Your thoughts on dorsal laminectomy + discectomy for my fur babies situation?
I have a 5ish year old rescue St Bernard mix. Over the past month, we have dealt with on/off weakness in her back legs. Shaking when trying to standing and crying out in pain. Some days she was her normal self, and then would have episodes of this pain. We went to the vet who has given her gabapentin and it is now well controlled. Based on the MRI results, the vet is encouraging surgery. I would love to hear any additional opinions. The cost is quite a bit for surgery. I’ve had recommendations from family to do acupuncture instead. Below is from the vet's report:
Diagnostics:
Lumbar MRI: Intervertebral disc extrusion at L7-S1 (likely chronic) causing severe compression of the cauda equina, worse on the right side with concurrent mild right seventh lumbar nerve radiculitis/neuritis. Multifocal noncompressive intervertebral disc protrusions. Multifocal degenerative intervertebral discs in situ. Multifocal lumbar and lumbosacral spondylosis deformans. Transitional S1 vertebrae incompletely fused to the sacrum.
Diagnosis/Problem List: L7-S1 intervertebral disc extrusion
Discussion: Sasha's MRI revealed a herniated disc in her lower back between the 7th lumbar vertebrae and the sacrum. This herniated disc is resulting in severe compression of the nerve roots and spinal nerves. The treatment options for disc herniations at this location include conservative management with rest and medications, epidural steroid injection(s), or surgery. We attempted an epidural steroid injection today but were not successful. Based on the degree of compression and Sasha's ongoing discomfort despite being on medications, surgery will likely provide her with the best prognosis for improvement in her comfort. The surgery would be a dorsal laminectomy + discectomy. Sasha would have a ~70-80% prognosis for improvement in her pain, though this improvement can be gradual in the weeks after surgery. Potential risks/complications include anesthesia risk, persistent pain, urinary/fecal incontinence, infection, incisional complications. Sasha would remain hospitalized for 1-2 nights for pain management and monitoring of her neurological status, and then go home for 4 weeks of rest. An estimate for surgery is $5500-7000 (range due to potential variation in amount of IV medications, anesthesia time, and post-op stay.)