Help...Considering second surgery for Maggie..

[jessimag]

On August 5th we brought our dog into the house, she was walking around as she always does and everyone in the house was doing their own thing. All of a sudden we heard her in the living room crying out and whimppering. We found her on the floor sitting on her behind with her right leg sticking straight out. We couldn't get her to stand, so we rushed her to the Emergency Vet. We thought she had misplaced her leg.

While at the EV we noticed that although she was able to place weight on her right leg, she didn't really want to. They examined her and did x-rays, they found what they thought may be a pinched nerve or a problem with one of her disks on her lower back. They gave us Rimadyl to give her and asked that we take her home and watch her for two weeks to see if she progressed or worsened. The following day we kept her on crate rest and she was able to walk, although a little wobbly, on three of her legs...Then Friday August 7th she woke me up early in the morning and she sounded in pain. I noticed that she was beginning to lose control of her left leg. I took her to the vet that morning and the vet said that she needed immediate attention, either medical or surgical treatment...After talking with the vet and him mentioning that if surgical treatment was an option to get it done asap...I then rushed my pet 2hrs. away to a Neuro Surgeon. The surgeon suggested a Myelogram to make sure surgery was the best treatment, the Myelogram showed that she had a herniated disk and also internal bleeding. Shortly after she went in for surgery at about 4pm that Friday. The surgery was about 4 hrs. long, since there was a lot of cleaning the surgeon had to do, due to the internal bleeding. They called me that night and said it went well. I picked her up August 10th and have had her home since. She hasn't regained any mobility to her hind legs or tail, she also sticks out her right leg. On August 21st we began message and joint therapy.

Today I took her in for a re-check with the surgeon and he noticed that she has no pain sensation on her right leg or tail. He was concerned since the day of the surgery he says she still had pain sensation. He said that our options were to put her on Prednisone for a few days, incase the spine is swollen and she may regain pain sensation on her tail and right leg. If this doesn't work he said our other option is to do another Myelogram and if he finds that there's more bleeding, he can perform a second surgery to relieve any pressure currently on the spine. We have an appointment with him on Monday for another re-check. I'm struggling with the idea of her undergoing another Myelogram or surgery. Please advise.

[CarolC]

I would hesitate to do another myelogram or surgery. Myelograms are good for diagnosing the problem but if an MRI is available that is safer, a couple of pets here have developed seizures and died after myelograms. Surgery is never guaranteed to work, although it has the best chance when the dog still has deep pain sensation going into surgery like your dog did, or if it is done shortly after the dog loses deep pain sensation. Once you go beyond 72 hours without deep pain it is not likely to help. If your dog has been without deep pain sensation for a week or more, I would not expect surgery to fix that. Sometimes deep pain sensation does return weeks or even months after surgery. My own dog did not have deep pain sensation at the time of surgery but did have it 149 days (almost 5 months) later. There have been other dogs here who developed deep pain sensation even later.

It is still very early after surgery for your dog, I do not think you can really tell yet what will come back. It is wonderful when the dog is walking the day after surgery, but often that is not the case. It does not necessarily mean the dog won't walk, it is too soon to tell. The prednisone is worth a try, I would do that if it were my dog.

Is this a large dog? And have you had her on strict crate rest since the surgery?

[jessimag]

Thank you so much for your response CarolC. She is a medium sized dog, about 25lbs. Since surgery we've actually had her in a small fenced area, since I felt it may be too difficult to get her in and out of her crate and I was scared to injure her. We try and keep her lying down, but she pops up and wants to get out of the area. I think shes just frustrated of being in there all day. She's a very happy dog and I just want to do whats best for her. Today I almost considered doing the second Myelogram, but I had second thoughts. I'll have to ask the surgeon if a MRI is available. From reading some of the posts it does sound like time will only tell if she will regain any mobility. However, the surgeon also mentioned that the longer we wait to perform the surgery the more permanent damage that can be caused and the window for her to regain mobility from surgery gets smaller. What are your thoughts on this? Thank you again, These past few weeks have been a living nightmare. I am very glad that I found this website to communicate with others going through similar situations:)

[critters]

I'd get her on pred ASAP, for sure.

[CarolC]

http://www.dpca.org/BreedEd/invertebraldiskdisease.html

I have the impression from what you say that either they are not sure what day deep pain "became" absent, or that it has probably been a number of days since this occurred. I am not a vet, your vet will have a more nuanced knowledge of what is possible with surgery. Ask him if he has had success this many days after loss of deep pain. Ask him how long he thinks it has been since she lost deep pain, pin that down. I think you are already outside the window of time when success was likely, but maybe that is not absolute.

Testing deep pain can be difficult, interpreting whether the dog responds to deep pain testing can be subjective. Also, we have seen a lot of dogs here who appear to the owner to have failed surgeries because the owner was led to hope the dog would be walking the day after surgery (some do), however eventually after a period of rest and recovery the dog began to respond to physical therapy/hydrotherapy weeks later, for example. We have had other dogs who never responded to anything and remained paralyzed, but they stood up 10 months later, a year and a half later, 4 years later. Recovery continues, regeneration of nerves is very slow.

I probably am not making much sense here, but what I am trying to say is, I would really press the surgeon to tell you how likely it is that the surgery will help at this point, because it seems like it is pretty late to be doing surgery. I also kind of wonder what is left to "clean up" if he already spent 4 hours in surgery, and again cleaning something up at this point may not be too beneficial. I don't want you to decide not to and then your dog remains paralyzed and you feel that someone here told you it wouldn't work, I'm not qualified to say. I'd only recommend that you really get a commitment from the surgeon on the likelihood of success before you put the dog through anaesthesia and discomfort again, and spend a lot of money. The truth is, sometimes even an expert surgery doesn't work...it's an unfortunate fact regarding disk problems.

I would be doing the prednisone if it was my dog.

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