Denny and Charlie (and the rest)
It started with OnePug...

Back Braces and Other Options

Monday, 12 March 2012 00:22 by robbi

Continuing where I left off last, I had been told by one of the veterinarians here in Houston about something that might help Denny’s spinal issues.

This was one of the vets here in town that has done stem cell therapy on dogs. He was pretty quick to dismiss Denny as a candidate for that, as he felt the problem was Denny’s spine and not the spinal cord itself. He told me that he had recently been to a medical conference and seen a new product available. It was a spinal brace invented by a veterinarian that forces the spine into proper alignment. It consists of a metal frame that is adjustable but very rigid. It is to be worn by the dog for several hours every day in an effort to realign the spinal column.

This local vet (I’m going to call him Brace Vet from now on to distinguish him from Stem Cell Vet who was the other Houston vet doing stem cell therapy) sent me some information he had picked up at the conference. The theory certainly seems sound; it is akin to what humans wear if they have scoliosis and are trying to straighten the spine. Richard & I talked it over and checked out the inventing vet’s website. We watched the before and after videos and decided it was definitely worth taking a chance on. We called and booked our appointment to see Brace Vet and have Denny measured for a custom fit brace.

MB Spinal Brace

A couple of days later I received a very disheartening phone call. Brace Vet called to tell me that the brace is not yet available. It is too new – the brace shown at the conference and on the website is a prototype. It’s not yet in production. Brace Vet has promised to keep in touch with the inventing vet and contact us as soon as we can get one for Denny.

I had been doing some digging about possible alternative braces. There are a couple that are readily available and marketed for dogs with IVDD (inter-vertebral disc disease) to help keep their spines straight and relieve pain from misaligned backs.



None of these were invented by vets and none of them have any clinical studies behind them. They aren’t meant to permanently realign spines, just give support. We had thought that maybe one of these would help Denny until we could get something more substantial sorted out for him. But when we spoke to his Rehab Vet, she recommended against it. Her logic was that currently Denny is using his own muscles to help hold his back; if we put a brace on him it would replace the job of some of those muscles. She wants him to get stronger using his own muscles and not rely on something to take their place. Essentially, the brace might make his muscles “lazy.”

For now, we’re going to take her advice and hold off on getting one of these.  But we’re not ruling them out completely for the future.

Denny’s options in summary:

Neuro-Surgeon says he can operate to remove scar tissue around spinal cord, but odds aren’t great it’ll help. Even if it does, more scar tissue will probably form resulting in a relapse like he has now.

Stem Cell Vet says he’ll do stem cell therapy and we might have a 50% chance it’ll help (assuming it is cord degeneration that is the problem; otherwise it is 0% chance of help)

Brace Vet says stem cell won’t help because it’s a spine issue, not a cord issue. The corrective brace will help but it isn’t available yet.

Rehab Vet says acupuncture, laser, underwater treadmill and chiropractic can get Denny strong again and keep him walking on his own power. He might never be 100% and may have a bit of a limp but he won’t get worse.

Rescue Vet was called for a bit of an overview. He is the Vet for PugHearts Rescue. He’s a friend and he’s familiar with Denny. I called him to get an outsider’s view (with a Veterinarian’s knowledge) of everyone else’s opinion and help us make a decision. He also believes it’s a spine issue, not a spinal cord issue. He expressed surprise that Surgeon didn’t want to operate but thought that probably wasn’t the way to go since we’d end up with more scar tissue again. He was extremely doubtful that Stem Cell therapy would help. He was open minded about the Brace, but wasn’t sure. And he felt laser therapy would give us real benefit, though he was not sure about acupuncture.

This has been so frustrating for us. We just want Denny better. We’ll do whatever we need to in order to make that happen. But it is rather annoying that we can’t get a definitive answer as to what it is we need to be doing!

For right now, we’ll wait to hear about the Brace. Stem Cell therapy is on the back burner but not ruled out. Surgery is a last resort, but I doubt we’ll go there. We’re going to continue with Rehab Vet.

Denny is definitely getting stronger. He’s happier. His walking isn’t really any better, but then again it’s not any worse. Considering how quickly he had started to deteriorate this fall, I guess that’s pretty good news.

When we first noticed his decline and took him back to the surgeon, we said we wanted him healthy again but if we couldn’t get that then we’d be happy with him just not getting any worse. So far we’re accomplishing that much.

Stem Cell Therapy

Monday, 5 March 2012 18:55 by robbi

As promised, today I’m going to discuss one of the other treatment options we have been looking into for Denny. Today, I’ll be going over our findings on stem cell therapy.

