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Post by Camille & Bean on Oct 4, 2018 10:55:23 GMT -7
![]()   Hello Everyone, I'm so very grateful for this amazing resource. Here are the details for our sweet girl Bean. Here is a summary of what happened: On Wednesday 9/19/2018, Bean was exhibiting signs of pain, similar to her first flare up in 8/2016. She was walking slowly, tail down and grunting (her typical vocalization of pain). We gave her Metacam and Gabapentin (from previous flareup) and let her crate rest. The next day Thursday 9/20, we took her to our holistic vet for acupuncture to help with the flare up. She was walking fine, and seemed to be in a bit less pain possibly because of the medication. On the third day, Friday 9/21 in the AM, Bean had a hard time peeing/pooping with her legs collapsing behind her when she tried to squat. By afternoon she could not stand up or walk but her legs were moving. We took her to our regular DVM who then confirmed she still had deep pain sensation, though her legs were not moving, paws knuckling, etc. It was about 3pm when they decided to do an xray. Xray showed increased calcification from xray of last year (8/2016). The DVM sent us home with same medication but when I asked if he suggested we do surgery, he said yes (but he did not talk to us about the 24 hour window, or that it was recommended to do it urgently due to paralysis). That same Friday evening she seemed to be in the same amount of pain but comfortable enough to sleep. I was worried however that she was sleeping the entire time with her head high . That night I spent alot of time trying to research about our options and decided to take her to surgery the next morning. On the fourth day, Sat 9/22, we took her to UC Davis veterinary hospital where emergency vets examined her before recommending to neuro around 11am. On-call neuro showed up and did their own tests. By that time (say 12ish) they said she no longer had deep pain sensation. By this point she had not peed for 24 hours. Neuro suggested emergency MRI/surgery and we went ahead with it. Her surgery was not performed until around 5pm. So from a conservative time estimate, she had no deep pain sensation for just a little over 24 hours. Report from neuro: Left sided T12-13 intervertebral disc hernation and spinal cord compression with material extending from T12 to L1; multifocal degenerative IVDD. performed left hemilaminectomy T11-T13 with T11-T12, T12-T13, T13-L1 fenestrations. No bruising present at spinal column and surgery went well. Bean was discharged the following Friday 9/28. She has no deep pain sensation, still paralyzed, and needs her bladder expressed. She was recommended immediate physical therapy and crate rest for 4-6 weeks. We are doing PROM and massaging as recommended by this website and neuro, and doing it 3-4 times a day. We are also doing acupuncture twice a week;
**I have a couple questions at the end of this post.** Other Information
1) Weight: 11 lbs; Medication: Was on Metacam 1.0 mL 1x day for five days as recommended by neuro (9/28-10/2), no longer on any pain medications; Also prescribed Trazadone 50 mg 3x a day (but we don't use it since she's no longer anxious); Supplements: Standard Process Brand - Canine Muscoskeletal, Gota Kula, Ligaplex; also Doc's formula and 0.33 mL of Hemp Oil 3x day.
2) Bean is a Chihuahua Dachsund mix (I'm Camille, her mom, and we have two other chi-weenies, Charlie and Rikki) 3) IVDD Diagnosis: diagnosis made by primary DVM on 8/2016 through x-rays showing calcification of discs after a flare up. No other tests were done but MRI pre-surgery confirmed IVDD condition and showed herniation. 4) Date of Surgery: 9/22/2018, performed left hemilaminectomy T11-T13 with fenestrations at T11-T12, T12-T13, and T13-L1. No complications and no bruising found on spinal cord. 5) Pain: Not painful (thankfully). 6) Food/Water/Poop: Eating and drinking well. Poop is firm and normal color. 7) Mobility: Bean cannot walk or stand, and legs are not moving on their own at all. As of 10/3 from primary DVM, no deep sensation.
8) Bladder control: We express her bladder 3-4 times a day. She cannot release pee on her own but she does not wet bed. There are leaks on occasion.Questions: 1) At home physical therapy: We've had Bean home recovering for about 6 days now. However on the 4th day she's starting to show discomfort when we do physical therapy/ROM movements. I lie her on her side and do bicycles and joint flexes and she will either look back, try to get away, or reposition herself as if she's uncomfortable. Why is she doing that? Yesterday (10/3) we went to acupuncture and the holistic DVM tested for deep pain sensation but did not see anything different. Am I hurting her when I do PT or is it some weird thing going on with her nerves? Just wondering if her nerves are getting worse, she's feeling pain, or if she's getting better and nerves might be firing? 2) I've been very concerned with how our regular DVM did not push us or recommend urgent surgery to save her mobility. I believe we may have missed the window because she got into surgery a little over 24 hours since she may have lost her DPS. Is this window really definitive? I read some article that some studies show no difference in success rates based upon the time of surgery from loss of DPS. Can anyone recommend some success stories/graduates who were in similar situations and regained mobility? Thanks for everyone's support! Camille and Bean |
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Oct 4, 2018 13:32:28 GMT -7
Camille, welcome to the Forum. It is way too early in the nerve healing department to be able to make statements about how much can take place. Deep Pain Sensation is hard to test for accurately without good training and practice. Only take the word of a specialist neuro (ACVIM) or ortho (ACVS). Nerves heal typically in the reverse order of the damage to the spinal cord. Surgery can still be successful in the window of 12-24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance. Precious hours can be lost with a vet that gets DPS wrong. 1. Deep Pain Sensation (Only correctly identified by a specialist.) 2. Tail wagging with joy at seeing you or getting a treat or meal. 3. Bladder and bowel control verified with the "sniff and pee" test. 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 place the feet. 6. Ability to walk unassisted and perhaps even run. More info: www.dodgerslist.com/literature/healingnerves.htm--So.... can she do a happy tail wag if you specifically do some happy talk to her? If, yes, then it may be time to give the sniff and pee test periodically The only way for humans to know if there is bladder control is with the “sniff and pee test.” Carry outdoors, set them on an old pee spot to sniff. Make sure the sling or your hands are not on the tummy area as that can press on the bladder. See if they will release urine on the old urine area. If urine comes out after sniffing, bladder control is returning. You should continue to do a quick express check to verify there is full voiding until you are certain it is consistently happening. Let us know what you observe. -- Good job if she is staying dry in between expressing sessions. -- A lot of times when a dog regains some degree of nerve repair to the legs, they will not like you doing the exercises. Again the only person to trust about DPS would be your specialist surgeon. The happy tail wag is something that no one can get wrong in assessing for nerve status. Let us know what you observe. |
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Post by Camille & Bean on Oct 4, 2018 20:42:00 GMT -7
Thank you Paula. There's no tail wagging yet. She's almost 2 weeks of post-op but neuro won't be able to check for DPS until her check-up in the beginning of November. It's disconcerting to hear that one can't trust general DVMs on DPS because most of us will likely see our general DVM first before a neurologist, and being that it can be hard to get a neurologist right away. I'm hoping that our DVM was correct when she still had DPS when I took her in that afternoon (a day before her surgery). Will keep waiting for that tail wag.
