Note: I am not a vet. This is information I've collected via research and thru personal experience.
Please consult with your own vet to see what's right for your Dachshund.
X-ray/radiography is used generally to rule out other conditions as x-rays only show bones and no soft tissue such as herniated disc material pushing on the spinal cord.
"... calcified discs do not necessarily mean that this particular disc is going to rupture. It only means that the dog very likely has IVDD and this chalky appearance to the discs is only a "normal" part of the abnormal aging process of such a dog's discs.
Your Veterinarian may point these calcifications out to you on your dog's radiographs. Do not be mislead into thinking that these calcifications are the only problem area if your dog is experiencing back pain or has suffered a disc rupture. In fact, most often, the actual site of the disc rupture is NOT at one of these calcified spaces. " from Dodger'sList Calicified Discs: What They Are and What They Mean in the Dachshund Back., Laurie Miller, Surgical Vet Tech.
x-ray of a dog's spine showing bone
MRI of a dog's spine showing detail of bone and soft tissue discs and spinal cord
The following three type of pictures require anesthesia. (As with any general anesthesia, complications may arise. Even though rare, anesthetic death can occur. With the use of modern anesthetic protocols and monitoring devices, the risk of problems with anesthesia is minimal) so recommended if surgery will be an option and is done prior to going into surgery.
Myelography is often the first choice as a veterinarian can perform the procedure himself. General anaesthesia is used. This procedure involves inserting a needle in the bag (dural sac) that surrounds the spinal cord. Dye (which can be seen on radiographs) is then injected. Radiographs (x-rays) are made to see where the spinal cord is being compressed. Myleograms are invasive. They do not give the same detail as MRI, and also have a degree of risk, siezures..
CT and MRI require anaesthesia to keep the doxie still and are non-invasive and gives multiplanar images of structures being evaluated resulting in cross sectional images with no superimposition of structures such as ribs. Bony changes are seen very well with CT but soft tissue differentiation is not as good as in MRI.
MRI results in excellent soft tissue detail and reasonable detail of bone and cartilage. MRI is considered the gold standard.
If surgery will not be an option and other diseases
mimicking IVDD have been ruled out, then err on the side of symptoms
being IVDD and put the doxie on strict crate rest for the next 8 weeks
and go with conservative
medical treatment from your vet until a diagnosis otherwise has
If your doxie exhibits any of the above signs however mild, immediately restrict movement by placing him in a crate and take him to a vet. IF your dachsie is dragging his legs/ has stopped using his hind legs completely, lost bladder control THIS IS AN EMERGENCY! Get your dog to a board certified neuro (ACVIM) or ortho (AVCS) surgeon specialist as soon as possible if surgery is an option for your family. Only a specialist's advise on surgery should be considered. General vets are not qualified to provide surgical opinion as to whether surgery is indicated or not. Without good training in this disease, mistakes can be made in correctly identifying a critical neuro responses called deep pain sensation or not emphasizing necessary crate rest. Neuro or Ortho specialists deal with IVDD cases, many each day. They accurately access DPS. After a dog is paralyzed there is a window of 12-24hrs from loss of DPS that surgery can STILL be successful. The longer after 24 hours, chances are reduced for success. Precious hours can be lost with a vet that is not specialized with IVDD. Often it is money well spent to get the right treatment immediately from specialists who know this disease, than to go from general vet to general vet trying to find one who knows IVDD.If surgery is not an option all hope is not lost! Immediate 100% STRICT crate rest 24/7 is a must to prevent worsening of the bad disc and to prevent permanent spinal cord damage. The meds do not heal discs nor heal nerves. Meds reduce spinal cord swelling (anti-inflammatory, provide comfort (pain meds) and protect the GI tract (Pepcid AC). A disc episode is a scary time. Your self education will make all the difference for you and for your dog. Be in the know:
Care and Support Forum for IVDD dog owners
Medical treatment (conservative treatment) of drugs
combined with 8 weeks of crate rest and acupuncture is a good approach
as long as the dog is only displaying walking problems and/or
discomfort. But once paralysis of the legs occur or loss of bladder
control, more aggressive therapy surgery can
be a consideration...hours
count in spinal cord damage. If surgery is an option, do not delay. Do
know that many dogs with partial paralysis or are completely paralyzed,
given enough time have been able to regain "normal" function without
surgery. Essential reading to weigh the
the difference of the two treatments (conservative
Dr. Isaacs, ACVIM
questions for those deciding
whether surgery or to stick with conservative as
well as what to expect with surgery, post-op,
Sometimes surgery is not an option financially or medically. It can still a good idea to have a consultation with a neuro or ortho specialist if you feel your vet is not comfortable with conservative treatment. The specialist has much more experience with these cases than the general practitioner vet does, that they can make a proper evaluation and prescribe proper conservative treatment medications.
