Friday, September 23, 2011

IVDD A tale of two outcomes

We have these weeks where the storm clouds swirl above you and the seas rise around you and your boat gets rocked hard. It is in the middle of the looming disaster that you test your abilities, and truly get a sense of where your strengths lie and where the weaknesses are cracking your hull. There was a time a few years ago where we literally did 12 splenectomies in a 2 month period. Before that first splenectomy I had been out of vet school for two years and not seen one. In the four years since I haven’t seen 2. So weird, but completely true.
In the last week we have seen two dogs with acute intervertebral disc disease cases. I thought their cases would be a good story to help you understand this disease and how easily an outcome can sway in the balance.
Today is Wednesday the 21st of September. It is the day that Porter had the disc that was putting pressure on his spinal cord at Lumbar vertebrae 2 and 3 removed. The intervertebral disc in the spine can best be described like a jelly filled donut. Those little jelly filled donuts are the pillows between the vertebrae that protect your lifeline; the spinal cord. The bones that makes up the vertebrae, (your backbone), are like the cars of a train. Once one of those cars gets loose in the track the rest of the cars are more vulnerable. It is an amazing framework of engineering, but one small problem has devastating consequences. If you injure your back to the point that the jelly is extruded from the donut the jelly can only go into your spinal cord space.  Any tiny amount of jelly in this very narrow place is painful and causes pressure and damage to the very sensitive electric wires that are your spinal cord. Too much pressure for too long causes paralysis of these fibers and then the messages your brain is trying to send to the body get slowed down or stop completely. It’s like losing your power to your house because a tree fell on the electric lines between the power plant (your brain) and your house (or say your leg). IVDD (intervertebral disc disease) is common in the dogs with the long backs. The most common dogs we see suffering from this disease are the dachshunds. I also see it a lot in beagles. The obese dogs seem to also have weaker backs.
In some cases we see this disease as a result of dogs playing to hard, or from trauma, like being hit by a car. And in some cases it just creeps in slowly and silently and persistently. Clients will walk in with their pet complaining of not wanting to walk up or down stairs, or not wanting to jump up on the bed, or not able to urinate or defecate. Sometimes it is that they aren’t eating. All of these complaints areyour dog telling you that they are in pain. I have had owners tell me that they think their dog has a belly ache because when they tried to pick them up they screamed. A dog with a “slipped disc” is painful. Sometimes they are painful everywhere, sometimes they are very good at hiding their pain. There have been a few patients that make me have to search hard to get them to elicit where their sore spot is. IVDD can happen in the neck (cervical) or lower back (lumbar). When it happens in the neck I see these dogs reluctant to walk, unwilling to move their head, (think whiplash) and then scream in pain when you try to move their head while holding the rest of them still. Sometimes we also see the four legs not responding normally to basic functions. A dog with lumbar disc disease will not want to jump, or walk up or down stairs, or not wanting to get their butt off the ground. In the end stages of this disease the disc cuts off the spinal cords ability to talk to the limbs ability to ambulate (move), and the body’s ability to urinate or defecate voluntarily.
The tale of Porter and Daymin is about lumbar IVDD.
On Thursday the 15th of September Daymin was brought to the clinic to be evaluated.  His chart read simply, “Exam, can’t get up, has $ issues.” That was written by the receptionist as was stated by the client to them at check-in.  The technician then wrote the following; “ owner thought he was constipated,  so they gave him an enema. Was fine, normal, all day, sat back, then fell over, urinating on himself.” I was not the vet that Daymin saw that day, but as I read his chart I am once again dumbfounded how many times clients think that their pets are constipated. I know that I shouldn’t make these broad sweeping general statements, but here I go.., “People! Dogs are hardly ever constipated!” As I think back, I have only ever seen one or two constipated dogs. (Now constipation in cats is a real problem, so my statement doesn’t apply to cats!) Perhaps constipation is a big problem in people?, so that’s why they think their dog is constipated? I don’t know? But darn it, don’t give anyone an enema without a Dr’s ok. Enemas can cause big big problems. The veterinarian who saw Daymin stated in her physical examination findings that Daymin was panting, painful, and unable to use his hind legs. Daymin was also very obese. Daymin is a Labrador Retriever and these guys don't typically get this disease, BUT, the fat ones are all susceptible. He had urine and feces on his hind end. The owners had enough money to run blood work and take x-rays. After these were run his preliminary diagnosis was IVDD. Based on the severity of his clinical signs the veterinarian recommended he immediately be sent to a veterinary neurologist specialist. Based on the cost (estimates range from 1700-8000+) the owners declined and sought conservative medical treatment. Based on my experience if deep pain is still present in their back legs (a test your vet will check) and strict cage rest for 8 weeks I would say that 40 to 50% of patients will have a return to function. For dogs without deep pain present this conservative approach has a poorer prognosis, and little chance of return to function. (When I say return to function I mean able to ambulate on four legs.) If the disc material can be taken out quickly the spinal cord can heal and I have seen many dogs go down (paralysis) and be looking normal a few weeks later. Daymin was given a barrage of medicines to try to stop the swelling, protect his stomach from the steroids he was being given, pain relief medications (opioids are the only thing with any chance of relieving this kind of pain) and strict orders to bring him back tomorrow for a re-check.
On the 16th Daymin was dropped off for the day for us to observe him. his medical record stated; “able to sit up, ate a little, unable to support his weight. No proprioception in the back legs, (this is a test that we do to see if his feet can talk to his brain and then his brain tell his feet that they are in the wrong position to stand). Does have superficial and deep pain present (this means his feet can feel a tickle and a hard pinch, or the nerves in the feet feel a sensation and tell the brain that they can feel something. Deep pain is one of the most primitive functions and the last thing the nerves let go of).  When this is gone there is complete paralysis and without relieving the cause little hope the nerves will talk to the leg again.  At the end of the day his progress report read “eating and drinking normally, leaking urine, but seems more comfortable.” The owners were given directions to keep him in a small confined enclosure, continue the treatment plan provided the day before, re-check on  Monday, or sooner if worsens, owner was told there is a 50% chance of recovery. Owner declined referral to neurologist.”
9/19 entry, “patient here for observation, seems painful.  Unable to support weight on hind legs, no superficial or deep pain. Prognosis poor.” Daymin was not getting better and he needed a neurologist. The owner also gave the Vet a handwritten letter. Dr. E held the letter up to me and gave me her “I don’t know what to do about this, and the guilt is crippling me” look. She summarized that the letter was written to her, because they liked her and trusted her.  “Dear Dr.  Daymin did good over the weekend, he peed and pooped and we kept him clean, like you asked us to. He drug himself around with his front legs. I’m not asking you, I’m literally begging you to please see if you think acupuncture is worth a shot. I just don’t wanna give up yet…please let’s just try a little longer. Please. Thank you..”  I don’t know how the acupuncture thought came into play, but this poor dog was waaay beyond the point of this helping. I am a big supporter of alternative therapies but he needed emergency veterinary care NOW!

Daymin stayed in his cage heavily medicated all day. At the end of the day the owner sent two friends to come pick Daymin up. The owner had made an appointment at the neurologists on Wednesday. He would have to wait until then. When we tried to move Daymin out of his cage he tried to bite the technicians, he also urinated and defected everywhere, despite being medicated, having a morphine patch on, and really no sensation to his whole back half he was in excruciating pain. I went outside to the friends of the owner here to pick him up and explained just how bad Daymin was. Medical management was not working in spite of every effort to provide him relief. His suffering was too great and I knew it wasn’t fair to him to wait and get even worse. The owner elected to euthanize him. it is a hard terrible thing to put down a sweet dog who may have had another outcome if the expense wasn’t so great.  I am in no way trying to pass judgement or assume that his outcome may have been different. It may not have regardless of finances or circumstances. There are many cases whose outcomes are decided by some intangible force no vet, no human, and no amount of money will change. It is the lesson your learn in medicine if you stick around long enough to not grow frustrated or indifferent no matter how hard you pray and want a patient to walk out with a "happily ever after."

Porter and I at Jarrettsville Vets Pets with Santa 2013
That evening my good friend Janet called me to tell me that her 13 year  old mixed Dachsund-ey looking dog was having trouble and reluctant to go up stairs. (Remember how I explained the splenectomy cluster we saw a few years ago? this week was disc disease bonanza).  I told her to bring him in right away. She arrived a short time later. Sure enough Porter was painful in his spine and his radiographs showed some narrowing in the spine at the level of L1 to L3 and L5 to L6, (top and bottom of his lumbar vertebrae). Because it was late in the evening I gave him some pain relief medications, told her to keep him calm and quiet and call me if he worsened overnight. If he wasn’t better by morning she was to bring him back in. at 10:30 pm I received an email saying that he was no longer walking. I told her I would see her first thing the next morning . Before I left for work that next morning I advised her to have a “worst case scenario” talk with her husband. I was pretty sure that Porter had ruptured a disc in his back and based on the fast progression and worsening of his clinical signs he needed to be transferred to a neurologist ASAP. When I saw Porter that next morning he was significantly more painful and would not support his own weight. We started calling to transfer him.

The next day he was examined by a Veterinary Neurologist and then was given an MRI which confirmed everyone’s suspicions. He has ruptured a lumbar disc. He immediately went into surgery. In the 48 hours between him being reluctant to walk up the stairs, he lost deep pain in his back legs. It was the worst case scenario. Luckily for Porter he received all of the care he needed in almost the shortest time possible. He is recovering at the neurologists over the weekend, but so far he is eating, comfortable, and has regained some sensation in his back feet.



I expect, and hope for, Porters full recovery. I will keep you all posted. His final bill will be somewhere in the range of $7000. I jokingly told his mom that they can check off the box that says “Most expensive thing that can happen to your dog”, box now.
Here are some post-op pictures of Porter with his mom giving him his post-op PT.He is doing great! He is a strong, determined, stubborn dog, and I have no doubt he will make a full recovery.


My expert general practitioner advice is to have pet insurance, especially for the predisposed IVDD breeds like dachshunds, Shih Tzus, and beagles. IVDD is uncommon in other breeds as long as they maintain an optimal weight and refrain from dare devil activities. 

For anyone in a financial predicament DO NOT GIVE UP ON YOUR DOG! Follow the vets conservative management guidelines. The most important of which is;
  • ABSOLUTE CRATE/CAGE REST FOR 4-8 WEEKS.
  • Leash walk only to go to the bathroom.
  • Use the pain medications prescribed.
  • Don't freak out in the first 3-5 days. They are the worst, but, things will get better.
  • Monitor for eating, drinking, urination, defecation. Call the vet with questions. You will need a helping experienced hand. They can help.
  • Be strong, be brave, have faith, and try. Your pet is an amazing soul who can beat almost the most impossible of things, IF, you give them a chance and a helping hand of love.

