Friday, January 20, 2012

Dogs with bad backs - Emmett's story

I've heard it said that 80% of people will experience back pain at some time in their lives.  While back problems are not as common in dogs as they are in people, they are still one of the more common conditions that a small animal veterinarian will treat.  Today's blog is about Emmett.  This cute little dog is up and walking around today thanks to his very astute owner and a wonderful surgeon.  (I have told you I like success stories, right?  *grin*)

I saw Emmett for a sudden onset of back pain one Friday last June.  I had to look up the month, but for some reason I can distinctly remember what days of the week this all happened.  Anyway, his mom brought him in on a Friday and I remember how painful Emmett was.  We took some X-rays and confirmed that he indeed had evidence of intervertebral disc disease.  (Click on the link for a very thorough explanation of disc disease in dogs.)  Just like in people with disc disease, pain is caused when a disc, which is the cushion in between the vertebrae, swells and bulges.  And just like in people, almost all dogs will heal with some anti-inflammatory drugs, rest and sometimes muscle relaxers.  Only 5% of dogs need surgery.  Emmett only had pain with his back disease and he did not have any neurologic signs such as weakness in his legs or paralysis.  And so, he got sent home on medical therapy, but I still remember how I thought Emmett seemed more painful than most dogs that I treat with this condition.

Four days later on Tuesday morning, Emmett's mom called to tell us that Emmett started have some weakness in his legs that just started that morning.  Tuesdays are my main surgery day so I was gloved up and working in sterile surgical field when all this was happening.  I remember my wonderful staff relaying messages back and forth between me and Emmett's mom.  At first Emmett's symptoms weren't too bad so it was decided to just wait a bit, but within an hour his weakness was much worse and progressing toward paralysis.  The question then was should Emmett come into the clinic for a recheck?  Well, I've seen symptoms progress this fast before and this is not the time to delay treatment.  We had Emmett's mom come and pick up his X-rays from Friday and go directly to see the veterinary surgeon.  Within hours, Emmett had surgery for a disc in his back that had gone from bulging to ruptured.

The next day, Emmett got sent home from the surgical hospital.  I remember how his mom commented how she was expecting to have to help him walk at least in the beginning as he healed from major back surgery.  When they left the hospital, Emmett walked over to a post and lifted his leg to pee on it.  Amazing.  Emmett is doing well today (although he did have a flare up of back pain a month and half ago but only needed medicine to treat).  Emmett is doing well because his owner was so incredibly on top of what was going on with her dog and also a big thanks go out to the wonderful surgeons and staff at our not-so-local referral hospital.

This is definitely a story of a bad disease where everything went right.  I am always amazed when I have an owner bring in a paralyzed dog and when I ask how long the dog has been this way, they tell me a day, or two, or three, or sometimes more.  Really?  Your dog goes suddenly paralyzed and you wait days to bring it to the veterinarian?  Bulging discs with mild to moderate pain and no weakness of the legs can wait until morning.  Ruptured discs that cause paralysis cannot.  This is definitely a disease where HOURS count.  Not days.  HOURS.  If it happens at night, you don't wait until morning to see your regular veterinarian.  Certainly there are many diseases where a "wait and see" approach is totally acceptable.  This is not one of those.  Even with quick action, not every dog will recover, but most will if treatment is not delayed.  Thanks to Emmett and his "mom" for letting me share his story.  He is a remarkable little dog to be sure.

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