12/13/2024
Always think medical before behavioral when we are ruling out reasons for inappropriate behavior.
At this point in time, most folks understand the link between pain and behavior. It’s logical: you don’t feel well, you have less patience and tolerance, you lash out or shut down or otherwise are not the best version of yourself. It makes sense that the same would be true for dogs.
But how do we know there is pain with animals who cannot verbalize that pain?
The short answer: we can’t know.
The longer answer: we also can’t know there ISN’T pain.
Meet Malus.
From puppyhood, he’s been a little spicy. But he’s a terrier, so that’s normal, right? He didn’t like having his feet handled. No biggie. And as he got older, he got a little reactive to other dogs - again, see “terrier” in the dictionary. And after he got neutered at 2.5 years old, his behavior spiraled - going after his housemates, aggression directed at his owners, even less tolerance for handling, increased fence fighting. But there’s some evidence of increased aggression after neutering, so maybe he just got unlucky.
For many folks, that explanation would’ve been enough. They would’ve worked on behavior modification, or just accepted a crate and rotate household, or managed the heck out of all of his triggers… or, honestly, would’ve ended up euthanizing him for his dangerous behavior.
Luckily, Malus’s mom is Katrina, who is essentially a terrier in a human body. She dug in.
Training, a veterinary behaviorist, consulting with other behavior experts, expensive testing - and then we got our first physical explanation: low zinc.
But even with a zinc supplement, his aggressive episodes remained unpredictable. Katrina had noticed some very, very intermittent lameness, foot chewing, butt/tail biting, so off they went to the first orthopedic specialist - one who cleared him orthopedically for all activities.
So they did physical therapy, and pain meds, and kept working on training.
But the weird, mild lameness continued, and so did visits to specialists. A neurologist who recommended an MRI, then more physical therapy for a possible psoas strain, different meds, another orthopedic/rehab specialist consultation, adjustments to physical therapy, a PEMF bed for home use, adjustments to behavior meds, consults with nationally respected trainers and behavior specialists, and finally - FINALLY - a recommendation to see a pain management specialist.
“I think he may have Tethered Cord Syndrome. I’m going to try different pain meds, but there’s a specialist in Massachusetts you should get in touch with.”
With the new meds on board, his behavior improved. He was brighter, happier, had fewer episodes of lameness, self mutilation, and aggression.
Yesterday, Malus had a dynamic MRI at Tufts, where Tethered Cord Syndrome was confirmed.
Today, he had surgery to relieve the adhesions to his spinal cord that have been causing him pain.
He was never “just being a terrier.” He was not acting out for no good reason. He didn’t need harsher training methods. He wasn’t aggressing for no reason.
He was in pain.
There are no words to adequately describe how thrilled I am for Katrina and Malus to have this diagnosis and surgery in their rear view mirror - it has been a long time coming. The strain on Katrina and Kevin’s emotions, time, resources, finances, and household over the last 5 years cannot be overstated. Most folks wouldn’t - and couldn’t - go to the lengths they did.
We can’t rule out pain. We can only rule out specific issues and diagnoses. For Malus, it took finding the right vet who had heard about this rarely diagnosed issue to connect them with the vet who could help.
To my clients I encourage to work with their veterinarian to try to find any physical explanations: Katrina and Malus are the reason why I will push you more if your primary care vet shrugs you off. It’s why I will push and push and push, especially if your commitment to training and management is excellent but we still are struggling to make progress. Malus is on my shoulder (sometimes literally), poking me with his nose, screeching in my ear to look harder.
If you’ve ever heard him, you know how hard that ✨ delightful ✨ noise is to ignore.
(PS - Here’s your sign to sign up for pet insurance.)
To learn more about Tethered Cord Syndrome:
https://vet.tufts.edu/news-events/news/breakthrough-surgical-procedure-relieves-dogs-chronic-pain
