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Spine/Disc Issues
This website contains nine sections.  There are also story boxes scatter throughout.  The toolbar below is designed to aid in the navigation of this page.  There is a tremendous amount of information here.  Please take your time!











Intervertebral Disc Disease or IVDD will effect one in four dachshunds.  This disease knows no age limits but is most common in dogs between the ages of 3 and 9 years of age.  IVDD need not be a death sentence.  Improvements in veterinary medicine and pharmacology make this procedure safer every year.  It is hoped that the information found here will educate you on this disease and make discussions with your veterinarian and veterinary surgeon easier. 

This page has been designed as a tool to educate and to help you find solutions to your IVDD issues so please scroll down the page to familiarize yourself with the information here.  As it can be a little overwhelming, it has been divided into 'mind sized bites'.  It has been suggested that the last section which contains the non-medical support info be moved to the top and this is why we ask that you scroll down before beginning your learning experience with IVDD.

Note: The information offered herein is for informational and educational purposes only.  Seek the timely care of a licensed veterinarian or veterinary surgeon if you believe your dog is exhibiting any of the signs or symptoms of IVDD.  This website does not seek to diagnose or treat IVDD.


Introduction to Intervertebral Disc Degeneration [IVDD]



Between each of the vertebrae (bones of the spine) lies an intervertebral disc. This disc is composed of a soft tissue, called fibrocartilage, that allows movement and acts as a shock absorber.  Normal wear and tear with aging results in deterioration of these discs(disc degeneration).  Although some older patients can show clinical signs, more often the deterioration progresses without any problems or symptoms. In some pets, this deterioration is accelerated and middle-aged patients can show clinical signs.



Type I Disc Degeneration

Two groups of patients are most commonly affected. The first group is typically small breed dogs that are usually between the ages of 3 and 9 years. The center of the intervertebral discs, the nucleus pulposus, become calcified and rigid losing it’s normal elasticity. With a mild traumatic event, and occasionally even normal movement, the disc can rupture and the calcified center be rapidly extruded or herniated. If the disc ruptures to the sides or bottom, the result may only be transient pain lasting for a few hours to a few days. It may even be unnoticed by many owners; however, if the disc ruptures above, the calcified contents are extruded into the spinal canal and can impact on the spinal cord.  This results in severe pain and varying degrees of paralysis. Immediate treatment is necessary or complete and permanent paralysis may occur. Surgery is necessary if medication alone does not work or if the signs are severe.


Type II Disc Degeneration

The second group of patients most commonly affected with disc degeneration are large breed dogs, usually 4 to 9 years of age. In these patients the disc degeneration results in a slowly protruding or bulging disc. The spinal cord may become compressed over the course of many months and thus symptoms may be gradual and be mistaken for arthritis. Treatment should be started before irreversible damage to the spinal cord has occurred. Again, the decision for medical treatment or surgery will depend on the severity of the symptoms and where in the neck or back the problem is occurring.


Traumatic Disc Rupture

Major traumatic events may also result in rupture of deteriorated or even normal discs in any patient.  Treatment in patients with traumatic disc rupture may be the same as for those patient with Type I or Type II disc degeneration. This condition has also been called Fibrocartilagenous Embolism or FCE in the past.



IVDD Prevention Steps



Every dachshund owner fears the worst when it comes to the well-being of their doxies spine.  Time after time we are asked what we do to prevent this tragic disease.  Prevention is not a word we use for the steps we take as here, it is thought of as risk management.  How can we lower or manage the risk of trauma.

Here are some suggestions:

  • Keep your dachshund fit and trim.  Look to the breed standard for what your dachshund should look like.
  • Feed a diet enriched in joint supplements such as Royal Canin JS.
  • Add additional joint supplements before serving their main meal.  Potency can be an issue with dry kibble as it is shipped and stored.
  • Exercise your doxie regularly in an age appropriate manner.  Remember that although both a 2 year old and a 9 year old are both at risk, their level of exercise tolerance is different.
  • Try to avoid activities that inflict trauma including jumping and twisting motions [down from bed, dancing, etc].
  • When adding a new dachshund to your family choose your breeder carefully.  Ask about the incidence of IVDD in their lines and always look to the American  Kennel Club [AKC]
    for responsible breeders in your area.
  • Learn to lift properly.  Here is a video on the correct way to lift.

To Be Inserted








Note that the back is always supported and straight throughout the lifting process.

Please drop us a note if you have found other ways to manage the risks for your doxies.  We want to hear from you.












     

Diagnostic Tools  

Several tools are used to diagnose IVDD with each carrying a different cost and serving a different function.

During the exam it is common to draw blood and attempt to obtain urine, but two other tools common in the diagnosis of IVDD are the Wartenburg Wheel and surgical clamp.

The Wartenburg Wheel



This pinwheel like structure is often used by veterinarians to help identify the vertebra which have been effected by IVDD.  The veterinarian will glide the pinwheel down the dogs spine observing the animal for pain or muscle flinching, thus identifying the disc in question.



The Surgical Clamp



A trip to the OR will not be necessary to check the level of deep pain sensation for dogs who have developed a loos of limb function.  The veterinarian will use the clamp to squeeze the pads of your  dachshunds foot and may continue testing for loss of sensation up to the base of the tail with this method.  The greater the deep pain, the greater the chance of recovery from a spinal injury.

Radiological Tools

X-Ray or Radiographs
Many veterinarians will take x-rays or radiographs in an attempt to see a suggestion of disc rupture.  These views are generally non-conclusive.  DRBC does endorse the use of x-ray or radiograph pre-surgically or for dogs in respiratory distress to confirm sound lung function eliminating the concerns for pneumonia which some dachshunds can develop. A radiograph of a dachshund with a ruptured disk is shown below.





Myelogram
The myelogram uses a contrasting agent or dye to illuminate the effected region of the spine.  X-Rays are taken before and after the injection of the contrasting agent.  The outline of the spinal cord and any herniated disc material can be seen on the post-contrast x-rays.  As technology improves this procedure is sometimes coupled with a CT Scan to provide additional information about a selected region of the spinal column. Shown below is a myelogram of a dachshund with a ruptured disc.



