Sian & Book
New Member
MALE- Maltese-Poodle mix
Posts: 10 
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Post by Sian & Book on Oct 24, 2017 9:47:01 GMT -7
Hello! I'm grateful to have found this website/forum.
There was no event that I am aware of that started it. On the afternoon of Sat., 10/14 my dog started walking funny. By that evening he wasn't able to walk at all. I thought it was a reaction at first to a new flea medicine I had given him earlier that day, but it turned out to be a ruptured disk. He had surgery on 10/15 by a neurosurgeon vet (ACVIM neurology).
Here is his information:
Name: Book (Shepherd Book - named from a character in the show Firefly).
Breed: Maltese-Poodle mix, 15 lbs. He is about 5 years old (a rescue, so not sure)
Medications: he's been giving prednisone for 3 weeks, tapering. First week was every 12 hours. This week it's 1 every 24 hours and next week it is one every 48 hours. He had a patch for the first few days coming home, but now he's on Tramadol. He gets 1/4-1/2 pill (50mg pill) every 8-12 hours as needed. I've been giving him 1/2 pill for the last few days every 8 hours and plan on tapering off a bit. My dog doesn't yelp or whimper, so it's hard to tell if he's in pain. I have seen him shake a little, but wasn't sure what that was from. With the prednisone, I also give him 1/6 a pill of bismuth subsalicylate/Pepto Bismol (1 pill=262mg). Is Pepcid AC better?
Currently his back legs are paralyzed and he cannot pee or poop on his own. I noticed yesterday that he is starting to move his back right leg a bit. Is that normal that one leg recovers first?
My biggest challenge is expressing his bladder. I think I'm doing it, but not sure I'm doing it enough. I notice that he tenses up when I express and it either comes out in a short whizz or he doesn't do it at all (or I missed the bladder). I wonder if he has partial control. This morning he seemed to pee a bit easier and I wondered if maybe he was doing it himself - his body was much more relaxed. But I couldn't get much out after the first whizz.
He doesn't yip, wimper or turn to me when I do it, so I don't think he is in pain. He does sometimes try to walk away, though (gets squirmy).
I made a sling for him that I use to test if he will pee or poop on his own (we don't walk, I just use it to hold up his rear for a bit). Is that ok?
I noticed that he also has started to get a little restless, trying to stand or scoot. He's in a pen (when I'm home - near me in the living room) or in his crate (at night, when I'm not here). He is crate trained so doesn't mind it. One question: should I put water in with him at night (I have been, though he doesn't seem to drink much if at all)? I had been getting up in the middle of the night to express him, but didn't last night for the first time and he seemed fine.
How can I tell if I'm expressing him correctly? I can't seem to tell if I've got the bladder or not. It's so frustrating!
Should I encourage attempts to stand?
I've made a bed for 2 1.5 memory foam pads - is that too soft? Should I use just one?
Have you ever expressed a dog and there was only one or two pee spots? I keep trying but nothing comes out. He occasionally has a pee spot on his potty pad, but, for example, last night there was none (and he went 8 hours!). I've been back to the vet twice to get training on expressing (so 3 lessons). One vet tech was great, but the other was rather unhelpful.
He does seem to be eating ok - occasionally won't eat right away, but overall he has been. And pooping - normal firm and color. Drinking comes and goes.
I have lots of little questions. I'm just so concerned whether or not I'm doing it right and getting him what he needs.
