Jasmine & Gawain
New Member
MALE - Pug/Frenchie Dx'd likely osteosarcoma 5/30/24
Posts: 5
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Post by Jasmine & Gawain on May 15, 2024 13:32:46 GMT -7
[Gawain / 10yr old Frenchie x Pug / Lost use of one back leg]Hi everyone, My 10 yr Pug x Frenchie Gawain is 30lbs, takes 100mg of gabapentin x2 daily, and is currently on NSAID [name of as of date?: ?mg ?x/day for how many days?] [MED LIST/HISTORY- Moderator's Note. Please do not edit
30lbs 10y.o.
post op 2018 discharged with no DPS
Never regained bladder control since 2018 surgery
Started STRICT rest 5/13
name of metacam of as of date?: ?mg ?x/day for how many days? then test STOP for pain neuro
gabapentin 100mg 2x/day
Gawiain needs GI tract protector, Pepcid AC, on board for duration of NSAID! ]
as a precaution with no signs of stomach damage. He isn't showing any pain but has lost all use of one back leg and increase in loss of bladder control.
Gawain has a long history with IVDD, including a disc extrusion in 2018 at T11-T12 to grade 5 that required surgery. While he was entirely paraplegic from waist down during that episode, after months of physio and hydro therapy he regained some mobility while never regaining urinary or fecal continence or deep nociception in his back legs.
I'm giving this context as while he has required me to express his bladder and push him about in his stroller when he gets too tired on walks, he has largely been independant and mobile for the past 6 years. We have dealt with occasional small flare ups of his IVDD by crating him for two months with NAISDs, and these episodes have always been easy to determine due to obvious dicomfort and the usual signs (arched back/uncomfy/tense/not interested in walks or play etc). Now on to the current situation. Since 05/10, he has lost all strength in one of hishind legs. He is constanly knuckling the foot, bunny hoping/draging that leg, and falls to one side when not stood square. He has also which is new, started leaking in his bed and round the home. Even with all this, he is happy as anything! He wants to play, wants treats and meals, is grumpy that he isnt able to go on long walks (I'm walking him with his post op rear sling harness to keep his back end up). There is no sign of pain or discomfort, no heat in any joints on that leg, and no visable injury. Our new (small and local) vetinary surgery is not interested in doing any diagnostic tests and has written off these symptoms as a progression of his neurological damage from the disc extrusion in 2018. This doesnt sit right with me, as the onset has been very rappid and the symptoms completely differ from his previous IVDD symptons. Can I please ask for the shared knowledge of the forum as to whether you've seen a progression of IVDD like this? Your opions on whether this is another flare up and should I crate him, even though he's not at all in pain, just to be safe?
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Post by Romy & Frankie on May 15, 2024 14:18:37 GMT -7
Welcome to Dodgerslist. We are glad you’ve joined us all. We’ve got valuable information we’ve learned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you! You DO have an emergency to crate Gawain right away. Anytime there is neuro diminishment you want to protect against it becoming permanent. Crate rest for conservative treatment is much stricter than for a post-op dog. It is to protect the damaged disc from doing worse damage to the spinal cord. Conservative vs. Surgical crate rest
Learn more about us and how we team up with veterinarians:
It may be an IVDD episode, so until you learn otherwise, it should be treated as a disc episode. This means that Gawain should be crated. Conservative treatment for a disc episode would be 8 weeks of 24/7 crate rest, out only for pottying and needed vet visits.
Here is some information about the crate rest process: www.dodgerslist.com/2020/05/14/strict-rest-recovery-proc
Most disc episodes are diagnosed by a hands-on exam, the breed often prone to disc disease and how the dog appears at the vet visit, but typically disc episodes are very painful. Also, after surgery in 2018, I would not expect progression of neurological damage from that disc. It could be another disc causing the problem.
For how long has Gawain been on an NSAID? Long term use of an NSAID would not prevent a disc episode. It could, however, be used as a treatment during an episode, since neuro deficits during IVDD are caused by inflammation of the spinal cord. Treatment for IVDD typically includes the use of an anti-inflammatory.