Whether your dachsie is paralyzed or mobile, showing signs of pain after several attempts to go off meds while on conservative treatment, then surgery may be a consideration to prevent a life of pain and discomfort caused by herniated disc material pressing against the spinal cord.
Laser light therapy and/or acupuncture is used for
relieving pain and inflammation and to help stimulate nerves to
regenerate. General relaxation is also a benefit. Acupuncture can be
done with needles or with cold laser therapy directed at the acupuncture
points. These therapies can be started at any time with a post-op or
conservatively treated dog. More information and directory: http://www.dodgerslist.com/literature/healingacupuncture.htm
Since there is no way to tell if your dachsie puppy has the disease and whether symptoms will show up later in life, it is very important: 1) to make sure your dog is used to a crate in case of a future need to confine 2) not to use stairs, 3) not to jump up or down on furniture (get ramps for your home). Sitting up, standing on back legs, tug-o-war are no, no's. Switch to using a harness for walks, the collar is too stressful on the spine. Index
100% STRICT confinement 24/7 to a recovery suite (wire
crate, ex-pen, pak n play) for 8 weeks to immobilize the spine except
for being carried to and from potty place is all important. How
to do crate rest:
steroid to reduce swelling. Until swelling goes down there will be pain,
muscle relaxants and pain relievers help to mask the pain. Release
of pressure on the spinal cord is measured by a decrease in pain.
Healing of the disc is is accomplished only with time and limited
movement...there are no meds to heal a disc. If a dog is allowed too
much freedom too soon the disc will leak again and dog can be back where
he started--or worse. How
the pain relievers work:
http://www.dodgerslist.com/literature/healingpain.htm How the
You will need to provide care for your doxie, no matter which treatment is used- 6 weeks of post op crate rest or 8 weeks of crate rest with conservative treatment. Return of neuro functions can take weeks to months, even as much as over a year dogs have been known to walk again. If the cord is too severely damaged the dog will never walk. However it is in the cards for all dogs to return to a pain free, loving and happy life again whether walking or using a wheelchair.
There are many factors that affect the outcome of your dog's injury. The two most important factors are the severity and duration of the injury. When paralyzled, there is one last indicator of neuro function left, deep pain sensation (DPS) When there is no DPS the innermost part of the spinal cord has been damaged. There is still a good chance for a successful surgical outcome if surgery is performed 12-24 hours from loss of DPS. The more hours after 24 hours, chances are reduced. Many general vets do not have the training to correctly interpret the DPS test of pinching the toe bone, crucial hours can be wasted while the delicate spinal cord deteriorates. If your dog is paralyzed that is an emergency, go to a neuro or ortho specialist ASAP. A specialist has the practiced eye and years of training to correctly perform a neruo exam. You will need to provide crate rest for your doxie, no matter which treatment is used. Recovery of leg functions can range from weeks to months, even as much as over a year dogs have been known to walk again. If the cord is too severely damaged the dog will never walk.
Doctors have no way to measure the amount of cord damage, nerves that are not totally damaged grow about 1-3mm a day. So think positive and never give up hope. Doxies don't read the statistics and their bodies often surprise us.
