dog suddenly almost paralysed - need help!

[troy123]

hi the dog in question weighs around 25 kgs, approximately 8 or 9 years old. according to the vet he has spondylosis: http://en.wikipedia.org/wiki/Spondylosis
within a 2 day time frame, troy (his name) has lost control of its limbs and seems to be unable to support itself. walks clumsily, keeps falling. he was quite active before this, but suddenly just doesn't have the ability to control his limbs, or to have them support him anymore.
he cannot pee or have a crap, yesterday and today I m taking him to the vet to empty his bladder, through a urethra insertion, then squeezing. I have seen youtube clips of peope expressing their pets by squeezing the bladder with their hands, but I have tried and it is not easy. my worry is that I make it worse for him to bear by pressing unsuccessfully.
his front right leg at times seems stiff from the upper joint, then at times comes back to normal flexibility. the lower part (where humans would have the wrist) keeps folding unto itself, and when he walks he lands on the joint bone, as the paw involuntarily closes inwards...
his hind legs can support him for few moments, but in a weak manner. they were the first issue, then suddenly the front as well.
vet is giving him vitamins, steroids, anti inflammatory injections, both towards the hip and the neck area. says its a nerve issue, as regards the front leg.

today I m going to try get him x rayed. I have to be at the vet in around an hour to get his bladder emptied again. I m hoping that he gets better, but was also thinking of buying a dog cart / wheelchair for hi. however I m not sure if this will work, since one of his front legs does not very properly support him. as is, he cannot walk properly and we have to carry him anywhere he goes.

I only have this dog for two weeks, he was abandoned, but could walk fine. then suddenly this. I m also calling a physiotherapist on Monday.

I ve read that at times surgery is required, that it is 90% successful. but I live in malta, a very small island, and nobody here performs spinal surgery. anyway, I m not even sure if that s what he needs.

any help is appreciated, he looks depressed and I would like to hope that this is not permanent. any questions or details needed, please ask..

[Bobbie]

That sounds more like FCE, too (see a recent post about paralyzed in all four limbs) but there are other possibilities, including disk injury and infectious diseases. I don't know if your area has tick paralysis but I'd check all over for a tick just in case, remove if you find any tick(s).

Is he in any pain?

Does he act sick or just unable to walk?

[CarolC]

Does he have any neck pain or pain anywhere?

[troy123]

That sounds more like FCE, too (see a recent post about paralyzed in all four limbs) but there are other possibilities, including disk injury and infectious diseases. I don't know if your area has tick paralysis but I'd check all over for a tick just in case, remove if you find any tick(s).

Is he in any pain?

Does he act sick or just unable to walk?

thanks for your reply. I will check about FCE as well, don't think it s tick paralysis, but will read and inform myself about it too, just in case. he does not act sick, in fact has a good appetite.. he can even move his limbs, but the front right leg keeps folding in, sending him off balance, and his back ones are not strong enough to make it work. they can support him for brief moments, but he cannot make any steps.

Does he have any neck pain or pain anywhere?

he doesn't look in pain or show it, although I suspect that he may at the lower spine. before he was like this, he was walking down the stairs in a clumsy way, and once yelped as I pushed his backside down to make him sit. I think it hurts only when disturbed or badly handled, but he s definitely not in constant pain.

[troy123]

these are the medications he s on.
one of them is for the liver (honestly don't know which one, and still need to google these up as some came from the vet without box) since blood test showed it was slightly damaged. nothing serious though. vet says it s ok to keep medicating all together. hope this info may be useful]


morning:

flexible joints (Vetzyme)- oil mixed with food
1 cynepathic chiens -
1 neurobine - forte . (vitamin B)
1 buscopan (to pee )

lunch:

once a day conditioner 'Vetzyme' (more vitamin B)
1 cynepathic chiens
1 buscopan

evening:

2 teaspoons flexible joints oil with food.
1 cynepathic chiens before food.
1 norocarp right after food.

edit : now also taking 40mg onsior tablet daily, for the pain.

