Owner: annie o'donnell, from bray, co wicklow
Pet: amy, her cross-bred collie dog
Background: amy developed a sore on her elbow, which keeps recurring
It's now nearly two years since Amy first injured her left foreleg. She was on a walk, rummaging around the bushes when she emerged with a nasty cut at the front of the elbow. Annie rushed her to the vet and the wound needed a dozen stitches. It healed up well and within a couple of months nobody would ever have guessed there had been a problem.
It was six months later that another problem first appeared. The thickened area of skin on her left elbow, known as the callus, became red and sore.
The elbow callus is the part of the elbow that's in contact with the ground when a dog is lying down. If you examine this part of most dogs, you'll see that there's a bald area here, about the size of a five-cent coin. The skin in this area is thickened, like a human heel.
In older dogs, especially in larger breeds, this bald, tough skin can be particularly prominent, because they tend to lie around more, so there's more pressure applied to the points of their elbows.
We first assumed Amy had lain down on something irritant: this is a common cause of this area becoming sore. She was given some soothing ointment and made a full recovery within days.
A further six months passed, then her elbow became sore again. Again, she recovered with simple treatment. But a month later, the problem recurred yet again. This time, we began to look harder for the cause. Was there something in her home area that could be damaging her skin?
Annie checked everything carefully. Amy had a habit of going into a narrow passage between the garden shed and the greenhouse.
It was a calm, cool place to lie, and she took her toys in there to chew them in peace, but Annie discovered that the sharp end of a nail was protruding on one side of the passage. As Amy squeezed in, it seemed likely that she had been scraping her elbow against this nail. Annie blocked over the passage and we all hoped that the mystery had been solved.
This week, Amy came back to me with the same problem yet again. At this stage, it's clear that a more aggressive investigation is needed. We need to look again to find what's causing the soreness as it is obvious that if we don't do that, it's going to continue to recur.
The investigation is happening in stages. First, we've taken a swab to look for rare, resistant bacteria. There are some infections that are exceptionally difficult to kill, requiring special antibiotics. If such a problem has found its way into Amy's elbow, she may need a long course of a potent antibiotic for a full cure. We're still waiting for the swab results.
The next stage will be exploratory surgery of the area. When Amy had the original injury two years ago, it's possible that a small piece of foreign material could have been caught in the deep recesses of the wound. A tiny piece of wire or even a speck of grass could be enough to cause a problem.
The only way to cure this would be to find and remove the foreign material.
If, even after all this, we still can't find a cause, the ultimate investigation will be a referral to UCD for an MRI scan. This would give us a millimetre by millimetre analysis of this part of Amy's body.
We will find an answer eventually, but these problems can take time -- and money -- to solve. Annie's pleased about one thing: at least she made the sensible decision to have Amy insured as a young dog.