Lumbosacral Stenosis

[NeylasMom]

I posted a little while ago that I have been thinking for a few months that something is "off" with Zuri. Originally I figured it was residual pain from his dislocated toe, but lately I have been thinking otherwise. I've held off on a vet visit because what I have to tell the vet seems so vague (I did take him in when this started and we x-rayed the leg and foot of the dislocated toe to rule out any possibility of a fracture, arthritis in that toe, and osteo in that leg and the x-ray was pretty much perfect).

 

What I've noticed was first some dragging on walks, then I noticed that Zuri was licking himself a lot. Mostly his front forearms and wrists, but sometimes elsewhere. Once or twice I saw him stumble or slip on the stairs but they were isolated incidents. He's also been on edge lately, more grumbly with the cat and even with me at times. And I also feel like when he stands, he holds his back legs out behind him a bit instead of directly under him, which I don't think is normal for him. He's also less energetic, I feel like in the last few months he went from being my usual puppyish boy to being an old man. Like I said, all of this is very vague and probably seems relatively harmless when looked at individually. It just comes more from a gut feeling of knowing what is normal for Zuri and feeling none of this is.

 

So anyway, when I noticed the way his back legs were positioned, I started thinking about LS. I read Dr. Stack's article and tried to do the pressure test today. I started with my thumbs on either side of his spine, just behind where the knobs of his spine stop being visible and worked my way back toward the hipbones. There was one specific spot that seems to match up with Dr. Stack's diagram where his back legs gave out somewhat. He didn't react painfully at all (and I think he would have) and his legs didn't completely give out, he just sank down with pressure. I did it twice and got the same response both times. Am I right in thinking he probably has the beginning stages of LS or could this be something else?

 

My main question is if this is what it likely is, where should I take him? I have a fantastic orthopedist close by who I really trust and he is familiar with greyhound issues so I was thinking we should get an appt there, but then I started to wonder if a neurologist wouldn't be better. Alternatively, there's also a doggie physical therapist that has a good reputation and that someone recommended in my earlier thread, but I don't think she's actually a vet so I'd hesitate to *start* with her although she may be good to provide treatment options. I don't think my vet is that well versed in LS in greyhounds so I'd rather see a specialist I think.

 

I'm really hope I'm wrong about this. My boy is only 7 and we have a lot of stairs so the thought of him developing a degenerative disease already really upsets me.

[MandysMom]

Jen, I'm sorry to read about Zuri. I understand your fear about the stairs as I have 39 stairs to get to my condo and no elevator.

 

I would definitely go to a Neurologist. When I suspected (incorrectly) that Mandy had LS, my pre-Dr. K vet referred me to Dr. Knockel at South Paws. I was impressed by him and his exam. He is also quite familiar with Greyhounds. Before he put a hand on her, he asked me where she raced, if she had traveled anywhere else in the U.S., and what TBD tests I had run. He spent a long time examining her, not just rushing through. He was also quite patient with my bringing up the research I had done on GT and other websites.

 

Edited to add: Mandy is quite a bit older than Zuri, her 12th birthday is in July, but she started really weakening in her hindquarters in the last six months. I started using Carol Wasmucky, who has helped tremendously. We do a series of stretches, plus work with the bands, ice therapy, massage therapy, and electric therapy (using a TENS machine). She doesn't walk like a 4 year old, but she has more control over her legs. The visits with Carol are in addition to monthly acupuncture, which has kept her neck and spine from the muscle spasms that used to plague her.

Edited February 15, 2012 by MandysMom

[BootsyCollins]

I don't even know what LS is, so I have no advice. Just s for you both.

[dante2zoe]

I am going through something similar with Dante right now. He was diagnosed with Lyme's Disease last winter and hasn't fully bounced back since. He sinks sometimes on walks and no longer goes upstairs with everyone else at night. At playgroup, if he stands still too long (he no longer runs with the rest), his back legs start shaking. He is 11.5 and my first dog EVER, so I don't know what is "normal" and what is not. The spinal pressure test would cause him to flinch in one spot. The vet said that was where the Lyme's was causing the most inflammation. That being said, he has an appointment next Friday, the 24th with a vet who is a certified accupuncturist. I am hoping that he can do something or at least tell me it is all in my head!

