a nutshell the essentials to protect and care
for your dog.
2. Disc Disease DVD
is a must have for all Dachshund owners.
3. Road map to implementing Conservative
4. Answers about IVDD surgery
the Dodgerslist Support Group to talk about your
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.
of Surgery Varies
widely through out the USA. Be sure to check out the University
Teaching Vet Hospital in your region There are many variables in total
surgery/post op costs, length & difficulty of surgery,
preventative fenestration, PT such as water therapy, in addition to
how many days stay in hospital after surgery, etc. DO
NOT go by price alone. One good way to reduce the risks
of surgery is to choose a specialist, a board
certified vet: neurological (ACVIM)
or orthopedic (ACVS)
surgeon, who has been well
trained to do the surgery and has plenty of experience and practice
with IVDD surgery. Working on the delicate spinal cord is a very
tricky and complicated surgery. Look into Care
Credit for no or low interest credit.
Here are some reported costs. Note, more current data
is available to members of the Dodgerslist IVDD
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,
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
·Head held high or nose to the ground with neck
· Reduced activity
· Slower movement
· Stiffness or difficulty climbing stairs
· Difficulty with walking and jumping
· Very tense abdomen
· Hunched back due to muscle tension
· Crying or shaking
· Inability to move rear legs
· Loss of bladder and bowel control
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 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.
If surgery is not an option, then immediate strict crate
rest is a must in addition to steroid treatment by your vet. General
vets usually don't see enough IVDD on a daily basis to have the
knowledge required to provide proper treatment.Without good training in
this disease, mistakes can be made in correctly identifying a critical
neuro responses called deep pain sensation or not emphaszing 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.
rest is the single most
important part of conservative treatment short of surgery (or until
surgery is indicated).The dog owner will play an instrumental role by
understanding the critical need for STRICT crate rest. Keep your
dachsie extremely quiet during the recovery period of 8 weeks for
conservative treatment and 6 weeks if post op. The dog will be carried
to and from potty area and allowed only a few steps on a leash. 100%
STRICT crate rest 24/7 only out at potty times 8 weeks is required for
those undergoing medical (conservative) treatment. The benefit of
surgery is PT can be started when the surgeon directs it. If the dog
is doing medical (conservative) treatment, the steroids often help a
dog feel better, so that they'll want to run or jump or move in ways
that could disrupt the disc trying to form scar tissue which often
leads to even more damage to the spinal cord. Some dogs do not like
the plastic crates and do better with a wire crate or wire panel fence
that provides more visibility. How to do proper
crate rest. A good list
of supplies and ideas to make crate rest go smoother. A road
map to understanding what makes conservative treatment work and
when to expect the various parts of the healing process to happen
Medical treatment 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 needs to be
considered promptly...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.
Sometimes surgery is not an option financially or
medically. It's still a good idea to have a consultation with a neuro or
ortho specialist. 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 several attempts to go off meds while on
conservative treatment, then surgery is 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.
It is highly suspected to be a hereditary disease in 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 without warning 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. Switch to using a harness
for walks, the collar is too stressful on the spine.
rate of treatment
Mild cases (not showing signs of paralysis) may be
managed successfully medically without surgery. 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. 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 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.
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.
There is hope
for all dogs. Dogs live in the moment. They don't pity
themselves or pine away for the days when they could walk. They adjust
and move on. Paralysis does not mean you and your dog can not live a
full happy life! In time your new routine will be normal. Of course
you will be making a committment of extra effort for your special
needs doxie. It's all about getting a schedule and setting routines.
All us special needs moms and dads have done it, you can too! Doxies
with permanent disabilities can enjoy life in their wheelchairs
exploring the woods, running in a meadow, going for walks with you.
Remember we don't put people to sleep just because they can't walk. Watch
how Tabby gets on with the good life. Watch Clark
win the race against an able dog. Index
"The greatness of
a nation and its moral progress can be judged
by the way its animals are
treated." -- Gandhi
knowledge (This is not a
complete list of drugs that could be used in IVDD treatment)
NOTE: some of the meds used for IVDD dogs
such as Prednisone, can be purchased at Wal-Mart
at their $4/30 tab price. Just ask your vet for a script. These are the
medications vets use in treating a disc episode.
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 (Note NSAIDs do not
provide neuroprotective benefits.) 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 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
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.
is a synthetic glucocorticoid steroid hormone. Adverse reactions are
GI irritation,ulceration and pancreatis, depression, vomiting.
synthetic glucocorticoid steroid. Dex is approximately 10 times
stronger than prednisone/prednisolone and long acting, but too slow on
the onset for a spinal cord injury.
"The use of dexamethasone for treating
animals with acute spinal cord trauma is no longer recommended due
to doubts about its efficacy and because of its detrimental side
effects "Clinical Neurology in Small
Animals - Localization, Diagnosis and Treatment, K.G.
Braund (Ed.) Traumatic Disorders (6-Feb-2003) http://www.ivis.org/advances/Vite/braund28/IVIS.pdf
last accessed 10/15/07
(Methylprednisolone sodium succinate), a synthetic glucocorticoid
"...methylprednisilone sodium succinate has been considered a
"standard of care" in the veterinary management of SCI as it has
been in human cases of SCI." JOURNAL OF NEUROTRAUMA Volume 21,
Number 12, 2004 p.1775.
