Hind Leg Weakness and Wheels for Dogs
By Marlene Smith-Schalkwijk DVM

Hind leg weakness and paralysis is becoming a more frequent presentation at our clinic.

Having treated these patients for many years doing a combination of acupuncture and chiropractic manipulations, we have now found an other way to help these pets and their people enjoy life a little longer when the rear end gives out!

See our newsletter of the fall 2010 and read the story about Buddy and his wheels.

If you have a pet suffering from hind leg problems here are a few reasons why that could happen and some tips on what is now available for you and your friend!

The discovery of putting these patients in a “wheelchair for dogs” has given many people and dogs several more years of enjoyment.

There was the Wired Haired Fox Terrier born with a serious spinal defect! He had several years of joy in wheels, sharing his joy especially with people and kids in wheelchairs! He used to play and chase balls in his wheels with the biggest smile you can imagine!

There was Baily the boxer with serious spinal arthritis being able again to run along his forest trails and the beach once he got wheels! Another boxer Cesar with progressive spinal myelopathy never slowed down once he was in wheels! And of course Buddy the Ducktoler who got wheels, after his surgery for a prolapsed disc failed to give him his mobility back! He swims, chases sticks and hikes in his wheels! From being left alone at home while the rest of the family is enjoying themselves in the great outdoors; he can now participate again!

Recently Marley joined the “Dogs in Wheels” club. Her spinal degeneration is slowly taking her mobility away, a condition similar to MS in people. Since her wheels she is chasing rabbits again and plays tug-of-war with her people and canine friends!

Giving dogs with hind leg problems wheels is not a cruel thing some people claim it to be! With the wheels you give your canine friend his or her life back again, to come for walks, play, swim, run and smile at life!
For more information here a few links:

www.DogKarts.com
www.Eddieswheels.com
www.wheelsfordogs.com

Here a few conditions which can lead to hind leg paralysis or weakness.

1. Paralysis from intervertebral disc disease. This can happen as a result of injury as hit by car, jumping, falling, slipping etc. It can occur anywhere in the spine and can cause swelling in the spinal canal, which puts pressure on the spinal cord, inhibiting proper nerve transmission. We see predisposition in the short legged and long backed dogs like Dachshund, Basset Hound end their crosses. However Spaniels, Labradors, Jack Russell and basically any breed can get a disc problem.

Typical symptoms are acute onset with a cry/scream or yelp followed by progressive loss of motor function of the hind legs. The lumbar spine is affected most of the time, due to lack of stability provided by the ribs. The thoracic vertebrae (especially T12-12 & 13) can also be affected. There can be obvious pain with a humped up back and inability to use the legs. The neck can also be affected and in more serious cases this can affect the hind legs and also we can see lifting of one front leg. Sometimes this can lead to quadriplegic (all 4 limbs affected). In cases of a neck disc there is often a yelping when one approaches the dog or if the dog moves.

Veterinary attention is needed immediately to reduce swelling and inflammation and also for pain control. In serious painful cases surgery might be the only way to go. The success of acupuncture depends on the duration of the disease; the sooner treatment is commenced the more successful the outcome! Therapeutic laser also has shown to be very helpful. Chinese herbal formula’s with corydalis and homeopathic treatment with arnica and hypericum also help in the recovery. Prednisone and robaxin are also often used.

prolapsed disc pushing on spinal cord

2. Congenital. Congenital spinal abnormalities happen occasional. In the cats we see this mostly in the Manx cat, where the tail can be absent and sometimes even the entire sacrum and last lumbar vertebrae! Marshmallow cat (she now has her own fund!) was one of those poor girls suffering this affliction; it shortened her life considerably!

spinal deformation in a pug

3. Spinal arthritis.
This can involve one or two vertebrae from excessive use, disc disease or trauma, or it can involve the lumbar or entire spine. In the last case we often call this a polyarthritis as it involves multiple joints and the cause is often immune mediated. Some breeds are more affected then others; the German Shepherd and its crosses seem to get a larger share; however the Rottweiler and Retrieving dogs and Boxers also have a high score. Cats can also be afflicted with the same disease. The cause is unknown and in human medicine there seems to be some thoughts of micro-organism and in endemic area’s Lyme’s disease. Activated immune complexes are also blamed for this problem. The onset of this disease can be early in life like two or three years of age; however the effects often don’t become apparent until older age. The first symptoms often are stiffness and inability to jump into the care or climb stairs. Cold and damp weather makes it worse. A reduction in range of motion of the spine is obvious in chiropractic assessment. The arthritis progresses and reduces the circulation to the spine through the foramina between the vertebrae; also the nerves themselves get into the squeeze.  This will eventually lead to loss of nerve control with weakness, dragging, and crossing, slipping (the splits), loss of urinary and bowel control and at the end inability to get up, walk or move.

