Dean, welcome to the Forum. Pinschers are one of the breed that can be prone to being born with IVDD. We are not vets here and depend on what a vet diagnoses. There are other diseases that can mimic the signs of a disc episode.
It appears that you HAVE written that Leo had Xrays?
How a disc episode is most often diagnosed.
A vet often suspicions a disc episode by knowing your dog is a breed prone to IVDD, his history plus the signs shown with a hands on neuro examination. If your dog improves with the prescribed medication and rest, then likely the diagnosis was correct.
Dr. Fingeroth, a board certified ortho surgeon explains to other vets how a diagnosis is made:
So and Xray would only be taken, when the vet has a list of several suspicious diseases it might be. An X-ray would be taken to rule out other problems/diseases such as broken bone, bone tumor, disc infection or other potential causes of spinal cord damage. X-rays can show narrowed intervertebral disc spaces that are consistent with disc disease but not proof of a current disc episode.
X-rays can only be used to suspicion a disc problem since they show hard tissue not soft the tissue of the spinal cord and discs.
Though intervertebral disc disease can be suspected, xray is inadequate to definitively diagnose it and the site of compression. Soft tissue vascular events cannot be seen on traditional xrays.
Diagnostic tools of an MRI, CT or myelogram not only see discs and spinal cord but also can confirm if another disease that can mimic disc disease is the problem. So when symptoms would worsen under conservative treatment, it makes sense to consult with a specialist and possibly employ one of the advanced imaging tools. Identifying the exact problem your dog has means the vet can match up with the correct treatment. Advanced imaging can run about $1,000 to get to the root of a worsening situation.
So your vet needs to give you confidence in his thinking and path for in ruling out various diseases that would make him good at his job of diagnosing. Not all vets have this diagnosiing skill to the same degree. Seeking a consultation with an vet with advanced training, a specialist in neurology or one in orthopedics, is needed when things are beyond the scope of a local vet.
UNTIL YOU HAVE A good DIAGNOSIS, CRATE at once! Until you know you are not dealing with a neck disc episode,
act like this may be a disc episode. Crating is the single most important care you can give. Crating is to keep the suspicion of a bad disc from further deteriorating (tearing) where the spinal cord then is seriously impacted. Pressure from a bad disc into to the spinal cord can cause leg paralysis in both the front and the back legs. Right now Leo is in pain only (no neuro diminishment reported) and a good candidate for conservative treatment IF, if, if he can get the pain in control. LINK to more info on disc healing:
www.dodgerslist.com/literature/healingdisc.htm Do what you can to
advocate for pain meds from your local vets as they work in one hour or less to provide comfort from pain. Go to this page to learn about the medications (tramadol, gabapentin, methocarbamol) to advocate for PLUS other things you can do at home to help Leo with this suspicion of a neck disc issue. LINK:
www.dodgerslist.com/literature/cervical.htmDo your best to
advocate for an anti-inflammatory drug. Ask what will it hurt to give it a try to see if a NSAID or a steroid) helps Leo get out of pain. Bone up on the two classes of anti-inflammatory drugs, so at least you are in the know and can help guide the discussion with your vet. LINK:
www.dodgerslist.com/literature/healingsweling.htmAnti-inflammatory use needs GI tract protection! Proactive vets don’t wait til there is lip licking of nausea, not eating, vomit, diarrhea leading to serious bleeding ulcers, red or black blood in stool due to the extra stomach acids anti-inflammatory drugs cause.
Pepcid AC (famotidine) blocks the production of acid. The usual dose of Pepcid AC (famotidine) with a disc episode is 0.44mg mg per pound every 12 hours. Pepcid AC has a very limited potential for side effects.
Ask if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health” issues answer, then go to the grocery store or pharmacy to purchase over the counter Pepcid AC (in the USA--- not sure about Thailand if over the counter) containing one single active ingredient (famotidine). In Thailand this product may go by another name— Gastril (Famotidine), GenRx famotidine, Famotab (famotidine)
HEALTH ISSUES: “Mar Vista Vet reports: Pepcid AC has a very limited potential for side effects, the reason of release to over-the-counter status. The dose of famotidine may require reduction in patients with liver or kidney disease as these diseases tend to prolong drug activities. There have been some reports of exacerbating heart rhythm problems in patients who already have heart rhythm problems so it may be prudent to choose another means of stomach acid control in heart patients.”
marvistavet.com/famotidine.pml 
Please do stay in touch, let us know your success in advocating for pain meds and an anti-inflammatory drug. Whether getting a neuro or an ortho consult is doable from your island.
