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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 14874
Experience:  Over 20 years of experience as a veterinarian.
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Our German Shepherd cannot stand without lots of effort -

Customer Question

Our German Shepherd cannot stand without lots of effort - otherwise she seems OK. No appetite loss, no moodiness...
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Kara replied 1 year ago.

Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am sorry to hear that your girl Piper has difficulty standing without great effort.

Has she ever had radiographs of her spine or hips?

If you pinch her toes on her feet does she feel it?
If you support her standing and flip her feet so the topside is down does she immediately right them?

It is important to find out whether she is too weak and painful to get up or whether she has lost the ability to do so.

Is she able to hold her eliminations and go consciously or has she has lost the ability to control her urine and stool (incontinence)? If she has loss of control she has loss of her eliminations it is likely that she has loss of neurologic function.

With her breed it is very possible that she is dysplastic. Sometimes it is simply too painful to get up. Symptoms can happen suddenly if a piece of the arthritic changes in her hip breaks off and is free in the joint.

But if she is dragging her toes as she tries to walk that can signify neurologic problems, such as an intervertebral disc(s) (cushions between the bony vertebrae) that are out of place or spinal arthritis putting pressure on the spinal cord or even a mass in or around the spinal cord compressing the spinal nerves.

Another possibility is a condition called FCE, fibrocatilagenous emboli, where a chunk of cartilage breaks off and lodges in the blood vessels that supply the spinal nerve roots. It is very painful initially as blood supply to tissue is blocked off. The pain only lasts a short time, less than a few hours to a day, but the weakness from the nerve damage it causes it can last for weeks or in rare cases is permanent.

Rotties and German Shepherds are prone to a disease process that primarily affects the rear legs called lumbosacral stenosis (LSS).
It can have many of the same symptoms as a FCE as it causes neurologic symptoms too. It is caused by weak spinal ligaments that allow the bones in the spinal column to move and place pressure on the spinal cord or it can be due to inflammation of the ligaments inside the spinal cord canal causing pressure on the spinal cord leading to loss of function, just like a FCE.

FCE are initially painful but after that it's just a matter of regaining function.
LSS can be painful on and off until the spinal column is stabilized and the pressure is taken off the spinal cord permanently.

Another possibility if she seems not painful is a condition called ascending myelopathy. This is a progressive degeneration of the spinal nerves that begins with incoordination of the rear legs then progresses to loss of urine and stool control (continence). This would be more likely with her if her symptoms came on slowly over time and slowly worsened rather than her symptoms coming on suddenly and not progressing much.

She really needs a veterinary examination as soon as possible. Radiographs to look for a collapsed disc space or arthritis of the spine and hip dysplasia would be helpful. We need to know what the problem is to treat it successfully.

If those look fine then an MRI of her spinal cord in the back of the body will be helpful.

Pain and inflammation in arthritic and inflammatory conditions is controlled with nonsteroidal anti-inflammatories like Deramaxx, Metacam, or Rimadyl as well as pain medications such as Tramadol and/or Gabapentin.
You can use these prescription medications with the omega 3's and glucosamines if arthritis or hip dysplasia is diagnosed. These nutraceuticals help improve cartilage and joint fluid health as well as reduce inflammation.

I recommend using a combination of a glucosamine/chondroitin product (examples are Dasuquin or Cosequin) and an omega 3 fatty acid (like 3V Caps or Derm Caps). I recommend an omega 3 fatty acid dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give her 20mg of EPA per pound of body weight per day. For example an 80 pound dog could take 1600mg of EPA per day. Omega 3's and glucosamine/chondroitins work synergistically and improve cartilage health and joint fluid quality and quantity as well as reducing inflammation. They can take several weeks to see full improvement but some dogs do very well with them alone. They are available over the counter.

Another option is a product called Duralactin. This is an anti-inflammatory product derived from milk proteins and it also has omega 3 fatty acids incorporated into it which can be very helpful. See this link for further information: http://www.duralactin.com/products_canine.html

There is no treatment for myelopathy, unfortunately. We can only truly diagnose that condition after death because it requires a biopsy of spinal cord tissue. We usually rule out everything else and with a history of little to no pain and a gradual onset then we assume it is myelopathy. There is a blood test that looks for genetic markers for myelopathy. If you want to test her for the disease there is a blood test available which is pretty accurate. Here is a link to a website which will give you information about how to get her tested:http://www.offa.org/dnatesting/dm.html

If she is not responding to cortisone or nonsteroidal anti-inflammatories then I think that more diagnostic testing should be done. An MRI of her spinal cord will help diagnose intervertebral disc disease or lumbosacral stenosis. Those conditions can be treated surgically.

In the meantime try and keep your pup quiet. With spinal instability the more they do, especially jarring activities like running and stairs, the faster the condition can progress.

Please let me know if you have any further questions.

Customer: replied 1 year ago.
It really seems to be one leg (left hind) that seems to be weak. I held her up and lifted her right leg and she was able to support herself on her left leg. I've also massaged with touched all around her bad leg and she does not seem to have pain. Is this an emergency situation, or can I wait until Monday?
Expert:  Dr. Kara replied 1 year ago.

Thank you for the further information. I think if her condition is stable, she is happy otherwise, and eating well as long as you can rest her and get her in and out to eliminate she can wait until Monday to see her regular veterinarian.

But if her symptoms seem to be rapidly worsening then having her seen on an emergency basis is best.