Geriatric Neuropathy In The Dog
One of the most common reasons people call me is because their dog is having difficulty getting up or lying down. The perception is that it’s “horrible” arthritis or “hip dysplasia.” This is often their veterinarian’s opinion also. The reality is that it is an age related neuropathy (nerve dysfunction) that is causing lack of feeling to the rear legs. This results in weakness and difficulty walking (especially on slippery surfaces like wood, laminate or tile). A similar condition is seen in elderly people and it’s called peripheral neuropathy. Because this condition in the dog is not well documented, veterinarians are taught that 90% of rear leg weakness is caused by intervertebral disk disease. This is where one of the cartilage disks between two vertebrae has degenerated and moved out of place putting pressure on the spinal cord. An MRI and surgery are usually recommended. Because the cost of such procedures is often out of reach for most pet families, treatment with corticosteroids or other medications is instituted. In cases where steroids are used there may be slight improvement but because this class of medication causes muscle atrophy (shrinkage), the weakness then gets worse. The end result usually leads to euthanasia, and often sooner than it needs to.
Most older dogs have some degree of arthritis, but this generally doesn’t cause rear leg weakness with nerve involvement. The discomfort associated with arthritis can be effectively treated with NSAIDS specifically formulated for use in the dog. This neurological condition is not preventable and is not treatable. It is also progressive and will eventually result in complete, or nearly complete, loss of use of the rear limbs and can even involve the front legs, as well.
In many elderly dogs, there can be also be a degree of dementia, or cognitive dysfunction, associated with the rear leg weakness, but not always. Pet moms, dads and families feel their pet is in pain because it takes the pet a prolonged period to get up or to lie down, or there can be vocalization that is often classified as pain, when it usually is related to cognitive dysfunction and/or anxiety. Fecal or urinary incontinence may also be part of the syndrome.
Once one understands that the disease is progressive and not amenable to treatment, then it becomes somewhat easier to deal with the situation from more of an intellectual standpoint. Many things can help the pet caretaker to better deal with the daily ups and downs of the malady. Yoga mats work well to provide a surface that won’t slip and help the animal to navigate. There are many different and comfortable harnesses with handles that can be left on 24/7. They make lifting the larger dog much easier. In addition, several companies make specialty lifts for just the back legs. And, some dogs tolerate doggie wheel chairs quite well.
One thing that is extremely important to know: never use the abdomen as a way to lift the dog or help the dog to rise from a prone position. That compresses all of the abdominal organs and, not only is uncomfortable for the pet, but can be traumatic if there is a tumor of the spleen and/or the liver. Also, it will be an exercise in futility to try to get the pet to stand on a surface that is slippery. They will try to use their nails for purchase and that makes it impossible for them. People get extremely frustrated in this situation and call me for euthanasia.
There is another scenario involving slippery surfaces that can be devastating for both the animal and the caretaker. This happens when the animal is left alone for a period of time and usually occurs after the neuropathy or myelopathy has progressed. Because there is a loss of strength, the back legs can slip out to each side from under the pet, essentially causing them to do the splits. On a slick surface, the dog simply cannot get his/her legs back into a normal position. However, they will try and try to get up. The longer the period lasts, the weaker and more exhausted they become. Often, they will urinate and/or have a bowel movement, both of which make the floor even more treacherous. When the caretaker arrives back home, they are mortified by what they find. Their beloved pet is in a horrible situation, which transports them into a very emotional state that is completely understandable. No matter how hard they try, it is impossible to get the dog to stand. That often translates in to the “end” for the pet mom or dad. However, as bad as this seems for the pet, it’s like any other trauma and the dog will recover and be back to relative normalcy in 48 to 72 hours. NSAIDS are extremely helpful in the recovery process. If you have a dog with rear leg weakness and hardwood or other slippery surfaces, it is vital that you “old dog proof” the house to make sure this doesn’t happen. If it has happened and your dog had recovered, then you realize how important it is not to leave them alone in a location where they can slip and get into this position.
As I mentioned, this syndrome is the most common reason that people call for an end of life transition. I believe it’s important to understand what is actually going on.
Please call for more information. I am happy to discuss this with you.