Jen's Hank 1/21 surgery 4-6wks

Thank you for your response!  I'll try to answer your questions as best as possible.  

The good news is, with some coaching from my regular vet, I've had better success "expressing" him! I'm no pro, but Hank's no longer giving me "the look" that says "mom, what are you hoping to accomplish by squeezing me there??"

Hank went to BluePearl Veterinary Specialists for his two disc episodes in 2015 and was seen by surgeons who treat most of the dachshund disc problems in the region. He is currently a patient of their rehab department and sees a specialist who has been helping him regain coordination using the water treadmill, cool laser treatments and a few acupuncture treatments. Over the weekend when I went there for help expressing Hank, they also did an ultrasound of his bladder.  They say he didn't have any evidence of bladder stones.  When expressed, his pee is very stinky and concentrated.  He just has no desire to do anything.  In light of that, he's not resisting being put on restriction until we can figure out what's going on.  With his prior injuries, he needed trazadone to be content with being restricted.  

Current weight - Currently taking:
14.5lbs
Prazosin - 1mg 2x per day (since saturday when the pee holding started)
Bethanechol - 5mg 2 to 3x per day (since yesterday)
Metacam - [as of 1/17]: 14lb dose 1x per day (since yesterday)
Doxycycline - finished up today, was on it for 30 days for a resistant bladder infection, will be re-cultured next week

Hank is not showing any signs I saw with his disc injuries.  He is not tense (except when he needs to be expressed but then relaxes immediately afterward), he is not showing any signs of pain when I pick him up.  He is not arching his back or holding his head down.  He can still stand on his own for a few minutes when I place his feet and "spot" him.  He had not yet completely stopped 'knuckling under" his back feet but was getting better.

He can still walk on his front legs with me holding him up on a sling when I take him to the yard to inspect his favorite spots. He can still wag his tail.  His ears perk up and he's interested in what's going on when my other doxie barks or he sees someone he likes.  He had not regained the ability to walk without support prior to this latest problem.  He has always been weaker on one side than the other since the last surgery.  I have been concerned that he would injure himself as he continue to make attempts to get up and walk, then have the weak leg fail him. His rehab doc agreed he should be trying to walk since he had regained so much muscle strength and coordination.  

Here's what he's NOT doing since this started last friday:
- He's not trying to pull himself up to a standing position and get places.  He's just laying around. He seems like he doesn't feel well, but is not exhibiting any signs of pain I can discern
- He's not peeing on his own (no dribbling, no loss of bladder control - in fact he seems to be holding it on purpose!)

Let me know what other information might be helpful!  

He first showed signs of a UTI six weeks ago.  It did not responded to clavamox or enrofloxacin so they did a culture and determined he had a resistant bacteria.  They put him on doxycycline which he just finished today.  He's scheduled to get another culture done next week.  They say you have to wait 7 days after stopping the meds.  Believe me, I'm hoping its the UTI and not another disc injury for his sake and mine!

A UTI can make a dog feel pretty crummy that all they want to do is lay around....the burn of a UTI can also make them not want to release urine because it hurts/burns. Does Hank have a temperature?

Recurrent UTIs are tricky for many reasons. It would be good for you to understand the challenges your vet faces and what the current thinking is on dealing with them. Dodgerslist collaborated with Dr. Olby Vet MB, PhD DACVIM (Neurology) in getting information for our IVDD community about UTIs that are difficult to get rid of: www.dodgerslist.com/literature/uti.htm

Do discuss getting a urinalysis tomorrow to see if there is infection present. If so then a urine culture to identify the exact bacteria and the correct antibiotic match.

What is the thinking behind the prescription for Metacam, a non-steroid anti-inflammatory drug?

Whenever an anti-inflammatory is on board, the GI  tract ought to be protected from the extra acids Metacam causes.  Pepcid AC suppresses those extra acids.  Mar Vista Vet reports: Pepcid AC has a very limited potential for side effects, the reason of release to over-the-counter status.  As always it is prudent for owners to know about each med that goes in the dog's mouth.  ttp://marvistavet.com/famotidine.pml  Do FiRST ask your vet if Hank has any health issues to keep him from Pepcid AC.  Find it on your grocery store shelves...same stuff people use for heartburn, etc.

The usual dose is Pepcid AC (famotidine)  5mgs 2x/day 0.44mg per pound 30 mins before the anti-inflammatory and thereafter every 12 hours. Give the anti-inflammatory with a meal as added protection. www.1800petmeds.com/Famotidine-prod11171.html

I'm glad to hear that you're getting an exam done by the surgeon and also the urinalysis.

Anti-inflammatory meds are not pain meds and only work on resolving inflammation. It's best not to self-prescribe meds without an exam and a vet's prescription. If it in fact is another disc episode, by giving Metacam before an exam, you're actually tying the vet's hands as to what he can then prescribe as there needs to be a 4-7 day washout period when switching to another NSAID or steroid. Please do let the surgeon know that you've given the Metacam.