[troy123]

today things may have taken a change for the worse. as soon as I come home my girl told me she moved him a bit as he was falling off the cushion, and he screamed in pain. now seems less comfortable moving, and is almost paralysed, so far helping either lying down on the side or into a sphinx kind of posture.. before he was standing up, clumsily, then falling... now not even that.
yes, he s definitely in pain - not when he s lying undisturbed, but movement hurts him. some places are fragile and I m not too eager to unnecessarily move him about as yet.

went to another vet and got him some painkillers. to give one daily. also cancelled the x ray, which was today, as I cant put him in the car. hoping that he will feel better and less in pain when I do so. painkillers are onsior 40 mg tablets.

[CarolC]

When your daughter moved him, could she tell if the pain was in his lower back or in his neck? Is the paralysis in all 4 legs? If it is in all 4 legs, that indicates a possible neck problem. Neck problems can be intensely painful.

I am not familiar with the name of the pain medication listed but looked it up and it looks like a good NSAID for this condition.

http://www.ema.europa.eu/ema/index.jsp? ... 058008d7a8

Here is some information on pain in disk problems.

You can see that they recommend giving a tablet to protect the stomach when the dog is on an NSAID for a disk problem.

http://www.dodgerslist.com/literature/healingpain.htm

I hope the pain medication is making him more comfortable now.

[troy123]

thanks for your reply.
I asked about the source of the pain, but she coudnt tell me and was unsure about it.
yes, I susupect that it is painful right under the neck, and also towards the back of the spine... around 6 inches or even less away from the tail . as unbelievable or odd as it may sound, I have two other dogs and when he was still fine, they would both stop and sniff that exact location while he would sleep or rest. I know dogs always sniff the other s behind, but this I on the top of the back, and higher up. it s almost as if they knew beforehand that something was wrong with him

I will read the links that you sent , thanks.
he seems to be doing better and has better mobility. i just hope its not the painkillers numbing and making him overwork or stress himself, but he was even trying to play and looks a bit better. now he s sleeping. i would hate to have to put him down, and wont do so unless he gets oo depressed, or in too much pain. as things are, he has a healthy appetite and a very strong will to live. wags his tail and tries to get up when i put my socks on to go out..

d you guys reckon he needs surgery? if things were easy, or chances good, i would even pay for someone to fly over for him.. and see if i can arrange for him to work in my vet s clinic.. however i understand things may be complicated and easier to think of than to realize...
anyway, thanks a lot for your time and help.

.

[CarolC]

thanks for your reply.
I asked about the source of the pain, but she coudnt tell me and was unsure about it.
yes, I susupect that it is painful right under the neck, and also towards the back of the spine... around 6 inches or even less away from the tail . as unbelievable or odd as it may sound, I have two other dogs and when he was still fine, they would both stop and sniff that exact location while he would sleep or rest. I know dogs always sniff the other s behind, but this I on the top of the back, and higher up. it s almost as if they knew beforehand that something was wrong with him

That is interesting.

I will read the links that you sent , thanks.
he seems to be doing better and has better mobility. i just hope its not the painkillers numbing and making him overwork or stress himself, but he was even trying to play and looks a bit better. now he s sleeping. i would hate to have to put him down, and wont do so unless he gets oo depressed, or in too much pain. as things are, he has a healthy appetite and a very strong will to live. wags his tail and tries to get up when i put my socks on to go out..

You make a very good point. In fact this is something they warn dog owners about. When the dog is on anti-inflammatory medication, it does make them feel better and they are likely to be more active than they should and possibly aggravate the very problem you are trying to treat. That is why they recommend confining or crating a dog that is on medication for a spinal problem, and only let him out on a leash. (If he has a neck problem the leash should be attached to a chest harness instead of a neck collar.) Absolutely no going up and down stairs, no running or jumping, while he is healing. You want him to stay fairly still so the swelling in his spine can go down and hopefully he will become able to walk and toilet without problem again. After that, they say to continue the restrictions of no stairs (use ramps) and no jumping off of furniture, etc. permanently, so this does not happen again.

