Possible back/spine surgery for 9.5 yo hound?

[GreytMom]

Wondering if anyone has done back surgery on on older greyhound? I’ve done three in the past on younger dachshunds, but am not sure what to do for my older hound should that be the recommendation on Monday.

My beautiful 9 yo greyhound started limping and favoring (sometimes not using) her back right leg approximately three months ago. The vet did an exam and it’s her back, lower back.  He put her on carprofen and she did better, in fact no more limping - but she took a bad fall (lots of scrapes and blood - one wound still healing) and stumbled another time, and that can be a side effect of carprofen so I stopped it after about 7 weeks. We saw the vet again a week later and he said to take her off of it because it didn’t seem as though it made much difference in her pain during exam although he thought the fall was a result of her back problem not the carprofen. But, he wanted us to see a neurosurgeon for an MRI or myelogram to “make sure we aren’t missing anything.” (Like a spinal tumor which one of his dogs had.) So, with my dachshunds they went from myelogram straight into surgery, but one wasn’t able to walk and the others were having difficulty. They clearly needed surgery ASAP. And, they were younger.

I’m concerned I may be asked if I want to go to surgery Monday depending on results of whatever type of scan. And, I’m just not sure about surgery given she has some discomfort but she is walking (odd gait though), no longer holding her right leg up, eating, pooping (although in an odd position), and doing pretty well. I still give her carprofen about once a day, not twice anymore. No gabapentin or tramadol - yet.

So, has anyone done a spine surgery on a greyhound? Advice? Results?

If I decide against surgery - is there any point in an expensive scan that she will have to be anesthetized for? 

I’m just not sure what to do for my beautiful brindle girl. Our appointment is Monday. Thx. 

[BatterseaBrindl]

Has she had any xrays of her back/spine?

 

[greysmom]

I would only go to the expense and stress of an anesthetized procedure if the outcome was going to impact the course of future treatment.

It seems to me that you still have non-surgical options you haven't fully explored,  namely a (different) nsaid since she doesn't tolerate carprofen well, in addition to gabapentin, and an actual pain reliever (not tramadol - we use codeine sulfate).  It also doesn't sound like you tried a course of prednisone?  That's usually what happens prior to trying any surgical procedure.   

Doing this also allows you to see if some other trauma, or even a spinal stroke may have occurred without the MRI.  Sometimes they just need a bit of extra healing time and medication support.

There is a GT member who had a successful neck surgery for her older dog, and I'm sure it's quite possible, but they are quite expensive with a long recovery time.  You need to be able to support a non-ambulatory dog for potty trips, and be home with them post-procedure to guard their recovery.

 

[GreytMom]

27 minutes ago, BatterseaBrindl said:

Has she had any xrays of her back/spine?

 

Sorry... left out that minor  detail. Yes, and they looked ok. 

[GreytMom]

9 minutes ago, greysmom said:

I would only go to the expense and stress of an anesthetized procedure if the outcome was going to impact the course of future treatment.

It seems to me that you still have non-surgical options you haven't fully explored,  namely a (different) nsaid since she doesn't tolerate carprofen well, in addition to gabapentin, and an actual pain reliever (not tramadol - we use codeine sulfate).  It also doesn't sound like you tried a course of prednisone?  That's usually what happens prior to trying any surgical procedure.   

Thx. You nailed my thoughts in your first sentence - but they hadn’t quite become that organized in my mind yet. 

And I do think there are other non-surgical options but my vet, who is the rescues vet and sees a lot of greyhounds, was clear on wanting me to see neuro. He may suspect something he hasn’t told me about yet.

I also didn’t mention when you flip her right rear paw upside down she is slow to right it and I believe that indicates spinal problems, usually not minor ones. 

 

 

[Rickiesmom]

I have been through something recently with my senior girl that has some similarities - she had lameness in one limb (proprioception was fine though).  Physical exam elicited a reaction in a location on her spine consistent with the lameness. X-rays pointed to a narrowing between two vertebrae that suggested disc compression.  We elected to proceed with an MRI and it instead pointed to issues with ligaments and tendons.  Apparent narrowing on x-rays not borne out by MRI.

Before the MRI I was emphatic that surgery was the solution of last resort, and I hoped that other options, like meds possibly combined with rehab would be viable.

In discussing the situation with my regular vet, she said that disc bulges were not only painful, but tended to get worse if left alone.  She said if the neuro recommended surgery, her opinion was that it was worth proceeding.   We were fortunate - never had to go there.  But, we also knew this neuro is very, very good, and if surgery was needed, he was the right person to be doing it.

Still, very relieved we didn't have to face that.  If we had, we would have authorized it immediately following the MRI so it could be done under one anaesthesia.

