Posts Tagged ‘hind leg lameness’

Pet Back Pain, Lameness & Paralysis: Ruptured Disks & Other Spinal Cord Disease

Dogs and cats have a number of diseases involving the spinal cord that produce lameness, paralysis, weakness and incoordination and consequently are easily confused with each other. These diseases include inter-vertebral disk disease, , degenerative myelopathy, Wobblers, lumbo-sacral stenosis, spinal cord tumors, and fibro-cartilagious infarcts. On initial physical exam all these diseases have a number of symptoms in common. Diagnostic tests which help further define the problem include radiographs, myelograms, and MRI’s.    All of the above diseases can cause hind leg weakness, incoordination and gait abnormalities. All cause a break in communication between the brain and back legs such that the head does not always know what the back legs are doing .   Such a communication breakdown results in the paws knuckling over, the hind end swaying or collapsing,  the dog having a hard time rising or going up stairs and the loss of bladder control.   Of these diseases, we can expect that pain may be present with only 3:  disk disease, wobblers and lumbo-sacral stenosis. Of the six diseases mentioned, inter-vertebral disk disease, wobblers and fibrocartilaginous infarcts usually have the a sudden onset. .

Intervertebral disk disease in the dog is an all to common problem especially in breeds with long backs and short thick legs, aka. chondrodystrophoid. These breeds include dachunds, bassets, beagles, welsh corgis, Lhasa Apsos, Shih Tzus, American cockers, Bichons and French bulldogs. In these breeds the problems may occur as early as 1 to 2 years of age.  IVD may also occur in non chondrodystrophoid breeds but usually at 6 to 10 years of age.  The most common symptoms of disk disease are pain, weakness, loss of coordination, and paralysis. The disease can also affect bladder control. However in very early stages of disk disease the dog may experience only pain and display an anxious uncomfortable attitude, a hunched back, tense abdomen and decrease in activity.   As the condition advances the pain commonly becomes very severe and the dog may cry out when he or she moves in a particular way or is picked up under the abdomen.  The next stage of disk disease  is often hind leg weakness, incoordination and/or paralysis. At this point the pain may or may not disappear.  Commonly this progression happens within days but can extend to weeks. If the disk protrusion occurs in the dog’s neck the pain is often more severe. Just petting the dogs head may cause him or her to cry out.  The dog will hold his head and neck in a rigid head down stance and will will turn his whole body instead of bending his neck.  Cervical (neck) disk disease can cause neurological problems in both the front and back legs whereas disk disease in the mid back will affect only the back legs.

It is difficult to distinguish cervical disk disease from a disease commonly known as Wobblers. Wobblers (aka cervical vertebral instability)  is, as the name implies,  a result of an unstable joint in the neck producing pressure on the spinal cord.  Wobblers is usually a disease of large, fast growing dogs. Great Danes usually develop the disease as puppies where as in Dobermans the problem occurs more often in adults. The disease most commonly presents as a dog with severe neck pain and gait abnormalities in both front and back legs. To distinguish this disease from a ruptured disk or a spinal tumor requires either a myelogram or an MRI.    Of course it is possible for the above symptoms to be caused by a blood clot in the spine or spinal tumor, neither of which occurs with any frequency.  Finally, if the breed of dog is correct for disk disease, and if there has been no sudden onset or trauma then there is approximately a 95% chance that a disk rupture has occurred.

Another disease that can easily be confused with inter-vertebral disk disease is Degenerative Myelopathy.  Degenerative myelopathy is a slow progressive disease of large older dogs, most commonly the German Shepherds.   In its early stages the dog owners often mistakes it for arthritis.   Degenerative myelopathy is an insidious, inflammatory, autoimmune disease that develops slowly over years. It is a result of degeneration of the fatty myelin sheath that surrounds most nerves and acts as an insulator.  One of  the first sign of degenerative myelopathy is the dragging of the top side of the nails on the back feet. This dragging can be detected either by the sound of the gait or by examining the top side of the back nails for abnormal wear. As the disease progresses the hind limbs become weak and an obvious incoordination develops. The hind legs may cross with one another and the dog may look drunk in the hind end. He or she may stumble. If you place the dog’s foot in a position where the top of the toes are on the floor, the dog will often not return the foot to the proper position or take a long time doing it. This is because there is a loss of “conscious proprioception” which means that the brain does not know the position of the back legs. If a dog has Degenerative myelopath then pushing on the dog’s rear end from side to side often causes the dog to fall over or have a hard time keeping his balance. In the later stages of this disease the hind end will become so weak and uncoordinated that the dog will be unable to get up. If the dog does manage to rise he or she will quickly fall down after taking only a few steps. The only good new about this disease is that there is never any pain involved. It is important to rule out a chronic disk disease before accepting degenerative myelopathy as your pet’s fate. Unfortunately that requires an expensive MRI or myelogram to make such a decision.

