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Christina A.T.
Christina A.T., Dog Holistic Healthcare
Category: Dog
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Experience:  Dog holistic healthcare! 30 yrs in healthcare, behavior, rescue, and socializing.
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7 week old puppys rear legs were paralyzed within 6 hours

Customer Question

I have a problem with a pretty 7 week old fawn puppy, and I really could
use some help on this one.

Background: She has had a infection in her front left shoulder for several
days--the cause is really unknown--could have been from a puppy tooth
puncture during play, but even that is speculation. The problem went on for
about week, due to the fact that although she was limping on the leg, it was
somewhat masked during the previous Vet visits due to the fact that her
temperature was never elevated until yesterday. When X-rays failed to show
anything significant, the thinking was that it were a soft tissue injury and
that she had perhaps strained it during play. During her Vet visit at
about 3:00 PM yesterday, the Vet noticed a slightly swollen area on her
left should, and she had 103+ temperature. He then drew out some of the
fluid from the swollen area, confirmed his suspicions that the area was
infected. He put her under for about 30 minutes, using what he described
as "...just gas.." and cleaned up the infected area, and he then started
her on antibiotics. This Vet has 33 years experience, and has treated my
boxers the entire time he had been in practice. When I met him 35 years ago,
he had a boxer then, and has one today. Just prior to me bringing her home
at about 6:30 PM last evening, they gave her a shot of morphine for the
pain. On the way home, and after we arrived, she would lie quietly for
10-15 minutes, then let out a scream: my thoughts were that this behavior
was probably related to the anesthesia wearing off. This continued
throughout the early evening. At about 7:45, I noticed that as she moved
around in her very large bed, it appeared as though she had lost control of
and she was dragging her rear left leg. I picked up and held her, and as I
did, her screaming episodes came further a part. At about 8:45, I placed
her back in her bed, and at that time she did not appear to have control
over either of her rear legs, and she was dragging both as she moved: and
then her screaming became more frequent and it intensified.
I immediately took her back to the clinic and saw a different Vet. Her
temperature had elevated to 105+: they quickly mildly sedated her and hooked
up an IV and commence giving fluids and antibiotics. This AM her
temperature was normal and her front left leg is much better--she can put
some weight on it and she doesn't appear to be in much pain--however, she
still does not have any control of rear legs, and drags both as she attempts
to move.....any ideas--we have about exhausted all theories on this end.....



Optional Information:
Age: <1; Female; Breed: Boxer

Already Tried:
see question for details





Submitted: 8 years ago.
Category: Dog
Expert:  Christina A.T. replied 8 years ago.
Is she still at the animal hopital?

I'm wondering if it could be meningitis. http://www.vetinfo4dogs.com/dmeningitis.html Also, there is the possibility of an allergic reaction to the morphine.

Have the vets said anything about either one of these possibilities?

Customer: replied 8 years ago.
She is still in the Vet Clinic.
Meningitis has been ruled out--because other than the paralyzes, there are no other Meningitis related symptoms.
I am not certain to the mophine reaction--but I would hope so.
Ed
Customer: replied 8 years ago.
Reply to Christina A.T.'s Post: Yes she is still in the clinic.
Other than the paralyzes, there are no other meningitis symptoms.
I would hope the morphine reaction has been examined, but I don't not. Most of the indicated morphine actions don't appear to be similar to the symptoms that she displayed.
Expert:  Christina A.T. replied 8 years ago.
Is it possible that the morphine injection was put right into her spinal area or an Epidural, because this can cause rear leg paralysis? Also is she completely lacking in any feeling in her legs or feet?
Morphine: http://www.petplace.com/drug-library/morphine/page1.aspx

Have they mentioned anything about the common Boxer Dog hereditary condition Intervertebral Disk Disease?
http://www.petplace.com/dogs/intervertebral-disc-disease-thoracolumbar-area-in-dogs/page2.aspx

I strongly believe that your dog had a strong allergic adverse reaction to the combination of drugs administered. Please let me know if there is any improvement or not.
Expert:  Christina A.T. replied 8 years ago.
Did you have a chance to read the information that I posted for you? Do you have any further questions or concerns that you would like me to address?
Customer: replied 8 years ago.
I have received one email from you and in it you ask 3 questions in which my reply provided you the my answers, for which I certainly had hoped for some definitive answer(s) to my problem question. If you have forwarded another email, other than this one and the initial one, I have not received such.
Looking forward to you answer,
Ed Payne
Expert:  Christina A.T. replied 8 years ago.
Hi Ed,
They may have not posted as quickly as they should have. I will repost them right here for you.

