I took Baron in to see a surgeon last week for a final diagnosis/opinion on his problem. I had wanted to consult with a neurologist, however there is only one locally (at Iowa State University) and I am not familiar with him. So instead I took him to Dr. Reimer at Iowa Veterinary Referral Center. I had received many great opinions/recommendations for him so I scheduled an appointment with him and hoped for the best.
|Baron waiting in the exam room.|
I briefly described wobblers in my post last year on Baron's acute pain and subsequent journey to the ISU Vet ER. With wobblers the neurological signs happen because of spinal cord compression. In Baron's case it's caused by compression of the spinal nerves or nerve roots between vertebrae C5 and C7 and this can actually cause a great deal of pain/discomfort. Dr. Reimer performed a physical and a neurological examination which was interesting to see. Who knew you use one of those reflex hammers so many places on dogs? :)
Besides the wobbly gait and neck pain, Baron is also experiencing:
- a lot of muscle loss through the shoulders
- limb weakness and difficulty rising after sitting or lying down
- loss of fine motor skills (problems stopping and turning)
Luckily, wobblers is usually a slow, progressive disease unless it's a case stemming from acute trauma, than it progresses very rapidly. We should still be able to enjoy much more time with our elderly man :).
|Baron was tuckered out from the morning's vet appointment.|
Wobblers can be treated medically or surgically. Medical management usually consists of anti-inflammatory drugs to reduce the spinal cord swelling along with restricted activity. Also, no collars should be used because it is a neck problem. We are using a chest harness to help take that pressure off. We are also going to continue the chiropractor appointments and add in acupuncture and possibly laser therapy.
We also have to rearrange our sleeping arrangements for him as he usually sleeps in his kennel in our bedroom. Sadly, our bedroom is upstairs in the half-story and the stairs are a huge problem for him. So we are moving his kennel downstairs and starting to recondition him to a new routine. Since he is already a slightly anxious dog, this is not going so well right now. But we are going to stick it out for a little while longer to see if repetitive routine exposure will start to kick in. He's been classically conditioned to the kennel routine in our house for so long that we are going to have major hurdles changing and rebuilding this.
Medical management is typically used with older dogs with mild symptoms, and dogs with multiple locations of spinal cord compression. Baron is seven and the typical life span of Dobermans is only about ten years. Ironically, his heart and everything else is good so he might out-average the statistic :).
The goal of surgery is to stop the progression of clinical signs. But because the spinal cord compression has been occurring over a long period of time, there is typically permanent spinal cord damage that can't be undone. Most dogs never walk normally even with surgery, however many will improve to be able to have a good quality of life.
We chose to not do surgery at this point for several reasons - age, severity of symptoms (his are milder at this point), and cost vs. benefit. The average life span of dogs treated medically versus surgically is the same so it's not a question of extending his life. It's more a question of what I can deal with as an owner and what Baron's quality of life is. I happen to think that we can maintain a good quality of life for Baron without surgery. Obviously, if that changes we will have to step back and re-evaluate.