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Post by Katie & Bella on Dec 31, 2014 1:15:13 GMT -7
My corgi Bella had IVDD surgery 12/26/14. She had deep pain sensation in her rear toes before surgery and has deep pain sensation post op. I know this will take time, but I have two concerns. She isn't sitting up using her front legs. Before surgery even though she had lost use of her back legs, she could still sit by pushing up with her front legs. Now all she does is lay there. When we take her out to potty she doesn't even try to take steps with her front legs when being supported by a sling in the rear. Is this normal 4 days post op? Also, she is on prednisone and the vet told me she would pant often because of the steroid, but Bella is panting constant, almost not even able to rest. She seems in pain to me but doc said she didn't need any more pain meds. Could she just be anxious over nonuse of her legs? I'm worried sick about her. I'd love to hear advice and personal experiences. Thank you:-(
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Dec 31, 2014 6:09:12 GMT -7
Welcome to Dodgerslist. We are really glad you have joined us. I can tell you one of the most important things you can do for your dog is self-education about the disease your dog was born with. Knowledge is to make sure the right things are being done for best recovery. And for yourself, knowledge lets you step out of a very scary place…"the unknown" and the toll it can take on emotions. There is no better place to start than on our "All Things IVDD" page at t his link: www.dodgerslist.com/literature.htm Great tips of setting up the recovery suite, supplies to make crate rest go smoother. Not wanting to move is a sign of pain. Has she been like this since she came home or has this just developed? I would strongly advocate today for pain meds. Bella's on no pain meds at all? Swelling pressing on the nerves of the spine can take 2-4 weeks to resolve and can cause pain - Bella should have been sent home with pain meds. Panting can be a sign of pain, too. Panting can also be a side effect of the meds or anxiety. A fan near but not pointed at the crate will help. Also a rice sock from the refrigerator can help them cool by laying their tummy along side of it. Fill a sock with 1-2 cups of rice and tie the end of the sock closed. Try a frozen broth ice cube to lick on. If a fan helps, then it is most likely a side effect of the meds. But since there is a second sign of pain - not wanting to move - I would definitely speak to your vet today about adding pain meds. In order get a better idea where your dog is post-op, could you please answer these questions? ▷ What is your name? ▷ Are you now doing 100% STRICT crate rest 24/7 only out to potty and for surgeon directed PT? …. No laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No chiro (aka VOM)? What did your surgeon direct for PT and for crate rest? ▷ How much does your dog weigh? Please list the exact names of meds currently given, their doses in mg's and times per day given? What was the start dose if a steroid, date of taper? Please include the all important stomach protector such as Pepcid AC. Phrase the question to your vet this particular way:" Is there a medical/health reason for my dog not take Pepcid?" If there is no reason, we follow vets who are proactive in stomach protection by giving doxies 5mg Pepcid (famotidine) 30 minutes before the anti-inflammatory. ▷ Currently can Bella move the legs at all? or wag the tail when you do some happy talk? ▷ Can your dog specifically sniff and squat and then release urine or do you find wet bedding or leaks on you when lifted up? Are you expressing her bladder? If so, how often do you do that? ▷ Eating and drinking OK? Poops OK - normal firmness & color -no dark or bright red blood? If there is pain or neuro diminishment, dogs can benefit greatly with acupuncture or laser light therapy. These therapies can be be started right away to help relieve pain and to also to kick start energy production in nerve cells to sprout. So if this therapy is in your budget, seek out a holistic vet. ahvma.org/Widgets/FindVet.html www.serenityvetacupuncture.com/index.php/faq_/ [one vet's overview/prices] Chiropractic is not recommended for IVDD dogs. I'm going to tell you about a disease called Myelomalacia, just so you have the information available to you, though I'm hoping very much that the reason Bella isn't sitting up on her front legs is due to pain and not Myelomalacia. The cause of Myelomalacia or how it progresses is still unknown. It is important that owners are also familiar with symptoms in order to promptly get vet help at any hour of the night or day. Although Myelomalacia was thought to be rare, we are finding that perhaps it is not as uncommon as once thought. Many vets have never observed a case of Myelomalacia so you might want to print out the symptoms listed below so you can discuss and have a plan. With Myelomalacia, what happens basically is that the spinal cord starts to die from the point of the spinal cord trauma moving forward toward the head. It is very painful and it will eventually shut down breathing. Here are some of the symptoms that are used to diagnose Myelomalacia and the symptoms that evolve as it progresses. It can happen fast, within hours. Should your dog be developing myelomalacia, before