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Old 07-29-2011, 07:19 AM   #1 (permalink)
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Question Dragging hind legs

Our sweet 5 yr old Bitzy, starting dragging her hind legs last friday night, on Sat Morning, we took her to the vet. Bitzy isn't in any pain and the vet could not get her to yelp. Infact all she wanted to do was lick everyones face...
Anyway, the vet took xrays and said it wasn't a disc problem that she was fine, but he suspects she has blood clots in her spine. We were given antiflammatory drugs, as well as pain meds. After the first two days of treatment Bits was improving,she would stand on all four legs and take a few steps at a time, about 5-10. We were very please and thought perhaps this was going to work, However, it has been 7 days now and she is back to square one she isn't improving anymore. She is still dragging her hind legs, we have one week left of meds.
Has anyone seen this before, any suggestion? We are going to bring her back to the vet Sat.
Surgery wasn't an option at this point and Bitzy doesn't have any tumors.
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Old 07-29-2011, 09:31 AM   #2 (permalink)
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My understanding is that a disc problem will not normally show up on an x-ray.

Besides anti inflammatories, did the vet recommend strict crate rest? If the dog is feeling better because of the inflammation relief, but is not actually healed, it can make the problem worse because they will do more than they should.

I would seriously consider a second opinion from a vet experienced with bassets, or at least with dwarf breeds. Maybe your breeder or local basset hound club can give you a recommendation.
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Old 07-29-2011, 11:19 AM   #3 (permalink)
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Quote:
My understanding is that a disc problem will not normally show up on an x-ray.
Generally a dye is required they call this a myelogram


from
Canine Intervertebral Disk Disease

Patricia J. Luttgen, DVM, MS
Diplomate, American College of
Veterinary Internal Medicine,
Specialty of Neurology
Denver, Colorado

Quote:
Intervertebral disk herniation is usually suspected based on the signalmen(breed, age, sex), history of appropriate clinical dysfunction, and a neurologic localization of the cervical or thoracolumbar areas. To make a positive diagnosis, spinal radiographs or Xrays will need to be taken. It is absolutely imperative that no movement occur and that the muscles along the spinal column be relaxed if an accurate assessment of vertebral relationships and disk spaces is to be made. Consequently, the only way to get good quality spinal radiographs is by administering a general anesthetic to the affected dog. The only exception would be if some other physical abnormality, such as severe heart disease, precludes this being done safely. In that event, surgical intervention is probably also not an option and specifically locating the offending disk is not necessary to carry out good medical therapy.
Once the dog is anesthetized, a series of plain radiographs will be taken with the dog lying on its side (lateral view). The veterinarian will be looking for changes in the normal relationships and density of the vertebrae and the disks. Those changes include narrowed or wedged disk spaces, displaced calcified disk material in the intervertebral disk space or intervertebral foramina, narrowed articular joint spaces, and/or many other suggestive signs. However, calcification of the nucleus pulposus does not necessarily mean that a disk will herniate. Unfortunately, most herniated disk material is not calcified enough to be seen on Xray. Therefore the exact position of the herniated material most often can not be determined on plain Xrays and a specialized study called a myelogram must be performed. Risks are involved and the possibility of worsening a delicately balanced situation exists. However, the manufacture of new less irritative dyes has removed a great deal of the risk and myelograms are now routinely performed without the great concern of the past.
In a myelogram, radioopaque dye is injected into the cerebrospinal fluid in the subarachnoid space. In a normal study, two lines of dye will be seen running on each side of the spinal cord more or less like railroad tracks running parallel to one another. When a disk has herniated, nuclear material and torn annular fibers can occupy the extradural space compressing the spinal cord. The normal parallel configuration of the two dye lines will be disrupted by either pushing them closer together or farther apart depending on the particular radiographic view examined. Additional oblique views can be taken to help identify which side of the spinal cord is more affected. By examining all views carefully, the amount of herniated material, and therefore the amount of pressure on the spinal cord, can be estimated. Also the preferred side to enter surgically can be determined.

Unfortunate too much time has passed for surgery to be clinical signifcant to help the current situation but if disk herniation is involved surgery could prevent further episodes. I highly suggest reading the entire article. A Basset with bilateral leg weakness in the vast majority of cases has a disk herniation of some type.
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Old 07-29-2011, 12:47 PM   #4 (permalink)
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Why is it too late for surgery? I know the longer the nerves are compressed the more damaged they become but as far as i know there isnt a set time frame for the point of no return. Plus humans can wait months & still have good surgical outcomes.
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Old 07-29-2011, 01:54 PM   #5 (permalink)
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In dogs surgery after 48 hours in general do not have better recovery rates than more conserative approach which is the reason for doing surgery. If however the disk that heriated is likely to herneate again surgery does not prevent the disk from herniating but it provides a place for the materai pushed out of the disk to go without impinging on the spinal cord so it can be sort of a preventative in further problems.

from the link above
Quote:
The spinal cord can compensate immensely if a compressive force is applied in a chronic progressive manner, as occurs in type II disk herniation. Clinical dysfunction develops in the classic stepwise fashion described previously (ataxia>>paresis>>paralysis>>lose of pain perception) at a rate proportional to the speed of the increasing compression. Because damage is occurring on a "one cell at a time" basis rather than the profound total involvement that occurs in acute spinal injury, the spinal cord has time to retrain itself and compensate clinically for a great deal of the damage occurring. Consequently, the outward clinical picture may not truly reflect the total degree of internal pathology that exists. Performing surgery in cases where spinal cord compression has existed for long periods of time and significant clinical loss has occurred can do little to improve clinical function if at all. What function is lost is most often irretrievable, so the best therapy in these cases is to arrest the slowly progressive nature of the compression before too much clinical dysfunction develops, most especially a loss of pain perception. By comparison, in cases of explosive type I disk herniation, decompressive surgery is of most value when performed immediately. Delays of even a few hours may make a major difference in the outcome of the case, especially if significant compression exists.
Medical therapy combined with restricted activity and physiotherapy is a good approach as long as an affected dog is only displaying ataxia and/or discomfort. However, once the line is crossed to motor deficits, more aggressive therapy is usually needed. It is true that many dogs that become paretic, or even paralyzed, given enough time can regain "normal" clinical function without surgical intervention. However, the degree of permanent pathologic changes inside the spinal cord and the time to functional recovery will be far greater than for the dog that receives surgical decompressive therapy early in the course of disease. If additional trauma is sustained in the future, the dog that has "recovered" without surgery will probably "decompensate" more easily because of greater preexisting spinal cord pathology, resulting in a much greater degree of dysfunction than the dog with similar dysfunction that was operated early.
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Old 07-29-2011, 01:59 PM   #6 (permalink)
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Ahh cord compression vs nerve compression... I get it!!
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Old 07-29-2011, 03:01 PM   #7 (permalink)
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Sorry you have to go through this Jodu, how heartbreaking I have posted a few times about back injury as my boy had this. His first episode he was completely paralyzed both legs but rebounded very quickly via meds/conservative route......was quite strange. I agree with a second opinion.....if you are near a vet school teaching hospital (OSU etc.) may be worthwhile as they have much more technology and diagnostics at hand. Getting a mobility cart is also an option, which hopefully in time your gal will improve. Please keep us updated on Bitzy's condition......
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