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Post by Curtis & Moet on Dec 12, 2016 13:16:06 GMT -7
Moet had another round of acupuncture today and here is the report:
"Moët will be starting rehab at NTAR shortly(has completed her initial evaluation). Her cart is OTW and she overall is doing quite well. Incontinence still present. She is getting her bladder expressed every 5 hours and wears a diaper. Owners are careful to be vigilant about hygiene and there is no urine scalding. Mild redness in inguinal area. Advised leaving area open and exposed to air frequently. Patellar reflexes 2+, minimal deep pain LH potential on last exam at DVSC. Withdrawal reflexes hyper responsive today.
Wei jian
electroacupuncture Liu Feng, BL 14, Shen Shu
BL 11, BL 25, KID 3, ST 36(partial),
aquapuncture GV 4, BL 18/17, Lu Gu"
She recommended water treadmill therapy again and we are trying to get Moet in for that ASAP. We all agree that with some buoyancy she should have the best success yet at attempting to walk.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Dec 12, 2016 21:08:56 GMT -7
Doctor concurs you guys are dong a good job of nursing care. There is still much time for nerve healing, it's very early in the game.
Looking forward to some pix at the under water treadmill and how Moet responds. Stay in touch with updates...we LOVE them.
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Post by Curtis & Moet on Dec 21, 2016 12:00:58 GMT -7
Moet had her first underwater treadmill experience today. They said she did VERY well. We weren't in the room since they are trying to get her accustomed to them without "mom and dad" in the room for her to whine to. She did 10 minutes straight and they said her rear legs were working the entire time! We will ask them to take some pictures and video next week when she goes back for another 30 minute session. After a few 30 minute sessions she may move up to 60 minute and/or twice a week. They recommended that we try and do some obstacles with her at home to encourage her to lift her back legs over things. She is pulling her thigh forward, but her knee down is still having some issues causing dragging (when not in the treadmill). They said they are still not 100% sure if it's spinal walking or mental. They noted that the surgeon let them know there is some possible deep pain sensation, so they are concentrating a little extra with her to help figure out what's spinal and what's mental. They also commented about her squatting to pee. We've also noticed the past couple of weeks that she is beginning to lift her legs to squat when we express her bladder, not just that her tail goes up. So that's also encouraging. Here is a video my wife took of Moet when she took her on her first walk in her cart down the block a bit. You can clearly see her rear legs moving at a slower pace. goo.gl/photos/ASr8wwkkzwozxCSC6Here is a video of Moet looking out the backdoor thinking about chasing rabbits: goo.gl/photos/PU481Bcm6FbbXfhV9 |
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Post by Curtis & Moet on Dec 25, 2016 18:36:43 GMT -7
Another quick update. While we've been gone for Xmas with Moet, she has gotten more walking/dragging around than normal and she has had more great progress with her rear legs. On several occasions we have caught her bringing her left leg (mostly) froward enough while dragging and then putting it under her body and pushing her rear up in the air! She has managed to keep her rear up in the air for a few steps in a row even! We have seen movement with the right leg too, but mostly left (which is the one that the surgeon said she was able to get some deep pain sensation from a couple weeks ago). Also, any time that she is in her cart, she is constantly moving her rear legs as she runs around. So we are very happy that things are progressing even more. It's very encouraging to see her actually lift her butt off of the ground with her leg that was being dragged behind her.
We are still having issues with incontinence, however she is still telling us that she knows she needs to go many times before she does. We think that usually picking her up and touching around her bladder is causing her to go right as we're taking her diaper off. Sometimes we're able to get it off before she starts to go, and she is squatting as i mentioned above. Also we've noticed that if we are expressing her but don't get it all out, wiping her stimulates her to contract her bladder and get the rest out. So while we get peed on sometimes when this happens, we're glad that she is either going on her own or we're stimulating her to go without having to apply pressure to her bladder.
We will try and get a video of her doing this partial walk from her rear legs and post it.
