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What to do for Wobblers?
I have a 9 year old Doberman, who has tentatively been diagnosed with presumptive Wobblers. He has all the classic symptoms. He can still walk and run, but gets unsteady on his feet, has difficulty arising, difficulty getting up on the bed, occasional days when he yips in pain, and in general is just slowing down greatly.
Occasionally he looses control of his bladder and bowels (not often at all)
How involved is the surgery for this? What type of recovery period is typical? Is the goal merely to maintain where he is now, or could he improve a bit?
Will a neck brace help (we have one, he hates it)
I know you can't answer my questions specifically. We cannot afford an $1800 MRI, and really don't see the reason for a neurology consult if we would not operate.
Just in general, what is involved? In your opinion, with a 9 year old Dobe, is the surgery worth it? Our goal is for our boy to not suffer, and to remain with a good quality of life for as long as he can reasonably expect to.
Thank you in advance.
Occasionally he looses control of his bladder and bowels (not often at all)
How involved is the surgery for this? What type of recovery period is typical? Is the goal merely to maintain where he is now, or could he improve a bit?
Will a neck brace help (we have one, he hates it)
I know you can't answer my questions specifically. We cannot afford an $1800 MRI, and really don't see the reason for a neurology consult if we would not operate.
Just in general, what is involved? In your opinion, with a 9 year old Dobe, is the surgery worth it? Our goal is for our boy to not suffer, and to remain with a good quality of life for as long as he can reasonably expect to.
Thank you in advance.
MEDICAL PROFESSIONAL
Peekawho,
Just to be on the safe side...
Whatever happens, please make sure you never give Rimadyl WITH steroids!
Dr. Phil Zeltzman
Just to be on the safe side...
Whatever happens, please make sure you never give Rimadyl WITH steroids!
Dr. Phil Zeltzman
MEDICAL PROFESSIONAL
You are correct. If he is doing find on the Rimadyl along (with tramadol for breakthrough pain) then do not give the steroid.
20 mg is a good sized dose and probably was the cause of what you saw.
I have a shepherd (100#) on 10 mg every other day (for 3 years) and he does fine. (severe back stenosis and arthritis pain). So it can be used successfully.
20 mg is a good sized dose and probably was the cause of what you saw.
I have a shepherd (100#) on 10 mg every other day (for 3 years) and he does fine. (severe back stenosis and arthritis pain). So it can be used successfully.
Would he still need steriods, if he's doing very well on the Rimadyl? (I know they can't be given together).
I'm gun shy of the steroids because of what happened when he had the single 20 mg tablet. He urinated everywhere. Dribbled pee for about 2 days afterwards, everywhere he walked. Peed while laying down on our bed. He drank, but not excessively. He just walked around peeing all over the place.
We were so distracted by the constant urination we couldn't even begin to worry about if it helped his pain. The vet said he'd have to be on a MUCH lower dose if he needed steroids again.
But since he's doing so well on the Rimadyl, it seems a moot point. Sometimes I'm skipping doses here and there, and he's doing fine. Has tramadol for back up, if he needs it.
I'm gun shy of the steroids because of what happened when he had the single 20 mg tablet. He urinated everywhere. Dribbled pee for about 2 days afterwards, everywhere he walked. Peed while laying down on our bed. He drank, but not excessively. He just walked around peeing all over the place.
We were so distracted by the constant urination we couldn't even begin to worry about if it helped his pain. The vet said he'd have to be on a MUCH lower dose if he needed steroids again.
But since he's doing so well on the Rimadyl, it seems a moot point. Sometimes I'm skipping doses here and there, and he's doing fine. Has tramadol for back up, if he needs it.
MEDICAL PROFESSIONAL
Hi, Peekawho --
I agree with the advice given by both Dr. Humphries and Dr. Zeltzman. Another option might be a meylogram, which should help to provide a definitive diagnosis. The problem is that, at this point, we aren't sure exactly what we're dealing with. It could be wobblers, tumor or a disc problem. If surgery is out, then definitely steroids is the way to go. You mentioned an increase in urination, did you notice any improvement when he was on steroids? Typically in a case such as this I would prescribe prednisone 20mg SID for 5 days then go to every other day. Realize the signs could worsen if it is not a straight-forward Wobblers.
Best of luck to you and your Dobey. Please let us know how things turn out.
