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A veterinary blog for pet lovers, vet voyeurs and the medically curious...
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Most of you already know about my Sophie Sue and the severe neck pain (due to intervertebral disc disease) that landed her at the specialist’s place last week. So many of you wished her well and sent hugs and smooches in her direction (for which I’m eternally grateful), but since then I’ve been remiss in reporting on her condition.
So here’s an update—with some basic facts on her disease tossed in for your learning pleasure. (Sorry for the repetition for those of you who’ve already tuned in to Sophie’s saga.)
First of all, let me say that Sophie’s doing extremely well. It’s no hyperbole to say that she’s like a new dog after her surgery. The first 24 hours were rough but it’s been smooth sailing ever since. Here’s a recap of the situation:
Sophie’s neck had been hurting since Thanksgiving. First it was a reluctance to jump and a reduced spring in her step that informed me of her discomfort. She never cried or whimpered as so many owners might expect to observe in the event of severe pain. Whenever I touched her neck (as if to massage it) I felt a marked tension in her muscles. Whenever I tried to move it she’d steel her muscles against the pressure.
Pain meds helped but didn’t fix her sluggishness and general malaise. X-rays revealed only a tiny bit of calcification (bony proliferation, as with arthritis) between a couple of the vertebrae in her neck, but this circumstantial evidence made it likely that this was the cause of her suffering: intervertebral disc disease.
With IVD (short for intervertebral disc disease), the disc (which acts as a cushion between the two vertebrae adjacent to it) has become diseased and the material inside it “slips” or “bulges” onto the sensitive nervous tissue of the spinal cord.
Dogs who suffer from IVD may simply shake (with pain) or refuse food. They may walk with a hunched back, as this can occur not only in the neck but between any vertebrae in the entire length of the spine. X-rays will often be inconclusive in diagnosing intervertebral disc disease, revealing no evidence of the calcification we saw in Sophie’s case (these changes take time to develop).
If the vertebrae affected are in the upper neck, all we typically see is pain, as in Sophie’s case. Lower down in the back, the discs will often push hard enough to actually cause paralysis, the manifestation of intervertebral disc disease most feared by knowledgeable Dachshund owners. These cases require emergency surgery but are often handled medically and with physical therapy due to the high cost of surgical intervention ($1500-$4500!).
Exercise restriction and pain relief is key for non-paralyzed dogs. But gentle massage and other therapeutic modalities (acupuncture, for example) can be helpful here, too. (Sophie had Reiki to help control her discomfort).
With neck pain, it’s often hard to decide whether to go for surgery to relieve the intense discomfort some dogs suffer. So many things can go wrong when working in this delicate area. We risk anesthetic reactions, reactions to the contrast material used in the myelogram (the X-ray procedure involving a spinal injection used to highlight the cord’s outlines), severe swelling of the spinal cord as a result of removing the offending disc material, etc.
But the end result has been worth all those risks, and not just because Sophie did so well. Truly, I had no idea how much pain she was in until I saw how gloriously happy and active she’s been ever since. From a post-surgical perspective, it’s clear that her pain must have been incredibly debilitating. From this free-and-clear vantage point, it seems unconscionable to have allowed her to continue to suffer.
Yet I can’t help thinking about the expense involved for most pet owners in serious IVD cases. Sophie had two blown discs. The surgery was a lengthy one. She required intensive post-surgical care for over 24 hours. Who can afford all that? After all, it comes to well over $4000 (at most hospitals) after all’s said and done.
As a vet, I get a discount from the vet surgeon (typically the only kind of vet qualified to undertake these procedures). Otherwise, it might not have been so easy to make the decision to take her to surgery (and God knows it took me long enough to push past my fears and get the deed done).
Enough musing and gnashing of teeth. The important thing for this mommy is that Sophie’s better. She’s looking for cats to chase and trotting all over the house, following me everywhere as she always did before her disc-related pain. Consequently, I’m a big believer in taking chronic pain sufferers to the OR rather than let them languish in intermittent discomfort for the rest of their lives—if you can afford it, that is.