difficulty breathing starts, you would want to help her cross to the rainbow bridge to spare a very painful death. Deep pain sensation nor leg function not returning right away alone are not a symptoms of myelomalacia. Myelomalacia can be easily confirmed by your DVM with the following: * about 3-4 days into recovery, they become painful. Within the first week, they are in a LOT of pain. * development of excruciating pain (more than just pain from the original disc herniation) • even the strongest pain meds do not help • once the symptoms begin continued death of the spinal cord happens fast.. in a matter of hours, requiring prompt ER vet help and prevent suffering that will only end badly in death. • hyper-esthesia (over-reaction to any touch sensation on body) * acute disc extrusion with no deep pain sensation * loss of anal tone, the anus hangs open, (anal flaccidity) and areflexia (below normal or no reflexes) * loss of cutaneous trunci reflex at a level more cranial to a previous evaluation over a period of hours to days with or w/o surgery * development of fever (normal rectal temperature is 100.5 to 102.5 degrees Fahrenheit) * sudden twitching or jerking of the neck and/or head * loss of voice, hoarse bark * can't hold body up, can't hold head up * increased respiration/ labored breathing as the nerves to the lungs begin to shutdown • On an MRI, extensive high T2 signal (brightness) within the spinal cord (>6 vertebral lengths) has been associated with myelomalacia in the setting of a disk extrusion. www.dodgerslist.com/literature/myelomalacia/3t-myelo-misdxb0002.tifMore on Myelomalacia: www.dodgerslist.com/literature/Myelomalacia.pdfI'm hoping and praying that M is not developing but just having a hard time getting pain under control. We anxiously await hearing back on what the vet says. |
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Post by Katie & Bella on Jan 1, 2015 21:33:09 GMT -7
My name is Katie. Yes Bella is on strict crate rest. She is only taken out of the crate to change bedding and to take her outside. She has to be carried because she is not walking at all. She weighs 33 pounds. I have to say when I read about myelomalacia I got very worried. My vet put her on pain meds yesterday. She took her temp and she did not have a temp. She is able to hold her head up she just can't sit all the way up yet. She has not had a bowl movement since yesterday at the vets office. She is eating and drinking just fine and sees the vet again tomorrow morning. My real concern for her is the myelomalacia since she seems to be having labored breathing although she has been this way since bringing her home on Tuesday night. Tomorrow will be 7 days since her surgery. She is on prednisone and started the first day of the "every other day" dosage of that. She is on The muscle relaxer Diazepam and she started Buprenorphine as a pain reliever yesterday. She has a recheck tomorrow. I'm so afraid she could suffer from this disease that I can hardly sleep. Any other thoughts or suggestions? Should I wait until tomorrow morning to take her in, or should I take her to the emergency vet?
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Post by Pauliana on Jan 1, 2015 22:06:06 GMT -7
Hi Katie,
It's a good sign that she is eating and drinking well, has no fever and can hold her head up. Prednisone can cause panting and Diazepam, instead of relaxing some dogs, it can cause the opposite effect of anxiety and over excitement. I am hoping that is what the problem is instead of Myelomalacia.
What are the dosages and frequencies given of the Buprenorphine. Diazepam and Prednisone?
If she develops a fever, dogs with M are in so much pain, they are hyper sensitive to touch and the pain meds don't work for it. It would be very obvious that she is in agony. If she develops those symptoms, take her to ER.
If Bella's pain seems relieved on the Buprenorphine and I hope that is the case, I would skip the next dose of the Diazepam and see if the anxious panting stops.. Discuss this with your Vet in the morning..
Try to get some rest and I hope Bella rests well too tonight.. Prayers headed your way..
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Post by Katie & Bella on Jan 2, 2015 1:44:24 GMT -7
I want to thank you for listening and giving your insight. Bella's dosages are: 33 lbs
Prednisone 1 - 5 mg every other day for three days. She got one yesterday and will get her next one on 1/3.
Diazepam 1/2 of a 5 mg tablet twice a day
Buprenorphine 3 ml syringe on mucas membrane every 8-12 hours. Bella is needing it every 8 hours.
The Buprenorphine really seems to help for sure. She sleeps so good after that though she is still breathing fast. It's 2:30 a.m. And she woke me up drinking water on her own in her crate. Another good sign I hope |
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 2, 2015 6:39:48 GMT -7
I'm glad that your vet has prescribed a pain med and that it helped Bella sleep, Katie. I hope you had some sleep, too. I know how frightening the thought of myelomalacia is as they were fearful of it after my Jeremy's surgery because his spine was purple from bruising during the surgery and I lost sleep too but he was fine. I just wanted to make you aware of it so you know what to look for. I know it's easy to say but try not to worry about something that may not happen.
