paralysis to recovery to paralysis! HELP!

[smileydog]

Hello everyone and thank you for welcoming me. This is long... so I hope you will be patient... but this is a very weird case so I want to paint a full picture.

Smiley is my newly-minted 9 year old Rottweiler. He was had idiopathic epilepsy for 4 years. Save for some digestive issues and side effects of various meds, he has been an energetic, athletic boy, right up to this incident.

Seven weeks ago, I returned home to the final 15 seconds of a seizure. He was on his side, pressed next to the corner of a chest of drawers in the kitchen (slippery floors). It is typical for his seizures to begin as focal, and then become grand mal/60 seconds. I didn't see this one happen so I can't speak for this particular case: it could have been longer. Our other dog was keeping her distance from him. She has been present before when he has seized, and she doesn't interfere.

Smiley had a particularly hard time regaining his gait after the seizure. Every attempt to get up resulted in frog-leg/splattering back across the floor. (It doesn't help he has always been loose/a bit cow-hocked in his front). Nothing much changed over the next 12+ hours, and main signs were very wobbly gait, slipping/tipping over, difficulty getting up, tripping, difficulty turning, sloppy leg placement... smooth floors impossible. *no loss of bladder or bowel control. The next morning I took him to the emergency vet where his neurologist also works.
She thought it was very likely a slipped disk. I agreed that an acute injury occurred during his seizure. We did a CT and Xrays of spine and neck. No slipped discs. Some spondylosis, some signs of cervical stenosis, nothing to really explain his gait.

Over the next few days he improved. And he kept improving. Within about 8 days, his right leg remained stiff and he'd be cautious going down stairs, but otherwise presented as a healthy "normal" dog, though not full of energy. About 4 weeks after the incident he had a massage and improved even more: he looked great. He seemed "fixed." I was sure he was. We continued massage and added acupuncture and recently a chiropractor (only one adjustment so far, and apparently PLENTY was out of alignment!). He was going to the park again, albeit at his own pace. We would take brisk walks.

Then, about a week ago, he started declining. First I noticed his rear end would lower slowly, and then gradually he was back to the beginning... slipping, tripping, losing his balance and landing in frog legs, NO chance on smooth floors... Bladder and bowels still under control. The "worst" days have been the last few.

Not surprisingly, his neurologist (ACVIM, former lead neurology Professor at my country's top veterinary school... basically pointless getting a second opinion!) is pretty firm that it's time to do an MRI and figure out what's going on. I know that only an MRI will give us the full picture, and I know that once we get the MRI the picture will either be "get surgery" or "he has cancer." I've researched cancers afflicting/arising in the spine... and his recovery without drugs/surgery, coupled with the fact the spinal problems came out of nowhere during a seizure, make him seem like a very unlikely patient. His abdomen and heart were both checked by ultrasound and there are no potential primary/secondary growths there. This leaves me ~~feeling~~ that this is an injury and not a cancer. (I know, I'm not a vet....).

Here is my concern, question, and reservation.......HE GOT BETTER (ON HIS OWN) ONCE. could he get better on his own again?

I realize an MRI won't harm him (save anaesthesia risk, and save his human-mom's dwindling finances....) but i'm wondering the value in WAITING it out a while, to see if he can pull it together on his own.

Here are my questions.

1) Does anyone have experience with a dog whose paralysis/paresis resolves and then returns with no apparent instigating factor? Google searches suggest this is extremely unusual. In lieu of experience, does anyone have any insights?
2) Given what I have described, what are your thoughts that rigorous chiropractic adjustments, continued massage, REST, and acupuncture could get my guy back to where he needs to be? Perhaps not 100%, but a happy and functional companion dog with a few limitations.

THANK YOU. I can't wait to hear from you all - real people with real experiences - but do want to emphasize that we see a highly-qualified and experienced neurologist with an equally strong consulting team, and with ACVIM diplomate colleagues (internal medicine, cardiology, oncology, etc) so questioning expertise won't be helpful here.

