Home from the neurologist...

Dee Dee and Hallie · March 13, 2008, 07:25:50 PM

and not sure what to think! He didn't think along the same lines as the first neurologist.

He didn't have any test results to look at but by his exam of her, what I told him of her history and what the other Neuro said, he is not convinced she has this syringomyelia thing.

He bent her head all around, took a little hammer to her little knees, used forceps on her nose and her shaved spot, did all kinds of neuro defecit tests on her, and her eyes, rotated her hips out, etc and she passed everything with flying colors and she indicated no pain in her back! She is walking around just fine too. He has diagrams of dachshund spines and MRI images all over his walls and he has markers that he draws with on them to illustrate things. He showed me how a herniating disc can protrude up into the spinal cord and block part of it off, causing a dilation. He said a myelogram can miss a disc like that (when I asked him why the myelogram looked normal disc wise). He feels her dilated spinal cord area is not what is causing her pain. He thinks it is a lumbar disc after all. She does not fit the typical symptoms of syringomyelia, although it doesn't always follow the same course so it still could be. In fact he put down "possbile syringomyelia" as her diagnosis, I had thought he told me syringomyelia doesnt' come and go but in his diagnosis he said it can.

The thing that can really tell us more is an MRI. But I am not willing to put her out for an hour to have it done at this point since she is doing well again. But at least now I have a plan of action, if this happens again I will give her a pred right off and then run her up there (2 hours) and we'll do an MRI and go from there at that point.

So this is potentially good news! If he is right, that this type of spinal cord dilation she has will not bother her, that is great news. He says a lot of dogs can have this, and they will often find it incidently on an MRI done for something else, and it never gives the dog any problems. So there are other dogs out there with it we don't even know about. I'm trying to get my mind around that she possibly does have a disc problem going on then. Better than the other diagnosis!

I have a few unanswered questions but at this point I am very happy to hear this possibility and I am hoping we never have a need to find out more as I hope she will do fine from now on. But chances are we will be revisiting this. I can't believe I can spend this much $$ and time and effort with 2 vets in the same field and get such differing opinions.

The bad thing about the other neuro is he said she does not have to be confined with this probllem. So I've been letting her go about as she wants. Now that it might be a disc, I should have had her crated these 3 weeks!! Luckily, since she felt like crud after the myelogram she didn't do much more than walk or slow trot, til the last couple of days where she's done a little more but nothing too crazy. Now I will keep her confined for at least a couple of more weeks.

Geez you guys I just don't know what to think...I am thrilled to hear this may not be what we thought!! But it seems to good to be true. So many have been praying for her, I think she and I both have been given several miracles in the last month. It's so good to see her feeling good again! Still praying this guy is right! I really liked him and the clinic was amazing, huge, modern, big screen TV and leather chairs in the waiting room...all the equipment and gadgets they need, about 10 Drs of different specialties.

I feel we have both gotten a second chance!

I have a question for those who have gone thru back surgery with their doxies, how many have had fenestration and how many have had laminectomies?

Teresa · March 13, 2008, 08:04:52 PM

That sounds like great news and what I was expecting (although I don't know why, I just was). When you wrote about Hallie's symptoms, they just didn't sound like the ones I had read about when I researched the syringomelia. Also, knowing it was usually present from birth, it seemed odd for it to start showing up just in the last year or so. The other explanation makes a lot of sense. It sounds like this neuro guy is great and very thorough. You will at least know that if you have to take her for an MRI there, you will be sure to get an answer and he will be able to explain it to you and will answer your questions. I think it is amazing and wonderful that she passed all the neuro tests so well. Way to go Hallie!!!
Now, get some rest and enjoy the good news. I'm sure keeping her confined won't be a problem. You are right about her taking care of it herself for the last little while so it won't seem like such a long time now. At least she isn't going to be confined AND on prednisone!!
Once again, I'm truly glad today went so well. Give Hallie lots of belly rubs for me!