MRI
The MRI provides the surgeon with the most accurate information possible and is the diagnostic tool chosen most often by DRBC.  Unlike the Myelogram, no foreign substances are injected and yet much better definition of the spinal column and herniated disc are mapped.   Shown below are the MRI results for a dachshund with three ruptured discs.









  



IVDD Medications


Your veterinary has many choices when treating IVDD.  Listed below by category are the drugs most commonly used to treat IVDD. 

Non-Steroidal Anti-Inflammants [NSAIDs]

DRBC does not advocate the use of NSAIDS for the treatment of acute IVDD.  It is our drug of choice for recurring or chronic  IVDD which is mildly symptomatic.  Both NSAIDs and  steroids carry inherent risks to the liver and kidneys.  Discuss the impact of your veterinarians choice of medication with them to understand the impact their decision may have on your doxie.

ZUBERIN® - This is the DRBC NSAID of choice for the treatment  of dachshunds with chronic or mild IVDD symptoms.  Studies have shown that Zuberin's impact on long term kidney and liver damage is the least of all NSAID medications available. 

Other NSAID's:
Rimadyl® (Carprofen)
Deramaxx® (Deracoxib)
Previcox® (firocoxib)
EtoGesic® (Etodolac)
**Piroxicam® (Feldene)
**Phenylbutazone®

**Currently under US and Canadian Drug Review, not recommended for use with dogs

Note: Other medications may be prescribed in a manner not suggested for dogs.  The prescribing of medications for off-label use is not included here.

Steroids [Glucocorticoids]

Dexamethasone - Administered as an injectable, this drug is the DRBC 1st line of defense against IVDD which may become acute or surgical.  This is a quick and long acting steroid which has resulted in positive results for the group when combined with strict crate rest and appropriate veterinary monitoring.

Prednisolone - Administered orally this steroid has less long term impact on organs including liver and kidney. This medication is a steroid, and like all steroids must be weaned from the dogs system.  Discuss your concerns about the use of steroids to treat your doxie and the importance of weaning them from any drug in the steroid category.

Prednisone - This drug is widely used by many veterinarians; however, it is metabolized or broken down in the liver to form Prednisolone.  DRBC abandoned Prednisone several years ago due to the impact this medication has  on the liver and kidneys.  Should your veterinarian prescribe this medication, please be sure to discuss the side effects and steps towards weaning them from the use of this, or any other steroid.

Special Note: The use of steroids will cause an increase in thirst and need to urinate.  They will also create a false sense of wellness. Take the proper precautions and provide ample water for your dog and remember to restrict movement to no more than 6 steps when going outside to meet nature's call.  Always discuss the process by which your doxie will be weaned from a medication in this category wit your veterinarian.


Gastrointestinal Protectant

Use of NSAID's or steroids can lead to the development of ulcers in your doxie.  Guarding against this additional complication is a step your veterinarian will most likely include in your treatment protocol.

Carafate® (Sucralfate)
Zantac® (Ranitidine)
Tagamet® (Cimetidine)

DRBC uses all three of the medications listed above to guard against the formation of ulcers while an NSAID or steroid is being dispensed.  Additional medications exist in the human market and are not included in this list.  Use of non-canine specific medications can lead to additional medical issues and complications.  Always discuss your choice of over the counter medications with your veterinarian to insure that the medications you provide your doxie will be safe and effective.

Pain Relievers

Managing the pain your dachshund is experiencing is an important part of the overall treatment protocol your veterinarian will address.  There are several drugs available for use in this area:

Tramadol® - This is the pain reliever of choice at DRBC.  Orally administered, it is safe and effective. 

Robaxin® (Methocarbamol)- Also used by DRBC on occasion. 

The pain medications listed below are considered controlled substances.  Fentanyl is applied as a patch for short term use, while the remainder may be administered as an injection or oral medication:


Antibiotics

Dachshunds which have experienced IVDD without prompt surgical attention or who are non-surgical candidates often develop urinary infections due to an incomplete emptying of the bladder.  Pneumonia is another concern for dachshunds with compromised immune systems and loss of mobility.  The dogs in our care are often placed on antibiotics and a urinary acidifier following a screen of their urine to eliminate these concerns.

While there are many antibiotics available to your veterinarian, our drug of choice is:

Baytril
®

Many veterinarians think of this medication as a 'big gun' and want to save it for when really needed.  Prescribed and administered properly, their concern for antibiotic resistance should be minimized.  Discuss this proactive position with your veterinarian, because this IS that really big event. 

Our acidifier might suprize you:


250 mg Chewable Vitamin C

Vitamin C has long been know as a urinary acidifier in the veterinary world and is currently being studied for it's anti-oxidants effects as well.



dog,dachshund,wheelchair,doxie,cart,dogcart,canine,disabled,paralyzed,animated,smilies,smiley






The Journey – The Story of Marty

It is impossible to participate in the rescue of this breed and not work with dogs that did not receive treatment, or for whom treatment was only partially successful or may have completely failed.  What then?

This is the story of Marty, a cute little doxie that did not receive treatment in time to save his spinal cord. 

One day we received a call about a little doxie who was not responding 2 months after his spinal surgery.  The rigors of the routine Marty required was too much for his family and they had decided that one way or another, it was Marty’s time to go.  So Marty came to DRBC.

Marty was very thin.  No one had kept up with his reluctance to eat after the surgery and he had lost weight.

Poor Marty had sores on his hind section from urine scald and his knees and legs had open cuts from where he had dragged himself along the ground. Marty’s hind end was completely paralyzed.

Marty had a bladder infection because no one bothered to express his bladder and bowels regularly.

But Marty had heart.  His tail could not wag, but his eyes were full of hope and he was anxious to share his kisses with anyone that stopped by to greet him. And so, Marty’s journey began.

Marty got a two baths.  He was stinky.  He was put in a recovery crate so that something soft would cushion his body, especially his hind end. 