This is our story.  Your situation, while it has similarities, is not the same.  The one thing I would say is, given the choice between an MRI and a myelogram, I would always choose MRI - it is non-invasive and less risky.

Sending good thoughts to you and your girl.  In these situations it feels like there is no right answer, but a matter of determining which is the best among unwanted choices.

[tbhounds]

Have you been to a neurologist?  Really need an mri to determine the next course of action.

[cleptogrey]

personally i would try adequan injections. i used it on both greys and saw a great improvement. have you also thought of water therapy and pt in general and acupuncture? to me surgery is always a very last resort. i hate to mention the C word, but often lameness will appear before a digital x-ray picks up anything. i know a couple of dogs whose C did not show up for quite a while and their owners observed that something was going on. and there were 2nd opinions and multiple x-rays of each case. hoping for some comfort for both you and your hound.

[Remolacha]

If it does turn out to be skeletal/muscular I would also recommend trying acupuncture, along with other pain control medicines. Surgery definitely a last resort. Good luck

[GreytMom]

@Rickiesmom thx for sharing your story. Hope your girl is doing better now. Your story makes me more confident that I need to proceed with some type of scan tomorrow to pinpoint the issue so we can determine the best course of treatment. You also mentioned knowing your neuro was very, very good. The neuro I used before is excellent, but I moved about 8 hours away and, while my vet says this one is very good and his credentials look good, I have complete confidence in the one I used previously and I haven’t met this guy yet. That has me a bit uneasy too. I might consult with my prior neuro after whatever scan if necessary. I’d make the 8 hr drive but if he did surgery the drive back would be too hard for her so I think going to him isn’t an option. So much to think about. Hopefully I’ll know more tomorrow. 

@cleptogrey I used adequan injections before on one of my dogs and found they helped her some, but only while receiving them very frequently so we discontinued after a while - but I thought of that option also. Glad to hear of your success. (In fact, I have already recruited friends to do the injections if necessary - because I don’t give shots and my vet is an hour away. So I’m ready if that is a suggestion.) As for cancer - when I took her to the vet initially I said I’d be ok with anything but an osteo diagnosis. Been down that path, but I strongly suspected that and had my plan figured out in my head. (Cried all the way to the vet, in fact, I was so sure that was the diagnosis.) I don’t think it’s that at this time because she seems a bit better, and certainly not worse, in the past three months. Fingers crossed. (As for water therapy I said to a fellow hound owner about a month ago that we needed to open one where we live - which is an hour away from any type of acupuncture, water therapy, etc. Kidding of course as I have no background in veterinary anything, but would be nice to have something closer.) 

@Remolacha Thx. I wish there were alternative treatments closer to me yet I will look into it. Neuro tomorrow and then figure out the next steps I guess. 

[Rickiesmom]

You could potentially ask your prior neuro if he knows the local one ahead of time, if your relationship is such that you feel you can do that.  

Will be thinking of you tomorrow.

ETA:  Assume there is a board certified anaesthesiologist who will be handling that end of things.  Probably is, but you want to be sure, and it's worth confirming they are aware of greyhound idiosyncrasies.

Edited May 12, 2019 by Rickiesmom

[cleptogrey]

being that you live in Arizona, have you contacted Greythealth? dr. stack(i believe that's her name)

[MaryJane]

Have leg x-rays been done?

[GreytMom]

54 minutes ago, cleptogrey said:

being that you live in Arizona, have you contacted Greythealth? dr. stack(i believe that's her name)

I didn’t realize she was/is in AZ. Found her... she is a (boring) 4 hour drive away in Yuma, but if tomorrow does not bring answers it would be worth the trip. And I’m glad you mentioned her as I wanted to take her info on lumbosacral stenosis with me and didn’t have that printed off yet. She suggests a type of injection I’d certainly give a try. I think my vet here would do it - he is very greyhound savvy and mentioned LS - but if not she isn’t that far. Thank you! 

[GreytMom]

20 minutes ago, MaryJane said:

Have leg x-rays been done?

To be honest I was so upset when I took her in I didn’t retain all of what he told me. I thought sure I was heading for an osteo diagnosis and was distraught. I believe he did back and back legs. He sent them to neuro I see tomorrow so I will clarify. Thx. 

Edited May 12, 2019 by GreytMom

[GreytMom]

3 hours ago, Rickiesmom said:

ETA:  Assume there is a board certified anaesthesiologist who will be handling that end of things.  Probably is, but you want to be sure, and it's worth confirming they are aware of greyhound idiosyncrasies.

I don’t see one listed, but there are two vets who specialize in radiology so there must be... although likely not board certified since not mentioned on website. Yikes. I’ll confirm they know about greyhounds. It’s a large specialty vet so I’d hope so. Thanks for the good thoughts tomorrow. 

