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Saturday, June 19, 2010

Pain In The Neck?

Here's a question from another Laura about her dachshund....

This past Friday, I came home from grocery shopping, put the groceries away, and went to finish cleaning.  Dodger usually follows me and when he didn't I noticed.  He had been in the hallway next to the maine coon cat we have.  Then I heard him yelp.  I came out of the bedroom and the cat was still in the same position-hadn't moved but I thought maybe Rufus swatted him again.  Dodger's head was leaned down like he had done something wrong.  He waddled over to me, got in my lap, and began shaking horribly.  When I tried to turn him around in my lap to look at his face for any cat scratches, he yelped like I was killing him.  I called the vet right away and took him right up.  We had to wait just over an hour and during that time he had calmed down a lot.  (Lady dachsi in the waiting room).  The vet couldn't find anything obvious so he gave us Rimadyl-suspecting maybe he twisted a muscle.
Over the weekend he did not seem much better -I took him back in Monday, this time he yelped while the doc was examining him and he suspects something going on between the middle back and his neck.  After walking a bit, he will lay down where ever, sometimes leaning on his breast bone with hind legs up.  So doc added tramadyl and valium to his meds and also gave him a shot in the butt.  It's been a week and there is not much improvement.  If you walk near him sometimes he yelps.  Also he yelps if his mother or father bump into him slightly.  Just today I noticed that dodger has a nasty dark brown spot under one of his front paw pits...and doc said before this was yeast.  I know that can be pretty painful.  I'm wondering if the yeast spot can be so sore that it's causing him to freak out this way?  If he has a zero tolerance for pain?  I hate to see my baby so drugged up and unhappy.  I'm wondering why no x-rays yet? 
Appreciate any thoughts you might have.
I'm sorry your pup is hurting, Laura.  Starting with one of the last comments/questions, a small area of a yeast or bacterial infection wouldn't be painful, especially to this degree.  And even if it was sore, if it was on a paw it should cause localized limping, not what you're describing.
The posture you're describing (front end down and hind end up) is a classic position indicating pain, though it's more common for abdominal pain.  This should be easy to determine with careful abdominal palpation by your vet.  Rimadyl and tramadol together are great pain relievers, and I suspect the valium was for relaxation, though there are better medications to achieve strict muscle relaxing.  If all of that isn't working well, there's possibly something more serious going on.

If this was my patient, the first thing I'd want to do is carefully manipulate the neck.  I have seen pets like this where there is very noticeable neck pain, and that can help localize the problem.  There are a number of different problems that can happen in this region, including a slipped disc (which would respond better to prednisone and may need surgery).  The next step, regardless of pain identified, would be radiographs.  If there was definitive pain in the neck, I'd want the x-rays only in this area.  If it wasn't readily identifiable I would want 2-3 sets of rads, concentrating on different areas of the spine and abdomen.  In many cases of slipped discs a "plain film" radiograph won't detect it, and a special study called a myelogram is needed.  This is normally done by a specialist, and involves injecting a dye into the space around the spinal cord and looking for narrowing of the dye pattern.

From your description I can't say that your vet has done anything wrong and I would have proceeded similarly with the exception of having recommended radiographs by now.  I would definitely let your vet know it isn't better, and talk to him or her about the next step.  Good luck!