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Post by Maggie&Maximum on Feb 6, 2014 17:55:08 GMT -7
Hi! I have been looking at this site all day today. I am so glad it is here. My name is Maggie and my little 7 year old rescue Maximum came out of emergency surgery last night to remove disc material and clean out a hemmorage near his 3rd vertebrae. King of Prussia, PAWhat is your dog's name? Maximum (Max) -- How much does your dog weigh? 19 lbs--What breed is your dog and did you specifically get a diagnosis of IVDD? Doxie/Pug/Beagle Mix the vet did NOT specifically say IVDD -- What was the date you saw the vet and started 100% STRICT crate rest 24/7? Max had his initial episode of yelping/shaking/pain on 2/4 in the evening. By morning he was wobbly walking. We took him to the local vet and he suggested that his clinical signs did not warrant surgery as he was still waking. He gave us Prednisone, Trazodone, and Tramadol and we were going to follow the conservative method of crate-rest. Sadly on Wednesday morning, yesterday, 2/5/14, we woke up and Max had lost feeling in his back legs. When we carried him out to pee/poo he pooped while sitting there and was not able to pee. We knew something was horribly wrong and even with an ice storm with roads shut down, my fiance drove Max to the vet. They had no power so they held Max there to wait for power to come back on to do the surgery. When we dropped him off he had deep pain sensation in his legs. Later in the day the local vet called and said that his deep pain sensation had worsened and that we needed to come and get him and take him to Penn since they could not do the surgery there with no power. By the time he got there he had lost sensation  He had his surgery last night at 6pm and the vets from Penn said that he is doing well and is feeling a lot better today. He is eating and drinking and nipping at the staff (Max is not so nice when at the vet). He has a catheter in and tomorrow they are going to take it out. She said that since he came in paralyzed, they expected that he would have no improvement yet. Only time will tell. She did say that he was up and walking around in a sling today using his front legs! He is a peppy, funny, little guy. We love him so much and are so scared. She said that we might be able to take him home tomorrow. I am the most nervous about expressing him. I cannot imagine myself doing this correctly. I so want to help my little baby but I am not confident in my ability to do this. What if I mess him up more? Read more: dodgerslist.boards.net/thread/28/introduce-dog#ixzz2salDjkhF |
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Post by Pauliana on Feb 6, 2014 18:24:59 GMT -7
Maggie, welcome to Dodgerslist! You will not mess Maximum up more, you will be fine, trust me. Please read this article and watch the videos on expressing. It will help you get more out of the lesson from the Vet. www.dodgerslist.com/literature/Expressing.htmHow well I know the shock of an IVDD episode! Experienced it with my sweet Tyler. You did exactly the right thing. You took him for immediate care and surgery - Max is one lucky boy! Marjorie's Jeremy also had no deep pain sensation and had surgery. It took weeks before he had the slightest movement in his hind legs. She got him a cart after crate rest was over, but he soon left that behind and was walking. Each dog recovers differently but don't give up hope that Maximum will walk again. Even if he doesn't, he can have a wonderful life. www.dodgerslist.com/index/SDUNCANquality.htmThere is a window of time where surgery is considered to be successful. That window of time is 12-24 hours from losing deep pain sensation (DPS). Even after that window of time, surgery is often successful. The spinal cord is very fragile, the more hours after the window, the less chance of a complete recovery. It would seem that Max lost deep pain sensation sometime late afternoon, early evening and he had the surgery the same evening, so it would appear to me as though you did have the surgery in time. Max will need 6 weeks of crate rest following surgery so you can see at that point how he's doing. Laser therapy and acupuncture can be helpful in getting the nerves to regenerate and can be started right away. www.dodgerslist.com/literature/healingacupuncture.htm And water therapy is great, too, after the stitches are out. www.dodgerslist.com/literature/watertherapy.htmHere's Dodgerslist page about what to expect discharge day. www.dodgerslist.com/literature/surgery.htm#dischargeHere is a list of questions to ask on discharge day, too. www.dodgerslist.com/literature/dischargequestions.htmAlso these two pages would be helpful for you to read: www.dodgerslist.com/literature.htmwww.dodgerslist.com/literature/healingsurgery.htmBe sure to get his recovery suite ready for his home coming. Here are some links to show you how: www.dodgerslist.com/literature/CrateRRP.htm www.dodgerslist.com/literature/cratesupplies.htm www.dodgerslist.com/literature/EmergencyCrate%20Training.htmHang in there. You've done exactly what Max has needed so far. And we'll be here to help you through the rest of it. So take a deep breath and spend the time while Max is in the hospital to rest up and do lots of reading on IVDD. Blessings to you and Max and prayers for a speedy and complete recovery for him. |
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Post by Maggie&Maximum on Feb 7, 2014 20:57:24 GMT -7
Thank you so much for all that information! It has already been very useful to us.
