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Rebecca
Rebecca, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 13574
Experience:  More than 30 years of companion animal practice.
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Can I ask about our dog's issues?

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Can I ask Rebecca about our dog's issues?
Customer: replied 1 month ago.
We have some questions about Max's current condition. He was laying down on his bed and then as he was getting up, he let out a loud shriek. Then he rushed to the corner and seemed very startled and in pain. He kept holding his left paw up and down, up and down. His back legs seemed slightly unstable as well. He was shivering and seemed to be extremely uncomfortable. We also noticed that the pain this time is more of a sharp pain because he yelps suddenly, instead of limping consistently. When he limped because of arthritis, he never yelped like this. Could this be because of the disc? From the radiology report I wrote previously? What exactly does "There is mild disc space narrowing involving C3-C4. " ?
Customer: replied 1 month ago.
Is there a risk of a pinched nerve?

Hello,
Thank you for using Just Answer. My name is***** am a veterinarian and will do my best to help.

Hello!

Yes, if the disc space in the neck (between C3 and C4, the third and fourth vertebrae in the neck; there are 7 total neck or cervical vertebrae) is mildy narrowed (meaning it is more narrow than normal, more narrow than the disc spaces next to that one), there could be a pinched nerve. The only way to know more would be to do an MRI.

Customer: replied 1 month ago.
Max has suspected atypical Cushings, but have never really been diagnosed since his liver enzymes are in the 700s but other than that, he shows no symptoms for Cushings. If he does have a pinched nerve, will giving a low dose of prednisone help? He is about 11.8 pounds and the prednisone dose is 2.5 mg tabs twice daily. Can prednisone twice daily for three days then once daily for three days and then every other day, so a total of one week, cause serious damage? Is this dose small? He is suspected of a pinched nerve so he is taking tramadol, prednisone, and methocarbamol.
Customer: replied 1 month ago.
We are worried about the prednisone because he already has high liver enzymes and he has taken prednisone when he was much younger for a long period of time, which we suspect has damaged his liver.
Customer: replied 1 month ago.
Can all these three medication and rest treat a pinch nerve?

Has he ever had a low dose dexamethasone test to confirm if he has Cushing's, or an ultrasound of his adrenal glands? If these don't give a definitive answer, there is a test done at the vet school in Tennessee that helps tell if a dog has atypical Cushing's.

I probably would not use prednisone if he has Cushing's disease.

If he has a pinched nerve I might try nonsteroid anti inflammatory medications, and/or gabapentin, and/or tramadol.

These three medications might treat a pinched nerve, and might not. Each case is different.

Customer: replied 1 month ago.
How can we treat a pinched nerve?

I said above: nonsteroid anti inflammatory medications, and/or gabapentin, and/or tramadol.

Along with rest and restricted exercise.

Customer: replied 1 month ago.
the nerves can heal on its own?

Nerves can heal, but very slowly. If there is permanent damage to a nerve, it might not heal.

Customer: replied 1 month ago.
What are the symptoms of permanent nerve damage?

If a nerve is permanently damage, it is not functioning, and you would see loss of what ever function that particular nerve has. If the nerve supplies muscles to a leg, the leg would be paralyzed. If there is pain, the nerve is still sending messages to the brain, or the pain would not be felt.

Customer: replied 1 month ago.
Ok so max can use all four legs fine but when he moves his neck in a certain way he shows extreme pain, lifts his left leg up and down repeatedly, trembles, and rear legs become unstable. But when the episode passes, he is able to move again. In this case, do you think the nerve damage is extreme or permanent? He is taking prednisone tramadol and methacarbomal.
Customer: replied 1 month ago.
He can pee and poop on his own.

It sounds like he is painful. If he feels pain, then the nerve is functioning and not permanently damaged.

This could be pain with the disc between the vertebrae; it might not even be the nerve itself. The pain may not even be in the same place as the radiology report.

