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Post by natureluva on May 22, 2013 16:18:32 GMT -7
Julie, it is common for dogs to neurologically regress after surgery due to post-op swelling. It takes about two weeks for the swelling to go down, and then many owners see improvement. So hang in there and try to be patient; give Frankie's body time to heal.
When a disc ruptures violently, it compresses the spinal cord, and hence, the nerves within the spinal cord. This can cause permanent or temporary damage. Only time will tell. Some dogs stand up a week after surgery and others, like my dog, take a much longer time to achieve the full extent of their recovery. It took my Goosie 11 months after his surgery to walk again. A few dogs do not regain the ability to walk, but they simply use a cart to get around and have a great quality of life, happy and pain-free. Each dog recovers at a different rate and to a different degree. If Frankie has neurological deficits, acupuncture and laser light therapy can help stimulate the nerves to heal more quickly and reduce inflammation. It's too early to tell how much neurological function Frankie will regain. These things can take time. Good news is - he got through the surgery and had the ruptured disc repaired.
Try not to be upset. Frankie's been through a major surgery, and like any major surgery, will require a recovery time and perhaps therapy.
We look forward to your next update. Best wishes, ~Lisa
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Post by julnewma on May 23, 2013 6:54:31 GMT -7
Hi,
I spoke to the vet this morning. Frankie's pain is under control! I am so very happy about that. The vet told me that Frankie has motor skills (he pinched Frankie's feet, and Frankie tried to bite him). He also expects Frankie to make a full recovery.
We get to see our boy tomorrow morning. I will bring something of ours to leave with him (thanks for that recommendation).
I am so grateful for the vet's hard work and for this forum's support. Thank you.
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Post by Remysmom-Amber on May 23, 2013 9:12:51 GMT -7
Hi Julie, just wanted to wish you luck with Frankie. I'm dealing with a similar situation with my French bulldog Remy. He ruptured a disc in his neck also and had surgery four weeks ago as of tomorrow. Getting the surgery done took such a huge weight off my chest. We also tried conservative crate rest but he was in absolute agony and we couldn't stand to see it anymore. After he got home from the hospital it was like nothing ever even happened....literally. I hope Frankie does just as well! Sending positive energy his way!
Amber
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Post by julnewma on May 23, 2013 16:14:36 GMT -7
Amber, thank you for the kind words! Like you, we, too, are a three-dog family!
Update from the vet: Frankie seems down, a bit depressed. The vet is lessening his pain meds, thinks he may be over sedated. Frankie wasn't willing to stand this afternoon (though he stood this morning), and the vet said he observed some weakness in his left leg, which apparently he expected. We are going to visit Frankie tomorrow at 9:30 a.m. Also, the vet said he's going to check on Frankie at 10 tonight to make sure he's ok.
I am so very excited to visit Frankie tomorrow. I hope our visit lifts his spirits!
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Post by julnewma on May 24, 2013 13:01:51 GMT -7
We visited Frankie today. The good news is he is no longer in pain. We brought him a bag of treats, and he was very interested in them and ate every last one.
He's still not mobile yet. I think he can stand. The vet said Frankie's experiencing some weakness still, but he thinks it will resolve over time.
We get to take Frankie home this Tuesday. Until then, we are going to visit him each day. I left Franks with a little hand towel that has our scent on it and his four-legged companions' scents on it. Hopefully that will comfort him.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 24, 2013 14:04:19 GMT -7
Yes, the good news is he out of pain!!! There is plenty of time for nerves to heal... it takes about 2 weeks for the temporary setbacks from the surgical swelling to subside...then you can best see the direction of healing. I know how exciting it will be to bring Frankie home. So that all your questions get answers in the excitement, do start jotting them down. Here is a list to get you started: www.dodgerslist.com/literature/dischargequestions.htmLet us know what the surgeon prescribes for crate rest and for PT and if any meds are sent home with Frankie on Tuesday. |
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Post by julnewma on May 25, 2013 6:37:12 GMT -7
We received a call this morning from VSS (Veterinary Speciality Services). Frankie can urinate on his own, is eating and drinking, but is still experiencing weakness on his left side. Maybe that side of his spine is still inflamed?