If you would like to learn more about IVDD please see the links below;

The leading source for IVDD help online; Dodgerslist.com



Update; Porter did very well with his slight stagger, and somewhat torticollis-sway back stagger for his remaining 4 years! He needed carpet to help him keep his feet from slipping, and he could not climb up stairs, but he never seemed to be in pain or distress and loved his walks with his mom up until his last days at the end of 2015. He lived to be 19. He will always be missed.

In an ideal world resources, financial stability, and access to experts is reality. For the rest  of us lean on your vet, get help where possible, follow directions explicitly, and be patient. There is the other side of this disease, and many pets will shock you at their degree of recovery. I never, ever give up on a disc disease pet. It may be hard to watch, difficult to manage and heart wrenching, but it will pass, and most will dramatically improve IF you can get through the first few days.

If you have a question about your dog with IVDD please find me on Pawbly.com. I am happy to offer assistance and encouragement. Pawbly is free to use and open to all pet lovers across the globe.

If you have a pet that you would like me to see you can find me at Jarrettsville Vet in Harford County Maryland.

I am also on Twitter @FreePetAdvice, and I have a YouTube channel with lots of helpful videos.

113 comments:

  1. Thank you for this post. I am currently going through conservative treatment with my dachshund for the second time this year

    ReplyDelete
    Replies
    1. Thanks for reading,

      I hope that your dog is doing well.

      Sincerely,
      Krista

      Delete
  2. Thanks for this info reading this makes me feel better. My dog lost the ability to walk on Friday morning took him to the vet and the vet said to rest her and bring her back the next morning for examination. We couldn't wait any longer on Friday evening we took her to emergency and raise our concern the vet at the same said that she still have a deep pain sensation and called the surgeon. The surgeon said it could wait til the next morning so Saturday he called us and let us know that our dog needs surgery and she is on stage 4. We are happy to for him to surgery however he said we have to wait til Monday since there are no staff to do the ct scan. We trusted him and have lil knowledge of the illness. Sunday morning he called and let us know that our dog no longer had DPS. So we don't want to wait any longer and manage to get the surgeon to find team to perform surgery that afternoon. The disk was prolapsed on her t13 and L1. The surgeon said if within 48 hours she doesn't get back her DPS pretty much the chances on recovery are very little.

    ReplyDelete
  3. Wishing you the best. I hope that he makes a speedy and full recovery. Be patient, sometimes it takes a little while. I think that most dogs and cats recover pretty remarkably given time and attention.

    Sincerely,
    Krista

    ReplyDelete
  4. Hi. My Cocker Spaniel was diagnosed with IVDD in March 2013. In hindsight, her symptoms then were not very severe. In any case - we medically managed that first bout and she recovered. A few times between saw April 2013 (when she was recovered) and end of January 2014, she had a minor bouts managed with Metacam. At the end of this past January, she started to act very strangely evident of much pain. She could always walk, the proprioception was normal (if I'm saying that right) and she had no actual pain (that she revealed) in her spine. She was one of those slow and persistent cases you mentioned. In any case, by early Feb, she had an MRI to have a herniation corrected - unfortunately, in her case, the jelly had adhered quite a bit to the spinal column. I cannot image how much pain she was in and "hiding". They removed 90% of the material from on and around her spine and made room for more if needs be. She was recovering very well and happy were we that we had the surgery because, being upward of $6K it was a big decision. In any case, after about 6 weeks, she had a good follow-up with the Neuro doc, was medication free and we were given the green light to go on short walks (with a supportive harness leash). She had a wee bit of weakness in her back left leg but some strength PT could improve that or, it may be a permanent deficit - time would tell. No sooner were we given the go when 2 days later, something happened, we're not sure what, and she was in pain again. Neuro put her back on pain meds only and we waited. 2 weeks later, she was okay again. Cautiously we took her off the pain meds. We even started calling her ninja-puppy cuz she would sneak upstairs past us before we could close the baby gate. In any case, about 10 days ago... she's in pain again. Noticed that her backBack on pain meds. Several days - things are getting worse. Took her to the vet last Saturday - her proprioception in the left back leg very poor. Pain meds + prednizone again. 5 days later - no marked improvement - in fact, she is show very slight signs of deficit in her right leg. She doesnt appear to be in any pain. She is very slow, relunctant to climb up a few stairs from the backyard but still walking and peeing/pooing on her own. I don't have another $6K so its medical management from her on out. Vet/Neuro says there is an outside chance that she might have an infection. Going for xrays to see if they can see anything in that arena - wherein, our last hope would be antibiotics. It's been a journey. I have cried a lot. I don't think I'm done crying.

    ReplyDelete
  5. Our 11 1/2 year old dachshund just had his 5th IVDD surgery this past Friday. He was having symptoms Thusday evening. Took him to Medvet Dayton where he remained overnight. The day doc was able to schedule him for an MRI at Medvet Columbus so they transported him over. The neurologist did a preliminary exam and the MRI confirmed his findings. The neurosurgeon was standing by so our baby went immediately in to surgery. We were able to bring him home Saturday afternoon and he is rapidly improving. It seems like recovery time from cervical surgery is much faster than lumbar - first 3 were lumbar & last two cervical. His ataxia is lessening by the day. I think the key is how quickly treatment is started after onset of symptoms. We have also medically managed when problems have arose. Gabapentin combined with steroids worked well. Of course strict cage rest is imperative when medically managing much to the patients usually loud vocalized protestations! I wish you all the luck with your cocker baby. Try to keep a positive outlook; I know that can be very difficult

    ReplyDelete
  6. Your blog makes it sound like the owners should have been able to afford this expensive surgery. In fact, you make it sound as if they were terrible people for not going to a neurologist sooner to go through with the surgery. You forgot to mention how extensive and excruciating the surgery and recovery is for the dog. Not to mention that surgery for IVDD is not guaranteed, it could reoccur even after surgery or make things worse (paralysis). This is no life for a dog. Sometimes euthanasia is the most humane route.

    ReplyDelete
    Replies
    1. Hello,

      The blog is written in diary form so I can use it is a tool to express my thoughts, my perspective, and my journey through veterinary medicine. Your points are valid and I agree that there is no guarantee with anything in life. Your pet is yours to decide how you best believe they are served. I will however argue the point that I have seen hundreds of dogs with this condition and that allows me to understand the condition, the resilience and the outcomes far better than a person not invested in medical care. Deciding what is and is not fair for a pet based on a humans belief of a dogs ability to thrive and function with even the most horrific of diseases, debilities, and challenges is where we people are short sighted, self absorbed, and caught up in feelings of self pity. Dogs, and animals can live a pain free, happy life in many cases if we try and allow them. They, like every creature have a strong will to survive, an ability to function and be happy in spite of obstacles, and paralysis is not a reason to euthanize a pet or a person, in my opinion. It is a reason to look deeper into the soul of who we are and provide compassion and love, the true testament to the meaning of life. I appreciate your taking the time to write and explain it.

      It is never my intention to pass judgement. Although it is something I struggle with in my efforts to help pets in the face of people who cannot, or will not, afford to do so.

      Sometimes euthanasia is a humane option. And many times euthanasia is used as the easy, cheap, and emotionally absent option. That is the society and world we live in.

      Sincerely,
      Krista

      Delete
    2. That is some really offensive line of thinking. You struggle to not pass judgement because someone is not in the financial position to pay $8k for a surgery that has no guarantees. I can only assume that you have lived a very privileged to not understand why this isn't even an option for some people - many specialists require this payment upfront and that is difficult for MOST people. Also, euthanasia is NEVER an emotionally absent option and it's so unbelievably offensive for you to say it is. I have had to have a pet put to sleep twice and both times it was the hardest and most emotionally wrought decision I ever had to make. I would love to be able to have a spare $4-8k, but like many people that isn't realistic. Many of us love our pets and do what we can to help them in the way we can. If you care so much, look into financial aid options for your clients in these situations and instead of trying not to pass judgement, just don't do it.

      Delete
    3. Agreed Bee. Krista sounds like she is quite out of touch with reality. Reading Lisa's story above is a good example of why many people who have limited resources have to make the difficult decision to euthanize their pet to prevent further suffering. I am fortunate that I could afford to pay for surgery if necessary for my dog but with the likelihood of a recurrent injury even with surgery, I completely understand why many people make the choice to put their pets down when they receive the IVDD diagnosis. It almost seems like Krista is trying to guilt people who can't afford $7k for surgery into doing anything they can to scrape the money together, regardless of how irresponsible that choice may be for their human family's well-being.

      Delete
    4. Hello,
      I agree that there is guilt in this blog. I just disagree with where you feel it has been placed. I know that the owners, the attending vet, and myself included all felt guilty that we could not provide the ideal care needed. It was a matter of cost. If I could have provided the surgery Daymin needed I would have done so at a price point that his family could afford. This is common practice at my clinic. I do not know how Daymin would have done even with the surgery. We never know this. But I HATE that cost is a reason we cannot provide it. Do I feel guilty about this, yes, of course. Nothing is worse than not having an option to help.
      I know that dogs who receive surgery as quickly as possible do better than those who do not.
      I wish that cost was not an obstacle for so many and that better options were available for those who cannot have surgery. In the case of IVDD there are options but they need to be discussed early on.
      Sadly, there are people who do not regard euthanasia in the same manner as you, or I do. For some people pets are disposable. Until you walk a mile in a vets shoes you may choose to argue or deny this, but it is reality.

      Delete
    5. I feel that your response was insensitive because it seems to be an attack on people who are lower income. My dog is 14 yrs with ivdd and I can in no way afford his surgery. I'm taking care of him the best I can. I bought him a nice back brace, a wheelchair, a tempurpedic bed, and a bunch of sessions of hot laser therapy at the fancy vet clinic by my house. Everyday I take him to work and feed him his breakfast and dinner of the highest quality dog food. I haven't left him for a day since this happened. I know maybe a lot of people can afford the surgery, but I think it is very separate from quality of life. The owner determines the quality of life not by dollar bills but by effort and time spent. I'm certainly ready to pull all the stops for my dog. My opinion remains that surgery on the spine is too risky for my senior dog.

