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Dr. Dave
Dr. Dave, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 4036
Experience:  20 years small animal general and emergency practice
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My 5 yr old Shih Tzu seemed to have injured himself and has

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My 5 yr old Shih Tzu seemed to have injured himself and has been diagnosed with a lumbar problem and is being treated with Pregnisone and Robaxin. Dog was normal when left for work and walking slowly with hunched back when returned home. The only thing he could have done to injure self was to try to jump into tub that was too high for him to jump in and out of and slipped and either hurt a shoulder or his back. It has been 2 weeks and he seems to now experience more pain in his front limbs at the joints. He responds well to steroids, but seems to revert back when not taken, as he is on one every other day. He walks with hunched back, sleeps alot, does not move around much or easily. It is difficult for him to get comfortable and seems to spasm in both front and hind legs even while lying down. He is eating when hungry and has normal bowel movements. He has had a blood test that has come back normal and he has been diagnosed by 2 vets to need rest and time and limited activity, but after 2 weeks, he does not seem any better. He seems Ok the days he is on steroids, and plays and moves around almosat normal, but then goes back to inactivity and seems very uncomfortable without the steriods. Would a torn shoulder or muscle in his front area mimic a back problem, or does this seem like back problem that needs time to heal. This dog is normally perfectly healthy and has had no other injuries to date. Can you please advise me on the next course of care to take
Submitted: 3 years ago.
Category: Dog Veterinary
Expert:  Dr. Dave replied 3 years ago.

Hello, and thanks for writing in. I'm sorry to hear that this is going on with Bear. It's hard to see our friends in pain and not able to get around well.
A shoulder injury could possibly cause what you are seeing, but I'm also concerned about a disc problem in the neck. A disc problem in the lower spine would only affect the hind legs, but if you are seeing problems in the front end at all, then I would be more suspicious of a neck problem (disc problem), since this is common in small dogs, and can possibly affect all four legs, and cause pain anywhere from the neck backwards. If the prednisone (steroid) and robaxin (muscle relaxant) are not taking complete care of the problem, I would recommend further diagnostics (i.e. myelogram, CT scan or MRI, consult with a veterinary surgeon), to see if there is more going on (herniated disc, fibrocartilagenous embolism, growth, etc.). I'm also concerned that Bear is not being treated with any type of pain reliever. Prednisone and other steroids are not used much anymore for back problems. More commonly now, drugs called Non-Steroidal Anti-Inflammatory Drugs are used, since they help with swelling and inflammation (like steroids), but they are also very effected for pain relief, which it sounds like Bear needs at this time! So, rest is very important, but at a minimum, I would ask your veterinarian to prescribe pain medication for Bear, and if he is not responding, he really needs further diagnostics to see if there is more that is needed for treatment. Also, sometimes surgery is needed to get the problem under control, especially if a disc problem in the neck is present. You can read more about cervical (neck) disc disease HERE.

 

I hope this is helpful. Please let me know if I can help further.

Dr. Dave

Customer: replied 3 years ago.
Thank you. I am asking everyone possible for advice. He was tested by 2 vets and his reflexes seemed normal. They would curl his paw over and it would return back. And they both checked his reflexes. I have been told by 2 vets that have watched him walk and move that all signs point to his back. He did not seem to be in pain to touch anywhere in his back, but I noticed on 2 occasions him pulling his front paw up as if he did not want to put pressure on it and just yesterday, he cried when I put pressure on the bottom of his pad while he was lying down. Also he seemed to experience pain in the joint where his shoulder meets his chest when I moved his leg. This is the first sign of pain and not just discomfort. I will now keep him confined to a crate and keep him medicated, but are their anti inflammatories that don't have the potential side effects as the Pregnisone. If he does not improve, what is the next test he should be given? He has had a blood test to rule out internal problems. We have not gone to x rays because it was thought that possibly nothing would show up, but what do you suggest for the next course of action for my little guy?
Expert:  Dr. Dave replied 3 years ago.

Thanks for your reply.

The Non-Steroidal Anti-Inflammatory Drugs (NSAID's) do not cause increased thirst, urination, and appetite, like the prednisone causes. They can all potentially cause stomach upset. You would not want to give NSAID's at the same time as prednisone - you would give one or the other. Personally, I would recommend giving an NSAID, a muscle relaxant (such as the Robaxin), and possibly an additional pain reliever (such as Tramadol or Gabapentin).

I would definitely recommend X-rays. It's true that the X-rays can be normal, and there can still be a neck or back problem, but I would start with that. If the X-rays are normal, and the medications are not helping, I would then recommend referral to a veterinary surgical specialist. This does not necessarily mean that he needs surgery! It's just that the specialists have the extra training and capabilities to diagnose the exact problem, and treat specifically. You can search for a specialist HERE.

 

Let me know if I can help further.

Dr. Dave

Customer: replied 3 years ago.

I was not able to locate any specialists by way of the link. Any chance you know of any in the Panhandle of Florida, Destin, preferably 32541 zip code or Pensacola, Fort Walton Beach, Panama City?

 

Now if he had an injury to his chest of tore something where he is trying to keep weight off his front paws, and hence hunching his back, can this be a possibility and would treatment for this injury be indeed the same of any for a back or neck problem?

Expert:  Dr. Dave replied 3 years ago.

Treatment for a muscle injury would be the same (NSAID's, muscle relaxants, possibly additional pain relievers, rest for a couple weeks).

 

To search for a surgeon, type in less information, and more surgeon's will be brought up. For example, just type in Florida for the state, and Small animal Gen. & Ortho. for the Area of Surgical Emphasis. Quite a few surgeons come up. You would just need to look through them for the one closest to you. If an adjoining state may be closer to you, you can also search for that state. Again, if you put in things like a zip code, or city, none may come up, so do more of a general search.

 

Dr. Dave

Dr. Dave, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 4036
Experience: 20 years small animal general and emergency practice
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