Did you hold back on giving the Diazepam as Pauliana suggested? Did that help with the heavy breathing? If so, speak to the vet about giving something else to calm Bella down. If the Diazepam is being given as a muscle relaxer due to muscle spasms and not as a sedative, then Methocarbamol works very well on the pain caused by muscle spasms.
Do you know if the Prednisone dosage is being tapered from an original dosage given in the hospital? The dosage of every other day sounds like a taper dosage. Since it may be that Bella is still in pain, a taper of the Prednisone should not be done at this time. Pain would indicate that there is still swelling pressing on the nerves of the spine causing pain and therefore, an anti-inflammatory dosage of the Prednisone would still be needed. We usually see an anti-inflammatory dosage of Prednisone prescribed of 5 mg 2x/day.
Pepcid AC should be given to protect your dog from the excess acid produced by the anti-inflammatory. Serious gastrointestinal toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms. Please get your vet's permission to give 5 mg of Pepcid AC (generic is famotidine) 30 minutes before the dose of the anti-inflammatory and thereafter every 12 hours. Phrase the question to your vet in this particular way: "Is there any medical reason my dog may not take Pepcid AC?" If your vet says your dog has no health issues such as liver, heart, etc to keep her from taking Pepcid AC, then do get it on board for as long as she's on Prednisone.
I hope the follow-up visit with the vet goes well today. Please let us know what the vet says after your visit and how Bella is doing today. Continued prayers. And hugs to you.
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Post by Katie & Bella on Jan 2, 2015 15:34:51 GMT -7
Well you were so right. I didn't even have to ask about the prednisone dosage. The specialist that did the surgery is the one that had tapered Bella's prednisone dose. So the visit today was my regular veterinarian checking up on her since the specialist is a 2 hour drive. My regular vet said exactly what you did. She said that Bella is still painful so backing off of the prednisone right now was too soon. She prescribed her a dosage of
5 mg pred twice a day for 5 days then 1 tablet once a day for 5 days then every other day for 7 days. She also automatically prescribed her with
10 mg of Pepcid to be taken 30 minutes prior to her prednisone pill.
She is still taking the pain meds and the muscle relaxer. She seems more alert every day. My vet also said that she believes that all of the panting is the prednisone because when Bella first had signs of a back problem when she was 1 year old we used prednisone to treat her and it was in her chart that she seems anxious on it. So she said not to worry. Bella also showed pain sensation in her left rear toes and anal puckering which she said were all good signs. The doc also did a rectal exam and Bella screamed and screamed which means she felt that too. She is using the bathroom on her potty pads in her kennel all on her own so I am not needing to express her. So this all seems like a positive move. I'm
Putting the meylomelasia in the back of my mind. Like you said why worry about something that hasn't happened. Thank you again for being a wonderful sounding board for me!!
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Jan 2, 2015 18:35:05 GMT -7
Pred can cause panting, you might see if any of these ideas help. --use a fan near crate but not pointed at the Belle. -- Frozen rice sock to lean against: Fill a sock with 1-2 cups of dry rice or dried corn kernals. Knot the end. Try a frozen broth ice cube to lick on. Dr. Isaacs discusses this issue: www.dodgerslist.com/neurocorner2/panting.htm |
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Post by Katie & Bella on Jan 3, 2015 21:01:48 GMT -7
Well the adjustment of meds sure seems to have drastically improved Bella's overall demeanor. She seems to be resting much better and isn't panting as much. I take her back to the specialist (a 2 hour drive from our home) on Wednesday to have Bella's sutures removed and for him to check her out. I have to say she has pain sensation in her rear feet, but I'm still not sure why she isn't at least pushing herself up with her front legs to sit. All she does is lay on her stomach and lift her head every now and then. Is that normal?
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Post by Pauliana on Jan 3, 2015 22:49:36 GMT -7
Hi Katie,
I don't know the extent of his disc herniation/surgery , can you fill us in on that? Each dog is different on how they heal and the extent of each injury is different so there is no set normal. It could be it hurts to move so she is just laying there in the most comfortable position for her. What did the Vet you just took her to say about Bella's condition? I would ask the Surgeon about that when you take Bella on Wednesday.
One thing to remember is it takes at least 2 weeks for the swelling from the surgery to go down and after that you should start to see some improvements..
Tyler did a lot of sleeping after his surgery but he did sit up and move around.. I would quiz the Surgeon and ask more about the actual surgery and see what he has to say.