Lumbo Sacral Stenosis is known by a number of names such as lumbo-sacral instability, lumbo-sacral malformation, lumbo-sacral malarticulation, spondylolithesis, and cauda equina syndrome. All of these describe arthritis involving the last lumbar vertebrae and the sacrum which is a part of the pelvis. This disease often involves the disk as well. Together both problems progressively narrow the spinal canal which in turn puts pressure on the spinal nerves and causes pain and dysfunction. The most common symptom is pain which involves the back, both hind legs, and the tail. Dogs usually have trouble rising. Defecating and urinating are difficult because of pain.  Dogs with this problem find defecation and urination difficult due to pain on squating.  They may become incontinent and may be seen biting at their rear end.

Blood clots and fibro-cartilaginous infarcts can also cause similar spinal cord disease but they are quite rare and so I will not discuss them at this time.

Now back to intervertebral disk disease (IVDD). Conventional treatment for IVDD  involves medicating with steroids, antioxidants,  muscle relaxants, cage rest and surgical decompression. If surgery is indicated a myelogram or MRI must be performed to pin point the exact location of the lesion and confirm the physical diagnosis. These tests commonly can run into many thousands of dollars and should only be considered if the owner is planning to follow through with any surgery indicated by the information these tests provide.  ” Disk fenestration” surgery or a vertebral “ hemi-laminectomy” are the surgeries performed to reduce pressure on the spinal cord.   Both surgeries can run into the thousands of dollars and the diagnostics plus the surgery could easily run between 4 to 5 thousand. If you have a dog that may require these surgeries you should know that the surgeries are not always successful in restoring function and on occasions dogs can come out of surgery in worse shape than when they went in.   You should also be made aware that these surgeries especially those involving the neck require long periods of recuperation.

Owners who are hesitant to put their injured older dogs through anesthesia, surgery, and an extended recuperative period may want to consider holistic modalities as an alternative. For those who cannot afford the expense of high tech diagnostics and surgery I also suggest you take a look at alternative or holistic modalities. The holistic therapies I am talking about include electro acupuncture, cold laser therapy, infrasonic therapy, pulsed magnetic therapy, chiropractic, electro crystal rebalancing, nutritional therapy, prolotherapy, bio identical steroid therapy, antioxidant therapy, megavitamin therapy, and systemic enzyme therapy.    Please understand that there are no guarantees with any one or a combination of the above alternative therapies, each case being unique in its own right. We have, however, had some excellent results with these alternative approaches and can offer testamonials to their effectiveness.

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Woodside Animal Clinic is a unique, very personal, one doctor practice where, for over 35 years, Dr. Simon has been healing dogs, cats, birds, rabbits, rodents, and reptiles with both conventional and alternative medicine. Dr. Simon is the author of 4 pet care books and he writes a monthly pet care column in the Mirror newspaper.  He is the past president of the Oakland County Veterinary Medical Association.

Woodside Animal Clinic sees pets from all over the greater Detroit Michigan area including Royal Oak, Berkley, Huntington Woods, Ferndale, Pleasant Ridge, Detroit, Hazel Park, Madison Heights, Warren, Centerline, Clawson, Troy, Sterling Heights, Southfield, Birmingham, Bingham Farms, Franklin, Farmington, Farmington Hills, Novi, Wixom, Brighton, Livonia, Plymouth, Commerce, Ann Arbor, Ortonville, Waterford, Union Lake, Rochester, Rochester Hills, Auburn Hills, Utica, Romeo, Windsor, and Toledo.