3-Year Old Malshi Diagnosed with Stage V IVDD

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.
Ry4n2109
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3-Year Old Malshi Diagnosed with Stage V IVDD

Post by Ry4n2109 »

My wife and I were on a cruise last week, and while we were away we received the sad news that our 3-year old Maltese Shih Tzu (Mickey) became paralyzed from the waist down.

We took him to a neurologist last Saturday and the MRI revealed he is not a candidate for surgery. Apparently, our pup's disc didn't slip, but instead, burst, and fluid is leaking into the spine preventing blood flow and cutting all communication. We're at a loss of what to do. The neurologist recommended we give him another week as sometimes the body does amazing things and he may heal himself, but she said if he shows no signs by this weekend he will be paralyzed for the rest of his life and says we should consider euthanizing him.

Mickey is regularly peeing himself, and I mean... all the time! He also has been pooping 1-2 times a day by himself without intervention. We do express him a couple of times a day to ensure he's as comfortable as possible. Overall, he is keeping a positive demeanor and even wanted to play with his toy last night. It just breaks our heart seeing him like this.

I've been reading a lot on this forum and I just can't seem to find a similar case as to what Mickey is going through. I'm not sure if there is anything particular we should be doing to care for him. Should we completely prevent him from moving or does it not matter because the leaking fluid is the real culprit here?

Also, my wife and I are trying to scrap for some sort of hope. From what the neurologist explained, it doesn't sound like nerves were damaged but rather blocked. Does that mean he has no chance for recovery? Has anyone experienced this before?
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critters
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

Post by critters »

:welcome: I'm not a vet, but I couldn't disagree more with putting a time limit on recovery; they can recover from spinal cord injuries for months, albeit slowly, just like people. Besides, even complete paraplegics can have a good life, but chances are your baby will begin to recover.

Did they call what happened a FCE (Fibrocartilaginous embolism)? That's what it sounds like to me, and many critters and parents have been there.
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CarolC
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

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Ry4n2109 wrote: Thu Nov 18, 2021 10:39 am My wife and I were on a cruise last week, and while we were away we received the sad news that our 3-year old Maltese Shih Tzu (Mickey) became paralyzed from the waist down.

We took him to a neurologist last Saturday and the MRI revealed he is not a candidate for surgery. Apparently, our pup's disc didn't slip, but instead, burst, and fluid is leaking into the spine preventing blood flow and cutting all communication.

:banner:
I am not a vet, but you may be describing a ruptured disk when you say it burst. The disk is a firm ring with a pulpy "liquid" inside. When the firm outer ring develops a hole or breaks, the inside can squirt out into the area surrounding the spinal cord. It causes a problem by putting pressure on the spinal cord and there can also be something they call a chemical cascade which causes secondary damage in the area. If left without surgery, the body will eventually absorb and clean up the offending disk material, but the nerve damage caused by the blood flow being blocked etc will still be there.

This situation reminds me of a dog here named Murphy. Murphy was a beagle and he had his disk episode while his parents were away on vacation in Hawaii. I remember the upset they experienced and talking to the vet by phone and the panic to get the long flight back from Hawaii to Pennsylvania so they could be with him.

Part of the decision on surgery in a case like this is timing. If a dog has a ruptured disk and loses deep pain sensation (can't feel his toes) and has surgery immediately, there is a chance of a successful outcome. But if you are not in a position to do surgery immediately, then the chance of success goes down. I would guess the neurologist looked at the ruptured disk, asked you how long ago it happened, and advised accordingly. It sounds like it was more than 24 hours between the time of the injury and the time of the MRI. They really recommend doing surgery within 24 hours of losing deep pain sensation (abilty to feel the toes). Beyond that the chance of success goes down hourly. However, you did the right thing getting the MRI, so you know for sure what is going on, because there are other conditions with similar symptoms to a ruptured disk. So you did not waste your money, you got the information you needed.


We're at a loss of what to do. The neurologist recommended we give him another week as sometimes the body does amazing things and he may heal himself, but she said if he shows no signs by this weekend he will be paralyzed for the rest of his life and says we should consider euthanizing him.