I agree with the advice given by both Dr. Humphries and Dr. Zeltzman. Another option might be a meylogram, which should help to provide a definitive diagnosis. The problem is that, at this point, we aren't sure exactly what we're dealing with. It could be wobblers, tumor or a disc problem. If surgery is out, then definitely steroids is the way to go. You mentioned an increase in urination, did you notice any improvement when he was on steroids? Typically in a case such as this I would prescribe prednisone 20mg SID for 5 days then go to every other day. Realize the signs could worsen if it is not a straight-forward Wobblers.
Best of luck to you and your Dobey. Please let us know how things turn out.
MEDICAL PROFESSIONAL
Yes, steroids does that and many veterinarians forget to remind clients that both excessive thirst and urinating are pretty consistent side effects. Steroids are problem best for him and at a low does he can be on them long term.
IF he just can't "hold it" and cannot be trusted in the house, you may have to go to NSAIDs and pain meds.
Tell Dr. Cruz hello for me and I hope she can help you.
IF he just can't "hold it" and cannot be trusted in the house, you may have to go to NSAIDs and pain meds.
Tell Dr. Cruz hello for me and I hope she can help you.
Fantastic! Laguna Hills is very nearby.
Regarding the steroids, they tried him on a very low dose, and he responded with a massive amount of dilute urine for several days, and just walked around peeing all over the house. We had to put him in diapers.
Regarding the steroids, they tried him on a very low dose, and he responded with a massive amount of dilute urine for several days, and just walked around peeing all over the house. We had to put him in diapers.
MEDICAL PROFESSIONAL
Considering the financial situation, I agree with Dr. Z's comment "There are TONS of other things you could do"... Some advances we have today in veterinary medicine are Outstanding, but also Out of reach for many people financially. But good practitioners of this art will work with you to find solutions that work within your budget.
One member of our group (both VNN and PetDocsOnCall.com) is Dr. Bernadine Cruz. She has been practicing companion animal medicine at Laguna Hills Animal Hospital for over 20 years. Perhaps that is close to you and she can help you. Might be worth a call.
One member of our group (both VNN and PetDocsOnCall.com) is Dr. Bernadine Cruz. She has been practicing companion animal medicine at Laguna Hills Animal Hospital for over 20 years. Perhaps that is close to you and she can help you. Might be worth a call.
MEDICAL PROFESSIONAL
Hi Peekawho,
I would agree with what Dr Jim wrote.
Instead of spending a penny in an MRI, I would suggest meeting with a neuroSURGEON or a surgeon who has lots of experience with this condition. There are plenty in California.
Only them can give you specific advice based on what your Dobie needs. They can go over the pros and cons of medical treatment vs. surgery.
They can tell you if they believe that he would be better off on steroids (cortisone) instead of Rimadyl (never give them together !!!).
There are TONS of other things you could do your your pup, so hopefully you will be able to be referred by your regular vet.
Incidentally, I am just about to publish a newsletter on a topic that may help you greatly one day. It's free and available on my web site.
Please keep us posted.
Good luck.
Phil Zeltzman, DVM, DACVS
www.drphilzeltzman.com
I would agree with what Dr Jim wrote.
Instead of spending a penny in an MRI, I would suggest meeting with a neuroSURGEON or a surgeon who has lots of experience with this condition. There are plenty in California.
Only them can give you specific advice based on what your Dobie needs. They can go over the pros and cons of medical treatment vs. surgery.
They can tell you if they believe that he would be better off on steroids (cortisone) instead of Rimadyl (never give them together !!!).
There are TONS of other things you could do your your pup, so hopefully you will be able to be referred by your regular vet.
Incidentally, I am just about to publish a newsletter on a topic that may help you greatly one day. It's free and available on my web site.
Please keep us posted.
Good luck.
Phil Zeltzman, DVM, DACVS
www.drphilzeltzman.com
Thank you very much. You were most helpful! I will watch for the other responses, too. At his age, I'm not inclined to consider surgery. If we have to pay for the MRI first, we will have limited funds to proceed surgically, anyway.
MEDICAL PROFESSIONAL
First let me say that we are in the process of training our PetDocsOnCall.com veterinarians to this forum. Consequently our full staff is not hear yet answering questions. Also, as we have tried to categorize better these topics, we are all going to have to learn to search better to find the specialty posts like this one. We are getting there.
Next I will specifically ask one of our Board Certified Surgeons to come to this post and give an answer. Dr. Zeltzman or Dr. Dew can give you expert insight into the surgical options.
