Pip diagnosis - Central cord syndrome

Neurological Disorders Resources. Treatment and care for pets having pain or trouble walking or standing due to spinal injuries or neurological disorders like IVDD, FCE and DM.
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CarolC
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Pip diagnosis - Central cord syndrome

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Pip was examined by a board certified neurologist today. The diagnosis is "Open for non-ambulatory tetraparesis and central cord syndrome". She doesn't think an MRI would change anything. He probably has either FCE, ANNPE, or syringomyelia, and it probably isn't syringomyelia because he's been improving. Her recommendation was to continue PT.

He seemed to like her and her nurse. He looked happy when they brought him back from the exam. And to top it off it didn't cost very much. She just charged for the exam and that was it! It couldn't have gone any better.

EDIT TO ADD: Note to anyone reading this thread. Pip was misdiagnosed by the board certified neurologist at this appointment, and correctly diagnosed by our family vet almost 2 years later with atlantoaxial instability. This was confirmed by advanced imaging by a different board certified neurologist at a different hospital. The first almost 2 years of this thread were based on the wrong diagnosis. The first neurologist got the central cord syndrome part right, but missed what was causing it and recommended PT, which was wrong. Don't ever let a board certified neurologist diagnose your paralyzed dog without imaging. If you ever begin to question a diagnosis, don't ignore your instincts just because the vet who made the diagnosis was board certified.
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critters
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Re: Pip diagnosis

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:wow:
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Re: Pip diagnosis

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I should have made him his own thread, but I'll post this here. I've sort of discovered something, or I think I have. His hind legs work better than his front legs (I've known that). A while back I discovered that if I put him in the double harness to practice walking, and want to get him started, I sort of "drag" his 4 paws across the tops of the grass and then what happens is...his hind legs start going first, then his front legs start. At first I wasn't sure that was what I was seeing, but yes, that is what happens. Hind legs walk first, then front legs begin taking steps.

Yesterday and today we discovered a new exercise. It's hard to describe this. He's standing in his harness on 4 feet (often the left front is not place correctly) and I slowly lower his bottom to the ground so he is sitting on his bottom but his front legs are still fairly straight, like you would get if you taught your dog the Sit command. Most paralyzed dogs are rear paralyzed and you have to practice sit-to-stands so they can learn to stand up from a sit. Pip has NO problem standing up from a sit, his hind legs work well. But what I noticed is, when he stands up, it seems to trigger his front foot to take a step. That's neat. I expect that is wired in from old habit (or he was born with it) and it still works. I think what that's about is, when his hind legs raise him up, he is then standing with his hind feet too close to his front feet, so he either has to fancy-step his hind legs back or move the front forward to have them far enough apart for stability.

It is quite amazing. He does not really like being seated and will raise up his hindquarters and do some fancy footwork with his hind feet, and while this happens for those few seconds, his front feet are also behaving more normally and the left in particular is not knuckled.
:trophy:
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critters
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Re: Pip diagnosis

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Interesting! He sounds something like a human I once heard of, whom they called a "walking quad." He'd broken his neck, but his legs came back. He still had little or no arm action.
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Re: Pip diagnosis

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We're working on the 'walking' part! :haha:
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Re: Pip diagnosis

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Since acupuncture Monday he's done 2 things better than before. Maybe the improvement is unrelated to the acupuncture, no way to know. The first thing was, he was standing more normally (with support). Usually he wants to bring his hind legs forward and he wasn't doing that, he was standing squarely. I actually felt like that was the acupuncture.

Then just now I was in the other room and heard a 'Whump!' sound which means he has jumped out of his bed. He had got out, went number two 3 feet from the bed, and got back in. Woohoo! That was amazing! That would be a first. There are days you wish you had a pet cam. :D

Then if that wasn't enough, he was lying in his bed facing north, and I watched him stand up (in itself amazing) and use his hind legs to take 2 perfect steps turning himself around south and he laid down again. CouId not believe it. He was like, "I'm going to stand up and turn around and face the other way," and he just DID! I don't know if the acupuncture helped, but we will go for the second appointment next week.
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Re: Pip diagnosis

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I always find jumping out of bed scary with wonkers. LOL Congrats!!
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Re: Pip diagnosis

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Thanks! :D He did very well on his wall treats, too. We are doing it going back and forth, so one direction he leans his right shoulder on the wall and walks to the treat, then we turn around and get the next treat going the other direction with him leaning his left shoulder on the wall. His left front foot is weaker, but he does it about equally well both ways. I want to get a video, but any distraction is enough to throw him off right now. If I try to video, he messes up because he knows I'm up to something, and this is about him and his walking, so no video for now. I hope to get a video when he has mastered it a little better. When we have a video you can really see how the Wall Treats (could be called Wall Walking) exercise works.
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Re: Pip diagnosis

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Baby was a wall leaner, too. It'll be interesting to see videos of him. Too funny that he knows you're up to no good! :smart: :twisted: :mrgreen:
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Re: Pip diagnosis

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That's interesting. I'm hoping or guessing that as he gets his feet under him, he'll lean less. I wish I had a longer wall for leaning. I looked outside at the fence but if you run your hands across it, there are rough spots, not good to lean against. I thought of putting a board against the side of the house along the foundation, but a 1x12 would not be tall enough. There is probably something that would work, perhaps that is not a board, a roll of something maybe, but I haven't thought of it yet.

