Odd spinal pain

[lehughes]

Hi Laurie,

I have had a look at a dog recently which has me a little puzzled and I thought I would ask your opinion. My apologies - this will be a little long.

The history from the owner - she is a veterinary nurse and competes successfully in agility with two Vislas and this Weimeraner (Dora):

I have had Dora since she was 14wks. She has always been an active dog with little self preservation. She has been a good agility dog who has never been a bar-knocker or missed weave pole entries, even at more challenging angles, though she has always struggled with turning tightly (presumably due to size). Not always a fast dog but very consistent in agility. She has always sat with her right leg sticking out, and often trots with her back legs wide apart.

Over the Easter holidays she leapt from a high bank (approx 2m, maybe higher?) and came down very hard on the uneven ground, her front legs went out from under her and she landed on her chin and chest. She seemed OK once up and continued her walk as normal, and was apparently fine with normal exercise over the next few days. It was only a few days later that I noticed her back was very sore, with lots of muscle triggering when I raised a treat above her head to stretch her back (she could do this without any signs of discomfort previously, to the best of my knowledge, though I didn’t do it often), and her back was very twitchy when lightly touched, from mid-back down. She also started to periodically nibble at her sides, back, tail area, which she didn’t do previously. Kelly did some acupuncture which didn’t seem to help, and I reduced exercise for a week.

At the end of April we had an agility show (I hadn’t done any agility training with Dora between the accident and this show, as I was too busy). Dora consistently missed her contacts and weave entries, and took several bars on hurdles that were after turns, including taking both bars off one jump on the Sat, and then crashing very hard through a jump on the Sun and knocking over the whole jump standard. Despite this, she was not ‘off’ in herself, and was still keen to do anything and everything (but I feel that is her nature, she is a very hard working dog). She was seen by S.W. a week or so later, who found that some of her muscles in her RHL were very stiff and ropey.

We trialled Gabapentin 100mg BID for about a month, plus a bit of acupuncture and laser of her back and hips. I wheat-packed her back every 2nd day or so, and kept a jacket on her at night. Cora remained consistently sore in the back, also sometimes sore in her illiosoas, hips, and behind her shoulders – though this was all inconsistent. The Gabapentin definitely helped Dora somewhat as her back’s reactivity was definitely worse before and after the month on Gabapentin, and her side-nibbling was reduced. Acupuncture seemed to have little effect, and laser had some very short term effect. I reduced exercise to on the flat, mostly leash walking (some slow LLW, some pulling into harness as her LLW is not great!), and some off-lead trotting during this time, though Dora had the occasional mad moment…

We stopped the Gabapentin in July and I built Dora’s exercise back up and started a little agility training. Her back definitely regressed in terms of soreness, and she started side-nibbling again, but apart from that she behaved as normal. We x-rayed Dora and referred this to Angela Hartman in July, and we also saw the chiropractor S.M., which helped immensely with Dora’s sloppy sitting issue. S.M. found that she was very stiff in her lower back and also in her neck, plus being a bit off in her pelvis. At agility training we did very little, and kept jumps low, and Dora didn’t have any issues with weaving or bars. We also went back to free reign with off-leash exercise, including running with the other dogs and running free in the hills (including going up and down banks). We ran an agility show on 5/8, just in Jumpers B and Novice. Dora kept all bars up (the courses were not very tight) but could not get into the weaves, even with multiple attempts.

After your assessment I restarted Dora on Gabapentin 100mg TID and Caprieve 100mg in the evenings, I am also lasering her back 2xweek. Her back pain is again reduced compared to how it was pre-gabapentin, and she has stopped side-nibbling again, but her back is still twitchy when touched and her muscles still trigger when she raises her head for a treat. We are only leash walking or off lead trotting in quiet places with none of my other dogs (mostly on a front-attaching harness as she pulls hard into a back-attaching harness which makes her back arch – not sure what is the right thing to do here?), plus doing a little bit of heeling and obedience work and doing spins, pivoting and backing up.

The radiographs were deemed normal by the veterinary radiologist, apart from very mild elbow dysplasia in the LF. When I looked at Dora her pelvis was straight but she had seen the chiropractor the week before and she had adjusted it. She was tight in the lumbar epaxials and I felt the intervertebral movement was reduced. I am wondering whether this dog may have some spinal ligament sprain after the fall and that she might have residual and possibly referred pain from this? I recommended a nsaid, a 6-8 week course of gabapentin, reduced exercise, twice weekly laser therapy and acupuncture as needed. They live 4 hours away from me, so seeing the dog regularly is not feasible. Do you think I am way off track with this, or should we be looking at a period of strict cage rest? My thinking was controlled exercise with limited or no marked spinal extension (no jumping or running) but that full rest would lead to loss of muscle mass and a weakened core which might not be helpful to the dog.

Any and all advice would be much appreciated. I am enjoying the membership so far - so much to read, now I just need an extra hour in the day!

Regards,
GK

[lehughes]

Hi GK,

Apologies for my tardy reply. I had so many deadlines at the end of August, I had to let answering e-mails ‘go’ for a while. I’m getting caught up now!

So, I think you are very much on track. This sounds like classic back pain, and SIJ pain, with some neural irritation (i.e. nibbling at her sides & why the Gabapentin worked).
My suggestions would be to carry on with the manual therapy - Chiro locally, or if she comes to you, then some mobilizations in flexion for the L/S and some SIJ gapping (or other generalized technique).
If she can access laser therapy, it should work along with the gabapentin to help with the nerve irritation.
I would also suggest assessing the motor control and timing: slide a back leg off the ground and see if she can maintain a level top line (see Video Training 17). If not, then that may need to be address.
It will be key to keeping things ‘in place’ & happy.
Your recommendations to stay away from anything causing spinal extension or tight turns etc is wise until you get the nerve pain settled. And you are correct that some degree of activity is important - walks, and specific exercises.

All in all, it sounds like you are managing this case very appropriately indeed! Good job!

Cheers,

Laurie