Any advice is appreciated.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Oct 24, 2017 10:21:23 GMT -7
Sian, welcome to Dodgerslist. First thing is to STOP the Pepto Bismol! It is an aspirin derivitive and should not be given with a steroid such as prednisone. www.peteducation.com/article.cfm?c=0&aid=3016 We are glad you’ve joined us on the support Forum ! While we are not veterinarians, we have lots to share with you. Our main goal is to help you become educated about IVDD so you can better work with the vet you’ve hired, protect your dog and give proper care during this episode, but also to be able to live many happy years ahead with the disease your dog was born with. Knowledge, is indeed, the power to fight this IVDD enemy and win! Bookmark so you can read the valuable info in the next days at the main Dodgerslist website: “All Things IVDD” page: www.dodgerslist.com/healingindex.htm GI tract protection with prednisone should be the antihistimin, Pepcid AC (famtoidine) as long as your vet says your dog does not have heart, liver or kidney issues. The usual dose during a disc episode is Pepcid AC (famotidine) for dogs is 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 Order of neuro function return is usual in the reverse order of the nerve damage. Usually bladder control will return before leg movement, but not always. Let us know what you observe during the sniff and pee test. 1. Deep Pain Sensation (Only correctly identified by a specialist.) 2. Tail wagging with joy at seeing you or getting a treat or meal. 3. Bladder and bowel control verified with the "sniff and pee" test. 4. Leg Movement, and then ability to move up into a standing position, and then wobbly walking. 5. Being able to walk with more steadiness and properly place the feet. 6. Ability to walk unassisted and perhaps even run. More info: www.dodgerslist.com/literature/healingnerves.htmSNIFF and PEE TEST. 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 pee spot to sniff it. See if urine is then released. 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, bladder control is returning. You should do a quick express check to verify there is full voiding until you are certain it is consistently happening. When bladder control begins to return the dog may be so cooperative with you. Refresher tips on expressing the bladder and how to express for poop: www.dodgerslist.com/literature/Expressing.htmWhat was the surgeon's directive for the number of crate rest weeks which include all the PT that he has also directed. Let us know which of these post op exercises your surgeon has directed for a dog with paralyzed legs.
MEMORY FOAM is excellent for the recovery suite -- 3 inch height foam is good. Have you setup the mattress system in a trash bag as suggested in our tips list? Here is the link to the rest of the details of that tip plus many other good ones: www.dodgerslist.com/literature/cratesupplies.htmThe signs of pain are what you want to monitor during the usual 2 weeks it may take for all the surgical caused painful swelling to subside. Seeing more than one signs of pain can also help to confirm. Shivering can be pain, cold, nervousness for example. Signs of pain: ◻︎shivering-trembling ◻︎yelping when picked up or moved ◻︎slow to move ◻︎tight tense tummy ◻︎arched back, ears pinned back ◻︎ head held high or nose to the ground. ◻︎ restless, can't find a comfortable position ◻︎slow or reluctant to move much in crate such as shift positions ◻︎ not eating due to painful chewing or in too much overall pain
◻︎not their normal perky selves Look forward to learning more about Book with your answers. |
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Sian & Book
New Member
MALE- Maltese-Poodle mix
Posts: 10
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Post by Sian & Book on Oct 24, 2017 14:37:06 GMT -7
Thanks for the tip on the pepto bismol! Oops, I guess I got it mixed up with pepcid AC. I'll go get some.
As for peeing, I'm a little confused. He has been sniffing around the last couple of days when I set him down on the grass (I got to the same spot). But I don't think he would go if he wasn't being held upright. You said "Make sure the sling or your hands are not on the tummy area as that can press on the bladder." How would you suggest holding him upright for peeing? Today I held him upright and went to express him and it went longer and easier than in the past (almost as if he did it himself). I was afraid to stop pressing (not hard) as I didn't want the stream to stop, lol.
I have an appointment about 3.5 weeks after surgery with the surgeon and he said he would prescribe PT then, depending on how Book is doing. He said he expected/hoped Book to at least stand by then. He gave Book at 75% chance of full recovery. He said that his injury is lower down on the back than he usually sees which makes it a bit harder to predict how he will do.
Yes, I have set up the foam mattress as you suggest. It works great!
Thanks for the tips about pain - it's still a little hard to read on him, but I'll keep at it. Is the dosage for his pain meds pretty normal? I've been going with 1/2 every 8 hours for now, but will try to draw that out a bit then start cutting back on them over the weeks. How long do dogs usually need pain meds?
Sian
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Post by Romy & Frankie on Oct 24, 2017 15:13:45 GMT -7
It can take up to two weeks for most dogs to recover from the pain of the surgery. If you suspect Book is having pain, then give him the 25mg of tramadol every 8 hours. Some dogs don't show pain easily, but you know your dog best and if you think there is pain there probably is.