Stem Cell Therapy This is fairly cutting-edge stuff, but not the moral minefield of Dr. Jekyll you may think of when you hear the term. This involves taking a bit of fat (adipose tissue) from a dog, running it through a series of processes which extract stem cells and then duplicate them. The resulting “stem cell soup” (I made that up, that is not a technical term) is then injected back into the same dog via an IV. The stem cells then migrate to areas of inflammation (kind of like white blood cells migrate to areas of infection) and start working to build up healthy cells.

It’s a very expensive procedure. And the IV injections are usually repeated several times, though the extraction of fat cells usually only happens once (with some cells being saved for the additional treatments.) Costs run around $5000 if the vet sends out the cells to a specialized lab to be replicated; it’s about $3000 if the vet has an in-house machine to do the replication. Very few vets actually do this procedure, as it is definitely not mainstream yet. In my research, I was only able to find 2 vets in all of Houston who have done the procedure. One does in-house and has been doing them for just over a year. The other sends out the samples and has been doing them for just about 6 months. Houston is the 4th largest city in the US. If only 2 vets do it here, I can only imagine how difficult it would be to find someone if you lived in a rural area.

MediVet is the name of the company that supplies the in-house machinery to vets.  They have some really interesting information on their website.

We spoke with both doctors about stem cell therapy as a possible treatment for Denny. This was going with the assumption that he has a degenerative disease of the spinal cord. I thoroughly researched treatment for DM and similar diseases only to find the options were pathetic. I understand what they mean when they say “no cure.” But why does that also have to mean “no real treatment?” Everything I read talked about caring for the dog as it loses its ability to walk. Mobility aids and palliative care seemed to be all anyone could offer. There’s some anecdotal information about diet changes and supplements, but nothing very encouraging. I was initially very excited about the prospect of stem cell therapy as a treatment. Firstly, it was something concrete we could try to “fix” his issue. Secondly, I kept seeing videos of dogs who had undergone the treatment and shown amazing results. I became a bit more disheartened when I would read more, as many of these dogs had suffered acute trauma leading to their conditions. These were dogs that had been in accidents; one day they were healthy and the next they couldn’t walk. Denny’s was chronic, slowly worsening over the last year. Also, there hasn’t been a whole lot of research into stem cell therapy. There are just a few studies done – almost all abroad – so there’s not much clinical data. The data I was reading seemed to suggest no more than a 50% chance of the therapy working for a dog with Denny’s symptoms.

It seemed a lot of money, a lot of pain and a lot of emotional minefields for something with a small success rate. Nonetheless, we trudged on and consulted both doctors here in Houston to see what they thought.

Our initial consultation was with the physician that pioneered the procedure here in Houston. He’s a very personable, likeable fellow – very down to earth. After dealing with doctors who have the “God complex” and who look down on us mere mortals trying to help our dogs and asking loads of questions, it’s kind of nice to meet a doctor who is so straight-talking. We took Denny in and brought copies of his MRIs for the vet to look at. I had exchanged emails with him, so he had a pretty good grasp on Denny’s situation but this was his first time seeing him in person. What happened next was a bit of a blur. He saw us as we walked in the door and greeted us himself. He took us back to a consulting room where he started to talk to us about stem cell therapy. I related Denny’s history once again, trying to not leave out any details. I wanted his honest opinion about whether or not this was the right path to take. He listened and began explaining some of the finer points of the procedure. He saw Denny walk about 2 feet on the floor of the room. He then examined him on the table, checking the proprioception on his back legs. The exam lasted about 2 minutes. He then turned back to me and continued to talk about the stem cell therapy. He explained in great detail every aspect of the procedure. He wanted to inject the first set of cells directly into Denny’s spinal cord – like an epidural. Subsequent treatments would be via IV line in his paw. We discussed Denny’s current medications (he was on a trial of steroids to try and reduce spinal cord swelling) and his activity level. He explained Denny would have to be off the steroids for a couple of weeks prior to the treatment. And that was it. Next thing I know he’s telling me that we can schedule the pre-op bloodwork in a couple of weeks and the operation to remove the fat tissue in another month. Then we were out the door, our heads spinning.

Make no mistake, this doctor definitely seems to know what he is doing with regard to the technical aspects of this therapy. And he has had amazing results with dogs suffering from arthritis – the primary patient that stem cell therapy is aimed at. But how do we know this is the right treatment for Denny? In the car on the way home, Richard asked me what I thought. The first thing that came to my mind was “I wish he had spent more time examining Denny.” Only then did we both realize that he hadn’t even looked at Denny’s MRI scans.

