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My 15 year old Chihuahua developed a wobbly walk four weeks…

My 15 year old...

My 15 year old Chihuahua developed a wobbly walk four weeks ago. He has always had IVDD, but never too severe. I took him to my vet, who gave him a Vetalog injection. Several days later he developed paralysis in his front legs and could not get up/sit up from a laying down position. He does have deep pain sensation (and still dislikes me touching his paws). X-rays show spinal compression in his upper shoulder region. He has good bladder control and sphincter tone. He has now been on daily oral steroids for two weeks, and the vet is recommending we move to a half dose and see how his pain level is (he has not been painful at this point). My dog has recently begun to sit "side saddle" on his elbows. I've seen several vets (though I continue to use one regularly), who explain that the spinal nerve damage causes paralysis to the nerves in the spine beyond the point of damage, since the messages can't go beyond this point. ...But that is not what is happening with my dog, so I am confused. Can you help me understand why he still has good sensation in the back half of his body. Do you have thoughts on his prognosis? At 15, he has continued to be a high-energy little dog and has not slowed down until this happened.

Veterinarian's Assistant: I'll do all I can to help. Could be a lot of things that cause lethargy. The Veterinarian will know how to help your Chihuahua. What is the Chihuahua's name?

Peewee.

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Peewee?

He has never shown signs of paralysis. The IVDD flare up in the past has happened twice, lower down on his spine, which was painful. He responded great to the steroid injection both times this occurred.

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Answered in 27 minutes by:
6/3/2017
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 32,192
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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I'm sorry to hear of this with Peewee. Deficits and segmental reflexes help to localize the lesion and we expect to see upper motor neuron signs in forelimbs and hindlimbs when there's a lesion between cervical vertebra 1-5 and lower motor neuron signs in the forelimbs, but upper motor neuron signs in the hindlimbs when the lesion is between cervical vertebra 6 and thoracic vertebra 2 (upper shoulder region?). In general, "upper" refers to increased muscle tone while "lower" refers to decreased muscle tone. You might not see a change in nociception (deep pain perception) in the back half of his body with either situation but testing segmental reflexes might indicate that his back half of his body is, indeed, affected.

The most important prognostic indicator is the presence or absence of nociception (deep pain perception) in his legs. This assessment is always subjective but apparent loss of sensation suggests the possibility for permanent paralysis regardless of treatment. Approximately 50% of dogs in this condition recover with decompressive surgery.

Approximately 90-97% of dogs with intact nociception, even if they're paraplegic or tetraplegic recover fully or nearly fully with surgical decompression. However, the time frame for recovery is extremely variable - a few days to many weeks or months.

With nonsurgical treatment about 85% of ambulatory dogs and 50% of non-ambulatory (but retaining pain perception) dogs ultimately recover but recovery can be quite protracted - weeks to months.

Please respond with further questions or concerns if you wish.

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Customer reply replied 8 months ago
it is the C6-T2 region. It sounds like he has 50% chance of recovery, based on those statistics, since I am not doing surgery. I have two questions...Does age play a significant factor? And, when you use the word "recovery," does that mean a full recovery (walking on four legs)?

Thank you for the additional information. Yes, his advanced age is a significant strike against him. "Recovery" implies the use of all legs but paresis (weakness) and ataxia ("drunken sailor") may persist. Please continue our conversation if you wish.

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 32,192
Experience: University of California at Davis graduate veterinarian with 45 years of experience
Verified
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Customer reply replied 8 months ago
Along with the lower dose of steroids, my vet showed me a couple of massage techniques to promote good circulation. He also recommended that Peewee sit for 15 minutes in his full support dog cart, 2X daily, to vary his positioning throughout the day. He is eating his regular food - I haven't changed his diet. I will see my vet again in 2 weeks. Is there anything you might suggest I add to his recovery regimen, or ask my vet about?

Her vet's recommendations are sensible. For more in that regard, I would refer you to a facility that provides extensive physical therapy for these patients. These are generally found in major metropolitan areas. You can expect the following in addition to swim pool rehabilitation:

  • Passive rehabilitation: flex and extend the joints of the hindlimbs. These exercises should be done three to four times daily. 20 minutes per session.
  • Active rehabilitation: assist your pet in a standing position. When your pet gets tired and lies down, allow a short period of rest (30 seconds) and then get him/her back into a standing position. Thank you for your kind accept. I appreciate it. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.
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Hi,

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

Dr. Michael Salkin
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Dr. Michael Salkin
Dr. Michael Salkin
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