| Disclaimer:
All statements are opinions and observations on
the subject and are not the opinions or position of any dog organization
or veterinary. I am not a canine neurologist or veterinarian, and
do not intend the information presented below to be used in lieu of
professional veterinary advice and treatment. Each dog, and each
back problem, is different, and general statements cannot be
used as a prescription for every dog. Just as with medical
doctors, it is often advisable to get second, third, or more
opinions for major veterinary medical treatments. Since all
doctors can have differing opinions, you can be certain that Dog
breeders will have opposing viewpoints, as well. The opinions
below are for educational use only.
Background:
Dachshunds are a dwarf breed of dog - the
technical term is "achondroplastic" - but "dwarf" is the common usage.
Their skeleton is basically that of a large dog, but the length of the
body has been exaggerated and the legs have been shortened. All of these
man-made changes have caused an unusual amount of stress to be placed on
the spinal column. Other "dwarf" breeds, like Corgis, Bassets,
Pekingnese, Papillons, Toy Poodles, and Shih Tzus, are also prone to
back problems known as IVDD, or Intervertebral Disk Disease.
The bony vertebrae that surround the spinal cord
make up the spinal column. Each
vertebra is cushioned from the adjoining vertebra by a disk, or pillow,
which is filled with a stiff, gel-like material. This allows the
spine to flex in all directions while still protecting the spinal cord.
When one of these disks "blows", the gel-like material inside
leaks out, either explosively or very slowly, and will calcify, or
harden, over time. The amount of damage done to the spinal cord depends
on which direction the disk gel leaks out. If the disk material
explodes upward into the spinal cord, or forward along the spinal cord
nerve damage, pain, and even paralysis, can occur because the spinal
cord is being compressed. Slowly leaking disks can cause pain and
a wobbly rear (ataxia), or paralysis.
What causes a disk to blow? Severe injury, such as
being hit by a car or falling from a very great height, accounts for
maybe less than 1% of ALL back problems in Dachshunds. The main
UNDERLYING cause (99+%) of all disk problems (IVDD), back pain,
paralysis, etc. in Dachshunds is GENETICS & VACCINE Damage(vaccinosis). If a breeder tells you
they have never had any back problems in their dogs they are either
lying, won't admit it, are burying their heads in the sand and calling
back "incidents" injuries, or have not bred enough dogs to have
encountered the problem in their line. ALL bloodlines and ALL sizes and
coats of Dachshunds have potential back problems. It is just in
the breed but it is impossible to predict it's occurrence in any
particular dog. Several genes must come together in the right
combination in order to cause a blown disk.
Although an event, such as a tumble down the
stairs, or falling off the bed, may SEEM to have caused a back problem,
the genetic predisposition to blow a disk has to be there first.
Consider this - thousands, or even millions of dogs of all breeds jump
off stairs or beds or sofas every day and never have any problems. If a
Dachshund develops a back problem, it is because he/she has the
unfortunate combination of genes that have weakened the disk(s) in its
back. Most Dachshunds blow a disk just sitting around, and many blow one
while sleeping. The owner puts a perfectly fine dog to bed at
night and wakes up to a paralyzed dog.
So, get over the guilt! While being overweight & being allowed to
jump down steps and off furniture may have caused the disk to blow a
little earlier than it might have if the dog had been in better shape,
most Dachshunds that blow disks are in good weight and condition.
Having said this, I try my best to prevent my dogs from jumping
down from stairs or furniture, or becoming obese. I measure their
food to prevent obesity. There are other injuries and illnesses
that may occur. Short-backed Dachshunds can blow a disk just as
easily as long-backed Dachshunds. Genetics determines whether or
not a particular disk will blow, and genetics and environment can act
together to determine when a disk will blow. There's not much you
can do to prevent a disk from blowing. Keeping your dog in good
condition and weight may lessen the severity of damage and enhance
recovery.
As a breeder, I find this very frustrating since
Dachshunds who blow disks are usually 4 or more years old (ages 4-6 are
the prime ages, although some back problems will show up at ages 10-12),
so I may have bred a dog several times prior to it going down. There are
currently no diagnostic tools, such as x-rays, that a breeder can use to
reliably predict whether a particular dog will blow a disk later in
life. If there were, we certainly wouldn't breed a dog that would later
have a back problem. Any Dachshund which has been used for
breeding that exhibits any signs of back pain and "the wobbles" or
paralysis, should be immediately and permanently removed from any
breeding program and neutered. Owners of this dog's offspring MUST
be notified that there has been a disk problem. Breeders must be
willing to share information about disk problems in their bloodlines.