 

Good luck with your handsome boy.

[Guest KennelMom]

He didn't react painfully at all (and I think he would have) and his legs didn't completely give out, he just sank down with pressure.

 

That's how our LS guy responded (we also did xrays of his back and spine, standard senior blood panel and tick panel). One of our old guys we thought might have it didn't sink at all (and he didn't have LS, he was just getting old).

 

Our regular vet managed LS...It's pretty straightforward. I took them Dr. Stack's article and they were willing to give the depo-medrol a chance...it worked miracles for our LS boy and greatly extended his quality of life where he didn't need any additional medication. He went from hobbled to running again. What's nice is that our regular vet has been able to use depo-medrol to treat other patients with good success.

 

Good luck with Zuri

[GeorgeofNE]

I took George to someone who specializes in surgery and pain management--and did her surgical residency in Jacksonville at one of the clinics that badly injured racers go to--so she knows Greyhounds. She has Greyhounds. However, this is NOT a Greyhound condition. Any breed can get it. People get it. So I would not be terribly concerned about a vet who is "greyhound savvy" for this particular issue.

 

Our doctor told me that she would not do the steroid shots, and that she didn't know anyone who would. She gave me her reasons, and they made sense to me. However, you hear about cases like KennelMom where they seem to help--I was willing to give them a go, but as she said, I am unable to find a vet willing to do it.

 

She said she could fix it surgically--but I wouldn't even consider spinal surgery, I opted for simple conservative treatment and managing the symptoms as they arise.

 

So far he's doing really well, although I do find that if he does to much, he suffers that night and the next day.

 

 

[MaryJane]

Last year was a tough year for Larry who had a toe fracture, puncture through his foot, and what appears to have been a knee injury. In December, after all of that was resolved, I noticed that his muscles over the back legs had atrophied and one more than the other. While one side might have been from the lack of exercise from the knee injury, this just didn't make sense and looked like it might be the start of LS. He did go about 6 months without regular walks because of all his foot/leg issues.

 

I went to one neurologist and he did a series of physical tests and it didn't look like LS - his diagnosis was atrophy due to old age (Larry is 10 years old) and said that if Larry had any more issues, to bring him in for an MRI and some type of electrical test. I went to a second neurologist and she also concurred that it was not LS but, atrophy due to old age. Both said that they needed to examine him at at time that he was having symptoms and depending on the physical tests, further tests might be needed. They did find one weaker point in the back but, not at an area that would cause the muscle atrophy. One did mention that it might have been a "sciata" and that it just resolved itself ....

 

Neither really suggested any additional care at this point but, I am checking on acupuncturists and chiropractors in the area.

[Hubcitypam]

I'd start with a full tick panel if he hasn't had one. Harley got all creaky and it turned out to be RMSF.

 

Dr. Herron himself diagnosed Rex. When he did the thumb test Rex didn't yelp but just collapsed. He then did that test on a much older female and she didn't flinch.

It is more common in big males.

The depo shots did absolute wonders for him. My then vet at VCA was willing to do them after I brought him the instructions.

Rex went from not being able to get off the couch to bounding up the back stairs. It was amazing. I know at tleast 3 vets here that will do the shots.

They really aren't expensive and Rex's lasted longer than most -- nearly 6 months.

 

I told Suzanne about people saying their vet wouldn't do the depo shots and she said to tell them to find an older vet.

 

When Buddy was in for his wellness visit I asked Dr. Josh how he felt about depo shots in case they were needed in the future (he is a BIG older dog).

He said absolutely no problem. Wait, he's a guy fresh out of Ohio State and he'll do the shots if needed? :blink:

 

I said "I thought younger vets were all against depo from what they were taught in med school".

He replied "Remember my Dad is a vet and I got to see lots of years of depo working for various things growing up."

He said that, oddly enough, several of his classmates felt the same as he did.

 

Good Luck!

