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I need help Crate Rest vs. Surgery

sweetpea7281
November 17th, 2005, 08:05 PM
Well,

Here is what the specialist has said

-mildly enlarged cardiac silohuette
-several disc spaces containing mineralized materials
-Dorsal to the L2/L3 disc space, there is a small amount of mineralized material within the spinal cord
-soft parasternal murmur (noted that Piper was shaking & Panting during)
-Pain elicited upon palpatation of dorsal spinous processes of the cranial lumbar spine
-rest of exam was unremarkable

Neurological Exam noted
-hindlimb ataxia
-delayed postural reactions in both hindlimbs
-Neuroatomic localization to spinal cord segments T3-L3

Likely Diagnosis is Invertebral Disc Herniation, but other rule outs include disospondylitis, myelitis, and neoplasia


70% Chance that strict conservative management will help
30% Of these dogs relapse that range from incoordination to paralysis

At least 80% chance that surgery will reverse clinical signs

Diagnostic Plan
-CT of T/L spine
-Decompressive Surgery

Due to diarrhea and blood discontinue metacam

I am not sure what I should do???


basically I can spend 5000 and get surgery, and Piper's chances are at the least 80% for recovery. Or crate rest for 6 weeks, only 2 - 10 minute walks a day - this is 70% recovery, and 30% of those that recover suffer relapse which could lead to paralysis.

Piper has already had episodes where he has been unable to jump, and a little wobbly on his legs, in these cases we rest him and give him Baby Advil and he is back to normal. The vet said given his history it is likely that Piper will relapse then if he has crate rest, and the fact that each time he is getting worse does is not favourable.

Piper has also recovered by about 50% with just 2 days crate rest. The issue I guess is if he has another attack that could potentially leave him paralyzed

BMDLuver
November 17th, 2005, 08:32 PM
oh Sweatpea, I have no advice for you but to say that you will know what is best.. it will come to you. I'm sorry that you and your little one are going through this. I can imagine how frustrating and difficult this is for all of you. :grouphug:

SnowDancer
November 18th, 2005, 11:14 AM
If you can do it, I would most definitely go with the surgery - if the surgeon agrees that your pup can withstand it. Chances are much better that your dog will not experience a second event - although you would have a much better idea say 6 weeks after the surgery once it has been determined the level of movement that has returned. If there has been spinal cord death due to leakage of nuclear fluid (Stage II) movement recovery will not be as great as if your pup had Stage I. I went through both. If you decide to go with the cage rest/steroids option I think there will be a relapse - although in my case it was 100% guaranteed with my first Dachshund. He was a pioneer in surgery in the 80s so had 3 cage treatments of 2 weeks each before surgery. But he did have his treatment at the vet's. If you go this route I would strongly suggest this, if vet agrees, as your dog will fight you on this. He will have to be moved to increasingly smaller cages - and of course your dog is small enough. Mine were 10 lbs. of solid muscle so a bit different but still the final cage just fit his body. They also administered the steroids and watched for any reactions - and worse, no return of movement. Cost wise, if you consider what it will cost you for cage rest and steroid treatment - and the most likely relapse versus the cost of the surgery, you will probably find that there is not that much of a difference in the end - particularly if you have a few cage rest episodes. Also if pup is kept at vet's you won't have to worry that if you are out and further paralysis sets in that dog will be alone and possibly suffering. 2 times when my dog had relapses, there was extreme pressure on the spinal cord causing great pain. With my last little guy, cage rest was not an option. He paralyzed in 15 minutes so had to be on table within a few hours, hence night race to Guelph - 3 hours of terror on the highways. None of my other Dachshund suffered from disc disease - just my 2 soul mates, the dogs of my life, and both cases were 2 of worst ever seen. I know other people whose Dachshunds suffer only say from calcification fo 2 discs so prognosis is much better and treatment not such a horrible thought. If it were me, surgery would be my first choice. Actually when it came down to it, surgery in both cases was my only choice - and I would do it again in a heartbeat. I hope your pup will be okay and that you will keep us posted on how things turn out.

sweetpea7281
November 18th, 2005, 11:27 AM
Thank you for all that info.

This is a really hard decision for us, and it is not totally about the money either. My vet (not specialist) thinks that we should wait, at least 2 weeks after cage rest to see the results. He says this b/c Piper is already almost better. He told me that there is no certainy in surgery or crate rest. I guess he is strongly suggesting I don't. I feel like the specialists are being pushy for surgery. They keep on phoning and wanting to book Piper today. I guess what is stopping me is the fact that Piper is recovering already with the crate rest. On the xrays it looked like one or two discs affected. I don't have any idea yet what the cost of steroids is, we are not going to try those for 2 weeks. So, I think our first step is cage rest for 2 weeks, Piper has a very small cage, he hasn't whined yet, although b/c he is feeling better he thinks he should be able to play. I am still not 100% sure, the more I read the more I get scared, then the more I read I get relieved. Thank you for opinion - this is how I like to base my decisions, case studies are so beneficial. I think anyhow. Thank you, I will keep you posted along the way.

SnowDancer
November 18th, 2005, 11:49 AM
I wish you the best of luck - am surprised though about no steroids - but I do realize a different breed of dog. Without steroids, no amount of cage rest would have allowed my dog to walk - and absolutely no way would he have recovered at home. But again every single disc was affected. I know that my personal vet would say to go for the surgery, but again, Dachshunds are different and 2 discs - as awful as that is - I am sure that you can understand how horrible it is to have every disc calcified - so for me, surgery sounds good. Cost wise the problem is that the neuros do expensive X-Rays prior to the surgery. Your dog would not be on the table for 7 hours as mine was, but there is the surgeon's fee and the cost would include X days of hospitalization. Not unlimited hospitalization I can assure you. It is possible that $5,000 is an estimate - you should ask about that - that could be the possible total cost - they just don't want to tell you $3,500 and have it higher but with only only 2 discs involved you might get a break. I can't say whether the neuro is in it for the money - but I am going to assume he is not. The 3 neuros that I have personal experience with were most definitely not - they just wanted my dogs to walk and time was of the essence which is why one guy was rushed to Guelph. You have the time so that makes a difference. I guess a lot will depend on your relationship and trust in your vet and her level of experience with this condition. But I caution you, if after the cage rest - and I can assure you, it will not be fun for a few weeks - few days okay, but then very ansty, if there is a relapse, call the specialist - fast. And, don't be surprised if further discs are herniated. I will hope for the best.