We have a 3 year old male, neutered mixed breed dog who weighs about 50 pounds. We currently live in Spain and since we moved here last summer he has progressively gotten weaker and more spastic in his rear legs. We have gone to several vets here, all of whom seem very competent, including two orthopaedists and two neurologists. Despite x-rays, a blood test, and an MRI there is no obvious cause to his symptoms. He can no longer jump onto anything higher than a few inches and is definitely in pain (he is now on Metcam - an analgesic / anti-inflammatory which helps). Any ideas for directions to search in would be appreciated. Thanks.
Type of Animal: mixed breed dog
Pet's Gender: Male
Pet's Age: 3 years
Name of Dog: Rocky
We have done little as far as treatment since we have not successfully diagnosed anything. He has undergone significant exams, xrays, blood tests, and an MRI. According to the vets here there is nothing explanatory in all of those tests. He is now on an analgesic / anti-inflammatory medicine for a couple of weeks with the equivalent of bed-rest (very few, short walks) to see if he improves.
Welcome to JustAnswer! I am a licensed veterinarian and would be glad to help!
Does he ever drag or scuff the back paws?
Does the metacam help?
Hello. No we have never seen him drag his back paws and his tail has seemed normal as well. We started the metacam this week and he seemed much better with it. Today, however it has not had much of an impact, but that might be because he is still recovering from the MRI he had yesterday
I just would like to be 100% clear - as some people confuse testing, are you referring to a true, $2,000 MRI when he is under anesthesia like they use in people?
yes, it was really an MRI and they are a LOT cheaper than that in Spain!
they were expecting to see a lesion on his spine - but it all looked normal
Did they do reflex testing?
yes - both neurologists who saw him did reflex testing and he was normal
Ok - great.
Assuming the testing was correct, what can we *assume* based on negative test results, meaning...what should have the test results ruled out if done correctly?
- Hip arthritis or dysplasia (x-rays)
- A spinal lesion (tumor, fracture, herniated disc)
- The history would also NOT support causes such as a FCE.
Did they do a CSF tap?
no they did not
Typically that is done AFTER the MRI.
If done before the MRI - an artifact will be seen...
So while they are under anesthesia, after the MRI, that is done.
Looking for infection or inflammation around the spinal cord.
Other causes such as a degenerative myelopathy, a progressive weakening of the back legs, can be difficult to diagnose, not seen with definitive results on testing.
If the metacam was just started and helping - great!
You may wish to see if that continues to help before more testing is performed.
yes, that is our plan. would you suggest any particular direction next? our strong suspicion is that there is something more serious going on then an injury which needs to heal - this has been progressing for 5 months or so now.
If the signs continue and there is no imaging finding, a CSF tap would be reasonable.
If not done already, and depending on the prevalence where you are, tick titers (bloodwork) would also be reasonable.
we did do blood work but unfortunately I can't tell you precisely what they were looking for. in the event it was negative.
Some would try steroids as well, but you can not mix steroids with Metacam, and would need to stop the metacam for approximately 1 week before starting steroids. (it would also be great to do the CSF before steroids are started)
is it reasonable to put rocky on antibiotics just in case there is some systemic illness involved?
one change in spain was that we took him for walks in the woods much more frequently than at home
Many do consider antibiotics (same reason as steroids, nice to have the CSF results) but yes - many do use them!
Doxycycline or Clindamycin would be common choices.
It's my understanding that tick borne diseases present differently and that it is hard to run one test to cover all (or most) possibilities. Do you know the most common that would occur in the Tahoe California area vs the Barcelona area?
The more common ones to consider for this include:
- Lyme- Ehrlichia- Rocky Mountain Spotted Fever- Anaplasma- Babesia- Bartonella
Ok, I'll pass that on to the vet here. Thanks for your review.
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