This week I saw Banjo, a six-year-old dachshund, whose owner was concerned he was lame in the hind legs.
Even though Banjo seemed bright in himself and had tucked into his breakfast that morning, he had not been moving around for a day or so.
Banjo's owner said he wasn't whimpering - but a lack of crying out or whimpering should not be equated with a lack of pain.
What was evident was that Banjo could not get comfortable: he kept shifting his weight around and could not seem to settle. Disconcertingly, he was not standing on his hind legs at all.
Earlier that day, when carried outside to the grass to toilet, Banjo sat right down rather than do his morning wee. He couldn't stand up by himself and, even when helped, his back end flopped down.
On physical examination, it was clear Banjo had paresis, or profound weakness, of his hind legs. He could not bear weight on them at all and, when he attempted to move, he would knuckle and drag his back legs.
His tummy was extremely tense, and when I put pressure on it, poor Banjo involuntarily passed stool on the table. His owner said he would never go to the toilet inside at home.
Banjo had an extremely sore back. I pinched the skin between his toes gently. Normally, most dogs will withdraw their hind legs from this stimulus. Banjo did not.
With the combination of Banjo's breed and clinical signs, I suspected he had ruptured a disc in his spinal column.
I referred him to a 24-hour specialist facility for an urgent CT, which confirmed a large disc extrusion of one of his lumbosacral (lower back) vertebrae.
Banjo underwent emergency surgery - a procedure called a laminectomy - to remove the disc material impinging on his spinal cord.
He will have a long recovery - six to eight weeks of strict rest, and gradual return to gentle exercise, but he will be able to walk again.
Banjo's apparent lameness was caused by inter-vertebral disc disease (IVDD), a common condition, particularly in some breeds like dachshunds.
In mild cases, dogs may be treated with a course of anti-inflammatories and strict confinement (no stairs, no jumping, no running or wrestling, gentle lead walks only).
But the presence of neurological signs (inability to use his hind legs, a reduced withdrawal reflex and the absence of pain sensation) are urgent indicators surgery is needed.
Had Banjo's owner kept him at home under observation for longer, he may have experienced catastrophic, irreversible spinal cord damage and lost his ability to walk permanently.
The bill approached $20,000, which is not unexpected given the level of expertise, equipment and round-the-clock care involved.
Fortunately, Banjo's owner had taken out pet insurance when Banjo was a puppy. That covered most of the cost.
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Banjo's owner raised an important question: if a dog seems sore in the hind legs, how do you know you should rush them to the vet?
If a dog is not weight bearing on a leg, or vocalising, it needs immediate attention. If it has neurological signs (inability to use the leg, is wobbly or unsteady, or appears to put weight on the knuckle or drag the feet), seek immediate attention.
- Dr Anne Quain is a lecturer at the Sydney School of Veterinary Science and a practising veterinarian.