Introduction and Experience/ Advice Please, Front Leg Lameness
 

Hello, we are the proud family of Tobie, the most amazing and loving 11 year old Yorkie. He has been such a blessing the last 10 years that we have loved him. He arrived in our home after being rescued from an environment that included never ending car carrier crating in a garage from what we were told. After a very short adjustment period, he blossomed into the sweetest, best behaved, social and loving (and trusting) little man. We adore him.

First off, he has already been to our Vet, had x ray, and we are now awaiting a visit next week to a Veterinary Specialist in neurology. However, I'm looking for anyone who may have any experience or anectodal information because I'm not convinced we're on the right path.

Tobie has for the last several months, in hindsight, intermittently walked with an arched back. However once he was up, stretched out, and on his walks he was back to nomral. I chalked it up to age. Starting about 3 weeks ago, however, I noticed that the back arching was more often than not and the ability to walk it off was declining. 2 weeks ago when I noticed that he was shivering and shaking alone and away from us I knew something was wrong. That was the first time he demonstrated what I can best describe and front leg lameness. He would be unable to get his front paws properly placed, worse left than right, and was stumbling, back arched the whole time. Immediately we took him to the Vet who suspected either brain stem or "pinched nerve" and x rayed. The x rays were very unremarkable and normal looking, no smoking gun. The only thing noted was a sizeable bladder stone that the Vet dismissed. He gave Tobie a shot of steroid and gave us an RX for oral steroid and sent us home.

I am a Physical Therapist and had palpated every little joint and muscle all along his entire body, no yelping, no complaining, no worsening of his shaking. No increase in symptoms when I passively ranged his little shoulders, hips, knees, elbows, or feet. Nothing when I moved his little head around. This, I add, was far more extensive than the exam my Vet gave him. I should add, he appeared so calm and really enjoyed all this special attention too.

Getting back to the history, 24 to 36 hours after starting the steroids he was 100 % normal, no shaking, no stumbling, no back arching, running around demanding love by propping his front paws up on our laps, etc. . 100 % normal. We were relieved, however once we began to wean from the steroid, his symptoms came crashing back, just as bad. Total heartbreak.

So, the Vet said to up the steroid dose for 3 days and we've been referred to the neuro specialist.

I am open to anything, experience, support, advice, questions. Whatever you may have that may help I'd appreciate. Our Vet is already stating that a $1,500 MRI and 3,000 surgery to alleviate the pinched nerve is likely and I simply cannot understand how he's jumping to that conclusion without even palpating his spine.

Anyone with any experience with steroids ? What information can we glean from the fact that he had total relief on steroids and total return of symptoms on weaning ?

Like everyone here, we just adore our Yorkie, he's such an important and treasured member of our family. I suspect we may not be on the right path, and I know the evaluation we've had to date left a lot to be desired (not even blood work ?!), so please, let me know your thoughts.

Thanks,

Tobie's Mum

The conclusion that could be reached when symptoms come back after stopping steroids is that there is likely a lot of inflammation in there that it was keeping under control. A neuro is your best bet. The vet didn't even palpate his spine?

We've been through the disc/steroid thing. This may or may not be that. The front leg weakness may not fit. The neuro may have an idea just with the exam. Wouldn't be surprised if they wanted to do the MRI.

Is he on any other drugs for this, specifically for pain?

It is never okay to just dismiss a sizable bladder stone. Your pup needs another general vet asap. It may need to be removed, diet change, etc.

IO have no idea, but I am hoping for the best for your dog. Hope the Neuro Vet can make a proper Diagnoses and treatment. Best of luck to all of you,.

Ellie May, I agree. I actually debated with my husband if we shouldn't just ask to be referred to their general Vet. before going right in to the neuro specialist. I'm so disappointed in my Vet., he's always been able to handle our dogs with good care, but we've had completely unremarkable needs up until now. I am going to ask the specialists (they are a group of all specialities, orthopedics, allergists, neurologists, etc.) if they have gerontologists there. I asked about the bladder stone and our current general Vet said the antibiotics would take care of it. I find that hard to believe that that is the beginning and the end of it. I agree, there should be discussion about diet and possibly further diagnostics...

ShodanUSMC, thank you for the support. He means the world to our family. I can't let him down.

Struvite stones are related to infections, but that doesn't mean an antibiotic will dissolve the stone.

I'd find a new general vet immediately and see the neuro. You wouldn't need to go to the specialty hospital for general care. Most won't see dogs for routine things.

Thanks, Crystal.