      Delete
    6. The purpose of this blog is not to offer an opinion on judging what happened nor why. Nor is it ever intended to place blame or judgement the families I meet. It is the true story of two dogs and the disease they both shared. Your love for your dog and your abilities to care for him are never wrong nor misplaced if they are done and decided based on a position of unselfish love and compassion. If you knew me and how I never ever turn down care based on financial constraints you might have a different opinion. But you dont and you are worried about your dog and likely frustrated that care is so expensive (of which I agree and find terribly unfair and unsettling). I am doing what I can for every pet I can and I do so with a clear conscious and a sense of pride in being able to help regardless of age or financial ability. I decide quality of life on a case by case basis BUT I also fear that we don't offer the same options and care to provide a peaceful pain free passing to every pet in need. To be honest the idea of deciding is sometimes over whelming for pet parents and too often too heavily influenced by cost and difficulty to manage an ailing pet. I hope to be able to offer kindness, care and support regardless of economic, regional, or physical constraints. I wish you and your dog the best and hope that he remains happy and pain free for as long as possible. best of luck to all

      Delete
    7. Dr,
      I'm sorry you're being so viciously attacked about your post and subsequent responses. I didn't feel at all like you were placing guilt or being offensive. You're a wonderful person and veterinarian for your views and for helping in any way you can regardless of cost in your clinic. I feel like maybe they don't understand that there are certain things you yourself can't do, such as the surgery needed for an IVDD patient. It seems like they think you should've just done the surgery even though you're not a surgeon. My boyfriend's dog is going through what we think is IVDD right now. We're in day 2. We haven't been told that's for sure the problem because the surgeon won't say on the phone. It's over an hour drive and they already said we need $6,000.00 if we bring her there. It's absolutely heart breaking to see him carry her everywhere and lay in the floor with her. Personally, I have never been a dog person (I was bit young and have always been scared.), but I'm so in love with this amazing animal. She's so sweet and so well-behaved. I'm here trying to learn all I can for both him and her. (Oh, I should state that we did get preliminary x-ray results that confirm disc degeneration.) I thoroughly enjoyed and greatly appreciate your article. Thank you for your work and for sharing your experiences so people like myself are able to learn about this horrible disease.

      Delete
    8. I have to agree with everyone in this thread, besides Jessica. I just had to put my dog down this morning from IVDD. It was the most painful thing I've ever done. This year I had spent already thousands on her, and I only wish I could have had thousands more to save her. But I just don't. But MORE importantly she was suffering. Laser wasn't helping, medication was not keeping her pain free. She only got worse, her odds of recovery only got worse. She was MISERABLE in that crate. She was not herself anymore, no quality of life. Just because we have the ability to do something medically does not always mean we SHOULD. We should take their suffering into account. There are people here saying they've put their dog through 5 or 6 of these surgeries with weeks being stuck in a crate. How is that a good life for them? If anything torturing them because WE can't let go is more selfish then giving them a pain free and peaceful way out of bodies that are letting them down. So good for you for having the money to put your dog through more pain then they deserve. When it doesn't even promise recovery, when it can and usually happens over and over again later. If I seem judgemental that's okay. It seems like that's all I see on this subject online, judgement and people acting like you don't love your dog if you don't put them through all of that. An emotionless decision, that comment says it all. I've cried for hours and will continue to do so. But I am grateful that I AM the one in pain now, and that she is FREE of pain and suffering.

      Delete
    9. Jennifer,
      I am so deeply sorry for your loss. I hope that you find comfort in knowing that you loved her and tried to provide for her despite terrible hurdles and a disease full of pain and anguish. In the end often all we can do is love with our whole heart and be grateful that we were loved back. I wish you lots of hugs and empathy in your grief. I know how difficult and hard it is to lose a loved one. You are in my thoughts.
      Sincerely
      Krista

      Delete
    10. Hi Jennifer, I'm going through it right now with my beautiful dog Milo. He was not diagnosed correctly by my vet and I've been back 3 times. Eventually a 2nd opinion and xrays shed light. He is going for accupunture twice a week. I keep him calm, give pain meds and anti inflammatory medication as prescribed. And sadly there is no improvement. I can't afford the operation as I don't have that amount of cash on hand. But I too, have to consider how long I want to continue with this treatment or do the right thing. I blame myself for not getting a 2nd opinion quicker as I feel the 3 week delay made things worse. This blog helped so much. Thank you to all

      Delete
  7. Sometimes you also have think about whether surgery is appropriate in an old dog. I have 13 1/2 year old Italian Greyhound. He has spondylosis in the cervical and lumbar spine for which he has had Prednisolone for some time and recently prolapsed cervical disc.As soon as we saw neurological signs he was put on complete rest. He can still stand and pee and poop but he will not do this if harnessed for support so he is allowed to' go ' in his little room which has non slip mats over it. He is in no pain now and we have been able to reduce his preds. I have bought him dog wheels with complete support and we put him in this at feeding time. He spends the evening with us carefully supported on the settee or in a small canvas pen. he happily wags his tail and we hope to get him to the stage where he can use his wheels. Actually he would now give half the chance but he is not ready for that. Would i put him through surgery. Absolutely not. We treated another elderly dog with the same problem the same way and he did very well.

    ReplyDelete
  8. My dachshund has IVDD and 3 years ago he could not move he was in so much pain. We tried crating, meds, lazer, all kinds of things. Then we went to a neurosurgeon who shares her practice with an alternative med vet. She suggested trying acupuncture (actually aquapuncture- B12 shots). It took about 5-10 minutes, and my old dog was back to new, walking like nothing ever happened. This saved me thousands of dollars. He still occasionally gets acupuncture with B12 shots and it has made such a difference. He just turned 17 years old

    ReplyDelete
    Replies
    1. Where can I get B12 shots ? I'm in Canada (Quebec city). Thank you. I'm currently trying acupuncture but i'll try aquapuncture as well

      Delete
    2. Your vet can help you. I think that Nutramaxx just came out with a commercial version too.
      Good Luck

      Delete
  9. I wanted another unbiased professional opinion. My 14 year old girl, a peekappo, was put down a month ago due to 2 ruptured discs. She saw 2 vets in the office, and neither of them recommended surgery after she developed paralysis in the hind legs. She stopped responding to all medication including tramadol, rimadyl, and gabapentin. Neither recommended acupuncture, just the medication. I spoke to the third vet over the phone and he said he could refer me to a specialist but he was concerned for her quality of life. So they sent a 4th vet to make a house call. She said munchkin had severe edema in her legs and believed she had swelling around her heart...chf. she didn't believe surgery was an option and said the best thing for her was euthanasia. I feel like I missed something. That there was something more I could have done. How did the other vets miss this? I know I can't bring my girl back, but what is your opinion?

    ReplyDelete
    Replies
    1. Hello,
      I'm so sorry to hear of your loss. This is a difficult situation to comment on as I was not with you and I did not see her condition. As you describe it it sounds as if it was very bleak. I also think that if you had 4 vets and all of them were giving here a very poor prognosis that you should not feel as if you let your dog down. We all grapple with the horrible decision to let our pets go, but I honestly believe that if you make that decision from a place of love and unselfishness that it is the right decision to be merciful and end the suffering of a non-treatable pet.
      I don't think that you missed anything, and I believe that your dog would feel nothing but gratitude to you for all of the many years of love and kindness that you gave her.
      Saying goodbye is incredibly hard, but you also have to love with forgiveness and acceptance. You are a loving pet parent and I believe you did everything you could based on 4 experts and a poor prognosis. I hope that the many fond memories of your time together help heal your heart.
      Sincerely,
      krista

      Delete
    2. Thank you  for responding  so  diligently.  I appreciate  your feedback. I've been asking  many vets if I missed something.  Putting my sweet girl to rest was the absolute  hardest thing I had to ever do. Always wanted her to go peacefully in her sleep,  like most pet parents. 

      Delete
  10. This comment has been removed by a blog administrator.

    ReplyDelete
  11. My 11 year old Chihuahua was diagnosed with T12-13 IVDD on June 7th. We're not in a financial situation for her to have the needed surgery so we've got her on meds/strict rest. She's currently on five meds; misoprostal, prednisone, tramadol, methocarbamol and gabapentin. We're at the end of day two on meds and she's still in an immense amount of pain. I've learned to express her bladder but each time she yelps, bites me and tries to "run" away (she's lost use of her hind legs). She is still eating and drinking but I'm worried since she has not defecated in two days. The vet said she shouldn't have any problems releasing but so far nothing. So my questions are...1) will the pain eventually subside after more time on meds/rest, 2) will she defecate on her own or do I need to assist somehow? and 3) by her having pain in her lower region indicate that she may/can regain use of her hind legs?

    Any answers you can provide would greatly be appreciated. For a dog with zero back issues until just a few days ago I'm at a total loss for answers. Thank you, Janet

    ReplyDelete
    Replies
    1. Hello,
      I apologize for the delay. If in the future you need quicker advice please go to pawbly.com. We answer questions very quickly.
      The pain gets better with time, and the defecation happens when they are eating normally and less painful. It is normal for this to be about 3-4 days after the injury (or surgery). Keep expressing the bladder as often as needed. Ideally, check it every 4-6 hours. Also, it is important to try to empty it completely. There is an art to 'feeling' this an knowing what the right amount of pressure is.
      Pain is not an accurate or reliable way to indicate what the future holds. The response to care, therapy, and progression of positive improvement are the best indicators. I will add that most cases improve and most pets compensate and function very well even if they don't regain complete function. They also live long happy lives with care from their guardians.
      Best of luck!

      Delete
  12. Hi there, my 11.5 yr old Shiffon Bubba Bear, Half shih-tzu and half brussels had cervical ivdd surgery 2.5 years ago. He made an amazing recovery and life went on. Unfortunately in the last few weeks he has been showing signs of this devastating disease again. He is being crate rested and is on steroids and tramadol. I will not put him thru another surgery so I am hoping and praying he will get better. I spend every nught and day by his side and tending to his every need. My question is.. My little guy has never showed me pain. I have no idea if he is in great pain or not. His walking is wobbly and he is stiff at times. But he is very alert and will be the first to jump up and try to get where any food might be cooking regardless of his wobbly weak legs. I am confused and need some guidance. He has never yelped or cried out in pain. It seems like he is in good spirits and that his brain is just not doing what he wants it to do. Regardless I will continue the pain meds and steroids and see how he does. I read a lot of posts where people have said their dog is in extreme pain. How do we know? Any help would be greatly appreciated. His first surgery cost me $7500 and I cannot afford another one. I am totally devastated. I love my dogs more then you can imagine. I guess what I'm saying is.. His walking is wobbly at best. He does not have good control of both his back legs and his left front leg. He is seeming to manage and he can potty outside just fine. Am I wrong for keeping him going like this? I don't want to let go.. But I don't want him in pain everyday. Someone just showed me the poem called "the last battle" and I'm just an emotional wreck. I pray I have the strength to let him go if he is in pain that cannot be managed. The poem gave me hope that I could do that for him. But I 'd like to know if I'm doing the right thing. Sincerely, Joanna.

    ReplyDelete
    Replies
    1. Hello,
      Follow the lead of your dog. If he is up and active and urinating and defecating normally then he is probably not in significant pain.
      Don't be devastated and don't beat yourself up. You do the best you can and be the faithful friend to your dog as he has been to you. Life has a funny way of reminding us that no matter how much money you have, or how much you will things to be different fate chooses its own path.
      If you are worried about assessing and understanding what pain looks like find a vet you trust and ask them to help you see and understand what he is teling you.
      It sounds to me as if you are a wonderful parent and doing a great job in helping him recover.
      I wish you the very best of luck.
      If you ever have a pet question or need any pet guidance please join us at www.Pawbly.com
      It is free to use and you will find lots of other caring and dedicated pet people there.. it is free to use.
      I wish you both the very best and many happy days together!

