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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.
Fast Facts: Intervertebral disc disease (IVDD)
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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 and do not give the same detail as MRI, and also have a degree of risk.
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. Index
If your doxie exhibits any of the above signs however mild,
immediatley restrict his movement by placing him in a crate and take him
to a vet. IF dachsie is dragging his legs/ has stopped using his hind legs
completely, THIS IS AN EMERGENCY! You must get your dog to a neurologist as soon as possible. Generally,
the chance of recovery is higher if the dog undergoes surgery within the
first 12 hours after onset of paralysis and decreases as time goes by to
an outside of 48-72 hours. If surgery is not an option, then immediate strict
crate rest is a must in addition to medical corticosteroids treatment by
your vet. Index
Medical management (non-surgical) vs. Surgery
Medical treatment combined with restricted activity 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, more aggressive therapy is usually needed. Many dogs that have partial paralysis, or are paralyzed, given enough time can regain "normal" function without surgery. However, the degree of permanent damage inside the spinal cord and the recovery time will be far faster for the dog that receives surgery soon after injury. If additional disc herniations happen in the future, the dog that has "recovered" without surgery will probably have more difficulty due to greater preexisting spinal cord damage, all things being equal than the dog that was operated on early.
Sometimes surgery is not an option financially or medically. It's still a good idea to have a consultation with a neurologist. The specialist has much more experience with these cases than the general practictioner vet does, that they can make a proper evaluation and prescribe proper conservative treatment.
Whether your dachsie is paralyzed or mobile, showing signs of pain after a week or two after conventional medical treatment, surgery is a consideration to prevent a life of pain and discomfort caused by herniated disc material pressing against the spinal cord.
Low-level laser therapy is emerging as the new high-tech device to treat a wide variety of aches and pains, injuries, and diseases, specfically in IVDD as a means to stimulate function and pain control. For example a class 3B cold laser could be used on acupuncture points as well as non- acupuncture points. It works on the theory of light stimulating the movement of molecules across the cell membranes. Low level laser is used along side the spinal cord not directly over the cord. There are different strength (classes) of lasers. A class 4 laser are hot lasers and can burn skin and fur. A laser in the wrong hands, including a vet who has not had proper training, could be a dangerous thing.
What is IVDD? It is highly suspected to be a hereditary disease in long, dogs with dwarfed legs. If the doxie puppy has the disease, the degeneration of the discs begins to occur within the first few months of life, but the actual disc herniation typically occurs suddenly at around 3 to 6 years of age. As discs age and degenerate, they lose water content, and become less able to withstand compression. They become less able to withstand forces placed upon them. If too much force is placed on them, they can be squeezed and expand or rupture. This rupture usually occurs in an upward direction, and the disc extrudes into the spinal canal where the spinal cord is. Symptoms develop either because of the force of the disc material hitting the cord, or due to the disc material compressing the spinal cord.Trauma to nerve cells causes their membranes to weaken and even rupture. Though the cells may survive, this membrane damage causes them to lose the ability to produce and carry nerve impulses along their membranes from one cell to the next. Chemicals seeping out of the dying spinal cord cells send a 'suicide signal' to other nearby cells, causing a chain reaction that kills off more cells than the initial injury did. The end result is damage to the spinal cord, causing partial or complete paralysis. Not all dachsies will get IVDD--that is why is it important NOT to buy from backyard breeders, pet store at the Mall. Choose a reputable breeder who can show you the dog's pedigree (here's an explanation of what you are looking for in a pedigree), you will pay more, but have less medical problems and heartbreak. Reputable breeders produce litters with far less incidence of back problems.
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. Index
Mild cases (not showing signs of paralysis) may be managed successfully medically without surgery. Confinement to a crate 8 weeks to immobilize the spine except for being carried to and from potty place is all important. Typical meds: 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. 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.
You will need to provide intensive care for your doxie, no matter which treatment is used. Recovery 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.
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 One indicator of the severity of the injury is the ability for the dog to feel pain in the toes. When there is no deep pain sensation, the innermost part of the spinal cord has been damaged. Normally, the chance of recovery from this type of injury is greatly reduced. The most favorable outcomes for recovery of function occur when surgery is performed within 12 hours of the injury with 48-72 yielding decreasingly less favorable outcome. You will need to provide intensive care for your doxie, no matter which treatment is used. Recovery of 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.
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. Index
"The greatness of a nation and its moral progress can be judged
by the way its animals are treated." -- Gandhi
----Steroids are used for their anti-inflammatory and immuno suppressive 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 (Note NOT NSAIDS.) Steroids affect many body systems not just the target area of the spine. 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 Pepcid, Carafate) to avoid potential stomach discomfort/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 pain medication such as Tramadol should be prescribed in addition. 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.
There are different kinds of pain that can be experienced after a spinal cord injury such as pain from swelling of the spinal cord, muscle spasms, abnormal signals of the SCI). Alternative treatments after the initial injury and use of steroids can include Adequan, NSAIDs, muscle relaxers, accupuncture to relieve some of the associated pain. A veterinarian will be cautious in timing rest days to clear the system before switching from the steroid to a NSAID due to the danger of increased risk of ulceration.
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
Certain corticosteroids at certain doses may improve recovery from acute spinal cord injury. There is little evidence that NSAIDs are beneficial, other than for mild pain control. (William B. Thomas, DVM, Associate Professor, Neurology & Neurosurgery, U of Tenn. October 1, 2000.Veterinary Information Network Conference.) http://www.ne.jp/asahi/takeuchi-vet/bamboo/page083.html last accessed 11/28/2007
----Pain Relievers
- 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.
----Muscle Relaxers
----Neuropathic pain (abnormal signals from the spinal cord) treatment
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. Index
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"
