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Doctor Jeff
Doctor Jeff, Dog Veterinarian
Category: Dog
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Experience:  Small Animal General Practitioner and practice owner with 8+ years experience
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My miniature shih tzu izzy has a slipped disc. Number 13.

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My miniature shih tzu izzy has a slipped disc. Number 13.
We took her Into an emergency room vet who did an X-ray and put her on steroids

He said to let her walk if she wants. She only has use of her front legs though but he said that's okay any damage done is already done.
When we got home we went to our local vet who said she must stay still for 3 weeks in order to have a chance at walking again. He put her on ibuprofen and a muscle relaxer.
Now these are pretty much contradicting orders. Which vet would be more accurate ? Can we let her walk or not?
Today she is panting very hard and shaking and moaning. The issue only began two days ago but she seemed better earlier today than she does now. And we don't know what we should do as her family. Please help. Thank you
Hi, I am Dr. Jeff. I will try to help you. Please feel free to follow up if any more information is needed. NEVER use ibuprofen in a dog. It can have GI side effects at lower doses and kidney effects at higher doses. Further, when used in combination with steroid you increase the likelihood of causing a GI issue (ie ulcer).

If surgery is not an option for you, the steroids are the best route to take. Steroids provide the greatest chance to reduce the inflammation in the disc space relieving the pressure on the spinal chord (which will help with the neurologic signs) and spinal nerves (which will help with pain). As for rest, I do feel restricted activity is important, but you can let her move around a room that has good footing and no stairs. I am actually a believer in letting her move as this will slow the progression of muscle atrophy.

If the steroids are not helping, it may be worth discussing an increase in dose with your vet. Considering that at this point, srugery is not likely an option, so you have nothing to lose from the increased dose.
It is important to understand that with spinal injuries, making sure she is peeing is very important. Some spinal injuries will result in an increase in urethral sphincter tone. So, make sure she still has the ability to voluntarily pee. If not, she is at risk for going into kidney failure.

The fact that she is so young and was diagnosed by xrays (which is not firm), there is a small chance that she suffered a fibrocartilagenous embolism (FCE). This is a clotlike event to the spinal chord which results in the dog crying out in pain and dropping down in the rear. These dogs will often improve within a span of a month or so. While I do not think this is what is occurring with Izzy, it is possible. Steroid (although steroids are debated by the academics) and therapy are typically the best ways to get these dogs to bounce back.

So, I would not use the ibuprofen, and continue the steroids. If you are not seeing an improvement, I would consider a visit with a boarded veterinary surgeon. This surgery to relieve the pressure off of the spinal chord is very expensive, but it rewarding in most cases. Where surgery is not a good idea is when a dog has lost the mental recognition of pain (ie vocalization of pain when a toe is pinched, NOT just a withdrawal of the paw). These dogs have less than a 5% chance to benefit from spinal surgery.
There is no home remedy I can offer at this time. I have no issue with her moving around a small room with good footing.
I hope this helps and gives you direction.
Dr. Jeff
Hi Lisa,

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

Doctor Jeff
Customer: replied 3 years ago.
Well she can use her legs a little bit now but very wobbly and not for long. But she is able to go to the bathroom and she wags her tail. She gets excited and happy. But must be sad at her inability to be mobile like before. Should we encourage her to walk? Or encourage her to lay still? She has one more steroid to take and two more muscle relaxers. Then no more meds.
I have no problem encouraging movement as long as the foot is foot--no slick floors. Assuming surgery is not an option, it may be worth discussing extending the course of steroids with your vet as your may see a decline once they are discontinued.
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