Our 6 year old dachshund, Ralphie, has intervertebral disc disease, first diagnosed when he was 4 in 2017. 25% of all doxies have this condition. Ralphie is our 4th Doxie – he did not beat the odds. He is energetic, affectionate and forever sweet. He has never growled or nipped. When happy his tail wags vigorously and he is know to rooooo when especially pleased. He charms everyone he comes in contact with.
In 2017 Ralphie’s first symptoms of disc disease occurred. He was medically managed on/off for months and with rest and TLC, symptoms abated within 2 weeks. By Spring the pain increased and our primary vet referred us to Dr. Logan, the neurologist at MVA in May. An MRI was done and lateral slot surgery performed to decompress a disc in Ralphie’s neck. Surgery was successful and he recovered well with no complications. He was roooooing again.
In 2018 Ralphie was again in pain, this time in his back. After months of medical management we were referred again to Dr. Logan at MVA. An MRI and left hemilaminectomy were performed on a disc in his back. Recovery was tougher this time. His ambulation was poor and he had weakness in the left hind leg. His back was shaved and staples placed – he looked like Frankenweenie. Despite all this Ralphie made a great recovery.
Dr Logan informed us that the MRI showed several more compromised discs. Although he had 2 successful surgeries he was at increased risk for future problems. She told us about LDA (laser disc ablation)which is only performed at 2 to 3 surgical centers in the US. LDA is a minimally invasive preventative procedure that could potentially fix Ralphie’s back discs. It was developed at Oklahoma State University in 1993 and has been found to be 97% effective. Dr. Logan had referred a previous client to Dallas, Texas for an LDA. Dr. Reaugh in Dallas has trained at Oklahoma State with the Vet who started LDA. After Ralphie was fully recovered we flew to Dallas in September. LDA can only be performed on back discs, not cervical discs. This is because of vital structures in the neck – carotid artery, esophagus- and laser would not be safe in the area. The LDA was successful and without complications and was one-third the cost of surgery (including air fare, hotel, rental car and meals). Recuperation was minimal.
Ralphie had his worst crisis this Spring, 2019. He was medically managed but symptoms rapidly worsened. After screaming upon moving himself in his bed and unable to sleep due to extreme pain, on Easter Sunday we headed to the University of Pennsylvania ER. They added codeine for pain – it didn’t help.
By Tuesday Ralphie showed neurological signs: his left leg was buckling. Our primary vet referred us to neurology at Penn or MVA. He had previously received excellent care at MVA. I called that day to schedule an appointment with Dr. Logan and was informed she was no longer at MVA and that Dr. Lipitz was now the neurologist. I was crestfallen. Not only was Dr. Logan gone, but Dr. Lipitz did not have an open appointment for several weeks. The nurse on the phone asked what was going on with Ralphie and after I told her she urged that I bring him to MVA’s emergency services. I arrived in 45 minutes and was immediately greeted by an ER nurse. She had already pulled up Ralphie’s history and asked if they could give him a shot for pain and she took him back to the ER. Dr. Lantz met with me soon after. It was obvious he had reviewed Ralphie’s history and was concerned about his presentation. He was going to ask Dr. Lipitz to see Ralphie.
Not long after, Drs. Lantz and Lipitz, along with other members of the team met with me. In the group was Brooke, the neurology nurse who had taken care of Ralphie during his 2 previous surgeries. I felt immediate relief. She remembered me and of course, remembered Ralphie. Dr. Lipitz recommended an immediate MRI. She was very concerned about Ralphie and said if I waited an hour and a half, she would meet with me again to discuss results. True to her word we met an hour and a half later. Ralphie had a severe disc that could not be medically managed. Her recommendation was another lateral slot surgery. Dr. Lipitz said that if we elected to have surgery she would clear her schedule and perform it the next day. She explained in detail that the disc was severely compressed and in a bad location. Surgery might take 4 hours and would be complicated. Dr. Lipitz was confident, compassionate and exceptionally knowledgeable.
Three surgeries in 2 years and a road trip to Dallas for LDA. Will Ralphie have another good outcome? Will his quality of life improve? Can we afford this cost? “This is not medically manageable” – I kept repeating that in my head. Ralphie would have no quality of life. He could barely ambulate and was in almost constant pain. He had the surgery.
Ralphie had his 2 week post-op appointment yesterday. His ambulation is great with some residual weakness in the left leg (which should resolve with time) but no buckling. His tail was wagging and he was rooooing. Prognosis is great. While in surgery to fix the compressed disc, Dr. Lipitz was able to fenestrate several more cervical discs as a preventative measure.
I want to sincerely thank everyone at MVA: the front desk staff who are always kind and courteous; the unseen nurses on the phone doing triage; all the staff in the back who took great care of my boy during the day, evening and overnight and gave me status reports; the ER nurse for her kindness and care; Dr. Lantz in the ER; and my angel, Brooke, the nurse who has been with us every time and is always professional and caring. Most of all I want to thank Dr. Lipitz, Ralphie’s angel. She is the extraordinary surgeon who responded with the highest levels of skill, competence, professionalism, compassion and most importantly, kindness.
Maureen and Ralphie