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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 28532
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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How serious is stage IV herniated disc in shih tzu, who goes

Customer Question

How serious is stage IV herniated disc in shih tzu, who goes from fine to not being able to get up from sitting position within a space of 2 hours
Submitted: 3 years ago.
Category: Vet
Expert:  Dr. Michael Salkin replied 3 years ago.
Aloha! You're speaking with Dr. Michael Salkin

Rather than relying on the subjective staging assessment, I feel that the most important prognostic indicator for these dogs is the presence or absence of nociception (deep pain). This assessment is always subjective, but apparent loss of sensation below the level of the spinal cord injury suggests the possibility for permanent paralysis, regardless of treatment. Approximately 50% of dogs in this condition will recover if treated with decompressive surgery within 12 hours of the loss of nociception. Beyond 12 hours, the recovery rate decreases rapidly to between 0 and 5%.

For dogs with intact nociception, even if paraplegic (no motor function), approximately 80-90% will recover fully or nearly fully with surgical decompression. However, the time frame for recovery is extremely variable (few days to many weeks or months). Patients treated without surgery may recover as well, regardless of severity of deficits. However, such recoveries usually take longer than in those dogs receiving surgery, and the recurrence rate for similar or worse clinical signs is much higher.

Fluff's vet should assess Fluff's degree of nociception and conscious proprioception (knowing where one's feet are in relation to the rest of one's body) to best give you a prognosis for Fluff. Time is of the essence. Please respond with further questions or concerns if you wish.
Customer: replied 3 years ago.

I am going to be honest. I had to have my dog put to sleep on Thurs because he was left for 24 hrs from when my vet assessed him. He had been unable to walk for 2 hours before she seem him. She said he seemed to have some feeling in his back legs, so she was happy to let him go home and would see him the following day. She called me later that day. I informed her he could only lift his head, he hadn't urinated and lost control of his bowels on the way home. I also said he is holding his front right leg stiff. She said to get in touch with out of hrs surgery if any change. He did get worse and spent the night in the vet. Thurs morn I was told they couldn't do anything. Nothing will bring him back. But I just feel so let down. He was a patient to them. He was my world. I just don't know how to start to come to terms with this. Thank you for your advice.

Expert:  Dr. Michael Salkin replied 3 years ago.
Thank you for additional information. My condolences for your loss of Fluff.

It sounds as if only prompt surgical intervention might have been helpful and the standard of care wasn't met if that eventuality weren't mentioned to you. Perhaps discussing Fluff further with his attending vet would assuage your feelings and if not, there should be peer review available to you through your vet's local veterinary association. If you prefer not to confront the vet in this manner, pet loss groups should be available to you if you live in a major metropolitan area.

Please continue our conversation if you wish.
Dr. Michael Salkin and 2 other Vet Specialists are ready to help you
Customer: replied 3 years ago.

She did say that if his condition hadn't improved after 24hrs then she would refer him for an MRI scan and surgery. But given how serious it was, and that referrals can't be made after hrs, she should have wasted no time and referred him straight away.


 


I know I am not going to closure, and nobody will pay for the heartache caused.


 


He was a beautiful little dog, so gentle in nature.


 


Thank you for your honest advice

Expert:  Dr. Michael Salkin replied 3 years ago.
You're quite welcome. I understand.

You may receive an inappropriate follow up from the site ostensibly from me. It wasn't and I apologize in advance should you receive it.

Please disregard the info request.
Customer: replied 3 years ago.

I will, and thank you again

Expert:  Dr. Michael Salkin replied 3 years ago.
(mod close)
Expert:  Dr. Michael Salkin replied 3 years ago.
Thank you for your kind accept. I appreciate it.

Customer: replied 3 years ago.

Hi. I am grateful for your advice. I have started a complaints procedure against the vet, but what I need is a UK vet who can tell me, based on the information I have given, that my vet should not have allowed my dog to go home without an xray or scan to see how bad the damage was.

Expert:  Dr. Michael Salkin replied 3 years ago.
We don't have a lot of UK vets on this site but perhaps my moderator can find one for you. Please contact [email protected] and tell support you'd like to speak to a UK vet. If I opt out, your question will be fair game for vets all over the world - not necessarily a UK vet.
Customer: replied 3 years ago.

Thanks. The second vet I took him to are releasing their files to me. They have been really nice, but are reluctant to say what they would have done that morning because they didn't see him. It's a well known fact here in the UK that one vet won't speak out against another. All I can do is see were my complaint goes. If it fails go anywhere, then I will start a justice campaign. I loved my little dog and won't let go without a fight.

Expert:  Dr. Michael Salkin replied 3 years ago.
I understand. If I can be of more help to you in the future, please let me know.