[CarolC]

I think I would want him on prednisone or an anti-inflammatory of some kind, and give it some time and see if it helps. An MRI would be noninvasive but it does involve anesthesia as you say, you would want to discuss the risks with your vet. At his age I would be inclined to try to avoid anything that might put a burden on the kidneys. It does sounds like spondylosis, and an anti-inflammatory medication would be worth a try if he can tolerate it. I'm not sure why they think spondylosis and cervical stenosis does not explain his gait, I would think it would be a good explanation. In laymen's terms, if you are an old person and already have a creaky old back and then take a fall, you can easily end up with inflammation in one or more spots. It sounds like his walking was probably pretty borderline before he had the seizure so it did not take a lot to throw him off his game. Because of his age I doubt if I would do spinal surgery, at least not before a good trial of anti-inflammatory medication, and maybe not at all. Disk surgery in large breed older dogs tends not to be as successful as it is in young chondrodystropic breeds with acute disk injuries. I would hesitate to do chiropractic, too. I have had a lot of chiropractic for my own back for mechanical issues and I know it helps me, but when the dog is older with spondylosis and has a general picture of spinal calcification, bone spurs, and probably spinal arthritis, I think adjustments and manipulations risk causing more problems. I agree with you on giving him some time and doing appropriate PT, but I would add an anti-inflammatory to the treatment if his stomach and system will handle it. I would also get some rugs or mats for the slippery floor. They don't have to be fancy, just something so he does not slip. Here are the mats I got for our slippery floor, they are just entry mats from Lowes or Home Depot, don't look that great but they work well, they stay in place and do not slide around on the floor. I wish I knew of a magic cure, it is hard when such a large dog is down and you want to try anything you can. Sometimes dogs will get to a certain place due to normal age related changes that are things you really can't do a lot about, just like humans. If you think his front legs are strong enough for a wheelchair, that might be worth considering.

[smileydog]

Thank you so much, Carol, for your very thorough response.
It is the first SANE and grounded thing I have heard since this all began...yet not dismissive or undermining, which tends to be the flipside of "sane" for the majority of people who just don't 'get' it with dogs. It's also the first NOT-apocalyptic response I've received after asking for vet advice on a forum, so thank you again. Your response helped me practically and emotionally.

I agree with you: it seems perfectly reasonable that a senior dog with spinal degeneration could be 'hit hard,' and in strange ways, after a crash. Yet, with these specialists, anything that is not directly reflected in THE DATA or THE RESULTS simply doesn't count. This is especially the case with the veterinary neurologists I've come in contact with: until they have THE PROOF, no explanation, no matter how reasonable, is possible. It seems Occam's razor just doesn't exist in this profession!

I contacted a friend's father who is a neuro-oncological surgeon. He has done a bit of collaborative veterinary neuro-surgery, and takes a keen interest in veterinary medicine. He offered to look at Smiley and his imagining but his bottom line was pretty clear: you won't know the best treatment for him until you get an MRI. That pushed me over the edge and I frantically arranged to get one booked for tomorrow, so we will be travelling the many hours to get Smiley to the only facility in the province which has an MRI that will fit him. If it wasn't tomorrow it would be next week and at that point his neuro would be out of the country and couldn't assess the images personally and quickly. I realized that if I waited, and he looked worse or took a sharp decline, I would not forgive myself.

I am scared, naturally, and sad he is unwell, but my gut is not telling me that it is NOT something terminal. I hope I am right. Today I gave him a deep thigh/hock massage to loosen his tight muscles. He stood for it (!!), semi-supported by my massage and forearms supporting his groin on the respective side, then after a little rest, he got up, and his gait was clearly improved. It was the first time in several days that I'd seen him walk all around our combo of carpet, smooth hardwood, linoleum, and area mats without taking a fall. And he stood properly in one place and waited for me, too, without lowering, and then tripping and/or falling. So what is clear is that whatever is or isn't going on in his spine/spinal cord, secondary muscle tightness is adding a huge burden and shaping the clinical picture. There's that, and the fact that .....well.......he already got better once.

I agree with you about the approach to surgery. He has been on a small bump of prednisone (he was already at a low dose for a digestive problem) but nothing major, and no pain meds. Unless he could be made whole with a very minor procedure, I would like to go the drug route as far as possible. I wish he wasn't so loaded with drugs, but my hope for an organic, holistic life ended when epilepsy began.

I know this was long but wanted to say it all in the event this post and this thread can help someone else down the road. THANK YOU AGAIN CAROL. WIsh us luck tomorrow.

I will keep this thread updated.