[Jester]

My vet won't diagnose LS without an MRI. She hasn't said it flat out, but she implies that she thinks Dr. Stack's assessments and treatment protocols are those of a quack. I asked her to humor me and do the LS check that Dr Stack recommended and she said, "Oh, he will absolutely collapse if I do that" and wouldn't do it . I asked her if she would try giving him the depo shot to see if it helps and she didn't refuse outright, but doesn't want to. She launched into a vet-speak laden discussion (that I only understood half of) about how the steroid shots are "contraindicated" for long term care and blah blah blah (there was more to her argument). Chad is 12 years old... what's long term?! Anyway, it's a bit moot for Chad right now because he has a tail wound that we are trying to get healed and adding any steroids right now will make that worse.

 

What we decided on was doing laser treatments to get his tail to heal and to go ahead and do the laser treatments for his back at the same time. She told me she'd like to do the laser treatments on his back long term if they help. He just had his 5th treatment and I'm just not sure how I feel about how it is helping. He still is very stiff getting up and down, and has to adjust himself to get into a poop crouch, but he LAUNCHED himself into the back of the SUV after the last treatment, so it must be helping (before he was 50/50 on his attempts to even get into that car with his front feet without help). I have also been working unusually long hours for the last week so I'm not seeing him all day to really see what he's doing.

 

On a side note, I am taking Chad to a much closer vet's office for the laser treatments and I asked the vet there for a second assessment. She wouldn't do the check on his back (the other vet already said he'd fall), and also agreed that "long-term" steroid use probably wasn't a good idea. She is a much older vet and commented that she used to dispense steroids a lot in her younger years but that new developments indicate it might not be the best choice. I gave her the same schpeal about Chad being 12, and seriously what's "long term" at that age and she didn't really have an answer. When his laser treatment was completed, she came back into the office and sat down with me and told me that she had taken some time to think about what I said and agreed that in a 12 year old Greyhound, "long term" steroid use really wasn't the problem, and quality of life should be a bigger consideration. She agreed to do the shots if I wanted them once his tail wound is healed, but she agreed with my current vet that the laser treatment may be just as effective and safer.

 

I don't really know if any of that helps you, Jen, given that Zuri is much younger but these are the things I've been told. Maybe the laser treatments would help him. I'm (as I said) on the fence about it and they aren't really cheap. We are doing 2-3 treatments a week for his tail and it's $40/pop at his regular vet, $300 for a 6 treatment package at the closer vet. They just charge me for one session each visit even thought it's three locations each sitting (1 tail, 2 on the back). I don't know if that's normal or not. I feel a little trapped with it all because I'm working so much and can only drive so far and I don't have time to "research" the laser stuff. I can tell you that its effects on his tail wound have been dramatic. After two weeks of trying to get it to heal on its own normally with no change, the wound is now 1/2 the size with 5 laser treatments (1.5 weeks). It also just looks 1000x healthier.

[greyhead]

So anyway, when I noticed the way his back legs were positioned, I started thinking about LS. I read Dr. Stack's article and tried to do the pressure test today. I started with my thumbs on either side of his spine, just behind where the knobs of his spine stop being visible and worked my way back toward the hipbones. There was one specific spot that seems to match up with Dr. Stack's diagram where his back legs gave out somewhat. He didn't react painfully at all (and I think he would have) and his legs didn't completely give out, he just sank down with pressure. I did it twice and got the same response both times. Am I right in thinking he probably has the beginning stages of LS or could this be something else?

 

My main question is if this is what it likely is, where should I take him?

(snipped)

I'm really hope I'm wrong about this. My boy is only 7 and we have a lot of stairs so the thought of him developing a degenerative disease already really upsets me.

It sounds like it could be LS. Can't tell you who best to see, but Spencer was diagnosed by his regular vet, via the Stack test. We go to a rehab vet for treatment with acupuncture/chiropractic, and it has worked for 4 years without any medication. His regular vet recently retested, at my request, and applied the pressure three times -- because it took that many to get much of a reaction. However, his function deteriorated immediately after. So 1) this type of treatment can bring improvement, and 2) don't pressure test them more than once or twice. (The rehab vet was appalled when she found out.)

 

Spencer was Zuri's age when we started on this road. At the time my researches and vets indicated that you get 2 years, at the very most, of benefit with the steroid shots, and then there would be decline. I decided to try the non-steroid approach first and save the shots for later. In Spencer's case, at age 11 now, I think "later" may be now. So I'll be very interested in staying tuned to hear what you discover and decide, wishing you and Zuri the best.

