the car, he insists on visiting his pee garden and verifying that everything is ok.  BUT, if I just take him outside to go pee on all the things in the yard, he wants nothing to do with it.

He also got something special this week that I can see myself baking for him often.  Biscuits.  I made them with almond flour instead of wheat flour and coconut oil instead of lard.  HE LOVED THEM.  He loves Bo Jangles biscuits but I don't let him have more than just a bite anymore due to the high carb content.  Cookie and my husband thought the almond flour biscuits were poison. 

3/4 cup of almond flour
1/4 cup coconut flour
1 tsp baking powder
1/4 tsp salt
1/4 cup unsweetened almond milk or coconut milk
2 T butter or softened coconut oil
5 - 6 egg whites

Preheat oven to 400F.
Mix the first 6 ingredients together in a bowl.
In another bowl, beat the egg whites until soft peaks form.  Fold into the other ingredients.
Use a 1/4 cup measuring cup and drop the biscuits onto a greased cookie sheet (I use a silicone mat instead of greasing it).  It will make 6 to 8 biscuits.
Bake for 15-18 minutes or until the edges turn a golden brown.

Next time I mix up a batch of the biscuits, I'll have to grab a picture.  The recipe is a grain free recipe for people but my dog is people. 

Dr. Williams is from Whole Health Mobile Pet Care.

As for Nixon's health, if he is where he is at right now and nothing else, he'll be good to go although we may have to bring a wagon either to put him in or CARRY all of his stuff.  He believes in comfort and needs a big mattress and a body pillow in order to lay down.  Otherwise he'll stand even if it hurts and his legs are shaking.  There are still some iffy things that need to get looked at.  His weight has been pretty steady at 59/60 lbs. He's got more ribs showing but the weight the vet tech wrote down is 65.8 and I didn't notice until after I got home the other day.  I'm hoping she meant 56.8 and just inverted the numbers when typing them.  If not, then we have trouble as that weight is not muscle or fat.   As I was looking at him this morning, he is not looking fit but just kind of letting everything hang out right now.    For my own piece of mind, I need to get his kidney and liver values checked.  I normally insist on doing that prior to starting any pain meds but I didn't do it this time around because I've never had issues with Previcox.  I may take him to his favorite ER vet this weekend to get the lab work done if I continue to worry (I am really good at that!).