Then Marty went to the veterinarian!  No more steroids; they were to be weaned.  3 meals a day; Marty needed to gain weight.  Medications for his bladder infection and cuts, a physical therapy schedule and Marty went off to his new foster home.

Life changed fast for Marty.  His cuts healed, his appetite returned, he was put on a schedule for his bladder and bowels and the special folks over at K-9 Carts made Marty his own set of wheels.  It was pretty clear to all of us that Marty would never walk again in spite of our efforts, but that was OK, Marty was still here with us and he was a love.

The day Marty’s cart arrived was an exciting one for the ‘Mart-man’, as he came to be know.  Unlike most doxies placed in a set of wheels, Marty froze.  Freedom was just a step away, but how to get him to move, this was the dilemma.  Food wouldn’t move him, praise and encouragement didn’t do it, and then, finally Marty’s secret passion was discovered:  soft squeak toys! 

All of the DRBC homes have plenty of safe toys for all the fur kids to enjoy.  Marty believed they were all his.  Every one of them.  He took great joy in chasing the toys across the floor in his new set of wheels.  His scheduled play sessions also helped him build the strength in his chest and front legs, which is very important to paraplegic dogs.  ‘Who’s toy is this?’ we would ask.  Why Marty’s, of course and away he went.  Over time the Mart-man developed a love for stuffed ducks and would drag one with him whenever he could.

Almost a year passed.  Marty returned to a normal weight and his feeding schedule blended into the normal foster feeding pattern.  He was checked frequently for bladder infections, but the schedule designed to prevent problems was working well.  He had become a pro with his wheels, anticipating corners and learning to stop on a dime.  Marty had been rehabilitated.  It didn’t matter that his hind end didn’t work, to us; he was just another one of the kids.  And so, Marty’s quest for a new home began.

Many people came to meet Marty, but no one wanted to take on the responsibility he represented.  Marty would look out the door as family after family declined him because of his disability.  ‘That’s OK Mart’ we would tell him, ‘its just not your turn yet.  It will happen.’   Almost one year passed.

One day a couple whose children had grown came to meet Marty.  They watched as he ran after all the toys.  They asked about how they could care for a dog like Marty and listened carefully to everything that they would have to do to keep Marty healthy.  They held Marty and kissed him.  They practiced taking him in and out of his cart.  They seemed to understand about the stuffed duckies.  They talked it over for a long while.  They looked at all the other dogs.  And then they adopted Marty!  Dog, cart and squeaky ducks!  It was Marty’s Turn!

Marty stayed with us for two more weeks as his new family prepared for his arrival.  Ramps were built so that Marty could see out the window and navigate the step in and out of the house.  Soft blankets and extra stuffed duckies were brought in so Marty would feel right at home.

It was a bittersweet departure as Marty left.  We loved Marty so much, but we wanted what was best and knew he had found it in this special family.  And we knew we would see him again and hear from his family because that is how DRBC works, but it was still tearful for all of us as the car pulled away with our little buddy.

Time passed, Marty flourished in his new home, but the function his hind end never returned.  No matter, he was loved.  Then, out of the blue we received a call that Marty needed a friend.  Marty’s family had more love to share and Marty, well he was everybody buddy.  An odd and special request came with it: could we find another challenged dog to add to their home?  We were stunned; this was an amazing family.

Fate is a funny thing.  Anyone in rescue will tell you that.  How that family knew we were about to receive another challenged dog mystifies us to this day, but two weeks after the request for a friend for Marty came, so did another paraplegic doxie named Suzie.  Her family had given up on her after just a month of care.  We contacted Mary’s family and told them to get ready for their new addition.

About a month later, on a warm summer day, Marty met his new bride.  They wheeled around the patio together and then out on to the lawn.    It did not seem to bother her that Marty had a cart and she liked the people very much.  As we worked on the adoption agreement they fell asleep in the sun together.  It was meant to be.

The family that adopted Marty and Susie went on to adopt several more special needs doxies.  Their love for those specially challenged doxies remains a tribute to the depth human kindness can reach.

Dachshunds with paraplegia go on to live happy and normal lives.  Marty, Susie and all the special needs animals out there are a testament to that.   Remember, every journey begins with a step or in Marty’s case a good set of wheels.

Do you have a special needs doxie?  Please develop a schedule that helps them be the very best dog they can be.  Work with your veterinarian to avoid the extra health issues your special doxie may present.  Please feel free to contact us at info@doxierescue.com if we can be of any assistance.  You can do it!





Alternate Therapy:
Canine Acupuncture

Acupuncture is one of the world’s oldest and safest medical treatments and relies on the use of very fine painless needles placed in strictly defined positions on the recipient, which is thought to affect the flow of energy around the limbs, body and head.

Canine Acupuncture results in the release of the body’s own endorphins which are very effective pain killers and can, in correctly chosen cases, have very significant beneficial effects not only on the musculoskeletal system but also on medical complaints and the LCRC believes it has an important role in the holistic treatment of veterinary patients.

Not Painful

Although insertion of needles may cause in a few cases a very short lived tingling sensation, small animal patients are in general very tolerant of acupuncture and some may even relax so much as to fall asleep during treatment!

Noticeable Improvements

Generally improvement in susceptible cases will be seen after 2 to 3 sessions though occasionally animals are immediately better with regards stiffness and improved mobility after their first treatment.

What to Expect

Many people wonder what it will be like to have acupuncture done on their dogs.  Here is a clip that shows what you might expect on a trip to the acupuncturist:











Bladder and Bowel Expression

Regardless of whether your doxie has lost the ability to sense the need to empty their bowel or bladder due to the effects of post-surgical swelling or because a conservative treatment path has been chosen, the need to empty their bowel and bladder on a scheduled basis may be indicated.

Learning this critical responsibility is best taught by your veterinarian or trained veterinary staff member.  While not difficult it is important to have them assist you in the proper way to address each of these tasks.

Ask your veterinarian or trained veterinary staff member before discharge on the proper methods and practice these steps in their presence to help your doxie with this issue.

