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Wobbly lab.

Species: Dog
Breed: Lab
Age: 5-8 years
Hello - About 4 weeks ago, Koda started acting very stiff around his neck so we visited our local Vet. He was also showing some signs of wobbling (like he was drunk) and was very lethargic. (I should note that we are US Expats living in Amsterdam and the Vet service seems to be much different than at home although maybe this is due to language differences). The Vet said Koda likely had a herniated disc in his neck or strain and prescribed Rimadyl. He seemed to feel better quite quickly but the wobbling continued and got worse. I researched Rimadyl effects and found that the wobbling could be a side effect. Since he was not showing improvement, the Vet suggested a neck x-ray which showed nothing. I told her my concerns over Rimadyl (she had never heard of anything) and prescribed Prednisone. He (Koda) does not seem to be in pain and is generally happy (and eats and goes to bathroom fine) but he is not better. Now his front legs are very unsteady (a friend described it as "Bambi walking on Ice" since he take two normal steps and then a bunch of baby steps. His back legs sometimes almost criss-cross. The Vet has suggested that we see a specialist for an MRI and considering the cost, I am not sure if it the right thing to do if the outcome will likely be something that cannot easily be fixed. We have asked the Vet to do a blood test next (they have never suggested this themselves) but do you think that's worth it? Is there anything he could have eaten that may cause this? He did go to the Vet just two weeks before this all started for a check-up and was given the nose spray for kennel cough but that was it and everything else checked out fine. In addition to the question above about our next steps, I wanted to ask what would happen if we choose to do nothing. Would he slowly get more uncoordinated until he couldn't walk? Also, should we continue Prednisone? My husband and I have discussed the possibility of having to put him down but with him not in pain and relatively happy (trying to squeak his toys etc.) this is a much harder decision. I also hate to consider this if this is something that could take care of itself. Any advice/opinions you coud share would be much appreciated. I do have a video of him walking if you want to take a look. It is here:




Thanks!


Online vet, Dr. Marie

Dr. Marie replied:

Oh, poor Koda. He looks like such a happy boy, but he's definitely having a hard time.

What I can see from the video, there are definitely some neurological things going on. I can see some ataxia in his back legs (which is wobbliness, or walking like he is drunk) and a definite issue with his right front leg/neck.

It sounds to me like your vet is doing exactly all of the same things I would do.

If I saw a dog doing this, the first thing I would think of is a problem with a disc in his neck. The problem could be that part of the disc is herniated or it could be that there is inflammation around the disc. Then, the herniation or the inflammation pushes up on the spinal cord and causes some problems with how nerve impulses are spread from that point on down his spine.

So, it makes sense that he was put on Rimadyl. Rimadyl is a good anti-inflammatory drug that would likely have worked well if this was just inflammation around his disc. The side effect that you mentioned with wobbliness in Rimadyl is not something that I have heard of before. It must be extremely rare. I am 99.9% sure that Koda's wobbliness is not because of the Rimadyl.

Now, if the problem did not resolve after a few days of Rimadyl then this means that there is something more going on than just inflammation. The next possibility is that there is some disc bulging into the intervertebral space. This is much more serious. Unfortunately this can be extremely difficult to diagnose with plain xrays. The only way to get a diagnosis here would be to do a myelogram or an MRI. And yes, these tests are quite expensive. And then, if there is some disc material in the intervertebral space then surgery is needed to remove it. This surgery needs to be done by a specialist and is fairly pricey. However, the success rate is generally good and Koda could have many good years of life left.

There are some other possibilities that are less likely, but still a possibility. It's possible that there is a parasite affecting the spinal cord such as toxoplasmosis or neospora. You can ask your vet if these conditions are seen in your area. If so, it may be worthwhile to try a course or an antibiotic called clindamycin which can sometimes work for these parasites.

Another possibility is a condition called fibrocartilaginous embolism (FCE). This happens if a piece of cartilage lodges in the blood vessels in the spinal cord. However, this condition doesn't usually get worse.

It's never a bad idea to do blood tests although I would be surprised if anything came up on the tests. But, if there was evidence of infection this could support the parasite idea.

This is probably not related to the intranasal kennel cough at all.

It's hard to say what would happen if nothing was done. If this continues to get worse then he will eventually lose his ability to walk. I know he's not showing you obvious discomfort, but the dog that I see in the video is uncomfortable. If he is limping then there is likely a degree of pain. Dogs, especially labs, are very good at not letting us know they are in pain.

I would definitely recommend seeing the specialist. I hope he is ok!

Dr. Marie.



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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Dr. Marie - Thank you for your very detailed answer. Koda has been on 40 mg of prednisone 1 x/day since I first contacted you but I am not sure if it is doing any good. He is still walking the same. The Vet here did prescribe a broad spectrum antibiotic at his 2nd visit since he had a slight temperature (as he did during the first visit). About day 2 and 3 after the antibiotic, he seemed to be much less lethargic. He still is not that lethargic but the walking problems continue.

A friend suggested that we try shots instead of the prednisone and I wanted to ask your opinion about that. Can the shots be given with the prednisone or does the prednisone need to leave his system first?

I also wanted to ask about a few lumps that I have recently found on him and to ask whether or not you think these might be related. I have found one in his armpit and one along his sides near his ribs. They are about the size of marbles and feel fairly hard although it seems like I can push them around (and none of this seems to borrow him at all). Do you think they are just normally cysts that some dogs get or something that could be related?

