Sudden display of disc herniation symptoms

Questions to ask your ER vet:

1. What tests or examinations will you perform to determine what my dog has? (neurological exam, x-rays, bloodwork?)
2. If my dog has a disc herniation, does he have deep pain recognition, bladder and bowel control?
3. What treatment options do you offer?
4. Are you staffed to keep him overnight? Technician or lay staff?
5. If you are going to administer drugs, which are they and what are their side effects? Pain meds?
6. Does your facility have a board-certified surgeon or a specialized neurological or orthopedic surgeon? If not, will you refer us to one if surgery is needed?
7. Surgery is not an option for us, will my dog continue treatment with you or will you refer me to another vet? If so, what are the recommendations of that vet? Can you transfer us to my regular daytime vet?
8. What is your final diagnosis and prognosis?
9. Have you ruled out any other diseases? How and what tests were done?
10. Will you write down all the drugs, tests and results of my dog for me to have, and to take to another vet if needed? Can I have a copy of my records and my x-rays to take to my regular vet or the referral surgeon?

Conventional treatment by a general vet

Questions to ask your GENERAL vet:

1. How do they treat? – basics
2. Do they use steroids? IV, injectable or pills? If so, do you recommend gastric protectors? Which ones and how much?
3. Views on NSAIDs and other medications used to treat. What would they use specifically? Pain meds?
4. Do they recommend crate rest and for how long?
5. Do they recommend acupuncture, chiropractic or other alternative treatments?
6. Do they recommend the use of supplements? Which ones? How much?
7. When do they refer to a board certified surgeon or a specialized neurological or orthopedic surgeon?
8. Can they recommend emergency numbers to you and the name of a specialist?
9. What is their case load per month treating IVDD and what is their success rate/ complications rate?
10. When do they recommend that the dog starts physical therapy and what kind?
11. Have you ruled out other diseases? How and what tests were done?
12. Do they have a technician to show me how to express the bladder and perform passive excercises?
13. Will you write down all the drugs, tests and results of my dog for me to take, or to give to a specialist if needed?
14. Will you warn me of the possible symptoms my dog may show of him getting worse, needing a specialist, or having a side effect?

Referral to a board-certified neurological or orthopedic surgeon

Questions to ask your SURGEON:

1. Do you use MRI, Myelogram or CT Scan to determine the site of the herniation? What are the risks of each one or the one you use?
2. What are the risks of surgery, length of time on the table?
3. What is your IVDD experience, IVDD case load/month?
4. What techniques do you use? Anaesthesia: premeds, IV or gas induction agent, monitors, post operative pain medication; ICU hours? Technicians or lay staff? – ask for explanation in layman’s terms if you don’t understand.
5. What specialized surgical equipment is used? (i.e. diamond bit high speed drill to reduce blood, bone rongeur, endoscope to reduce cutting, operating microscope)
6. Do you fenestrate? (operate on adjacent discs to prevent a future herniation). If not, why not?
7. What symptoms must the dog show for you to perform surgery? (do they wait until the dog is paralyzed, just in pain, just wobbly, etc).
8. What drugs are usually recommended after surgery? Will you provide an pain med Rx in case at home pain occurs?
9. What post-op protocol do you usually recommend regarding passive crate rest therapy and after crate rest therapy?
10. What prognosis of recovery do you give with surgery? I know there are no guarantees, but with my dog’s particular neurological signs, what is the usual prognosis?
11. Is there a technician to show me how to express the bladder and perform excercises?
12. Will you provide me with a list of symptoms that might indicate that something is wrong with my dog’s healing process once he is at home?
13. What is my procedure if something goes wrong during healing at home? (who to call, where to go, what to do).

What is Board Certified?

When looking for a vet or surgeon, patients generally see many credentials and certifications. Many times these credentials are confusing, and there is little opportunity to weigh the relative value of seemingly similar credentials.

With a veterinary degree and a license, a vet may practice any kind of medicine with or without additional special training.

Vets who have qualified for specialization are called board certified; they have completed an approved residency and passed the board’s exam. Board certified vets are referred to as Diplomates of the Board.

Veterinary Internal Medicine (ACVIM) is the official organization of the veterinary specialist of neurology among several other specialties.

American College of Veterinary Surgeons (ACVS) veterinarian who has been board certified in veterinary surgery and is called a specialist in veterinary surgery

While many vets who are not board certified do call themselves specialists, board certification is the good standard by which to measure competence and training.

You can be confident that vets who are board certified have at a minimum the proper training in their specialty and have demonstrated their proficiency through supervision and testing. While there are many non-board certified vets who are highly competent, it is more difficult to assess the level of their training. Naturally, board certification alone does not guarantee competence, but it is a standard that reflects successful completion of an appropriate training program.

Find Board certified specialists near you:
http://www.acvim.org/websites/acvim/index.php?p=3#
http://www.acvs.org/AnimalOwners/DiplomateDirectory/