My ten year old, Pasha had some of the same problem that you are having. He had a bladder stone and was peeing everywhere. He had to have surgery and they removed the stone. It was an oxalate stone which will not dissolve. Steroids are hard on these little guys so an anti-steroid was given to him for inflamation. He did not do well as he was allergic to the sutures inside the bladder. Back to surgery to remove the sutures. He walked rather hunched over because he was always in the pee position but with time he has gotten better--not good but better. Then he started losing the use of his back legs. The vets diagnosis was a slipped disc. His back is always arched just like Tobis. Plus when he walks he is straggering all over the place because his back legs are very wobbly, and he sometimes falls. It is very scary. Try this to see if Tobi's spine is in trouble. Take his pawand bend it like he is making a fist, so it on a flat surface. If he dosn't straighten his foot back up to it's normal position it is likely his spine. Pasha's back paws did not return to their normal position so the vet determined it was probably a slipped disc. They did an exray which looked fine, but only 50% of the time does this show up in an exray. Treatment for this has been muscle relaxers and acupuncture. He'sonly had one treatment has another tomarrow. He is slowly getting a little better.but still walks like he's drunk. Keep me informed, and a kiss to Tobi.

:thumbup::thumbup:

I totally agree with all of this. I would definitely keep the neuro appointment!

Welcome to YT :)

LadyJane, thank you for the welcome.

Krystal, thank you so much for sharing your experiences. I hope Pasha continues to hang in there. They are such sweet little old men, aren't they ?

Here's the thing with the dorsal paw reflex... My Vet did that with Tobie, however Tobie is a really gentle passive soul. My Vet just stood him up, put the paw in the position then saw nothing happen, and passed judgment. However, as a Physical Therapist, I thought to myself, that's Tobie for you. If he thinks you want his paw like that, he'll leave it there until you move it, he's just shifting his weight to the other 3 paws. I really suspected this because the Vet never fully let go of supporting Tobie's belly.

Anyway, I did the test myself, this time gently pushing Tobie to weight bear evenly and wouldn't you know it, one at a time, each paw popped right back to the correct position.

What I did notice during this little weight bearing exercise, however, is that he is reluctant to bear weight on his left front paw. The reflex is there but he still would rather not bear weight there as strongly as the right front.

Anyway, I know I'm going on too long, I just wanted to thank you for the advice and throw the results out there to you. I will keep you posted Tuesday is the Vet. visit and I'll let you know how it goes. We're weaning the prednisone very slowly and he's doing alright at 20 hours between doses, so today we'll try 24 hours, and continue trying to wean to every 48.

I am not so sure about the reflex thing. Reflexes are just that....reflex and involuntary. My thoughts are that the steroid may be helping him. Now, I am not a vet or a neurologist, but I have had many pups with various ortho and neuro issues.

I also personally would not wean one of my pups off of steroids unless advised to by my vet.

Just trying to give you a bit of feedback.

LadyJane, I'm following the Vet's advice, he tried to have us wean to every other day more quickly and the poor little guy regressed so badly, so we went back up to 2 pills a day with the instructions to wean him down to every other day (one pill) gradually. We're taking it slowly since it went so poorly when we tried the original rapid weaning schedule. Originally our primary Vet had him on 1 pill twice a day for 5 days then told us to wean immediately (that day) to 1 pill every other day. We went slower than that doing 1/2 pill the morning (that we saw the Vet and he said, start every other just one pill) and 1/4 pill that evening, then going 24 hours and 1/2 pill, then trying 36 hours, 1/2 pill, but by 24 hours after that (not ever reaching the 48 hour mark) he regressed and we went back up. So, this time we're weaning extremely slowly and so far so good. But, I'm so nervous about what will happen as the time starts stretching.

Oh, I did not see that. I do hope he can be weaned off without any exacerbation of the symptoms.

Thank you, Lady Jane, me too. It's so hard to see him perfectly happy and comfortable knowing that the last time we weaned he regressed to such a painful place.

I really think the original weaning schedule was simply too aggressive, and I'm hoping that a gentler, longer, taper will do the trick.

Thank you all again so much for the experience, advice, and support. He's such a sweet baby, we just hope that we can keep him happy and comfortable for a few more years. His birthday is July 4th, so I'm hoping that he can dance on his big day.

I hope so, too! :)

I have two thoughts and really and mostly I think I would recommend getting a second opinion. But First of all, a sizeable bladder stone being just dismissed concerns me. That can be so uncomfortable that I could see it causing some of your symptoms but not all.... The other thought is that the number one symptom of Lyme disease is lameness so I'm wondering if there is any possiblity that this could be causing his discomfort? In any event, I hope you figure out what is going on with your guy. It is so hard to see them in pain and not know how to help!

tjdMom, I'll bring that up at Tuesday's visit. We do treat with flea and tick preventatives but I suppose anything is still possible. Tobie is never off leash, even in our back yard, because we've got too many large birds of prey for my comfort level, so it's not like he gets into a lot of areas with dense underbrush, etc. . But, I'll leave no stone unturned.

