Jennifer's Bandit 6/3 surgery -Japanese Chin SAN DIEGO

Hi Jennifer!

So glad to hear that Bandit's pain is under control. That does make all the difference in the world as to his recovery. Now he can begin healing in comfort.

We will have our fingers crossed for a smooth taper beginning on June 1st. Nerve healing takes time but he is on the way.

Hi everyone. Despite my best efforts, Bandit had a relapse in pain. Although he still stood and walked to relieve himself, I noticed there was noticeable paresis and ataxia in his hind limbs. Because of the nature of his episode (difficult to control pain) and because we have already tried the conservative treatment for over 30 days, he was brought in for an MRI and hemilaminectomy on Tuesday, June 3rd.

I ended up going with an orthopedic surgeon as opposed to my original neurologist because of the cost. I was quoted anywhere from $5-7K for a CT and hemilaminectomy (without post-op hospitalization or drugs) with the neurologist, whereas the the orthopedic surgeon quoted $4.3-4.7K for a MRI, hemilaminectomy, and 4 nights post-op hospitalization. (For anyone interested, my surgeon was Dr. Hampel at Animal Medical Center of East County.)

Dr. Hampel took a look at Bandit's initial X-rays (April 21) and was able to see significant calcification at L1-2 and L2-3. After taking the MRI, she was able to see some calcification from the dorsal view but not from the side. She ended up taking another set of X-rays and BOOM, Bandit's case becomes a first in her 20+ year practice as a surgeon. 

This is Bandit's radiograph before the surgery, June 3.



Exactly where the mouse is pointing? That's Bandit's mineralized disc. It had ruptured in one intact piece, a highly unusual occurrence as the disc typically ruptures into smaller pieces when herniated to such a degree. Even more unusual, the disc had turned 90 degrees and was now lying completely parallel to the spinal cord. By all accounts, Bandit should not be walking or functioning! The disc had moved over the period of weeks, and was now completely out of the intervertebral space. The compression against the spinal cord was so severe that the ganglia was 4X the normal size, hugely contributing to his pain. My vet even took a biopsy thinking it could have been cancer (negative, thank goodness!). Dr. Hampel ended up deviating Bandit's spinal column to relieve the compression. Removing the disc was not an option, as it was covered in fibrous material and because of its proximity to the spinal cord--it would have almost certainly caused complete paralysis. She shaved the herniated disc down a bit, and then closed him back up after the decompression was complete.

Since the surgery, Bandit has been stable. Because surgery causes more swelling, Bandit is actually worse than before he under the knife. However, he is improving each day and the prognosis is (hesitantly) good. He has good reflexes, though there is decreased pain sensation on his right (where they entered to do the surgery) side. I saw him today (48 hours after surgery) and he was alert and sweet. He is has some anticipatory pain (will yelp/scream) but it's more out of fear than actual pain. The vet noted that he screamed when she just LOOKED at him in his recovery area, because he associates attention with being picked up and therefore pain. In any case he's currently sedated with lidocaine, ketamine, and morphine and resting well.

In our case surgical intervention was the only way Bandit would have any sort of quality of life. However, my surgeon strongly, strongly suggests that everyone try conservative care before getting surgery. In fact, she said that she would have asked me to continue medical treatment instead of getting surgery if I had seen her even two or three weeks ago. Bandit had a very unique case, but I'm happy that I made this decision for him. I'll continue being his champion and hopefully he'll be wagging his tail again in no time.

Hi Jennifer, your story resembles ours, we also tried over 30 days of conservative last year until finally came to the conclusion with our vet that the pain is not diminishing unless surgery is performed. You did everything according to the book and gave Bandit all the possibilities for crate rest success, but sometimes it is simply not enough - unfortunately; we never know in advance. Now, after the surgery, it is certainly not surprising that he is worse than before the surgery. IVDD surgeries are always quite traumatic on the body and it takes time for the swelling to go down, but this you of course already know. Eventually, you will see improvement and I'm so happy to hear the prognosis is good already now! Bandit seems to be in the good hands of the vet clinic but when you manage to bring him home, do let us know if you have any questions or concerns regarding the post surgery recovery. It can be stressful the first few days, but you'll get the hang of it quickly! Love, Lola

I have gone to Dr Hampel for years although never for this type of thing. She is by far my favorite vet and surgeon in SD. The prices ate always really fair and i live near the clinic. I really can't say enough good about her I Love her! It's good to know she did his surgery. i thought about taking daisy to her but ended up taking Daisy to a neuro instead. I hope your baby is better soon!

Hi Jennifer,

So glad you now have Bandit back home with you.  There actually isn't a video on how to determine deep pain sensation because only a specialist can determine that.  Bandit already has deep pain sensation if he is flexing his right foot and able to use the other leg as well. 

Some times they refuse to be expressed when bladder control is coming back. It is best to take him out and do the sniff and pee test, even if you have to support him. If you can't use the sling with him, try to support him using your hands.. Another option is putting a pee pad down in front of his crate and setting him on it to  see if he will attempt to use that instead of going in his crate.  Failing that, keep trying to express him.. Contact the vet tomorrow if he doesn't show he can go on his own,  and let them know the trouble you are having with expressing. There are medications they can give him to make him easier to express. 

Has he been shaking or trembling, or any other signs of pain, other than anticipating pain?  If so I would give him the Tramadol and Gabapentin 3 times a day to keep pain under better control.

Nerve functions return in this order:

There is no timetable anyone can give you when to expect nerve repair to happen. In fact, there is no time limit for nerves to heal...it can take weeks to more like a year or even longer. However, it is known that neurological function usually returns in the reverse order of the damage. The first big sign you want to look for is that wonderful tail wag!
1. Deep Pain Sensation (Only correctly identified by a specialist.)
2. Tail wagging with joy at seeing you, getting a treat or due to your happy talk.
3. Bladder and bowel control proved by passing the "sniff and pee" test.
Take your dog out to an old pee spot in the grass. Let him sniff and then observe for release of urine.
4. Leg movement,<---Bandit is here! and then ability to move up into a standing position, and then wobbly walking.
5. Being able to walk with more steadiness and properly placed paws.
6. Ability to walk unassisted and perhaps even run.

Hi Jennifer!

Great news about Bandit having bladder and bowel control!  You are starting to see some wonderful improvements!  All signs that some of the surgical swelling is starting to go down.

They do allow PT with dogs after surgery so ask your surgeon what PT they recommend and when it would be best to start.. It is a great sign that he is regaining his strength and attempting to stand.. Limit his dragging so he doesn't hurt himself so soon after surgery.. PT is more controlled as the vet will tell you what exercises he can do safely under your supervision.  In dragging he could move wrong and undo some of that healing he is accomplishing.

I am so excited about his progress!