 










Physical Therapy Sessions


It is not always possible to be present when a dog receives physical therapy.  If you are considering this for of rehabilitation or if you wondered what too place during a water treadmill session the next video should help:







Sling Walking and the Cart

Post surgically it is important to provide ample support for your dog as he or she recovers.  Often, your veterinary surgeon will suggest sling walking our doxie until the gain control of their hind and rear limbs.  Still, other will suggest a cart or 'doggie wheelchair' for the short or long term.

As the video below shows, you need not hurt your back while supporting theirs and you will probably be more concerned about their transition to a cart then they ever will.  Enjoy!










Signs and Symptoms of IVDD



The symptoms list below are all cause for concern. 

Some, such as a dragging limb or inability to move head or limbs are reason to crate your dog and move immediately to a qualified veterinary surgical center, but any animal exhibiting the symptoms listed should be seen as soon as possible. 

Early crating and veterinary intervention can make the difference between a dog that regains the ability to walk and one which does not. 

Let us say it again, do not wait, crate and seek veterinary care.
  Imobilization and veterinary intervention are key in the recovery of an IVDD dog.

Neck
  • Neck sensitivity
  • An inability to shake neck and/or ears
  • An inability to reach an ear to scratch

Limbs

  • Dragging a limb
  • Inability to move one or both rear legs
  • A crossing of one or both back legs while walking
  • Stiffness or difficulty climbing stairs



Generalized Complaints

  • Pain when moving or attempting to move
  • Difficulty with walking and jumping
  • Slower movement
  • Reluctance to move
  • Crying or shaking due to pain
  • Very tense abdomen
Rear Body Complaints
  • Difficulty urinating or defecating
  • Tail cannot wag
  • Hunched back due to muscle tension
  • Loss of bladder and bowel control
  • Painful urination




Causes of IVDD


There are two categories of cause for IVDD in the dachshund:
      • Genetics
      • Trauma
Suprized?  Don't be.  Let's take a look at each to understand the true cause of this disease.

Genetics

Dachshunds are hunters, maybe not today, but this is their heritage.  Long before they were the small pets that watched TV with us and sat on our laps, their frames were larger, more balanced and they were used to hunt badgers by tunneling down long badger runs and capturing their prey.  Those days have long passed and preferential breeding has led to the dachshund we know today.

Pictured below is a black and tan Dachshund and a black and tan Coonhound.  The Coonhound was chose to illustrate a very important difference between these two hunters: the percent of long bone vs the percent of cartilage and its effect on spinal stability.

    

Looking at these two pictures points to the vast difference in body balance.  The average height of a Dachshund [left] is 8 inches while that of the Coonhound [right] is 25 inches; the Coonhound has a better overall weight distribution.  Back in the Dachshund's hunting days their average height was 20 inches and IVDD was not a notable disease for the breed.   Amazing what a little genetic tinkering will do for you.   This makes genetics the largest contributing factor to IVDD.  Now you begin to understand why puppy mills, pet stores and back yard breeders are leading to the majority of the problems seen in the breed; they ignore the importance of good genetics in their breeding practices.

Trauma

When most people hear the word trauma they envision a serious auto accident or a gory scene at the local emergency room.  Rarely, is this image that of a dachshund jumping off the couch, yet one can be as serious as the other.

As the dachshunds front legs strike the floor, a tremendous force travels up the legs and is displaced through the spine.  Time after time, this and other incidents insult the stability of the dachshund vertebra leading to IVDD.

So what are some of these destructive forces:
  • Jumping, any kind [off the bed, the couch, the chair] and jumping down caused a greater one time insult than jumping up.
  • Twisting, any kind, as in jumping up on the above mentioned, jumping up to catch a ball AND improper lifting by humans.
  • Falling as in falling down the stairs, out of someones arms or off the table because no one pushed the chairs in and the smell of food was still there.
  • Weight problems.  Look at the pictures above.  Who can handle 2 lbs of extra weight better?  Many people tell us they love their dachshunds to death; they can't deny them those treats.  It is a shame they do not want to love them to life, because IVDD in an obese dog carries extra risks and increases the chances that those animals will become IVDD statistic.




Treatment Protocols for IVDD



DRBC IVDD General Considerations
DRBC always thinks surgery first, even though this may not be the option followed.  The rationale behind this thought process is the number of options it gives us in the treatment of suspected IVDD.  Using this approach leads to a reduced number of IVDD surgeries for the rescue and a more successful conservative treatment result.

Keep in mind the best tool here is the eyes of the owner or in our case the foster family.  As dogs walk or play we are looking at the animals gait and energy level.  We also look at shape and form and modify food and activity level to reduce the chances that the doxie in question will experience a trip to the neurosurgeon.  A key to who they are prior to placement it also provides important information about the health of their spine.  Being an observant parent for your fur kid is one of the best ways to stay on the fast track to recovery should IVDD become an issue.

Our second tool is a crate.  Immobility is critical to recovery from this disease, again this is with or without surgery.  It is not cruel to crate when it can save an animal's life or maintain the quality of that animals life.  Crate train early and this will not be an issue should your doxie suffer with IVDD or any other illness.  Oh, and by the way, we never wait for a veterinarian to tell us to crate rest a dog, we take the step long before the trip to the hospital.

Third, we act in a timely manner to have the issue addressed.  Time = Function.  We want to keep or regain the largest percentage of function possible should IVDD present as the diagnosis.

Given these considerations all DRBC dogs begin their path to recovery at a single point: the General Exam.  Following the exam, the path may be surgical [Path I] or Non-Surgical [Path II] for a variety of reasons.  Each of these steps is described below in an attempt to help doxie owners use the same logic we do here at DRBC.



DRBC IVDD General Exam

The
general exam is an important starting point for the complete evaluation of IVDD.  Loss of motor function may not be the only problem present and failure to correctly evaluate the entire physical picture can lead to complications at a later point.  Here is what to expect:

Exam: It is important that we confirm that this is a healthy animal with our veterinarian.  During the exam our veterinarians conduct a head to toe exam.  It is important that the heart and lungs be cleared should surgery be required.  Additionally, some medications are contraindicated when heart disease is present.  It is also not uncommon for IVDD animals to develop pneumonia due to a weakened immune system and this requires immediate treatment with or without surgery as an option.