Here is a link about conservative treatment of a disk problem (that means treating it with rest and medication, as opposed to surgery).

http://www.dodgerslist.com/literature/conservative.htm

When my big dog went down, they put him on steroids for 2 weeks, checked his reflexes (to see if he would put his paws down flat like he should, or if he would turn them under), and he was better but not well so they put him on another 2 weeks of rest and medication. After that he was pretty good, though never as good as before the disk problem. It takes 6 weeks for a disk to heal assuming the dog is quiet and does not keep re-injuring it.

d you guys reckon he needs surgery? if things were easy, or chances good, i would even pay for someone to fly over for him.. and see if i can arrange for him to work in my vet s clinic.. however i understand things may be complicated and easier to think of than to realize...
anyway, thanks a lot for your time and help.

You are truly an rescue angel to take in this dog, and then to be so willing to do everything you can to help him. Again I am not a vet, but I would look at this case from different angles. He is 8 or 9 years old. That is not too old for surgery, but that is an age where you would want to do pre-screening of his liver, kidneys, heart, etc., and you would expect a slower recovery. Some dogs are old for their age, and some dogs are young for their age. But if he passes the pre-screening, then surgery would be an option. Next you need to look at the type of disk problem. Here is a general explanation of the types of IVDD.

Intervertebral Disc Disease

Intervertebral disc disease, the protrusion or extrusion of one or multiple discs between the vertebrae, is a common cause of weakness and back pain in dogs. Major trauma can cause an acute extrusion of disc material, but it is more likely to be secondary to an underlying degeneration of the disc. The two types of disk degeneration are chondroid degeneration (most common in Dachshunds, Pekingese, and Cocker Spaniels) and fibroid degeneration (most common in older, large-breed dogs).

Chondroid degeneration often results in an acute extrusion of disc material (type I extrusion), while fibroid degeneration results in a slower, more progressive extrusion (type II protrusion). The clinical signs are usually less severe and have a slower onset compared to type I extrusions.

Therapeutic exercises, electrical stimulation, massage, the underwater treadmill/swim tank, pain management, and acupuncture are frequently used for rehabilitating this condition.

Your dog does not sound like a chondroid breed, though I think there can be individual differences in dogs of any breed. It just seems more likely he has the slowly progressive condition that is described in larger, older dogs, and in fact your vet diagnosed spondylosis. If you can manage it by limiting his activity, and giving him anti-inflammatory medication, I would probably do that. However, if the problem is in his neck and if at some point you cannot get adequate pain control (because neck problems can be so painful) then you may have to look at surgery, and if it is painful enough then you may be looking at emergency surgery. I think you indicated that might not be available, so I guess it would be best to ask your vet what you should plan on doing if that happens...

If you think you want to investigate surgery further, the best way I know of would be to get him an appointment with a vet hospital that is equipped with a certified surgeon and an MRI or CT machine. You would give them permission to sedate him, they would do the MRI or CT, and based on that they would have your permission to take him straight into surgery if they determine it is needed. It's important to keep in mind that even surgery does not always work. I know you are not concerned about the financial aspect, but it is possible that after surgery is done, he will be more pain free but still not walking. He may require rehab or possibly long rehab, and may or may not walk again. Since he seems to have a neck problem in addition to a lumbar problem, he is not the best candidate for a wheelchair, as the dog really needs to be strong in front. There are 4-wheel wheelchairs, but I would consider that as either a last resort or as a temporary tool to use during recovery. Based on that...personally?...I think I would try the conservative treatment first and see if you can get him back to being reasonably pain-free and walking, and see if you can keep him that way with lifestyle modification as long as possible. He may always have some discomfort, like many humans who have sore backs or arthritis in old age, but if you can get him to a reasonable quality of life, then that's pretty good. Just my , I am not a vet.