From a general practice stand point I can offer some help.
I understand that the expense of this can be an issue. Although an MRI would be helpful (and perhaps a requirement prior to surgery) if your veterinarian believes your Doby has Wobblers Syndrome from plain radiographs, then he is likely correct. Not only are there radiographic signs, but the symptoms the dog exhibits can be diagnostic. (remember we diagnosed and treated these cases long before MRI).
The treatment seems to me to be the main focus. Surgical treatment will be much more expensive than $1,800. It would involve cervical fusion perhaps at many levels. Depending entirely on the severity of the symptoms, surgery may not be a good option for you. Depends on the cost factor, how bad his symptoms are, and how well he responds to medication and neck bracing. I've treated many of these years ago this way and as long as they had a good quality of life with as little signs / pain as possible we felt we were helping them.
Surgery stops progression of the symptoms (hopefully) and sometimes we see actual improvement. But it is not without risk and serious post op care !
Because this is an inherited cervical vertebrae instability I'm sure you know there is no easy fix. The anti-inflammatory meds and pain meds you are giving are correct. My hope is that these will continue to make his life tolerable for many years to come. Also if he gets worse, don't be afraid of using steroids, even long term, to help control the amount of inflammation he has in that cervical spine.
There may also be some new neck bracing techniques, and some physical therapy techniques that could help.
I personally suffer from this both in neck and lumbar spine. I've lived with pain, life-style changes and meds / PT etc. for many years. I finally did have a level of fusion done because it was very severe. However, I can say that with certain changes, meds etc. I can live with the symptoms and without more surgery. This is what I am hoping for your Doby.
Remember, many Dobys live normal lives with Wobblers, and others are so severe as to require euthanasia. You will have to decide - with your veterinarian's advice, how your dog is doing - almost month by month, and do what you can to make his life manageable.
Medical and Physical Management - mild to moderate cases and if their response is good.
Surgical Correction - if severe and pain is not manageable and if you can afford it.
I hope this has helped. Perhaps others will chime in here to give us some other opinions and perspective.
Next I will specifically ask one of our Board Certified Surgeons to come to this post and give an answer. Dr. Zeltzman or Dr. Dew can give you expert insight into the surgical options.
From a general practice stand point I can offer some help.
I understand that the expense of this can be an issue. Although an MRI would be helpful (and perhaps a requirement prior to surgery) if your veterinarian believes your Doby has Wobblers Syndrome from plain radiographs, then he is likely correct. Not only are there radiographic signs, but the symptoms the dog exhibits can be diagnostic. (remember we diagnosed and treated these cases long before MRI).
The treatment seems to me to be the main focus. Surgical treatment will be much more expensive than $1,800. It would involve cervical fusion perhaps at many levels. Depending entirely on the severity of the symptoms, surgery may not be a good option for you. Depends on the cost factor, how bad his symptoms are, and how well he responds to medication and neck bracing. I've treated many of these years ago this way and as long as they had a good quality of life with as little signs / pain as possible we felt we were helping them.
Surgery stops progression of the symptoms (hopefully) and sometimes we see actual improvement. But it is not without risk and serious post op care !
Because this is an inherited cervical vertebrae instability I'm sure you know there is no easy fix. The anti-inflammatory meds and pain meds you are giving are correct. My hope is that these will continue to make his life tolerable for many years to come. Also if he gets worse, don't be afraid of using steroids, even long term, to help control the amount of inflammation he has in that cervical spine.
There may also be some new neck bracing techniques, and some physical therapy techniques that could help.
I personally suffer from this both in neck and lumbar spine. I've lived with pain, life-style changes and meds / PT etc. for many years. I finally did have a level of fusion done because it was very severe. However, I can say that with certain changes, meds etc. I can live with the symptoms and without more surgery. This is what I am hoping for your Doby.
Remember, many Dobys live normal lives with Wobblers, and others are so severe as to require euthanasia. You will have to decide - with your veterinarian's advice, how your dog is doing - almost month by month, and do what you can to make his life manageable.
Medical and Physical Management - mild to moderate cases and if their response is good.
Surgical Correction - if severe and pain is not manageable and if you can afford it.
I hope this has helped. Perhaps others will chime in here to give us some other opinions and perspective.
He's on Rimadyl 125mg bid, and Tramadol 50mg bid for now. He doesn't always get these twice a day--it depends on how much pain he seems to be in.
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