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Various issues and injuries can cause the spinal cord to compress. This creates great pain in the affected animal, and also results in severe instability. A dog suffering from spinal cord compression will likely sway or wobble when on its feet. The goal in treating dogs with this problem is to minimize pain while restoring movement to the limbs and neck.
X-rays are often used to confirm that compression is the reason behind gait instability. Once this has been completed, multiple surgical procedures are generally attempted, including cervical traction stabilization techniques. These stabilizations use metal implants to secure the affected vertebrae together. This helps lower compression in the spine. Sometimes only a few synovial joints need to be attached together, while in severe cases the entire spine may need to be fused. This surgery should only be performed by an ACVS board-certified veterinary surgeon.
To visualize what is happening internally, radiographs or an MRI will be needed. With these images, the surgeon can decide the best way to perform the surgery (either dorsally or ventrally). The dog will then have to have a full panel of blood work done to assess its overall health and clotting abilities. This will help determine if the dog is healthy enough to undergo general anesthesia. To prep for the operation, the dog will likely have to fast for 6 to 12 hours.
Before the surgery can begin, the area being operated on will have to be shaved and cleaned. Either one large incision or multiple, small portal incisions will be made depending on whether the procedure is being performed arthroscopically or with open surgery. Once inside, holes will be made in the cervical articular using a nitrogen-powered drill. Any abnormal cartilage that is found during the process will be removed. Bone that has been grafted from either the removed dorsal or from the humerus will be put into the articulations. Orthopedic wire is then run through the holes and tightened to secure the vertebrae together. This stops them from moving individually. The surgical site is then suctioned and closed with sutures.
The overall success of the procedure will greatly depend on what caused the instability in the first place. Very mild cases may respond well to oral corticosteroids and not require surgery, although this method does not resolve the problem causing the compression. If the injuries or problem areas are moderate, surgery can permanently correct instability in the dog. If multiple lesions exist, or if the lesion is large in size, the prognosis tends to worsen.
The dog will need to be closely monitored as it wakes up from the surgery. In some cases, the animal will not gain mobility of its limbs for some time. The area of incision will be dressed with a padded bandage. A prescription for pain medication will be given as soon as the dog is conscious. Corticosteroids will also be needed to reduce compression during the healing process. Broad spectrum antibiotics will be administered, continuing for at least three days longer than the steroids.
As the dog is likely to be tetraplegic for some time, it may be advantageous to construct a small cart to help move the animal around. Use of a large water bed during the recovery stage is also recommended. A follow-up appointment is scheduled 6-8 weeks after the operation has been completed. At this appointment, x-rays are taken to confirm that the fusion has successfully been completed. Regular limb function will likely begin around this time.
Cervical traction stabilization involves a very invasive and complicated surgery. Advanced imaging is almost always necessary to plan the operation. The cost of stabilization generally ranges from $3,000-$7,000, with average procedures coming in around $5,500. There are not many alternative techniques other than drilling holes into the bone and wiring the vertebrae together. Stabilization may or may not be paired with spinal decompression or other surgical treatments. Treatment will vary on a case by case basis.
Like any surgery, cervical traction stabilization carries risks associated with the use of general anesthesia. Some dogs experience complications with the metal implants. If these implants begin to loosen, a second surgery will be needed to remove them. While this procedure is often performed ventrally, more risks are linked to this entry.
Trauma to the spinal cord is possible from use of either scalpels or the drill. The operation takes a considerable amount of time to complete. There is also a risk of the venous plexus rupturing, which results in hemorrhage. Sometimes more lesions are created from the surgery itself. Full recovery is not always possible, although most dogs are able to exist comfortably after the procedure.
Some causes of spinal compression are genetic, such as Wobbler's Syndrome. This issue affects many breeds, but seems to be very prevalent in both Great Danes and Doberman Pinschers. Males develop this problem twice as often as females. Rapid growth can lead to the malformation of vertebrae. Proper nutrition as your puppy grows is key to help prevent bone issues. Use high-quality food that promotes slow growth. It is also very important to keep your dog's weight under control to not put extra pressure on its joints.
Using elevated feeding dishes can help keep the dog's head at a relaxed level. Providing a round pillow for your dog to rest its neck on can also alleviate compression. Obtain a harness that goes around the dog's chest instead of using a traditional collar. Try to discourage your dog from jumping up onto things. Do not roughhouse with your dog, as vigorous play can result in injury to the spine. The first indication of a problem may be seen as your dog stands up, so do not ignore any unsteady motion.
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