Jessie's Penelope 4/2 Surgery — Basset

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.

Get ready to fight this disease with this current episode and in the future by knowing how you can help now and after crate rest is over. There is no better place to start than on our main web page covering "All Things IVDD" at this link www.dodgerslist.com/literature.htm Tape this flyer to your fridge so the whole family knows what things are emergencies: www.dodgerslist.com/literature/FridgeInfo81907.pdf

Add this comprehensive "must-have" $3 DVD on IVDD to your arsenal of educational resources. Friends, family and those who will be caring for your dog should also watch this DVD www.dodgerslist.com/store/DVDorder.htm

In order get a better idea where your dog is post-op, could you please answer these questions? I realize she isn't home yet so answer what you can and the rest can wait until she comes home..

▷ What is your name?
▷ What was the date of the surgery?  I estimated April 2nd for your topic header. 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?

▷ Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy?

 List the exact names of meds currently given at the hospital?   When they discharge her let us know what medications they send home with her and 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.  Since she is a larger dog please ask your Vet for the proper dosage for her size.  I see she is having Stomach and GI issues while at the hospital.. What medication did they give her for her gastroenteritis?

Here is a list of questions to ask when you go to pick up Penelope..   www.dodgerslist.com/literature/dischargequestions.htm

Here is an article and video about expressing that you can watch so you get more out of your lesson from the Vet when the time comes..  www.dodgerslist.com/literature/Expressing.htm

▷ 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.

IVDD is not a death sentence.. Many dogs that are paralyzed live a happy life. Please read this, I think it will help you feel more encouraged about her prognosis.   There are no time limits for nerves to heal.   www.dodgerslist.com/literature/healingnerves.htm  and also dogs don't view being paralyzed as a limit..  Where there's a will there is a way!   www.dodgerslist.com/index/SDUNCANquality.htm

Hi Jessie! 

For urine , make up a pot of green tea, let it cool and then use it  with a cloth to clean Penelope. The remaining green tea can be kept in the fridge for later re-heating and use. The green tea neutralizes the acidity of the urine and helps prevent urine burn and leaves a nice smell.

She is on medication that helps to her pee more freely, so it is best to express her more often. Every 2 to 3 hours. Until you find a timing that keeps her bedding dry.  

Pumpkin works for both constipation as well as loose stools. To firm up stools use one teaspoon of pumpkin with her kibble and no water added.  To loosen stool add one teaspoon of pumpkin and water with her kibble..

_ Blankets and change of bedding: Fleece fabric as a bottom sheet wicks moisture away from skin (have 2-3 on hand) and dries quickly. Inexpensive fleece throw can be cut to sizes at Big Lots, Walgreens 2/$10. You can buy fleece yardage at JoAnn Fabric Store or the like. This is a no-sew project as fleece does not ravel. Layer in this manner: Trash bag enclosed mattress, pee pad*, fleece bottom sheet tucked in all around mattress. *Use human pee pads as they have no scent to encourage peeing. *OPTION to disposable pee pads are reusable waterproof absorbent bed pads: reasonably priced, washable and last a long time. www.allegromedical.com/ ; look for children's disposable bed mats at your grocery store. Cut down the twin size to make several crate size ones.  

REGAINING NEUROLOGICAL FUNCTION has no time limit for nerves to heal. Nerve repair is individual as each injury is different and each dog’s ability to heal is different. If deep pain perception (DPP) is present, even in paralyzed legs, there is a chance your dog may be able to walk again. For those dogs who have lost DPP, do know nerve regeneration can take place and that function may return. Once deep pain perception is regained, your dog has a chance at a walking recovery. Thousands of dogs on Dodgerslist have regained functions in as little as 2 weeks, others 11 months, and still others 3 years later. IVDD is a disease of patience to allow the body to heal on its own terms. Acupuncture and Laser Therapy stimulate the cell’s metabolism that leads to the body’s natural repair abilities and can be started at any time.

Once nerves have repaired then muscles will also have to be retrained to relearn proper placement of the paws. Some muscles will need to regain strength for walking. Consider learning to walk again as it would be for a stroke victim or a baby learning to walk. At first, the steps will be weak and a bit unstable. Relearning to walk takes coordination, building up strength, and lots of patience.

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!
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.

