This week has seen Carl's evaluation with the neurology team at NC State vet school. The findings were not unexpected, but also not what I was hoping for.
Carl is now totally paralyzed from his L3 vertebra down. There is no way to tell if this occurred immediately after surgery or if he did improve for a while then start to deteriorate again.
Radiographs show that his L3 vertebra is very abnormal. This is puzzling to the neurologists, radiologists and oncologists. The lesion in the vertebra is very aggressive but is confined to just the one vertebra. If it were cancerous it should have spread (although it may be a low grade plasma cell tumor which would grow very slowly), and if it were osteomyelitis then it shouldn't have resolved without Carl receiving antibiotics ....
On physical exam it was determined that Carl as no conscious movement nor deep pain in his hindlimbs. Reported movements and ability to urinate were likely simple reflexes and urinary overflow from a full bladder. Carl also has a skin infection and is a bit painful at his affected vertebra.
The plan .... I now express Carl's bladder three times a day which has made a huge difference (no more dribbling), have him on antibiotics for his skin, and Gabapentin for his discomfort. The most exciting part is that Carl will be enrolled in a clinical trial at NC State. It is for dogs with long term paralysis and involves giving two experimental drugs to see their effect on bladder and hindlimb function. For more information visit:
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