Min Pin all disks in neck are bulging

Question
QUESTION: Hello,

Eddie, our 12yr old min pin has been progressively unable to walk.  Started w/ front paws, now its all4 legs. We had an MRi after the prednisone was not helping, and the neurologist saw that every disk in his neck was bulging.  So she said she couldnt take all 6 disks out, but wants to do a surgery that will shave the bone to alleviate the pressure on the spinal cord.  The DR can not promise this will work, and also said it is very painful for the dog and rehab will be needed.  She wll have to go through the shoulder and cut through the muscle to do this procedure. What is your advise?
many thanks

ANSWER: Hi Jason,

I'm sorry to hear of your dog's condition.

You don't have much in the way of options.

Surgery never comes with guarantees, it may work, it may work a somewhat, or it may not have the desired effects. There's no way of knowing. A big part of how successful a surgery can be is if your veterinarian has experience doing this kind of surgery. If he or she hasn't done many, it would be worth the effort to get a recommendation to a veterinarian who's done this surgery many times, and has had success with the procedure. How well you follow the post surgery regimen of care also contributes to how well your dog will recover.

I would imagine that pain medication can be given post surgery. Recovery can be several months, it would be unthinkable to have your dog suffer pain, and not have pain medication for that long a period.

Sadly, the only other option would be to put your dog to sleep, rather than inflict a life of immobility, pain and suffering upon her. It's a humane option, but it certainly isn't an easy choice.

Your finances have to be considered too, if the cost of surgery and rehabilitation will be just too much of a burden.
Ask your veterinarian what the chances would be that your dog wouldn't show improvement after surgery, and would need to be put to sleep after enduring the operation. If the odds of her gaining some mobility and pain relief out weigh the negative, you'll have a better idea of if you should even attempt the surgery.

There comes a time in each pet's life when we must say goodbye. We want that pets to live a long and happy life. When longevity isn't an option the best we can hope for is a good quality of life, however short that may be.

I hope I've been a help.

Feel free to write back if I there is something more I can offer.
Best of luck,

Patti





---------- FOLLOW-UP ----------

QUESTION: many thanks patti,  And that is what we want for eddie, (good quality of life).  The neuro surgeon said it would be a dorsal laminectomy, to cut bone to alleviate the pressure for 4 bulging disks.  She said she could not remove the disks by going through his neck, (would be too invasive).  But she said the dorsal laminectomy would be very painful for eddie, b/c they have to cut through muscle, etc. Have you ever heard of any success stories with this surgery in small dogs?

ANSWER: Hi Jason,

I honestly don't know what the prognosis is for the kind of surgery your dog requires. Maybe you can find answers at one of the following web sites:

This web site is about Canine Intervertebral Disk Disease, primarily in the Dachshund breed as they prone to develop disk problems, and includes info on their treatment, including dorsal laminectomy:

http://www.dachshund-dca.org/discbook.html


You also might find these web sites helpful:

http://www.royal-canin.co.kr/admin/upload/Intervertebral%20disk%20surgery.pdf

http://www.vsg.co.nz/documents/lumbosacral.pdf

http://www.petplace.com/dogs/laminectomy/page1.aspx

http://www.sconevet.com.au/companion/invertebral.html

http://books.google.com/books?id=B_nh6zSr4wUC&pg=PA1205&lpg=PA1205&dq=dog+dorsal

Most dogs are hospitalized after this surgery until they regain control of bowel and bladder. Strict exercise restriction for three to four weeks is critical. Physical therapy is important part of post-operative care, in order to maintain muscle tone and flexibility.

I hope that helps!

Patti

---------- FOLLOW-UP ----------

QUESTION: Patti,

we rcvd a 2nd opinion and some hope.  Our 1st surgeon said dorsal laminectomy is the only way (dog has 4 bulging discs in neck), and that she can't take 4 out at once doing it under the neck, (would make the dog unstable).  The 2nd opinion DR said he could do the less aggressive surgery and take out the 4 discs via multiple ventral slots.  In turn we want to do the less invasive surgery (not cutting through 3cm muscle, only 1cm.  Less rehab, etc.  The ist DR called after I told her my choice, and said that the 2nd opinion surgery will leave the dog unstable, and she would not let her own dog have that surgery. She was taught to only take 1-2 discs out at a time.  So that is why she wanted to do the dorsal lam surgery. She said she was going to send out the mri to her collegues to see how they would handle the surgery.  So we are now dealing w/ dueling surgeons that are leaving us very confused.  Have you heard of both surgeries?  the 2nd dr said he does that surgery 1 time a week, and just removed 3 discs from a min pin successfully recently....

Jason

Answer
Hi Jason,

By not going through the muscle, I assume you're describing a laproscopic procedure. The advantages of laparoscopy is 3 small incisions are made, versus a very large incision for major surgical procedures, so it's a less invasive means of surgery, and has a quicker recovery after the procedure. Many human surgeries are done this way, for the same reasons. If Eddie's surgery can be done laproscopically, I would think that it's probably preferable.

The second veterinarian you consulted, is he a board certified veterinary orthopedist? If he is, I'd be more inclined to follow his recommendation, over the opinion of my general veterinarian. Doing the procedure on a weekly basis means he knows what he's doing. I forget if you told me or not, does your regular vet have as much experience as the second doctor?

Even though your vet told you that she was taught to only take 1-2 disks out at a time, there are advances in medicine all the time. When was she in medical school? Has she kept current with advances in the field?

Regardless of which vet does the surgery, Eddie should have the MRI before having the surgery. It's an imprtant diagnostic tool.

I found more information on dorsal laminectomy here:

http://books.google.com/books?id=B_nh6zSr4wUC&pg=PA1235&lpg=PA1235&dq=dog+bulgin

Lastly, there are Internet veterinary consultation services. You could get a third opinion, which might help you make your decision. Here is one such Internet consult:

http://alamoheightspetclinic.com/consultation.htm

This Internet consult service is for veterinarians, maybe you can ask your vet if she'll submit the info for you:

http://www.vetmed.lsu.edu/vth&c/Orthopedics/referringvets.htm

I hope that helps!

Patti