Ivdd Specialist In Melbourne

[Brookestar]

My dog had an episode in December in which she collapsed on one year leg and was unable to walk at all. I had a friend with me at the time and we filmed it on her phone. Took her straight to vet. Referred to specialist hospital for immediate MRI, as considered neurological. MRI confirmed an Intervertebral Disc Disease at the lower back, lumbosacral region, which means it is not impacting on the spinal cord, but nerve endings. The primary symptom is pain, if the pain becomes too intense, she is simply unable to stand up. I was prescribed some pain med's and advised to put on her strict crate rest for 4-6 weeks. The dog had 8 weeks of 100% crate rest, the ONLY time out of the crate was to toilet, which was done on command, 4 times a day on leash. Pain was evident throughout this period. I went back to the specialist, who told me to take her off crate rest and begin short walks of 5 minutes, twice a day. I decided to enlist the help of an animal physiotherapist to assist with this process. I started off with one minute walks, she continued to show signs of pain. Had regular periods back on crate rest. Just over a week ago, she had another severe relapse, but this time lost the ability in both rear legs. I took her straight to my usual vet, closest, put back on all previous pain med's and a call made to specialist clinic for an appointment. Was unable to stand for 2 hours. Took her to specialist clinic the following morning, at which stage, she was pretty doped up on pain med's and walking. They refused to assess her with me present. Took her out of the room, something I will never forgive myself for allowing. The dog is a reclassified guide dog, and has the most stoic temperament imaginable and holds in pain like nothing else. Also lets vets to anything to her, my vet loves treating her, but hates diagnosing her! But you do know she is in pain via facial expressions, the way she holds her body, etc.

Specialist came out, said she is obviously not in pain, as she did not growl at them, when they tried to put pressure on her. At this stage the dog is lying on the floor absolutely still, refusing to move and refusing liver treats (something this Labrador never does). They said to just keep on crate rest, for as long as necessary, even if that means life. Said an operation was a possibility, but since the dog is not in any real pain, just my imagined pain, then really not worth it. Went to leave, with the dog walking slower than I have ever seen her walking and screwing up her face in absolute agony at every step. It was 2 days before she even wagged her tail again.

I decided to get another specialists opinion. I emailed them explaining what was happening and what her signs are, they responded via email, saying given the level of pain, they would recommend surgery. I made an appointment to see them. They spoke to the original clinic before I got there, said that they had assessed her as having no real pain, surgery was over-rated and would not help. Said I could consider an epidural steroid injection into the affected area, but did not give any information about expected outcomes, quality of life, etc. Did not real assessment of the dog, other than asking me to walk and then run with her. Said she was walking funny on her front paws, which is due to pain in her rear end and hence putting too much pressure on her front paws, but still says no real pain present!!

I love this dog dearly and do not want to loose her, but equally I have to consider her quality of life, which has basically been living in a crate for the last 4 months. I get crate rest is needed to help healing, but I feel I am being told to crate a dog for life, which is cruel and inhumane in my opinion. I cannot see a reason to euthanize a perfectly healthy dog, but equally I cannot leave a dog living in this much pain, and lying in a crate permanently which is basically all I am being offered. The dog was hip and elbow scored at 12 months, scoring 0 for everything, absolutely no orthopaedic issues, no signs of arthritis, blood and urine tests come back completely normal.

Is there a specialist who will take this seriously, and give me real advice, or do I honestly consider euthanasia, which seems incredibly drastic for a healthy dog, but I can hardly leave a dog lying in a crate in pain for years on end.

[Christina]

How infuriatingly frustrating for you & your poor dog.

I can't recommend a specialist not having any experience but I have had several steroid injections & while it doesn't cure the relief is amazing. Effects lasted from 10 days to 23 days & just getting some sleep helped so much. So it can't do any harm & your dog will feel better, even if temporarily.

Questions I would be asking is

Do you trust the initial MRI interpretation & diagnosis.

Was the specialist influenced by the report & diagnosis from the original clinic/vet.

Apart from not walking how much is this affecting the dog ?

Does she have normal appetite ?

Is she alert & interested in her surroundings & whats going on even if not walking ?

Does she cry or groan in pain ?

Does she have to be in a crate ? Can't she just lie on a big cushion on the floor with the choice of moving if & where she wants ?

I wouldn't euthanise this quickly unless the dog is really in extreme pain, not eating, lethargic & miserable etc.

I would try another specialist & start with a clean slate & not mentioning or referring back to the others for a new & unbiased approach.

Outcome may be the same but you don't know unless you try. Best of luck.

[cavNrott]

When my dog developed IVDD I asked my vet for a referral to the Melbourne Veterinary Specialist Centre in Glen Waverley. They also have a practice in Essendon.

At this point my dog who was perfectly normal the day before, could not walk and dragged his hind legs. I saw Dr Pete Laverty who did a myelogram and called me whilst my dog was still under GA to say he needed surgery and was I happy to give him the go ahead. My dog had ruptured a disk in his spine.

Surgery was performed immediately and within a week my boy was walking, though very wobbly. One month later he was walking normally. It is now over four years since the surgery and my dog has never looked back. He runs, walks and plays the same as any other dog.

I highly recommend Dr Pete Laverty. Please don't think about euthanizing your lovely dog before speaking with a brilliant surgeon who will be able to help your dog.

If you go down this route don't forget to bring the imaging films taken of your dog. He surely must have had a spinal MRI at great cost.

I have spinal damage and suffer nerve pain running down one leg. I can tell you it is the most excruciating pain I have ever experienced. Many pain meds, even opioids do not ease the pain all they do is make you doped up but the pain remains.

I'm so sorry for your poor dog who is clearly very much loved.