It is nothing to be ashamed of but vital if this disease is to be
conquered, or at least, mitigated.
There have been some extensive studies
done overseas concerning the number of calcifications in a
Dachshund spine at age two(2) and the prediction of it blowing a disk at a
later age. No connection has been proven. Some dogs with lots of
calcifications never had back problems, and some with no calcifications
ended up paralyzed. Most calcifications tend to disappear after
age two(2), for no apparent reason. Back x-rays have yet to be proven as a
useful screening tool for disk disease.
Becoming paralyzed is NOT an automatic death
sentence for any Dachshund. Do not allow your vet to proclaim your dog
has back/disk problems and must be put down. Find another vet
immediately (not the next day) because time is of the essence in
treating disk problems. There are many treatment options for back
problems, and most can be successful if implemented immediately.
However, no matter which treatment the owner chooses, at least 6 weeks
at the minimum must be allowed for the dog to recover. If your dog is
still paralyzed after 2 weeks of treatment or after surgery, do not give
up hope. Some Dachshunds who were paralyzed for many months
made full or functional recovery. If you truly love your dog,
give him/her enough time to recover with appropriate nursing care.
Blown Disks - complete or partial paralysis or maybe not a blown disk at
all.
If you come home, or wake up, to a Dachshund who appears to be
paralyzed, or partially paralyzed in the rear, or simply hunched up in
pain and/or wobbly in the rear, or completely paralyzed front and rear,
your dog MAY have a blown disk requiring IMMEDIATE emergency veterinary
treatment. I say "may", because there are other conditions which can
make a dog ACT like it is paralyzed or experiencing great back pain. Make sure your vet rules out these other possibilities first. Too many vets are
quick to pronounce the verdict "back problems" simply because it is a
Dachshund. This does a great disservice to the dog and the owner.
Although time is of the essence when treating a blown disk,
these other, easily remedied conditions MUST be ruled out first. All of
these can be ruled out by running a complete blood panel (CBC, liver
enzymes, kidney function, etc.) and giving the dog a thorough physical,
all of which should take less than an hour to perform.
Here are some
common conditions which can mimic disk disease symptoms:
1. Gut
pain - a lot of Dachshunds are wimps when it comes to pain of
any kind. I had a dog who was the "perfect" age for back
problems - 5 years. He refused to come out of his crate,
refused to stand, and screamed when I tried to pick him up.
This was back in the days before I knew that much about disk
disease. The vet said "back problems" without doing any blood
tests, gave me steroids and anti-inflammatories and said to
crate rest him. That evening, the dog had severe vomiting and
diarrhea, so we stopped all medication and just tried to get the
diarrhea stopped. The next day he was perfectly fine, running
around and playing normally. He had had a severe tummy ache,
that's all. He is now 15 and has been totally normal since that
"incident".
Note: If your dog
makes a complete recovery in a day or two from any kind of "back
pain", then he was not suffering from any kind of disk
problems. True disk problems take many weeks or months to
resolve.
2. Kidney,
liver, or pancreatic problems - any one of these can cause a
Dachshund to hunch up and scream in pain when touched. A simple
blood test (complete blood panel) to check kidney/liver function
and liver/pancreatic enzyme levels should quickly rule these
out.
3. Muscle
or soft tissue injury - these will generally cause just back
pain without any sign of neurological deficits like a wobbly
rear, dragging leg, or paralysis. Most true disk problems cause
some form of neurological (nerve) problems. If the dog does not
progress to any neurological signs (wobbles, dragging legs,
paralysis, etc.) and recovers in the next two days with strict
crate rest and medication (steroids and anti-inflammatories),
then it was a muscle or soft tissue injury.
4. Prostate
problems in males - I have had several intact (not neutered)
boys stand hunched in pain and screaming when touched who were
suffering from nothing more than enlarged prostates brought on
by being around females in heat. A quick digital exam by the
vet and a blood test confirms this and simple medication cures
it.
5.
Tick paralysis - The bite of one infected tick can render a dog
partially or completely paralyzed. The tick may have fallen off
by the time the dog shows signs of paralysis. A blood test can
confirm this. Removing the tick, if still attached, and
supportive care will quickly cure this condition.
6. Other neurological problems like
Lou Gehrig's disease. These are very rare.
What If your
vet has ruled out all of the above conditions and it appears
that your Dachshund has true disk problems?
What do you do? Please DO NOT WASTE YOUR
MONEY ON X-RAYS. The only reliable method of determining a
blown disk is a mylogram. This must done under sedation
just prior to the dog undergoing surgery.
