Gloria Atwater Posted January 20, 2012 Report Share Posted January 20, 2012 Well, alrighty, then. I've had a good cry, now I'm trying to shake my brains into some useful order. Dr. Richardson called this evening with a diagnosis for Nick, having received and viewed the X-rays. (Which I forgot to bring with me on my visit, last week!) He's saying Cauda Equina. He's saying surgery. What he saw in the X-rays did show the sacrum pressing on places it should not. Guys, I'm devastated. Nick is everything to me, my first open-quality border collie and the vehicle for so many dreams. More, he's my best friend, my partner and my pal. He is my heart dog, in every sense of the term. I look in those big golden eyes and see so much love. He gives me everything, every ounce of his strength and every beat of his sweet, gallant heart. But my Nick is not sound. He's not even 4 years old, his trialing career has barely begun, and he faces a debilitating problem. Oh, there WILL be surgery. At some point in the fairly near future. He's not in dire shape - heck, right now, you'd never know there was a thing wrong with him! I've been able to work him and trial him with never a mis-step. But if he overdoes it, there's pain. So ... now we manage our finances and plan for that surgery within the year. Meanwhile, I try to wrap my mind around the fact that my beloved Nick will have to go under the knife. Dr. Richardson did seem to think Nick's prognosis would be good, with surgery. (He mentioned Spondylosis, but then went to the Cauda Equina thing. Not sure how that relates...?) What he would do, Dr. Richardson said, is go in and remove just a wee bit of bone, no more than a thumbnail, to remove pressure on those nerves. He said he's done this same surgery for this same condition on working K-9s, particularly Malinois police dogs, and they are able to return to service. And ... that's encouraging. But I'm not easy about this. My first border collie turned out to have severe hip dysplasia and a vet advised a Femoral Head Ostectomy. This was done, but she was never really sound, again. By age 6, she was pretty much retired. Thus, the idea of someone whittling on my dog's spine scares me to death! So, I guess what I'm looking for, here, is feedback from anyone who has had a dog go through this, or has known dogs who have. What have people seen? Do dogs generally recover from this and return to full functionality? Or should I expect Nick to have some limitations, throughout his life? How long is the recovery period? (I'm thinking 2 months?) What sort of after-care should I look into? I'm hoping that Nick's youth and the apparent intermittent nature of his condition means it's not as dire a case - (yet) - as it could be, and that his outlook will thus be good. But I'm interested in any thoughts or input or advice folks here may have, regarding surgery for Cauda Equina. If you have anything to say, please speak up. At this point, information is my new best friend. Now I'm gonna go hug Nick and then eat some chocolate chip cookies. I already cleaned the house today, so baking is the only stress relief I've got .... With thanks, Gloria Link to comment Share on other sites More sharing options...
rushdoggie Posted January 20, 2012 Report Share Posted January 20, 2012 I don't have advice, but I wanted to offer support and tell you I know how you feel, having your heart dog diagnosed with a debilitating condition. Hugs to you both. Link to comment Share on other sites More sharing options...
Gloria Atwater Posted January 20, 2012 Author Report Share Posted January 20, 2012 Thanks, Rushdoggie. I know lots of other folks have been in my shoes. That's comfort, in a way. *hugs* Kind of ironic - guess I don't need to lay Nick off half the winter, as I planned. Sounds like rest or no rest won't make much difference, unless he is in pain, again. But I'm still leaving him off-duty for a couple more weeks. It sure can't hurt, and maybe it will even lessen the incident of inflammation or pain coming back quite so soon. And I'll monitor his work to keep him from doing too much. (As if!) Gonna be a long, weird, scary next-few-months ... ~ Gloria Link to comment Share on other sites More sharing options...
Cody & Duchess Posted January 20, 2012 Report Share Posted January 20, 2012 I am so sorry to hear about Nick's pending surgery. My one non BC dog has very bad elbow dysplasia that at this time the specialists have said surgery won't help. I wish she could start each day telling me exactly how she felt so that I could shape her day accordingly. I feel like I communicate well with my dogs, but I always wish we spoke the same language when they are hurt. Good luck to both you and Nick, I hope someone here can give you some insight on what to expect. Give Nick another hug from us. Link to comment Share on other sites More sharing options...
