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Post by Angie & Livvy on Apr 5, 2014 14:14:28 GMT -7
Hi! I'm so glad to find this forum!! My miniature dachshund, Livvy, had surgery Thursday for a herniated disk. She is approx 5 years old and 10 pounds. She started yelping in pain Wednesday night while playing with my other dog. Within 2 hours she was being examined in the emergency vet clinic. She has now been diagnosed with IVDD. The damaged disk was low in her back and the surgeon described it as a "sudden blow-out." She had previously shown no symptoms of back problems. I get to bring Livvy home. I've used suggestions on your website to set up her recovery suite and have hired a pet sitter to care for her while I'm at work.
Yesterday the vet thought she had myelomalacia, which from what I understand would be progressive and untreatable. After assessing her today he has decided that's not the case. He did say the neurological exam showed she has no deep pain response on her inside toes. This would mean the signals are not making it down her spinal cord. He thought this might improve with time and said the test is subjective so there may not be a problem. She is currently still in the hospital but they said she's no longer on pain meds, just prednisone.
Can anyone give me any advice on what I might be facing if there is damage to the spinal cord? The surgeon said she may not regain use if her back legs and it would also affect bladder control.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Apr 5, 2014 15:20:44 GMT -7
Angie, welcome to Dodgerslist. Sorry to hear LIvvy had a disc problem. At anytime prior to the surgery had she lost the ability to walk, move her legs? It is very early still to know the direction of nerve healing. Because nerves of one of the slowest parts of the body to self heal, we think in terms of months rather than days/weeks. Another thing is it normally takes about two weeks for all of the swelling due to the surgical procedure itself to go down. So glad to hear that you have found her main webpage and you are taking the time to invest in learning about this disease. The more we know the better we can help end the less scary situation is. Check out the orange button on "nerve regeneration" to help you get a better understanding about how the body heals, the order, etc. www.dodgerslist.com/healingindex.htm as time permits do we each of the buttons on that page. If perchance Livvy needs to have her bladder expressed on discharge day go ahead and take a look at this link now so that when you pick her up you will get more out of the hands on top of your hands type of expressing less. Make a list of all your questions as they come to mind so everything gets an answer. Here's a good starter list: www.dodgerslist.com/healingindex.htmLet us know when LIvvy gets home or if you have anything on your mind. |
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Post by Angie & Livvy on Apr 5, 2014 21:09:11 GMT -7
Thank you for the information. There is so much useful information on that site! She had never shown symptoms before the day it happened. We will have a follow-up appointment in 2 weeks, so that makes sense with you saying it takes about that long for the swelling to go down. Her recovery suite is set up and I'm ready to get her home. I know it will be a long road to recovery but she's a very strong-willed girl and I know we can do it together!
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Post by Angie & Livvy on Apr 6, 2014 11:35:40 GMT -7
Livvy is home now. They showed me how to express her bladder. She came home only on prednisone so I'm a little concerned that we have no pain meds. She seems to be a little sore right now- probably from the 40-minute car drive from the hospital to home. She does have Valium for her anxiety and they let me give her one for the car ride home. Got her from the carrier to her home recovery suite ok, then about 15 minutes later she showed signs of pain. Now she's finally sleeping.
update: I'm really stressed about the pain situation. Livvy has been home 5 hours, has slept a good deal of the time but still won't let me move her without yapping and biting. Her bedding needs to be changed. I probably just need to relax but I know she can't continue lying in her wet bed.
She came home on 5 mg prednisone twice per day. She had her morning dose at 10 am at the vet before I brought her home.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Apr 6, 2014 15:38:25 GMT -7
Angie, you will need to get with the surgeon and if he is not available then you do need the help of ER. Pain is not something to have any patience with. Not only is it torture but you can't care for her when she is in pain. With proper dose in mgs, frequency and mix of pain meds are right, pain will be in control within the hour and stay that way dose to dose. Ask for Tramadol and possibly gabapentin as those two pain meds work synergistically and are safe to use with Prednisone. A little background reading on pain for discussion with a vet. www.dodgerslist.com/literature/healingpain.htm Let us know which vet helps you and what was prescribed. |
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Post by Angie & Livvy on Apr 6, 2014 18:13:11 GMT -7
Thank you! Sometimes it helps to know what to ask for. The ER called the surgeon and he approved Tramadol. I'm just waiting for a friend to bring it to me.
UPdate:
The Tramadol has helped so much. The pain seems to be gone and I'm able to move her as necessary to keep her clean and dry. She's resting much better and so am I!
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Post by Angie & Livvy on Apr 9, 2014 20:44:21 GMT -7
How long should I expect Livvy to need the Tramadol? The initial Rx I got was for 6 day's worth. Right now she's taking
10 pounds
Tramadol 1/4 of a 50 mg tablet every 8-12 hours. I've generally been giving it every 12 unless she's showing signs of pain after the 8 hours.
5 mg of prednisone twice per day
Valium as needed, which she was previously taking for anxiety. Also getting
Pepcid AC.