If your dog is
showing back pain and is wobbly in the rear, but can still walk
and is not dragging a hind leg, your dog probably has a
partially blown disk. In this case, immediate surgery or
steroid blasting are not required. It could even cause
more harm than good. Neither are x-rays or a mylegram.
Do not let yourself be talked into expensive surgery at this
point. Give your dog a chance to recover on his own. Have your
vet give your dog a steroid shot like Solu-Medrol, some steroid
pills (Medrol or prednisone) in decreasing dosages for the next 2 weeks, and a
muscle relaxer pill like Robaxin. Tagamet or Carafate in the
correct dosage is also very necessary to give prior to each
steroid pill to protect the stomach lining. Remember, never
give an NSAID (non-steroidal anti-inflammatory drug) like
Rimadyl or Metacam with steroids - the combination can kill your
dog.
Then take your
dog home and put it in his crate. This is where crate training
REALLY comes in handy. Merely confining your dog to the
bathroom or a small utility room is totally worthless. Your dog
must be nearly immobilized for at least 6 to 8 weeks. Yes, I
said SIX to EIGHT WEEKS! It takes at least that long for the
leaking disk material to calcify, or harden sufficiently to
where it won't move around and cause further damage to the
spinal cord. The break must calcify to heal ( same
principle with leaking disks). Sometimes it takes as long as 3
months of strict crate rest and several rounds of steroids and
Robaxin for the dog to recover completely. Believe me, it is
worth being patient.
The crate must be
only big enough to allow your dog to stand up and turn around,
nothing more. The less the spine is allowed to flex or move, the
better for healing or recovery. Hand-carry your dog outside to
a very small exercise pen to potty, or keep it on a short
leash. Do not let the dog walk more than 3 feet in any
direction while going potty. Then hand-carry the dog back to
its crate as soon as it is finished.
Strict, lengthy crate rest is
absolutely essential if you want your dog to recover completely
and avoid surgery. Do not give in if your dog starts walking
normally within a week or two. The
steroids are making the dog feel good but the disk material has
still not calcified. Steroids will make your dog need to
urinate more often. Make sure the dog's bedding stays clean and
dry and he is taken out more often than normal.
Most vets do not
emphasize the immediate and lengthy crate rest right away.
Some never mention it at all. They may tell you to "keep the dog
quiet for 10 days". This is HORRIBLE advice and will more than
likely lead to your dog becoming totally paralyzed. A number of
vet schools are now teaching their students to avoid steroid use
with disk disease. This does a
terrible disservice to Dachshunds and their owners. Steroids are
necessary to quickly reduce the swelling around the spinal cord
and prevent further damage to the nerves leaving the spinal
cord. INSIST on steroid shots and pills. Just
remember that this is YOUR dog and
you want to prevent expensive and painful surgery
if at all possible.
Acupuncture
is an excellent additional treatment. Most vets & surgeons
highly recommend it. It helps open up nerve pathways that have
been damaged by the bulging or exploding disk material and helps
ease back spasms and pain. It should be done once every two
weeks for several weeks to have an optimal effect.
During the next
6-8 weeks, keep a close eye on your dog's wobbly rear. If it
seems like the rear end is getting progressively weaker or your
dog starts dragging a hind leg, or the dog suddenly becomes
paralyzed, then IMMEDIATE further treatment is needed and the
options are discussed below.
Treatment options
for paralyzed or partially paralyzed dogs.
If your dog is
paralyzed in the rear end or partially paralyzed (dragging a
rear leg) and your vet has ruled out the other 6 conditions
mentioned above that can mimic disk disease, your dog will
probably be paralyzed, or partially paralyzed due to a blown
thoracic or lumbar disk (anywhere from the middle of the back to
the rump). Complete paralysis due to a blown neck disk is rare
but can happen. You now have 3 options - 1) surgery, 2) steroid
blasting, or 3) do nothing but give longer crate rest (6
months), acupuncture, and more medication.
Surgery:
If you choose to do
surgery to have the disk material removed, you must first
remember several things:
1. First, surgery must be done within 24
hours, preferably within 12 hours or less, of the dog becoming
paralyzed in order to be even partially successful. Past 24
hours, the success rate drops dramatically to the point that
surgery is nearly worthless and a waste of money.
If you go past 24
hours, consider the other 2 options (see next sections).
Surgery involves removing some bone from the side of the
vertebrae in order to remove the exploded disk material and
relieve the pressure on the spinal column.