That I cannot agree with at all. Especially with a small dog. There is NO need to do that if you are willing to give him just a little extra care. Not time consuming. Not difficult. Here is a video about a dog who remained paralyzed. You can see she is still loves life.



Mickey is regularly peeing himself, and I mean... all the time! He also has been pooping 1-2 times a day by himself without intervention. We do express him a couple of times a day to ensure he's as comfortable as possible.

This is kind of a minor point, but I will say it anyway. Urinary incontinence is different in different dogs, depending on what location of the spine got injured. Some dogs tend to retain urine (never leak) and will require expressing. Some dogs are able to keep dry if you express 3-4 times a day. And then some dogs may dribble 24/7. I have a dog like this. Her injury is in her lower back and she dribbles 24/7. I can't express her because there is nothing to express. I had her checked with a bladder ultrasound twice to be sure I wasn't just missing something, but no, she is constantly empty. I am not sure which type of incontinence your dog has, but my dog gets by with just diaper changes and no expressing. Since you have a male dog (yay!) it is easier because he can wear a male doggie diaper (male wrap, aka belly band) to catch any dribbles.
:malewrap:

Overall, he is keeping a positive demeanor and even wanted to play with his toy last night. It just breaks our heart seeing him like this.

I suspect he is glad you are home and glad for the extra attention. He lives for love and companionship, he is happy. It sounds like he is already pain free, so that's great. It can take time for pain to subside with a disk episode, but in most cases is does, and it sounds like he's doing really well.

I always feel like it helps when the dog is so upbeat. There is a saying that dogs don't ask "Why me" as a human would do, they just go on making the best of life! It is hard for you to see right now, and it was unexpected so it kind of puts you in shock, but quite possibly he is adjusting more quickly than you are.

I've been reading a lot on this forum and I just can't seem to find a similar case as to what Mickey is going through. I'm not sure if there is anything particular we should be doing to care for him. Should we completely prevent him from moving or does it not matter because the leaking fluid is the real culprit here?

I think you would have to ask the neurologist on this. If it was my dog, I would strictly crate him and keep him from moving regardless of the prognosis. There is still some healing that needs to occur whether they think he will walk again or not. If you have not seen it yet, there is a website called Dodger's List with a lot of information on disk problems.

Also, my wife and I are trying to scrap for some sort of hope. From what the neurologist explained, it doesn't sound like nerves were damaged but rather blocked. Does that mean he has no chance for recovery? Has anyone experienced this before?

I think it is too soon to tell. It is better to be prepared for either outcome. With his size, and being only 3 years old, he is a great candidate for a wheelchair, if needed. Being male, he can wear a belly band and you don't have to worry about diapers. And there is something called spinal walking that some dogs can learn to do. Some dogs learn by themselves, and others learn with physical therapy. Spinal walking is a form of walking where the dog remains paralyzed (can't feel his toes) but he learns to use his hind legs to walk anyway. There is a reflex called the crossed extensor reflex which means that when the front legs are moving, it fires signals to the hind legs that still work even in total paralysis. Some dogs can learn to use this to good effect and walk. The dog I mentioned before, Murphy, was a spinal walker.
http://www.everythingdachshund.com/dachsyinfo/dachshundintervertebraldiskdisease.htm

Occasionally a dog that has transverse malacia of its thoracolumbar spinal cord (no deep pain sensation) can learn to "walk" again using the crossed extensor reflex that may still exist in the hindlimbs. Without motor connections to the brain, this reflex is "released" and causes the involuntary motor movements that are frequently observed in the limbs. Through extensive physiotherapy, many of these dogs learn to swing their bodies to get their hindlimbs under them and allow the reflex walking movements to be effectual. This form of walking is called spinal walking and looks a bit "motorized" but serves the function well. Unfortunately many of these dogs are also permanently incontinent. Many owners lifestyles do not allow the time necessary to properly care for incontinent dogs. As a result many of these dogs are euthanized rather than allowed the time to see if they can develop spinal walking abilities.