Edited: to say that 'specialist' who said your dog was suffering from imagined pain needs to suffer just one day of nerve pain in the legs caused by a spinal injury himself, then he would change his mind super fast about imagined pain.

Edited March 19, 2015 by cavNrott

[brightstar123]

It seems very odd that two veterinary specialists (neurologists?) assessed your dog as pain-free.

Here's some information from a great vet school in the USA:

"Most animals with disc disease need surgery to remove the disc material compressing the spinal cord. Sometimes an animal with disc disease does not undergo surgery, but instead is treated with strict rest, which is accomplished by means of confinement to a cage. In general, this approach is used for a first attack of back pain and in animals that do not have problems walking. Strict cage rest does not relieve spinal cord compression, but it may help to reduce some of the pain and swelling around the spinal cord, and give the torn outer rim of the disc time to heal. It is not uncommon for animals treated this way to suffer repeated attacks of pain, lameness and paralysis, as often more disc material herniates and places additional pressure on the spinal cord. Each episode of disc herniation may cause additional permanent damage to the spinal cord. Surgical removal of disc material from the spinal canal is the treatment of choice. Surgery provides the most rapid and best recovery of spinal cord function, and is the recommended treatment at the Veterinary Medical Teaching Hospital(VMTH) at UC Davis."

As far as I know this is also the opinion of many neurologists in Australia, although it's hard to comment without seeing your dog and the MRI results.

[cavNrott]

Brightstar, that was very similar to the information given to me. I opted for immediate surgery.

I must say I'm very grateful my dog was not seen by Brookestar's specialists because he would not be with me today.

My dog did not growl at the surgeon, he is a Cavalier KC Spaniel and in his almost 11 years of life I've never heard him growl at anyone. If something caused him pain he would yelp but not growl.

[Brookestar]

Veterinary Neurologists are incredibly rare in Australia and you could count them all on one hand. In most states there are none at all. None the less one of the specialists was a Neurologist, the other was a specialist surgeon, who are the most common to treat the condition in Australia.

A full MRI has been performed, I do agree completely with the results. I also agree with the belief that nerve pain is the worst. Before the MRI our general vet did full x-rays and while under a full general anaesthetic was wincing in pain when her feet were touched, which is the most sensitive part for her. She now lives with boots permanently on her feet to stop her from chewing them off (all nerve pain), and when I cannot supervise her completely she also has a bucket on her head, as she will chew at her legs often as well, but I can distract her from that, the feet I cannot. She is doped up on pain med's, including Gabapentin, which is supposed to the best for nerve pain, but I don't think it touches the surface.

She does not have problems walking unless she is in acute uncontrollable pain, ie, if she suddenly moves in a funny way, she will suddenly stimulate the most painful nerves and her body will spasm in response to it, meaning she cannot walk. But once that acute pain is gone she will walk normally. I keep being told she can be treated via cage rest and the reason she has not is that I have not done it properly enough. Anyone that knows me would disagree with it completely. I have gone and purchased brand new physio approved bed, bought small step to put food and water bowls on, so she does not have to bend down, putting extra pressure on her spine, etc. The ONLY time she ever had out of the crate was to toilet and that was on command, not when she wanted. The pain has not resolved and as such the swelling has never gone down, hence any attempt at torn outer rim healing itself, has not been able to occur. It is being suggested that an epidural steroid injection into it, MIGHT reduce the inflammation and hence allow it to heal itself, but given how much pain she is in, that seems doubtful to me.

I'm also being told that the condition is not being worsened by her being in the crate and so she can safely live in the crate for life if necessary. The dog should have at least another 5 years of life, assuming normal life expectancy, and I'm being told to leave them in a crate for that length of time, well that is what it feels like to me. I would really like them to explain their reasoning to the RSPCA. While I agree that crating for medical reasons has a very important role to play that is for weeks, not years!!

Edited March 19, 2015 by Brookestar

[cavNrott]

May I again suggest you consult with either Pete Laverty or Simon Kudnik at the Melbourne Veterinary Specialist Centre. The are both specialist surgeons and they know their stuff.

[Brookestar]

My usual vet is overseas, and I am waiting for them to return before I see anyone else, I will require a referral from them. I trust my usual vet completely and have a great relationship with them, and they really get and read my dog well. I could possibly get a referral from another vet, but I think it is better to begin again, from the beginning and get my vet involved.

I have however booked my dog in for the epidural steroid injection for Tuesday, so that I can at least give her more pain relief for now.

[Christina]

Its all too sad.

If you can't get better treatment for her & light at the end of the tunnel I think euthanasia may be the kindest thing you can do. Life in a crate in pain is no life.

Nerve pain is excrutiating. Hope the steroid gives relief.

[cavNrott]

Christina there is excellent treatment available in Melbourne. My dog is testament to that.

Brookestar I would not wait for your regular vet to return. Your dog is in serious pain. The referral for my dog wasn't from my usual vet. It was a vet that I occasionally see at a surgery closer to me and this was an emergency early on a Sunday morning when my regular vet is not open. All I needed to do was ask the surgeon to please send all information to my usual vet, who as luck has it is a good friend of his. All information was sent to the vet who gave the referral and also to my regular vet. This gave me the option of seeing either of these vets. I chose to see my regular vet but the information is on the local vets computer for the sake of record keeping. The Specialist Centre will send all information to whichever vet/s you request. Tell them your usual vet is overseas at present. You can get treatment for your dog urgently.

I hope the epidural steroid injection works, they are notoriously unsuccessful in humans as well as animals. At least your dog will have a general anaesthetic because those damn things are painful. The neurosurgeon who performed my successful spinal fusion has a very poor opinion of these steroid epidurals. He said they hurt, they're expensive and they don't work.

Failing all that I agree with Christina that euthanasia would be the kindest thing to do. As she said, nerve pain is excruciating.