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Post by Katie & Bella on Jan 3, 2015 23:45:29 GMT -7
She had a herniation between T12 and T13. The surgeon said he had to remove quite a bit of disc material. I will definitely ask more questions on Wednesday when I see him. As for my regular vet she says that we just need to give it time. It's way too early to make any judgments on how she is progressing. I have been reading quite a bit about other dogs experiences and not many folks mentioned that their dog wasn't even sitting up so I just wanted to know your thoughts. I need to just give it time and stop worrying. Bella is acting more and more like her old self every day.
We bought a red wagon for her that we equipped with another orthopedic bed just like what is in her kennel. We take her outside in that wagon to get fresh air and we wheel it right into the living room for her to hang out with the family and she LOVES it. Thanks again for being the voice of reason when I worry so so much. You truly have made a difference in this journey of ours:-)
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Post by Debbie Blackwelder on Jan 4, 2015 7:01:52 GMT -7
Good Morning Katie & Bella, my name is Debbie. I know the word time is hard to hear but trust me I do realize how hard it is having bottle raised a litter of five Dachshund puppies who now three of them have IVDD. My two babies have had three surgeries, two were very successful and one took a little bit more time, so don't give up. My Rooter's last surgery was very complicated and he could not urinate on his on, we had to express and it took him months to stand on his on and walk again. Do you have a sling or have you made one to walk Bella around? Using a leash, towel, or other cloth item in front of the rear legs under the abdomen as a sling is OK. There are slings that you can purchase, but the hope is your dog gets better and there is not a need for a sling long term.
www.dodgerslist.com/neurocorner2/slings.htm
I am concerned about you riding her around in the red wagon right now. She is only 9 days post op and without her being restrained in the wagon anything could happen. I know she can't walk right now but things do change and sometimes quickly. If your surgeon approves this then its ok, but just be real careful. You have come so far with Bella and your sure don't want to do anything to set her healing back, especially for the first two weeks.
Have you subscribed to the Dodger's Digest yet? It is full of great tips on IVDD and has wonderful success stories. It is $8.00 for a emailed web copy and $11.00 for a mailed paper copy. My story is in this issue and it is very good reading for all who have babies with IVDD. Here is the link if you are interested:
www.dodgerslist.com/newsletter.htm
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Jan 4, 2015 10:31:35 GMT -7
Katie, I too share the concern Debbie does about that red wagon. Over the years here at Dodgerslist we have learned from our members and just too many bad things happen with an unsafe recovery suite as dogs ALWAYS do the unexpected. One much more safer idea is to consider is a pet stroller to keep her by your side as you move about the house. www.dodgerslist.com/literature/strollers.htmAnother option is to attach casters to a wire crate to make it mobile available on-line or from your local pet store.  Katie can you tell us a bit more about her neuro functions: -- Have you seen the front legs move at all as she may try to reposition herself side to side in the recovery suite? -- How are the back legs, can they move at all? Do they make any walking motions? -- Bladder function, did the surgeon say specifically that she has bladder control? Most dogs would absolutely abhor releasing body waste where they sleep. So can you tell us that the urine on pads in the kennel is not overflowing by reflex? Does she indicate before urine releases the need to go where you could lift her outside the recovery suite onto a pad near the crate? The only way for us humans to know if there is bladder control is with the sniff and pee test. Carry outdoors, set on an old spot to sniff it when you know Bella should have to go. Does she choose to release urine at the spot? Make sure the sling or your hands are not on the tummy area as that can press on the bladder. If urine comes out after sniffing, that is bladder control. Let us know what you observe. Here are a couple of other options for both a front end sling and rear sling if you determine Bella has bladder control and can be taken outdoors to eliminate. figure 8 sling: www.dodgerslist.com/literature/cratesupplies/Figure8.jpg Gingerlead: gingerlead.com/Walkabout: www.walkaboutharnesses.com/collections/walkabout-harnesses/products/walkabout-back-harnessHere's one you can make from an old sweatshirt www.lyonpuffpetsit.com/htmlslp/sling.htmlNever give up, stay focused, stay postitive and stay strong! NEVER have any patience with pain. Great inspiration to read Travis's storyhttp://www.dodgerslist.com/monthstory/TravisVilardi.htm |
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Post by Katie & Bella on Jan 5, 2015 10:37:45 GMT -7