Dogs don't know the word impossible. Doctors and people can say there is no hope but to a dog, they know where there is a will there is a way.. They don't give up hope!  They also take life as it comes and play the hand they are given the best way they can.  If they can't walk, then they take to wheels just as well after 6 weeks of post op crate rest. They find joy in life as long as they have the love of their family..
Check out Paula's Clark, he is such a happy dog on wheels! 

One of our moderators had a dog that was paralyzed for 11 months, walk when her wheeled cart fell off. She took a few steps while her amazed Mom couldn't believe her eyes!  Nothing is impossible, nerves can heal!  Ree Goosie's story:  www.dodgerslist.com/monthstory/goosieSullivan.htm

Sending healing thoughts and prayers to Penelope! Comforting thoughts to you..

I think this format is called a Forum..  Could be called a blog too, I suppose. 

Jessie, very good news on Penelope SEEING and then wagging! Use the search box on our website www.dodgerslist.com and enter "nerve repair" It is always good to know what to expect, the order nerves typically repair in. That article tells you how to do the "sniff and pee test" now that a tail wag has been observed you will want to periodically do that test.

what is the name of the added med for the gastroenteritis? Is she still on it?

Avoid cotton absorbing flannel and look for synthetic wicking fleece. More detail on setting up the mattress and lots of other tips to make crate rest go smoother: www.dodgerslist.com/literature/cratesupplies.htm

When you have achieved the desired level of expressing proficiency Penelope will stay dry in between expressing sessions. You will likely need to start expressing every 3-4 hours and adjust your schedule as you see she is staying dry. When you are proficient, expressing can easily go to every 4-6 with 8 hours the max during daylight hours. When first learning to express you may not be fully voiding the bladder and so the bladder tops off quickly. The goal is to feel with your hands/fingers the last stage of voiding. One hand can almost feel the fingers of your other hand. You will want to also express for poop so that Penelope is not stressed by having poop where she sleeps. The information on expressing urine and poop plus a video for large dogs will be very helpful to you. On our main web site www.dodgerslist.com use the search box and enter "expressing" to read EXPRESSING the BLADDER and see the videos.

An overflowing bladder will promote UTIs. As reflex can't void all the urine, the part that remains becomes an excellent breeding ground for bacteria. Don't hesitate to express right in your local vet's office and have the vet tech check your work. I would take up water say at 8pm and express right before bedtime at 10 pm. She should stay dry til morning as the body produces less urine during the dark of night.

Let us know how the expressing of urine and poop goes for you.

Jessie, you may not be getting all the urine out at each session so Penelope is topping off her bladder and then it overflows in 2 or less hours. Can you feel her bladder in all the stages of emptying? Can you feel the fingers of the other hand at the last stage when the bladder has been pretty much voided?

Reflex happens without the brain involved. Just like we pull back our hands from a hot stove, we jerk it back without thinking. Reflex movements tend to be jerky because no brain is involved to smooth out the movements.

Standing can be just a reflex movement. It is the rising up into a standing position that is likely brain directed.

Because a dog does not talk to us about thinking, we can only know if the brain is involved by being able to send a message down the spinal cord highway to the legs, to the bladder to the tail is if there is a head level action involved with those other functions. So you have a confirmed new neuro function return with the seeing (head level) you and then a tail wag!

Not having bladder control means not being able to hold it and choose where to release body waste. Dogs do not like to be near their waste so they move away quickly. If they had bladder control they'd wait til in an appropriately deemed place, maybe sniff (head level) and the release urine. That is the sniff and pee test we need to see passed to let us know they have bladder control. Since there is now a tail wag, the next function to test for is bladder control. Let her sniff an old pee spot and wait to see if she will choose to release some urine. More detail on nerve monitoring: www.dodgerslist.com/literature/healingnerves.htm

Discuss your problem with the vet who prescribed:
Prazosin, decreases internal urethral sphincter tone requiring less hand pressure to cause release of urine
Bethanechol, enhances detrusor muscle contraction
Perhaps the vet would recommend going off them to see if now they are not needed? There would be less overflowing?

Can you let us know if you are using flannel (content is cotton) or are you using fleece (content is synthetic)?

I would phone the vet to give feedback about the leaking prior to expressing every 2 hours and also your question of how long it Bethanechol would be out of the system.

Have you gone back to the vet, local or specialst, to express right there in their clinic and have the vet tech check your work? I may well be that at each expressing session the bladder is not being fully emptied.