It sounds like Book is beginning to regain bladder control if he sniff and tries to pee. He may need support and stabilization to help him go. During the time that my Frankie was regaining bladder control, he could not squat either. What I did was take him out and kneel down and hold his back legs while he was going so as not to press on his stomach. I admit this was sometimes a bit messy. His legs were not strong at that point and his back legs would slowly sink down so he definitely needed help.
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Post by Michelle & Keira on Oct 24, 2017 22:34:35 GMT -7
Hi Sian,
Our dog had this surgery just yesterday, but also had it back in February 2017.
In regards to your question about one leg recovering quicker than the other - this happened for us with our first surgery. One leg started to be able to scratch her ear etc, whilst the other didn't do much. Within a few days both legs were then responding and showing little movements.
I assume you have some physio exercises to do at home? When doing them, over time you will feel his legs very slowly getting stronger as the muscle tone starts to fire up again. This is a process you have to be so patient with, but once you see improvements it is amazing to see how they can build back their strength.
For the first few weeks after surgery, whilst dog is either not walking or still wobbly, I would think you will need a sling under his rear torso to help support him. His spine needs to be supported and cared for whilst recovering.
I wish you and Book the best of luck for a speedy recovery.
Take care,
Michelle
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Sian & Book
New Member
MALE- Maltese-Poodle mix
Posts: 10
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Post by Sian & Book on Oct 25, 2017 8:31:27 GMT -7
Thank you Romy and Michelle for your advice and support!
I haven't been given any exercises by the doc yet. He said he would recommend some after his time of rest. Normally, do you get exercises? I can ask him - it might be that because it is lower on his back, he doesn't want to jar it or something.
I do have a sling for him and put it on him periodically to help him, but he hasn't really used it either to move or to pee/poop. He just stands there. I'll keep trying it tho.
How much time do you spend expressing your dog? I have been spending about 15 minutes - stop and go. Sometimes he goes easily and other times not so much. Sometimes he needs to poop and that can take a while. I'm single and live in an apartment. I'm lucky that I have a flexible (but intense) job, but it's been exhausting with the worry and trying to figure out his schedule. I've been able to figure out something of a set schedule. It will get easier when he's off pain pills and can express himself, for sure. I have next week off, too, which will help.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Oct 25, 2017 9:31:24 GMT -7
Sian, I would ask your surgeon if Book can now do some of the exercises shown in the post-op PT video in one of my past posts. The reason is appropriate physical therapy can help maintain the muscles with lost nerve connection. Therapy keeps muscles in optimal condition while in wait to receive regenerating axon terminals. Also the range of motion exercises are to keep the joints flexible and not freezing up for the day when Book is able to move his legs on his own. Normally post op range of motion and massage is Rx'd to begin right away at home.
Once you are able to get a happy tail wag when you specifically do some happy talk or wave a yummy treat, then you would predict that bladder control will be the next neuro function to return. When you identify a happy tail wag, you would then periodically every other day take him outside for the sniff and pee test. Until you get a happy wag then just express his bladder inside the apartment. You can express on a pee pad. IF you have a good traction mat in the shower stall floor, you can express there.
While on pred you would expect to express every 2-3 hours. When off of pred then expressing can go to every 4-6 hours and maybe 8 hours. Your proficiency in fully voiding the bladder at each session will extend the length between exprressing. When first learning we don't always fully void the bladder hence having to express more often as the bladder fills to the top sooner.
SNIFF and PEE TEST
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 pee spot to sniff it. See if urine is then released. 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, bladder control is returning. You should do a quick express check to verify there is full voiding until you are certain it is consistently happening.
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Sian & Book
New Member
MALE- Maltese-Poodle mix
Posts: 10
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Post by Sian & Book on Oct 25, 2017 14:47:51 GMT -7
HI Paula, I got some Pepcid today, so I'll start giving him that.