I so appreciate your concern about the red wagon but my husband or myself NEVER leave her side and it has very high removable sides. I love that there are wheels for her crate and was not aware of that, so I will look into it. I would love to post a picture of her in her wagon for you to see if that is possible. Also, we see the surgeon on Wednesday and he is going to do some neuro checks then, but I can tell you what I have witnessed. Yes she is moving her front legs and moves from side to side. In the last couple of days her tail wags and her left leg moves up and down in conjunction with her front legs when she is excited to see us. There is not much movement from her right rear leg. I'm encouraged to see this from her and she definitely has gotten her personality back over the last several days too. She does get "panicked" right before using the bathroom in her kennel, and then after going she tries to move away from it. My husband and I saw her "panicking" this morning and took her out of her kennel and laid her on a pee pad and she went within 15 minutes. We do have a sling for her, but was asked by her docs not to use it quite yet so we have not done that. I will send an update after her appt on Wednesday. Any other insight to what I reported today? I love the feedback and advice!!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Jan 5, 2015 10:55:05 GMT -7
Did not know your wagon has high rails. Would love to see a picture...how to up load to our photo gallery and then use the addres in a post here: dodgerslist.boards.net/thread/2262/put-dodgerslist-photo-gallery-calendarVery wonderful news about have not just deep pain sensation but also front leg movement and seemingly bladder control. Not enough info yet from you to prove it. The reason is is might feel the bladder pressure and knows she should have to pee, but does not brain controlled use of the bladder to open the sphincter. The bladder when overly full will use reflexes (not brain directed) to open the sphincter. So the sniff and pee test is the gold standard test to know for sure if there is bladder control. Not expressing when a dog has no bladder control is bad for health...invites UTIs and stretches the bladder causing perhaps permanent loss of bladder tone. Can you and hubby hold her up with your hands on thighs/chest but not on the tummy area, so see if she will sniff and then soon right after (not 15mins later) choose (brain invovled) to open her sphincter? Love to hear what the vetsays on wednesday, he should be quite excited! |
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Post by Katie & Bella on Jan 5, 2015 19:18:58 GMT -7
I haven't had a chance to upload a picture of Bella in her wagon yet, but I wanted to write tonight with good news. When I got home from work tonight I took your advice and took Bella out into the yard, held her up with her sling and she started using her front feet to move about and sniff. After sniffing the ground for a few minutes, she peed and had a bowl movement. I was super excited about it. I will post more after her appt with the surgeon on Wednesday.
Ok I got Bella's photo uploaded. For some reason it is turned the wrong way, and I can't figure out how to turn it the right direction. Anyway.....I hope you like the picture. She has a big happy smile on her face in the pic:-)
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 6, 2015 7:21:36 GMT -7
Absolutely wonderful news on the return of bladder and bowel control, Katie! Great sign of nerve healing. She's sure a beauty!  |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Jan 6, 2015 9:36:23 GMT -7
Katie, thank you for the most wonderful update!!! Your vet will really be ecstatic on your proof of bladder control and leg movement. I rotated the picture at the gallery for you: www.dodgerslist.com/gallery/albums/userpics/10002/normal_Katie_Bella.jpgMy concern is the wagon is not a safe place for Bella to recover in as the rails are not high enough. Dogs ALWAYS do the unexpected even ones with paralyzed legs. So do think about quicklygetting her back inside the wire crate, an ex-pen for her protection. She is going is such a good direction of healing, do not want anything to happen to jeopardize her recovery! She is beautiful!!! |
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Post by Katie & Bella on Jan 8, 2015 21:35:54 GMT -7
I understand your concern about the wagon, but I assure you Bella is NOT recovering in it. We have her spending most of her time in a wire crate. The wagon is simply a way to help us move her around to mainly save our backs in the process of taking care of her.
Well she had a great report from the surgeon. He was quite happy with the progress Bella is making. She wagged her tail and kicked all four feet in excitement when she saw him. He was sooo happy to see that. Bella is also no longer using the bathroom in her crate. We take her outside several times a day to potty ad she is getting VERY good at walking using her front paws as we hold her rear up with a sling. He was also very happy to hear of that as well. From here on out he said he is comfortable using my regular veterinarian as his eyes and ears since he is 2 hours away. He gave us some exercises that he would like us to start doing with Bella's back legs to help her maintain range of motion. He said we just need to give it time to see how much of her function she gets back. I hope you find this as good news...... We did:-).
She is back in her daily routine - the same as before her back went out. Her personality is back and she does everything the same as she did before, minus walking on her own. All dogs love a schedule. Bella particularly is a dog that loves for her schedule to stay the same every day so my husband and I feel it is important to give her that and it truly has made a HUGE difference in her emotional state. We will keep you informed of her progress.
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Post by Pauliana on Jan 8, 2015 22:02:35 GMT -7
Hi Katie!
Excellent news on Bella's check up with her Surgeon. I am sure he felt so good about her major improvement! We are all excited to hear that as well!
Thanks for keeping us posted!
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