It is possible that the morphine injection was put right into her spinal area or done as an Epidural, which would can cause rear leg paralysis. Also is she completely lacking in any feeling in her legs or feet?
Morphine: http://www.petplace.com/drug-library/morphine/page1.aspx

Have they mentioned anything about the common Boxer Dog hereditary condition Intervertebral Disk Disease? This condition can also cause paralysis. http://www.petplace.com/dogs/intervertebral-disc-disease-thoracolumbar-area-in-dogs/page2.aspx

I strongly believe that your dog had a strong allergic and adverse reaction to the combination of drugs administered. I've read that giving milk thistle can help to reverse such effects. Please let me know if there is any improvement or not.
Expert:  Christina A.T. replied 8 years ago.
Ed, I reposted the information for you. I hope that this helps you. Please let me know if you anything further you'd like me to address.
Customer: replied 8 years ago.
Thanks for your reply:
At 3:00 PM the only mobility problem that she was encountering was in her left leg that was being cause by the cyst in her left shoulder--that was subsequently removed a few minutes later--the other three legs were ok, thus a disc disease can be eliminatd.
She was put under with simple gas that she had been give twice before for x-rays, and the only drugs that were administered prior to the morphine shot was the antibotics for the infectious area, and a antibotic injection at approximately 4:00PM. The morphine was andninistered just before I picked her up at 6:30PM--so I am not certain what interaction/reaction could have come from the medications administered. After rr-readomg the side effects of morphine--to the contray, she became more intence--not sedated as the evening wore on.....As you can see we have expended a great deal of effort on exploring the possiblities--thus, the reason to seek outside assistance. Any other help, or idea....???    
Thanks,
Ed
Customer: replied 8 years ago.
I am not quite certain what your answer(s) really was and/or were, Christian--at this point I don't see that I am any closer to an answer than I was with my initial question posting....
Ed
Expert:  Christina A.T. replied 8 years ago.
Hi Ed,
I understand you have been doing a great amount of research and it is very possible I will not be able to tell you anything that you have not already figured out yourself. You may want to find out the exact name of the Gas that your vet used to sedate your puppy. Then you will be able to look at interactions of morphine, gas and antibiotics and their relation to puppy’s and/or Boxers in specific. Your puppy did receive three strong medications and may have had a severe adverse reaction just from her own personal sensitivities or a breed specific sensitivity. Also, there is the possibility of where exactly the injection was made and if it had caused any damage. The infection, if identified what kind (bacterial, fungal, etc) may also shed light on the various types of reactions that can take place. I’m sorry that I cannot give you a specific answer, which you and your puppy so deserve, but many of the keys to finding out this answer are held by your veterinarian and the information he has. If you can get more specific information, I may be able to tell you much more than the obvious. I hope that I have been able to help you at least a little.

http://www.dogaware.com/misc.html sited this information about ANESTHESIA
You may want to ask your vet what kind of anesthesia will be used, as the older drug Halothane is not considered as safe as Isoflurane and other newer anesthetics.
If you have a dog prone to seizures, talk to your vet about avoiding the use of phenothiazine tranquilizers (such as acepromazine) and ketamine.
Certain breeds are thought to have problems with certain drugs, including Belgian Shepherds, Greyhounds and other Sighthounds, Brachycephalic dogs (such as Pugs), and Mastiffs, Boxers and Bull Terriers (Acepromazine), so be sure your vet is aware of this before your dog has surgery. Note that Acepromazine and possibly morphine are among the drugs that Collies and related breeds (Australian Shepherds (including miniatures), English Sheepdogs, McNabs, Old English Sheepdogs, Shetland Sheepdogs, Longhaired Whippets and Silken Windhounds) may react to. The Handbook of Veterinary Drugs says "Giant breeds, as well as greyhounds, appear quite sensitive to the clinical effects of the drug [Acepromazine], yet terrier breeds appear more resistant. Boxer dogs, on the other hand, are predisposed to hypotensive and bradycardic effects of the drug."
See Your Pet is Going to be Anesthetized... for an excellent article on anesthesia issues. For more technical info, refer to the Veterinary Anesthesia Support Group.

