Cynthia's Punkin 3/28 & 4/5 Surgery

A little background, Punkin is a female doxie that we adopted from a shelter in October of last year.  We think she is around 6-7 yrs old.  Sometime in February, she was in bed with us and was on my lap when I needed to get up.  When I went to budge her off of my lap she screamed like she was hurt.  She seemed okay after that, but was acting painful and not wanting to eat the next morning, so I took her in to my regular vet for a checkup.  At the vet, as we were sitting in the exam room, she came over to me and sort of put her head down and started to roll to the side like she was going to ask for tummy rubs, but midway through she froze and started screaming like she was in terrible pain and she flipped on her side and thrashed around.

After we got her settled down, the vet examined her but couldn't find any neuro symptoms and was able to move her head and neck all around with no problems.  She said she suspected a neck or back issue, but since she was showing no paralysis she wanted to try just meds and rest first.  So we went home and started her on tramadol, an NSAID, and a muscle relaxer.  The plan was to try that for a couple weeks then try weaning her off.

Well, she seemed fine while on the meds, then we started weaning her off and she still seemed okay for about a week, then back to acting like she was in pain and having screaming episodes if she moved the wrong way.  So, back to the vet, xrays showed possible calcified discs in her neck so we were referred to a neurologist.  She was examined there and still had no paralysis symptoms.  So the neuro vet put her on Gabapentin, Tramadol, Prednisone, and we had Methocarbimol if needed.

Neither vet said she had to be on strict crate rest, as long as she was kept quiet and away from my other doxies and wasn't running around.  Well, she had no interest in running anyway so we set up a space in our guest bathroom with an egg crate bed and a towel with a pee pad so she pretty much stayed in the bed other than the short walk back and forth to either her food/water bowls or to potty.  After 5 days on the steroids, I came to find her acting in severe pain and being very wobbly on her back end.  She was clearly having numbness in her back legs and having trouble placing them properly.

We rushed her to the neuro vet and they did the MRI and found a ruptured disc in her mid-back and did surgery with fenestration the same day (3/28).  She was on IV pain meds and in the hospital for a couple days and then we were able to go pick her up.  At first, she seemed to be so much better and her old personality was back.  We took her home and were giving her all the meds, which included all the stuff she was on before, plus a couple of extra drugs to help with her digestion because she'd had problems with regurgitation after the surgery.  We used a wire crate to make the space she had access to in the guest bathroom even smaller, no walking except out to her potty pad and back to the crate.

Almost a week after the surgery, she started acting in severe pain again, so I took her back and this time the vet said she acted like her neck was hurting.  I asked if they'd seen anything on the MRI in her neck, at which point they told me they only scanned her back.  This really upset me since we'd told them from the beginning that we thought her pain was in her neck and the xrays showed calcified discs there so we thought they'd be scanning the whole spine to make sure to catch any ruptured discs.  They said that the vet had thought it was her back based on the exam right before the scan and that when they found the ruptured disc in her back they'd stopped the scan because it would have cost more and taken longer to do the whole spine. 

So, we had to pay for ANOTHER MRI and this one found that she also had a ruptured disc in her neck so she went back in for a second surgery on 4/5.  This time she had to stay in the hospital longer because they had trouble weaning her off the IV pain meds.  When we finally picked her up they said she was still having issues with muscle spasms because her nerves had "learned" to react that way and would take time to recover now that the injury was fixed.

Well, it's been over a week since the surgery and she is still having frequent bouts with severe muscle cramps and spasms in her neck and shoulder area.  I took her back to the vet this past Friday for a re-check and the vet said I could give her an extra dose of methocarbimol when she started having spasms, and sometimes it helps, but sometimes even with all the meds she still lays there in terrible pain and is scared to move while you can see the muscles in her neck and shoulders jumping and writhing around and can feel knots in the muscles.

On the advice of my vet, I have tried using a hot compress and lightly massaging her neck and shoulders, and it does seem to provide some comfort, but it doesn't make the spasms stop.  The vet also suggested letting her take short walks for 3-5 minutes at a time a few times a day to get her muscles moving and doing something else besides cramping.  Her paralysis symptoms have already completely resolved since the surgeries, though she is a little wobbly from meds.  She really does seem to be happier when we give her a chance to walk around a little and we really only let her walk in the house around the living room for a little bit so she's on a even surface and all the rest of the dogs are penned up. 

Other than the brief walks, she spends most of her time confined to the recovery area in the guest bathroom.

She has good days and bad ones.  Sometimes she seems comfortable and pretty happy, sometimes for a whole day at a time.  Other times, like yesterday, she has non-stop spasms all day and screams and cries out when she has to move for any reason, like if she has to get up to walk over to her potty pad to pee or poo.  I absolutely hate seeing her like this and wish there was more I could do.

All of the info I find relates to helping with spinal recovery, but her healing in that area seems to be doing just fine.  The problem seems to be that her superficial nerves are firing at random and causing her muscles to spasm.  I imagine that having had surgery on the bones in your neck and back is probably painful enough, but has to be worse if your own muscles are pulling and jerking around and moving the injury site while it's trying to heal.  Not to mention the pain of having charlie horses in your neck and shoulders.

She's already on pretty much every type of pain killer she can have (Gabapentin, Tramadol, Acepromazine, and still tapering off on Prednisone) and we are giving her a LOT of muscle relaxer and it doesn't seem to be working.  With the methocarbimol, she is supposed to get 1/4 of a 750mg tablet every 8 hrs.  She weighs about 18lbs right now.  The vet told me she could have another dose if she has a spasm attack.  She was very vague on how often it would be safe to do that, even though I tried to pin her down on it.  She just said all dogs react differently to it, some are knocked out with a very low dose, others tolerate much higher doses.  She said as long as she was not so sedated that she couldn't get up to eat or drink and her breathing was affected it was fine...but how in the heck is THAT a good guideline?

I mean, by the time you know that a dose is high enough to give them trouble breathing, it's not like you can take the pills back out of the dog, right? 

Anyway, I would appreciate ANY advice from anyone who has dealt with muscle spasms after disc surgery.  Any other drugs your vet has used for muscle spasms or other types of treatments that have helped with it (laser therapy? massage? acupuncture?).