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Doc Sara
Doc Sara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 952
Experience:  I am a dog and cat veterinarian with a lifetime of experience in our family veterinary hospital.
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My dog has been examined by multiple vets, MRI, brain scans,

Customer Question

My dog has been examined by multiple vets, MRI, brain scans, spinal tap, blood work, digital imaging, many exams and nobody knows what is wrong with him. He can not walk, started with back legs but front legs are going also. Where do I go now? He has been to a vet school and a surgical center in OKC, OK and his file has been sent to multiple experts. I've brought him home and do not know where to turn. Male Doberman, almost 10 yrs, 100 lbs. Thanks
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Doc Sara replied 1 year ago.
Hi there, I'm Dr. Sara. I'm a licensed veterinarian who works exclusively with dogs and cats. I also have a special interest in hospice and palliative care as well as end of life decisions. I am so sorry to hear about Max's troubles. I will do my best to help. He is truly blessed to have such a conscientious caregiver in his corner - you have done an amazing job of taking care of him and advocating for his quality of life so far. Does your veterinary team have any working diagnosis or presumptive diagnosis at this time? I'm not a neurologist or surgeon, but I would expect that they've ruled out intervertebral disc disease and likely spinal tumors as well from the MRI. The progressive nature from hind end forward makes me concerned for a progressive spinal cord degeneration or atrophy or the involvement of the central nervous system (the brain). There are plenty of neurodegenerative diseases in people that have been well characterized, however that's not the case with dogs. It's not that we don't see them - it's that we typically aren't able to fully characterize the nature of the problem because few owners are able to afford the diagnostics needed and even fewer would allow risky things like brain biopsies or autopsies to be performed after their pet has passed to learn what exactly caused the problem after the face. Have they done any nerve conduction studies? Based on the thorough nature of your work up so far, it may have been done. A nerve conduction test checks the connection between the nerves and the muscle tissue. Sometimes the problem isn't in the nerves, but in the muscle tissues' lack of ability to receive the nerve impulses. In that case a biopsy of muscle tissue would be required for diagnosis. I'm reaching here, though. It's worth discussing with your vet, but if it hasn't been done so far it could be that there's a reason they didn't feel it necessary.Unfortunately, many of the potential diseases that you'd be diagnosing here are going to be things that are not treatable. In such cases where the investment of large sums of money will only get you an answer, not a treatment, many owners do elect not to continue pursuing diagnostics.As I said before, you have done an amazing job of caring for Max and advocating for Max's quality of life. When all curative options have been exhausted, this is the time when Max will need you to continue being his biggest advocate and to protect his dignity and quality of life. With my patients, this is when I would transition to what I consider hospice care. In this situation, we are basically treating the pet's symptoms to mitigate their discomfort and anxiety. In many cases we can do this for a time, but at some point we will not be able to keep the pet comfortable enough to maintain a good quality of life. Admittedly, his size and hindered mobility will also be a huge challenge for you to physically and mentally surmount. Staying on top of his needs in terms of hygiene and prevention of bed sores alone is basically a full time job. I work with the type of owners who do this sort of full time hospice for their pets for as long as they feel that they need to, however it's definitely not easy or cheap. That sort of dedication is admirable, but not necessary to prove your love to him - he knows.There is a range of time in a pet's life where euthanasia is an acceptable option. There is a time before we enter this range where we would refuse to euthanize a pet, and there is a time near the end of that range when we regret waiting too long. You are in that range with Max. That doesn't mean that euthanasia is your only option, however it would be an acceptable and kind option if you were to choose it for Max. If you'd like, I can see if there is a hospice veterinarian in your area with whom you can discuss home hospice arrangements.Once again, I'm so sorry that you're going through this difficult time with Max. Please let me know what questions I can handle for you.~Dr. Sara----------------------------------------------------------------------------------------------------------------------------My goal is to provide you with the most complete and accurate “five star” answer. If my answer isn’t what you were expecting, it’s incomplete, or you have more questions please simply reply with your follow up questions. I would be happy to continue chatting. If my answer has been helpful to you, please show me by giving me a favorable rating. Thank you so much :)