We are not vets and can not diagnose, but if you have any concerns about the vet's diagnosis, definitely consider getting a second opinion.
Transporting a dog during an IVDD episode can be risky. If you seek another opinion, transport Gawain by car, pad out the crate with rolled up towels or blanket so that he will not shift in the crate as you turn a corner or brake.
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Jasmine & Gawain
New Member
MALE - Pug/Frenchie Dx'd likely osteosarcoma 5/30/24
Posts: 5
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Post by Jasmine & Gawain on May 19, 2024 8:15:45 GMT -7
Thank you for the quick response!
I asked for nsaids (metacam) at Gawains vetinary appointment on the 05/13 in case it was an IVDD episode.
We were able to get a vetinary appointment at our previous clinic in the city on 05/17. They actually examined Gawains leg and hip but stated that it was "as useful as checking a sedated dog" and that they couldnt determine anything. They dismissed my suggestion that he be refered to the neurological team at the large vetinary hospital in the next county (where he had his previous operation) as he "seems fine in himself".
I have put him on strict crate rest from 05/13, and for the first time ever, he is finding it tough.
As he isnt in any pain, he is very bored. During previous episodes, he would be content with a kong, some chews, practicing his commands, and some dog tv on a tablet.
This time round, unless i'm lying on the floor by his crate, he is barking and tearing up his bedding almost constantly.
He is now [5/19?] not able to move the [which leg? Left or right?] rear leg at all, though still shows no sign of pain.
As he is fully crated, he is being taken out for more frequent bladder expressions and that seems to have stopped any bed accidents.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,793
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Post by PaulaM on May 19, 2024 8:43:59 GMT -7
Jasmine, it is not clear yet, but IF you are reporting NEW, INCREASED or all together now as of 5/19 loss of neuro function in the rear leg (right or left rear?) that would be deemed an emergency by a Neuro Clinic in the USA. Call them and tell them you are bringing Gawain in for help.
What country are you in?
You can help us by using a date rather than, now, yesterday, etc.
When you have time, after calling the Neuro Center, would you fill us in on more details
Which legs are affected, describe the degree of function for each (full knuckling under, can't right at all or can slowly right the paw, wobbly, etc.
Front right-
Front left-
Rear right-
Rear left-
Anytime there is neuro function decline, the prudent thing IS to STRCTLY crate to prevent worsening damage to the spinal cord. Good job in crating on 5/13. And good job in increasing the time between expressing to prevent the bladder from "overflowing" in bedding.
If you are noticing any signs of bladder infection, get him into for a urinalysis. Change in urine color or smell. Some UTIs do not show observable signs. The urinalysis is the proof if there is infection in the bladder or not.
Ask for a prescription sedative such as traZODone to keep him calm in his recovery suite.
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Jasmine & Gawain
New Member
MALE - Pug/Frenchie Dx'd likely osteosarcoma 5/30/24
Posts: 5
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Post by Jasmine & Gawain on May 19, 2024 8:55:36 GMT -7
Unfortunately, we're in the UK and the only way to be seen at the vetinary hospital is by referal via a vetinary practice.
It's his left rear leg, which was always the weaker of the two post his 2018 operation. He only ever regained automatic walking (no pain, no sensation, no bladder/bowel control).
For the past 6 years, his feet would only knuckle after a lot of excercise.
Now [date?] the left foot is constantly knuckled, if it isn't locked straight. I think the issue we're facing is that the vets do not see pain and considered it abnormal that he could walk without any feeling, now that he cannot walk but is in no pain, they are dismissing us entirely.