Sue R Posted January 20, 2012 Report Share Posted January 20, 2012 Haven't had anything like this, but am keeping you and Nick in my thoughts and our prayers. Very best wishes! Link to comment Share on other sites More sharing options...
terrecar Posted January 21, 2012 Report Share Posted January 21, 2012 I'm so sorry you are having a tough time. This is the part of pet ownership that I don't like, as I know how upsetting it can be. Hannah is spending the night at the ER Vet tonight, as she became ill this afternoon. Good thoughts and prayers going forth for Nick. Link to comment Share on other sites More sharing options...
Gloria Atwater Posted January 21, 2012 Author Report Share Posted January 21, 2012 Back again, in the event others come to read up on this. I got the report from Dr. Richardson, detailing his opinion of Nick to my vet. Here's what he said: "He does appear to have some mild expression of Transitional Vertebral Segmentation as evidenced by what I believe is a small vestige of soft tissue at the juncture of S1 and S2. The LS (lumbosacral) Spondylosis is also evident and I would correlate that early development to this transitional aspect of the L-S anatomy. Consequently, ruling out the hips as you have his radiographs and my evaluating his knees by physical exam, we are left with a clinical diagnosis of Cauda Equina, with episodic expression by his bursts of activity. I have informed Ms Atwater that this will likely worsen in time and thereby prepared her for possible surgical intervention when deemed necessary. I have had more success than not in helping such patients by dorsal decompression, guided by an in house CT scanning immediately before entering the OR. Many of our law enforcement dogs have returned to work, and I would expect an athletic outcome for Nick, providing neurologic damage does not ensue before decompression." So ... it looks like he's saying that the early onset of the spondylosis is due to the TVS in his sacrum, and that Nick's physical exertions (he uses himself like an Abrams tank!) trigger his painful physical symptoms. And apparently he feels surgery will halt the whole nasty mess. It's going to take time to get money set aside for any operation, and in the meanwhile ... I guess I'm just going to keep an eye on Nick. He's still laid off of work for at least 2 more weeks, so he'll have had a minimum of 1 month off at home. I'm kind of curious to see if the lay-off will make any difference in the recurrences of his symptoms, or not. Sounds like I should expect "not," though. Here's an article that makes me feel a little better about Nick's situation: http://www.acvim.org/websites/acvim/index.php?p=197 It's kind of hard to tell, from reading Dr. Richardson's note, if I should expect Nick to collapse or ruin himself at any moment, or if this is a vague sort of condition that could manifest over months or years. Anyhow, I'm going to get another set of x-rays and another opinion, just for my peace of mind. Speaking of which, think I'll have a glass of wine to chase my cookies. I want to SLEEP, tonight. ~ Gloria Link to comment Share on other sites More sharing options...
Indira Posted January 21, 2012 Report Share Posted January 21, 2012 Gloria, do you really want to operate his Cauda Equina? There are 2 methods to do this but both are complicate and it is not sure that your dog is without pain after that. I know a lot of owners with dogs who have Cauda Equina - most of the dogs are working sheepdogs or makes agility. And all dogs have to be retired from work and sport. This concerns the working dogs and the sport dogs. I have several links about CE for you but they are in German. If you understand a bit I can post them here. Link to comment Share on other sites More sharing options...
Blackdawgs Posted January 21, 2012 Report Share Posted January 21, 2012 My 10.5 year old mutt has this, AKA lumbar sacral stenosis. Actually, we have a presumptive diagnosis of this based on xrays, an MRI would be needed for confirmation. The idea is that if there are spurs and bridging (spondylosis) on the outside of the spine (that you can see), the same changes are occurring on the inside of the spinal canal (that you can't see on an xray). Anyway, I think that my dog has had this condition since she was at least 7, but we had xrayed the wrong part of the dog. Her initial symtoms were that she stopped doing the agility weave poles, her agility run times got slower, and her performance was inconsistant. I've been working with a rehab vet, who said that in her experience outcomes from surgery are not good, that 6 months after surgery, the dogs are back to where they started. These are working police dogs. Of course, some surgeons are better than others and your surgeon may be better than the one that is operating on the dogs here and there may be other reasons why some dogs do better than others. I will say that both my father and his sister have spinal stenosis in the lower back and their outcomes after surgery have not been good. Both have had multiple surgeries and still have chronic pain. One of the issues is that everytime you cut into a body, scar tissue is created and that scar tissue can cause problems. Before embarking on any non emergency surgical adventure, I would recommend a second opinion. Also, I would strongly suggest a referrel to a rehab vet. Strengthening and stretching excercises can go a long way towards stabilizing the spine and minimizing dysfunction. It is likely that you dog has all sorts of muscle imbalances that are contributing to its issues. We are not considering surgery for my mutt, instead we are doing rehab therapy and her back is MUCH LESS SORE THAN IT WAS. All of these excercises are done in my living room and surburban backyard. Link to comment Share on other sites More sharing options...
