Suspected intervertebral disc protrusion between C5 and C6 cervical vertebrae
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April 7, 2008 at 4:44 pm #3195
We live in Zagreb, Croatia. We would appreciate your opinion a lot, please, help: Geff, German Shepherd Dog, ten years old, we encountered all complicated and little-known illnesses that could have happened. In spite of all that, he is of lively spirit and extremely active, well-cared-for and pert dog friend. In March last year he was in the office with us where he accompanies us three times a week since he is really active and has to have his attention occupied all the time. He stood behind the client who didn’t see him, the man lost his balance, grabbed the door-post and pressed Gefo on it in the neck area of the left front paw. Gefo squeaked, lied down, fell asleep and when he woke up hardly got up on his feet. He was so much in pain that he couldn’t lay down again and held his left front paw in the air, putting it down from time to time. We went to see the vet immediately: manual exam revealed no pathological changes, blood tests showed increased calcium and lowered leukocyte count but not excessively, Gefo was sedated and x-ray and contrast radiography was performed, cerebrospinal fluid tumor markers were negative. Diagnosis: suspected intervertebral disc protrusion between C5 and C6 cervical vertebrae. One day of morphine, five days of Rymadil with Peptoran before that, strict bed rest. Gefo started recovering by the end of the 4th week. During the five weeks, after the first pain caused by the pressure and the one caused by all the tests and exams has ceased, he was no longer in pain but only limped and walked heavily and slowly.
During the recovery, from the fourth week on, he had ten acupuncture treatments. In the mean time SLO returned: Symmetrical Lupoid Onycodystrophy, autoimmune illness that we have been fighting for three years, considering how bad it can get, so far our fight has been successful. Our vet has been a great help and made a lot of effort to get Gefo a proper therapy with small advances and a lot of patience. Also, yahoo SLO group was an excellent and great psychological help where we shared a lot of experience as well as complete and detailed information.
Present: on February the 20th he started limping on the left front foot. He is throwing his paw like a puppy while his wrist joint is reaching the floor. He didn’t fall, didn’t hit himself, we are together almost all the time and even if I didn’t see, I would hear that something has happened. He isn’t in pain, has no temperature and no swellings, just limping problem. He is leaning on the front left paw but wrist joint is lowered towards the floor. We started all the tests all over again: blood test – the same as the first time – leukocytes lowered, calcium increased, manual exam again revealed no pathological changes, x-ray of front paws was performed without sedation because he really understands everything but he is also swift so one has to find the right moment. It was stressful but, all together, we did more than 15 tests – ok, no fracture or dislocation. We even managed to get to MRI, by some miracle, for which he was sedated. Diagnosis: suspected intervertebral disc protrusion, however, we all feel that lots of things don’t fit. Our vet put a lot of effort into helping us and took that pile of tests abroad. Colleagues neurologists gave several hypothetic diagnosis: suspected intervertebral disc protrusion between C5 and C6 cervical vertebrae, perhaps neurofibroma (and there are really many kinds..), Schwannoma, or perhaps degenerative myelopathy, and then there’s some Wobbler’s syndrome… They agreed on one thing only that the problem goes from the root of the nerve towards the periphery (and, as far as we understand the real problem can appear if the impulse goes upwards, towards the spine) and that most probably starts from that C5 or C6 cervical vertebra. Based on what they saw, they say, they couldn’t be certain. Honestly, as much as all of this is difficult for us and such an answer doesn’t really solve our problem, we still prefer and appreciate that human and ethical approach to a wrong diagnosis because of someone’s personal interest or a wish to acquire new experience. We could be cornered with no other choice but a surgery and then we could face possible paralysis, lack of disc, or we could solve the compression of this disc and nerve and mess up the others… or something like that… We understand that neurology is a complex science and a true art of making diagnosis… but we are not giving up! In consultation with our vet we went to see the others who made completely different diagnosis: the neurologist said it was not a neurological problem, the orthopaedist said it was a ligament injury and arthrodesis was required. We are not excluding anything but how can we perform that? There’s no swelling, no pain, no temperature… We have three more tests and, as far as we know right now, the closest place where they can be done is Bern: scintigraphy, 4D ultrasound and electromyography, PET and SPECT Scans.
Right now we have decided to wait and stick to the Hipokrat’s saying: when you don’t know what it is, do no harm.. As long as Gefo is not giving any signs that things are getting worse we are trying to find out as much as we can about what is going on, getting information from all sort of sources and experiences – vets, people and their dog friends. Anyway, a hypothetical recommendation is to have a surgery after these three tests, which is, as you all know very well, highly risky and as long as Gefo is walking I’m afraid that will not be our decision. Until we get arguments that could not be refuted… In the meantime we bought a Bioptron lamp and we are just waiting for the producer to confirm if it influences the growth of tumour cells by increasing it or not. The information we obtained from the internet are contradictory and neurofibroma are benign tumours but you never know… He has been eating Hill’s j/d for a year to strengthen the muscle system and soft tissue in his latter years, before that he ate d/d because of SLO and allergies and he has also been taking Caniviton for three years now. I bought Neurobin Forte pastilles but still haven’t started giving them to Gefo since our vet says they are fattening and any extra pound endangers his foot. However, we also heard from a different source that it is a B vitamin bomb which does not provoke hunger, therefore there is no fattening… And I haven’t got any experience: has someone taken that and why, what are the results, what does that pastille really does to the nerves, is the regeneration of any nerve in the body possible (probably not since there would be no disabled animals then) and in which phase of the damage? We can’t start with physical therapy before we find out what is wrong, can’t we? In the meantime we are afraid that while we are trying to collect as much information and advice as we can get, the ligament might strain and tore. It’s best that he rests as much as possible until we get enough information…
Do you thing or have experience does this problem with limping on left front leg can be associate with autoimmune disease (also, neither
from all tests – on alergies, biopsy, rtg., MRI, blood tests, contrast.. – never showes anything!).
There, thank you very much for reading this and we would appreciate any information from your experience, opinion or advice from you – absolutely any of that is most valuable to us at this moment…
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