      Delete
  13. I agree, if the vet is so emotionally intelligent then they should have used their privilege to pay for the surgery and save the dog. 8k is an entire year's income for a person on disability pension in Canada. I have a real problem with vets that use shame and blame to inflate their own bank account balances. Capitalist trying to come across as compassionate. So gross.

    ReplyDelete
    Replies
    1. A real eye roller, LLP. No Doctor of any kind would be held responsible for paying your debt.Obnoxious.Get real. If you can not afford a responsibility then do not take one on then cry poor mouth and expect others to foot your bill for the care you requested. Entitled much? gross.

      Delete
    2. I'm glad someone finally said something to these people. I had a whole long post typed and it disappeared when I tried loading it. Krista apologized several times and even stated that she does provide care even for those who can't afford it. Some people like to play the victim even when it makes them the bully doing it.

      Delete
    3. Thanks Jessica.
      I have learned that it is far better to let angry people vent than to permit it to deteriorate my willingness to try to help a pet. In the end I really dont care what the haters spew. They can live with their venomous rhetoric. I dont have time to waste on it. I feel very confident that I help every single pet I can with whatever I have to offer. I never turn anyone away and I always give each case my best effort. I am not perfect but I give as much of myself as I am able. In fact I have been keeping an IVDD dog Hank for the last week because his family could not afford to treat him and I was unwilling to give up on him. He is doing great! I hope others are inspired to help and I also hope no one gives up on trying even through the dark and dismal days.
      Wishing you peace love and happiness regardless of what life (or the nasty people) throw at you!
      ;-)
      krista

      Delete
  14. My pug developed a deviated disc in the cwrvical area. We spent the money for the MRI and opted for surgery. Condition did not improve, in fact it worsened. Turns out the surgeon ( board certified) operated on the wrong disc. A second surgery was performed. Condition did not improve only got worse. 4 weeeks in hospital. Urinary infection, never regained abiiity to control urination and did not regain use of legs. Brought him home and was expected to express bladder, administer meds and do range of motion exercises. Difficult but willing. Rehab was suggested so we paid for that too. Had his consultation and first session. Mood and spirits were fine. Not improving and could not pee on own. Difficult to express bladder. Took him by vet hospital. They did some express but had ti use a cat to drain urine. Vitals all good. Took him home. Ate and drank well. Returned from work on Dec 23rd to find that our beloved family member had passed away. No one could explain. Had an autopsy for digs performed. Nothing in vital organs point to death. Do yku have any thoughts on what may have caused Manu to pass away suddenly and unexpectedly?

    ReplyDelete
    Replies
    1. Hello,
      I am sorry to hear about all of this. It is possible for these patients to throw a blood clot which can be acute and fatal. It could have been something else too, like a heart condition, organ disease, or even cancer that went undetected.
      I am sorry for your loss.

      Delete
  15. My doxie 3 days ago ruptured discs and is paralyzed in her hind end. She is being treated for her pain and with steroids. Surgery is not an option financially for us unfortunately. She is only 3. Its heartbreaking as she means the world to us. At present she will not take anything by mouth so I am trying my best to syringe water and soup if she will take it...it's a real challenge. I guess I just need to ask if I'm doing the right thing by her. She is at stage 5 so there is no feeling at all in her legs, bladder and no control of her bowels. We are seeing how she will do for couple weeks. Sometimes I feel like I'm being selfish for keeping her with us. Feeling frustrated and guilty and completely heartbroken.

    ReplyDelete
  16. Our 3 yr old miniature dachsund spontaneously ruptured her discs 3 days ago. She is completely paralyzed in her back hind area. She has no feeling with her bladder or bowels. She is being treated with pain meds and steroids. Unfortunately surgery is not an option due to its expense. She will not eat or drink and I'm doing my best to syringe water to her and soup if she will take it. I guess I just need to ask if I'm being selfish by keeping her here with us. She was a real spitfire and we had loads of fun with her. Now we feel frustrated, guilty and heartbroken. I am going to try with her for 2 weeks and see if her pain subsides. But it is heart wrenching to see her like this. I'm afraid too that she will die of dehydration as she won't eat or drink without me forcing her. She tries to bite me and that's just not like her. It's terrible to see. She sits in her crate and doesn't move. She just buries her face in the blankets.
    Am I doing the right thing...please help us. We love her so much.

    ReplyDelete
    Replies
    1. Hello Shelley,
      I have seen many many dogs just like this. I would say that it takes about 4-6 days for them to get comfortable enough to start eating, drinking and feeling better. In that time they need to be kept caged (keep caged for 6-8 weeks) and monitored very very closely. In some cases I instruct clients how to give SQ fluids, monitor bladder size, keep them calm, comfortable, and pain free. I have never euthanized a pet for IVDD. I know it seems difficult to see your pet struggling now (please call your vet for help with the pain there are options to manage this). A few weeks of cage rest can save your dogs life. Please ask any questions that your might have on Pawbly.com. There are lots of people there who can help. Very best of luck

      Delete
    2. Thank you Krista. Abby has a wonderful Vet that has called everyday to check in on her. It's nice to hear that maybe over time she may have a happy life once again. I appreciate you replying. Thanks again.

      Delete
    3. Hi again Krista. We tried everything we could for Abby and I never left her side through the entire horrible ordeal. She never regained any feeling her hind end and ruptured another disc in her neck causing her to be completely paralyzed. She was unable to eat or drink and we unfortunately had to put her to sleep. Our vet said her spine was actually mushy feeling and that we were making a right and unselfish decision for her. It was the hardest decision I have ever made. We are completely heartbroken but believe she is now pain free...running jumping and doing all the things she always loved.
      I thought I would let you know and to thank you for your help.

      Delete
    4. I am so sorry for your loss. You are in my thoughts. With love, Krista

      Delete
  17. My 11 year old doxie is hurting from what we believe is a ruptured disc in her lower neck... xray could not tell exactly- but that is the assumption. Vet has her on prednisone, tramadol and gabapentin - along with crate rest- I am doing the best i can with crate rest, she does not like being in there and has gotten out a few times. she is can walk ( wobbly) and hangs her head low. she will scream in anticipation of being picked up. She is eating and going to the bathroom normally. 2 weeks on the prednisone and really does not seem to be getting significantly better. Surgery will be a tough option because of the cost.. any advice ? stay the course?

    ReplyDelete
    Replies
    1. Hello, Have you followed up with your vet? There are lots of pain options and often the first few days/ weeks are the worst, but they often improve over time.
      Please keep your vet posted and hold fast. If your pet is eating and urinating/defecating I advice clients to keep hopeful.

      Delete
  18. I have a doxie that is almost 6 years old. About 6 months ago, I noticed she was struggling with going upstairs and seemed to be in pain. I took her to the vet and they put her on muscle relaxers and steroids. The vet also said to limit her activity for the next couple weeks. I was not told to put her in a crate as part of her treatment so of course once she started feeling better limiting her activity was very difficult. Fast forward to a couple weeks ago, she started to show the same signs again. I took her to a different vet and they prescribed anti-inflammatory and pain relievers and again did not say anything about IVDD or keeping her in a crate during recovery. I finished her meds and she showed zero signs of improvement and now would scream and run away if I touched near her back. I took her back to the vet yesterday, same clinic different vet. They did x-rays and said there is a lot of compression between vertebrae 3 & 4 in her neck. I don't remember all the details or correct terminology, but she said there was no space between the vertebrae anymore and there was calcification. She recommended surgery with a neurosurgeon. She also said it could be $8-12k, I do not have the means to afford a surgery of that cost. She also mentioned laser therapy and medication as other treatment options. She gave her a steroid injection and prescribed steroids and muscle relaxers and said she needs to be on strict confinement in a crate for two weeks.

    So now that I'm doing more research on her condition, I'm finding that a lot of places say the strict crate rest needs to be longer than two weeks. What would you suggest is the appropriate length of crate rest? Also, do you have any knowledge/experience with laser therapy? Since my dog is still able to walk does this mean her condition is still in the early stages?

    ReplyDelete
    Replies
    1. I think 8 weeks is the usual recommendation. I hope that she is feeling better soon.

      Delete
  19. This comment has been removed by the author.

    ReplyDelete
  20. My dog Beethoven (lhasa apso, 5y) recently had the same problem and went through surgery. I feel like we shouldn't have allowed/taught him to jump on/off furniture. So I decided to do something to warn other dog parents. I wrote what happened on my blog and made a video. If you're interested, here's the link: http://goo.gl/Jc7x7B

    Now I'm looking for solutions to prevent him from jumping and climbing stairs. Any ideas are welcome. Thanks.

    ReplyDelete
  21. Hi...great blog, thank you.

    My 12 year old was showing signs that, after the fact, all pointed to IVDD. With rest and initially meds, all symptoms have improved. We have stopped using carprofen and only use methocarbamol and tramadol as needed. She's on a regular does of gabapentin.

    That said, the one symptom that has improved the least and comes and goes is a "resetting" of the front right paw. This was evident a few months prior to the event which caused me to rush her to the emergency clinic. Essentially, she sort of lifts the paw but keeps the front of it in contact with the ground, which is why I refer to it as "resetting".

    I'm not sure if this is root nerve pain, or what it could be. I have videos of her doing it btw. Some days, she'll be pretty much fine. And then, other days, she'll do a lot of resetting.

    Thoughts?

    Btw, there's a page about her on my training site.

    Thank you

    John

    ReplyDelete
  22. Hi I'm going through this now, my dog has signs of calcified discs all along her spine although currently only one causing problems. If we decide on surgery is it likely that more discs will herniate in the future?

    ReplyDelete
    Replies
    1. It is hard to say. Every case is different. I am not a neurologist or a surgeon so they may have a better answer for you. But, I have seen many dogs like this undergo surgery for one disc that is causing pain and paralysis. Some dogs have had to undergo multiple disc surgeries, but most have done very well, and almost all of the clients who elected surgery were very happy afterward. They felt that their dog was much more comfortable, ambulatory and happier.

      Delete
    2. Indeed. My dog has just completed 1 month after the surgery and he's doing amazingly well! If it wasn't for the scar and the precautions recommended by the neurologist, I'd say he's fully recovered.