PS: I've put down area mats and try to keep him in carpeted areas but he seeks out cool smooth surfaces! I think he is overheated from his drug combo and inflammation...

[CarolC]

It was great to see he is standing for the PT, that is the very best news. It will be interesting to see what the results of the MRI show. It is always nice to have more information. I hope everything went well and you'll be able to proceed with confidence now.

[CarolC]

Did you get the results yet?

[critters]

Smiley had a particularly hard time regaining his gait after the seizure. Every attempt to get up resulted in frog-leg/splattering back across the floor. (It doesn't help he has always been loose/a bit cow-hocked in his front). Nothing much changed over the next 12+ hours, and main signs were very wobbly gait, slipping/tipping over, difficulty getting up, tripping, difficulty turning, sloppy leg placement... smooth floors impossible. *no loss of bladder or bowel control. The next morning I took him to the emergency vet where his neurologist also works.
She thought it was very likely a slipped disk.I would also postulate a bit of brain damage. It can be extremely difficult to tell the difference between the two, and, frankly, my monsters have had vets misdiagnose that several times. It can certainly happen that seizures can cause further brain damage. I agreed that an acute injury occurred during his seizure. We did a CT and Xrays of spine and neck. No slipped discs. Some spondylosis, some signs of cervical stenosis, nothing to really explain his gait.


. This leaves me ~~feeling~~ that this is an injury and not a cancer. (I know, I'm not a vet....). I would say that you're probably right, regardless of whether it's a spinal thing or a head thing.

Here is my concern, question, and reservation.......HE GOT BETTER (ON HIS OWN) ONCE. could he get better on his own again? I don't see why not.

I realize an MRI won't harm him (save anaesthesia risk, and save his human-mom's dwindling finances....) but i'm wondering the value in WAITING it out a while, to see if he can pull it together on his own. Frankly, I would. I've seen so many furs come back from such things!

Here are my questions.

1) Does anyone have experience with a dog whose paralysis/paresis resolves and then returns with no apparent instigating factor? Google searches suggest this is extremely unusual. In lieu of experience, does anyone have any insights?Hmm. It depends on the cause/s of the paralysis. IVDD can do that.
2) Given what I have described, what are your thoughts that rigorous chiropractic adjustments, continued massage, REST, and acupuncture could get my guy back to where he needs to be? Perhaps not 100%, but a happy and functional companion dog with a few limitations. My herd has only done a smidge of rest acutely and steroids for back injuries of both acute and chronic sort, both spinal cord injuries and IVDD-type problems.

:

[critters]

Thank you so much, Carol, for your very thorough response.
It is the first SANE and grounded thing I have heard since this all began...yet not dismissive or undermining, which tends to be the flipside of "sane" for the majority of people who just don't 'get' it with dogs.Plenty of vets don't "get" disabilities, either!! It's also the first NOT-apocalyptic response I've received after asking for vet advice on a forum, so thank you again. Your response helped me practically and emotionally.

I agree with you: it seems perfectly reasonable that a senior dog with spinal degeneration could be 'hit hard,' and in strange ways, after a crash. Yet, with these specialists, anything that is not directly reflected in THE DATA or THE RESULTS simply doesn't count. This is especially the case with the veterinary neurologists I've come in contact with: until they have THE PROOF, no explanation, no matter how reasonable, is possible. It seems Occam's razor just doesn't exist in this profession!

I contacted a friend's father who is a neuro-oncological surgeon. He has done a bit of collaborative veterinary neuro-surgery, and takes a keen interest in veterinary medicine. He offered to look at Smiley and his imagining but his bottom line was pretty clear: you won't know the best treatment for him until you get an MRI. That pushed me over the edge and I frantically arranged to get one booked for tomorrow, so we will be travelling the many hours to get Smiley to the only facility in the province which has an MRI that will fit him. If it wasn't tomorrow it would be next week and at that point his neuro would be out of the country and couldn't assess the images personally and quickly. I realized that if I waited, and he looked worse or took a sharp decline, I would not forgive myself. Extremely curious what showed up!!