I know the neurologist was not overly positive, but when it comes to recovery, every case is different. My dog had a very severe injury. She had a complete spinal fracture, the two parts of her spine separated and one part tried to leapfrog over the other, pinching the spinal cord in between. She was like that for hours before she had surgery. She had no deep pain sensation before or after back surgery. The surgeon wrote on the pre-surgery consent form that she would likely never walk again, even with surgery, and I should consider getting her a wheelchair. It took her a loooong time to recover, but she is walking. A slow recovery is still a recovery. :)

I would give him a chance, or if you can't because you travel all the time or have some reason you just can't do it, perhaps contact rescues and see if anyone will take him. Rescues are constantly taking wheelchair dogs, and with his age and breeding, someone will surely want him. I hope you can work something out. Paralysis should not be a death sentence. I strongly disagree with the neurologist on that. Some vets may think it is best for the dog if the owner is not going to provide proper care, but if you are willing to take care of your dog, they should support you in that.

You may want to get additional views on the forum on Dodger's List. www.dodgerslist.com
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

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Ry4n2109
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

Post by Ry4n2109 »

Thank you all for the replies and glimpse of hope. We took Mickey to the neurologist yesterday and she did not identify any deep pain in Mickey, but still said it was very early on. She suggested we start water therapy with him, as well as gave us a couple of other tactics to start his physical therapy at home. Additionally, she suggested we try a couple of sessions of acupuncture to see if that helps.

She said Mickey doesn't need to be crated and actually suggested we allow him to scoot around more as his muscle are starting to deplete some. She also suggested we feed him a little more.

Overall, Mickey has been doing great. He scoots himself around just fine and we ordered some booties and one of those bags to help protect his little legs.

I was just playing with his right foot and little bit and actually felt him pull back a few times! This is the first time we've seen him have any movement or reaction in his hind legs.

My wife and I will document his journey for the chance it may help someone else in the future.
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

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:welcome: prayers your baby continues to improve. Never give up hope!
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

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Ry4n2109 wrote: Sun Nov 21, 2021 1:30 pm Thank you all for the replies and glimpse of hope. We took Mickey to the neurologist yesterday and she did not identify any deep pain in Mickey, but still said it was very early on. She suggested we start water therapy with him, as well as gave us a couple of other tactics to start his physical therapy at home. Additionally, she suggested we try a couple of sessions of acupuncture to see if that helps.

Deep pain can return later, even months later.

Hydrotherapy is wonderful. When the dog uses the front legs for swimming or walking on an underwater treadmill, it helps fire signals to the hind legs. It is also super good for overall conditioning. They may do short sessions at first and then build up to longer seessions. It can be helpful to get the dog used to the hydrotherapy gradually. They will probably towel dry your dog. I don't think they blow dry, but you can ask how they do it. You may want to go prepared with a warm blanket to wrap him in the car on the way home. If you are doing a drop off and pick up later, then he may be dry by the time you come pick him up. If you are waiting while he does his session, then you will want a blanket. Hydrotherapy can be cheaper if you buy a package, like 10 sessions for X amount. You can ask the therapist/neurologist, but I would guess once or twice a week may be his schedule. Nerves heal slowly and by providing PT at home or professionally, you help him make the most of his recovery along the way.

I have had 3 paralyzed dogs and a paralyzed bunny, and the dog I have now is the first one I have tried acupuncture with. I've always been persuaded it could be helpful for pain but was not sure if it would be helpful for recovery, so I have approached it as very much a skeptic. We have gone for 4 sessions. I cannot tell for sure if it is helping, but I'm about 55/45. 55% leaning toward it is helping, 45% thinking still not sure. He's been progressing gradually, but it is hard to say how much is because of the acupuncture since he would likely be improving anyway, but I do sort of think it helps. It isn't hurting him, and they don't put the needles in far at all so he does not seem to mind. If you are short on finances and need to choose what to pay for, PT or acupuncture, I'd do PT, but keep in mind that recovery will be slow in any case. Nerves heal slowly and it will likely take months to know how much he can get back. Steady PT over time it is the key. In my experience, recovery with spinal injury continues literally for years.

