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My pug is a 8 year old pug and she has been having problems

with her back legs and...
My pug is a 8 year old pug and she has been having problems with her back legs and she falls over when she is peeing and when she poops she is wobbling and she staggers over to er side. She can be sleeping and she poops where ever she is laying. Also when we are getting something to eat she poops between our legs so we end up stepping in it.
JA: I'm sorry to hear that. Could be a lot of things that cause lethargy. The Expert will know how to help your pug. What is the pug's name?
Customer: Sassy
JA: Is there anything else important you think the Veterinarian should know about Sassy?
Customer: She had a xray at the vets which showed a small area on her disc and he said a small amount of hip displaysa
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Answered in 5 minutes by:
9/15/2017
Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 17,287
Experience: Over 20 years of experience as a veterinarian.
Verified

Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help. Please give me a moment to review your concerns.

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Customer reply replied 2 months ago
OK
Customer reply replied 2 months ago
I just want a answer here online.

I am sorry to hear that Sassy has rear leg weakness and incoordination now seems unable to control passing stools too (fecal incontinence).

Does she seem painful at all?
If you pinch her toes on her rear feet does she feel it?
If you support her standing and flip her rear feet so the topside is down does she immediately right them?
It is important to find out whether she is weak and painful to move the way she used to or whether she has truly lost the ability to do so.
Since she has loss of fecal control she has loss of neurologic function. So in her case, especially if she isn't showing signs of pain I would focus on reasons for loss of neurologic function.
I understand that she has radiographic signs of hip arthritis. Sometimes it is simply too painful to jump or climb stairs. Symptoms can worsen suddenly if a piece of the arthritic changes in her hip breaks off and is free in the joint. But then she should be painful, and that should NOT cause fecal incontinence. So I don't believe that is behind what you are seeing.

If she is dragging her toes that can signify neurologic problems, such as an intervertebral disc(s) (cushions between the bony vertebrae) that are out of place or spinal arthritis putting pressure on the spinal cord or even a mass in or around the spinal cord.
Another possibility is a condition called FCE, fibrocatilagenous emboli, where a chunk of cartilage breaks off and lodges in the blood vessels that supply the spinal nerve roots. It is very painful initially as blood supply to tissue is blocked off. The pain only lasts a short time, less than a few hours to a day, but the weakness from the nerve damage it causes it can last for weeks or in rare cases is permanent.
Large breed dogs are prone to a disease process that affects the rear legs called lumbosacral stenosis (LSS). 
It can have many of the same symptoms as a FCE as it causes neurologic symptoms too. It is caused by weak spinal ligaments that allow the bones in the spinal column to move and place pressure on the spinal cord or it can be due to inflammation of the ligaments inside the spinal cord canal causing pressure on the spinal cord leading to loss of function, just like a FCE.
FCE are initially painful but after that it's just a matter of regaining function.
LSS can be painful on and off until the spinal column is stabilized and the pressure is taken off the spinal cord permanently.
Another possibility if she seems not painful is a condition called Constrictive Myelopathy, seen only in Pug dogs. This is a progressive degeneration of the spinal nerves that begins with incoordination of the rear legs then progresses to loss of urine and stool control (continence). This would be very unlikely with her if her symptoms came on very suddenly, but it sounds like this has been a progressive process. It appears to be secondary to a constriction of the spinal cord at the thoracolumbar junction (the area of the spin between the chest and lower back).

She really needs to see a veterinary neurologist for an examination as soon as possible. Repeat radiographs to look for another collapsed disc space or worsening of her arthritis of the spine and hips would be helpful. We need to know what the problem is to treat it successfully. An MRI of her spinal cord in the back of the body will probably be the most helpful given what you have told me so far.
Pain and inflammation in many of these conditions is controlled with nonsteroidal anti-inflammatories like Metacam, Deramaxx or Rimadyl as well as Tramadol and/or Gabapentin for pain if she isn't moving normally because she is painful.

You can use these with the omega 3's and glucosamines if arthritis or hip dysplasia is diagnosed. These nutraceuticals help improve cartilage and joint fluid health as well as reduce inflammation.
I recommend using a combination of a glucosamine/chondroitin product (examples are Dasuquin or Cosequin) and an omega 3 fatty acid (like 3V Caps or Derm Caps). I recommend an omega 3 fatty acid dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give her 20mg of EPA per pound of body weight per day. For example an 18 pound dog could take 360mg of EPA per day. Omega 3's and glucosamine/chondroitins work synergistically and improve cartilage health and joint fluid quality and quantity as well as reducing inflammation. They can take several weeks to see full improvement but some dogs do very well with them alone. They are available over the counter.
Another option is a product called Duralactin. This is an anti-inflammatory product derived from milk proteins and it also has omega 3 fatty acids incorporated into it which can be very helpful. See this link for further information: http://www.duralactin.com/products_canine.htm
But if she isn't just painful and has lost feeling in her rear feet/legs as well as the ability to move them then emergency surgery to relieve pressure on her spinal cord may be needed.
There is no treatment for myelopathy, unfortunately. An MRI of the spinal cord is needed for a diagnosis.
If she is not responding to cortisone or nonsteroidals then I think that more diagnostic testing should be done. An MRI of her spinal cord will help diagnose her disease process.
In the meantime try and keep your pup quiet. With spinal instability the more they do, especially jarring activities like running and stairs, the faster the condition can progress.

It can be helpful to increase fiber in their food so they can feel their stools building up. Getting her outside to pass stools more often may help lessen accidents in the house.
Please let me know if you have any further questions.

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Hello, I wanted to make sure that you didn't have any further questions for me, and I'd like to know how things are going for your pup Sassy. If you could give me an update that would be great, thank you, ***** *****

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Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Kara
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Customer reply replied 2 months ago
Hi, Just a update for my pug Sassy. Her legs are dragging in the back more. I have been giving her the Garbapentin. You had mentioned different things to try but I can't decide which one would be better. I have called different vets for Neurology and have been quotes a 225-285 for the intial exam and then the one that is giving me the amount will cheerfully say oh she will probably need a MRI and cheerfully will say oh and that will be 2800 do you want to make a appointment. Really! My husband and myself are disabled and she thinks I can come up with that money. It seems if I take her to the Neurologist it would be a waist because I couldn't pay for her MRI. We are leaning towards the wheelchair device . What are your thoughts on that and we will get the things you said to try

I'm sorry to hear that things aren't improving for Sassy despite adding Gabapentin.

To be fair to give you an accurate diagnosis an MRI would be necessary, and I'm sure that you would prefer to know that ahead of time before you spend over $200 for an exam.

If an MRI isn't financially feasible then even if this were something that MIGHT be helped with surgery then that too would be beyond your budget.

If this is Pug Dog constrictive myelopathy then she will worsen no matter what you do for her. And given what you have told me that would be the most likely cause of her symptoms. Even with all of the money in the world we couldn't change her outcome with that disease. Glucosamine and an omega 3 won't hurt her, and they are relatively inexpensive, but they won't help a dog with myelopathy.

I would strongly consider the wheelchair. At the end of the day keeping her mobile and happy within your budget is what is important.

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Customer reply replied 2 months ago
Thank you

You are very welcome, my best to your girl.

Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 17,287
Experience: Over 20 years of experience as a veterinarian.
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Dr. Kara
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