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Post by Pauliana on Dec 25, 2016 21:57:01 GMT -7
Moet is making wonderful progress! Thank you for the wonderful update! We will look forward to the video!
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Post by Curtis & Moet on Dec 27, 2016 6:53:11 GMT -7
Another update this morning. Moet went in for her 3rd round of acupuncture yesterday morning where she twice wagged her tail slow and steady in reaction to hearing another dog barking at the vet's office! Also, later in the day my wife was going to pick her up and she rolled over for a belly rub (very typical). When my wife had just started to rub her belly, her tail began to slightly wag with high frequency like it used to when we would do this. It's possible this was a reflex, however we have not seen her tail wag like this when rubbing her belly since the surgery. So more and more positive signs keep occurring that are very encouraging. She has more water treadmill time tomorrow morning and we will post a video tomorrow after that.
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Post by Curtis & Moet on Dec 28, 2016 8:52:27 GMT -7
Here is the video from this morning of her treadmill time. Pretty amazing to see her back legs working so well! It's very clear that her left leg is doing great, but the right she is dragging.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Dec 28, 2016 9:11:27 GMT -7
Moet is progressing. It is wonderful to see both of the legs moving in a walking motion. The right will very likely continue to self repair the nerves to bring better control during walking with time. You both are doing a fine job of caring for Moet and helping her to re-learn the art of walking.
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Post by Curtis & Moet on Dec 28, 2016 11:54:15 GMT -7
Thanks, we are very excited that things are doing so well. From your experience with so many cases like this on dodgerlist, does this look like "spinal" walking to you? We are encouraged by the slight deep pain sensation a couple weeks ago in her left leg, and the tail wags Monday, but we're unsure what kind of walking this is.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Dec 28, 2016 19:30:31 GMT -7
Curtis, it is dogs who do not have any deep pain sensation who might be able to learn to use crossed extensor reflexes to spinal walk. Here is a video plus more detail about spinal walking: www.dodgerslist.com/literature/IVDDcourse/spinal_walking.html As you are aware Moet has deep pain sensation and happy tail wags...so pretty sure you are seeing the neuro function of leg movement not reflex. |
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Post by Curtis & Moet on Dec 29, 2016 9:39:21 GMT -7
Thanks for the link and actual name of the neurological process happneing. A lot more detailed info comes up when I search "Crossed Extensor Reflexes" than "Spinal Walking".
We will keep our fingers cross for more happy tail wags and further walking function in her rear legs and report back. She is on weekly treadmill therapy for now, and will go to twice a week probably the end of Jan.
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Post by Curtis & Moet on Jan 5, 2017 6:32:46 GMT -7
No video this week, but at therapy the tech's said that Moet was walking significantly better on her right leg. She wasn't dragging it behind her like she was last week. More good progress! We asked again about whether this was spinal walking or mental, and they once again said they didn't want to say for sure. They recommended that Dr. Thompson does another deep pain sensation test to see if she has had further progress there. We've seen a couple tail wags the past week, but no dramatic increase really. Still, it is good to see this.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Jan 7, 2017 10:22:47 GMT -7
Curtis, sounds like real neuro improvement to observe less dragging of the right leg....nerves are continuing to heal, connections being established with muscles and brain. Would be great to have Dr. Thompson's confirmation of DPS to correlate with what is being observed.
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Post by Curtis & Moet on Jan 8, 2017 7:20:27 GMT -7
Agree, we will hopefully get some confirmation in a couple weeks when Moet will have to stay at the surgery center on "Medical Boarding" because we will be out of town and the rest of the family is gone/unavailable as well.