Rich · March 13, 2008, 09:27:11 PM

I can't imagine how relieved you must feel right now. This is such good news - lots of hope - where not so long ago there wasn't much. I think your plan to wait for an MRI until the next episode is a good one. I never thought I would be hoping that a problem like this WAS a disc, but at least that is treatable!

papbouv · March 13, 2008, 09:57:38 PM

Sometimes with people disk problems heal on their own time do know for a fact they can be very painful think it is a good idea not to rock the boat since she is feeling better maybe she will not have any more problems in the future. Glad to hear the news was better than you thought it might be.
Hugs more Rays (can't hurt)
Patches Buddy
Papbouv
If Hallie had one MRI recently you might request a copy of the results or the MRI???? I have a copy of the interpretation of my MRI's

PattyInAK · March 13, 2008, 10:10:46 PM

Yikes. Its all so complicated, and these second opinions can really make you question stuff. I wouldn't know what to think. I guess its all in who you feel you can trust gut-feeling-wise. Disc and back problems are so complicated. As I am finding out. Still don't have the results from my MRI, but its funny how a injury in the neck can make my right arm so painful that I want to cut it off. I don't think Hallie was damaged in any way by not being crated these past three weeks. You already do so much to keep her back from being injured, its not like you had her in competition. Thanks for the update, its all very interesting. And confusing. Keep us posted.

Roberta · March 13, 2008, 10:17:09 PM

Thank goodness, good news. Your idea if it happens again you take her for the MRI is a good idea.
Backs are pains in the a^%$$'s, and like the others I don't think she would have done much damage, as you said she did not feel like moving.
Enjoy your week-end and just love her.
Take care and we will still keep you and misses in our prayers and send rays. Now we all have to work on Patti
Roberta

Brekkesmom · March 13, 2008, 11:49:20 PM

Little Gretl-Angel's was fenestrated. Heidi-Angel just had calcification on the same exact spot - between the 12th and 13th.

Paul Coover · March 14, 2008, 06:26:32 AM

When IVDD is the case, an MRI usually does not show any damage. It is a very difficult thing to diagnose. But 100% strict crate rest is the most important thing to do right now. You can't go back and change the past few weeks, but you can do the best you can right now.

Vets can have very different opinions. Some are very experienced in IVDD and handle it very well. Some just give the advice to put the dog down, it's hopeless. Every vet is different.

Good luck!

Barb · March 14, 2008, 07:44:36 AM

DD - how frustrating to get 2 so different opinions. You are so in tune to Hallie that you will be watching her like a hawk and will see early signs of any problems. I think the plan to "wait and see" at this point is the best one, since you don't have a truly conclusive diagnosis. Waiting and doing the MRI in the future is a good idea..... keeping all fingers and paws crossed here that it never comes to that - EVER !!!! Sounds like our Hallie is truly on the mend and you both can get back to some sense of order in your lives. We will ALWAYS be interested in how she is doing - so please don't hesitate to post updates for us !!!!

GO HALLIE, GO DD !!!!! Have a great week end !

Kari · March 14, 2008, 08:09:38 AM

Wow...that is crazy that there are such differing opinions! But I'm glad to here she seems to be doing better...Go Hallie Go!!

Penny had fenestration done when she had her back surgery...

Delia and girls · March 14, 2008, 08:24:22 AM

This goes right along with Stormy's birthday...miracles really do happen. Now, Hallie...I seem to remember a promise from your mom that you would go shopping for new blankies! Just a reminder!

And just to add to the list...Gretchen had a laminectomy

Barb · March 14, 2008, 08:53:52 AM

What is the difference in fenestration and laminectomy? Sorry for probably asking the obvious....especially to those parents here who have gone through back surgery......

Dee Dee and Hallie · March 14, 2008, 10:40:06 AM

It's crazy opinions can differ so widely on the same thing, even between neurologists who went to the same school! (just a few decades apart). You almost have to do research and figure these things out yourself.

Thanks for your input Paul, I know you've dealt with this a lot. I went through the back surgery thing with my last doxie (I believe the 25-30% estimation of doxies that get back problems is WAY underrated!) so I'm not an expert certainly but I know the basics from going through that. I have always been extremely careful not to allow Hallie to jump or do stairs and to keep her thin (I have ramps and put in a window at ground level in the living room so she can see out without getting up on anything and she is trained to never jump on anything without me lifting her up and also to never jump off herself which she hasn't done now since a few months after I got her). We've always gone on daily 30 min walks to keep her back muscles strong, she's been on cosequin, etc.