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"The greatness of a nation can be judged by the way its animals are treated."
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- Mohandas Gandhi
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Dr. Khuly, you have echoed my sentiments almost verbatim on the short article I've written & going to print, about my experience dealing with IVDD and successful sugery for my Sealyham Pearl.
Yours is much better written, though.
I can tell you feel much better as well... =)
Of course, it's not always so good. We had a family member who went through the same thing and opted for surgery in the Bay area where it's much, much more expensive. His dog never recovered and didn't adjust to being a wheel chair dog very well.
mb
(and a bad typer - ARGH)
I find it annoying when people say that it's a matter of love and devotion, etc. and that no amount is too much. I don't love my pets any less because I won't jeopardize the REST of my family's needs and life to do everything possible medically for a pet. Some people just can't afford the extreme emergencies that come up rarely. And the answer, "Don't have a pet then," isn't an answer because what, the joys of pet ownership are only for people who are rich or have thousands of dollars to spare for this? I can provide for my cat's basic needs but I cannot afford thousands in surgeries, diagnostic tests and the like. Of course I would do so for my husband - but I can't justify that kind of cost for my pet - not when it would deeply impact our human lives.
There are those of us who are loving yet practical because we are conscious of our monetary limitations.
I'd never fault anyone for deciding not to do it. It's a personal decision and everyone's situation is different. Deciding to take a different route doesn't mean you don't love your dog.
1-Strict rest!
2-Regular meds (as directed)
3-Start saving your pennies--consider that surgery might be helpful if things don't improve in a few weeks.
Best to you and Monty--I feel your pain!
THANK YOU so much for the help~ sleepless in seattle
And yes! A boarded surgeon or neurologist is a must! (I assumed you had done that part already). Please note: Surgeons think their tissue handling expertise and constant experience in the OR makes them far better at these surgeries. Neurologists think surgeons have no business touching the spinal cord. I think it's all about TRUST. Getting an opinion from one of each and (if you must go to surgery) select the one that you feel most comfortable with or who your regular vet feels is most capable of helping you.
www.parkerandcompany.blogspot.com
This was a photo I took of him two days ago and didn't realise that he must of been in pain then. He rarely sleeps likes this and is doing so now as he seems to not want to sleep on his side. I am thinking a blow up inflatable collar might help? Any suggestions?
It all started with a few crys and yelps when landing after a jump or when out on hikes.... I assumed on most occasions there must be a foreign body in his paws and just kept checking them all.... then I decided it must be down to his mild patellar luxation and all the trees down from Hurricane Ike that we've been having to hurdle on our walks in the woods lately.
Today in said woods - Parker was lagging badly... then I noticed he would not life up his head. Just his eyes were looking up at me. I immediately picked him up and he was panting and making sounds like he was having difficutly breathing. He was REALLY clenching his neck and trembling feverishly with his jaws clamped shut. I got my hands in his mouth to check for an obstruction, when I noticed his toungue was turning BLUE! Not a good sign.....
We sat there for about 15 mins as I held him and regulated his breathingmassaging his throat. He was still in his crouching head down pose but his breathing was better- albeit panting. I then carried him the 1.5 miles back to the car (and he's a big 29lb Boston - not fat - just really muscular, people think he's a Frenchie all the time).
IVDD is the suspected diagnosis - and he's been ordered 4 week crate rest (I don't even OWN a crate) and meds: Rimadyl / Tramedol and Famotidine. I think the rest will kill ME more than him - and I'll still have to walk my other critter crazed mutt! I also have to go buy a harness to avoid any pressure to his collar/neck on the little walks I can take him on.
I hope surgery isn't needed (as I've been unemployed since May) but will happily pay for this treatment if necessary.... I just am confused as to if the 4 week rest/wait will make matters WORSE if indeed surgery is the only answer? He's really pathetic and sad right now - trying to fall asleep (he's pretty sedated still) in a sitting up position.... he really doesn't want to lie down.
Any additional advise would be really helpful - I was thinking would a "blow-up" collar be helpful to avoid the side-to-side / up-down head movements that hurt so much??