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Post by Curtis & Moet on Jan 27, 2017 7:45:16 GMT -7
We are back from being out of town when Moet stayed at the surgery center. They said they performed another DPS test but it came back negative on both sides. A little discouraging considering that we really thought that she was showing positive signs on her left side with the last test when she tried to bite the dr. They said she did great again at physical therapy with the treadmill, and she continues to move both legs quite a bit and is trying to walk even more. So at this point it's pretty clear it is indeed spinal walking, which is ok, however that means no progress towards her incontinence. We are going to get her in for a UTI test to be sure that we're handling that all well and get into a normal schedule of bi-monthly tests probably. Hopefully we can arranged a way to send of samples instead of having to take her in every time for that.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Jan 27, 2017 11:27:11 GMT -7
Did a neuro specialist at the surgery center specifically give the DPS test or was it another kind of vet? We have found it is only the specialist's who have the training and eye to correctly identify what they see. Anybody can give the DPS test, but so many general vets do not have the practice nor the eye to correctly interpret what they have observed. The sign for DPS could be so very subtle as change in pupil size.
How is Moet doing now that you are back...I bet she was overjoyed to see you.
She lives in the moment, she has you to drive to the store for food and you provide her with love and a warm place to sleep. Moet will likely be thinking much the same as my Clark. She is also a "can do" girl and it matters not to her how she chooses to get from point A to point B.
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Post by Curtis & Moet on Feb 1, 2017 16:01:42 GMT -7
We're not sure who did the DPS test, but since it was at the surgery center, assume it was the same doctor as before. We definitely understand how difficult the test can be, so aren't too disappointed really. We have seen signs that we think indicate some nerve repair, so we'll just keep hoping that continues to get better. We have noticed that some of the muscles in her back legs have started to show signs of atrophy, but that is probably expected since she isn't using them much anymore really. She loves her cart, and we try to get her on a short walk around some of the neighborhood every other day or so. She gets around dragging quite a bit as well. At my parents house she gets up on her back legs more often than our house because we have slick wooden floors downstairs. She has gone almost all the way across rooms at their house on all 4.
Moet went in to our normal vet today and they said that she has a minor/mild UTI with a very slight amount of blood in urine (I believe is what my wife understood). We were suspicious because her urine smell has changed (musty kind of) and we are not getting her to go as much at once lately. We have been finding that she rather consistently has urine in the diaper even when we're expressing more than we should have to (every 3-4 hours). The vet watched my wife express her bladder (for the UTI test) and then checked and said that she was correctly expressing the bladder all the way, so he wasn't quite sure what may have caused the UTI. They gave us a round of Enrofloxacin (Baytril) to give her daily, so we will start that in the morning. They also gave us some test strips to use to help identify when she has a UTI, and we'll order more of those online if we can find them. I know that you and others recommend a culture to find out what strain of bacteria to fight, but the vet today did not mention that was necessary right now. Perhaps they want to try this round of antibiotic first to see, and then culture next.
Other than that, she is acting just fine. Her typical self.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Feb 1, 2017 19:45:50 GMT -7
Curtis, this article on UTIs can give you some ideas to prevent bacteria entering the bladder with the scooting Moet is doing. Also lots of useful info written especially for our IVDD community in understanding more about UTIs. www.dodgerslist.com/literature/uti.htmAre you able to put down some inexpensive rug runners that you can find at the big box stores. Place them on Moet's usual flight pattern. With nerve damage slick floors are very difficult for a dog to walk on, they need the traction carpet provides. |
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Post by Curtis & Moet on Feb 1, 2017 22:30:34 GMT -7
Thanks for the additional information on UTIs. We are keeping a diaper on Moet most of the time, even when scooting. The only real problem we have with that is that she slips out of it often when scooting around or in the pack-and-play overnight!
Good idea with some additional rugs. We will give that a try. We try to put her in her cart rather than her scooting around so that it isn't so much stress on her front legs and muscles to drag her full body weight around, as opposed to less friction with the cart.
Will let you know how the round of antibiotics goes. At least she isn't in pain from it (that we can tell)
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Feb 2, 2017 12:54:11 GMT -7
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Post by Curtis & Moet on Feb 3, 2017 14:42:56 GMT -7
Great ideas with the onsie and the "cape". We tried a couple "pants" with straps to keep them up, but the straps just come off too. The onsie may work better to stay on, and the cape is a uniquie idea to prevent the diaper from touching the ground and getting traction to come off. We'll try and give these a shot. Thanks!