2. Pick an orthopedic veterinary
surgeon who has SUCCESSFULLY operated on a lot of Dachshund
backs. There are a lot of vets out there who have operated on
Dachshund backs but with a less-than-stellar success rate. If
you own a Dachshund, check out potential back surgeons when the
dog is still a pup, so you have several names to choose from if
you should ever need one. Get names and numbers of past clients
and call them up to see how well their dogs recovered from
surgery. Word of mouth is the best way to find a good back
surgeon. University vet schools are the
WORST places to go -
they are training grounds for new vets and you cannot pick and
choose which surgeon you want. The surgeon you get at a vet
school is the one who is on rotation or on call at the time your
dog becomes paralyzed. Independently owned, specialty
veterinary clinics are the best bets for finding a back
specialist, but they are not cheap. Plan on spending $2,000 to
$5,000 for a back operation.
3. Skip the x-rays at your local
vet - they are a big waste of money and usually won't show the
location of the blown disk. My local vet took x-rays of the 3
dogs I had who were paralyzed, and the correct location of the
blown disk never showed up. If the dog is going in for surgery
anyway, the orthopedic surgeon will do a myelogram on the dog
just prior to operating. This is an invasive procedure done
while the dog is anesthetized, since it involves injecting a dye
directly into the spinal cord. Then when x-rayed, the dye will
show where the spinal cord is being compressed by the blown disk
material and the surgeon will know where to operate.
Myelograms
are never performed unless the dog is being prepped for
surgery. The myelogram can also show the location of other
disks which may be weakened and about to blow. You should
insist that the surgeon check for any other potentially bad
disks and remove the disk material from them as well while the
dog is still under anesthesia. Otherwise, your dog might be
facing later surgeries.
4. Don't worry if your dog does
not seem to show any deep pain response at the vet's office -
usually the webbing between the hind toes is pinched really
hard. Dachshunds can be very stoic and refuse to show signs of
pain in front of strangers.
5. Many Dachshunds come out of
surgery still paralyzed, even if they were not totally paralyzed
before surgery. Don't expect your dog to be up and walking
after surgery. Your dog may be paralyzed for several weeks
following surgery, so be prepared for intensive nursing care,
very strict crate rest for at least 6-8 weeks even if your dog
is walking, and physical therapy.
Fifty(50 bicycles per hind leg at
least 3 times a day, swimming in the bathtub or underwater
treadmill after the sutures heal, towel-walking several times a
day, etc.).
6. Insist that your dog be given
injectible steroids immediately following surgery. It is
imperative to get the swelling around the spinal cord down FAST
to prevent further nerve damage, and only steroids seem to do
this effectively. NSAIDS like Rimadyl
just do not do a very good job, nor do they control pain very
well. Get your dog home as soon as possible after surgery. There's no need for the dog to stay in the vet
hospital any longer than that. He will make a better
recovery at home.
INSIST that they teach you how to express
your dog's bladder (it's not hard) and take your baby home,
along with oral steroids like Medrol or Prednisolonein
decreasing dosages, Tagamet, Carafate or
famotidine(pepcid ac) to protect the
stomach.
At this point, DO NOT use NSAIDS at all
while the dog is still on steroids.
7.
Definitely get some acupuncture treatments in the weeks
following surgery. They will help eliminate painful back spasms
which are common during the healing process, and will help open
up damaged nerve pathways.
Surgery
is very expensive and not always successful.
I,
personally, will never do surgery again.
Do not feel guilty if you cannot afford
surgery.
There is another treatment of choice for paralyzed or
partially paralyzed Dachshunds. It is called steroid blasting.
2) Steroid
blasting:
This section is
under construction but I wanted the bare bones of this treatment
to be available for reference.
This procedure is
NOT for dogs who are merely in pain with a wobbly rear.
This treatment is for dogs who are showing definite signs of
paralysis in one or more legs and are candidates for surgery but
who, for one reason or another, are not going to have surgery.
One vet in Texas reports that his success rate in treating
hundreds of paralyzed or partially paralyzed Dachshunds (mainly
rescues) with steroid blasting is around 98%.
Your vet HAS to
be willing to take the risk of the high intravenous steroid
doses (they are VERY high doses). The vets who have done this
procedure but have reduced the dosages are seeing poor results.
This procedure requires around-the-clock treatment for 48 hours.
Leaving the dog at the vet clinic by itself overnight and
resuming treatment in the morning will NOT yield satisfactory
results. Treatment MUST BE CONTINUOUS for 48 hours to be
successful. Also, steroid blasting MUST be done
within 12 hours (preferably), or at the most, within 24 hours,
of the dog becoming partially or completely paralyzed. Mixed
results have been reported on dogs who have been paralyzed for
several days, weeks, or months. However, there are quite a few
anecdotal reports of Dachshunds who have been paralyzed for
several months regaining most of their mobility immediately
following steroid blasting. It is worth a try to save the dog's
life and is not nearly as expensive as surgery ($500-$900 range
is typical for steroid blasting, depending on what city you live
in and whether or not there are complications).