I am scared, naturally, and sad he is unwell, but my gut is not telling me that it is NOT something terminal. I hope I am right. Today I gave him a deep thigh/hock massage to loosen his tight muscles. He stood for it (!!), semi-supported by my massage and forearms supporting his groin on the respective side, then after a little rest, he got up, and his gait was clearly improved. It was the first time in several days that I'd seen him walk all around our combo of carpet, smooth hardwood, linoleum, and area mats without taking a fall. And he stood properly in one place and waited for me, too, without lowering, and then tripping and/or falling. So what is clear is that whatever is or isn't going on in his spine/spinal cord, secondary muscle tightness is adding a huge burden and shaping the clinical picture.Is he taking a muscle relaxer? Spasticity isn't unusual, including spasticity in the bladder itself. There's that, and the fact that .....well.......he already got better once.

I agree with you about the approach to surgery. He has been on a small bump of prednisone (he was already at a low dose for a digestive problem) That makes me feel better! Pred is my friend!! but nothing major, and no pain meds. Unless he could be made whole with a very minor procedure, I would like to go the drug route as far as possible. I wish he wasn't so loaded with drugs, but my hope for an organic, holistic life ended when epilepsy beganWhat does he take for the seizures? Phenobarb? KBr?.

I know this was long but wanted to say it all in the event this post and this thread can help someone else down the road. THANK YOU AGAIN CAROL. WIsh us luck tomorrow.

I will keep this thread updated.

PS: I've put down area mats and try to keep him in carpeted areas but he seeks out cool smooth surfaces! I think he is overheated from his drug combo and inflammation...

[smileydog]

HI Carol and Critters,
YES: we got the results.
- no signs of cancer
- nothing in lumbar-thoracic region to explain gait
- some mild spongy/patchy areas... degenerative myelopathy can't be ruled out (but we're dealing with an acute issue here, so i'm not even letting my mind go there)
- brain is the same as in 2012

The ONLY thing of note is some moderate disk extrusion at C6-C7. As I would bet everyone here knows, C6-C7 are responsible for forelimbs particularly shoulders/triceps. This is NOT Smiley's problem, although I am now realizing that he has always had a slightly odd gait which was mainly clear with the swing in his hips (I thought it was quite handsome and looked like a swagger, actually!) but may have had some forelimb overextension as well.

Surprise, surprise, the neurologist and neurosurgeon are discussing "plans" for C6-C7. HA! Over my dead body.
Let's recap this insanity:
First, they tell me a hindlimb problem like his MUST be in the spinal cord of T3-L3. So I get the MRI.
Then the MRI shows nothing in the spinal cord of T3-L3 that would explain.
But it does show something in his neck..... that the neurologist even says: 1) could well be incidental (1/10 MRI'd dogs at this age would have it), and 2) would certainly and necessarily cause MARKED forelimb problems, which are not apparent, but again... doesn't explain the hind (from the perspective of neurological medicine/ the spinal CORD specifically).

My dog is NOT having spinal surgery unless it would have a 90%++ chance of GREATLY improving his life. At this point, it is clear this is not the case.

I believe the neurologists are now grasping at neurologically-relevant explanations to validate all the tests and continue to make themselves the indispensable piece.

I love doctors and I believe in medicine - even the kind you pay away your savings for, for pets! - but this is nutty.

We are continuing with physio, massage, and GENTLE chiro. Carol, I know you mentioned your hesitation but given all the (non) findings, I feel good about this chiropractic routine, and Smiley is responding well.

I think the bottom line we can all take from this is sometimes there is no "diagnosis".... just do the best for your pet, trust your gut, and let them (the animal!) tell you what they need.



PS: Critters, he is in Pheno 210mg 2x/day (which is now his max dose) and zonisamide 450mg 2x day. We are new to zonisamide but seeing no side effects!

[critters]

HI Carol and Critters,
YES: we got the results.
- no signs of cancer
- nothing in lumbar-thoracic region to explain gait
- some mild spongy/patchy areas... degenerative myelopathy can't be ruled out (but we're dealing with an acute issue here, so i'm not even letting my mind go there)
- brain is the same as in 2012

The ONLY thing of note is some moderate disk extrusion at C6-C7. As I would bet everyone here knows, C6-C7 are responsible for forelimbs particularly shoulders/triceps. This is NOT Smiley's problem, although I am now realizing that he has always had a slightly odd gait which was mainly clear with the swing in his hips (I thought it was quite handsome and looked like a swagger, actually!) but may have had some forelimb overextension as well. But don't forget the seizures. He may also have a touch of cerebral palsy (they call it cerebellar hypoplasia in critters).