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Post by Curtis & Moet on Feb 9, 2017 18:27:32 GMT -7
Well some days we are a bit discouraged by her progress, but then there are days like today! Take a look at this video of her walking around!
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Post by Julie & Perry on Feb 10, 2017 5:48:32 GMT -7
Wow look at Moet go!!! That's terrific.
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Post by Curtis & Moet on Feb 12, 2017 8:31:55 GMT -7
Yes, we are very happy with her improvement. It looks like she is wagging her tail a bit as she does it, but hard to say if that's actually her diaper forcing her tail to move. Other times when she is VERY excited (usually when my wife or I get home), we think we see a bit of movement from her tail. Like I've mentioned before though, even if it is spinal walking, we are happy that she is able to even do this!
Also, an update on her UTI. It has been over a week now since we started antibiotics, and it has definitely helped! We notice a difference in that she is not wetting the diaper between times that we express her (which was almost every time before), and her urine is more of a consistent darker color. Expressing her is also a steady stream until she is empty too. When she had the UTI it was lighter colored and possibly cloudy (though hard to tell midstream, we never captured some to put in a clear cup to check). Also my trick of wiping her extra to get her completely empty has stopped working, and we can empty her bladder all the way just doing normal expressing now. So I think it's actually good that she had that UTI so that we know the signs with her from now on. We have an extra dose of the antibiotic, and also some test strips (though there is no identifying marker on them at all to try and order some ourselves), so next time that we can tell she has one, we can get her started on antibiotics quickly. Of course, the goal is to avoid that, but we're not 100% sure how she got the one before. We'll just have to continue to be consistent with her expressing and be sure to wipe "front to back" with her. We are in town consistently until the end of April so we'll have a good length of time to watch her closely ourselves.
If anyone knows where online to purchase test strips like our vet gave us, please let me know. Thanks!
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Post by Joann & Baxter on Feb 12, 2017 9:27:45 GMT -7
Curtis....you can get them from Amazon. I order them myself because my Baxter can't be expressed, so I use a catheter 3 times a day. I check his urine twice weekly. The indicator box will turn purple if there is a suspicion of a UTI.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Feb 12, 2017 9:56:58 GMT -7
 Those dipstick strips are available for alot of different tests. The bottle of strips has a color key on the label as assessment for each test. The tests you are likely interested in is the pH, nitrites and maybe leukocytes. The bottles come with 100 strips. You likely will not use all before they expire. If you buy the same brand as your local vet uses, then you would have the bottle with the key on it and thereafter could just buy a few fresh strips from the vet to re-fill your own bottle. You might discuss with your vet to confirm which tests might be useful in helping to suspicion if a UTI is developing. This is just one of many companies you could Google offering dipsticks: www.mountainside-medical.com/products/rapid-response-7-parameter-urinalysis-reagent-strips?gclid=CLPcqKqCi9ICFQcLaQodGroCIQ |
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Post by Curtis & Moet on Feb 13, 2017 10:43:01 GMT -7
Thank you both. The vet just told her to watch the bottom one for any hint of green, but I wasn't there to confirm what that's testing. I have a marine aquarium so am very familiar with chemical tests, but wasn't sure what to watch for. Thanks for the link. We'll order some additional in the future after we go through the ones we have now. We may do a test every month or two, or when we suspect that there is something going on again.
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Post by Curtis & Moet on Feb 27, 2017 9:54:39 GMT -7
Another quick update and video. My wife caught Moet standing for well over a minute as she ate her breakfast this morning.
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Post by Julie & Perry on Feb 27, 2017 10:53:38 GMT -7
Yay!! That's so exciting. Go Moet! I'm so happy for you.😄
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,941
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Post by PaulaM on Feb 27, 2017 12:00:14 GMT -7
Curtis, did Moet move herself up into a stand? Or was she placed into a stand position?
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