Today we got the call that Max would be able to come home from Penn before 4pm. We were excited and nervous! We had a lot to do before he came home! We used the crate information from Dodgerslist to make him a little Recovery Suite. We got a pen type crate and an egg-crate mattress from the pet store and some pee-pads at the pharmacy. Everything was ready to go for his return.
I wonder if we will someday look back on our first time expressing Max and laugh about it. It was a DISASTER! He has loose stool from food changes and medicinal side effects so as soon as we put him on the floor to get his harness on to take him outside (made at the hospital - he puts his back legs in the harness and powers himself using his front legs) loose stool went all over the floor and all over him. So we hurried him upstairs to try to express him in the tub. We think that we got the urine out in tiny streams. Cleaning him off was a problem as we were so afraid of getting water on his sutures that we were yelling at each other and freaking out the whole time. STRESSFUL! And i know that at a time like this we need to be calm for Maxy. Tomorrow we hope that we do better.
He is on Prednisone, Tramadol, and Pepcid. We will start doing PT by us doing passive range of motion exercises three times a day for the next two weeks.
As for the loose stool problem we are to give him chicken and rice mixed with his food tomorrow.
I hope that we do better at expression tomorrow.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Feb 8, 2014 7:18:24 GMT -7
I'm sorry to hear how stressful your first attempt at expressing was, Maggie. It will get better with practice. If you do express him in the tub, be sure to put down a rubber mat so he doesn't slip. And no baths for now. Not only is there the risk of getting the incision wet but a wet dog is a slippery dog and that can be dangerous. Plus there's too much movement with bathing for him right now. Use baby wipes to clean him with. You can use cooled down green tea to wash his belly and legs with. Green tea neutralizes the acid in the urine and helps prevent urine burn and smells nice, too. You should speak to the vet about adding Sucralfate in addition to the Pepcid AC since Max is having loose stool. Sucralfate works in a different way to bandaid the damaged mucus lining and also promotes a healing environment. Sucralfate will require timing with other meds…so do your homework so you can discuss things with the vet: www.marvistavet.com/html/sucralfate.htmlAny signs of pain? When you get a chance, please let us know the dosage in mgs for each med and the frequency given. You should use a front harness and a leash to control Max, along with the hind end sling. Did the surgeon say he could walk a bit at potty time yet? What instructions were given for crate rest? We usually see crate rest of 6 weeks prescribed after surgery. Hang in there. It will get easier. Please keep us updated. Glad Max is home.  |
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Post by Maggie&Maximum on Feb 8, 2014 12:47:14 GMT -7
We will take your advice and no longer try to express him in the tub. The slipping is exactly why that is not such a smart idea. That and water getting in his incision. I bought some green tea so that I can try to wash his belly and legs. Our patient room is smelling like urine - the nurse at the hospital said it is normal for him to be leaking urine. One thing I noticed now is that he won't stop licking his penis area. It is all wet under that area and I thought that was pee but it wasn't.
I have been a little better at expressing him today - but only by luck. I have no idea where the bladder is and what it is supposed to feel like! But I am able to get streams to come out of him by imitating online videos.
No loose stool today. I really think that was the switching of food and maybe the stress of the hospital. We gave him chicken and rice this morning for his breakfast.
It is so cold that he is shivering like crazy when we take him outside. There is snow on the ground so we shoveled a little area clean for him out back. I have not had the heart to put him in the sling and walk him about out there. He just wants to come back inside. But I did take your advice and use a hardness and leash this time so i could feel more control over him.