Acupuncture, with Moxa in colder days, Yang (Kidney Yang) herbs, warmer area’s to sleep, anti-inflammatory and anti-oxidants’, homeopathic remedies and western medicine (Metacam) all help. Regular chiropractics especially in early phases are very helpful and keeps the animal much longer mobile. Rehabilitation with exercises, swimming and underwater treadmill and wheels for dogs are extremely useful to maintain nerve impulse control.

Spondylosis, arthritis of the spine

4. Degenerative Spinal Myelopathy.
This term literally means progressive degeneration of the spinal cord and nerves.

There are many reasons for this condition and again the German Shepherd and their crosses top the list, Boxers, Corgis’, and Retrievers are also on the list. Spinal arthritis, described above is one of them. Spinal trauma and contusion or damage to the membranes around the cord is another one. New research is being conducted into the genetic predisposition to this disease. For more information go to the OFA website and look under genetic diseases and spinal myelopathy.

The typical symptoms of this disease are onset in later age of life. Most of the time there is NO pain involved. There is a slow or rapid progression of loss of control of the hind legs with neurologic deficits as placing problem, crossing over, losing the control on slippery surfaces, dragging and eventual inability to control the hind legs all together.

Treatment is similar as above with chiropractics, rehabilitation, acupuncture, therapeutic laser, and herbal and homeopathic medicine can prolong life and improve quality of life. A canine Wheelchair can give the patient and owner some extra time. Prednisone can give some temporarily relief, there is currently no cure for this condition. Vitamin B 12 is sometimes useful in patient with MS, a disease which resembles this condition in the dog.

5. Fibro cartilaginous thromboembolism.
This is a stroke in the blood vessels of the spinal cord. It is an acute onset, mostly involving one hind leg and it is non painful. The dog loses control within an hour and it progresses quickly to complete paralysis. It can affect any dog at any age and we see most of them at about 7 years of age. Acupuncture done as soon as possible has a remarkable positive outcome as it does in central located vestibular syndrome. Steroids are often used to try and reduce the swelling as result of the vascular infarct. Most dogs recover well if treatment is initiated soon; some remain with some form of neurologic deficit.

6. Thromboembolism in cats/saddle thrombus.
This condition is unique to the cats. A small (or larger) blood clot gets lodges ad the bifurcation of the aorta in the pelvis. At this level the aorta splits in two each branch going to a hind leg. Underlying heart disease with or without hyperthyroidism is often the underlying cause. The event is very painful, leaving the animal crying in pain with both hind legs completely paralysed and cold to the touch. Prognosis is poor even with immediate veterinary intervention with heparin via intra venous drip. Some cats recover, many relapse again at a future date. Integrative medicine, a combination of western and oriental and homeopathic medicine has shown to be helpful.

7. Poly-neuropathy and neuro-muscular disease.
This condition is relatively rare and the Labrador and their crosses seem to bear the brunt. We see a progressive weakness mostly starting in the hind legs and progressing forward to the front limbs, oesophagus and heart. This disease is often combined with laryngeal paralysis and megasoephagus. In the first condition the dog’s vocal cords are unable to open completely when panting resulting in a raspy breathing, cough and gag and also gagging after drinking. In the second condition we see a projectile easy vomiting right after eating, it is more a regurgitation then vomiting. Causes can be genetic, immune mediated and mostly unknown. Treatment options are limited with steroids and palliative care, swimming, chiropractics, acupuncture and a variety of nutraceuticals and herbal formula’s to extend  mobility and quality of life.

8. Malignancies
Tumours, abscesses, parasites and Cryptococcus granuloma’s can also invade the spinal cord and brain. MRI’s are mostly used to diagnose these conditions. Treatment options are very limited.

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