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Lumbar Disc Herniations


Weighing treatment options  

6 members have voted

  1. 1. Surgical decompression? Non-surgical treatment? What's been your experience?

    • My hound did undergo surgery, and I'm happy with the outcome
      1
    • My hound did undergo surgery, but did not improve
      1
    • My hound did undergo surgery, but I regret my decision because....
      0
    • No surgery, opted for other type of medical treatment
      1
    • No surgery, opted for alternative therapy only (acupuncture, chiropractic, etc.)
      3
    • None of the above (please explain)
      0


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I may be facing this decision with my galgo, Dandi, who is approx. 7-8 years old. He was evaluated by a neurologist/neurosurgeon whom I trust implicitly (Dr. Sisson at Angell in Boston). Basically, I've suspected back issues for over a year, as he's shown signs of sciatica in his R hind. I first had him evaluated by a chiropractor who agreed that there were signs of some type of lumbar dysfunction, and tried VOM (veterinary orthopaedic manipulation) with him - I thought with some improvement, but he would not tolerate it after the first 2-3 treatments, so we had to discontinue after he wouldn't even allow massage or gentle manual manipulation.

 

Today, the neurologist confirmed that he has marked tenderness at L5-6 and is knuckling on his R hind. He suspects some type of nerve root compression at that level, though Dandi will need further diagnostics for confirmation, and to determine not only the exact location and type of lesion, but also whether it is correctable with surgery. So, I'm mulling the possibilities:

 

Neuro (who is NOT an aggressive, every-expensive-diagnostic-test-in-the-book kind of vet) suggested an EMG (nerve conduction test done under anesthesia) followed by MRI to see if surgery is even an option. If so, Dandi is young and healthy enough that I would consider surgical decompression if it will likely be curative. (So, I won't eat for the next 6 months.... :blush )

 

We can also try to find another anti-inflammatory/analgesic that will be more effective than Rimadyl or meloxicam, which have only helped minimally. Neuro does not believe this will help significantly, and it certainly won't address the neurologic deficit he already has. But Dandi also has recurrent colitis, so we run the risk of any new meds exacerbating that.

 

And of course we can simply opt for alternative therapy, with acupuncture, physical therapy, etc., though I don't know how much handling Dandi will tolerate, given his, um, "difficult" temperament. :rolleyes:

 

I'd like to hear the experiences of others who have faced this decision, including what type of treatment you opted for, and if you went ahead with surgery, how your hound did post-operatively.

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We are in the middle of acupuncture treatments for our 14-year-old. Given her age, she is not a good surgical candidate. She is generally pretty shy, but she actually seems to enjoy the acupuncture and it seems to be helping. If she has a particularly rough day, she gets a mild pain reliever (deramaxx) with her meals.

Melissa, Penelope (LC's Wild Rose)

Missing sweet Bell (EMK Bolivar Bell). I'll never forget you.

"If you pick up a starving dog and make him prosperous, he will not bite you. This is the principal difference between a dog and a man."

- Mark Twain

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Guest greyttech

Alice, our 9 yr old, has been dealing with a herniated lumbar disc since around March. Her neuro doc said he was pretty comfortable waiting for 12 weeks, and monitoring for any improvement. At that time she was having severe sciatica in her right rear, but no nerve dysfunction. We started her on 100mg of Tramadol every 8 hours, low-dose Previcox daily, Phycox, and most imortantly STRICT rest. (No jumping at all - not even on the couch :omg , and leash walking only.) We also started acupunture three times a week and weekly massages.

 

As of today, she is only on Tramadol as needed, and daily Phycox. We still limit her activity, but she has her couch back. Her neuro would like her on an NSAID, but her little tummy just couldn't handle it. At her last recheck, we were told to watch her closely since most dogs relapse, and the 2nd time will probably require surgery.

 

I hope this helps, and Dandi starts to feel better soon!

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If you are talking lumbarsacral stenosis or the compression of the lower spinal column my Rex had it at 5. Dr. Mike Herron did his first depro medrol shot and then my vet did the rest using the guidelines in Dr. Stack's article on her Greythealth website. He went from unable to get off the couch to bounding up the stairs from the yard. The shot does NOT go into or close enough to hit the spinal cord and with Rex it lasted about 6 months or so for $75. It truely made all the difference in the world in his quality of life for two years until a disc between his shoulders ruptured into his spinal column and was inoperable.