Surprise, surprise, the neurologist and neurosurgeon are discussing "plans" for C6-C7. HA! Over my dead body.
Let's recap this insanity:
First, they tell me a hindlimb problem like his MUST be in the spinal cord of T3-L3. So I get the MRI.*snort* I used to know several humans who were C5-6 quads, and one of their friends had a C-spine injury (I don't know what level). This guy could WALK, but he had total arm paralysis. They called him a "walking quad" (quadriplegic) because there wasn't a term for that (and I don't know that there is a term even today). There's NO end of the funky stuff that can happen with spinal cord injuries!!! Just because stuff doesn't usually happen doesn't mean it can't!
Then the MRI shows nothing in the spinal cord of T3-L3 that would explain.
But it does show something in his neck..... that the neurologist even says: 1) could well be incidental (1/10 MRI'd dogs at this age would have it), and 2) would certainly and necessarily cause MARKED forelimb problems, which are not apparent, but again... doesn't explain the hind (from the perspective of neurological medicine/ the spinal CORD specifically).

My dog is NOT having spinal surgery unless it would have a 90%++ chance of GREATLY improving his life. At this point, it is clear this is not the case.

I believe the neurologists are now grasping at neurologically-relevant explanations to validate all the tests and continue to make themselves the indispensable piece. Human docs like to do that too!

I love doctors and I believe in medicine - even the kind you pay away your savings for, for pets! - but this is nutty.

We are continuing with physio, massage, and GENTLE chiro. Carol, I know you mentioned your hesitation but given all the (non) findings, I feel good about this chiropractic routine, and Smiley is responding well.

I think the bottom line we can all take from this is sometimes there is no "diagnosis".... just do the best for your pet, trust your gut, and let them (the animal!) tell you what they need.Truer words were never spoken!!



PS: Critters, he is in Pheno 210mg 2x/day (which is now his max dose) and zonisamide 450mg 2x day. We are new to zonisamide but seeing no side effects! Interesting! I've never heard of using zonisamide; it must be relatively new for critters.

[smileydog]

Hi Critters, yes - good point about the spine. "It's complicated"! I am just blown away that the only finding is typically unrelated, reveals minor primary signs IF any, and likely incidental.... and they would be ready to operate! On a spine! Like this is just a nail trim or a dental cleaning!

I like your point about the front gait and seizures/ some cerebral palsy. The chiropractor suggested his (significant) cervical misalignments could well be the cause of his seizures, so lord knows all the mysteries stewing in there. Things vets and specialists will never say..: info you need from a practitioner with an alternate viewpoint, or a kind stranger online!

As of today, Smiley is walking independently but needs help rising on slippery floors. His right leg, as it was when he was healing from the initial symptom onset, is much weaker and gives out more often/ seems "lazier". So this isn't a unilateral condition [[EDIT: this isn't a BILATERAL condition. OOps]]. But he can walk!!!!!!!!!! So anyone out there reading this, yes, a dog can go from partial paralysis / paresis to independent walking (and back around again!) without surgery or major intervention. The plan for now is REST and respect for him: giving him time, without pressure, to recover comfortably.

Re zonisamide. Are you in Canada? (we are). It is usually adjunctive to pheno and tends not to be used as a primary route. I won't give him bromide because it gave him life-altering ataxia, and because he had one incident of pancreatitis and there is some correlation between the drug and the condition.(More likely, it was the tub of shea butter he found and ate that caused it....%&%^@!!) Keppra was off the table because of the 8hr dosing schedule and my schedule being irregular.
Zonisamide is not approved for human use in Canada but can be compounded if prescribed by a vet. In the States, I've heard, it can be picked up at any pharmacy and is relatively inexpensive. we pay something around $90CDN/month including courier for a starting dose for a 100-lb dog. Incredible to not deal with the usual side effects from seizure drugs

Oooofff- I write a lot! Figure thhe more helpful stories make it onto the Internet, the better....

[critters]

Hi Critters, yes - good point about the spine. "It's complicated"! I am just blown away that the only finding is typically unrelated, reveals minor primary signs IF any, and likely incidental.... and they would be ready to operate! On a spine! Like this is just a nail trim or a dental cleaning! Well, surgeons tend to be that way!