Needless to say, I will be trying to get him reffered again on Monday.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,793
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Post by PaulaM on May 19, 2024 10:21:13 GMT -7
Jasmine, only dogs who no longer have the last neuro function called DEEP PAIN SENSATION (DPS), might be able to learn how to walk without direction from the brain. Spinal walking involved reflex walking. You can learn more about Spinal walking here: dodgerslist.com/2021/09/27/spinal-walking/ ( after 5/20/2024: www.dodgerslist.com/spinal-walking/ ) Trust only a neuro or an ortho surgeon to correctly identify if Gawain still has DPS or never regained DPS after his surgery. Many general vets, do not have enough training nor practice in IDing DPS. They get it wrong too many times. Hopefully you can get an appointment for a neuro consult to find out what Gawain's diagnosis is and if the treatment would be different than strict rest you are doing. Right now doing the strict rest is prudent, until you know you are not dealing with a new disc episode that caused diminishment of the left rear leg. Date metacam started? ?mg ?x/day for how many days RXd? then test STOP for: _pain _neuro gabapentin 100mg 2x/day Gawiain needs GI tract protector, Pepcid AC (famotidine), on board for duration of Metacam! Read up on the "why" of using a GI tract protector with any anti-inflammatory drug. dodgerslist.com/2020/05/06/stomach-protection/(After 5/20/2024: www.dodgerslist.com/stomach-protection/) As I understand in the UK--- The newer generation, stronger, preferable Pepcid AC (famotidine) is only available via prescription in the UK so you would need to ask for an Rx from your vet. |
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Jasmine & Gawain
New Member
MALE - Pug/Frenchie Dx'd likely osteosarcoma 5/30/24
Posts: 5
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Post by Jasmine & Gawain on May 20, 2024 4:37:59 GMT -7
Hi Paula, Sorry, I might not have been clear. Gawain was discharged www.fda.gov/animal-veterinary/animal-health-literacy/controlling-pain-and-inflammation-your-dog-nonsteroidal-anti-inflammatory-drugsin 2018 with no recovery of nociception (or as you put it, deep pain sensation). While he is ambulatory, he has been unstable (wobbly) walking since 2018 which his neurologist stated was spinal walking.I will look for some stomach protection for him to take with his nsaids and continue to strict crate him until he is seen by a vet that doesn't dismiss him as simply being a neurologically damaged dog. [MED LIST/HISTORY- Moderator's Note. Please do not edit
30lbs 10y.o.
6mos post-op 2018 discharged with no DPS
Never regained bladder control since 2018 surgery
Started STRICT rest 5/13
metacam of as of date?: ?mg ?x/day for how many days? then test STOP for _ pain _ neuro
gabapentin 100mg 2x/day
Gawiain needs GI tract protector, Pepcid AC, on board for duration of Metacam! ] |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,793
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Post by PaulaM on May 20, 2024 10:12:47 GMT -7
Jasmine thank you for making clear your thought that Gawain likely does not have any deep pain sensation in 2024, and is not wobbly walking. Wobbly walking requires brain direction. Nerves have just not healed enough to allow for a more perfect gait yet. Spinal walking can only be achieved by some dogs if there is no deep pain sensation function. The dog's crossed extensor reflex is used by these dogs to simulate a kind of ambulation totally by reflexes. Because the brain doesn't control movements, they are a bit jerky and not smooth and movement in a straight line. To turn corners the dog usually must sit and then change direction. When you speak with a specialist you may wish to discuss these things: 🚩Can specialist confirm if Gawain was one who was able to heal DPS and thus maybe had had some degree of other neuro function partially healed within a year of 2018 surgery? Again only trust the word of an ortho or a neuro about the existence of DPS. General vets get DPS wrong too many times. Order of nerve healing 1. First: deep pain sensation which then allows for potential for more nerve healing 2. Ability to do a happy tail wag 3. Ability for some degree of bladder control.... That first can sniff an old pee post and attempt to release some of his there on that spot? 4. Next is return of some degree of brain directed use of back legs. For us pet parent humans to be able to distinguish between reflex and brain directed, we have to see some sort of head level involvement with the tail, with a limb or with release of urine so we know the movement was done with purposeful thinking.
--- Sniff (head level nose) on an old peed spot, then release of urine would be brain directed.