Tramadol 50 mg - one tablet every 8-12 hours for pain
Prednisone 5 mg - 2 tablets once daily for 3 days. 1 tablet once daily for the next 3 days.
Pepcid 10mg - one tablet by mouth twice daily
Crate rest for 6 weeks has been prescribed. With 5-10 minute slingwalks during the day that I have felt horrible doing because he is shaky with pain.
I think he is in pain. He shakes when we pick him up and put him back in the crate. He has a voracious appetite and woofed down his chicken and rice in about 1 second. He is not acting like "our Max" but my fiance is reminding me that he just had major surgery 3 days ago and that he is in pain and uncomfortable.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,595
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Post by PaulaM on Feb 8, 2014 13:40:32 GMT -7
There is no reason to allow that pain. This is what should be discussed with the vet asap today.
1. Tell him about your observations with pain. Tramadol has a short half life and likely would not control pain unless you give it promptly every 8 hours. Have you been giving every 12 or every 8 hours?
2. I would alert your vet to the penis licking. It can be two things. One is a bit of urine leak and he is cleaning himself up. It could be a urinary tract infection…when learning to express we often do not get all the urine out and the part that remains becomes a breeding ground for bacteria (UTIs) So a urinalysis is in order to rule out infection and the need for anti-botics. UTI can quickly move up to the kidneys where it becomes life threatening.
The other thing about penis or leg licking is that is does not progress to nibbling, bitting or chewing. Everyone has felt Paraesthesia in their limbs by sitting badly, resulting in numbness and pins and needles. Your dog can be feeling abnormal nerve sensations that are mild pins and needles to quite painful burning, on-fire feeling that makes them bite to stop the pain. You would need to stay on top of observing for any signs of chewing on body parts as this can lead to death. Immediately put a e-collar on or a lengthwise folded towel and secured closed with duct tape. Get to a vet for a medicine that can help to control these very painful sensations. The name of the drug is called gabapentin.
NOTE: gabapentin is a med vets are finding good success with general pain too…as it works synergistically with tramadol.
3. Giving 5mg Pepcid AC 2x a day to keep a more even dose in his body. Give 30 mins before Pred and give Pred with a meal.
Why is Max not on his normal food? His body has a lot of repair jobs to take care of and needs the right combo of vitamins, minerals, protein and calories that chicken and rice do not provide.
Let us know how the vet fine tunes the pain meds so that Max is not suffering with any pain at all.
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Post by Maggie&Maximum on Feb 9, 2014 10:12:40 GMT -7
Thank you for your reply.
I spoke with the Vet this morning and she said that I could give him the Trazodone which the first Vet prescribed to him back when we thought we were going to be able to use the Conservative Method before his conditioned worsened. She suspects that anxiety is why he is shaking.
The vet told us that Max could be licking his penis because of the catheter that was in place while he was in the hospital from Wednesday to Friday morning. She also said that it is common for dogs like him (or my fiance says all dogs) to lick his penis. She said to watch for foul-smelling and discolored urine to keep track of a UTI. If we see or smell anything out of the ordinary, then we should get him tested for bacteria in his bladder.
I am still not able to express him properly in that I actually feel the bladder. I feel like a failure. Thankfully my fiance is able to so at least one of us can. I am determined to be able to feel that water balloon!
He is wolfing down his food. He is not drinking from the water bowl in his crate. We bought one of those water bowls that fastens to the crate. He will drink from a bowl of water that we present to him.
I have two questions for the community:
1. What, in your experience, is the best kind of insurance to purchase for a dog with a pre-existing condition like IVDD?
2. Are you allowed to place a blanket over your dog in his Recovery Suite? We have not been because we don't want to disturb his incision, but he loves blankets so I thought I would ask if anybody knew a definitive answer.
Thank you!