Note: DRBC does not allow for the bending of the neck or twisting of the head or limbs as part of the exam.  Identifying IVDD should be done with an examination of the individual vertebra  with a gentle touch to identify the effected area and by squeezing the pads and limbs for deep pain.  No need to worsen the situation with odd twisting or contorting.  We stop anyone trying to evaluate our dogs using rough techniques.

Testing of Blood and Urine:  So much of what an animal is going through physically is reflected in their bodily fluids that it is an excellent means of determining what problems are present in your doxie.  Many doxies develop urinary tract infections early in the IVDD cycle due to an incomplete emptying of the bladder.  This compromise of the immune system needs to be addressed quickly with proper medication to avoid additional problems for your doxie during this time.

Having defined a sound medical base, it is now time to decide if surgery is an option or if a conservative path would be more appropriate.  Both contain risks and all must be considered for the treatment and long term recovery of the dog.





DRBC IVDD Surgical Approach [Path I]

More often than we like, surgery is indicated. 
Fortunately, we have the base exam results.  Now what?  Here is a typical scenario for our group when surgery is the path chosen.

One of the rules we follow with a dog that has been examined and found to be healthy is the no more than 96 hours can pass from the time of the injury to the surgical relief to the spinal cord and the evaluation of deep pain sensation.  This is less time that it appears, a fact that is complicated by rarely being able to determine the moment of injury.

For this example, the dog was not located in a DRBC core foster home and needed time to reach us for transfer to the emergency hospital.  This is a worst case scenario for us, but it can happen.  The dog involved returned to normal function, but both the neurosurgeon and all of us here at the rescue questioned if we were in time.

Notice we skipped the trip to the general care veterinarian which eliminated the drive distance between the two facilities. 
This is common for DRBC, but may not be the average owners first step.  Add 5-6 more hours to your timetable if the general care veterinarian is included in your plan.


 Time [Hours]
 Treatment Progression
Hour 0
The injury occurs.
Hour 50
The problem is detected in the home.  Normally a 36 hour credit is given here unless we witness the injury, but in this case the injury was not clearly obvious to the foster home.
Hour 53
The dog arrives at DRBC for transfer to the emergency hospital.  3 hours were allotted here to allow for settling family matters and driving time.  DRBC will move without an appointment for a presumed disc injury and will proceed to our neurosurgeon. 
Hour 55
We arrive at the emergency hospital and check-in.  Within 15 minutes we are seen by a veterinary nurse and surgical resident or intern.
Hour 57
The general exam is complete and the neurosurgeon will talk to us about diagnosis, treatment plan and potential prognosis based on observed findings.  This is also the point at which the decision to have a myelogram or an MRI is made.
Hour 69
Unless immediate surgery is required DRBC will opt to stabilize and wait for the MRI.  The wait can be upwards of 12 hours depending on when the MRI is being used for neurological evaluation.
Hour 70
The results of the MRI and other tests are reviewed by the neurosurgeon and DRBC is contacted to discuss.  Surgery will be scheduled for purposes of his example.
Hour 78
Our dog was not the most critical case on the surgeons docket that day.  Our dog waits their turn.
Hour 80
The dog is prepped for surgery and moved to the operating room.  The surgery begins.
Hour 83
The surgery is complete and the immediate danger has been removed.  The animal is recovered form surgery and transferred to the post op area or ICU.   Medications to reduce swelling and inflammation are given along with supportive fluids.
Hour 91
The animal recovers from anesthesia and the wait for the return of deep pain begins.

It is not hard to have time, a critical key to surgical success, get away from us all.  DRBC's response time is generally quicker and thanks to a phenomenal team of surgeons we have a 99% success rate, but every second counts and that transportation, tests and waiting take time.  This is why we crate and move without haste to the neurosurgeon.  Just like the MRI, time is an important tool for this highly qualified veterinarian.

Surgical Risks

Risk is part of any surgery.  Here are the risks DRBC considers when approaching a doxie that requires surgery:

  • A myelogram may cause seizures related to the dye used during the test.  While seizures usually subside within 24 hours, this procedure is not suggested for older animals or animals with other inherent health risks.
  • Infection is always a risk for any surgical procedure.  Our surgeons take every precaution to prevent this risk, but it is evaluated for all DRBC dogs.
  • Anesthesia can cause death.  This risk is very, very low, but must be included in our evaluation.
  • The surgery could fail and the animal could be left paralyzed or might die.  This is the risk that we talk the longest with our neurosurgeon about.  Timing and the degree of disc rupture and post operative inflammation will be key factors here.
  • Additional disc ruptures may occur in the future.  Elimination of cause is critical in reducing this risk.
What Can you Expect?

Great question.  The answers are as varied as the dogs that undergo this procedure.  Here is a video that will give you an idea of what to expect:



Remember, be sure to discuss your expectations with your veterinary surgeon.  He or she will help you understand what is most realistic for your doxie. 




DRBC IVDD Conservative Approach [Path II]
The conservative or medical approach to IVDD does not involve surgery, but it will involve an exam, blood tests, a urinalysis,
medication, crate rest, limited movement and may or may not utilize an MRI as a diagnostic tool.  Here is why:

Use of an Radiology: Although surgery may not be a path that you decide you want to take or even need, MRI is another decision that supports good definition of the local and degree of IVDD for your dachshund.  It is not always necessary though and should be discussed fully with your general care veterinarian and veterinary neurologist.

Medication:  DRBC dogs are treated aggressively with steroids, if surgery is not indicated.  The medication section of this page reviews the various meds our veterinarian prescribes, but we will  typically start with a high dose and step down the dosage level until the animal is weaned from the steroid usually over the course of 3-4 weeks.  The level of medication and the rate of weaning are dependent on the severity of the symptoms observed.