The neuro who did my last girl, Jessie's back surgery was the same one Hallie and I saw first here this time. He is older school now, (approaching retirement in a few years) and he does fenestration. He will do the entire area, Jessie had a bad lumbar disc and he fenestrated her lumbar and cervical both, prophylactically. She did have painful bouts that required crating every 9 months like clockwork the rest of her life but they were mild and resolved with meds and rest, so maybe it did help lessen the severity but it did not make it "go away".

The neuro we saw yesterday is younger, he has been in his own practice for 10 years. He is a big believer in laminectomy. He said there have been studies now that show that prophylactic fenestration does not increase the percentage of dogs reoccuring and is not as successful overall as laminectomy. He showed me on the diagram and MRI how the 2 differ and how fenestration can shove the material on the opposite side further up into the cord and is hard to get out. With laminectomy you have a larger window to work with and can get more of the disc material out. I don't know personally, this is just what he explained.

I would also like to hear more about your thoughts on the MRI....the neuro yesterday showed me MRI images of dachshunds that showed where the damage was, he said taking images with a myelogram was like driving a car in a snowstorm, with an MRI it was like driving on a bright sunny day and would show a lot more of what we are dealing with. If Hallie does have a bad disc, then the myelogram did miss it. I don't know if you followed her whole story but up until yesterday, we were told she does not have a bad disc but a congenital dilated spinal cord (which would be much worse than a bad disc) so I've been beside myself and trying to learn more. This second neuro said her dilated spinal cord is more likely a result of a disc that herniated and pinched off the cord causing the dilation and that the dilation itself is most likely (although not for sure) not contributing to the pain she has been having. So we may or may not be dealing with a typical disc problem with her, if not then the treatment, etc would be different. That is why I'm so frustrated because I am getting totally different opinions from 2 neurologists and trying to ferret out what is right and what is not. So if you have thoughts on myelogram vs MRI I'd love to hear. You sure are right about vets having such differing opinions! I have dealt with that too, with every major health problem with my last dogs too, it's really frustrating when you are beside yourself already to then have to figure out who is right or wrong. Especially with what we are paying them!

Barb fenestration is where they go through the side of the spine with a thing like a dental tool and reach in to scoop out the disc material. According to neuro #2, it is harder to reach all the material this way and you are going in blind.So its very hard to get it all out (I have read a case where a dog's lumbar was totally fenestrated and he did reoccure at a fenestrated disc from disc material that was still there). With a lamenectomy, they cut a hole in the side of the vertabra to have a bigger window to work with and it's easier to get all of the material out. According again to #2, there have been fairly recent studies that show better results with a laminectomy. BUT I am learning that very easily, I could go to another neuro and learn totally different things than I have from this first 2! So who knows.

My thoughts exactly Rich, in the first clinic I was looking enviously at all the dachshunds coming in with staples down their backs thinking how lucky they were to have been able to have surgery! Who would have thought we'd be wishing for disc disease is right!

Papbouv the first neuro does not have an MRI machine so we only have a myelogram and CT Scan so far and he won't send those to me since they are on film and there are no copies. I tried to get copies but all they could send me were his notes. I do have all of Jessie's xrays here still and I have all of Freds too so they used to let the clients take them home.

Patty I am sure you are feeling similar frustrations and i hope you get a more solid answer right off than we did. Let us know what you find out!

Roberta that is the one thing that I am glad for, she was feeling so bad from her myelogram she didn't do much. Even though neuro #1 (why do I feel I will soon be talking about "neuro #23" ?????) told me she didn't need to be confined, I still did watch her and had she felt good enough to run around much I would have toned her down at least. But I still envision the few times she went from a trot to a slow lope, few strides but still now knowing it most likely is disc that puts me over the edge!! Hallie sez she went on a bender and when she woke up, she was sportin' a hair doo she NEVER would have agreed to had she been sober! We're just glad there were no tattoos involved.