RoseAmy Posted January 21, 2012 Report Share Posted January 21, 2012 Gloria, First off this is very hard for me to read, brings back a lot of painful memories so I know where your at. I had something different but very simialiar. I had a weimaraner that as a young dog..4 yrs. would experience a limp every so often. Treated etc.. (trying to keep this short) Long story short one morning she let out a scream and fell to the ground. After many tests they found out the she had disc problems in her neck..over the year that this had been going on her body tried to heal itself and was forming bone growths that were pushing on the spinal cord. She had surgery, my luck of course..she started to bleed in the neck region and the dr. could not take out as much bone as he wanted to. She was left unable to stand..but he felt hopeful because she had feeling in her legs..took her home she lived on a dog bed in my living room..I sleep next to her on the floor. In about aweek she could stand with help..towel wrapped around her middle.. It was a long road..BUT she made a full recovery went on to hunt again and back to sar work. NEVER had another problem in her life and died one month short of her 16th birthday. If you need any advice or moral support just pm me...I KNOW what you are going though..Not to mention the cost. But for me it was worth it. Link to comment Share on other sites More sharing options...
workindogs Posted January 21, 2012 Report Share Posted January 21, 2012 Gloria, please get a 2nd opinion before agreeing to surgery. Dr. Richardson may be dead on with his diagnosis. But surgery is an extreme measure. Also investigate rehab vets...they can do amazing work sometimes. Link to comment Share on other sites More sharing options...
Gloria Atwater Posted January 21, 2012 Author Report Share Posted January 21, 2012 Erks. Well, you guys have scared the pee-wad out of me! Anyhow, yes, I am going to get a second opinion, as well as (including) another set of x-rays. A friend knows another very good orthopedic vet in southern California, so when I get the new x-rays, I will send them to her so she can hand-carry the x-rays to this second vet for a consultation. This is back surgery. It's not to be messed with. As I said above, I had a dog whose hip was operated on and she never fully recovered. Right now, today, Nick is the very picture of good health, bouncy and silly and ready to rumble. I'd hate to rush into a procedure that could leave him forever in pain or forever disabled or diminished. But at the same time, I'd hate to let a condition go on, that could be easily fixed, and risk it degenerating into something that is NOT easily dealt with. From what I've read, Cauda Equina can be successfully treated with surgery, (surgical decompression) if it's done before significant damage has been done to the spinal nerves and other, more acute symptoms appear. That's what I'd worry about, if I let Nick go on too long without surgery. Regardless, it's going to be some time - weeks or several months - before we can begin to afford surgery. I have plenty of time to get second opinions and investigate further options. But we'll always be limited by finances, so whatever we do, it has to be the most effective option. We simply won't be able to string ourselves along for thousands of dollars worth of this, that and the other. Meanwhile, he's continuing laid off for at least two more weeks, (thinking longer, again, now that I'm all boogered about it!) and then I'll start bringing him back to work. Time and observation will tell if the lay-off has any effect or if he keeps returning to those periods of unsoundness and discomfort. He's been cold-lasered, he has an appointment for acupuncture tomorrow - though our weather has abruptly taken a bad turn, so maybe it will be cancelled. I am looking into other means of helping him, while we wait for both our finances to come together and for that 2nd opinion. So ... we'll see. Indira, unfortunately I don't read a word of German, so I appreciate the offer, but I'm just a mono-lingual little country girl. Thanks for the input, guys. Now I'm going to go be scared half to death, again ... Will feel better when I've got that second opinion. ~ Gloria Link to comment Share on other sites More sharing options...