Crate Rest:
Crate rest for the dachshund with suspected or confirmed IVDD is mandatory.  Please do not wait for your vet to give this instruction as for some reason, many assume you already know this.  So crate.  The confinement the crate provides allows little movement for the dog and provides a safe place for the back to rest and heal.

Limited Movement: Like crate rest, not allowing your dog movement when out of the crate for potty breaks and alike is also critical.  Only a few step should be taken.  No walks.  Face it, you know where their favorite spot is in the yard, so take them there and don't allow wandering.  That little bit of motion can be detrimental to the healing process.

Sanitary Conditions: Dogs which have limited or no sensation in their hind quarter will eliminate their bladder and bowels in a non-controlled manner.  This can lead to urine scald and represents an unsanitary form of living.  Express these animals on a scheduled basis and keep their crate clean and well padded with blankets for comfort and absorbability.  A pee or wee-wee pad can be placed over the blankets to help keep the crate clean while a warm soapy washcloth will remove urine from the skin.  A soft towel should be used to dry your doxie.  Unsanitary conditions can lead to open sores and infection, so be sure to check the doxie's bedding frequently.

Conservative Treatment Risks

Risk is part of any surgery.  Here are the risks DRBC considers when approaching a doxie that requires surgery:

  • Infection is a risk for the conservative treatment path.  These include:
    • Bladder Infection - Incomplete bladder emptying.
    • Skin Sores - Ineffective cleaning or allowing the dog to move and drag limbs.
    • Pneumonia - Caused by a compromised immune system and prolonged confinement.
  • Anesthesia can cause death.  This risk is very, very low, but must be included in our evaluation.  Anesthesia may be used to obtain radiographs or conduct an MRI.
  • Medications will be used to reduce inflammation of the disc[s] and some doxies will experience side effects while using these medications.
  • The conservative treatment could fail and surgery may still be indicated. 
  • Additional disc ruptures may occur in the future.  Elimination of cause is critical in reducing this risk.







IVDD Post-Injury/Treatment Plans


The treatment path followed following surgery or during the conservative treatment path is critical for the maximum return of functionality for dogs with IVDD.  A well thought out schedule and attention to the needs of the recovering doxie are the minimal requirements for support.  It is important to remember that although full recovery may not come for weeks or even months, the steps taken during those first days of the recovery process may make all the difference o you and your doxie.

Recently, DRBC was faced with the treatment of both a surgical and conservative path incident of IVDD.  Please red the two cases below.  While the choice of treatment was different our goals for outcome were the same:  maximum recovery of function.


Case 1: Smokey

Smokey is a very special little guy.  He is pictured in our banner and some of his stories appear throughout the website.  While all are loved in his home, Smokey is a favorite son.  Smokey will turn 19 yrs old Feb 14, 2010 and no one could have anticipated that this spry senior would develop an acute disc rupture, but he did. 

One night as dinner was being prepared, Smokey's voice was not heard.  He didn't come running into the kitchen with his brothers looking for his bowl.  Smokey was found in the front hallway, just sitting.  His tail was not wagging and he was trembling.  He could not stand or walk.  And so his journey began.

Smoke needed surgery, but he was high risk.  His age, the fact that he was in the early stages of renal [kidney] failure and the presence of a mild heart murmur were all against him.  Still he was crated and after his brothers and sisters finished dinner he was whisked away to the emergency vet.

He failed his neuro exam and his pain was worsening.  The decision was made to admit him for a morning MRI following a night of fluids for his kidneys.  The MRI told us that he needed surgery and so the decision was made.  Smokey had surgery that morning to removed the ruptured disc material and relieve the pressure on this spine.  And then his recovery began:

Time [Days]

Progression

Day 0

Smokey had surgery.  No one could visit Smoke that day.  He needed his quiet time to recover.  That did not stop the phone calls from his Mom, who called every 2 hours to check on his recovery.  It did not appear as though Smokey had any deep pain sensation and he could no urinate or defecate on his own.

Day 1

The effects of the anesthesia were gone, although Smoke was given medication for his pain.  Still no sign of deep pain, but little help needed to urinate or defecate.  Everyone here at DRBC was ecstatic and hopeful!  We made the trip to visit this sad little guy.

Day 2

Our trips to the hospital continued.  Smokey didn’t want to eat and it took a lot of encouragement to get his half way through his favorite foods. His surgeon told us she thought she sensed a slight response on his exam for deep pain and that she was pleased at how he barely needed help with urination and defecation.  His supportive fluids and pain medications continued.

Day 3

Smokey felt deep pain!  You would not have known that to look at him.  When we visited he fell asleep in his dinner and our arms.  We were all exhausted.

Day 4

Because of his renal issues, Smoke stayed one more day at the hospital for fluid therapy.  His limbs were still motionless but he could hold and empty his balder and bowels on his own.  Dinner remained a problem.

Day 5

Smokey came home.  He was excited, we were excited and his brothers and sisters were all excited.  Now the recovery work began.


A recovery crate had been set up for Smokey.  The bottom layer was a double folded layer of eggshell foam.  On top of that was a hospital wheelchair pad in case of accidents.  A soft blanket covered that with an airline blanket to tuck him in for warmth completed the crate.  The top of the crate removed easily to change his bedding and to take him out of the crate.  No one was allowed to go in his crate with him.

Post Surgical Week 1

Smoke’s pain patch was removed and he switched to oral medications to manage his pain.  Because of his renal disease he could only receive a very low dose steroid to reduce the inflammation surrounding the area where surgery had taken place. 

Finishing meals was still a problem and his feeding was changed to 3 small meals a day as he had now lost 1.2 lbs.  His only time out of the crate was for bedding changes, wound checks and sling supported walking. 

Limited physical therapy was started by bicycling his back legs gently to maintain muscle tone.  This process was repeated 6 times daily.

During this time Smoke’s ability to sense touch returned as did his control over urination and defecation.  He remained crated in-between potty and physical therapy sessions and was checked every 2 hours to be sure he was dry and clean.

Post Surgical Week 2

Smoke’s low dose steroid regiment continued, but his pain medication was stopped.  The stitches at the incision site were removed.  His appetite returned and his weight stabilized. 

