Border collie Jack passed away on February 28, 2022

Re: Jack: bad back and anxiety issues

I am sorry to be so slow to get back to the forum and to report on our visit. I have a huge pile of work to do this week and on top of that have had serious trouble sleeping the past two nights. Might be the last of the flu bug as I didn't sleep at all the day I felt so terrible and usually I would. I feel pretty good now but I can tell that there's some vestiges of the flu left.

The neurologist was extremely harried today. I got the impression there was something critical going on in the back with another animal and he had to leave the room rather abruptly for a few minutes mid-appointment. So I wasn't able to get all of the information that I needed.

The potential solutions haven't changed. I mostly wanted him to run his tests and see how much impairment there seems to be.

So... have I bored you silly before getting to the point?

He did the pinch and proprioception tests and was able to see the stiff gait and limping. One thing he didn't find was signs of pain when he pressed on the area where the discs are damaged. But he does believe that there is pain. His feeling is that there is currently some reduction in communication across the spinal cord and that Jack is rotating his legs when he walks because he doesn't have a clear sense of where they are.

I asked if we needed to do something equivalent to crate rest and he felt like we basically are resting him in that his activity is pretty limited. He's not doing anything strenuous.

Options, same as before, are:

- Gabapentin (Neurontin) which treats pain generated by nerves.

- Steroids - antiinflammatory

- Better diagnostics: MRI or Myeologram that would possibly lead to surgery.

Jeff and I both agree we would want MRI cuz of the risks of a Myelogram. And that surgery has to have a demonstrably very good chance of making the situation better.

I sometimes feel like the neurologist gets frustrated because I don't want to go the steroid route unless I have to. But I've been there before and I'd really like for Jack not to be a diabetic or have Cushing's disease (call me crazy) so I just can't make myself put it at the top of the list. I will do it if we have to.

And since he's not paralyzed or incontinent or falling down, we're not ready to go to an MRI yet either - not until we have to resort to a much more serious and invasive treatment if there is one.

So that leaves Gabapentin at the top of the list, followed by steroids, followed by MRI to see if anything else can be done. Jeff is not on board with Gabapentin yet but I think it's worth trying as the side effects and risks are smallest.

One thing I didn't get to ask is why Gabapentin alone or steroids alone would work... maybe I'm confused but my understanding is that they target very different pathways - nerve excitability versus inflammation. So if inflammation is behind the impairment, why should Gabapentin iimprove his gait? It seems like it might reduce the pain but not improve spinal cord function.

As far as what to do about my questions... I may make another appointment and just leave Jack at home. And in the meantime, we may be able to try to Gabapentin and see if it helps.

Natalie

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