MyTDogs Posted January 22, 2012 Report Share Posted January 22, 2012 Gloria, I am sorry to hear of Nick's diagnosis I would encourage you to see a neurologist. A joke in the veterinary community about surgeons (e.g. orthopedists) is "A chance to cut is a chance to cure". Meaning many surgeons recommend surgery to fix most problems even when there are viable alternatives. Gilly was seen by a neurologist & I was advised to have surgery (after a confirmatory MRI). But if we didn't do surgery then she was to have strict rest (leash walks only) and steroids for the inflammation. It doesn't sound like your doc recommended any of that?? I am also concerned that he would diagnose Cauda Equina and even recommend surgery in the absence of MRI or at least CT scan. In addition, the films you posted are poor quality and I have never heard of a specialist recommending surgery based solely on poor films (1 view?) taken by someone else. He didn't find any evidence of CE on physical right? Did he mention anal sphincter tone? Has Nick been incontinent at all? Did he have any neuro defecits? I am sorry to cause you more worry- I know there is some bit of relief when a diagnosis is reached [even when it is a bad one] vs dealing with the unknown. Link to comment Share on other sites More sharing options...
gcv-border Posted January 22, 2012 Report Share Posted January 22, 2012 Gloria, First, I am so sorry to read of Nick's problems and wish the best for him. I know you will make the decision makes the most sense for his situation. I have forgotten if your first set of X-rays were digital. If not, try to get digital X-rays for the second set. They are so much clearer and thus might be able to provide more information. I hope you have a vet in your area that has invested in this newer technology. Side note: another advantage to digital X-rays is the ability to share via email and make copies so that you don't have to send the one and only copy from vet to vet. Jovi Link to comment Share on other sites More sharing options...
Gloria Atwater Posted January 22, 2012 Author Report Share Posted January 22, 2012 Cindy, you have good points. I don't know for sure that the film was actually that bad - I think I posted a picture of it, in my original thread. Did you see it? But my vet friend who looked at Nick secondly did not care for the film's quality, and a non-vet friend of mine (who has seen a lot of x-rays over the years) didn't think much of it, either. So ... hard to say. But it was just a single view of Nick's back. Dr. Richardson *did* do a full rectal exam, and only commented on Nick's prostate being a touch large, since Nick is intact. But every other neurological response was totally normal, and nothing in the physical exam turned up one thing wrong. The ONLY thing Dr. R. noted (and did not care for) was that he thought Nick's croup was a little too rounded, and that sometimes Nick let his tail hang completely straight down. He said the "limp tail" look could indicate something awry, as could the slightly tucked look to Nick's croup. But that's all. Nick's sphincter tone was normal, he's never been incontinent, he's absolutely normal in his urination, lifts both hind legs equally, and has no problems defecating. I'm honestly not sure what to think. I am getting another set of x-rays done and I'm having another orthopedic vet look at them. This 2nd ortho vet doesn't even live in the same state as me, she's like 12 hours away, so she will NOT be looking at Nick as a prospective patient. Thus, I'm hoping hers will be a more impartial opinion. I'm not arguing that Dr. Richardson believes what he saw, but ... I want to know more. I want to be *sure* before I let anyone start cutting on my dog! I've been advised to see a neurologist, as well, so I guess I should research that. The scary thing is, again, finances. If it's another several thousand dollars to do that, I'm kinda sunk. But I guess it's free to ask and find out. I just need to find out WHO to look for. *sighh* I wish there was a road map for this sort of thing! Thanks, Cindy. You actually address some concerns I have, and reasons why I'm definitely going to pursue a second opinion. Or even a third. Thanks again. ~ Gloria Link to comment Share on other sites More sharing options...
Gloria Atwater Posted January 22, 2012 Author Report Share Posted January 22, 2012 Gloria, First, I am so sorry to read of Nick's problems and wish the best for him. I know you will make the decision makes the most sense for his situation. I have forgotten if your first set of X-rays were digital. If not, try to get digital X-rays for the second set. They are so much clearer and thus might be able to provide more information. I hope you have a vet in your area that has invested in this newer technology. Side note: another advantage to digital X-rays is the ability to share via email and make copies so that you don't have to send the one and only copy from vet to vet. Jovi Jovi, I'll have to see if anyone does digital around here. The first plate was just film, as that's all my vet does. But maybe someone else in my area has the technology. I'll look into it! Thanks! ~ Gloria Link to comment Share on other sites More sharing options...
MyTDogs Posted January 22, 2012 Report Share Posted January 22, 2012 Hi Gloria, Yes, I saw the films & they are poor quality, IMO. Like Jovi says...digital is a HUGE plus- actually it would be a requirement for me. Nick needs to be sedated and be thoroughly radiographed (multiple views of his back end). Frankly, any board certified specialist will require advanced imaging (MR is best but CT will do) to make the diagnosis and perform surgery. If you go to a specialist center (a group of multiple specialists together)where they have a radiology department you will have the benefit of a radiologist to review the films as well. Look Here to find a neurologist in your area [i saw 2 in Las Vegas]. Select neurology as the specialty. Here (in Central FL) a complete Neuro exam will run around $150...more for films, etc... good luck! Link to comment Share on other sites More sharing options...