His time out of the crate stayed limited to bedding changes, wound checks and sling supported walking. 

Limited physical therapy continued by bicycling his back legs gently to maintain muscle tone.  This process was repeated 6 times daily.

During this time Smoke’s tried to stand.  He also began to resist the bicycling, which told us his function was returning.  He remained crated in-between potty and pt sessions and was checked regularly to be sure he was dry and clean.

Post Surgical Week 3

Smoke’s medications were weaned.  His weight returned to normal. 

His time out of the crate was expanded and the sling walking was discontinued.  Physical therapy continued the bicycling and introduced swimming.

During this time Smokey regained his ability to walk.  His time out of the crate, although highly supervised, increased.

Post Surgical Weeks 4-10

Little by little the function in his hindquarter returned.  It will be months before he is our normal little boy again, but he had regained 85-90% of his function.  His hair will grow back and is well on its way.  Smokey remains crate rested at night and is prohibited from doing stairs or jumping at all.  His physical therapy continues.



 
Case 2: Byron
The phone rang late one afternoon and unlike many of our calls this one came from Poodle Rescue.  DRBC routinely works with other rescue groups, but this one was different.  A neighbor had suffered the tragic loss of a family member at a young age.  Two dachshunds were in the home and one appeared to have difficulty walking.  Could we help?

A few questions later it was clear that the family had not crated and was too overwhelmed to take on the care of this little guy.  The question moved from 'could we help' to how fast could Poodle Rescue get involved and get the dog to us.  The arrangements were set and Byron arrived at 1AM.  God Bless Poodle Rescue, their timely response was the difference between surgery and medical treatment.

Byron could still walk, but he did have pain.  The decision was made to treat using a conservative approach.  Byron recieved steroids to reduce the inflammation of the disc disease, received a GI protectant and a pain medication.  And then his recovery began:

Time [Days]

Progression


A treatment crate had been set up for Byron.  The bottom layer was a double folded layer of eggshell foam.  On top of that was a hospital wheelchair pad in case of accidents.  A soft blanket covered that with an airline blanket to tuck him in for warmth completed the crate.  The top of the crate removed easily to change his bedding and to take him out of the crate.  No one was allowed to go in his crate with him.

Post Injury Week 1

Being timely and paying close attention to Byron's signs and symptoms allowed for the conservative treatment of his injury.  A scheduled was developed aimed at maximum recovery. His medication was given timely, his bedding cleaned regularly and his movement was highly restricted.  His only time out of the crate was for bedding changes and sling supported walking.  Limited physical therapy was started by bicycling his back legs gently to maintain muscle tone.  This process was repeated 4 times daily.

During this time Byron fought the crate.  None-the-less, he remained crated in-between potty and physical therapy sessions and was checked often to be sure he was dry and clean.

Post Injury Week 2

Byron's hate of the crate did not change, but he came to accept it.

His time out of the crate stayed limited to bedding changes and sling supported walking.  Physical therapy expanded with the addition of limited and supported walking and bicycling his back legs gently to maintain muscle tone.  This process was repeated 4 times daily.

Byron appeared to be healed, but we knew he was not.  He remained crated in-between potty and physical therapy sessions and was checked regularly to be sure he was dry and clean.

Post Injury Week 3

Byron’s medications were weaned.  His time out of the crate was expanded and the sling walking was discontinued.  Physical therapy continued.

During this time Byron appeared to have a normal gait or walk.  His time out of the crate, although highly supervised, increased.

Post Injury Weeks 4-10

Byron was lucky.  His weight was perfect.  He was healthy and his treatment was timely.  Byron recovered fully in the weeks that followed, but his injury will leave him as a high risk for the rest of his life.  Best of all Byron has found a new home.  He is not allowed to jump and will forever be under a watchful eye for return of his symptoms.  Byron was very lucky.




Supplemental Support and Reference Information for IVDD




Listed below are a group of references to cover issues we have not in the previous sections.  Please review the entire list.  More than one may apply.  Finally, let us know if there is something else you would like to see referenced here.  We are more than happy to make this site the best that it can be for you and your doxie.


Choosing A Surgeon

You will want a neurosurgeon or at the very least, an experienced orthopedic surgeon should you decide to take the surgical route for your dachshund.  This procedure should not be performed by a general care veterinarian.  There are several choices:

Within the DRBC Area [PA/NJ]:

Eric N Glass, MS, DVM, ACVIM
Red Bank Veterinary Hospital

Noemie M. Bernie, DVM, DACVIM (Neurology)
Garden State Veterinary Specialists

Outside the DRBC Area [PA/NJ]:

American College of Veterinary Surgeons [ACVS]

   

Choosing A General Care Veterinarian

Finding a veterinarian that can administer the proper protocols for conservative management or support your decision not to take a surgical path will be critical to the long term health and well-being of your dog.  Here are some of the very best:

Within the DRBC Area [PA/NJ]:

Sherwood M Gloth, VMD
VCA Freehold Animal Hospital

William H Petit, DVM
Peticote Veterinary Clinic

Dr. Scott Turk
Dr. Darren Weisenstein
4PAWS Animal Hospital

Outside the DRBC Area [PA/NJ]:

American Animal Hospital Association  [AAHA]

   

Choosing A Physical Therapy Program

Physical therapy represents one of the fastest growing segments of the veterinary industry.  Recovery from an IVDD injury can be maximized through the use of physical therapy techniques.  Choices are limited, but are high quality:

Within the DRBC Area [PA/NJ]:

Red Bank Veterinary Hospital

Outside the DRBC Area [PA/NJ]:

  University of Tennessee National Database

   

Financial Assistance Programs

Veterinary surgery and support carries appropriate short and long term expenses.  Many families are not prepared for the estimates that face a dog with IVDD.  Tough economic means looking at alternative means of support.

There are a tremendous list of financial organizations to help finance the cost of IVDD.  This list can be accessed via download.  Just click on the 'I Need Financial Aid' icon to the left or by accessing the document at the DRBC Download Center.