--- Hear (head level ear) you doing some happy talk and then tail wags is brain directed. Tail movement during potty time can often be a reflex
--- Itchy sensation at neck and then tries to scratch would be purposeful movement. Tickling paws, etc can cause reflex leg movements of pushing in or out.🚩Is it likely that Gawain has had arthritis in his spine... the facet joints for which you have described as periodic "disc flare ups"? After the disc has healed for some few dogs and older dogs there can be pain caused from the original disc episode that may just have to be dealt with for the rest of his life. This won't be impossible once you realize what it is and come up with a plan just as people do for themselves when the weather is bad or they over due things. This doesn't mean your dog lives a poor quality of life, it means that once you figure out what's going on you figure out a way to deal with it. Heck, who doesn't have an ache or pain now and then that causes you to slow down. A bit more technical explantion by Dr. Wheeler, below and a video to see more what might be going on with your dog.....something to discuss with your vet. Where synovial facet joints are located in the spine:
" Like other synovial joints, the facets react to trauma and inflammation by manifesting pain, stiffness, and dysfunction with secondary muscle spasm leading to joint stiffness and degeneration. This process is borne out, as previously described, through the degenerative cascade of the trijoint complex. Numerous radiologic and histologic studies have shown that diskal and facet degeneration are linked and that, over time, degeneration of the segment leads to osteoarthritis of the facets." Pathophysiology of Chronic Back Pain Author: Anthony H Wheeler, MD, Pain and Orthopedic Neurology, Charlotte, North Carolina . Discuss with specialist: If Adequan instead of using a NSAID with its serious side effects would be right for Gawain if this is not a current disc episode 2024. Adequan resources: adequancanine.com/veterinarians/resource-libraryBrochure to d/l: adequancanine.com/Content/pdf/Adequan_Canine_Owner_Brochure_APV_Aug2023%200594%20LK.pdfWhile staying on NSAID Metacam until you see the specialist, know all about it and what the warning signs are to immedately STOP it and contact your vet: www.fda.gov/animal-veterinary/animal-health-literacy/controlling-pain-and-inflammation-your-dog-nonsteroidal-anti-inflammatory-drugs1) Jasmine we look forward as much as you will, to fully understanding Gawain's current neuro status (does he have DPS currently or not)? 2) And what could be the issues that had you using Metacam periodically? 3) If the current use of Metacam is compatible with what the specialist's diagnosis is? |
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Jasmine & Gawain
New Member
MALE - Pug/Frenchie Dx'd likely osteosarcoma 5/30/24
Posts: 5
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Post by Jasmine & Gawain on May 30, 2024 8:06:41 GMT -7
[Update 5/30 diagnosis: fracture of the [hip] femeral neck, likely caused by osteosarcoma]
Hi all, not the best outcome but finally an update on Gawain.
After making a nuisance of myself, I was able to get xrays done for Gawain. While the vets did not want to investigate, and told me i was putting him through an "unnecessary risk" with sedation and imaging, this was based on my belief thats his lameness was a pain response even without any reactions on limb manipulation and no swelling in his leg. As previously stated, Gawain has never regained deep pain sensation post 2018.
The results of the xrays were that Gawain has a fracture of the [hip] femeral neck, likely caused by osteosarcoma. While this is not good news, it finally gives us a reason for his sudden lameness and puts an end to two weeks of trying to get Gawain the care he deserves.
We always have to advocate for our disabled pets, as many vets dismiss their issues as purely disability based. Thank you all for your advice and this just proves to me that those of us caring for our IVDD pets should trust our instincts when it comes to protecting their health and happiness.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,793
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Post by PaulaM on May 30, 2024 9:24:04 GMT -7
Jasmine, I am sorry to hear the x-ray showed a fracture in the hip (femur neck) with a diagnosis cause of likely osteosarcoma. You did the right thing with your high suspicion this might not be a disc episode to press for imaging. Imaging of an x-ray can show the hard tissue (bones, tumors, bone infection) to determine if there might be another disease that is mimicking a disc episode. That is what vets are supposed to do.
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