Serena+Eluane B.C. Posted January 26, 2012 Report Share Posted January 26, 2012 Gloria, I don't know what to say but everyone is giving so much fantastic advice already.... All I know is how much you care and are so worried about Nick and would give the world to have him be better and in pain-free health. We will continue keeping our fingers crossed, Gloria that he will get the best care possible. And it's great to have second opinions and a good films which clearly show what's going on.... Link to comment Share on other sites More sharing options...
Aussiedawgs Posted January 26, 2012 Report Share Posted January 26, 2012 It's kind of hard to tell, from reading Dr. Richardson's note, if I should expect Nick to collapse or ruin himself at any moment, or if this is a vague sort of condition that could manifest over months or years. Anyhow, I'm going to get another set of x-rays and another opinion, just for my peace of mind. Speaking of which, think I'll have a glass of wine to chase my cookies. I want to SLEEP, tonight. ~ Gloria Hi Gloria, What you are describing is very similar to what my Aussie, Cowboy has and I understand what you are going through. I don't think you need to worry about him collapsing or ruining himself - it is not usually an "acute" thing but damage can be progressive over time particularly when arthritic changes (spondylosis or further narrowing of the spinal chord channel occurs). From what the vets at OSU told me (this was 9 years ago) - the neurological problems become worse in heat or after excercise because the blood vessels that share the same channels swell and put further pressure on the nerves in the too-narrow channel. Cowboy has a transitional vertebra that is malformed (and - in my opinion - likely due to the fact he is a natural bobtail with an extremely short tail - no nub, just a flap of skin). His malformed vertebra is first sacral/last lumbar and the holes where the nerves to the hind legs come out are malformed and too small. He was actually showing neurological abnormalities as a pup but we only recognized that on hindsight (who expects a puppy to have a problem?). Overtime arthritic changes set in and there has been permanent damage - spondylosis resulting from instability in the spine as well as decreased disk space that reached a crisis last summer. He is now eleven and we have him on Rimadyl and physical therapy to try and increase strength and propieception(?SP?) in his back legs. He is happy and mobile, but he can no longer work the way he loves so we do other things. I think when you have a young dog like a BC or Aussie, it could worth doing the surgery (but you should definantly get good xrays and a good neurologist's opinion). These dogs LOVE to use (and abuse) their bodies and in time it can become a quality of life issue. Surgery is not an option for Cowboy and he is eleven (I wouldn't put him through it) but if he were one, and his problem could have been fixed with surgery (and I could have afforded it) - I would try it. You wouldn't want to wait until there are already arthritic changes or significant neurological deficits. Surgeries with the best prognosis are those done while there is still little nerve damage. The other thing to consider once you have it, is hook up with a good physical therapist - they can make a huge difference in getting the dog back to full function. The one I take Cowboy too has been amazing. In 3 months he has gone from a dog I thought I'd have to put down to a mobile and happy butthead (yes, he is at times ) You also might want to check out German Shepherd forums - Cauda Equina is really common in that breed and you might find some good advice, tips and experiences to help you out. Anyway - I feel for you, it is devastating to discover your dog has this issue, and it's scary - but your boy sounds like he has a good prognosis and that's a positive Hope & Cowboy Link to comment Share on other sites More sharing options...
Gloria Atwater Posted January 27, 2012 Author Report Share Posted January 27, 2012 Sorry, late getting back over here. Cindy, thanks for the link. Las Vegas is actually about 8 or 9 hours from me, as I live up towards Reno! Sacramento area is closer, so I can check for neurologists there. However, a huge consideration is money. I don't have much. I'm kind of hoping that since the Loomis Basin Vets website seems to indicate he's had training in neuroscience and "routinely performs" neurologic procedures that he'll be able to apply expertise from both a neurologic and orthopedic standpoint. I hope. But I can make some phone calls just to see what's out there. So, thank you! Serena, thank you for the good wishes. I appreciate that. Hope, thanks also for your experience with Cowboy. He's sure a handsome rascal! You are right, if surgery is going to prove necessary, I don't want to wait until something has gone wrong that can't be remedied. I need Nick to get fixed, recover, and go on to run at the National Finals some day! ... Hey, I've got to dream, right? ~ Gloria Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.