My pup was never a big tail wagger, but I'll look for something. Here's what I'm noticing on the expressing:
When I first started expressing it would come in spurts - press, then some would come out, wait for about 15 seconds and repeat. Generally I could get him to express. I would find on occasion, though, pee spots on his puppy pads under the fleece where he was laying. This is what got me worried that I wasn't doing it well enough (I took him to vet twice because of this).
Starting yesterday, I noticed that his "expressing" is easier. I barely press on the bladder and it comes out in one long whizz, like he would when peeing. When I wait 30 seconds and try again (and I do this multiple times) I can't get anything to express. And now he has no pee spots on his puppy pads.
So I'm wondering - does he have partial or some bladder control? He does sniff around when I put him on the grass, but he doesn't seem to go until I apply some gentle pressure (barely at all), then it comes out very easy. I haven't seen his tail wag, but it does go up when peeing or when pooping. Maybe it's all in my head, but I thought I'd see if anyone else had this experience. I'm just happy he's able to go! :-)
Sian
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Post by Romy & Frankie on Oct 25, 2017 15:01:53 GMT -7
It may be that he is beginning to regain bladder control and he just needs some help getting started but he is not there yet.
The tail moving when peeing or pooping is reflex. What we are looking for is the tail wagging in response to something that makes Book happy, like you talking to him or maybe a treat. Keep an eye out for this as this usually precedes bladder control.
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Post by Michelle & Keira on Oct 25, 2017 17:24:39 GMT -7
Hi Sian,
Yes I agree with Paula and would suggest calling your surgeon to enquire about starting physio.
Our surgeon started physio the morning after surgery, and they did physio every 4 hours over a 24 hours period. My dog has just been discharged home this morning, and now I am to do physio at a minimum of 3 times per day, but they said if I have time to do so every 4 hours. In saying that though they also suggested if she seems to be in any pain or discomfort from doing the physio, they would recommend spacing it out a bit more. No need to do physio overnight, so you will get some sleep! Just do it first thing when you wake up, and make sure you do one just before bed.
Your surgeon also may be able to recommend a dog physio for you, they will guide you through it and every so many weeks update your exercises as your Book's strength increases.
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Sian & Book
New Member
MALE- Maltese-Poodle mix
Posts: 10
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Post by Sian & Book on Oct 30, 2017 18:10:39 GMT -7
Woot! Tonight when I took him out to pee at one point he kind of lunged forward and walked a couple of wobbling steps before I could stop him. I know he's supposed to be on complete bed rest until I see the doc on the 19th. I have a harness for his legs (to lift him up) and a harness for his back. Any advice about keeping him inactive, when he wants to walk?
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Post by Sian & Book an hour prior
OK, so I think his tail is wagging a bit. LIke I said, he's not much of a tail wagger for emotion, but I swear I've seen it move - and I think he wagged a bit when I went to take him outside for his pee. Also, when I touch it, it flicks. Is that a good sign?
As for peeing - he seems to be "fighting" me a bit. I know I'm hitting the bladder and he doesn't go.Then when he does go, he goes in one long stream, vs. before. So I think he has some bladder control. oi! I keep hoping I'm not reading into all of this, but the signs seem hopeful. He definitely is more alert and wanting to be active. I also see his back legs (especially the right one) pushing him up a bit, when he's sitting or trying to move around in his pen/crate. I so wish this was faster, but I'll take any little thing!
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Post by Pauliana on Oct 30, 2017 21:57:23 GMT -7
Carry to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog's back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. www.dodgerslist.com/literature/slingwalk.jpgAn ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on! I agree that Book might be ready for some physio.. Please discuss with his surgeon. |
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Sian & Book
New Member
MALE- Maltese-Poodle mix
Posts: 10
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Post by Sian & Book on Nov 3, 2017 10:06:03 GMT -7
So here's an update:
1. I spoke to a Vet Tech. They are ok with me doing some physical therapy with him now.
2. He's walking wobbly! After starting to despair, he up and walked about 6 feet. I even have video, lol. He can move both legs, and is very wobbly, but he is doing it. Woot!