I do not know whether to add this or not, because it seems a little farfetched, but I will anyway. When you said above that the other dogs were sniffing the spot, it reminded me that some dogs are trained to sniff tumors in humans. Nobody likes to think about cancer, but I guess it could be a possibility. You mentioned that you had planned to do x-rays for him but had to postpone them because you did not want to transport him, very understandable. If he improves maybe you can still do the x-rays. X-rays are not the best type of imaging to detect a disk problem because a disk is soft tissue, and x-rays show hard tissue like bone best. Sometimes if a disk has become flat, the vet can detect the disk problem on an x-ray by seeing that the space between 2 vertebrae is narrowed, and they would assume it is because the disk is flat. If there is bone cancer, that may also show because it will eat away the bone, however I think it would have to be pretty advanced and x-rayed at the right angle. My bunny developed a spinal tumor and the regular vet could not really tell from the x-ray. He sent the x-ray off to be read by a specialist at another location and got the diagnosis that way. (My rabbit was not in pain when he became paralyzed from the spinal tumor, however there are different kinds of tumors and I do not know if some spinal tumors might cause pain.) If you later decide to take him someplace for advanced imaging like an MRI or CT, you should probably discuss with them what you want done if they find a tumor. I think I would also mention the fact that your other dogs sniffed the spot on his back to your family vet. He may say it means nothing, but it does not hurt to mention it.

.

[troy123]

hi again , thank you so much for all the help. I have just spent the night up with this dog. pain sees to be getting worse. the knuckling in the video here is exactly how he steps on his front paw. http://www.dodgerslist.com/literature/conservative.htm
so I m suspecting that he may have a disc issue. the pain s getting worse. I would hate to put him down, but it s just not nice to see him suffer. the painkiller only seems to have a 6-8 hr effective time frame. it does not do miracles but makes him feel better, able to move around on his cushion, to get up for a few seconds to eat. however the rest of a 24 hr day is painful. since he has a liver issue I am worried that I may make things worse by giving him another pain killer as soon as the one wears off.
his liver count on the blood test was 265. I have also read on the link you provided that I should not use onsior on dogs with a liver condition. however it is the only thing that sees to make him feel better. it was also recommended by 2 vets on him...


he is getting his daily medication, but I do not see any difference, he s getting worse. I know these things take time... but now it is obvious that the dog is suffering. he spent like 3 days or more on a cushion, being helped to urinate or have a crap. I don't know what to do.
I do not wish to put him down if he can recover, and do not wish to give up on him. .. but this whole night I wash thinking about it. selfishness on my side could make him suffer a lot more. I m sleeping downstairs, on the floor right next to him, for 3 days.

an unrelated question, by loss of bladder control, does it mean that a dog is unable to urinate, or that he does so involuntarily?


he seemed to be doing better yesterday after physiotherapy. as I have no x ray yet the physio did not touch the spine, just worked on the limbs etc.. however he s so much worse today. I ve called another vet that I found out has an interest in orthopaedic cases. they told me to get the dog down to them, even if he s in acute pain. I can do so this evening, which was the earliest appointment I could make. however it is quite a drive. I m sure the minute I try to lift him / put him in the car, he s gonna yelp in pain.. and its gonna be nasty to carry him.. i m also not sure if thee guys at the clinic really care or just want to make money. wondering if I should put an end to his misery, get a vet home to do so.. feels so hard to make the right choices..


anyway, thanks for everything

[troy123]

feeling better now, breathing has slowed down.. having a deep sleep.

[CarolC]

I know that whatever decision you make, it will be done carefully with his best interest in mind. They say that a dog on crate rest for a spinal injury should not have physical therapy, only passive range of motion. It sounds like right now he would be better without therapy, just rest and as little movement as possible. If he is still eating, you might consider raising his bowl on a stand so he does not have to bend his neck to eat (if you think it would help him). There are many pain relievers and anti-inflammatories for dogs, including narcotic pain relievers that are very strong. My dog was on a morphine derivative following her spinal surgery. Possibly the vet could give him something stronger for a few days, or even an injection if you take him in, but I agree transporting might make things worse. Perhaps you could call the vet, explain that the pain medication is not adequate, and that you need something that lasts longer, he is having breakthrough pain and the medication that is supposed to last all day is only lasting 6-8 hours. The vet has many other options for medications if the one he has now is not adequate. If it were my dog, I would want him on prednisone.