Don't give up.  Money is only a tool, it is the means to an end, not the end itself.  Veterinarians and the veterinary community are for the most part very compassionate; they want a positive out come as well.  Be the best advocate you can be for the outcome you want to achieve.  Don't stop asking 'how can you help me', until you have the help you need.  Also be sure to ask 'if not you, then who'; that is a tough question to walk away from when a life is at stake.  And finally, don't give up!
   

Pet Insurance Programs

US pet owners do not take advantage of the health insurance programs available for our four legged kids, often regretting it when a disease like IVDD strikes.  Affordable, obtainable and easy to receive benefits from, the companies that offer insurance cover wellness and critical care issues.

Here our the two preferred by DRBC:
VPI Pet Insurance

PetFirst Healthcare
   

K-9 Cart Companies

There are a few companies that make k-9 carts out there.  Our rule of thumb is that if we have to take more measurements than we ever though about when it comes to the height length and width of our doxie and their chest, legs and body, we have the right cart company!

Here's one that gets the DRBC paw of approval:
K-9 Kart Company

   

K-9 Ramp Companies

This is like shopping for furniture or trying to put in a new kitchen, not to mention that you get the ramp and you still have to train them to use it.  Get the camera out for a UTube submission and trust us there will be laughter.

Try these folks for a quality ramp and great customer service:
FetchDogs

   

In Need of Hope

This is a tough one.  I can't link you anywhere for this, you can't buy it at the store and your veterinarian won't have it in their pharmacy, but it may be closer than you think.  This section was left for last for a good reason.  It is here to remind you that dachshunds, like children, never stop hoping, they just adapt and go on doing what they do best...loving you.

This is Calvin.  Take a good look into his eyes.  Do you think he has given up?  I doubt it.  The look of the hunt is there in his eyes and he is on the move...in his cart.  This picture comes to us from Calvin's Mom and although she didn't tell me if this cart was equipped with snow tires or all season treads, the one thing that is clear is that this little guy is having a great life.  Why?  His Mom didn't lose hope and they adapted!  IVDD ending in paralysis is not life ending.  Ask Calvin and his Mom.




This is Molly.  She is sunning in front of the garden bed where she often climbs with her brothers.  She came to DRBC inoperable and for a while was treated as though she was handicapped.  Her brothers knew she was handi-capable and now she walks and climbs with only a slight limp.  Molly didn't loose hope.  Don't you.



Believe.  Believe in yourself and your conviction for the best outcome for your pet.  A lot comes from the convictions of the heart.  Look in their eyes and then follow your instincts, not family or peer pressure.  Be at peace with your outcome; realize it may not always be what you might think.  Hang in there, you can do it.
   


Conjunctive Therapies

DRBC uses both physical therapy and nutritional supplements as part of our conjunctive support program. There are times when we will use acupuncture as well.

Physical Therapy

Recovery from an IVDD related injury is one of many conditions treated with physical therapy.  This field is one of the fastest growing in the veterinary industry for good reason.

Helping your injured pet return as much function as possible is hard work, for both you and your dog.  A physical therapist can best design a program of recovery that may include:

  • Underwater Treadmill Therapy
  • Pulse Signal Therapy
  • Low Level Laser Therapy
  • Electrical Stimulation
  • Therapeutic Ultrasound
  • Hydrotherapy
  • Whirlpool Therapy
  • Massage
  • Range of Motion Exercises
  • Hot/Cold Therapy

Noticeable Improvements

Generally improvement in susceptible cases will be seen after 2 to 3 sessions though occasionally animals are immediately better with regards stiffness and improved mobility after their first treatment.

Nutritional Supplements

DRBC utilizes a combination of Glycosamine, Chondroitin and Hyaluronic acid (also called Hyaluronan).  These supplements are used in a preventative manner daily and have been shown to aid doxies in their recovery from IVDD injuries.

Glycosamine, chondroitin and Hyaluronic acid sulfate are naturally occurring components that act as building blocks for the functioning of healthy cartilage and flexible joints. These organic supplements work by minimizing cartilage damage and swelling, increasing joint lubrication, helping to rebuild the cartilage that cushions and protects joints, and enhancing new cartilage production.

Numerous studies on the effects of these supplements have found them components to be critical nutrients that assist in supporting flexibility, comfort, and range of motion — for pets as well as for humans.

Chondroprotectants (chondro - cartilage) such as glycosamine, chondroitin sulfate and Hyaluronic acid are being prescribed increasingly by conventional as well as holistic veterinarians. The combination of these supplements has been found helpful in relieving inflammation and may even reverse the degenerative process in some dogs. 

These supplements work by nourishing the cartilage and increasing viscosity of the synovial fluid (the joint's lubricating system), thereby reducing friction and pain. Glycosamine, chondroitin and Hyaluronic acid attract fluid into the joint's cartilage system and help the body repair damaged joints while keeping the cartilage-destroying enzymes under control — all with equal or better results than anti-inflammatory drugs.

In short, chondroprotectants:

  • Help to lubricate joints
  • Provide a mechanism for nutrient absorption
  • Produce an anti-inflammatory effect on joints
  • Regulate activity on cartilage
  • Inhibit enzymes that break down cartilage

Noticeable Improvements

Generally improvement in susceptible cases will be seen after 4 to 6 weeks, although improvements may be noted in some animals at the 2-week mark.

Remember to talk to your veterinarian before beginning any regiment that includes dietary supplements.

 

Weight Control

Controlling the weight of your dachshund can only improve outcome.  Although there is no guarantee that dogs meeting a lighter weight standard will not incur IVDD, numerous studies indicate that a proper conformance leads to a lower risk.

Lowering your dogs weight is often a readjustment on the part of the owner and not the dog.  A proper diet, not a diet food is the best means of achieving this goal.

DRBC shares its dietary guidelines and breed conformance profiles at the links sited below.  Additionally, we invite you to attend our webinar series entitled: Diet & Your Doxie, which may help in the proper weight management of your dachshund dog.

Here are those links: