Random episodes of pain

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Neuro Corner Answers


Dr. Andrew Isaacs
DVM Diplomate ACVIM (Neurology)
Dogwood Veterinary Referral Center

Primary interests include intervertebral disc disease, seizure management, luxations/fractures of the spine, and surgery for brain tumors


Question

VICKIE ASKS:

After surgery for IVDD my dog will occasionally have random episodes of pain every three to six months. He jumps up, cries out in severe pain, turns around and looks at his rear end. It takes about a day for it to go away. Is this typical, why is it occurring, and what can be done about it?

 

ANSWER

Painful episodes are one of the more frustrating presentations we deal with.  Unfortunately, there are so many potential causes of pain that it can be a difficult hunt to go on.

It would be important to have a good exam performed by your veterinarian to try and localize the source of the pain (neurological, orthopedic, abdominal, soft tissue, etc.).  Depending on their exam findings it may be warranted to perform additional diagnostic (radiographs, ultrasound, blood work, etc.).

Potential causes related to IVDD surgery include residual compression of the spinal cord and/or nerve roots, and paraesthesia secondary to abnormal healing of the nerve tissue.

Residual compression

Sometimes it is difficult and risky to remove all fragments of disk material with surgery.  Therefore, when your dog assumes certain positions there is the potential that the residual fragments irritate the spinal cord and/or nerve roots.

Paraesthesia (Neuropathic pain)

The other potential cause for the episodes is abnormal neuropathic pain— paraesthesia.

Paraesthesia  is a sensation of tingling, pricking, or numbness of the skin with no apparent long-term physical effect. The manifestation of paresthesia may be transient or chronic.  In cases of severe spinal cord injury I have seen dogs go on to develop paraesthesia.  The fact that your dog had absent deep pain sensation prior to surgery is consistent with a severe spinal cord injury.  Therefore, in the healing process there is the potential for signals to get “crossed” and result in paraesthesia.

If the painful episodes are not increasing in severity or frequency, associated with neurological deficits, and your veterinarian is not able to identify any other causes a drug to discuss a trial course of is gabapentin (Neurontin).  If the gabapentin helps some, but not adequately, another drug to consider in the same category (but more expensive) is pregabalin (Lyrica).


Disclaimer:

This information is presented for educational purposes and as a resource for the dog IVDD community. The coordinators are not veterinarians or health care professionals. Nothing herein should be interpreted as medical advice and all should contact their pet care professionals for advice. The coordinators are not responsible for the substance and content contained herein and do not advocate any particular product, item or position contained herein.

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