Hypoplasia of dens in small yorkie

My friend has an 11 month old 3.5 pound yorkie. He was just diagnosed with hypoplasia of dens, they also called it atlantoaxial subluxation--but he does not have the dens for sure. They first told her that the only was to save him was for him to have neurosurgery. They took him to Chicago last week to be evaluated for the surgery. They told her that due to the dogs small size doing the surgery would be really risky and might not even be successful. Instead they talked her into this "brace" type thing that he will wear for 3 months, they said the point is to form some scar tissue that will hold the 2 vertebra together-- well this brace is awful! The dog cannot walk, he falls face foward and he cannot hear, as the large cumbersome brace is completely over his ears. He has to be held or in a crate for 3 months to see if this might work. My friend wants to cut the brace off and let him live out whatever time he might have. What do you think about the chances of this brace working?? How about just letting him live his life, do you think it would be short due to the problem? They say it was a birth defect and common in small dogs. My friend is just about as depressed as the dog! Thank you for your time!

[Aleda M Cheng, D.V.M., C.V.A]

The surgery is more effective than the brace but the brace is successful in approximately 60% of the cases.  If the brace is that miserable for your friends poor dog than I would consider a second opinion at another veterinary neurosurgery practice about having the surgery.  Perhaps the surgery is warranted if your friend is willing to allow the dog to die rather than wear the brace.  No matter how uncomfortable the brace at least the dog has a chance at survival.  Unfortunately, there are no other options for this kind of congenital problem.    Additionally,  there are several kinds of braces, the brace should be adjusted for comfort.