Have you ever wondered why vets recommend one drug over another?
We’ve usually researched it ourselves.
Or we have a wealth of first-hand experience.
However, sometimes the health claims are just too complex to easily assess. That’s when we might trust the company data. But how many vets have the time to double check what they say?
I’ve made a reputation as a ‘difficult’ customer, and I know I’m not alone. That’s because there’s often more than one way to look at the same data. Here’s just one example from the past week: a good product sold by nice people.
Sudden loss of control of the hind legs is a life threatening emergency
Keep affected dogs as still as possible until a vet can examine them
Home care or surgical options exist, & dogs can go on to live normal lives
Now dive deeper…
Have a look at the video below and pay close attention to how Rickey is walking. That’s not a limp caused by a sore leg. To a vet, that’s an emergency. If your dog ever starts walking like this, especially after a jump or fall, keep them very still and see a vet immediately. Their life may depend on it.
What Is Ataxia?
Rickey is ataxic. That means he’s lost some control over how his legs are moving, and it’s a hallmark of neurological disease. Something is interfering with his nervous system’s ability to move his legs.
Later I’ll give you a long list of possible reasons for ataxia, but one cause stands head and shoulders above the rest…
Intervertebral Disk Disease
Intervertebral disks are the flexible pads that sit between the spinal vertebral bones in the back. They act both as joints and cushions, and are yet another marvel of nature. IVDD is when the disk fails, and although it’s often called a ‘slipped disk’, that’s not really what happens in dogs.
Rickey’s disk didn’t slip, it burst after he jumped off a chair. In Type I IVDD, the disk itself degenerates and the ring of fibres that holds it together weakens. Eventually it gets weak enough that a sudden compressive force, usually from jumping off furniture, causes the outer fibres to split and the inner disk content to be violently expelled.
The bad news is that when it ruptures, contents of the disk often travel towards the spinal cord. That’s Rickey’s xrays showing which disk is the likely culprit. You can see that the spinal canal containing the cord runs just above the disk. What we can’t see on the xray is that some of that disk material is now pressing on the spinal cord hard enough to stop the flow of nerve signals.
Which Dogs Are At Risk
IVDD is mostly associated with certain dog breeds. These include:
American Cocker Spaniel
Cavalier King Charles Spaniel
Dandie Dinmont Terrier
English Springer Spaniel
Jack Russell Terrier
Poodle (Miniature and Toy
What all these breeds have in common is a genetic defect called chondrodystrophy. The same thing that causes their cute body shape also causes premature degeneration of intervertebral discs. IVDD is always more common in overweight dogs of these breeds.
In our clinic, IVDD also occurs in very excitable and energetic dogs of any breed. This may explain an increased prevalence observed in male dogs. There is a higher risk in desexed (neutered) females that could be explained by increased weight.
Why Is IVDD Serious?
Rickey was lucky; his cord injury was only partial, his owner brought him straight down and he responded well to treatment. All three of these factors can easily go the other way.
Disks can rupture with enough volume or force to totally and permanently disable the spinal cord
Movement of the spine can cause more and more disk material to press on the cord until paralysis ensues
Some dogs don’t respond and need advanced referral surgery
If a dog has lost all voluntary movement and pain sensation to the hind legs, there’s still a chance that rapid surgical decompression can save them. However, if paralysis can’t be reversed there’s not much hope for quality of life. I know from bitter experience that no matter what people say about how good their dog is on a cart, the reality of their life is very different.
Neurological Lamenesses In Dogs
I can’t stress enough that the diagnosis must be confirmed by a vet. Many diseases of the nervous system can look exactly the same, such as:
Dogs with IVDD often have back pain at the time of the spinal injury, shown by arching of the back, shivering and lethargy. It’s especially important to be aware of signs of the disease in susceptible breeds such as the Dachshund, Beagle, Shih Tzu, Lhasa Apso or Pekingese. Sometimes the main problem is pain from nerve root compression, not neurological dysfunction.
Confirmation of the diagnosis is only possible with advanced imaging such as CT scans or MRI. However, in most cases the combination of the history and examination plus plain x-rays are enough for vets to be confident. X-rays such as Rickey’s often show a narrow disk space and/or calcified disk material visible in the spinal canal.
There are two options for treatment:
1. Conservative Treatment
For dogs with mild to moderate signs, and no further worsening, conservative treatment is often very successful. However, I have personally seen too many dogs get worse with poorly managed conservative treatment.
The theory behind cage rest is that if the dog is kept extremely still, the disk material will stop moving and the body is able to wall off and repair the damage. Dogs must be confined in a cage that is only just big enough to fit their bed plus food and water.
The only times a dog should be allowed out of the cage for at least the first two weeks is while being held to go to the toilet. Yes, it sounds cruel, but if the dog is near the owner, they are usually happy enough. The consequences of failure are just too serious to take chances.
A vital part of conservative treatment is close monitoring by the owner and vet, with the readiness to change course quickly if necessary.
2. Surgical Treatment
Surgical referral is best if a dog is severely affected, has repeated episodes, or fails to respond to conservative treatment. The option of referral is always available even in milder cases even if only for a second opinion and advanced imaging.
Rickey responded well and will eventually be able to return to a normal life. However, he’s always at risk of a recurrence so we’ve made a few changes:
Weight loss: he wasn’t fat but we want him as thin as is comfortable
No high impact activity: walking is good, running and jumping are bad
No access to furniture: an example would be settling in a crate at night to stop a dog jumping on the bed
Rickey’s case was successful for more than one reason. When his owner rang for a Saturday appointment, we were already booked to 5:30pm and the nurse, to her credit, didn’t hesitate to slot him in, even though it was ‘only a leg problem’. Who could have guessed over the phone how much danger Rickey was in?
Have something to add? Comments are welcome below and will appear within 24 hours of lodging. By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. These help topics are from a series regularly posted on email and Twitter. Subscribe via email here to never miss a story! The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.