http://www.jlhweb.net/BOSS/ace.htm sites this information about Acepromazine, a tranquilizer that is often used as a preanesthetic agent and the sensitivity to Boxers.
Customer: replied 8 years ago.
Reply to Christina A.T.'s Post: Again, I am not finding answers, only more of your questions....she was given morphine later on Wed evening at the Vet Clinic and no reaction--so thought is out...the gas didn't do it when they pup her under. The anitbiotics mixture has been ruled out....since she also received basicall the same durgs administered again during the late evening hours. The morphine shot was given into the muscle of her right lower hip...so the likelyhood of that causing the swelling of the spinal cord is remote....No noted disc problems--that would come on that quickly....any real answers in the making on this one....for it appears that that at this point I have provided more difinitive diagnosis that you......?????
Ed
Expert:  Christina A.T. replied 8 years ago.
Ed, I'm sorry I don't mean to upset you or antagonize you. I truly understand your concern for your puppy. But without be able to examine her, you must understand my disadvantage in diagnosing her. I have to say, once again that I think your puppy was allergic to the morphine. She showed signs of possible hallucinating (screaming) and also when a person or animal is allergic to morphine the drug does not actually alleviate pain it intensifies it. I think between the weakened immune system from the infection and all of the drugs that were administered in a short period of time may have damaged your puppies nervous system. Whether she will recover depends on how bad the damage is. Another possibility is that she was dropped or twisted when they were taking an xray.

My suggestion, or what I would do if she were my puppy, is take her to another vet (possibly one that specializes in Boxers or large breed dogs) and have her xrayed and fully examined. There is nothing else I will be able to tell you from here and there are no magical answers I can give you.
Customer: replied 8 years ago.
As I stated in a prior response, she was given morphine later Wed evening with no adverse effects--thus, that theory is out. And she was also administered the same antibiotic that evening as she was given immediately after the cyst was removed--so not hit there. The dropping has been explored and ruled out-- and the lack of any physical damage to her spine/rear luombar area has been verfied by x-rays; before I took her for a CT scan on Thursday morning, they took a sizable number of X-rays of her complete spine, rear legs/lumbar area, and of course, the front legs/shoulders had already been x-rayed as we chased the infectious cyst in her left shoulder over a several day period. Before the CT scan was performed, she was examined by an certified emergency room Vet during her check in and she was also examined by a board certified surgeon sometine during her 9 hour stay at that facility .....The Vet had a boxer when I met him 35 years ago, even before he had graduated from Vet school, and he has had boxers ever since, including the current one; and he has treated and cared for my boxers for the 33 years that he has been in business, thus, I would consider him well qualified and experienced with the boxer breed.
I don't mean to create an adversary role here, but I hope that you are realizing the amount of effort, and $$$s, that has been expended thus far on this little puppy, and again, this is my reason to contact this service looking for a experienced, outside opinion, or I wouldn't be drafting this reply.
Ed
Expert:  Christina A.T. replied 8 years ago.
Ed, I truly do understand what you are going through with your puppy and how expensive it gets without even having exact answers. I have been in this situation myself with a kitten I found with no feet. I look at your messages and can see the love and concern that you have for your puppy and I know that you have put numerous hours into looking for the answer. I apologize for any confusion that has been created. This is one of the problems with emails. One never truly understands the others tone and clarification of ideas and facts sometimes seems tedious. If we were to just sit down and talk about your puppy, it would be so much easier.

What you are expressing to me is that she had Morphine on Wednesday with no reaction, then she had morphine again on Friday (as stated in your original post). I still see the Morphine as a possible cause, but here is another possibility. It is possible that the cyst ruptured or leaked fluids into her body releasing foreign proteins into her body which triggered a major allergic reaction.
Expert:  Christina A.T. replied 8 years ago.
Ed,
I left one more post for you. I know that I have not told you anything new as of this point. I can't help but wonder what reasons your vets are giving you for this tragic turn of events. Has your puppy shown any signs of improvement throughout the day?
Expert:  Christina A.T. replied 8 years ago.
Ed you never responded when I asked you if you were aware of hereditary invertabral disk disease in boxers.

Have you or your vet considered that what your puppy may be experiencing is the presence of a peripheral neuropathy. Progressive axonopathy is a hereditary problem in boxers. It often manifests itself before the age of 6 months and will affect all limbs by 1 year of age. It presents with a decreased or absent of reflexes, proprioceptive (pertaining to the body's own sensations) loss, and a decrease in muscle tone and weakness which begins in the pelvic limbs and progresses to the thoracic limbs. Usually appearing in boxers beginning as early as 1-2 months. Here are links:
http://www.upei.ca/cidd/Diseases/nervous%20system%20disorders/peripheral%20neuropathies.htm
http://www.neurovet.org/Shelton1/shelton1tahfinalnew.htm
http://www.dcavm.org/dec99.htm

Let me know if that helps you.
Expert:  Christina A.T. replied 8 years ago.
Hi Ed,
How is your puppy doing today? Any signs of improvement? I have some more information for you that I believe will be useful and a good possibility of what is going on with her.
Please let me know if you have further questions.
~Christina

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Christina A.T.
Christina A.T.
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Dog holistic healthcare! 30 yrs in healthcare, behavior, rescue, and socializing.