Paralysis: It doesn't have to be permanent
by Kate Fitzwater, DVM, DACVS
Dachshunds are the number one breed to suffer from
intervertebral disc problems. The intervertebral discs are located beneath the
spinal cord, in between each vertebra, and are like jelly doughnuts. Each has
an outer fibrous layer, like the crust portion of the doughnut, and an inner
nucleus pulposus, like the jelly portion. Dachshunds and other breeds like
Beagles, Pekingese, Cocker Spaniels can develop mineralization of their discs,
which causes the nucleus pulpous (jelly portion of the doughnut, remember) to
become like bone, which makes it more predisposed to rupturing.
When the disc ruptures, the nucleus portion of the disc
causes compression on the spinal cord. The most common place for rupture is at
the thoracolumbar junction or mid-back. It can also occur in the neck, but this
article will not address this location. Depending on how compressed the spinal
cord is directly correlates to the severity of the clinical signs. Pain is the
first sign, which can progress to complete paralysis (loss of all movement in
limbs) and loss of deep pain (unable to feel and recognize a painful stimulus
to the limb). Prognosis for recovery depends on how severe the clinical signs
are and what treatment option is pursued; each case is different. Surgery is
most commonly recommended to remove the disc from around the spinal cord if the
signs are worse than just walking wobbly, which is called ataxia.
Prognosis for complete recovery with surgery is 85-90% as
long as the dog still has deep pain sensation. It is best to not wait until the
dog is completely paralyzed, but as long as deep pain is still intact, the
prognosis is good with surgical intervention. Once deep pain is lost, there is
a 50:50 chance of walking again if surgery is pursued soon after injury.
Rehabilitation with underwater treadmill therapy is the
mainstay of recovery after back surgery. Here at Circle City Veterinary
Specialty Hospital, we have a CT scanner available for imaging the exact
location of the ruptured disc prior to surgery. In some cases myelogram may
also need to be done, which injects contrast material around the spinal cord to
highlight the ruptured disc. Our two boarded surgeons, myself (Dr. Kate
Fitzwater) and Dr. Rebecca Ball that can perform the surgery, even on emergency
basis if needed and work closely with our in-house rehabilitation team of two
certified rehabilitation practitioners, Dr. Kelly Fisher and Dr. Karen Hull for
continued therapy after surgery.
Diagram of a ruptured
disc compressing the spinal cord, which is the dark gray structure