      Delete
  23. Hi. I had a 10 yr old chi x pom. We thought she did a disc as she was jumping like an idiot to answer the door. presented with pain, yelping, hunched back, wobbly back legs and just wanted to lie down and not get up.she cried with pressure on her front leg when picked up too. Went to vet and pressumed disc. So on metacam and cage rest for 4 weeks. After a few days she was really good. Finished the 10 days of metacam and only let her out of cage for toileting. All good for a month. Then one morning i got her out for the toilet and she seemed a bit sore so put her back in cage. Went to toilet and next thing she was screaming. Quietened down when i checked on her but screamed when she barked at someone knocking at the door. Went back to vets more metacam a cage. She come good in a few hrs. Was good for 2 days then gor no readon came up all hunched and wobbly back legs again and sore front leg near shoulder/ neck again. Watched her for a few hrs and she was good again. next dsy all good and same thing in the arvo. I couldnt underdstand what was happening to her and neither could the vet. I couldnt afgord surgery so didnt do xrays and i opted to put her to sleep the pain was present on metacam and coming more frequent. i fidnt want her to suffer and live in a cage for ever. After she had passed on the vet found a swelling at the bottom of her neck going up half way up her neck. She had a bit of a stiff neck but was never crying when it was moved or reluctant to move it. I feel i betrayed her and im left wondering what was going on with her. I gave up on her too early i think after reading. I feel so guilty but i was trying to protect her from suffering and i couldnt afford surgery. The not knowing is killing me.

    ReplyDelete
    Replies
    1. I am so sorry for your loss. Truly. I wish there was something I could do to help you. All I can add is that you loved your dog and you did what you could. That is far more than many dogs ever have. Please try to remember the good times and please try to find peace in knowing that you did what you could based on what you knew at the time. It is so easy to beat yourself us and blame yourself for things you couldnt have possibly known. I have seen many cases go wrong even with the best care and unlimited funds. The problem is that none of us have a crystal ball and none of us know what is best when a pet is in pain.
      I am thinking of you. I hope that you find a way to move forward and find another dog to love. There are so many that would be lucky to have such a devoted parent.
      Very best to you

      Delete
    2. Thank u Krista. Im trying not to beat myself up over it. The greif and guilt is so overwhelming. If only i had the money things could have been different. I miss my girl so very much it literally hurts. But i am lucky i have my beautiful am staff boy Rogue to give my doggy kisses and cuddles.

      Delete
    3. Jess...I feel your pain. Having to put our 3 yr old dachshund to sleep was the most painful thing I've ever had to do. But it's a caring and unselfish way to show your love for them. ♡ I hope you can open your heart to another animal who needs someone just like you. I did...very hesitantly at first...to another doxie who badly needed a good home. He's 7 and I have to admit it was really tough as I only lost my Abby in January. But he has helped fill the void and I am so thankful he is part of our family. We love him to pieces!
      Thinking of you Jess...you did the right thing
      *Shelley*

      Delete
    4. Jess...I feel your pain. Having to put our 3 yr old dachshund to sleep was the most painful thing I've ever had to do. But it's a caring and unselfish way to show your love for them. ♡ I hope you can open your heart to another animal who needs someone just like you. I did...very hesitantly at first...to another doxie who badly needed a good home. He's 7 and I have to admit it was really tough as I only lost my Abby in January. But he has helped fill the void and I am so thankful he is part of our family. We love him to pieces!
      Thinking of you Jess...you did the right thing
      *Shelley*

      Delete
    5. Thank Shelley, its a tough road to travel isnt it. Im sorry for ur lose, im glad u have found a new furry one to share ur love with. I keep expecting to see my girl Mia all the time. I miss her so much. My vet says that the swelling in my girls neck was most likely a tumor growing off one of the nerves at the top of the spine,and thats why the pain was coming and going, so thinking now it probably was never her disk after all.( krista u can delete my post if u wish, considering its off the original topic)

      Delete
  24. On February 6th our 4 yr. Old Doxie had surgery for a disc herniated in 2 places, that was a Saturday. On Friday, I came home from running errands to find my dog shivering and not acting his normal self.I thought it was something he ate that didn't agree with him.I picked him up, put him on the sofa where he stayed until we took him outside to potty. He reluctant to go outside but went. He was walking with no problem and I had no hint that he had blown a disc, that was 8pm, by 10pm he could not stand on his hind legs. Since it was so late as decided to wait until morning to take him to emergency.They tested him and told us he had no deep pain sensation and that he needed surgery and time was of the essence. Within 30 minutes we were seen by the neurologist who explained our options and the odds of him ever regaining feeling in his legs 50/50 because he came in with no deep pain sensation. The quote was $7500 but luckily we had purchased pet insurance that covered 80% including rehab although even without the insurance we would have opted for surgery. He was in the hospital for 8 days and on the 7th day he regained pain sensation in his legs,we cried. We were taught to express his bladder which we did until about 6 days later when he peed on his own! Now he had bladder control and soon afterwards bowel control. 3 weeks after surgery we started physical therapy twice a week. They did acupuncture, laser and ultra sound and later hydro therapy. They gave us exercises to do at home which we are doing 3 times a day. We are now 7 weeks post surgery and the little guy is standing well and walking. He is wobbly but it's coming along. He gets stronger and more stable everyday. He can now go for short walks to be increased gradually and he is now working on balance. The therapy cost us $1400 for 10 sessions and has been worth every penny. It has been a long journey but the outcome has been better than I could have hoped for. I only wish I had known more about IVDD so I would have acted sooner to get him help.

    ReplyDelete
    Replies
    1. Hello,
      Many thanks for sharing your story and your experience. I am so glad to hear that your pup is recovering well and that you are such an active and integral part of this recovery process.
      I think that your story is very similar to many other patients I see. It can be a scary road full of ups and downs, but with time and TLC many of these patients do very very well.
      Very best of luck to you all,
      Krista

      Delete
  25. Hello, thank you for this wonderful and insightful blog. My 8 year old Rottweiler saw the vet last year for pain when laying down (yelping), stiffness and odd gait and vet did a physical and diagnosed with pinched nerve due to aging. She prescribed metacam and methacarbonol and he got better in a week. She warned me though that it could happen again, and that she had a patient who got it every year. What a coincidence now a year later my dog got it again. So we are back to the meds with added tramadol this time as he slept only 4 hours all day because he wouldn't put his neck down it hurt too much. I have some questions,: what exactly is the medical term "pinched nerve?" is it IVDD? does neck pinched nerves have a better prognosis than back pinched nerves? can it progress too back leg paralysis loss of bladder/bowel control or is that only for back pinched nerves? Also, can rolling over or shaking a toy trigger it? or is it just part of aging and happens no matter what? what can I do to prevent further episodes? Last but not least, said to give meds a week and restrict activity a week meaning no running, jumping, playing. She said a brief walk with harness is fine as it's better drain energy than have a dog bouncing off the walls. All other websites say instead 8 weeks rest and strict cage rest, but this is for IVDD and my dog has pinched nerve, not sure if it's the same...so I am confused. I trust my vet, but my understanding is not all vets know a lot about this condition. Sory so many questions, I love my dog so much and will do anything to help him!

    ReplyDelete
    Replies
    1. Hello,
      Yes, often we use IVDD and pinched nerve synonymously. Without an MRI it is very hard to distinguish the difference and in real cases they manifest the same way with the same clinical signs.
      Anything can trigger it. In people sneezing or bending over can trigger back pain or back injury.
      To prevent future episodes it is important to keep your pet at an ideal body weight, maintain excellent body and muscle mass, exercise regularly, and try to avoid jumping or high impact incidents (like jumping of the couch/bed, etc).
      Strict cage rest is essential for dogs with IVDD who have paralysis, or impaired lower limb function.
      Often my recommendations are a combination of my patients physical exam findings, their demeanor, activity level, owner ability and history. Cage rest is for the severe cases.
      very best of luck!

      Delete
    2. Hello,
      Yes, often we use IVDD and pinched nerve synonymously. Without an MRI it is very hard to distinguish the difference and in real cases they manifest the same way with the same clinical signs.
      Anything can trigger it. In people sneezing or bending over can trigger back pain or back injury.
      To prevent future episodes it is important to keep your pet at an ideal body weight, maintain excellent body and muscle mass, exercise regularly, and try to avoid jumping or high impact incidents (like jumping of the couch/bed, etc).
      Strict cage rest is essential for dogs with IVDD who have paralysis, or impaired lower limb function.
      Often my recommendations are a combination of my patients physical exam findings, their demeanor, activity level, owner ability and history. Cage rest is for the severe cases.
      very best of luck!

      Delete
  26. I am going through this struggle right now, crying my eyes out at the thought that we may have to put down my 13 year old Bichon mix Cleo.. 6 months ago out of the blue she started to shake and cry when her lower back was touched.. She also was having a hard time walking. We took her to the animal hospital er since it was late. They said she had a bulging disc and gave her prednisone, gabapentine and tramadol. I was thrilled when I saw she was improving... Fast forward to yesterday out of the blue she started shaking and her back legs gave out. This time it was worse. She couldn't stand at all and can barely sit . I rushed her to the vet and was told her condition worsened. Now her paws are knuckling.. The only good thing is she has sensation but other than that there is no use of the back legs. The Vet said that the neuro surgeon was the best answer at this point or to try the medications again. I cried knowing that we cannot afford the surgery and therefor will probably lose my best friend. It's not even an option since my husband was laid off answe are barely able to pay our mortgage. It's just not there the money. So I was up all night trying to get Cleo to urinate because her bladder is full. I've been cradling her back belly like a wheelbarrow so she can walk on her front legs. But she just stops and sits. I'm freaking out just so sad and feel hopeless. I know she's a senior dog and it may be her time, but I just can't not feel that if I had more money she would at least have a chance. At this point I'm trying to keep her pain free and get her to pee or I will go back to the vet.
    Thank you for letting me post.

    ReplyDelete
    Replies
    1. Hello Alexandra,
      I am sorry to hear about your dog and your struggles. I know it can be scary and overwhelming for pet parents, but I also know that animals are incredibly resilient and many will surprise you with their ability to heal and persevere with even the most debilitating of diseases and illnesses. I think that you need to keep providing medical therapy for pain, talk to your vet about learning how to palpate and express the bladder and provide a diet that will not require straining to defecate. After that time and TLC can do miracles.
      Please dont lose hope and please dont give up. Age is only a number and I have seen lots of older dogs recover from this.
      Best of luck

      Delete
    2. I would like to update you on Cleo.. You were right she did well on medication and while not 100% she is running and even walking up steps.. Amazing!!!! Thank you for your reassurance 😊

      Delete
    3. That is sooo wonderful!! Thank you for the update.. wishing you many more happy and healthy days!

      Delete
  27. My 8 year old labrador retriever has an appointment to see the neurologist in 12 hours. He went from exhibiting some signs of generalized pain (Saturday) to more pain Sunday, to a wobbly gait Sunday night, to an inability to bear weight on his hind legs (Monday morning), to hind leg paralysis with no proprioception and only some superficial pain and deep pain (Monday afternoon). We took him to the vet on Sunday who prescribed opiates and NSAIDs, but he obviously worsened throughout the day and overnight, so we took him to the ER Vet on Monday and had X-rays. The ER Vet indicated that she thought it is disc disease and he needs to see a neurologist ASAP. We made the first appointment we can get (9am Tuesday).

    I have three questions: If not disc disease, the ER Vet mentioned it could be FCE or possibly something else. Based on your experience, does this seem most likely to be disc disease? Our dog is clearly in pain.