[HopeForHounds]

Jake was diagnosed with LS a few months ago. Our vet would consider the depo medrol shots but has concerns about them for Jake and after hearing her out we opted not to use steroids unless necessary. Her concern is that Jake already has a compromised immune system and steroids suppress your immnue system. Plus the shot isn't reversable so if he had any issues from it, we'd be screwed. If we do need to use steroids in the future we would start with prednisone.

 

Right now Jake is getting Cartrophen shots (similar to Adequan) every 3 - 4 weeks for his hips since he does have arthritis. These help him almost immediately, he stands totally straight within 36 hours of getting a shot.

 

He also gets AntiFlam by Omega Alpha. It was recommended by a friend who raises racing greyhounds and he said his kennel would be lost without it. It's herbal and it's for horses, there is a pet version but after talking to a company rep I opted to go with the horse version. We now own a litre of the stuff!

 

After a bad spell in December, when we had the discussion about the depo medrol, we decided to put Jake on Gabapenten. What a difference! He does great on 2 100mg caps a day. I do add a 3rd one at the 3 week point of his shots, that is discontinued the day after the shot.

 

I am hoping that once winter, the enemy of Senior dogs with issues, is over we can start having some very short walks to help him regain some strength.

[NeylasMom]

Thanks everyone for all of the feedback so far, although it's all rather conflicting input.

 

Someone told me today that my orthopedist, Dr. C has a neurologist on staff, which I didn't realize or had forgotten. I really wanted to take Z to see Dr. C. because he's perhaps the one vet I've worked with that I trust rather implicitly so now, knowing there's a neurologist there who can be on our case as well if needed I will definitely go there.

 

The facility is a state of the art ortho facility built a few years ago (well probably more than a few now) with a fancy gait analysis treadmill thing among many other things, his wife is a vet there as well and does PT and was getting certified in acupuncture when Neyla was diagnosed nearly 2 years ago and they have a holistic vet who does acupuncture and chiro work so he will be able to give us all of our options regardless of the dx. Of course, you pay out of the *** for this stuff, but what can you do.

 

I do sort of still fully expect that I'm going to go in there, list off my various vague symptoms, pay out the wazoo for more x-rays on top of the consult fee and have him tell me he can't find anything.

[GeorgeofNE]

I told Suzanne about people saying their vet wouldn't do the depo shots and she said to tell them to find an older vet.

 

 

That's exactly what the specialist told me. Although she said "a much older vet."

 

She didn't say anyone was a quack (and if you read Dr. Stack's explanation of the shots, it's not "her" protocol as someone taught it to her), but she did say that while relieving inflammation NEXT TO the spine might help temporarily, since LS is the compression of the spinal column and the squishing of nerves INSIDE the spinal column, the shots actually do nothing for it. Her exact words were "bad science."

 

And as someone else pointed out, they're long acting and not reversible.

 

I also have a friend whose husband is a neurosurgeon, and while it is possible to get steroids into the spinal column where they'd actually help, you'd need a neurosurgeon to do that, and it would be very risky.

[krissn333]

I don't have much input on the LS thing, Jen, but, if it turns out it's arthritis or something like that instead, we had GREAT results with the cold laser therapy we did for Sutra on his knees. I had to carry him into the office for his first treatment because he couldn't walk, and he was able to walk out of the vet's office that day on his own. They really worked well for him.

 

Hope you can get some answers...glad to hear that a vet that you trust has a neuro on staff...that always makes you breathe a little bit easier!

[Hubcitypam]

"bad science."

It may be bad science, but it sure made a 100% difference in Rex's life. I don't know about it lasting more than a couple of years as he went to the bridge from something else about 2 years after he started the shots.

 

She didn't say anyone was a quack (and if you read Dr. Stack's explanation of the shots, it's not "her" protocol as someone taught it to her...

Yes, Dr. Mike Herron, head of small animal at Texas A&M for 35 years and a former greyhound breeder. (his prefix is "Dox").

 

 

 

 

 

 

Edited February 17, 2012 by Hubcitypam

[GeorgeofNE]

I want to make clear that I am not suggesting the shots don't work for some dogs--just explaining the logic of why my vet won't do them, and what she told me!