Julia that is the most common spot alright. I am wondering if we'll be seeing more laminectomys now, if neuro #2 is right then the new school says that is the better way to go. When I was researching all this the name Dr. Rod Bagley kept coming up (my local vet mentioned him, internet, etc) as being one of the top neuro surgeons around and also having trained some of the top neurosurgeons. He is over at WSU in Pullman (4.5 hours away). I would be happy to take her there if she needed surgery but no guarantee he'd be the one to work on her. Anyway he trained neuro #2 that we saw yesterday and he said Dr. Bagley does teach that they have found laminectomy to be a better route to go. But I don't believe anything anyone says anymore, so am trying to do more research but everything I am finding on the net are older studies. I'd really like to see the current study he was talking about. I was also hoping to hear that laser disc ablation was a great way to go (easier on the dog) but I'm hearing that now they say it's not any more successful and not many clinics want to put out that $$$ for the machine so you don't see it much.

Kari was Penny's vet older or younger? And did she have just the one disc fenestrated or several?

No kidding Delia...the two black and tan miracles of the week! :) I'm so happy for Stormy too he is the SWEETEST boy...oh and we already did go shopping for a new blankie but they did not have on befitting the Princess. :) We'll be back!

Kari · March 14, 2008, 10:49:15 AM

Dee Dee...Penny's neurologist was younger...I would say probably in her late 30s and she did fenestrate a number of discs.

tpoof · March 14, 2008, 10:50:51 AM

DeeDee!, we are so glad that things seem to be working out better for you and Hallie! We will continue to send rays your way!

We haven't been on line for awhile as we are going thru a family health crisis as well!...When it rains it pours...

Doxherding Karen · March 14, 2008, 11:26:26 AM

Quote from: Barb on March 14, 2008, 08:53:52 AM
What is the difference in fenestration and laminectomy? Sorry for probably asking the obvious....especially to those parents here who have gone through back surgery......

Silly, silly Barb

- a laminectomy is when your contractor take out your old laminated counters. Marbleizing is when he puts in new marble counters. :thinik:

Fenestration is when your contractor encloses your yard with doxie-proof fencing (Sorry about that Merlin!).

Dr. Bob Villa Leaky
Surgery AND House remodeling - one stop shopping :thumb:

Kathleen · March 14, 2008, 11:39:05 AM

Dee Dee, where did you take her? I'm curious because I've had three different vets at two different vererinary clinics tell me to keep Dr. Harrington at the Tacoma Emergency Clinic on file in case of emergencies, and that he's the best neurologist in the state with a terrific success rate. If he was your second opinion, I would value that very highly. He's going to be my first stop if any of my three have any back problems!

This is their web site, just in case you don't have it.

http://www.theaec.com/

Dee Dee and Hallie · March 14, 2008, 12:14:51 PM

Ah Kari well there goes that theory that they are teaching the younger neurologists to go with laminectomys.

Tpoof I'm so sorry to hear you are having problems too I will keep you and your family in my prayers. I hope things are better soon. You are right when it rains it pours. Love the doxie eye view photo!

Karen I am learning way too many big words I never wanted to know! You just added to the list.

Hi Kathleen. I hate to tell you but Harrington is no longer in practice in Washington state and rumor is if he starts up again it will be in another state (and definitely not at the Tacoma ER) but that isn't verified at this point. I tried to email him but it bounced back so I'm guessing he has cut off all lines of contact. I missed being able to see him by about a week! There is talk the Tacoma clinic will be getting their own neurologist but that hasnt' happened yet. Here is the latest page re: Harrington if you call that number there is a message saying his office is closed. http://www.veterinaryneurosurgery.com/

Clarese · March 14, 2008, 08:12:43 PM

DD,

As you know, Conrad's neurologist typically does not fenestrate. Although he has had three surgeries, they have all been laminectomies. Finnious (who had his surgeries by the same neurologist) did not have his spin fenestrated but did have his neck done. The neuro told me that fenestration does not reduce the risk of future problems to the degree that it was once thought, but fenestrating the cervical spine does not have the same potential of complications as the thoracic or lumbar spine because there is more room within which to work.

