Caudal Articular Process Dysplasia - Lily's Journey (Part 1 - Symptoms & Diagnosis) by Ann-Marie Fleming

26 November, 2016


Over the past year my senior pug Lily ( 11 yrs) has been facing some challenges. At first she was walking with her right leg showing signs of stiffness and she was starting to scuff the toes on her right paw. I thought it was arthritis. She had a previous knee injury and I was told by her vet that she would most likely develop arthritis in this joint as she aged. In addition she began to lose control over her bowels. In fact her poop would just pop out and surprise her as much as me, but I knew from my previous pug and from many customers that this is not uncommon in senior dogs so I was not too concerned. 

Caudal Articular Process Dysplasia - Pug

However things continued to get progressively worse. Her left leg started to show similar issues so now both legs seemed stiff, both back paws were scuffing and over time her rear legs have become very unsteady and weak. She falls very easily and can no longer go up or down steps. And perhaps the most telling sign was the fact that her tail, once curled like a typical pug, was now limp. She was not exhibiting classic signs of pain, which was comforting, but I also feel that this could be my desire to stay optimistic or Lily's desire to be heroic. Looking at all her symptoms I suspected that she had Degenerative Myelopathy (DM) which I knew had no cure.

Things started to change when over the past 6 weeks her condition worsened and new symptoms appeared. She started to have muscle spasms when she would get very excited. For example if the door bell would ring or if she fought with her sister Winnie over a carrot, she would go into a muscle spasm that would shoot her rear legs forward and she would urinate uncontrollably several times and in some cases would also poop. Her tail would curl up and wag at a rapid pace clearly not being controlled by Lily.

In fact during these episodes I often can only stop her spasms by placing a warm compress onto her muscles to relax them. Eventually I would see her tail stop wagging and fall limp once again letting me know the episode had passed. I now knew that this was more than simply getting older and I no longer thought she had DM, but I did know that she needed to see a neurologist so we could find out what was going on.

That week I took her into to see her vet. I knew from past experiences that there is not much a veterinarian can tell you when it comes to spinal issues. Even with x rays they may not be able to diagnose so my main goal was to get Lily a referral to a specialist. Her visit went as expected in that he really couldn't say what it was only that a spinal tumor was a possibility. I was disappointed though because even with me asking for the referral and explaining that Lily has insurance, her vet tried to discourage me from spending the money to see a specialist since he did not feel they would be able to do much for Lily. I explained that the reason I wanted to find out what is causing her problems is not only to see if we can fix it, but to also understand even if we can't fix it, what I can do to help keep her comfortable. Some spinal conditions do well with exercise, some do not. Some conditions have pain and she'd need pain management, but others like DM do not - how would I know how to take care of her to the best of my ability if I do not find out what is wrong?

Caudal Articular Process Dysplasia - PugRegardless of his hesitancy I did get the referral and took Lily to Canada West Veterinary Specialists in Vancouver, British Columbia for a series of tests which included x rays, an MRI and CT scan. When the results came in there was clear information explaining her condition. Lily has a congenital malformation referred to as caudal vertebral articular process dysplasia. With this condition Lily was basically born with a malformed bone in her vertebrae that would normally be responsible for stabilizing that vertebrae. Without it there is too much movement in that area and over her 11 years this movement has caused constrictive myelopathy in the form of a herniated disc which is putting pressure on her spinal cord.

The good news is that this is a condition which can be addressed with surgery. In discussions with the 2 neurologists involved in Lily's case I have learned that in the past surgery was not effective because the focus was on correcting the damage rather than addressing the cause. Over the past couple of years the surgical procedure now focuses on stabilizing the vertebrae with the malformation by inserting a plate. The dogs that have undergone this new procedure have shown remarkable results. In Lily's case not only would they put in a plate, but they would also remove the herniated disc. As scary as this sounds, she should have almost immediate relief.

The risks of this procedure center around the placement of the screws used to secure this plate. However thanks to technology they are going to be printing a 3D model of her vertebrae so they can plan the exact placement of each screw prior to the surgery. This will be key in ensuring a successful procedure since every dog is slightly different even when of the same breed, so knowing how much bone he has to work with ahead of time, as well as the shape and positioning, will allow the surgeon to be incredibly prepared.

I was also relieved to learn that Lily will be able to walk right after the surgery. While she will need to stay in the hospital for at least 2 days, she will not need crate rest and will be encouraged to walk, but of course no jumping or running until she is fully recovered. I will also be able to do most of her rehab at home.

Right now we are waiting on the 3D model to be completed so the surgery can be planned and scheduled. I will discuss more details about her surgery and her recovery as we go through this journey. To be honest I am terrified, but I know this is her best chance to have a higher quality of life and to be as pain free as possible. I look into Lily's eyes and I ask her to trust me. I ask her not to be mad at me and that we will get through this together! I hope she understands because she means the world to me and all I want to do is take care of her and give her the best life possible.

Ann-Marie Fleming is the Founder & CEO of Dog Quality, a provider of products focused on improving the quality of life for older dogs.

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