    As time really seems to be a critical factor in recovery, how soon would our dog need to have surgery to have a reasonable shot at recovery? I am unfortunately not feeling very optimistic.

    Lastly, is MRI the only way to diagnose disc disease (as I mentioned we already did X-rays), or are there any more affordable options?

    ReplyDelete
    Replies
    1. Hello,
      I am sorry to hear about your dog. The neurologist can help identify IVDD vs another possible cause. In truth these are overwhelmingly IVDD cases, very few cases are from other causes. But the cause identification s key to the treatment options and prognosis so a neurologist is your best place to start. I would also say that most cases progress like this. They go downhill within days and are usually worst between day 3-6, perhaps even longer depending on which treatment option is chosen.
      MRI is the only way to diagnose IVDD vs FCE.
      Whatever you do stay optimistic!! These cases (the HUGE majority) resolve with time and TLC! And Keep your dog fit and trim!
      Best of luck

      Delete
    2. Hello and thank you for your rapid reply. Unfortunately, our lab (who was fit and not overweight, but a large dog) had progressed to complete paralysis and loss of feeling in his hind legs by the time we got to the neurologist (only about 24 hours after the initial onset of neurological symptoms). The neurologist said it was 50/50 whether he had IVDD or a tumor and this would only be determined by MRI. If a tumor, there would be nothing they could do. If IVDD, he would need surgery within hours, but that given the severity of the paralysis (including loss of superficial and deep pain) and the speed at which this had occurred, the prognosis would be poor. Less than 50% chance that he would ever walk again, and that would probably take 4 -8 weeks after surgery to get him up on his own at all. There was no option for any kind of medical management. We were forced to make the very painful decision to say goodbye to our wonderful dog. I wanted to share this story on your blog to help inform other dog owners. If your dog has any neurological symptoms, get them to a neurologist ASAP and before symptoms can progress.

      Delete
    3. I am so sorry for your loss. I wish you all the best in remembering the good days and hope that you find great comfort in knowing how lucky you were to have each other for so long.
      I also sincerely appreciate your sharing your experience with everyone here.
      All my love, and again deepest sympathies.
      Krista

      Delete
  28. Thank you so much for the encouragement. She is still chugging along, albeit a lot slower. We just take it day by day and try to keep her happy and comfortable.

    :)

    ReplyDelete
    Replies
    1. Thats all you can do.. have a little faith, lots of TLC, and time.. very best of luck!! Im rooting for you!

      Delete
  29. My 11 year old Chihuahua has had 3 spinal surgeries in the last 2 years. The first one she was in a lot of pain and held her head low and screamed frequently. She had the disk removed in her neck for around $6,000 with a neurologist. This was very costly for me and I had to take out a loan to pay it off. Exactly one year later all her symptoms returned. The neurologist took another MRI and said the adjacent disk in her neck was buldging and had to be removed, another $6,000 that I didn't have - another loan. She was perfectly well and pain free after her surgery, but then just 6 Months later her symptoms returned. This time the MRI showed a disk in her middle back was buldging and needed to be removed. The same neurologist said he would give me a break and charged me $5,500 for the surgery. After this surgery she was well and pain free with a little clumsiness on her one side from possible injury from the surgery, but she was pain free and felt back to her old self. Well, yesterday, 8 months since her third surgery the severe symptoms in her neck returned. She is in a lot of pain and can't move very much without screaming. I still have not paid off the 3 previous surgeries, and I don't know what to do.

    ReplyDelete
    Replies
    1. Hello,
      I am so sorry. I would call the neurologist back and be completely open and honest. If you cannot afford it dont do another surgery.
      Here is Dr Kelcourses advice that he gives on Pawbly (the fastest way to get a hold of me and get help,, btw).
      http://kmdvm.blogspot.com/2016/05/ivdd-dr-kelcourses-advice.html
      I strongly recommend you ask for help with pain management and consider strict cage rest. Most pets do very well with this option.
      Best wishes and lots of love!

      Delete
  30. My dog Beethoven went through surgery in February and is 100% recovered now. I worry that he may have the same issue again in a different disc in the future (as happened to so many dogs in this forum). Thus, I'm considering buying insurance for him. My question is: would a 2nd incident be covered by insurance or be considered pre-existing since he had it once? Anyone knows the answer? I welcome insurance recommendations as well. Thanks.

    ReplyDelete
    Replies
    1. Hello Renato,
      Every insurance company is set up differently. You should inquire and specifically ask when you call and query them. My advice is to call Trupanion AND start your Beethoven an emergency account.
      Very VERY best of luck.
      Please let me know what they say.
      Sincerely
      Krista

      Delete
    2. Thanks Krista, that's exactly what I did. In summary, they do not cover recurring related IVDD incidents. I've decided to buy insurance from Healthy Paws anyway as they have unlimited coverage for so many other conditions.
      I will share below the answers I got from insurers as I think it may be helpful to others here (keep in mind these are email exchanges and not any sort of official/legal statements).

      Petplan
      "Petplan is set up to cover signs or symptoms of any accident, illness, or injury as long as it is not preexisting to the policy. Any condition related to this particular disk would be excluded from coverage. Also, if it turns out that the previous disk injury is related to degenerative disk disease, anything related to this would not be coverable. If a completely unrelated injury occurs to a different disk, we may be set up to cover it."

      Healthy Paws
      "Conditions which show propensity to recur would not be eligible for coverage if there were signs or symptoms of the condition present prior to enrollment. Ruptured spinal discs are typically considered pre-existing, as IVDD can often predispose the pet to future spinal injuries. It is safe to assume that future ruptured discs would not be eligible for coverage. All of our claims decisions are based on the medical records and written opinion of your veterinarian, however, so an unrelated, acute spinal issue could be eligible for coverage if your veterinarian believes it to be new and separate from previous issues. Without the medical records, we cannot guarantee coverage for any particular condition. Medical records are reviewed at the time of your pet's first claim with us."

      Trupanion
      "Trupanion would be unable to cover future health costs if a different disc is involved. This holds true if there was any sign or evidence of the potential manifestation of it in any part of the spine prior to the Policy Enrollment Date or during any applicable waiting periods."

      Delete
  31. Does anyone know of vets who perform acupunture or alternative ways to surgery. Both of my beagles had ivdd surgery 6 weeks within each other. I am still paying for it. My girl beagle has had symptoms return in the cervical area...we are on the triad of meds. But id like to know anyone around southern indiana that performs alternative methods for this. Please please please. I cant afford another surgery for my baby girl. There is nothing wrong with her except her neck hurts.

    ReplyDelete
    Replies
    1. Hello,
      At the clinic I own we have a veterinarian on staff who does acupuncture. The clients who have utilized her overwhelmingly believe that it has helped significantly. A google search and some inquiries with your vet should provide some direction. There are also national veterinary acupuncture sites to use as guidance.
      Here is Dr Kelcourses advice on IVDD.
      http://kmdvm.blogspot.com/2016/05/ivdd-dr-kelcourses-advice.html
      Very best of luck.
      You can find immediate help from me on pawbly.com

      Delete
  32. This comment has been removed by a blog administrator.

    ReplyDelete
  33. Thank you for this blog Post. My pup has responded well to treatment but is relapsing as prednisone is being tapered. She is a champ though. I caught her running (with back end hopping side to side like a person on skis) after a squirrel.

    ReplyDelete
    Replies
    1. Hello Holly,
      Continued best wishes for a happy and healthy recovery. I hope that your pup has many more days chasing those elusive squirrels.
      Thank you for reading.

      Delete
  34. My 3 year old toy poodle is going through this now. She is on steroids gabapentin and muscle relaxers. She has no feeling in her hind legs and no bowel or bladder control. She is more comfortable. But now has diarrhea and a very inflamed bottom. I am constantly cleaning her up and her last pill came out whole in her stool. I don't know what to do. And my heart is broken.

    ReplyDelete
    Replies
    1. Hello,
      I dont know how far along you are in the healing process,BUT I always remind my clients that pets are incredibly resilient and capable of healing after the most devastating of injuries and diseases. Try to keep your chin up and dont give up until your pup does.. which I hardly ever see happen with this disease! Very best of luck and please find me on Pawbly.com for additional help or any questions. At minimum give your pup a few weeks of recovery time if you can. They do amazing things if given time and TLC.

      Delete
  35. I'll leave the best advice anyone is ever going through this can have. Read this website...http://dodgerslist.com

    It changed my world! I'm sorry but I was talked into a surgery once, and my dog had 3 additional episodes. So no, no one plans to pay for this type of thing. I also don't think it's fair for you to say people shouldn't have animals if they don't have enough funds available for one of the most expensive diseases. That's ridiculous and ignorant. Very few animals would have homes in that case.

    Im fortunate to have a wonderful and experienced neurologist who works through things with me. She understands 4 surgeries would be unrealistic and even one may be for most people. I guess I shouldn't have gotten an animal if I couldn't afford all the surgeries.

    Anyways, Savannah is doing great! She runs, plays, and frolics around regardless how much I frown upon it. But, she's happy and episode free for the last 6 months.

    I'll continue to work through every episode conservatively. I will be her strength, legs and best friend on every bad day. Because either she will be happy running in a wheelchair, or freely on her own will. I know my dogs happiness is all that matters. Dogs so not hold onto the past. Humans do. Humans care if they at one point could walk, or hear. Dogs live for the day. My dog is happy with me and if I have to push her down the street for walks, I will. You don't see people putting thier family members down when they can't use their legs. And my dog is my family.

    I know it seems impossible but, I promise it's managable. 3 years of learning everything I can and working through the the hard times. But every great day is well worth the select bad ones.

    ReplyDelete
  36. Hi there , my little dog has spinal surgery 9 days ago, he is a 6 year old dachund. He never had any symptoms really... And one day his back legs just seemed a little wobbly. After half hour he was lame on his back legs. We took him to the vets and he had a severe disk rupture. Anyway... Long story short we brought him home last night. I just really wanted to know what to expect over the next few weeks. He is dragging his legs either side he is cage rest and I'm only taking him out for toilet. Feel a bit helpless really.. And I'm so worried he won't gain the use of his legs again!! Lucky we have really good pet insurance X

    ReplyDelete
    Replies
    1. Hello,
      I think the best advice is to keep calm, be diligent in observation and dont hesitate to call your vet for help. In the first week I expect to see my patients almost daily. e dont want you to feel overwhelmed even though we know it seems to be. Here is a blog I wrote on just the subject you are asking about.
      Post op IVDD
      http://kmdvm.blogspot.com/2016/08/ivdd-days-immediately-following.html
      I hope this helps.
      You can do it!

      Delete
  37. Our 4 yr. old mix breed was diagnosed with a herniated disk on 9/21. He was doing the drunken walk, not eating. He did pass the test for knowing his back legs were still there.Vet started him on steroids and something for his tummy. We are on 6 wks. of crate rest. He is feeling better and eating. He still has the drunken walk, although not as bad. (I know we are only going into wk. 2 of this rest and heal period). Vet said he only has a 50/50 chance of a full recovery. Do you think surgery or acupuncture would help or he may still recover completely after 4 more weeks. Thank you.