 

[Batmom]

Not bad science at all.

 

If a dog were in pain, I'd go a long ways to find a vet who'd do the shots.

[Hubcitypam]

Obviously Dr. Herron has no credentials...

 

From Aggieland Animal Health --

 

Dr. Mike Herron, DVM

Dr. Herron is our board certified orthopedic surgeon. His career spans over three decades with a special interest in sports medicine.

He was head teaching clinician at the Texas A&M veterinary medical school for 35 years.

He is a world-renowned surgeon, and we are thankful to be able to offer his expertise to our clients with companions in need of orthopedic consultation or surgery.

Edited February 17, 2012 by Hubcitypam

[Guest tammara]

This is what I think our Bear had. He lasted 4 years between the original "diagnosis" and when we had to send him to the bridge. I will also say that the three vets that we took Bear to over those years also did not believe in the shots. The way it was explained to us was unless you were putting the shots right into the spinal canal (not next to) it wouldn't matter if it was steroids in shot or pill form. So we went with the pill form. Bear was managed initially with chiropractic, and acupuncture which was continued up until the last 6 months or so, when the vet felt they were no longer working. There were long stretches of steroid pills and more and more pain medication. Bear when they would do that test on his back would sink down and as the disease progressed it would take him longer to come around after the test, so I agree with others it should not be done often and only when necessary. When Bear first became ill, we considered the decompression surgery, but for many reasons we held off... we waited a few years and made up our minds that it was time for the surgery but the specialist told us is was too late. Because we never did the surgery Bear never had the myelogram that would have shown if it truly was LS or not (Bear had a metal plate in his leg and could not have a MRI). Bear was also 7 when he developed this too.

I hope some of this helps

[ozgirl2]

Jen- I'd definitely get a full tick panel done - we have TONS of Lyme and Ehrlichia in our area, and a bit (though not much) of RMSF. I'd rule those out first, then go to your ortho... (although he'd probably do them anyway, I'd think...)

 

Good luck!

[philospher77]

My first greyhound, Trinkett, had some LS and a slightly bulging disc in her neck (the result, I think, of being attacked by a Great Dane). She was acting like your dog... dragging her feet slightly, and just "not right". I managed her condition with Adequan injections (for the neck issue), acupuncture (which she really liked and handled well... the assistants liked working with her because they basically got to sit around for 30 minutes ), physical therapy (to keep the range of motion, since once they get into a habit of walking funny, it makes the other muscles work harder and that sets up a chain reaction of things getting more off), and hydrotherapy to keep up the strength (the underwater treadmill, which she also loved. She'd walk in there, they start filling it with water, she would promptly lay down and then slowly start getting into sort of a crouch so that she could keep as much of her under water as possible as long as possible), and laser therapy, and t ice/heat. That all seemed to help. There are risks associated with long-term use of steroids, so I would hold off on them for a while if I were you and see if more conservative treatment helps first. Having said that, I do have one of my cats on it, since it's a quality of life issue for her, and in human years she's around 95. As someone said, at that age, what's long term?

 

I will say that one issue I ran into with LS is that it disguised the osteo symptoms that Trinkett had. If a dog with LS starts walking funny, it's really easy to say that it's the LS flaring up, and not go and get things looked at. I will always wonder if things might have turned out differently if I had done that, but such is life.

[NeylasMom]

My vet won't diagnose LS without an MRI. She hasn't said it flat out, but she implies that she thinks Dr. Stack's assessments and treatment protocols are those of a quack. I asked her to humor me and do the LS check that Dr Stack recommended and she said, "Oh, he will absolutely collapse if I do that" and wouldn't do it .

So I have been thinking about this and wondering where the truth lies when I realized the easiest way to find out would be to do it on a dog that I know is healthy and see if the dog collapses or not. So I did the test on Violet today and she did not react in any way, nor did she collapse.

 

Granted, she's only one dog and she is a female. Is anyone else willing to test it out on their young, healthy hound? The article is here, but like I said, I started applying pressure along either side of the spine a few inches "above" the hip bones (toward the neck), basically around where the spine starts to no longer be visible if you have a fit dog and then I just inched my fingers along reapplying pressure each time I moved them. When I got close to, but not quite at the hip bones I got the reaction from Zuri.