I like your point about the front gait and seizures/ some cerebral palsy. The chiropractor suggested his (significant) cervical misalignments could well be the cause of his seizures, so lord knows all the mysteries stewing in there. Things vets and specialists will never say..: info you need from a practitioner with an alternate viewpoint, or a kind stranger online! Vets don't tend to know much about permanent disabilities because it's so new for them.

As of today, Smiley is walking independently but needs help rising on slippery floors. His right leg, as it was when he was healing from the initial symptom onset, is much weaker and gives out more often/ seems "lazier". So this isn't a unilateral condition. But he can walk!!!!!!!!!! So anyone out there reading this, yes, a dog can go from partial paralysis / paresis to independent walking without surgery or major intervention. The plan for now is REST and respect for him: giving him time without pressure to recover comfortably. With spinal cord injury it's not unusual for bilateral involvement but to have one side worse than the other.

Re zonisamide. Are you in Canada? (we are).U.S. It is usually adjunctive to pheno and tends not to be used as a primary route. I won't give him bromide because it gave him life-altering ataxia, and because I had one incident of pancreatitis and there is some correlation between the drug and th condition. Keppra was off the table because of the 8hr dosing schedule and my schedule being unsteady.
Zonisamide is not approved for human use in Canada but can be compounded if prescribed by a vet. In the States, I've heard, it can be picked up at any pharmacy and is relatively inexpensive. we pay something around $90CDN/month including courier for a starting dose for a 100-lb dog. Incredible to not deal with the usual side effects from seizure drugs Sounds like you've been there, tried them all!!

Oooofff- I write a lot! Figure thhe more helpful stories make it onto the Internet, the better.... So true!

[CarolC]

The plan for now is REST and respect for him: giving him time, without pressure, to recover comfortably.

i love this.

It could be true about the seizures and his neck. My co-worker/friend had a lifetime of epilpesy that caused significant neck problems. A cervical problem can definitely affect the hind limbs, too. If the disk is bulging more on one side, then one side will be more affected. I would want to make it my goal in life to protect his neck as much as possible. No jumping off the sofa, try to avoid stairs, I know you can't predict the seizures. I don't know what to suggest as far as him wanting to lie on the floor instead of the rug, some dogs are just that way. But slipping on the floor is going to jar his neck... I don't know if it would make a difference to turn the air conditioning colder so he'd lie on the rugs. There are a number of products that are supposed to give a dog grip in his feet so he does not slip. Boots are one option. There is a spray called Show Foot Spray that you spray on the pads, it is designed for champion show dogs who have to compete on slippery wood floors. I've never tried it but I assume it must work because they've been selling it for years. Or Dr. Buzby's ToeGrips. A vet tech I know tried them with her dog and gave a positive review (linked below).

http://www.showdogstore.com/bio-groom-show-foot.aspx
https://www.toegrips.com/faq/
viewtopic.php?f=22&t=17564

You may also find it convenient for him to wear something like a basic nylon chest harness, to give you something to grab to help him up.

Disk problems in the neck can become so painful that in a worst case you are faced with emergency surgery or euthanasia. I agree I would not want to do surgery unless there was absolutely no choice. That being said, you probably want to think of a plan on what to do if he were unexpectedly to develop severe neck pain on a weekend or after hours. Neck surgery is something I would only want done by an experienced board certified surgeon, which may rule out a lot of emergency room vets.

Here is an article discussing various nutrients that may help with the healing of a disk problem.

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

Oooofff- I write a lot! Figure thhe more helpful stories make it onto the Internet, the better....

Yes, it makes a huge difference. It gives something for others to use to help their pet. It helps!!!

[smileydog]

Hi Carol, we are using the Help 'Em Up harness which helps a lot with supporting him. No collar.
Stairs are a concern because I want him to sleep in the same room as me, and that requires stairs. I try to help him up and mostly down, with the harness, as much as he will allow me/ needs it. I wish I could give him a stair-free life but I just don't know how. Luckily he has chosen himself to avoid beds/couches. He knows his limits.

Yes: the slipping is upsetting to see and not always something I can control. I've gone through tons of boots that just slip off. Toe grips are next. And I do my best to direct him to the floor areas with more "texture".