----Steroids are used for their anti-inflammatory effects. The initial swelling of the cord due to impact of a disc bursting into the spinal cord is a type of inflammation that responds especially well to the corticosteroids and their neuroprotective effects . Steroids affect many body systems not just the target area of the spine and a blood panel is recommend to test health of the organs before using. For example suppression of immune and inflammatory systems may result in increased susceptibility to secondary infection (UTI). Gastric ulceration (stomach problems). Steroids are often accompanied by GI protectant drugs (such as over the counter Pepcid AC) to avoid potential stomach damage. Allow at least one week if switching over between prednisone and NSAID's. Steroids must never to stopped abruptly, they need to be tapered off. Note: A genetic predisposition for diabetes is suspected in Keeshonds, Puliks, Cairn Terriers, Miniature Pinschers, Poodles, Dachshunds, Miniature Schnauzers, and Beagles. Most dogs are diagnosed between 4 and 14 years old. Any dog suspected of having an insulin related disease, should have tests run before using steroids.
NOTE: Steroids are NOT pain killers. Dog will be in pain until the swelling starts to go down. A general analgesic pain medication such as Tramadol and possibly methocarbamol for the pain from muscle spasms are typically prescribed. Nothing worse than to get your dog home to find later that night or on the weekend pain kicks in and you have nothing on hand.
Although they [NSAIDs] have never been reported to be neuroprotective in spinal cord injury models, there has been a long-standing interest in these drugs because of their potential to block prostaglandin production...None of these drugs have been tested extensively for neuroprotective effects. Experimental Therapies of Spinal Cord Injury. Wise Young, Ph.D., M.D. Last updated 7 January 2002.
NSAID have minimal benefit in acute spinal cord injury and increase the risk of complications, especially if used in conjunction with corticosteroids. ("Trauma" The Merck Veterinary Manual. © 2006; Merck & Co., Inc.Whitehouse Station, NJ USA.) http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/100713.htm last accessed 11/28/2007
- Treating pain early usually brings quicker and better results. Healing occurs faster when pain is under control. Pain affects blood pressure, heart rate, appetite, and general mood. Until all the swelling is resolved on the inside via surgery or conventional medical treatment, there will still be a source of pain. Herniated discs, damaged spinal cord require a significant amount of time to heal. New tissue must be generated. Swelling must have time to subside. Pain is so important to the overall well-being of a patient that it has become the 5th cardinal sign of human assessment. (Philips DM. JCAHO pain management standards are unveiled. J.Am Med Association 284(4):428-429, 2000) Institutions can risk their federal funding if they do not routinely assess for pain.
- Tramadol is an atypical opioid which is a centrally acting analgesic (pain reliever), used for treating moderate to severe pain. Adverse reactions are nausea, vomiting and panting. Does not cause gastric bleeding. Can be given with either a NSAID or steroid.
This type of pain is uncommon and usually felt at or below the level of the injury. Abnormal signals from the nerves damaged by the SCI feel like mild tinglings to very painful on-fire sensations causing a dog to lick, chew and in some cases chew off a foot, penis, or more tragic lethal damage. These abnormal signals explain why a paralyzed dog can feel neuropathic pain in an area that otherwise has no sensation. Many different medications are used for neuropathic pain, including antidepressants at low doses, anticonvulsants such as Neurontin (gabapentin), narcotics (morphine, codeine) or NSAIDs. Sometimes combinations of drugs work better than a single drug. Dog must never be left alone without an e-collar or no-bite collar. These symptoms can periodically surface during the dog's lifetime.
Vets are finding good success with harder to control pain during a disc episode by using Gabapentin along with Tramadol and Methocarbamol.
Please let your vet know what treatment level you are looking for. If you want the best care for your pet, say so. If you want your vet to provide the best possible compromise between the hypothetical "best treatment" and the "best cost" treatment, let her know. Don't allow your vet to take multiple X-rays and fix a fractured leg and THEN tell him that you really only wanted to spend $25. Your veterinarian really is trying to understand what sort of care you want for your pet"