Maggie, Mitch, and Max
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,595
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Post by PaulaM on Feb 9, 2014 12:05:35 GMT -7
Maybe others have more experience, but as far as I know a pre-existing condition of IVDD means you are not likely to find insurance to help with a future disc problem. Probably a better solution would be to start your own self-insured solution with a savings account for Max. Check the "insurance" section to read more about pet insurance works, etc.: www.dodgerslist.com/links.htmI don't see a problem with a blanket for Max. I'd give it a try, you can always remove it if you see it not working out. How about something warm for him to snuggle against? A comfort idea is a warm rice sock buddy to lie with, rest the head on or lean against. Fill a sock with 1-2 cups of dry rice. Knot the end. Microwave for 1-2 minutes. Test in crook of your arm for warm not hot temperature. Wrap in a towel so it's not too hot for the skin and place in crate. Let Max snuggle against when you are present to supervise in case he has a desire to munch on the warm rice. Note: human heating pads can get too hot burning skin on an IVDD dog. Snuggle Safe is a commercial product that will keep warm the whole night. www.valleyvet.com/ct_detail.html?pgguid=E53AAF66-347A-4789-AFCC-5D6FA77ED8B6&item=30459&ccd=IFP003&utm_source=froogle&utm_medium=free&utm_content=30459 |
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Post by Maggie&Maximum on Feb 15, 2014 14:37:20 GMT -7
It has been a week since we brought Max home from his surgery. We have had a ton of snow in PA this week so it has meant that we have been able to spend time working from home and keeping Max company.
We have seen some improvements! The past two days he has been sleeping a lot more. When he first came home whenever I would take a peek in his crate he would be awake and looking uncomfortable with his cute buggy eyes. I felt so bad for him that he wasn't sleeping! I am so happy that he seems more comfortable in there.
I have mastered (well almost) expressing him! Yes!!!
After going back and reading some of the posts I am not sure if I should be guarded or excited about this next part WE HAVE NOTICED A TAIL WAG! At first it was just in his little sling so we though it was a reflex as he tends to poop while he is in his sling. The past two days, which has coincided with his seeming more relaxed and sleeping a lot, he has been wagging his tail when we come in and when we take him out for PT and expression! I noticed it when I came home from work on Wednesday. My Mom and I noticed it later on Wednesday. And then finally my fiancé noticed it on his own on Thursday.
One other thing I have noticed is Max yelping in pain a little when I pick him up sometimes. It is a short sharp yelp. I am not sure why but I will definitely be bringing this up with the Dr. Maybe it's his incision?
He gets his sutures out on Tuesday and I think he will get tested for Deep Pain Sensation. I am very cautiously hopeful that he has it. I am scared that he won't. But I am trying to be optimistic either way as it is still really early yet.
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Post by Pauliana on Feb 15, 2014 22:05:31 GMT -7
Hi Maggie, Here is a video that shows how to lift Maximum, hope this helps: and here are some pictures:  Yelping means his pain medications aren't right yet. Please let your vet know he is still in pain and have the medications adjusted. Are you giving the Tramadol every 8 hours? Is Max is wagging his tail in happiness such as when you talk happy to him, when you get home or in anticipation of a treat? If so that is a very good thing! That means nerves are healing and that he likely does have deep pain sensation. Thanks for keeping us posted. |
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Post by Maggie&Maximum on Feb 16, 2014 15:15:44 GMT -7
Thank you for your response, Pauliana. This site is such an amazing resource for motivation and support. I can't tell you how grateful I feel for having someone respond back to what I say on here.
That video helped. He has not yelped since I started focusing on making sure his back legs are even with his front legs when I am picking him up and putting him down.
He is definitely wagging his tail when we get home and in anticipation of food or a treat!
This morning we took him outside on his sling where he normally does his pooping. We were amazed and shocked to see him slightly sway to one side like he wanted to lift up his leg and then have pee come out! Two little puddles of it onto the snow. We tried to take him out in the afternoon and see if he would repeat this and he did! But only a small trickle of pee. We took him inside and expressed him and got a lot out. I am wondering if this is normal that he would need help emptying his bladder out but is able to pee a little on his own?
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Post by Pauliana on Feb 16, 2014 22:48:20 GMT -7
Hi Maggie!
When dogs are just beginning to get bladder control back, they often do need help to make sure they get all the urine out. They will go a little and then need help to finish. It's a good idea to help him out each time until you know he is going normally. I still think it would be a good idea to take in a sample of his urine and have it tested for a UTI just to be on the safe side.. If he has a UTI, it needs to be treated quickly before it progresses to a kidney infection.. It's much better to catch things early..