 

I am by an large not a believer in spinal surgeries for dogs, but that's just me. They are hard and very painful, and as one surgeon that looked at my yorkie said "no guarentee that it's not gonna happen next year with the next disc up". Look into accupuncture...I wish I'd have tried that with Rex's shoulder rupture. With Rex's shoulder tramadol, rimadyl and metacam didn't do anything. The only thing that worked for him was Deramaxx (at almost $4 a pill). We never had any side effects from it even though he had tummy issues in the past.

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Thanks for your input, guys!

 

I'm seriously considering acupuncture, but the veterinary acupuncturist I know in this area has about a 2 month wait for an apppointment... I'll look around to see if anyone else is in practice.

 

I would be far more inclined to just treat this conservatively if Dandi didn't already have a neurologic deficit in his R hind.

 

Pam, this is definitely not LSS. If it were, I'd actively push for a depo-medrol injection. I did discuss with his neurologist non-surgical options that we often use for humans with disc herniations, such as epidural steroids, but apparently there have not been any good, long-term studies on this method and so the neurologist does not perform them.

 

Deramaxx - won't use it. My 13 yo Arielle had scapular osteo (this was in 2003). The oncologist she saw gave us Deramaxx to try. Within 24 hrs, Ari was vomiting intractably, having severe abdominal pain, and had to be euthanized. She'd had a massive GI bleed. I'll never allow any of my dogs to be given Deramaxx again.

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Guest BooMooandDoo

Mazie just had surgery for a disc herniation between L7 and S1. We tried Rimidyl, tramadol, consulted chiro and accupuncture, but decided for us. . surgery was the way to go because of quality of life issues.

 

Mazie's case may be a bit different, because her L7 was deformed which cause a ton of movement between the joint where there should be none. This caused extra pressure and movement around the disc herniation and the compressed nerves. She just turned 3 and she's always had rear end problems, but it had gotten so bad that she would self crate for 80-90% of the day and would only get up to go to the bathroom.

 

As for the surgery. . . . we would do the surgery again in a heartbeat. Her recovery has been awe inspiring, and it was worth every penny to get my little spitfire back. Recovery was a struggle for the first two weeks, but has been smooth sailing ever since. We're hoping to take her to a field and let her run sometime next week, which will be one month post surgery.

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Wow, thanks so much for sharing Mazie's story! Could you also tell me more about her diagnostics, and also what was involved in her post-op recovery? What surgical procedure was done? Was it a laminectomy and diskectomy, or did the surgeon also have to do a fusion?

 

Only 3... you really didn't have much of a choice for this baby. I'm so glad to hear that she's recovered really well and is going to be able to live out a normal, pain-free life!

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Guest MomofSweetPotatoes

Hi Jordan,

 

We've had good luck with accpuncture for Battle. Unfotunately, he's begun to progress and may need to make a decision for surgery for him too. However, accupuncture has given him 2+ years of quality time before we've started gravitating towards the surgical route.

 

Here's a link list of IVAS vets in NH hope this helps. CLICKY

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Guest BooMooandDoo
Wow, thanks so much for sharing Mazie's story! Could you also tell me more about her diagnostics, and also what was involved in her post-op recovery? What surgical procedure was done? Was it a laminectomy and diskectomy, or did the surgeon also have to do a fusion?

 

Only 3... you really didn't have much of a choice for this baby. I'm so glad to hear that she's recovered really well and is going to be able to live out a normal, pain-free life!

 

Mazie's issue was first noticed in an Xray looking for hip dysplasia.

 

We then went to a neurologist and he performed neurologogical testing in the room which showed several deficiencies. . . such as no withdrawl reflex. He ordered a MRI, and the MRI confirmed the herniated disc. When he opened her up her realized that her L7 was deformed. It looked more like a L6.

 

I don't know the "official" terminology, but what they did was remove the tops of both L7 and S1 and stabilize the joint with screws. . . fusing them together.

 

Here's her story. . .

Mazie's diagnosis

Mazie's surgery

Mazie's Post Surgery PIcs

 

PM me if you want to chat.

 

Edited by BooMooandDoo
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