Thank you for your help! - Linda


Online vet, Dr. Marie

Dr. Marie replied:

You're very welcome.

That's interesting that Koda improved after the antibiotic? Which one was it? If it was Doxycycline, clindamycin (or possibly Baytril) it may be that Koda actually does have one of the rare parasites that I mentioned.

A steroid shot is not a good idea here. These shots are not usually any better than oral steroids. Plus, they deliver a large dose of steroid and once we have given the injection then the steroids last in the system for up to 6 weeks. So, if there were any side effects from the drug there is nothing we can do to change the dosage that Koda is getting.

The lumps are tough to comment on online, but it's very unlikely that they are related to his current condition.

Glad to hear that he is improving! I hope things continue to get better!



Customer reply:

Dr. Marie - While we are still waiting to take Koda to the ortho specialist (they could not see us until 5/26) I have been investigating other options. A friend recommended a sort of chiropractor for dogs. I wonder what your opinion is of this and if you think they could do anything for Koda's (unknown) condition or if I'd just be wasting my time. If you want to check out the website of the recommended place for "orthomanual medicine", it is http://www.kreupeldier.nl/home-mainengels-143.html

Thanks! - Linda


Online vet, Dr. Marie

Dr. Marie replied:

I have many animals that I send to see a chiropractor. I think most of them are great! My only caution is to make sure that the chiropractor is actually trained in VETERINARY chiropractic medicine and not simply a human chiropractor who works on animals as there is a large difference.

I checked out the site that you gave me and it does indeed look like a veterinary practice. I think it's definitely worth a try.

With that being said, you should get your vet's permission first.



Customer reply:

Dr. Marie - When I went to the Vet here yesterday to pick up more Prednisone I asked about the "chiropractor" and they said I should wait until after the orthopedist visit (which is still not scheduled until next Thursday). He was not doing well yesterday and today he is much worse and does not want to get up at all. It has been 4+ weeks and he is only getting worse. It is obvious to us that he is in pain and my husband and I have agreed from the beginning that we would not let him suffer. This morning, we called out Vet here to ask what the procedure would be if we wanted to put him down. The Vet basically refused saying that we just picked up more Prednisone and we have a specialist appt scheduled so we cannot do that. My husband explained that we are not willing to spend several thousand Euro on an MRI and surgery if needed. They told us he is a young dog and that it would need a Vet's special permission. What will be a very difficult decision for us is now even harder since the Vet is basically teling us we should not be thinking along those lines. We asked what we should do for his pain so she has now given me 16 100mg tabs of Tramadol Retard with the instructions to give them 3-4x/day for 2 days and has agreed to talk about his situation again in the morning. I know you cannot tell us what to do but I would really appreciate your input. Also - if we decide to give this more time - how long could he or should he be on the Tramadol? Thank you for your help. - Linda


Online vet, Dr. Marie

Dr. Marie replied:

Oh, I'm so sorry to hear that Koda is getting worse. I am really concerned for him.

It's tough for me to advise you here. From what you've described it sounds more and more like there is a serious problem in his neck - likely a disc problem. While this could potentially be fixed, it's likely going to need surgery and this, as you know, is really expensive. Plus, there is no guarantee that he will do well after the surgery.

I understand your vet's desire for him to see the specialist first. It would be a shame to put him down if there was something that could be done. However, if you look at things logically, I can't see a happy outcome to Koda's situation without spending a lot of money.

The specialist likely won't be able to give you a diagnosis without doing either an MRI or a CAT Scan or possibly a myelogram. Any of these tests are really expensive. Then, if we do get a diagnosis he is likely going to need surgery.

I think at this point, with the degree of pain that Koda is in, a chiropractor may not be safe. It's not likely to have a dramatic effect when the pain is this bad.

So, if Koda were my patient I would be giving you the following options:
  • Keep him on the Tramadol until his appointment with the specialist. If the specialist feels that they can't help without the expensive tests and surgeries then go ahead with euthanasia.

  • You didn't mention what antibiotic he was on before. If he hasn't been on a course of clindamycin (Antirobe) then I would likely try some. This is on the off chance that this is neospora or toxoplasmosis in the spinal cord. (But this is quite unlikely).

  • I don't think it's an option to keep going like this on medication. So, if he was really uncomfortable, I would go ahead with your wishes for euthanasia.



When is your appointment with the specialist? If it is within the next week then I would likely persist with the medication and have him seen. If it is several weeks for now then I don't think it is fair to have him in pain for any longer.



Customer reply:

Dr. Marie - I thought I'd let you know that after the visit to the Orthomanual Vet this morning we decided to have Koda put down. After looking at his x-rays and examining him, she felt strongly that this was a neoplasia/spinal lesion especially since the heavy doses of meds he was on were doing nothing and he was in obvious agony. She said that euthanasia was a good choice and wrote a letter to our primary Vet saying that. I like to think that he enjoyed his 6.5 years with us and that he died relatively peacefully in the end.

Thank you for all of your help and answers over the past weeks. It really helped me a great deal.

Best wishes - Linda


Online vet, Dr. Marie

Dr. Marie replied:

Oh, I'm so sorry to hear that Koda was put to sleep. It does sound like you did absolutely everything you could for him though.

I know he will be greatly missed.



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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

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