We're going to visit him later this afternoon. I can't wait. I had a difficult time falling asleep last night and staying asleep because I just want to him see.
As each day passes, the amount of time I spend worrying about Frankie lessens.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 25, 2013 8:28:59 GMT -7
Weakness is from nerve damage…. it will very likely self repair in a timely manner… it is still very, very early post op. Set your worries aside…Frankie is going to be fine!
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Post by julnewma on May 28, 2013 8:09:51 GMT -7
I spoke to the neurologist this morning; he is puzzled about Frankie's weakness on his left side, especially because before the surgery, he was mobile.
He's doing an MRI at 11:30 am. to make sure there's not a neurological explanation for Frankie's weakness, e.g. stroke or bleeding.
Frankie was supposed to be discharged today, and I was so excited (and nervous) to bring him home.
Aside from the second MRI and weakness on his left side, Frankie is pain free, eating well, barking, and interactive.
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Post by julnewma on May 28, 2013 11:08:57 GMT -7
MRI revealed two things:
1. The tissue that was affected by the rupture may be causing the weakness
2. There is still a 20% block (prior to the surgery, there was a 50% block).
We have two courses of treatment:
1. Conservative route: wait and see if Frankie continues to improve, if he regains strength and mobility over time
2. Ventral slot: perform a ventral slot (neuro. used a dorsal approach for the first surgery) to remove the offending disc material
I am meeting the neurologist today at 5:00 to discuss our options in more detail. As of now, he recommends the conservative route.
What are your thoughts?
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Post by natureluva on May 28, 2013 14:20:00 GMT -7
This is my opinion only, and I am not a vet - I would do conservative. I wouldn't put him through another surgery unless it was absolutely necessary. He could still have some post-op swelling. He's already got bladder control back, which is excellent this soon after surgery. To me, slight weakness in one leg is no big deal. But then again you're talking to someone whose dog it took 11 months to walk again after his surgery. He still can't scratch his ears or climb or run very well. Many times it takes months for dogs' nerves to continue healing and their muscles to strengthen. So this could be the case with your pup.
8 weeks of strict crate rest plus meds to reduce inflammation and mask any pain can do wonders.
Acupuncture and laser therapy are also very helpful - stimulate the nerves to heal, induce a state of well-being, and reduce inflammation.
Please let us know how you are going to proceed. Best wishes, ~Lisa
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Post by julnewma on May 28, 2013 15:55:54 GMT -7
The vet showed me the before and after MRI images. The after image shows a protrusion that occupies a little under 20% of the space. The vet said the protrusion, black spot, could be disc material, or it could be a blood clot.
The after MRI images also showed that there's a lot of inflammation on the left side of the space that was operated on.
The vet thinks we should treat this conservatively for now. So the plan is to taper Frankie off meds to determine if he's still in pain and start water therapy tomorrow. Frankie is still at the clinic.
We will reassess on Thursday.
Prior to the MRI this morning, the vet said that Frankie was lively and moving his neck all around. When I saw him this evening, he was very very sleepy.
I just want my boy to get well so I can bring him home.
Oh, the thing I find confusing about Frankie's case right now (the vet, too) is that he's exhibiting weakness on the left side, front and back, and that leads me to think the weakness is the result of inflammation/nerve damage. If he were still experiencing disc pain, is this how it would manifest itself: weakness in the front and back of his left side?
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Post by natureluva on May 29, 2013 7:16:48 GMT -7
I agree that post-op inflammation may play a role in his weakness. The weakness likely isn't due to pain, but due to nerve damage. There may still be swelling on his spinal cord that needs to resolve with time. So that weakness may improve. This can take weeks or months as nerves regenerate. Sounds like your vet has a sound plan. Please let us know what his pain level is when they taper his meds. Hoping for the best, ~Lisa
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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 May 29, 2013 10:34:23 GMT -7
I am so glad that Frankie is safely through his surgery and doing so well. conservative treament now is a perfectly reasonable thing to do, to allow the swelling to go down and the healing to commence. I think that you will all be so much happier once you have your little guy home  Keeping you in thought and prayer |
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Post by julnewma on May 30, 2013 5:22:06 GMT -7
Frankie's homecoming was last night. I'm elated to have him home, but, I've got to say, this is not how I pictured his homecoming.