"Methylprednisolone succinate (MPS) presently remains the drug of
choice in people with acute spinal cord injury due to its
neuroprotective effects against the physiological cascade associated
with the secondary spinal injury events. These beneficial effects
occur when MPS is given within 8 hours of injury. Clinical studies
in humans suggest that spinal cord damage may be exacerbated if MPS
treatment is initiated more than 8 hours after injury."
Clinical Neurology in Small Animals
- Localization, Diagnosis and Treatment, K.G.
Braund (Ed.) Traumatic Disorders (6-Feb-2003) http://www.ivis.org/advances/Vite/braund28/IVIS.pdf
last accessed 10/15/07
"The National Acute Spinal Cord
Injury Studies (NASCIS) II and III, a Cochrane review of all
randomized clinical trials and other published reports, have
verified significant improvement in motor function and sensation in
patients with complete or incomplete SCIs who were treated with high
doses of methylprednisolone within 8 hours of injury...In the NASCIS
III trial, ..the study found that in patients treated earlier than 3
hours after injury, the administration of methylprednisolone for 24
hours was best. In patients treated 3-8 hours after injury, the use
of methylprednisolone for 48 hours was best." Spinal Cord
Injuries. emedicine last updated Aug 8, 2006. http://www.emedicine.com/emerg/topic553.htm
last accessed 10/23/07
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
of Spinal Cord Injury. Wise Young, Ph.D., M.D. Last updated 7
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
Never give aspirin, a NSAID, or steroids
along with another NSAID.
10 to 14 days is recommended when switching to
another veterinary NSAID from aspirin
Pfizer recommends a 5 to 7 days a
washout from the body before changing from one NSAID to another or
to a steroid. Vets who practice safe medicine follow the 5-7 day
washout out period to avoid bleeding ulcers and other
NSAIDs should be approached cautiously in dogs with
kidney, liver, heart and
Never give your dog an NSAID unless directed by your
Don't assume an NSAID for one dog is safe to give to
another dog. Always consult your veterinarian before using any
medication in your pet.
Only give the NSAID as prescribed by your
veterinarian. Do not increase the dose, the frequency, or the length
of time you use the drug unless first discussing this with your
Ask your vet to prescribe something like Pepcid,
Carafate to protect the stomach lining and decrease stomach
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
exerts its effect by acting on the central nervous system (i.e., the
nerves that control the muscles) rather than on the muscles
themselves. Methocarbamol can be used in any condition where
painful muscle spasms should be reduced for patient comfort. An oral
dose of methocarbamol is active in the body approximately 30 minutes
after administration with activity peaking in 2 hours (in humans).
Has some sedative properties. Sensitive animals will salivate or
Valium (Diazepam) The
injectable form of diazepam is often used in anesthetic protocols.
Diazepam is rarely used as a tranquilizer for animals as it simply
not very strong and not very reliable. Diazepam may have a stronger
than expected effect if used in conjunction with Tagamet
(Cimetidine). Anti-acids may slow the onset of effect of
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
As a lay person, it's hard to know if your vet has
prescribed the proper medical treatment. We tend to trust that we are
placing our pets where they will get safe, effective and the
most-up-to date procedures. As with any profession from your hair
stylist, car mechanic to your own doctor, you realize some are better
than others. Same with vets, some are more personable, smarter,
skilled and do more research.
A general vet can't possibly be as up-to-date on
specialized areas as a neurosurgeon can. You would not go to your own
general doctor for brain surgery, you'd be referred to a specialist, a
neurosurgeon. If at anytime you question something, or just don't feel
right, seek a second opinion, consult with a specialist, do your own
research on the Internet, communicate with support groups who've been
there/ done that. Be an educated consumer so you understand what your
vet is saying and ask good questions, your pet so depends on you! Join
DodgersList for education
Disc Disease DVD
Everything you need to know about IVDD and taking care of a downed dog.
Education will be a game changer for you and your dog. This DVD
is priced at $3 including postage so everyone can afford one. DVD is also
available in the UK (via the UK Dachshund Breed Council.) See the promo
video clip and then order.
Chock full of information on the two treatments for disc disease PLUS tips
your vet may not have had time to tell you about during home care
recovery. A must for all Dachshund owners.
Comments from a vet's perpective:
"Many people know the symptoms of one disease
very well...Veterinarians are almost all general practitioners. Most
work on several species of animals and treat disorders of all body
organs and systems medically and surgically. Inevitably, they are not
going to know the medical problems of every single dog breed or cat
breed well. They are not going to have "cutting edge" knowledge about
every organ system in their head. It is very easy for a non veterinarian
to learn the medical problems of one or two breeds in more depth than
their veterinarian. It is a little more difficult, but not close to
impossible, for a lay person to learn more about a particular organ
system than the average veterinarian. Especially if it affects a beloved
pet of theirs...My knowledge of veterinary medicine surpasses almost
every lay person's knowledge, in general. That gives me the ability to
research many topics more quickly than a lay person can. It doesn't take
me as long to get "up to speed" as it took a particular client to
acquire an in-depth understanding of a particular disease affecting
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"
Mike Richards, DVM.