Loss of bladder control can mean both things, because there are 2 types of incontinence. If the spinal injury is in the lower back or tail area, the dog may dribble urine and urinate involuntarily. If the spinal injury is up in the chest or neck area the dog is more likely to retain urine, and is unable to urinate. He will not urinate until the bladder overfills and overflows, and when that happens he will not necessarily empty the bladder. Expressing the bladder is very important for both conditions, but especially for the dog who retains urine, as you do not want the bladder to stretch, and when urine remains in the bladder it can create an environment where germs can grow and cause an infection.

I know you are doing your absolute utmost to help him. I hope he does better today. The fact that he is still eating seems like a good sign. This is a very helpful link.

http://www.dodgerslist.com/literature/cervical.htm

[troy123]

hi, thank you for your reply.
today, since the morning, he s been looking better. I gave him another painkiller, and thought it was a good opportunity to finally take him in the car for an x ray.
I was surprised that it was easier than I thought. the neck is the source of pain, and when I hold from the rib cage, if I m careful, he s fine. also I know that it hurts him more to move the neck to the right, than to the left.
the x ray does not show the discs between the vertebrae, but the spacing. lower back seems fine, however the two vertebrae at the lower part of neck seem to be touching. apparently it is a disc that can no longer cushion the two bones..as in the clip that you sent to me in the link. I suspected this already, since his knuckling and weak back legs are very similar to the clip. so thanks a lot for that.

bad news, but at least I know what he has, and with my limited resources, what to work on.keeping him on neurorubine forte and onsior (40mg). I also got some codeine pills for the night, only to use if he gets really bad, since I was told they may also constipate. it has been over 7 hrs since his painkiller, and he s actually looking better. I m anxious to see if this will hold, perhaps it s a better day.

let me know if you still think he should be on prednisone, and I will talk to my vet again. I will also give feedback on how strong the pain is, since I understand that this may depend on how troy is doing.

I spoke to the vet about Pepcid ac, and he told me that for now there is no need for a stomach protector. I will mention that again to him though. wish to know if it may have any adverse effects if used (Pepcid ac) or if it would harm the liver... if not, I think it may be a good precaution.

I was using a cherry seed cushion, putting it in a microwave, wrapping it in a towel and placing it on his neck where it hurts... however I will try get the snuggle safe on the link you sent.. apparently it lasts longer. he is also most times in front of a gas heater, kept pretty warm.

I will also look into laser treatment, not sure if anyone here does it, but definitely something to check about.

I have already built him a wheel chair, almost finished, for when (and if) he gets a little better... like this one, more or less - http://www.youtube.com/watch?v=BJa2UFw82kk

the vet told me that he may, or may not get better. if he does, it will still hurt and hinder him a bit, but he may walk again. for me this would be great, as I believe that he could still lead a happy life with minor neck problems.

however if not, then he recommends that we put him down.

I am still getting the physiotherapist to see him. everyone I spoke to spoke highly of her, and I trust she knows her stuff. however I also wished to ask whether you think it may be a better idea to do without her, as it may at times do more harm (?).

I will read the link again, and keep you posted on any progress. have not yet figured out whether I can attach pics on this post, could show the x ray, also the dog..

once again, thanks.

[CarolC]

hi, thank you for your reply.
today, since the morning, he s been looking better. I gave him another painkiller, and thought it was a good opportunity to finally take him in the car for an x ray.
I was surprised that it was easier than I thought. the neck is the source of pain, and when I hold from the rib cage, if I m careful, he s fine. also I know that it hurts him more to move the neck to the right, than to the left.
the x ray does not show the discs between the vertebrae, but the spacing. lower back seems fine, however the two vertebrae at the lower part of neck seem to be touching. apparently it is a disc that can no longer cushion the two bones..as in the clip that you sent to me in the link. I suspected this already, since his knuckling and weak back legs are very similar to the clip. so thanks a lot for that.

I'm glad that went well.

bad news, but at least I know what he has, and with my limited resources, what to work on.keeping him on neurorubine forte and onsior (40mg). I also got some codeine pills for the night, only to use if he gets really bad, since I was told they may also constipate. it has been over 7 hrs since his painkiller, and he s actually looking better. I m anxious to see if this will hold, perhaps it s a better day.