3. The weird thing is this (and I'm hoping for some advice): He is still not peeing on his own. The Vet Tech thinks that he's gotten used to me expressing him and so is waiting for me to do it. The recommended that I just "out wait" him. He does sniff around him when I put him down on the grass, but doesn't make a move to pee (he will sometimes poop tho deliberately outside, though sometimes it falls out of him inside too). I'm going to try getting him a rather full bladder today and hopefully that will do it. I do have a front harness on him now. I do have a sling, but he just stands there and doesn't move when I put the sling on him. I've tried waiting him out or nudging him to move and he won't budge. Sigh. Have you seen this before and have any advice?
4. Medicine-wise, he is down to 1 prednisone every other day (4 more treatments) and I just give him 1/4 pill during the day of the Tramadol, weening him off the pain killers. The Vet Tech thought I could stop altogether, but I'm going to take it down in increments, just to be safe. He seems fine tho.
Thanks for all your support. I hope your pups are doing well!
Sian
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Nov 3, 2017 10:30:49 GMT -7
Sian, if a dog can control his bladder then he surely would not be waiting around with an uncomfortably full bladder til someone came to express him! Sian, it seems is not following the exact classic textbook order of nerve function return. So just keep allowing him to first do the sniff and pee thing every 4-6 hours now that pred is every other day. If nothing, then you express. You can also express for poop, just to avoid anxiety of his finding poops where he sleeps: www.dodgerslist.com/literature/Expressing.htm#poop |
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Sian & Book
New Member
MALE- Maltese-Poodle mix
Posts: 10
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Post by Sian & Book on Nov 3, 2017 18:39:59 GMT -7
He peed on his own tonight! Woot! He got up, wobbled around and sniffed and then wobbled and peed at the same time. I dont' think I would ever be so happy to have my dog pee! :-D
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Nov 3, 2017 18:42:56 GMT -7
Sounds like some funciion may be beginning to come back. Did you do a quick express check after he released urine. You'd want to do that til you are satisfed that he can fully void the bladder on his own each time.
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Sian & Book
New Member
MALE- Maltese-Poodle mix
Posts: 10
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Post by Sian & Book on Nov 9, 2017 21:36:28 GMT -7
So Book got his first check up today and the Vet was thrilled at his progress. He is now off the VERY strict bed rest and is now on the semi-strict bed rest. HE can be out of his crate/pen when I am around - no climbing, jumping, etc. Still needs to be carried out to pee. After one month I can take him on short walks. He's off his meds (just one more prednisone) and peeing on his own for the last week.Now I realize I need more rugs as he kind of slips around - which can't be good for him. And I need to get a ramp for my bed - it's pretty low down to the ground, but still high enough. Do you have any advice on which brand is good? Sian  |
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Post by Pauliana on Nov 9, 2017 21:51:20 GMT -7
Sian, delighted to hear about how well Book is doing after his check up! We have several rugs and rug runners scattered around to give Tyler traction. He had his surgery just under 5 years ago... Here are links relating to ramps and a couple relating to training on how to keep them from jumping and training 4 feet on the floor.. Hope these are helpful to you and Book. dodgerslist.boards.net/thread/867/ramps dodgerslist.com/literature/ramptrain.htmSit not jump : 4 feet on the floor: |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Nov 10, 2017 11:13:07 GMT -7
Sian, congratulations on Book's graduation to a slow and incremental re-introduction to family life again! The links Pauliana gave to train for ramps and 4 on the floor are good ones! Lots more very good idea in this "Crate rest is over, now what?: article www.dodgerslist.com/literature/AfterCrateRest.htmNow is the perfect time if you haven't already to make those home modifications so that you can reduce the stress on the spine in the future such as blocking furniture all together. Many ideas and more are in this link: www.dodgerslist.com/literature/protectback.htmWould you consider helping another trying to make decisions… We have a directory where you can share surgical info. Here is the link you can share your dog's info: dodgerslist.boards.net/board/10/guidelines-posting State: Hospital: Address: Cost: Date of surgery: What was included in cost (MRI?, days stay, ER? PT? meds for home, sling, etc.) Comments: |
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