I did feel in my gut that dismissing the stone was not good care. He's always been a good Vet, but we've never needed anything more than routine care. In the past when he's had to refer us out he's always done the right thing until the referral. I don't have faith in that this time. I'm hoping that now that Tobie will be in the hands of the specialists (whom we have used twice before, my poor Sheltie had to have a complicated pad surgery for a growth that was interfering with her walking and again when she had to have exploratory surgery, our first first Vet (not this one) missed a bit of ovarian tissue and she had to have it removed... anyway, they're top notch) he will get good comprehensive care.

Thank you again.

The Veterinary Specialists were outstanding and beyond thorough. Hours and hours of testing yesterday and we have come to a very difficult cross roads. They will attempt a spinal surgery although the risks to such a small older dog are great, or they can help guide us in a non surgical fashion. They are very satisfied that the problem is intervertebral disc disease. They have directed us on treatment of the bladder stone as well and that is really the least of our worries as the treatment is more clear cut. I really appreciate your advice and words of support. To update, for today, he's doing great, has weaned down to 33 hours between prednisone and I'm going to continue to try to get him down to 48 hours as I have been told to. The goal would be to get down to little or none and only resume on an as needed basis. I have had such a soft spot for Yorkies my entire life, since I was a very small girl of 3 or 4, and Tobie is the first I was blessed to have as a part of my family. It is so hard to know that he is hurting and to know that either decision carries such risk and side effects. I know everyone here understands. Thank you for listening.

i will keep you and your sweet little tobie in my thoughts and prayers. wishing the absolute best outcome and that he will make a complete speedy recovery. you're doing a great job making sure he gets the best possible care available. tobie is lucky to have you!

and welcome to yorkie talk!

Hello! I am just seeing this thread. I'm sorry for all you are going through with Tobie. My yorkie, Layla, also has invertebral disc disease, however she went down quite quickly and lost the use of her back legs totally. She had surgery and didn't recover any feeling. She had another flare-up, but in her neck, about 7 months later and we treated it conservatively (crate rest and medications) and she recovered fully.

I just want you to know that many dogs do get better conservatively, without surgery. Surgery is really hard on their tiny bodies, and if they are kept still enough, even a slipped or ruptured disc can heal without it. A lot of people just think surgery is the only option so I wanted to let you know that conservative treatment can also be quite successful (and much cheaper!) Dodgerslist is a website (and yahoo group) that has helped me a lot as a resource for IVDD. You can check it out if you want some information and people to talk to who have all been through it: Dodgerslist Home Page

You and Tobie are in my thoughts!

Lindsey, thank you so much. I had hoped in my heart that there was more hope than I would allow myself to feel, and your reply tells me that it is ok to have some hope. Layla is just precious in that picture.

Lindsey's post reminded me to tell you that it is very likely that my girl has/had a bulging disc. We elected conservative management first and have been very happy so far with her progress.

Surgery was a last resort here. Her vets said only do it if absolutely necessary.

Thank you, Crystal. All the positive outcomes are encouraging.

Definitely keep some hope! :) The hardest part for us was trying to stay positive but we got there eventually. Your dog can tell when you're upset about something, and if he can just relax and rest and know you're happy, he'll be content and happy too!

Absolutely! Layla's vets said the same thing. When she had her second flare-up they said they would only do surgery if she got progressively worse, to the point of losing neurological function. Until then, they would avoid putting her body through the extra stress.

I agree with the other posters; but I want to add that while some people are very pro surgery, some are the opposite. I believe it comes down to individual cases and thorough testing and consultations with specialists as you are doing.

I have had both positive and not so positive results with neuro surgery. It is indeed a very tricky field.

My beloved Maxwell who passed in 2006, had disc surgery at Texas A&M in 2004. Maxwell had come to me as an adult and our best estimate when he passed was that he was anywhere from 14 up; so he was perhaps 12 when he had the surgery. This was after he herniated two cervical discs and was unable to stand up on his own. Following the surgery we almost lost him due to his collapsed trachea; but he did recover and did amazingly well.

I agreed to the surgery because I had two options: surgery or let him progress to being a quadridplegic with the later not being a good option and I took the risk. Thankfully, I had two more wonderful years with my beloved Maxwell. He was actually able to stand on his own the day after surgery. It was amazing. What I will say is that back surgery is easier on the pups than it is on humans; but it still is not without risks just as in humans.

I share his story only to give you something to see in terms of surgery being successful...certainly not to suggest that is the right choice for Tobie.

I wish you well in your decision making and hope that things go well for your Tobie. :)

Thank you, LadyJane, for being kind enough to share Maxwell's story. It's going to be a tough call.