I do hope the exam goes well for Hank tomorrow. We'll be awaiting word after the exam.

Unfortunately Hank has blown another disc. He was so close to getting back on his feet!  He had a CT scan this morning and is in surgery this afternoon.  So we are starting over.  ☹️  He had us all fooled because he wasn't exhibiting any signs of pain and was completely relaxed once his bladder was empty.  We all thought the bladder infection was the reason he stopped peeing and wasn't his happy self. Thanks for all of your ideas and support. Pray he'll at least get back to where he was a week ago and that if he can't, I'll help him achieve the best quality of life possible for us both.  

Jen and Hank

Hank is out of surgery and in recovery.  His doctor said he had a huge extrusion.  I'm going to see him in a bit.  The way I see it, I'm not getting back less dog than I brought in.  He had deficiencies but we were handling it and he was happy. The surgery gives him the chance of a fuller recovery.  Thankfully I have the ability to work from home and an understanding boss.  Thanks for your prayers for Hank! 

Hank is now home from the hospital and resting comfortably.  He looks good and is happy to be home.  Time will tell if he gets function back after this second disc problem in 5 months.  We're basically starting over with crate rest and then restarting rehab.  He has not yet regained the ability to let me know he needs to pee, but his doctor says she's seeing some signs that he's aware when his bladder is full.  I've now been trained how to express him and it's not a big deal now that I know where to squeeze!  Here's hoping he'll be back on track with his recovery by Spring!

jen

HI all-
Hank is doing well after surgery.  He's on 4-6 weeks of crate rest and taking

[14.5lbs]
100 Mg of Gabapentin every 8 hours and a
15 lb dose of Meloxicam once per day.  I can start to wean him off of
Gabapentin depending on his comfort level.  

He is letting me know when he needs to do #2 and just let me know for the first time that he needed to pee.  I took him out on his sling to his favorite spots but he can't yet go on his own.  I expressed him when we came back inside.  He did need to go, so I'm going to take that as a sign that he's becoming somewhat aware when his bladder is full.  I do range of motion exercises with him and he stands up to eat his meals twice a day with me "spotting" him to make sure he's not going to fall.  He seems very happy to be home and is not at all uncomfortable.  I hope to get him cleared to go back to rehab when appropriate. We're essentially starting over, but he's happy and healthy apart from his back end!

jen

His tail wag was back before this latest setback, but unfortunately he is currently wagless. That came back about 6 weeks after surgery last time.  

Jen, who took the stitches out the surgeon or your local DVM vet and observed no deep pain sensation today?

Laser therapy is highly recommended post op and can be started right away. You can read more the research U of FL has done on their post op patients and laser therapy www.dodgerslist.com/literature/healingacupuncture.htm

Do wait until all 5-6 weeks of crate rest have been completed. At that time you will best be able to assess whether investment in a wheelchair while waiting on more nerve repair to take place is money well spent or if seeing indications of bladder control or leg movement then money would be best spent on underwater treadmill therapy.


It takes 2 weeks to make a cart so after graduation you will be starting a gradual several weeks return to physical activity for a couple of weeks anyway....so still time for a cart to arrive should it be needed.

If a wheel chair would be indicated on graduation day, then you will want to purchase one based on the features an IVDD dog requires: www.dodgerslist.com/links/cart.htm

It is still very early days in Hanks's recovery. It is quite possible that he would not need a wheelchair. When my Frankie had surgery, he was paralyzed for several months. What helped get him moving was walking on an underwater treadmill. You can see how this works in the video Paula put in her post.
When Frankie first started this therapy he could not even stand alone. After about a month of 2X a week therapy he began to walk. I don't think Frankie would have recovered anywhere near as quickly without this therapy.

Two weeks post-surgery today.  He's off Gabapentin and much perkier.  Still can't pee on his own, but he's happy.  

Hank visited his rehab doctor on Saturday. She did acupuncture and laser treatment.  She works with his surgeon and also compared his level of function pre/post surgery with what she saw on Saturday.  She said he now has motor function in his right rear leg and she believes he has deep pain sensation in both.  I'm noticing in the past few days he's back to bouncing up and down when his bladder is really full.  He needs me to express him, but he seems to know when he's full.  So small steps forward!

Jen and Hank

Four weeks this Thursday post Hanks second disc surgery in six months. I had to remind myself we are starting over. Still not peeing on his own, but that was at around the 6 week mark following his first surgery. Still not clear evidence if he can feel his feet. Sometimes he shows his doctor he does, sometimes he doesn't. He loves his rehab Doctor so much his priority when he sees her is getting his belly rubbed. Still getting him acupuncture and laser treatment once a week. His surgeon has cleared him for the water treadmill and longer walks on his sling. He's not on any meds, his front end is frustrated and eager to get going again. He sees his back end as a nuisance he's willing to drag across the house if I'd let him (I don't let him). My mind says we've been doing this since September. But like I had to remind myself several times this week...that second surgery reset the clock.