[ozgirl]

If you can find an animal acupuncturist in your area, I'd suggest trying that . PS - (it's expensive!).   Cody had acu every 3 weeks for 1.5 years for her spinal stenosis.  It helped a lot in the beginning, less so after about a year, but did seem to relieve the pain for a few weeks each time...

[cleptogrey]

2 hours ago, GreytMom said:

I didn’t realize she was/is in AZ. Found her... she is a (boring) 4 hour drive away in Yuma, but if tomorrow does not bring answers it would be worth the trip. And I’m glad you mentioned her as I wanted to take her info on lumbosacral stenosis with me and didn’t have that printed off yet. She suggests a type of injection I’d certainly give a try. I think my vet here would do it - he is very greyhound savvy and mentioned LS - but if not she isn’t that far. Thank you! 

i presented the article to my vet who happens to be a walking encyclopedia of drugs and side effects. she felt the shot was out of date(her opinion only- many on this board have used what stack suggests and found success).we started felix on predisone. easy to regulate the dosage and stop using if it's not effective. that brought on his much needed appetite and gave him a good couple of months of mobility. but felix was just shy of 12. greyhound do not age as gracefully as other breeds. i am not sure if it's the wear and tear of being an athlete or just not being built for the long long haul of old age. yes, some do make it to 14, many start falling apart when the double digit birthdays are near.

ah a 4 hr drive ....not that long! southern az back to san antonio, then back to new york- that's a L-O-N-G drive! check out roadside america and look for some interesting places to stop along the way.

[Rickiesmom]

Is Dr. Stack still practicing?  I thought she had retired.

 

[GreytMom]

1 hour ago, Rickiesmom said:

Is Dr. Stack still practicing?  I thought she had retired.

 

Looks like you are correct. She shows up at Ironwood Vet Clinic on veterinarians.com but when I go straight to ironwoodveterinaryclinic.com she is not there. I would assume it is more current. 

Thanks so much for your input here. You, @cleptogrey , and others have really helped me think about how I need to approach this tomorrow - and I feel pretty grounded and prepared going in at this point. Of course, I could dissolve in a puddle of tears in the morning and lose my brain, but hopefully not. (The poor neuro I saw with my dachshunds - first time I saw him, when he came back in room with the bad news after the scan, I could only shake my head to say go ahead with surgery, couldn’t even talk.) 

[GreytMom]

5 hours ago, ozgirl said:

If you can find an animal acupuncturist in your area, I'd suggest trying that . PS - (it's expensive!).   Cody had acu every 3 weeks for 1.5 years for her spinal stenosis.  It helped a lot in the beginning, less so after about a year, but did seem to relieve the pain for a few weeks each time...

I thought it was an hour to the closest one but just found one near me. That vet is known for being pricey anyway, so... yikes! They also have the cold laser and do stem cell so more advanced/cutting edge than most vets near me. Sounds like it is worth a try. Thx. 

[greysmom]

Write everything down!  Questions, concerns, alternatives  -  just so you have something to refer to when you get distracted by emotions and information. 

[GreytMom]

Good news so far!! I liked the neurologist... he was very attentive to my girl. Way to get off to a good start with both of us. 😉

He suspects she is experiencing nerve weakness, possible nerve degeneration, not spine problems or LS stenosis. He said the X-rays that my vet took look really good. He would do a CT, maybe move to an MRI if necessary - but can generally see what he needs to on CT, and probably do a nerve conduction test at the same time. But, he was fine with taking a very conservative approach and trying Gabapentin for a few days to see what happens. If it is nerve weakness she should have fast results with the Gabapentin. If no improvement we can move to doing the CT. He also said we really haven’t pursued much in the way of meds and there lots of drug options, and epidurals, we can think about without having to think about surgery if there is something more going on. Carprofen shouldn’t have helped/be helping if it is nerve weakness, and it did help the initial limping, so that’s an indication against nerve weakness, but he still suspects that. Even the knuckling he said can be nerve weakness, not necessarily spinal cord problems. So, yay! 

So... Gabapentin and go from there. (I have seen some discussion on here about Gabapentin, I admit I haven’t read it, but I’ve had a prior hound who had an amp due to osteo on it with no difficulties - so I’m not concerned.) He is starting her on 300mg every 8 hours and decrease by 100 if it is too sedating. Again, he thinks I should see change within 2-3 days if that is it. Whew! 

Edited May 13, 2019 by GreytMom

[Rickiesmom]

That is certainly better news than expected.  Thank you for the update, please let us know how things go!

[Remolacha]

Good update!  hoping it is something easily treatable!