Degenerative Polyneuropathy

Update from mooses momma:



This week has been a rough one but things seem to be slowly improving. In my last post I had just seen a bit of improvement in his ability to coordinate his paws but it didn't last long. It seemed he would get better for brief periods then worse again (though I was grateful that even the bad periods were no worse than the day after I brought him home). I was hoping that it was just taking a long time for the anesthesia to wear off but given that the trouble seemed so specific to two opposite legs even the surgeon was baffled and that is when I got really scared.



When he wasn't improving on Thursday he referred us to a neurologist so we went right away. The neurologist found neurological deficiencies in all of his legs but it was worse in the front left and back right for sure. Given that he also had laryngeal paralysis which is often caused by nerve degeneration she said the most likely cause of the walking trouble is degenerative polyneuropathy. I was not completely surprised by this based on what I have read in the last two weeks. In many cases dogs who have unilateral tie back (the surgery he had on Monday) will be spared from a fatal breathing crisis but will gradually lose function in their back legs until they can't walk and have to be put down. The time frame for that is generally about two years. In an already senior dog, two years is possibly their natural lifespan anyway so I had not been too upset by reading that, after all that is an average and I have heard about several cases who progressed much slower. In the past year I have noticed an occasional toe drag but it had not become more frequent so if that is the rate of progression then I assumed it would be years for sure.



However when I asked the neurologist why he went from being able to walk normally to walking like a drunk with rocks in his shoes overnight she said that dogs often compensate for a long time then get to a point where they can not anymore and people will see what seems to be sudden setbacks. Why did it coincide with surgery? Well, anesthesia affects nerves that are degenerating differently than healthy nerves. The good news is that there is a chance this anesthesia effect will gradually wear off and he will get back to his pre-surgery state in the next weeks but the bad news is there is nothing that can be done to reverse or even stop the degeneration that has already started. The best way to slow it down is to strengthen the muscles as much as possible. This of course involves being able to do exercises that he is too weak and un-coordinated to do at the moment. The worst part of her assessment was that she found that the extent of muscle wasting suggested that this has been going on for a year already and that the timeframe from this point to the time where his mobility would decline to the point that I would have to put him down was 6 months to a year. I know I have a senior dog - he turns 11 this month but until the past month or so he did not act his age at all. I hoped the slow down I was seeing pre-op was his discomfort from being unable to get a good breath when he tried to do anything and that surgery would help me keep him active. As it was we were having to shorten our walks before surgery and no way could he go out in daytime when it was hot. But now I am afraid the slow down may have been more from the loss of muscle- it is a vicious cycle.



The good news is that last night and this morning he seems a little better able to get around and seems a bit more alert and interested in things. Cheese seems to really help his legs move! So I am more hopeful that he will get closer to normal. I have heard that acupuncture can help a lot so I called a local vet who was highly recommended. If I can get him to the point of being able to walk enough that he can get exercise I am hopeful we can really slow it down.
He is otherwise healing well from the surgery and his breathing is much better. He is hacking and gagging a bit more but I understand that is expected.



This has been devastating to me and lots of friends have come out of the woodwork to offer concern and support and I am so grateful that I have people who understand and care. It is so awful seeing your dog suddenly unable to move, particularly a moose sized dog who I am unable to physically lift by myself. Luckily I have neighbors who have helped me get him in and out of the car.