I hope so. And I hope you will both be able to get some sleep tonight.

let me know if you still think he should be on prednisone, and I will talk to my vet again. I will also give feedback on how strong the pain is, since I understand that this may depend on how troy is doing.

My dog was on prednisone and it is pretty standard here, but different vets have different preferences. Steroids are more powerful anti-inflammatories than NSAIDs, but both have side effects (please see the following link). As far as I know, if your dog is using an NSAID and you want to start prednisone, you need to wait a few days until the NSAID is out of the system, but I am not a vet and your vet would have more knowledge on this. The problem is that when both an NSAID and prednisone are in the system, it increases the risk of gastric bleeding.

http://www.dodgerslist.com/literature/h ... weling.htm

I spoke to the vet about Pepcid ac, and he told me that for now there is no need for a stomach protector. I will mention that again to him though. wish to know if it may have any adverse effects if used (Pepcid ac) or if it would harm the liver... if not, I think it may be a good precaution.

The information in my veterinary drug book (Plumb's Veterinary Drug Handbook 7th ed) on Famotidine (Pepcid) says:

Caution: Patients with cardiac disease, significantly impaired hepatic or renal function; (consider dosage reduction)

The problem with steroids or NSAIDS is they can cause gastric upset or even ulceration (bleeding) which can be serious. If you notice any bloody or black stools that look like tar or diarrhea, I would tell the vet right away. There was a dog here who required surgery for GI ulceration caused by medication.

I was using a cherry seed cushion, putting it in a microwave, wrapping it in a towel and placing it on his neck where it hurts... however I will try get the snuggle safe on the link you sent.. apparently it lasts longer. he is also most times in front of a gas heater, kept pretty warm.

The Snuggle Safe is something he would be able to lie on or lie against, but it is a hard somewhat heavy plastic disk that you would not be able to lay on his neck. Your idea of the microwave cushion wrapped in a towel may be superior. It sounds wonderful.

I will also look into laser treatment, not sure if anyone here does it, but definitely something to check about.

I have already built him a wheel chair, almost finished, for when (and if) he gets a little better... like this one, more or less - http://www.youtube.com/watch?v=BJa2UFw82kk

That is super! It does not have any straps across the neck. He is one lucky dog. He will probably have to wait to use it until he is feeling better, so he can rest and not strain his neck in any way, but that looks great.

the vet told me that he may, or may not get better. if he does, it will still hurt and hinder him a bit, but he may walk again. for me this would be great, as I believe that he could still lead a happy life with minor neck problems.

however if not, then he recommends that we put him down.

I am still getting the physiotherapist to see him. everyone I spoke to spoke highly of her, and I trust she knows her stuff. however I also wished to ask whether you think it may be a better idea to do without her, as it may at times do more harm (?).

I am a huge believer in physiotherapy, but right now I would be scared to do it. I feel sure he needs to rest for a few weeks, and not do anything to make his neck worse. It is hard to know if the PT earlier this week made him worse. You mentioned he was worse the next day, but it is hard to know it that is because of the PT or not. Personally, I would not take a chance... Perhaps he could have PT later when he is past this rough patch.

Dogs on conservative treatment crate rest who are not paralyzed are able to move around a bit in the crate and at potty time to keep their joints and muscles toned. No additional therapy is necessary.

I will read the link again, and keep you posted on any progress. have not yet figured out whether I can attach pics on this post, could show the x ray, also the dog..

At the bottom of the composing screen is a button that says "Upload attachment". If you have any trouble with it, there may be a need to reduce the attachment to a smaller file size, as really big pics will not upload. I would love to see a photo of him!

once again, thanks.

[troy123]

ah, I missed that some photos..
a client of mine bought a house, and the morning after found troy in it. when he called his previous owner to see about it he was told that he ll come put him down, as he had nowhere to keep him. that's the reason I took him in, initially not to keep but to find a new owner for him, as I already have 2 other dogs in the house..
but he was too much of a great dog to give away