Frankie is still having a lot of trouble walking and standing. His left side just won't cooperate. It breaks my heart that he's not mobile. I know I've got to give him time to heal, and I will.
This evening, we are taking Frankie to his second session of hydrotherapy. His first wasn't that productive because apparently, he did not take to the water. I am not a bit surprised. I bet hydrotherapy can be scary.
Frankie is still pain free. He's snuggly and can't wait to eat and drink.
He's on Prednisone twice a day and Gabapentin three times a day. I'm going to talk to the vet today about adding in Pepcid.
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Post by natureluva on May 30, 2013 7:09:03 GMT -7
Hi, wish I could take your worries away. I'm not sure how to comfort you other than to say that Frankie just had major surgery only 8 days ago. We as humans also need long recovery periods from major surgeries. Try to keep things in perspective and focus on the positive: He made it through the surgery, he is in no pain, his disc has been mostly repaired, and he already has bladder control-tail wagging ability-leg movement back. I might've mentioned this before, but it took my dog 11 months after his surgery to walk on his own again. Some dogs stand up a week after surgery (like yours), and others need a much longer healing phase to recover to their full potential.
If it is within your budget, I recommend acupuncture and laser therapy. Glad you will be adding in the Pepcid. Tell the vet you want to be proactive about protecting Frankie's stomach.
Please hang in there. I know this is an emotional time - been there myself!! Things get easier. Our dogs immediately adjust - it takes us much longer to adjust as humans!
Sounds like Frankie's personality is back in full force. Take a deep breath and focus on the many positive things about your and Frankie's love.
We're here if you need us - vent, scream, cry, and laugh with us! ~Lisa
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Post by julnewma on May 30, 2013 18:42:55 GMT -7
Thank you, Lisa.
We had our second water therapy session today, and Frankie was walking on the treadmill with all four limbs. It was so great to see him use his left side. The therapist also used a leash to support his middle, told us to stand on one side of the room, and Frankie darted toward us. Compared to how little he had been moving in the previous days, it was hard to believe the amount of moving he did today during PT.
We are supposed to support him as needed while he stands for 20 minutes a day. We are also supposed to practice walking at a slow pace.
Frankie is going to have PT 2x a week and then taper down to 1x a week.
Hope is alive!
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Post by natureluva on May 30, 2013 18:53:04 GMT -7
Julie - sounds like Frankie is going to do just fine with physical therapy!! Water treadmill is an excellent therapy. Glad you are feeling more hopeful. Take it one day at a time and enjoy the little things. :-)
Please keep us updated. Best wishes, ~Lisa
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Post by julnewma on Jun 1, 2013 16:32:18 GMT -7
Hi,
Frankie's left limbs are very stiff, so stiff sometimes it's challenging to manipulate them, bend them and put them in place.
Has anyone else's post-op dog encountered this? Any explanations as to why this rigidity is occurring?
Thanks!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jun 1, 2013 16:52:23 GMT -7
Clark's legs are also at times hard to get him to bend at the knee. This is what I do.
Very gently put some pressure behind the knee cap and gently help him to bend.
Another way is to use the tickle between the pads as that also will allow the knee to often bend.
Sounds like Frankies PT is going to yield some very promising results!!!
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Post by julnewma on Jun 3, 2013 10:50:48 GMT -7
Hi,
Question about meds: Frankie has only 2 or 3 more days of meds, Pred 2X a day and Gabapentin 3X a day. Neither are being tapered.
Should I check in with the neuro on this? Based on the readings on this site, it seems like both of these medications should be tapered.
If you think I should ask the neuro about this, how do I do so diplomatically?