    ReplyDelete
    Replies
    1. I forgot to mention that we bought a back brace online. Our Vet doesn't seem to think it will help. What do you think?

      Delete
  38. As long as it doesnt hurt I wouldnt be afraid to try it. Although I too would be skeptical.

    ReplyDelete
  39. Do you think he would benefit from acupuncture and when would be the time to try it. After the 6 weeks of rest?

    ReplyDelete
    Replies
    1. I think that trying acupuncture is a wonderful idea. very best of luck

      Delete
  40. I have a 11 year old Shih Tzu male. At the end of September he developed a very acute inflamation of his cornea due to his chronic dry eyes. I give him cyclosporin eye drops.but for some reason, it did not work through August and September. When he developed the acute eye problem, I sensed something else was wrong. Took him back to his vet who said he was in pain, back pain. Took xrays, nothing showed on them. He gave him tramadol. The tramadol seemed to help but he had days that were not good, some days were okay. I went back to the vet. He said that my dog was still in pain, prescribed a NSAID. My little dog is good on some days, not so good on other days. If I cut back on the tramadol, the pain becomes worse. I have limited his movement. I keep in sequestered in a small area of the bedroom. When I come home from work I let him out of the area but I carry him around the apartment, carry him outside. I do let him sit on the sofa with me (i do not let him jump on or off the sofa) and I do let him lie on the bed with me. He has never been diagnosed with IVDD but I assume that this is whats going on since it has lasted 6 weeks. My question, can I get results similiar to those with crate resting doing what I am doing?

    ReplyDelete
    Replies
    1. Hello Mark,
      I am sorry to hear of your dogs troubles. Have you gone to see a different vet to get a second opinion? Maybe they can help provide better and more effective treatment options? Or ask for a referral to a specialist. I dont expect the KCS to be related to the IVDD, but maybe an examination from another vet can help?
      I wish you both the very best of luck and a happy healthy recovery.
      Best Wishes

      Delete
  41. I have a 11 year old, almost 12 year male Shih Tzu. Around the end of September he started with a servere cornea inflamation caused by his chronic dry eyes. I give him cyclosporin drops twice a day, but for some reason, it didn't seem to work in August and September. I and the vet were focused entirely on taking care of the eyes although I did notice that he was not acting like his old self. I sinced something deeper was wrong. We got his on a better cyclosporin ointment. His vet also removed a little skin tag on his eyelid that was causing problems. I was still sensing something else was wrong. After the eye surgery, I started thinking he was be experiencing some pain. I thought it might be how he was handled during the surgery (One time after his teeth were cleaned I noticed his little body seemed sore). When I took him to get the suture removed a week later I mentioned to the vet that I thought something else was wrong. He gave him and examination and said he was experiencing back pain. He took and xray which showed nothing. He prescribed tramadol and we went home. The tramado seem to help somewhat. Saw glimpses of his "old self" He began to want to play again. But he also was still having bad days. I went back to the vet. He did another xray .the first actual did show calcium deposits so he did a close up of that area. This time it showed nothing. He did a neurological exam and he said he had no neurological impairment. He put him on a NSAID for two weeks. It has now been 6 weeks since this all began. Not much improvement. On the tramadol, he has times where he is doing well. I would think his pain is from mild to moderate. He never yelps. Some days his mobility is fair to good and on some days he does not want to move. I notice some tensing up and twenching of muscles in his back. I assume he may have IVDD. I have not crated him but I began limiting his movement quite a bit. During the day, I sequester him in part of the bed room. When I am at home I let him out but I carry him from room to room and carry in outside to go the bathroom. I do let him walk a few feet until he has releaved himself. I do let hims lay on the sofa with me (don't let hims jump on of off the sofa). And I do let him sleep on the pillow next to me at night. He doesn't move off the pillow. My question is, will I get some positive results from the restriction of motion that I am doing or is it comepletely necessary to crate rest. I know humans get better from a herniated disc with some movement, I would assume a dog could also??

    ReplyDelete
    Replies
    1. Hello,
      The crate rest is to keep your dog quiet and allow the body to heal. The concern with not crate resting is that one jump, slip, fall, or moment of weakness and all of the healing done thus far might come undone. If you are keeping him with you at all times, making sure he is safe and quiet he can be with you. He must always be supervised and you should never leave him alone or in any place he can fall, jump, or hurt himself.
      I hope this helps
      best wishes
      krista

      Delete
  42. My Italian Greyhound/Chihuahua/WhoKnowsWhatElse mix is going through her second IVDD episode in two years. This one is much worse than the first, which happened when she was three. We've decided to again go the conservative treatment route rather than surgery. In the past 3 days since we first noticed it coming on and crated her, she lost the ability to use her legs. I feared the worst. After a couple of days on Rimadyl and strict cage rest, I see her able to stand, if not walk. I am hopeful that she will regain the ability to walk again in some fashion--this time. Thank you for this blog post. It is helpful. Fingers crossed.

    ReplyDelete
    Replies
    1. Hello,
      I often see that these dogs worsen over the first few days (like 3-5). I hope that she recovers.
      very best of luck and warm wishes for a speedy recovery!

      Delete
  43. My frenchie Wilson, 3 years old, just experienced a traumatic IVDD. We were playing around and he jumped from the couch. Somehow he lost or caught his footing on the carpet and I found him unable to get up and he started yelping like I had never heard. What a horrible sound that I can still hear in my head. After a moment, he was able to stand and walk for a short distance, but his head was stooped a little low and obviously in pain, trembling. He did not exhibit additional signs/symptoms at any other time. We immediately took him to the vet emergency and the vet told us by x-ray that he had cervical narrowing between two of his cervical vertabraes (forgot which). He was given pain medications but the vet seemed to be concerned of his breathing, panting and tachypneic, in regard to the location of injury. His breathing is usually abnormal, specific to his breed, but definitely heightened. We left him at the vet overnight because of her concern over his respirations, but also for him to be comfortable with a Fentanyl drip and sedation. So my questions are:
    Prognostically, do you think he will be able to recover from crate rest or is surgery the more reliable route to healing?
    And how long do we need to wait before having to make this decision?

    Thanks and I hope to hear from you soon. I hope your Christmas was better than mine.

    -Tom

    ReplyDelete
    Replies
    1. Hello,
      My personal opinion is to not make a decision for two weeks. It can take about this long for them to heal enough to understand where they are and how long the recovery process might take. There are lots of pain options ask about them,, and ask about which can be increased, or used more frequently. I just published a whole series of videos on Hank a beagle with cervical IVDD. You can find them on my YouTube channel. Very best of luck,, and dont give up. I know it can be hard and difficult. But many do recover very well

      Delete
  44. Hello. I found your diary to be a very good read. My 6.5 year old Chocolate Lab, who is 105 pounds (not obese, just large) who is very hyper and active. Who also suffers from seperation anxiety. The past year, every time he would have a doggie playdate, take a long walk or even if he was laying down too long, he would begin to limp. His 2 back legs would hurt. We had his hips checked regularly and were told they are okay, but he is a big dog so hip dysplasia is common. On Tuesday 2/7/17 we found him unable to move his backside. We took him to an ER where he saw a neurologist. They performed basic tests and confirmed that he was paralyzed in both back legs, no sensation at all and unable to release bowels or urinate. They called it IVDD. They said they wouldnt know for certain the severity without an MRI which would cost $3,000. We agreed to the MRI and wanted to know the severity BEFORE we had to decide on a surgical or non surgical option. The vet said okay, i will be back as soon as the MRI is complete. She came back and she said it was late in the evening and she had to call the staff in and the surgical staff in (in case it was surgery he needed) and told us that we are either all IN for MRI and right to Surgery for $10,000 with a 25% chance he would walk again or we are all OUT and we euthinize him or spend $2,000 to let him stay overnight so that we could revisit our decision in the morning upping the cost to $12,000-$13,000. As I said he is a very large, hyper, active, anxious dog. We have twin toddlers who crawl on him all the time. We decided to euthinize him. We just thought that this new way of life would not suit him. He can't sit still, he can't stay away from the kids, he loves socializing with other dogs and people, he loves walks and running! I cannot help but think We made the wrong choice and gave up on him! I can't help but think that we should have figured out how to get him an MRI without having to commit to further treatments before knowing the results. You seem like such a compassionate vet. What would your advice be if you were his Doctor? How would you have handled it?

    ReplyDelete
    Replies
    1. Hello,
      thank you for taking the time to read and add your experience. I wish you and your pup the best!

      Delete
  45. I have a shiba inu who is 14 1/2 yrs old. I took her out potty about 3 weeks ago and she suddenly was unable to walk crying in pain. I rushed her to the vet who thought it was a slipped disk. She kept her for the day gave her a steroid shot and some other rxs. I brought her home giving her methocarbamol, carafate and prednisone. The first day home she had bloody urine so the vet added rimadyl which took care of that right away. It has been almost 3 weeks now and she has had a few bouts of diarrhea which is hard because pretty much she cannot stand on her back legs. The vet then added a 5 day metrondonizole. We though it was from all the rxs she was taking. She has actually squatted once or twice but mostly stays laying down. She can sit up as well. She still eats and drinks. I am having a terrible time knowing what to do. Some days she seems alot better than otbers. As alot of others I am unable to do a surgery because of financial reasons. I wish I could but its not possible. How long would you suggest I let her continue this way? I only ask because originally when I took her in she was paralyzed in the back end but still has the feeling and sometimes seems to be makibg one step forward but three steps back.