I received an email from the vet later that day, recapping his plan. He signed it off by telling me he was consulting some other vets about Denny’s case and that he was “getting very excited.” My heart sank a bit. Denny was an exciting case; a chance for this vet to try this procedure on a different type of patient than what he had been treating. Denny is so much more to us than a patient, or even a dog. He’s our boy. He is special. I’m not opposed to trying something experimental on him if it is our best hope. But I wasn’t convinced it was.

I decided to continue to try to get in touch with the other vet in Houston who had done stem cell therapy. I wanted a second opinion and this was the only man qualified within 200 miles to give it to me. Eventually, I was able to speak with him via phone. I described Denny’s symptoms and relayed the details of his case. As soon as I had completed telling everything, he said “I wouldn’t recommend it.” What? He explained that based upon Denny’s improvement after surgery and the subsequent deterioration in conjunction with the swelling, he believed his symptoms were probably the result of compression on the spinal cord. Yes, the swelling due to scar tissue could be a factor, but most likely there was more to it than that. It’s a bit of a vicious circle – he has swelling and pain, he can’t hold his spine straight; that causes more pressure which makes his cord even more pinched. He said it would be a waste of time and money to do the stem cell treatment. What did he recommend? Well, he just happened to have recently been at a conference where someone was demonstrating a brace for dogs which forced their spines into alignment….

We’ll make a full post on that one next, with details about all sorts of stuff you probably didn’t know existed!

In the meantime, I should state that we haven’t ruled anything out.  Denny continues on his rehab therapy.  It seems to be making him stronger, and as I wrote before he enjoys the laser therapy.  But we’re a bit frustrated because we’re not seeing much in the way of improvement in his walking.  True, it definitely isn’t any worse.  But we were hoping for more. 

Perhaps we will pursue stem cell, perhaps not.  But I wanted to share this information so that anyone thinking about it would have a little bit more information on how it works and what is involved.

Until then, I thought I’d post a random pic of Stewie. 

Please sir may I have some more?

He had finished his dinner and decided to give us his most pitiful look in hopes that he might get seconds. Silly boy!

Denny’s Rehab Therapies

Monday, 27 February 2012 12:47 by robbi

There was probably a time (long before I ever knew the joy of pugs) when I would’ve scoffed at acupuncture, chiropractic adjustments or even laser therapy for dogs. If you’re not emotionally invested in an animal, it probably does seem silly. But if you think about what you would do to help your child walk again – probably anything – and you realize how much we love our dogs, then you will understand. We will do anything we can to make sure they are as healthy as they can be.

As I’ve posted before, Denny has been having some real challenges with his walking. His back is sloping downward and he has difficulty picking up his back legs when he walks. We have been doing loads of research to see what we can do to help. It’s been a bit complicated, since we haven’t had an iron-clad diagnosis. MRIs seem to show some compression due to scar tissue formed since his surgery – but is it enough to account for his deterioration? While a DNA test has ruled out DM, could it be another un-named degenerative disease of the spinal cord? We have posed these questions to several doctors. Some have actually seen Denny, some have just discussed the case with us. Nobody seems to agree on anything. So as you can imagine, if we can’t get a definitive diagnosis it becomes much harder to determine the appropriate treatment.

In future posts, I’m going to detail some of the information about some of the other treatments we have been discussing with the doctors. But for now, I’m going to share with you some photos and information about some things we are trying. We have found a wonderful “rehab vet” who does all sorts of therapies to help dogs, cats and even horses regain function. So far, we have tried acupuncture, chiropractic adjustments, laser therapy and underwater treadmill. I’m going to break these down a bit:

Acupuncture: Okay, I admit, this one seemed a little weird to me. I kept reading really positive things about it from other dog owners though, so I thought why not? It’s fairly non-invasive and I couldn’t really find any risks. Now Denny is our Eeyore – he is a worrier and not particularly thrilled with vets, so I wasn’t sure how he would react. I needn’t have worried. I cannot explain it in practical medical terms (without using all that chakra-chi kinda nonsense) so all I can say is that Denny was very relaxed throughout and actually seemed much calmer by the end. I guess the only real downside with acupuncture is that it is not a “quick fix.” It takes several sessions before you can see any improvement. So I guess the jury is still out on this treatment. I think it is helping but I can’t see any definitive proof. However, I know it’s not hurting and Denny actually seems to enjoy it now. I will post updates as this therapy continues.