Today I tried something that worked better than expected for a first try. I ordered an 8' tram track from strip-curtains.com and some rollers. I "installed" it by propping it between some crates and tying it in place (there are screw holes at each end). Then I attached his front and rear harness to the rollers. Unexpectedly, he took off running, went to the end, and kind of left the ground slightly and turned around and kind of tangled the harness. So we did some more with me guiding the harness so he wouldn't run like that. I am kind of laughing because he ran so well, but kind of not because I think the unfamiliar set up may have frightenend him. I'd been thinking he would walk sedately from end to end for treats. Did not expect him to run flat out and practically go airborne. I put it all away and will think about it some more. He can also think it over.

Here is the one I got, the 16 gauge Gauge Galvanized Steel Track - For Sliding Curtains and Doors - 8' Length for $24, and the rollers are $1.75 each. This track is SO strong you could put a rottweiler on it if the rollers would hold. I got the 30-lb nylon rollers but they make 90-lb rollers for $4. They make track connectors so you could make it longer. Dunno, worked as proof of concept, has potential, definitely too short if he's going to run. Boy can he run with that little bit of help for balance. He's outrun me outside when in his double harness, but I can't run with my back and I didn't know he could go that fast. The other thing is, there needs to be something to keep the 2 rollers spaced so they don't get close together and he spins.
:thinking:
https://www.strip-curtains.com/order/tr ... rdware.php

track.JPG
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Re: Pip diagnosis

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Creative idea!! :smart:
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Re: Pip diagnosis

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Update on Pip. He had his second acupuncture. I was not in the room and it didn't take long. He seems to be still improving, and there is no way to know if the acupuncture is contributing at all, but it doesn't seem to be hurting.

We are/were still doing the Wall Treats exercise twice a day till today. When we did it this morning, we had finished and I was putting treats away when I got a phone call, and Pip remained sitting along the wall. When the call was over, I had to go meet someone, so I put him in his bed and noticed a wet spot by the baseboard where he had been sitting. Quick without thinking, I grabbed the Nature's Miracle and sprayed it real good and went to meet the lady. An hour later I realized, I just sprayed smelly spray on the carpet of our practice wall. Our ONLY practice wall. Right on the spot where I set the treat going one direction! If I'd thought about it, I would have blotted it with water and left it. Now it's all perfumey. So this afternoon we didn't do Wall Treats because I basically ruined the wall till the smell goes away!

We did the tram track again since we couldn't use the wall. He did really well. By the time we did it a number of times, he was initiating the walking without me starting him. I think he kind of likes it. I am going to buy another track to join, they are only $24 each. Then he can run 16' instead of 8'. I'd like to make it even longer but it would have to be outside. I spent quite a bit of time with the tape measure trying to figure out how to set it up outside and didn't really come up with a workable plan, so it may have to be inside and just 16'. It's really good exercise, getting his front feet going, and he doesn't have to worry about me stepping on him. :oops:

I made a spacer to keep the 2 rollers from touching each other when he gets to the end. By the time he gets to the end, he is running and swings up into the air and if the rollers bunch up and touch then he may spin, but if the rollers holding the front and rear harness are kept apart that doesn't happen.

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Re: Pip diagnosis

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Interesting... :thankyou:
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Re: Pip diagnosis

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He is doing a lot of standing now, these past few days. When he does his Wall Treats exercise, he often remains standing after he gets the treat. Before he tended to lose his balance when getting the treat. Now he is picking it up and then remaining standing. I'm so impressed!!!
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Re: Pip diagnosis

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This morning we were out in the yard doing our "ex-ies" where I carry him in a football carry in my right arm and put my left hand under his front feet and he bears weight. Suddenly he noticed something in the other yard and did like dogs do, trying to launch like a rocket out of my arms to go after it. I felt something and looked down and his left leg was repeated pawing and pushing hard against me trying to launch. His left paw! The one that has been the most affected.

His Wall Treats are continuing to go better. It's like he cleaned up the placement of his feet and everything is more precise now. 3 days ago he was doing Wall Treats west to east and he started to take the next step and realized (either saw or felt, I couldn't tell which, he did look down) that his left foot was about to knuckle and he FIXED IT!!!!!

:wub:
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