With respect to the MRI not being a good diagnostic tool - that is new to me. With each of the five MRIs I have seen it has been clearly evident where the problems were. Additionally, we were able to identify areas of degeneration throughout Conrad's neck by looking at his last MRI.

cheryl186 · March 15, 2008, 10:09:42 AM

Dee Dee, I am so relieved to hear that Hallie is doing so much better!!!!!! Hubby is waiting to go out so I can't write much right now....but...when Zoe had her surgery she had a laminectomy. The results of which have been fantastic :xfinger:....we don't wanna jinx ourselves......Hugs and smoochies to Dee Dee and Hallie!!!!!! I am sooooo glad you got this second opinion

Dee Dee and Hallie · March 15, 2008, 08:10:00 PM

Thanks Clarese, it is disappointing that fenestration did not turn out to be more successful. :( Also disappointing that one surgery doesn't always take care of the whole problem. It's such a problem in our breed! I took Hallie in her stroller today into a store to help with her boredom and some people were petting her and saw her shaved spot and were telling me about their doxie who went down and had surgery (and she did walk again) but they said they never got and never will get another doxie for that reason. (I won't have another Dane for those health reasons either). I said I know what they mean and that I'm sure a lot of people feel the same way. Hallie is my 2nd and I've had back problems with both. And of course both C and F have had problems too...no fun. Sometimes I really am surprised how popular dachshunds continue to be with so many back problems going on. It's so heartbreaking. I'm glad to hear you have had good results with the MRI though I don't know enough about that one to know, it is one of the few things I've dodged with my dogs so far.

Thank you Cheryl. I am so glad Zoe is doing so well! No jinxing! She will continue to do great I just know it! :thumb:

Roberta · March 15, 2008, 08:19:39 PM

Just reminded me when you spoke of Haillies shaved area. My girlfriends lab Zela had to get curciate ligament surgery and the shaved the same part of her for a pain patch, one guy actually asked Brenda is they went in from the back to get to the lower leg area...................go figure!!!!!!!!!!anatomy was no tone of his strong points.

Roberta

Julia H · March 15, 2008, 10:27:34 PM

I just KNEW it! Listen to neuro #2. I think I told you I had dowsed and dowsed and kept getting that Hallie doesn't have syringiomyelia (sp?)!

Besides, I didn't have a positive feeling when I thought about neuro #1, but I do about #2.

You said, "But it seems to good to be true."

Geez, woman! Do you WANT it to be worse?! Let go of that old protective fear stuff (it DOESN'T protect you, you know!)! It's NOT too good to be true. NOTHING is too good to be true! If anything, the other was too BAD to be true!!!

Gooooooooooo, Hallie!!!

Now. From this moment on, let's focus on all the things that are RIGHT about Hallie, and forget about stuff that could possibly be wrong.

Doin' the happy Snoopy dance!!!

sollysmom · March 16, 2008, 02:01:24 PM

Oh what good news!! Here are more healing rays for Miss Hallie, and I will continued to keep both of you in my prayers.

Darcel :apls:

MyLittleBoo · March 16, 2008, 06:28:46 PM

Yeah for Hallie!!! We are glad to hear that you are on the uphill side of things.... Sending more rays though, just for good measure... And, of course some belly rubs to one beautiful girl!!!

Dee Dee and Hallie · March 16, 2008, 11:03:03 PM

Wholly Kow Roberta I hope that guy is in a field without living subjects! Gads.

I am glad you have had good feelings about this all along Julia. That makes me feel better! I appreciate you dowsing, and the encouraging results! I am happy about her progress 95% of the time, worry creeps in 5% but for me that's pretty good! :thumb:

Thank you Darcel. We will take all the prayers and rays we can get too, she is doing well but far from her normal self I've not seen her take this long to recover before but then I am not sleeping so I keep her awake half the night hugging and kissing her.

So maybe she's just tired, tonight I am vowing to lay awake quietly and keep my hands off the poor girl so she can sleep.

Thank you too Tara I will definitely give her some extra belly rubs for you.

LesleyandStrudel · March 17, 2008, 09:23:42 PM

Oh, boy, I'm so sorry little Hallie is having problems! She was just a little munchkin when I got out of touch a few years back! It sounds like she's getting first rate care, so that, with everyone's hugs and prayers, will hopefully get her back on her little feet again soon!

Meanwhile if they ever come out with the shatterproof dachshund, I'll be first in line! With all that can go wrong, us dachsiholics REALLY love our furbabies! I'm resisting the idea of looking back at all the problems I had with Strudel (she got Lyme disease, and that was a constant worry for six or so years! Then the diabetes did her in before we got it diagnosed ... sigh.) I figure with Pfeffernusse, I'll just keep him on Frontline, keep him fit and trim, and keep my fingers crossed!

Anyway, best of luck with your love-love, and know you've got my hugs and prayers! :)