Here's the actual
treatment protocol that your vet will need to have for referral:
| The information
below came from "Spinal Cord Injuries in Dogs and
Cats" by Cheryl Chrisman DVM, M.S., Ed. S,
ACVIM-Meurology University of Florida, College of
Veterinary Medicine:
Emergency
treatment of spinal cord trauma is aimed at
reduction of free radical production, inhibition of
lipid peroxidation, and enhancement of spinal cord
perfusion. Intravenous methylprednisolone sodium
succinate (Solumedrol - Upjohn Co) or prednisolone
sodium succinate (Solu Delta Cortef - Upjohn Co) 30
mg/kg should be given as soon as possible after the
injury. Two and 6 hours later 15 mg/kg is given
intravenously and then 2.5 mg/kg per hour for the
next 24 hours or longer if no deep pain is present.
This aggressive
glucocorticoid protocol may produce gastrointestinal
irritation and ulceration and pancreatitis, so
animals must be closely monitored for depression,
anorexia, vomiting or melena. Cimetidine 4 mg/kg
and sucralfate 500 mg - 1 gm can be administered
orally 2 hours apart every 6-8 hours to help prevent
GI disturbances. If available, a prostaglandin
analog misoprostol (cytotec - Searle) 3 mcgm/kg
orally every 12 hours should be given in place of
the Cimetidine and sucralfate and has a more direct
protective effect against GI damage.
Dexamethasone
sodium phosphate and Dexamethasone solution (Azium -
Schering) are too slow in onset to provide the rapid
neuroprotective effects needed and recommended in
spinal cord injuries. |
Warning: Pancreatitis
is the most common complication from steroid blasting! If your
dog starts acting sick and starts vomiting after steroid
blasting, RUSH him back to your vet and assume it has developed
pancreatitis. This is a medical emergency. Do not wait till
morning to bring the dog to the vet or you will have a dead, or
half-dead, dog. All steroids must be
stopped immediately. All food and
water must be withheld for 24 to 48 hours until vomiting has
stopped, and the dog must be put on IV fluids. An
anti-vomiting medication like Centrine must be given as well as
an antibiotic like Baytril. Do not let your vet just give the
dog a Centrine shot for vomiting and send it home with you. The
dog MUST stay there at the vet hospital on IV fluids and be
monitored for at least 24 hours. Once the dog has recovered
from the pancreatitis, it can be put back on oral steroids, a
muscle relaxer like Robaxin, a stomach protector like Tagamet or
Carafate, and possibly a pain killer like Torbutrol, and sent
home.
Following the 48
hours of steroid blasting, and assuming that there have been no
complications like pancreatitis, the dog can go home and
directly into its crate. It may
have regained some use of its limbs or it may still be
paralyzed. If still paralyzed, make sure your vet shows
you how to express the bladder since this will need to be done
at least 3 times a day until recovery occurs. A full course of
oral steroids (Medrol) plus a stomach protector (Tagamet and/or
Carafate), a muscle relaxer like Robaxin, and possibly pain
medication (torbutrol, no NSAIDs like Metacam or Rymadil) should
be sent home with the dog. These are all pills which can be
disguised in pieces of string cheese or hotdogs or simply
stuffed down the throat. Total crate rest as described
previously will be needed for at least 8 weeks. This is
critical since the pieces of disk material are still floating
around near the spinal cord and must be allowed to harden and
fuse. I sometimes will give the dog a week or two off from the
oral steroids and then do another round of oral steroids if I
don't think the dog is making much progress or still seems
uncomfortable.
Acupunture with
electrical stimulation should be started within a few days and
continued for several weeks.
Exercises like leg bicycles (50 per leg at least 3 times a day
with the dog laying on its side or back) can be started right
away and towel walking (towel or scarf looped under the belly to
hold up the rear end) can be used to help the dog go potty.
Swimming exercises should not be attempted
for several weeks as it is imperative to keep the spine as
immobile as possible at first because the exploded disk material
is still floating around in there.
Generally,
recovery from steroid blasting takes a little longer than
recovery from surgery so be patient. After 8 weeks of crate
rest, the dog can be allowed a little more freedom to start
building up muscle mass again if it is walking without pain. It
can be put out in a very small pen (no bigger than 4 ft. by 5
ft.) for a few hours per day or put in a very small room like a
bathroom for a few hours a day. No running, pulling on a leash,
or jumping should be allowed for a few more weeks, depending on
how the dog is progressing.
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