Canine Spinal Column Injury

Wow, I have been terrifically busy lately, and frustratingly, I have had little to no time to post on this Blog. I have several interesting pieces I am working on and hopefully will be published soon, but there does not seem to be enough hours in the day. Of course, this is a familiar complaint, particularly with many "dog people" as we spend a great deal of our time caring for our animals. Naturally, something always goes wrong requiring unexpected medical care, more trips to the veterinarian, then the pharmacy, then staying close to home because of an injured or sick dog, and so on.

Take a recent example involving my Veteran male wolfhound of almost eight years of age who was apparently roughhousing with his sister and they must have collided with one another. Though I did not witness this particular event, many times I had seen their horseplaying and have had to step in quickly before someone got hurt. They frequently have done so without previous trauma but this time was different. To boot, one would naturally expect that the bitch would have sustained injuries, but mine is not your average wolfhound bloodlines. In my bloodlines, many of my bitches average 160 pounds and are built like linebackers. My males usually range 180-190lbs. This particular litter sister he was playing with is built like a tank, as solid as a log, and hitting her would be like running into a brick wall. Though my male weighs in at 183 pounds, he was the one who got hurt. Apparently, she did not feel a thing.

His symptoms began with a lameness in his left forequarters, and he was panting heavily. The pain was not specific to the foot, Radius, Humerus, Scapula or muscling and he would not lie down on his left side, crying out when he tried to do so. With a doctor present, we palpated but could not elicit pain from him though this is not unusual for an Irish Wolfhound. This breed is so damn stoic that they often are on their death bed before being symptomatic of a critical illness or injury. Although he was kept quiet, his lameness did not diminish but worsened along with his having measurable neurological weakness in his rear hindquarters. Digital radiographs were taken of his left forequarter vertical bones and joints looking for the dreaded "C" and, for good measure, his lungs and chest cavity as well. All appeared normal. I was suspicious that he had a disc injury and also, his panting was due to the extreme pain. We had to wait several days for an appointment with a Board Certified Neurologist, and we now have our answers.

First, let me back up here to make an important point. I like and have great admiration and respect for this Neurologist, who unarguably is an expert in his field. But, as I discussed with my husband, we are quite fortunate that I am not just a typical pet owner. Due to my having 32 years of experience in seeing just about everything in this breed, I have developed an innate diagnostic talent along with a finely tuned intuition. I am not gloating, but truly I have relied on this ability for years now and moreover, I am pragmatic. Here is how this skill has aided me in this particular situation.

After a detailed examination of my hound including a thoroughgoing outdoors gait analysis, the neurologist's first recommendation was to perform an M.R.I., which is a medical imaging that is superior for producing images of soft tissue injuries or tumors, nerves, and internal organs. This is today's "go to" diagnostic ideal, with starting costs of $2,500--$3,000 aside from the $200 office visit. This is just an initial expense. I thoughtfully listened to his opinions and considered his top three typical and possible causes for my wolfhound's disability and pain. These being soft tissue tumor, degenerative lumbosacral stenosis -- a disorder of the vertebrae in the lower back that causes compression of the nerve roots often found in large breeds, or, lastly, caudal cervical spondylomyelopathy. The latter is frequently seen in giant breeds and is known as "Wobblers Syndrome" but is seen mostly in younger animals less than two years of age.

Then, I initiated the "what if" treatments or solutions discussion to any MRI findings, of which there was just one, surgery. As a significant adjunct, one factor that would determine the length of recovery is the angle of the surgical entry to repair or remove the issue. For example, a Hemilaminectomy approach (from the left or right side); or a Dorsal approach (from the top); or a Ventral Slot (approaching the spinal cord through the bone from the bottom). Hospitalization times would depend on the surgical method, and are usually up to a week or slightly longer and then "at home" recovery of approximately 3-6 months. Such surgical procedures and stays at a 24/7 Specialty Hospital as this 37,000 square foot facility range from $6,000 to $8,000, without an MRI. Now, how does my valuable intuition and experience aid me in this situation? Well, many average pet owners with disposable income, especially in our giant breeds, would comply with a Specialist's urging and have the expensive but accurate and valuable diagnostic tool. Though I have spent countless tens of thousands of dollars on one or more hounds surgeries and specialty care, my sense was that this male got injured in boisterous, rough play. Roughness and rowdiness unlike what this doctor, or for that matter, most all other doctors have ever seen. Regardless if this boy is eight years old as most all our veterans are lively and uproarious, and this particular stallion hound is especially powerful.

You see, the most significant contrast in experience between Veterinarians and Specialists who see thousands of canine patients per year -- many of whom have diagnostics down to a science -- and me is that I live and have lived with a pack of Irish Wolfhounds for 32 years. It is amusing because, over these years, I have attempted to explain the breed as well as my Wolfhound's daily lifestyle, their habits, and personalities, play and exercise routines, and so on to new specialists. Yet, the new Doc's -- not my regular veterinarians -- don't seem to get it. When I narrate how these hounds roughhouse and describe the extent of their power, or when I discuss prey drive; there is often a blank or disbelieving look on their faces. This vacant look is similar to the expressions on that of non-dog persons and dog persons from other breeds faces as well, after I explain how traumatic an Irish Wolfhound fight can be. They just look at you as if you must be exaggerating. This Doctor did not disappoint.   

Having received all the information needed, I opened the discussion of compromise for proceeding conservatively. That is to say, no M.R.I., suggesting and requesting instead that we have digital radiographs of the hounds spine and cervical vertebrae to ascertain, if any, disk damage. Further, I inquired, and it was explained that, yes, we might be able to rule out a tumor which is often found in giant breeds spinal columns though we cannot have absolute certainty because radiographs can only depict a tumor that is typically 50% in size or larger. Most importantly, I pointed out that the hound was not a candidate for surgery due to his age, and consequently, the MRI would be unfulfilling. My Specialist softened and yielded to my logic and experience.

After having five digital radiographs of his spinal column and cervical vertebrae (neck) with a machine built for horses allowing for the dog to stand while being x-rayed, thankfully, no soft tissue tumor was detected. Instead, we saw the obvious issue. His cervical 6th and 7th vertebrae are compressed, bone on bone. Consequently, the pain and the injury has radiated down the spinal cord and has caused ataxia of his hindquarters (incoordination). My veteran hound is now being maintained on a painkiller, along with a brief steroid therapy that I dread. However, the steroid that I chose to administer -- yes, there are several to select from all with varying side effects -- Methylprednisone -- has somewhat fewer side effects but is expensive. We will begin chiropractic therapy on Monday and go from there with the goal to alleviate this poor gentleman's pain. We will have to see if this mediates or diminishes his obvious discomfort but at the very least, my practical and intuitive approach saved me an initial $3,000.

Danny's sister, Ballyhara Dallas 8 years of age. "The tank" is what we fondly call her...