Customer: replied 1 month ago.
Is treatment option only the prednisone tramadol and mehacarbomal?
Customer: replied 1 month ago.
disc damage is different from nerve damage?
Customer: replied 1 month ago.
He lets out a sudden shriek like a sharp pain
Customer: replied 1 month ago.
He also shakes his head kind of frequently. Maybe three or four times daily?
Customer: replied 1 month ago.
Maybe even more four or five times daily.

Other treatments might be: cold laser, therapeutic ultrasound, working with a pain specialist, injections of steroids, hyaluronic acid.

Not disc damage but inflammation of discs.

If he shrieks, it probably is sharp pain.

Shaking his head could be his neck, ears, allergies.

Customer: replied 1 month ago.
Is sharp pain related to nerves? If he shakes his head, could it be because he has pain in the neck? When the vet examined his neck, Max did shriek suddenly.
Customer: replied 1 month ago.
Or could head shaking be neurological?

Sharp pain could be a disc problem, nerve, internal pain, joint pain, any sharp pain. It could be pain in his neck.

Head shaking can be seen with neck pain.

Customer: replied 1 month ago.
just to clarify, if it is a pinch nerve in his neck, can strict crate confinement, methacarbomel, tramadol, predisone completely heal the issue? Or are there other things we could do?

If it is a pinched nerve, these medications may help, but the narrowed space seen on the Xrays won't change so this could be a recurrent problem.

You could have an MRI done and/or a consult with a neurologist.

Customer: replied 1 month ago.
What is the treatment for the narrowed disc?
Customer: replied 1 month ago.
tramadol, prednisone, and methacarbomel is not enought to treat narrowed disc?

It may be, or it may not be enough. For some dogs, just an nonsteroidal anti inflammatory medication is enough; for other dogs no medication is enough; they need surgery or other therapies (laser, acupuncture, etc.).

Customer: replied 1 month ago.
Our vet suspects a pinch nerve so we have been giving these three medications. At times he seems ok, but he has several instances maybe 3 or four times when he starts shivering and we can see he is in pain. Sometimes, while still on the meds he shrieks and starts trembling. Does it take time even with medication to heal?
Customer: replied 1 month ago.
Or with the three meds, should he have no pain at all?

These can help with pinched nerves.

Yes, it can take time to heal even with medication.

If he still has pain, I might try a different combinations of drugs, such as stopping the prednisone and trying a nonsteroidal anti inflammatory, and/or adding gabapentin (another pain drug).

Customer: replied 1 month ago.
We've been giving these three medicication for about three days now and he is still having pain episodes when he triggers his neck. Lots of trembling and sudden shrieks here and there. Does this mean the meds are not working? How long should we wait?
Customer: replied 1 month ago.
Just now we were giving him dinner and as he lowered his head it triggered again and he started trembling in pain.
Customer: replied 1 month ago.
Our vet says the three meds and rest will help but we have not taken an MRI. She says we don't need specialist. If we go to specialist, such as neurology, is the treatment different?

If you are not seeing improvement in 3 days, I would try something different: adding gabapentin, changing prednisone for a nonsteroidal anti inflammatory, going for acupuncture, etc.

A neurology specialist might start a different treatment or therapy, depending on what is found.

Customer: replied 1 month ago.
Is a non steroid anti inflammatory drug better than prednisone?
Customer: replied 1 month ago.
Max took prednisone low dose when he was about 3 years old for almost two years. Could he have become immune to the drug?

No, he would not become immune to it.

A nonsteroidal is differetn; not better. If what is being done now is not helping, I would try something different.

Customer: replied 1 month ago.
If it is a nerve pinch in the neck, how should we feed him? We just tried to give him dinner but as he was starting to eat he had another episode of shrieking then trembling. Should we raise the bowl?
Customer: replied 1 month ago.
After this question we will open another question if we have follow up questions.

It might be a good idea to feed him from a raised bowl, or to put the bowl on some books or a box.

Rebecca and other Dog Veterinary Specialists are ready to help you

Thank you for the great rating and bonus.

Hi,

I'm just following up on our conversation about Max. How is everything going?

Rebecca