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Conservative treatment first

Conservative treatment first?

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

LAUREN WRITES:

My dog Alexis is 8 years old and has had 3 surgeries for IVDD so far. The first was in her back when she was about 5, then at about 6 she had her first one in her neck, and a second on the neck recently in the spring when she was 8. Our neurologists tells me this is very rare for them to need 3 however she still shows signs of it possibly being needed again in the future. We have days where I have to give pain medicine because she is obviously in pain from her IVDD. She has also been having painful nerve episodes where she hold her front leg out to the side, cries in pain, and wont move for about a min then it goes away. I guess I want to make sure that I’m doing the right thing by continuing to do so many surgeries and wondering how many times this will happen? Are these nerve pain episodes a sign that another disk is beginning to herniate? She has done well and fully recovered from each surgery and we take all the precautions to keep her from jumping and being too active for her back to handle.

ANSWER

I’m so sorry to hear about Alexis.  Unfortunately, even with taking the precautions you have, we occasionally see dogs that herniate more than one disk in their lifespan to the point of requiring multiple surgeries. It’s similar to people getting struck by lightening.  It’s unusual to get struck once, but then you hear about people that have been struck multiple times.  Also, if you do not take precautions there is a greater chance of getting struck multiple times. Ultimately, it comes down to trying to do what you can to give him a good quality of life.  If he has responded well in the past there is no reason to not consider surgery this time. I would want to exhaust medical management first, which it sounds like you are.  To help decide if surgery would be helpful advanced imaging (MRI or CT/Myelogram) would warrant consideration if he is not responding to medical management. Then, with additional information, you can make an informed decision with his best interest in mind. [Editor’s NOTE: Tips and ideas to provide  good crate rest recovery during medical management (conservative treatment) or after a surgery:  https://dodgerslist.com/strict-rest-recovery-process/ ]
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