And is there anything I can do about the diarrhea?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Apr 9, 2014 22:48:59 GMT -7
Your vet needs to know about the diareah...as it is likley a RED FLAG signal that Pepcid AC alone is not protecting the GI tract. Has there been any recent food changes to account for it? Really one can't take a chance whether benign food change vs. serious prednisone problem. So I would strongly advocate for sucralfate ON TOP of Pepcid AC. Are you giving 5mg of Pepcid AC 2x a day? Are you giving prednisone with a meal? Background reading on sucralfate prior to first thing in the AM discussion with vet: marvistavet.com/html/sucralfate.htmlDon't be stingy on the Tramadol, give it promptly every 8 hours. Once pain rears its ugly head it is much harder to get back under control. So the idea is to give pain meds on time and regularly — not on as as needed basis. Normally when the vet calls for the start of a prednisone taper, then the pain meds will also be backed off or stopped to have a clear picture that post-op pain has been resolved. Each dog is different so teaming up with your vet about pain observations lets him know what course to take. |
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Post by Angie & Livvy on Apr 17, 2014 17:37:53 GMT -7
Update- We have the diarrhea under control. There were a lot of food changes. All she would eat for several days after surgery was baby food. Graduated her to hamburger and rice then back to her normal food. The meds helped. She is no longer needing pain meds and the prednisone is tapered to 1/2 tab twice per day. She is acting much more like herself though she still has no bladder control or use of her back legs. From what I'm reading here, though, that is not unusual at this stage. Follow-up with the surgeon is Tuesday. I am anxious to hear his assessment of how she is doing and what the recovery process might look like for her.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Apr 18, 2014 5:55:03 GMT -7
I'm glad to hear that Livvy is doing better. Please be sure to give 5 mg of Pepcid AC 30 minutes before the Prednisone and every 12 hours thereafter for as long as she's on the Prednisone so that she's protected against the side effects of the steroid. Yes, nerves can take a very long time to heal- months, even a year or more. My Jeremy had no movement whatsoever in his hind feet and legs for months following surgery but then he started improving and was walking 6 months after surgery. 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, 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. What directions has the surgeon given for crate rest and PT? Here are our recommendations for at-home PT that you might want to run by the surgeon for his approval: www.dodgerslist.com/literature/massagepassiveexercises.htmDogs can benefit greatly from acupuncture or laser light therapy. These therapies can 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. www.dodgerslist.com/literature/healingacupuncture.htmAlso water therapy can be performed after the stitches/sutures are removed. Some of these exercises can be done right in the bathtub. Just be sure to check with the surgeon before starting any of these. www.dodgerslist.com/literature/watertherapy.htmI hope the follow-up visit on Tuesday goes well. Healing prayers for Livvy. |
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Post by Angie & Livvy on Apr 18, 2014 19:53:44 GMT -7
I am definitely giving her the Pepcid and it has helped. Thank you for the links. This will help with the discussion with the surgeon at the follow-up. At this point she was put on strict crate rest and I was told discussion about physical therapy would take place at that visit. Now I have some idea of the right questions to ask.
Today her tail began twitching just the slightest bit when she gets excited. I'm hoping this is a good sign.
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Post by Pauliana on Apr 18, 2014 20:04:10 GMT -7
Hi Angie, That tail twitching is a GREAT sign! Keep an eye out for a tail wag: 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!  |
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Post by Angie & Livvy on Apr 25, 2014 21:36:08 GMT -7
At the follow-up the surgeon talked like he didn't think there was much hope of Livvy getting leg and bladder function back. The physical therapist that he referred me too, though, had a more positive outlook. What she had to say matches up with what I'm reading here. It can take lots of time and it's impossible to say now that she won't regain functioning. Her first appointment/assessment will be Wednesday. I'm looking forward to getting therapy started with her. The therapist mentioned laser therapy, electrical stimulation therapy and underwater treadmill as possibilities. Her spirits are high despite the restrictions. She's a very determined dog and I know she will fight to get better!
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Post by Pauliana on Apr 26, 2014 19:57:41 GMT -7
The Physical Therapist is right to be more positive about Livvy's recovery. There are no time limits for nerve healing and dogs know where there's a will there's a way. www.dodgerslist.com/index/SDUNCANquality.htmWe will look forward to hearing about how her PT is going! |
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Post by Angie & Livvy on May 20, 2014 19:17:38 GMT -7
Livvy is doing well. She is in PT but due to my work schedule has had only one session. The PT gave me some things to work on at home until I can get her back in next week. We are getting reflexive tail movement when I pinch her tail and it's lasting longer and longer each day. Her cart is scheduled to arrive tomorrow. She's 7 weeks out from her surgery now so I am looking forward to the mobility the cart will give her. I continue to refer to your website frequently and am learning much from reading posts that others are making on this board. It is a great resource for me!
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Post by Pauliana on May 20, 2014 20:33:12 GMT -7
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on May 21, 2014 9:04:41 GMT -7
Congratulations! Snap a picture we'd love to see LIvvy in her wheelchair. Don't forget to add a photo to the gallery and one for the 2015 calendar that will be coming out this Fall. Directions here: dodgerslist.boards.net/thread/260/upload-photo-dogWe are pleased you are finding reading on the Forum useful. Don't forget to bookmark the meat of our IVDD information... the core IVDD readings on our main web page covering all things IVDD: www.dodgerslist.com/literature.htm |
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Post by Jean & Mimi on May 22, 2014 8:05:36 GMT -7
Congratulations!!! Enjoy your snuggles with Livvy again  |
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Post by Angie & Livvy on Jun 7, 2014 19:19:54 GMT -7
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Post by Pauliana on Jun 7, 2014 20:46:12 GMT -7
Hi Angie,
So glad to hear Livvy is enjoying her cart and doing well with her therapies.
Always glad to hear from you and Livvy!
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