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Post by Scott Squared on Jun 3, 2013 13:13:00 GMT -7
I can't speak for the Gabapentin as we've never come across a taper from 3 different physicans (2 primary and 1 neurologist). As for the steroid, I would DEFINITELY contact your prescribing veterinarian about a taper. I have a background in human medicine and steroids such as these should never be stopped abruptly as your body has grown accustomed to the constant supply. It basically puts your adrenal glands on standby. I sudden stop in taking an oral steroid doesn't give the adrenal glads time to get back in the game. This can result in a lot of needless suffering and any number of complications or "adrenal crisis". I know what it's like to have to question a physician. I do it on a daily basis. We are groomed to look up to people of authority and not question their actions. There's a saying in healthcare... It's all the "little people" in medicine that stop physicians from accidentally killing you.  Maybe someone else will have a tidbit of wisdom in this case, but I would simply call and share my concern about a lack of a steroid taper. Other than that, there is always the almighty second opinion. Best of luck! Little |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jun 3, 2013 20:51:02 GMT -7
Your local general vet did have a taper for prednisone. You can coordinate the taper with him or you can call and tell the neuro you would feel prefer if he would give you a taper to every other day schedule for Prednisone.
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Post by julnewma on Jun 5, 2013 17:34:22 GMT -7
Frankie had his sutures removed today. At our visit, I asked the neurologist about a Prednisone taper. He said that would be fine, so that's what we're going to do.
I also asked him if Frankie should be kept in a pen or crate for the next 6 weeks, 4 now because he spent 1 week in the hospital after the surgery and has been home for 1 week. He told us that as long as we supervise Frankie, he does not need to be kept in a pen or crate and that we should encourage him to walk.
I'm not quite sure I agree with this recovery plan. I'm more comfortable keeping Frankie in a pen so that he can heal properly before resuming normal activities. Plus, in addition to Frankie, we have two other doxies, and at this point, I like knowing that they can't accidentally jump on Frankie or entice him to do something he should not. Additionally, our floors are wood, and wood is too slippery for Frankie to walk on right now. We plan on getting rugs down the road to remedy this problem.
Thoughts about following the dr.'s advice or sticking with crate rest? The last thing I want to do is hinder Frankie's progress.
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Post by Scott Squared on Jun 5, 2013 18:10:36 GMT -7
As a newbie on these boards, take what I'm going to say with a grain of salt. I'm sure there will be more experienced replies shortly. I was actually quite shocked that our Neuro only wants our Kiko on strict crate rest for 2 weeks at home (total of 17 days post-op). Especially since they weren't able to perform his surgery from the front like they wanted. This was mostly so his incision would heal without complications or seroma. When we go in for his staple removal (the end of his 2 weeks), I have no plans on "just watching" him. He's part JRT so that's not an option. We're going to do a hybrid of crate rest after next Friday. We plan on keeping him crated when he's not directly in our control or by our side for a few weeks. After that, he'll sleep in his crate and be crated when we're away from home from now on. I don't want to take any chances. I think that what you should take from this is that you should be comfortable. As long as Frankie is not in danger of hurting himself or over doing it, a little "controlled" escape from the crate is OK at this point. We already have a small, fleece lap blanked (clearance at Target) washed and ready for Kiko to join us on the deck this summer.  Little |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jun 5, 2013 20:41:49 GMT -7
Julie, kudos to you for speaking up about the prednisone taper. Good job!
Graduation day is not long off at July 3rd! With a surgical patient, crate rest terms can be a bit confusing. The surgery took care of the offending disc pieces, so physical therapy can start soon after surgery.. With conservative treatment the healing really depends on 100% STRICT crate rest 24/7 only out for potty for a full 8 weeks.
So with post op crate rest there still needs to be healing for the bone that was cut into in accessing the disc and spinal cord and all the soft tissue of muscles hence crate rest. We all know people with a broken arm need to rest it in a cast for 6 weeks.
