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I have a dachshund who cannot walk on his back legs we went…

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Hi I have a...

Hi I have a dachshund who cannot walk on his back legs we went to vet and an X-ray shows some disc issues in L1-L2

Veterinarian's Assistant: I'm sorry to hear that. Have you looked to see if there is a wound on their foot?

He recommends a MRI to determine if surgery is an option but we can't get in until tomorrow for the mri i read on the internet that this is an emergency, but they are being casual about scheduling

Veterinarian's Assistant: What is the dog's name and age?

Frank, he is 10 10.5

Veterinarian's Assistant: What is the dog's name?

Frank

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

Just that he is an active dog and I am worried that surgery would cause him to be unhappy

Submitted: 8 months ago.Category: Dog Veterinary
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Answered in 1 minute by:
11/19/2017
Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 8 months ago
Dr. Meghan Denney
Dr. Meghan Denney, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 1,984
Experience: Veterinarian at Kingsland Blvd Animal Clinic
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Hi I am Dr. Denney. I am currently reviewing your post now. Please give me a few minutes to type my response. Thank you for trusting us with your question. This service is used for general information only and is no substitute for a veterinarian patient relationship by examination.

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 8 months ago

You are correct that this is an emergency. I usually try to get my patients like this seen as soon as possible by a surgeon to get evaluated by imaging (MRI) to see if they are good surgery candidates, but we are often limited by the facilities that have the MRI machines. Is there any other specialty centers near you that have one that is staffed now so we can get Frank seen sooner?

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 8 months ago

If he is a good surgery candidate he should have a good recovery and most dogs do really well after we get them through the that recovery period and go on to live happy lives.

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 8 months ago

Does Frank have superficial pain ? Or is he deep pain only?

If he has superficial pain then waiting until tomorrow is ok. If he only has deep pain or has no pain sensation then I would see about another specialty center with an MRI and see if they can get him in tonight.

That may be why your veterinarian thinks he should be ok until tomorrow ( if he has good pain reflexes that is a better prognosis and waiting a day or so can be ok)

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 8 months ago

Here is a break down going over treatment

Treatment

Once it is clear from the radiographs and neurologic examination that the patient has disk disease, the decision must be made as to whether or not surgery should be pursued. Spinal surgery is very expensive and requires a long recovery period but may be the best choice if the dog is to regain normal function. There are some general rules that are typically applied in making this decision:

  • If the dog cannot walk, surgery affords the best chance at recovery.
  • If the dog can walk, medical (non-surgical) treatment is a reasonable choice but this also depends on how much pain the patient is in, how long-standing signs are, and what sort of treatments have been unsuccessful in the past.
  • The longer the neurologic deficits have been going on, the poorer the results of treatment.
  • If the dog cannot walk but can still perceive pain in the limbs, there is an 83-90 percent success rate for recovery with surgery.
  • If the dog has been unable to walk, has no deep pain perception in the limbs but has only been down less than 48 hours, success with surgery drops to 50%. After 48 hours in this situation, prognosis is much worse and it may not be worth considering surgery.
  • If the dog cannot walk, medical management may still have success though surgery is definitely more likely to yield success.
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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 8 months ago

Here is more information on surgery and recovery time

Surgery

Spinal surgery is highly invasive, very expensive, and with potential for great outcome as well as poor outcome depending on the damage already sustained by the spinal cord. Patients are generally not candidates for surgery unless they cannot walk, have only been paralyzed for a few days at most, and, of course, have a disease (such as disk herniation) where there is pressure on the spinal cord that can be relieved surgically. There is frequently a great deal of nursing care following surgery along with physical therapy. Spinal surgery is generally performed on an emergency basis.

The first step will be localizing the area of the compression. A patient may have several areas of disk disease but the surgeon will need to know which one is the active one. This will require some kind of advanced imaging such as CT scanning, MRI imaging, or myelography. The patient commonly goes directly to surgery after imaging without being awakened from general anesthesia.

Several procedures can be used to decompress the spinal cord and remove the disk material. Several common procedures you may hear about are: hemilaminectomy, pediculectomy, dorsal laminectomy, ventral slot, and fenestration.

Hemilaminectomy
This is most commonly performed on disk herniations in the thoracolumbar area. In this surgery the articular facets (where the two vertebrae connect) are removed, as is the vertebral bone adjacent to the spinal cord. This procedure can safely be performed over up to five adjacent disk spaces.

Pediculectomy
Similar to hemilaminectomy except only the articular facets are preserved. This is best performed when the disk herniation is slightly off to the side rather than straight upward. This procedure is less invasive and less destabilizing to the vertebrae than is hemilaminectomy.

Dorsal Laminectomy
This is probably the most invasive of all the procedures and involves decompressing the spinal cord from the top rather than from the bottom. It can only be done over one disk space and involves removing the dorsal spinous process and lamina as shown below.

Ventral Slot
This procedure is reserved for neck disks. Here a slot is drilled in the vertebral bodies of the bones on either side of the disk creating a small window over the disk space. Mineralized disk material can be removed and, since the window includes adjacent bone, there is room for the swollen spinal cord to decompress.

Fenestration
This is a preventive procedure often performed on the disk spaces near the herniated space. It involves making a slit over the annulus fibrosus and removal of any mineralized nucleus pulposus. For some patients, this is the only surgery needed but it is not truly a decompressive surgery. Whether or not fenestration truly reduces the chance of recurrence of signs is a controversial subject.

Recovery after Surgery

The goal of surgery is to restore the pet's quality of life. In most cases this means return of the ability to walk. How long it takes the patient to walk again after surgery is highly dependent on how much dysfunction the dog had prior to surgery. Patients with voluntary motor control commonly recovery the ability to walk within 2 weeks while those with deep pain but no voluntary motor control might require up to 4 weeks. Nursing care for a dog that cannot walk can be intense, including expressing the patient's bladder, keeping the patient bedded, and performing physical therapy exercises. Check with your surgeon regarding the exercises listed above as to which might be recommended for your particular pet.

When the Pet is not Expected to Walk

More on Physical Therapy

Taking care of a dog that is down in back is a big project, and definitely not something that every dog owner is able to commit to. Still, it can be done and for the right dog and the right person, it is a highly rewarding experience. A great deal of progress can often be made using physical therapy exercises as described in the medical management section, plus there are a number of resources and products available to assist caring for an immobile pet.

Physical therapy for pets is a relatively new field and we are finding that rehabilitation exercises make a huge difference to patient comfort and ability in many situations. Physical therapy is an area that not all veterinarians are comfortable performing

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 8 months ago

I hope this helps clarify information and guide you on next steps and the terminology that comes with this condition because it can get confusing. Good luck with Frank.

If this was helpful I would be most appreciative if you could take the time to rate my assistance so the site will credit me with helping you

Without a rating (the stars at the top) the site will not compensate me for helping you.

I am also here for additional questions you may have just reach out to me here and I will be more than happy to assist you.

Kind regards,

Dr. Meghan Denney

This Content is not intended to be a substitute for a professional veterinary exam, diagnostics, diagnosis, or treatment. Always seek the advice of your attending veterinarian with any questions you may have regarding a medical condition of a pet.

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Dog Veterinarian: Dr. Meghan Denney, Dog Veterinarian replied 8 months ago

If you have a veterinary school near you or a few hours drive away they will have emergency services and can fast tract an MRI and the surgery if that is the option you decide to go with.

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