She said Mickey doesn't need to be crated and actually suggested we allow him to scoot around more as his muscle are starting to deplete some. She also suggested we feed him a little more.

There is one school of thought not to crate rest a dog recovering from a spinal injury. I think those vets are in a very small minority. The common and widely accepted recommendation is to crate rest. The only difference is that some vets will recommend more weeks than others. Muscle tone will return when activity resumes, it won't be permanently lost by a few weeks of crating.

Overall, Mickey has been doing great. He scoots himself around just fine and we ordered some booties and one of those bags to help protect his little legs.

Just to be on the safe side, I would try to keep the bag clean when you try it on him, until you know it fits. I bought one online where I thought I measured and got the right size, but it was super tight in the waist and would not zip all the way. It looked like it might fit a ferret and not my 8-lb dog.
:roll:

I was just playing with his right foot and little bit and actually felt him pull back a few times! This is the first time we've seen him have any movement or reaction in his hind legs.

My wife and I will document his journey for the chance it may help someone else in the future.
It may indeed help someone.
:thankyou:
Ry4n2109
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

Post by Ry4n2109 »

Thank you for the detailed responses. We’re currently at the acupuncturist’s office and she recommended we crate rest Mickey for a few more weeks, as well as avoid hydrotherapy during this time. She said hydrotherapy right now would do more harm than good as the affected area on his back needs more time to heal.

Now we’re just not sure what to believe. From what I’ve read online our gut is telling us to put him back on crate rest and avoid hydrotherapy for the next couple of weeks. Anyone have any advice for us on what they would do as the next steps?

Also, he is going to be going through Ozone treatment today.
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

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I absolutely agree with the acupuncturist. I think strict crate rest is the way to go, and hydrotherapy later. If it was my dog I would want crate rest plus an anti-inflammatory such as prednisone. Then hydrotherapy later. I was very surprised by what your neurologist said...
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

Post by Ry4n2109 »

Thank you for your response. We will begin crate resting him again. While we were at the acupuncturist we saw his tail actually wag back and forth strongly 4 times, which was amazing to see. Hopefully this is a precursor showing the treatment is working.

She wants us to put him on a diet of chicken soup and Paul Newmans canned food. Also, she provided us with herbal supplements to give him.

We have another treatment scheduled for next week. Still praying and hoping for a miracle.
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

Post by Ry4n2109 »

Hi all -

It's been a while since I've last posted here, so I wanted to provide an update.

Mickey is unfortunately still fully immobile on his hind legs. He has undergone 5 acupuncture and ozone therapy sessions, which has seemed to have improved his overall reflexes dramatically. Currently, any sort of touch to his back feet cause him to kick us back with forth. Our neurologist also expressed her excitement for how well his hips move back and forth when he drags himself around.

The consensus between our acupuncturist vet and our neurologist is that they think he will walk again through his reflexes, but are uncertain if he'll ever get full control of his feelings or his bowel movements.

Mickey (and us!) is going through a rough time and has been having diarrhea the last few days. It's been a lot of clean up, and we are trying to get him into the vet tomorrow morning to get looked at. I just boiled some rice and chicken and am only going to feed him that for the next couple of days. The good news is we aren't seeing any signs of blood or worms, so I'm guessing it was something he ate and got his mouth on.

Overally, it's been about 7 weeks now and Mickey is in great spirits and is a very happy paralyzed pup. He's scooting around like crazy and still love to play/eat like a monster. We just ordered a doggy wheelchair for him a couple of days ago and that should allow him to go out once or twice a day for a short walk.

We're still hoping and praying he at least gets better control of his bladder. The rest is easy... but it is exhausting and draining when he has a bad bowel movement. Has anyone had experience with their paralyzed dog getting control of their bowels?
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

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Oh yeah, diarrhea in wonky critters is terrible. I guess you tried diapers? Yes, that's a double-edged sword with diarrhea. It sounds counterintuitive, but sometimes increasing fiber can help absorb some of the water pouring out as diarrhea. Is he taking anything that might be causing it?