The half life of bethanechol, which is the amount of time half the drug is eliminated from the body, seems to be unknown. Though some medications have extended half life of several days those drugs are few, I suspect the bethanechol will be out of Penelope's system by the time you call the vet, likely it is at this point if tomorrow will be day three (sixth dose).

If you are still having leaking at all it could be as Paula suggested that her bladder is becoming full and then overflowing (leaking). We always recommend that people have a few hands-on demonstrations of expressing as it's not a skill most of us have learned or used before. You mentioned that Penelope has a history of UTI's, keeping her bladder properly emptied is vital to preventing UTI's as well as helping to clear the one she was diagnosed with during her hospital stay. Passing urine facilitates the flushing of bacteria from the urinary system. Also, urine is a great place for bacteria to grow so if the bladder has urine in it for any extended period of time those bacteria multiply and cause infection. Your regular vet or a tech at their office should be able to do a hands-on demonstration for you. You will put your hands on Penelope and the staff person will put their hands over yours and explain exactly what you are feeling, how hard to press, etc.

It is hard to get some dogs to potty outside in the rain even under ideal health conditions. When your weather clears I'd really urge you to try the sniff and pee test. It will be good information about Penelope's progress and if she is indeed able to pee intentionally it is best for her health to allow her to empty her bladder that way.

We do recommend fleece rather than flannel as fleece is more wicking and thus helps keep the moisture off the dogs skin. Flannel or other cotton fabrics hold moisture keeping it close to the dog.

Keep us updated as to how things are going. Hang in there.

Hi Jessie,

Has Penelope had her urine tested to make sure the antibiotic she is on (or was on), is working on her UTI?

Bethanechol Side Effects Your Dog May Experience:

(Should your dog have any of these, please notify your vet immediately.)

· Not wanting to eat

· Nausea

· Vomiting

· Drooling

· Need to urinate more often  

It might be a good idea to go off the Prazosin and Bethanechol and see if that would help stop the leaking. Since she is tail wagging, bladder control should be right around the corner..Have you tried the sniff and pee test with her outside yet.. Hope the weather has improved out your way..

Jessie I'm sorry you are having a problem with posting.

Enter text in the white Quick Reply rectangle towards the bottom of the page and then press the "Post Quick Reply" button. That is supposed to make your post immediately visible on Penolope's thread.

You may wish to first compose in your computer's notepad or a little text editing program. Then just copy/paste the text into the "Quick Reply" block. That way you'd still have the notepad version should something go awry.

Have you been able to do the valuable "sniff and pee test" to see if any degree of bladder control has returned? You may even be able to put a small piece of urine soaked pee pad on a fresh pee pad to see if she'll sniff and release urine on her own.

It can be more of a challenge to express a larger dog. The part that takes some learning is to be able to actually feel the bladder's shape. When the bladder is quite full, you it fills most of the tummy area and you probably won't discern its shape. As the bladder empties some it is then that you can feel its shape. Can you feel the shape of the bladder at all? Expressing is physics. The pressure on both sides of the bladder need to remain consistent and with the right amount of pressure so that the neck of the bladder is overcome with the pressure of the urine. The sphincter mucscle then releases allowing urine to come out. An overflowing bladder can also release urine. At the point the bladder fills too much, it activates reflexes and the urine excapes/overflows. UTIs happen because not all the urine can escape and the urine becomes a breeding ground for bacteria. The reason to avoid having the bladder overflow is that it can weaken bladder tone and eventually the bladder just will not longer work without tone.

Before expressing you might try some warm towels from the dryer to relax her tummy muscles so you have the best chance to feel the bladder. Express in a part of the house where there are no distractions that might cause her to tense up her tummy making it hard to feel her bladder.

The Bethanechol is to enhance the bladder muscle contractions to be stronger in pushing out urine. The Prozosin is to decrease the neck of the bladder's sphincter tone where you won't have to use so much pressure to overcome it's strength.

Have you had a vet tech place their hands on top of yours so you feel comfortable in pressing hard enough? Are you expressing every 4-6 hours?

We don't like the idea of diapers per se, but until you can get a handle on this, you may wish to investigate this idea for keeping laundry down. tinkletrousers.com/

She is still taking Clavamox? Have you had a urinalyis done just recently to check on the UTI progress and if this is actually the correct antibiotic for the bacteria?

There can be no timetable for how long it takes for nerves to self heal and reconnect. We just know the typical order they return in as Pauliana listed for you.