The neurosurgeon is an ACVIM diplomate in neurology (as is his lead neurologist and other consultants) so my sense is this is as specialized as it goes! Or am I wrong? He would be performing any hypothetical surgery... it is not something I would leave to an attending general vet. I trust this neurology team as far as technical expertise and training but find that they are so aggressive with diagnostics and so quick with invasive treatment plans that I often have to pull back just to keep a clear head. It is very difficult to maintain balance (no pun intended!) when the people who help my dog, have the technical knowledge but see him as a case study and not his whole life. I feel they are VERY quick to intervene extensively and so I have to trust myself to know when to say "stop"... and also when to say "go." It's a tough thing to manage when you have no medical background! (And they know it!)

On that previous note, how would I identify severe neck pain? It may sound like a no-brainer, but he is a pretty stoic dog... he's a Rottweiler! It does take really extreme pain (ie, acute pancreatitis - which has been described as excruciating) for him to show his cards... and even then, that would be with withdrawing and being despondent, which might be more difficult for me to really see since he has been very low-key since the first incident. In fact, he is sleeping soundly and not waking up anxiously mid-night as he has done with previous discomforts/drug side effects. He will wake up once for a drink of water and fall back asleep without pushing on me for for attention/help. His breath is not shallow, nor is he panting or pacing, and his energy seems settled - though he isn't holding back his smiles in the sunshine. I really do want to know that I am "in tune" with him, and feel I am, but I don't trust him to always let me know if he's hurting. I've been told the extrusion is moderate (not serious, severe, or critical, Thank Dog), and presents in such a way that it could be an incidental finding due to age, so my sense is it would take a big wallop to worsen things to severe.... but I'd really like to be sure I know how to identify that!

Pleased to say he is holding steady, in terms of balance and gait. His biggest difficulty is with slippery surfaces, and he has some incoordination on stairs (most of his stress is with going down). If NOT on a slick surface, he can stand up on his own, he can hold a stand for some time, and he can walk around at his own pace without falling. I am doing my very best to focus on the good - he has improved and is NOT worsening!

Thanks, new friends. I hope one day I can help as you have helped me...

[critters]

There is/was a spray called Show Foot Spray that people used on the limbs to help prevent slipping.

[smileydog]

I wanted to check in and give an update for anyone following/interested now or in the future. I find 9/10 times i find a useful thread or forum topic, it ends before I can learn the turnout/ prognosis/ etc.

SMILEY HAS IMPROVED.

Smiley has been having chiropractic care 3x week since the MRI. At this point, his spine is in much better alignment, but we will continue with close/regular appointments until we get to 10. (We have done 7). After 10 we will have a sense of how far chiropractic adjustments can get us, and then we will be in a rehab phase.

* I know that chiropractic care is a bit controversial and there are differing opinions, which i absolutely respect. Given Smiley's layered neurological history (facial nerve deficits about a year ago in addition to seizures that never quite fit the "idiopathic" diagnosis despite having ruled out 'causes') as well as gait issues (which I now realize were existent well before the paresis), I felt TOO strongly that there was necessary correction to his spine before I could give him a fair shot at returning to [his version of] normal.
So far I have been SO HAPPY with the chiropractors' support, wealth of information, and absolute dedication to supporting Smiley's recovery and collaborating with his neurologist -- even if she refuses to think outside of her own training.

At this time (2 months from original issue and 3 weeks from relapse):
- Smiley can get up from lying on any surface in one effort most of the time, two efforts some of the time
- Can get onto and off of the couch and bed
- Can take stairs up and down, although he is quite slow and measured on downward flights, so I walk down helping him by his harness.
- Has run across the yard once.
- Has urinated once with his right leg raised.

- Still needs help with any big jump, of course, such as getting into or out of the car. I need to find a ramp and it's surprisingly difficult to find one without 'steps'
- Still drags right leg slightly (only notice dragging when i can hear his nails on concrete)
- Still generally 'clumsy' with the rear end.
- Still quite stiff/'tight' in muscles through hind legs.

We got the toe grips but they have not seemed to work for us. The rear ones constantly pop off, despite being correctly fitted. I could go down a size, I suppose. The front grips stay on better but now after maybe 10 days, two have popped off. (They are supposed to last a month with normal wear).

I hope Smiley's story can be of some help or positive support to someone who finds this. If things take a turn or I learn new information, I will return and update.