Physical therapy is always done under supervision, in a slow deliberate manner. If the surgeon wants him to walk to and from the potty place for example, you do it with a leash and harness on. Dogs don't get PT! When they are out of the crate they want to go, run, chase, dart. So all the PT a surgeon prescribes is done…but with a harness and leash to control speed. After PT is over then back in the crate for the balance of 6 weeks to finish healing.
I think Texas A&M explains it best:
All patients with spinal cord injury whether they have had surgery or not, need to be on strict cage confinement. Rest allows for the healing of surgical incisions and will allow for scar tissue to form over the disrupted annulus.
Many clients are confused as to why exercise restriction is often necessary after spinal cord injury in veterinary patients. While limited scientific study has been devoted to this topic, a period of exercise restriction combined with physical rehabilitation is believed to hasten recovery from spinal surgery and certain spinal cord injuries. Vertebral column injury and surgery can disrupt the normal stabilizing structures of the spine such as muscles, bone, joint capsules, and the intervertebral disk. Excessive, unrestricted activity after surgery or certain injuries can lead to vertebral column destabilization and prolonged healing of the injury site. The intervetebral disk, in particular, is very slow to heal and healing may be incomplete; excessive vertebral column motion after disk surgery may therefore lead to recurrence of disk herniation. Additionally, animals that are weak or incoordinated may accidentally traumatize themselves, leading to orthopedic and soft tissue injuries.
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Post by julnewma on Jun 6, 2013 7:25:33 GMT -7
I'm sticking with crate rest until July 3rd. Definitely.
Frankie is off pain meds as of today. We are also starting laser therapy tonight, and I'm very excited about that.
He's still making progress every day, and I am very, very thankful.
Little: It sounds like Frankie had the same surgery as Kiko, but instead of staples, Frankie had sutures. Also, Kiko tolerated the surgery much better than Frankie as Kiko was walking the same day of his surgery. That is so awesome and impressive!
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Post by julnewma on Jun 6, 2013 8:36:34 GMT -7
I spoke to Frankie's neurologist about laser therapy. He said although there's a lot he doesn't know, he doesn't necessarily recommend it because there's not enough peer reviewed literature out there about it.
After that conversation, I am second guessing my decision to pursue laser therapy for Frankie.
The veterinary practice that will be administering the laser therapy had very positive things to say about the treatment (to be expected, of course).
Anyone care to share their thoughts/experiences with laser therapy after surgery?
Thanks!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jun 6, 2013 9:42:10 GMT -7
Do your own research, Julie, on laser light therapy akin to acupuncture, electroacupuncture, but done with light instead of needles. This is for starters: "Electroacupuncture combined with conventional approaches for IVDD shortened the time needed to recover deep pain perception and ambulation compared to standard of care alone in dogs with TL IVDD, based on a study published in 2007 in the Journal of the American Veterinary Medical Association. Acupuncture stimulates neuronal regeneration, possibly through stem cell mobilization, differentiation and other avenues" www.veterinarypracticenews.com/vet-practice-news-columns/complementary-medicine/laser-therapy-may-work-on-tl-ivdd.aspx "It’s worth emphasizing that laser therapy does not just accelerate healing; it actually improves repair, regeneration and remodeling of tissue. Post-op complications are reduced. Muscle atrophy can be reversed. Type 1 collagen production yields better tendon and ligament strength and elasticity. There is a positive effect on neurologic function and axonal sprouting. The joint capsule, synovial lining and fluid, and cartilage all benefit. Therefore range of motion, function, flexibility and mobility are all enhanced." www.veterinarypracticenews.com/vet-education-series/therapy-lasers-too-good-to-be-true.aspx "Clinicians at UF's Small Animal Hospital began using the procedure routinely after results from a year-long study showed the laser's effectiveness in patients with intervertebral disc disease... The study is the first ever to compare dogs with intervertebral disc disease treated postoperatively with lasers to dogs not treated with lasers, Schubert said. He called the results "revolutionary." veterinarypage.vetmed.ufl.edu/2011/09/19/laser-treatment-helps-dogs-with-spinal-cord-injury/ [UF 1 yr study] |
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Keeping you in thought and prayer 