    ReplyDelete
    Replies
    1. Hello,
      I know these cases are hard and frustrating.. I will repost the advice i gave below;
      I hear and understand your frustration. I think that I can't give you the answers you need. I can't because I am not in your shoes and you are already struggling. Having someone take the burden and blame isn't going to make your dogs life better, nor yours, although it might sound like it initially. I can tell you that I have seen lots of miracles happen. Sometimes they are tiny and unrecognizable to anyone except the parent, and sometimes they are monumental and magnificent!
      I think that you should do a few things;
      1. reach out to supportive friends for a break. Try to get your mind off of the daily grind for a little while. Every over worked over stressed caregiver needs a break. Find someone to help you. Use Facebook, your vets FB page, Nextdoor, call rescues and shelters to find people in your shoes. I can tell you that at my clinic I could call four people to offer you a shoulder to lean on. They have been where you are. It helps to not feel alone.
      2. Have faith and be patient. Even with every road block and tripping stone.
      3. It is ok to be paralyzed. Don't wait for this to change. Adapt your life in case it doesnt and hope that it does.
      4. Learn how to manage your dog as she is, and get help in understanding what to look for if things get better OR worse. communication with your vet is vital and critical!.
      Don't beat yourself up about surgery. If you cannot afford it move on,, dont look back,, and dont beat yourself up,, it wont do anyone any good.. AND i have seen some cases with all the money in the world go bad,, in some cases the pet might have been better without the surgery.. there is never a guarantee.
      Don't worry about others, their progress or their outcome, you are you and your dog is yours.. life is full of too much stress already.
      And above all never lose heart... in too many cases it is all we ever have and all you ever need. If your dog is happy, regardless of the physical disability regale in the joy.. there are important life lessons to learn from our companions.. they don't give up if you give them a chance. I honestly believe this.. and it has served me well. It is why I write this blog and advocate for my patients. I dont give up on them

      Delete
  46. Hi Krista,
    In the last 5 months we have become IVDD experts (obviously not vet level!); our 2 frenchies each suffered a herniated disc both requiring surgery, both lower lumber, cant remember right now the each discs. Our has also been a tale of two outcomes. The dogs are mother and daughter, 4.5 and 3 years old.
    Mom had surgery Nov 4 after an insidious 3 day course from pain to more pain (meds from vet, no neuro sx), and then loss of motor on day 3, to vet teach hospital and surgery the next day. Never lost DPS, crate rest 6 weeks, no formal PT and she looks 100% today- no one would know.
    Of course we have always been careful with our dogs but when Mom got the diagnosis, we got pet insurance for baby and bought baby gates, ramps, etc.
    We came home from the store (gone 2 hours, Baby in her crate) in January, let Baby out of her crate, and she was screaming in pain- hadnt shown any symptoms prior. We went straight to the vet hospital (5 min away, distinguished teaching university) and the ER vet sent us home on crate rest with meds because no motor loss. I regret going home to this day. She cried all night despite pain meds, and lost rear motor over night. Back to the hospital in AM and surgery later that day.
    She didnt lose DPS before surgery but everything went to hell (pardon me). She awoke with no DPS either leg and spinal cord was swollen during operation. They asked to do another MRI suspecting myleomelacia and we agreed, radiologist and neuro both believed per the 2nd MRI it was very likely- however...there was additional herniated disc material from the same location. They wanted to do a 2nd surgery in case it was not in fact myleomelacia, but instead the additional herniation. We agreed. Out of surgery, No DPS still... so we waited for upward progression of motor function loss and probable euthenasia. But days went by and nothing happend. DPS in one foot 4 days after surgery. After 2.5 weeks we decided to take her home as apparently there are no answers in this field. The great mystery.
    So, she has been home for a month Krista, and she is just not improving. Incontinent- we express (well) but she leaks, She has been on antibiotics x2 rounds for a UTI that wont resolve. The neurologist confirmed DPS in her other leg about a week ago. She cant stand and although she has some motor in her right leg, it is stiff as a board, we flex and bend and work so much with it but it is rigid at rest. The left leg is atrophied and floppy, often getting tucked under her in odd positions. Recently (last 2 days) it is rotating towards the right leg, no pain, but appears almost hip related.
    I am very active on Dodgerslist and have sought out every opinion, research, etc. Dodgerslist is pro-wheels, pro life extension. This Baby dog is my baby, I raised her from birth, but I am losing heart.
    I know no one can tell me what to do and that neuro progress is slow, but I follow dog owners on instagram that have incontinent, post IVDD dogs (1,2, 3 years post op) and I feel broken hearted and sad.
    What is right for my dog?
    Are we doing this for us or her?
    When to give up?
    I am at the end of my rope.
    Thank you for listening.
    -Katie

    ReplyDelete
    Replies
    1. Hello Katie,
      I hear and understand your frustration. I think that I can't give you the answers you need. I can't because I am not in your shoes and you are already struggling. Having someone take the burden and blame isn't going to make your dogs life better, nor yours, although it might sound like it initially. I can tell you that I have seen lots of miracles happen. Sometimes they are tiny and unrecognizable to anyone except the parent, and sometimes they are monumental and magnificent!
      I think that you should do a few things;
      1. reach out to supportive friends for a break. Try to get your mind off of the daily grind for a little while. Every over worked over stressed caregiver needs a break. Find someone to help you. Use Facebook, your vets FB page, Nextdoor, call rescues and shelters to find people in your shoes. I can tell you that at my clinic I could call four people to offer you a shoulder to lean on. They have been where you are. It helps to not feel alone.
      2. Have faith and be patient. Even with every road block and tripping stone.
      3. It is ok to be paralyzed. Don't wait for this to change. Adapt your life in case it doesnt and hope that it does.
      4. Learn how to manage the bladder. It can be done. Get a culture and sensitivity done to get the current infection under control. You may need to be on medications for the bladder (even two or three) ask about them.. specifically bethanechol and/or prazosin.
      Don't worry about others, their progress or their outcome, you are you and your dog is yours.. life is full of too much stress already.
      And above all never lose heart... in too many cases it is all we ever have and all you ever need. If your dog is happy, regardless of the physical disability regale in the joy.. there are important life lessons to learn from our companions.. they don't give up if you give them a chance. I honestly believe this.. and it has served me well. It is why I write this blog and advocate for my patients. I dont give up on them

      Delete
    2. Thank you so much, Krista. She is at least free of a UTI x2 weeks. We are allowed to start her on hydrotherapy because of this, but there has not been improvement otherwise. I'm trying not to lose heart. I can say that we are enjoying our time with her and she with us.

      Delete
    3. Hello Kathleen.. I'm thinking you you and your pup.. very best of luck! We all have only today,, and we all must make the best of it.. hugs to all..

      Delete
  47. My story could almost mirror Kathleen's. Our little Maggie a little over 3 years old became very quiet the around Jan 5. I took her to our vet and he thought she had a pulled muscle. With 8days of rest and meds she worsened. On Jan 13, 2017 She needed surgery immediately as her back legs were very weak. We allowed the surgery and the very next day Maggie was standing and eating. She came home the second day after surgery. She continued to recover but her legs were slow in gaining footing. Two months to the date she became suddenly paralyzed. We rushed her back to the neurosurgeon. He admitted that he saw a narrow column that needed to be repaired but didn't want to go into that tiny space. Here we are now with a paralyzed Maggie. Our heart! She was completely helpless and in severe pain. We permitted yet another surgery. Maggie came home four days after this surgery. No change in her legs. She could not urinate and I had to express her bladder. She went to PT 3x week. She awoke one morning with a bloody diaper. It was diagnosed as a urinary tract infection. Five meds twice a day! I worked everyday with my girl. But Monday, April 4,2017 we awoke and my girl was extremely thirsty, shaking. I fed her and when I took her diaper off it was full of blood. She could barely stand. We had to let our precious sweet Maggie girl go. She made our home such a warm place. But I feel today that the #1 Pet Neurosurgeon in our area missed it and we lost our fur baby!

    ReplyDelete
  48. Hi Lisa,
    I am so very sorry- I want to say it's comfort to know I'm not the only one, but I wish that had never happened to you and your sweet Maggie. Our hearts have been hurting so much for so long. I am so sorry for your loss. We still have our Hera and she has been clear of a UTI for a couple of weeks. We are taking her to hydrotherapy next week but just grasping at straws. She is still paralyzed and incontinent. As horrible as that must have been for you, I am ashamed to admit that sometimes we have been waiting for a "turn for the worst" just so we aren't living in this limbo with her. I dread a UTI every day. I can't decide if it's selfish to keep her with us or selfish to put her to sleep. I wish you peace.

    ReplyDelete
  49. I'm glad I found this blog as it gives me some hope. Our Border Collie is nearly 12 and was diagnosed with arthritis to his rear right leg and then his front left elbow. He has managed well first with Previcox and additionally Tramadol. He unfortunately had a fall getting out of our stream, seemed ok to start with but then went off his rear legs. We rested him for a couple of days, no better so saw our vet. She said the only sure diagnosis was a CT scan or we could try conservative management. Having experienced his poor recovery from anaesthesia for X-rays I opted for the latter. She prescribed steroids which had to be held back for a week to allow the Previcox to escape his system. Literally overnight he regained his ability to walk and so we carried on for about 7 days when he started to vomitand pass stools with blood in them which then became diarrhoea. Back to the vet, she gave him Omeprazole and reduced his steroids. After a couple of days nothing changed so I stopped his steroids. For a few days he was still mobile but then his rear went again.

    We took him back to our vet and saw someone different, she was very thorough and recommended an ortho vet who could do a CT followed possibly by surgery, that was the route we took and he has had surgery for ivdd and is post-op 6 days. Firstly I want to repeat what the Ortho vet said repeatedly, if a dog has ivdd then he needs surgery asap, no ifs, no buts as this gives a much, much better chance of recovery. Murphy's CT showed a herniated disc, an atrophied spinal cord and some compression. He still responded to pain and reflex tests and he retained bladder and bowel control. The surgery went well, disc fragments removed but with difficulty given the length of time he had the problem, there was, as someone mentioned, a hardening of the disc material and this had to be scraped off rather than sucked out.

    What what has heartened me is that with 48 hours he was struggling to his feet, he could stagger a few steps too. Over the next few days my darling old dog (who was a rehome to us at 7) seems to be making really good progress with his Gabapentin, Metacam and antibiotics, wound has healed well and he is able to stand and walk for longer distances incrementally and using the sling to support him outside but independently inside. I am concerned that one rear leg appears quite floppy as it seems limp when I hold it. He is being passively exercised, I have a heat lamp on him occasionally and I massage his rear lots. As Krista points out, he doesn't appear to consider that he is limited in any way! We have to hold him back as he would just career off and then flop when he runs out of steam.

    So, I am optimistic. I didn't have insurance but fortunately we have the means to pay, it could have been rather different if we hadn't. I would now advise pet owners to really consider that if they want a pet then they should be sure they can afford any treatment needed, it's just so random whether they are going to be ill or injure themselves. I can understand why some of the contributors have chose euthanasia, watching your pet suffer is a terrible situation, I've also cried many tears over this dog and a previous Collie we rehomed who had to be euthanised at 14 as there was no more we could usefully try him with and he was suffering. I guess also that what a lot of owners experience is having other responsibilities too so taking on a pet, not matter how much you love animals, should be a serious consideration not a whim or because you really want a dog or cat, there is always an expense, be it decent food, care when you're away or the ever present possibility of illness or injury, sometimes the choice is hard but the pet should always come first.

    A question I'd like to ask, I've been reading about using sodium ascorbate for dogs who have been stressed through illness or injury or simply to help with arthritis, has anyone had good results? I've just started this with Murphy.

    ReplyDelete
    Replies
    1. Hello!
      Many thanks for adding your experience and thoughts. While I whole-heartedly agree that surgery done asap provides the best chance at a full recovery it comes with a hefty price tag that many cannot afford. I hope that this blog provides hope regardless of circumstance or financial ability. I hope people TRY to help their pets. I am sorry but I do not have any experience with sodium ascorbate. I will poke around and ask for you though.. you can also post this on Pawbly.com,, maybe someone there has experience?
      Best of luck to you both!
      Sincerely
      krista

      Delete