7 weeks is still pretty early on, so I wouldn't give up hope yet.
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

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We have put him strictly on a rice and boiled chicken diet for now. He seems to be a little better this morning, so hoping we got through the worst of it.

Mickey has been on hydrotherapy from home the last week via our Neurologist's recommendation, and he is seeming to enjoy chasing around a treat in the bathtub. We've also been doing physical therapy exercises and stretches with him daily.

We haven't lost hope yet by any means! He is in really high spirits and we see small improvements every week. It seems like he keeps on trying to lift his entire butt up recently. One time he did this hilarious acrobatic type move and his entire butt went into the air and landed on his doggy bed.
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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

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Yeah, the thing where his rear levitated into the air happens because a dog with a mobility problem in the hind legs will shift more weight to the front legs. He may also lean out farther forward over his front legs to move his center of gravity more to the front, and stretch out his neck so his head is as far forward as possible for balance. If he overdoes it just slightly, it can result in a partial or even full handstand. When they go into a full handstand and then lose their balance, I call it tipping.

:arrow: :arrow: viewtopic.php?p=18238#p18238

On the diarrhea, absolutely agree, diarrhea is no fun in a down dog. Fortunately it does not happen often, but if it does you are doing a lot of laundry and bathing and cleanup.
:wash: :laundry: :mop:
Where might he have got something that disagreed with him? Is it possible the rehab place you've been taking him gave him a new kind of treats? You might ask them. They can go back to the old training treats if that is a likely culprit. Or do you have kids sneaking him leftover holiday food?

I guess you've been to the vet by now. I can't remember if I suggested it before, but it might help to shave his rear to make clean-up easier. Don't worry, it will grow back and it doesn't necessarily show that much. You shave the bottom under the tail, and maybe the inside of his legs or anyplace you are having to clean a lot. The vet can do it for you, it's called a hygiene clip. Or you can do it yourself if you have a home clipper. I used a Wahl home haircutting kit (for humans, $20 at Walmart) to shave the "feathers" along the back of my dog's leg and her diaper area.

I know your rehab suggested the Newman's food. I haven't tried it but I assume it is good. The best food I have found for an incontinent dog is Science Diet w/d dry kibble. It gives firm, low-odor, non sticky stools that do not gum up your dog's fur or stain the carpet. I think it has a lot of fiber like critters said (and low fat). The canned variety did not give us the same results, but the w/d dry kibble is great. It can take 3-6 months (general guideline, not a definite time limit) for bowel control to come back, but when your dog has outstanding poop texture, it matters much less whether he regains it or not.

Here is a video I did of my one paralyzed dog. I express her bottom and the stools fall on a clean potty pad. The point of the video is to show how they leave no mark on the white pad. Imagine if it was your carpet or your dog's bed, how nice that would be. The video is a little graphic, but not too bad. :D

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Re: 3-Year Old Malshi Diagnosed with Stage V IVDD

Post by Ry4n2109 »

Thank you for the suggestions Carol. We'll definitely take a look at your food recommendation.

My wife and I decided to pause the acupuncture sessions as he's been to 6 sessions already. Our neurologist suggested we do "routine" acupuncture sessions, but I'm not sure how helpful a once-a-month session would be. It's about $100 per session, so it's not super negligible as far as costs go.

We took Mickey for his routine check-up with our neurologist this past weekend, and she expressed concerns about where Mickey is at with his reflexes. She was hoping to see some back leg movement even without any deep pain. However, it's still only been about 9-weeks so we're not giving up hope that he'll be able to walk even without feeling. Of course, our biggest hope is for him to get more control over his bladder.

Our last update is that we purchased Mickey a cart from handicappedpet.net. We're impressed with the construction of the cart and Mickey is slowly becoming accustomed to it. When motivated (i.e. seeing another person or dog) he's fast on his cart! It's beautiful to see him running and being a dog again. We'll try and load the video we've taken onto YouTube and share them here!
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