 

If anyone is willing to test it and report back, I'd be interested to hear the results. I definitely don't want anyone doing it on a dog who has or has had health issues with their spine.

 

In the meantime I have the appt with our orthopedist. He can't see us until mid-March so I guess I will take Z in a bit early and get his snap test done. I would be surprised if he has a TBD, but now that you guys have suggested it, his symptoms do mesh up and it's certainly not out of the question although I've never found an engorged tick on him and we do use preventative. I'll probably also get blood work done while we're there as we tend to do that annually and I think I skipped last year because funds were tight after Neyla's passing. Assuming nothing turns up from that, we'll see Dr. C in March and see what he says. Thanks for all of the input.

Edited February 20, 2012 by NeylasMom

[greyhead]

Both our dogs see a rehab/acupuncture/chiro vet, Spencer for LS, Shane for arthritis, hip & kidney issues. When she did the Stack test on Shane, he did not sink. So there's one result for your data set.

 

ETA: From what I've seen when watching these tests done a few times, the proper degree of pressure is pretty mild to moderate. It should not be the case that any dog would sink in response to it, as far as I can see. If the degree of pressure applied is strong enough to sink any dog, then I'd suspect it's too much pressure.

Edited February 20, 2012 by greyhead

[NeylasMom]

Both our dogs see a rehab/acupuncture/chiro vet, Spencer for LS, Shane for arthritis, hip & kidney issues. When she did the Stack test on Shane, he did not sink. So there's one result for your data set.

 

ETA: From what I've seen when watching these tests done a few times, the proper degree of pressure is pretty mild to moderate. It should not be the case that any dog would sink in response to it, as far as I can see. If the degree of pressure applied is strong enough to sink any dog, then I'd suspect it's too much pressure.

Yeah, and that's part of the issue, that I don't know if I'm doing it properly. I don't think I pressed that hard, and I certainly didn't apply less pressure to Violet, but now I'm afraid to do it again since some people had said it seemed to aggravate their dogs condition if done repeatedly.

 

How was Spencer's LS diagnosed?

[greyhead]

Yeah, I wouldn't trust myself to apply that test either, even having seen it done several times, unless I had to for some reason.

 

Spencer's LS was diagnosed by his regular vet, using the Stack test in my presence, after I brought him in and described his symptoms. His observable symptoms were his tending to fall over when lifting a leg at a bush, his inability to pivot to either side from his back legs without falling over, and his difficulty rising from the dog beds. As I'm using the term, "tending to" fall over means he'd start to tip and then prevent it by aborting the maneuver. (You could tell he was surprised at this new development, too.) With the pivot he might, for instance, have his front legs already higher than the back ones, like with his front feet atop a low wall; so to turn back to the sidewalk, he'd raise the front of his body and legs up farther, transfer his weight to the back legs, and try to use them to pivot to the side. Then he actually would fall. It only took a couple of those instances before I took him to the vet. Part of the problem is that they lose track of what their feet are actually doing, because the nerve sensitivity lessens in the LS condition.

 

As I thought back on it, though, there had been times going back a couple years earlier when he'd become less apt to get off his bed unless he had compelling reason, as for meals or if he was called by name. Prior to that, he'd jump up off the bed just to come see us for the heck of it, you know? And I can think of a couple of instances where he may have injured himself, like when he fell hard while running with a playgroup pack in some serious Seattle mud. Don't know if any of this rings bells for you, but that's our story.

 

After diagnosing it as LS, the regular vet referred us to the rehab vet for acupuncture/chiropractic. That second vet didn't repeat the Stack test, just took the first one's word for it. We asked whether an MRI would be appropriate for Spencer. The vets said that the only reason to do one would be if we wanted to go for some kind of surgical intervention. Then you'd want and need that kind of precision. But they trusted the Stack test, and we trusted them on that (verified by our inquiries on GT and other sources) and turned our attention to the outcome. Since he started doing so much better so very fast -- as in the day after the first treatment -- we decided that the vets knew what they were doing. If it hadn't worked, then we would have sought further diagnostics.

 

Hope this helps some. It sounds like you have lots of possible vets from which to choose, which sort of makes it harder than it was for us.

Edited February 20, 2012 by greyhead