Pincushion Pug

Chiropractic: I didn’t know if Denny was a candidate for this. Especially in light of his recent surgery, I thought maybe manual manipulation of the spine wouldn’t be necessary. I have no qualms about chiropractic; my brother had an accident years ago and without chiropractic care he simply would’ve been doped up on painkillers – this cured his back pain, not masked it. So I had no objection to Denny trying it if the Vet thought he should. It takes literally seconds for the vet to work her way up his spine, Denny enjoys it very much, and he really did seem “looser” after it. So far he has had 2 treatments of this. I’m very pleased and would happily have him continue this as long as needed. Did it help with his walking? Not sure. We saw some improvement with him after his last visit, but he had a combination of a couple of things so I’m not sure what to credit. We will continue this one.

Laser therapy: Our dear friend Cindy swears by cold laser. For herself. With a badly infected PICC line in her ankle causing her doctor to threaten her with amputation, she used a cold laser on a daily basis to help her heal. I’m very happy to say her ankle is fine and her foot is where it should be. She credits the cold laser and who am I to disagree? I had wanted to try this to reduce the swelling in Denny’s spinal cord that the MRI found. I discussed this with every vet we’ve had contact with and none of them agreed on this. Stem cell doctor said don’t bother, surgeon said he didn’t think it would help but do whatever we wanted, the PugHearts vet said it’s the best thing since sliced bread so get going! In fact, when I told him that Denny had his first treatment, he insisted I schedule him for at least twice weekly visits. Our rehab vet was very happy that we were on board with this. Did it reduce the swelling? Who knows – the only way to know that would be to do another $1000 MRI. Did it help Denny? YES! This is by far his favorite treatment. He LOVES it! The little guy just kinda melts into a puddle of fur when this thing is on his back. The theory is that the laser wavelengths penetrate the skin and “massage” the tissue below, redistributing the cells within thereby reducing swelling or relaxing muscles. All I know is this little guy actually runs across the room to the tech when she comes in with the laser. And I will happily take him to as many laser sessions as he wants. Again, this is used in conjunction with other treatments so it’s hard to tell which one(s) are helping. We will definitely continue this one.


AquaPaws (underwater treadmill): This is kind of a no-brainer. Nobody disputes that underwater exercises are beneficial. The ability to move muscles without fighting gravity allows a range of motion that is difficult on land. Elderly people, people rehabbing from surgery – thousands of people every day use this therapy. The only risk is that you can push yourself a little too far because it feels so easy, thereby overdoing your workout. As long as a trained tech is calling the shots, it should be fairly risk free. Now remember that Denny does not like water. He hates our pool and doesn’t even like getting his paws wet from damp grass. However, we strapped a lifejacket on him and put him on the treadmill (with the tech holding him the entire time to make sure he was safe.) He did very well. The tech reported that he showed he had retained his “muscle memory” and was able to walk fairly normally. That means the muscles are still working in his legs and if we can get his back sorted out he won’t have any loss of function. The exercises also mean his legs/hips are working out, getting stronger which will help him maintain his posture better to support his back properly. He has now had 2 sessions. They are definitely his least favorite treatment, but he has done well (the bribery/treats help motivate him.) Is it helping? Not sure. He only had his second session today. It makes him very tired on the day; he slept all day last Friday. But his walking was definitely improved Saturday. Again, this therapy was combined with laser so I’m not sure what to credit. But as I see no downside to this, we will continue this one as well.

Richard took some video of the treadmill session, so I’ll get him to post that soon.

Next post, I’m going to elaborate on some of the other therapies we have been considering.

Catch-Up Time!

Friday, 24 February 2012 15:59 by Robbi

It’s been far too long since we have posted here. It’s been a very eventful year and we have neglected this blog whilst we’ve gone about our daily lives. The webcam has remained in place and we know it gets checked regularly by people wanting a peek at the pugs. We use it ourselves whenever we’re out and just want to check that the doggers are okay.

But in light of recent developments, we felt it was time to recommit to the blog.

I will start with a brief recap of this past year’s events. I may elaborate further on certain items in future posts, but for now this is just a quick catch-up.

Firstly, I am happy to report that the number of furkids in our house continues to outnumber the humans. There has been no change to our cast of characters.

Munchkin the cat celebrated her 14th birthday this past fall. She still looks like a kitten to me. Denny turned 9 this past summer, but has very little gray to show for it. Maggie’s birthday is not known, but we choose to celebrate it in May. We believe she will be 11 or 12 this year. The black markings on her face are fading into a beautiful white-gray and she looks like the feisty old lady she is.