Thanks for keeping us posted on how Max is doing. Healing and comforting thoughts..
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Post by Maggie&Maximum on Feb 17, 2014 13:05:20 GMT -7
Just to clear this up in my own head: Do you mean that we should get him tested for a UTI because it is coming out just a little bit outside? And not the whole amount?
Maximum goes to get his sutures out tomorrow at Penn. I am going to write down all of my questions tonight to ask the doctor.
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StevieLuv
Helpful Member 
Conservative Treatment 3x. It really does work!
Posts: 1,335
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Post by StevieLuv on Feb 17, 2014 19:41:57 GMT -7
Tail wagging is GREAT!!! So are his attempts to pee on his own - he is doing really well Good job! |
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Post by Maggie&Maximum on Feb 18, 2014 13:02:14 GMT -7
Thank you for your kind words, "StevieLuv"! I do feel that we are doing a better job now than when he first got home. We were a wreck!
Max had his sutures removed today at Penn. The doctor concluded that his right back foot is definetly deep pain sensitive. His front back foot was "inconclusive". We are so happy that he had feeling in one of his feet!
This Dr was neither optimistic nor pessimistic with Max's chances for walking again. He said that next time we come, at the 6 week mark, he would give us more information for a cart for Max if there is no improvement in mobility from here but still expressed hope that Max could walk even past that point. I have seen some posts on here that had me fearing for a pessimistic doctor when it really does seem that every case is different. This Dr. repeated that sentiment saying "every case is different". I have really appreciate the vets that we have seen through this process so far.
Another noteworthy event: Max has emptied his bladder fully twice today. I am so happy!!!
Max is now officially off the predizone and pepcid. He is still taking his Tramadol and Trazodone. In fact, the Dr. upped the Trazodone because Max is being extremely barky and unsettled in his crate and out of his crate. When we took him to Penn he was behaving like a Mexican Jumping Bean, very excited and trying to move and jump all over and barking like crazy. The Dr said it was safe to give him 25 mg/twice a day. I feel guilty about this - but i don't want him to hurt himself.
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Post by Maggie&Maximum on Mar 12, 2014 5:37:48 GMT -7
Today marks five weeks since Max's IVDD surgery  This has been quite a learning experience for our little family. My fiance and I are getting married in June and we have really learned a lot about each other during this process. I have learned good things about him - he is a loving and patient Dad to our Max. Max has been doing weekly Physical Therapy. The Dr uses a laser and electro therapy on Max each week. Every day we still do our passive PT exercises at home. Our Dr. is not certified in accupunture so we are thinking that we may need to branch out and find that for Max at some point. Everyone on this site seems to say good things about accupuncture. At the 4 week mark we were so excited to see Max stand up to eat his food. It is not a straight stand but a wobbly one but we'll take it! Now we are at the 5 week mark. Yesterday when I took him outside to do his business I was able to let him off his sling and let him try to walk by himself. He is able to move both legs now but is very wobbly and falls over to one side in the back after a few steps. We have our 6 week appointment with the surgeon next week. I am wondering what she will say about Max's progress. Will he need a cart? Will he keep getting better? Will he have another episode? The unknowns are so scary but we are trying to take it one day at a time. Most importantly, Max is back to normal personality wise. No pain and just as funny as ever. We are so glad and grateful that he is ok. |
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 12, 2014 6:41:20 GMT -7
Max has come a long way in a short time, Maggie! Excellent signs of nerve healing. There's every reason to believe that he will continue to improve. Nerves are very slow to heal and it can take months, even a year or more. My Jeremy continued to improve for over a year. I would hold off on that cart. Max hasn't had much of a chance yet to try to walk and to build up his muscles and stamina. Continue to use a sling to stabilize his spine. And continue with all of the therapy that you're doing. Then, in a couple of months if you haven't seen any sign of more improvement, you could look into a cart. Keep up the fabulous work with Max - he's doing great! |
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This has been quite a learning experience for our little family. My fiance and I are getting married in June and we have really learned a lot about each other during this process. I have learned good things about him - he is a loving and patient Dad to our Max.