Phoebe has just turned 6. Her playful personality remains but she is really starting to go gray around the chin – even more so than Denny! Charlie has a touch of gray around his mouth and speckles on his belly.charliegraybear

It still shocks me to see the gray, especially since he doesn’t let us see his belly that often.  His back is still a beautiful black so I forget about his gray until he rolls over to stretch.  He turns 6 this summer and though he will always be my puppy, I’m looking forward to seeing his salt-and-pepper fur over the next few years. Stewie has grown so much. He celebrated his second birthday a couple of months ago. He’s solid muscle and the same size as Phebes, but his face still looks like a pup.

Unfortunately, we’ve spent more than our fair share of time at assorted Veterinarian’s offices this year.stewpotswollen

We were blindsided by Stewie’s severe allergic reaction to his annual vaccines. We had a speed-limit-breaking dash to the afterhours emergency vet when his face swelled so severely we could barely see his eyes. Thankfully we were able to give him some Benadryl before it got too bad so that by the time we got to the vet his swelling had stopped progressing. He was treated with steroids and antihistamines and sent on his way home where I don’t think I let his feet touch the ground. A few months later he had a reaction to something in the garden, so the Benadryl was administered around the clock until he was clear. It looks like he’s going to be our “sensitive” pug and we will have to keep a close eye on him for future reactions.

Maggie has developed some arthritis in her front left leg. It doesn’t bother her during the day when she’s moving around, but she’s quite stiff when she first wakes up or if she jumps off the sofa. Sadly, I can’t seem to stop her jumping, but we’ve put rugs down in the living room so at least she has a cushioned surface to jump down on. It seems to help. Plus we’ve increased her glucosamine supplement and added some more things to her diet to help her be more comfortable. We’ll be keeping an eye on her to see when we need to look at more aggressive treatments.

Denny has been through a lot this year. We had noticed last spring that he seemed to be having more difficulty walking. We started him on glucosamine, thinking it was hip dysplasia or arthritis. Initial x-rays seem to confirm dysplasia. We had additional x-rays done with our local vet so that we could get a referral to see an orthopedic surgeon. However, those x-rays showed the hips were clear. As time went by and he didn’t get any better, we got a referral to a neurologist to check his spine. He had began “knuckling under” in his back feet when he walked and his back had started to slope. He had an MRI in August which revealed disc compression in his middle spine. We scheduled him for surgery, hemilaminectomy, in late August.

Acupuncture and Laser this morning.

He came through with flying colors and seemed better immediately. In fact, it was quite tough keeping him calm and on crate rest during the recovery period. His post-op check up confirmed what we knew – the surgery was a success and he was getting control back to his legs. He continued to show improvement over the next month or so, enjoying his walks and looking better than he had in months. However, by late November he was starting to look a little weaker. By December it was obvious that he was deteriorating. We consulted his neurologist who said it was possible that scar tissue had formed at the surgical site and was causing pressure on the spine again. We tried a round of steroids to see if it helped. It didn’t. In January we decided to have another MRI to see what was going on. It showed no new area of compression, but some scar tissue at the surgical site and a bit of swelling on the spinal cord in front of the surgical site. At first the neurologist said he could do surgery to remove the scar tissue. But after speaking to his colleagues he told us he didn’t think surgery was a good option. He left it with us that we could try another round of steroids, with strict crate rest, to see if the swelling could be reduced. If that didn’t work then we could discuss surgery again. So we started the Prednisone and brought the crate in from the garage for Denny.

We also started researching alternative therapies. When Denny had his surgery, we elected to have a new genetic blood test done to check for Degenerative Myelopathy. We knew that it was a possible cause of his symptoms. There is no cure for DM and there’s not really definitive treatment either. Thankfully the results came back negative, so we could rule that out. However, the neurologist did tell us that he could be suffering from degeneration of the spinal cord, just not DM. So without a definitive diagnosis we started digging around, trying to see what we could do for the little guy.

This story doesn’t have an ending yet. We are still researching, still trying things and ruling things out. But from our research we know there’s a lot of other owners out there trying to find answers for their dogs. We’ve learned a great deal from others who have posted their stories in their fight to help their dogs, so we felt we should do the same. We’re going to show what helps him and what doesn’t. And we’re going to share all the research we do, in case something we find that doesn’t work for Denny might work for someone else.

In the meantime, I can assure you that Denny is still living the pampered life that he always has. He and the other furkids are happy and overall healthy. They have devoted parents and a lifestyle and most dogs would envy. We plan on sharing all aspects of their lives here – not just chronicling Denny’s condition. So if you want random pics of pugs living the good life, this is the place as well!