I just purchased Gingerlead, a sling to help her practice some walking. Anyone use that brand before, or recommend another?
At this point, is it okay to put her in an enclosed stroller so we can go outside for some fresh air? I know she's supposed to be in her pen most of the time for the next 4-6 wks, but she would move just about the same, if not more, in her pen.
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Post by Pauliana on Oct 4, 2018 21:26:26 GMT -7
Hello Camille, welcome!
It is best to use the stroller in the house as an additional recovery suite under supervision only.. When her crate rest is over you will enjoy lots of stroller walks like Tyler and I do daily.. Although Tyler is doing more walking than strolling these days..The problem is getting in and out of the house without bumps and sometimes the sidewalks can be bumpy.. Her disc is still in the early healing phase and the healing can be disrupted causing her more pain and setting healing back.. If there are only smooth surfaces coming and going it might be ok..but be cautious!
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Post by Camille & Bean on Oct 5, 2018 21:52:51 GMT -7
Thanks Paulina, all very good and valid points. Other than Kong's, what other things are recommended for mental stimulation for pups on crate rest? I noticed she's not even comfortable yet with holding her Kong with her two front paws so I don't know what else I can give her to pass the time.
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Post by Julie & Perry on Oct 6, 2018 0:06:08 GMT -7
You could put Bean's recovery suite near a window so she could look outside.
But I'd make sure it's one where there's not a lot of people or action to get her excited.
Also, if you have a larger or multi level place having more than one recovery suite enables Bean to see her family and what's going on.
Some members find their dogs like calm classical music. There's even calming music available for dogs.
Hope this helps.
Sending healing thoughts and prayers to you both.
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Oct 6, 2018 4:47:18 GMT -7
When you say that Bean isn't comfortable yet holding a Kong with her two front paws, why do you think that is? Could she still have some pain from the surgery? Does she also have some nerve damage in her front legs? Can she push herself up with her front legs? You mentioned that she appears to be uncomfortable during PT. Does she ever take any notice of her legs or hind area other times than when doing PT? I'd like to make you aware of neuropathic pain which can sometimes occur when a dog has had a severe spinal injury. This isn't common but you should know about it so you can watch for signs. This kind of pain is abnormal, phantom pain sensations. Signs are obsessive licking of paw, leg, genitals, tail. Escalates to biting, life-threatening chewing off parts. Immediately put on an e-collar (or lengthwise folded towel around neck and duct taped closed) to prevent access to lower body. Contact vet immediately for Gabapentin or stronger Lyrica (pregabalin) for neuropathic pain. More info: www.dodgerslist.com/literature/neuropathy.pdfIs Bean in a crate or ex-pen? If in a wire crate, you can attach caster wheels to the crate and wheel it from room to room with you so she's in the middle of daily activity. Good low cal snacks are carrots, apples, or frozen green beans, licking a frozen low sodium broth ice cube. Good thick low salt/no fat chicken broth is full of cartilage-building proteins and amino acids. Freeze it up into cubes for easy access as you need it. Fun and keeps the body hydrated: place cubes in a bowl for licking. www.dodgerslist.com/literature/CrateRRP.htm |
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Post by Camille & Bean on Oct 8, 2018 12:16:15 GMT -7
Thank you Julie! Yes we have a space and crate for her near the window where I place her sometimes so she can see the goings-on outside of our house. Sometimes I hold her on my lap while we sit on the ground in the backyard to soak up some sun (one of her fave things to do was to go to the backyard on her own and sunbathe, so I'm trying to continue that routine of hers even if she can't make it out on her own to the backyard). And yes I've always played calm classical or other soft music for my dogs throughout the day (it helps them nap really well too!). Marjorie - I'm not sure why she's not comfortable holding her Kong yet. She has no pain in her front paws and can lie down and sit up on her own fine using them. In the past with treats like bully sticks or Kongs, she usually lies on her belly and uses her two front paws to hold up the treat while she works on it. I'm fairly certain she has no pain in her two fronts, they are very strong and she uses them pretty effectively to scooch about in her pen. She did not have any nerve damage or pain in the front pre-surgery, and can push up easily on them when she wants to sit up. As for the discomfort in PT, I asked the neuro DVM about it and based on the symptoms, it doesnt look like it's pain. She believes it might be a tingling of nerves when I'm doing the exercises and maybe just feels strange to her. I have been doing the bicycles while she's standing and she doesn't mind it in that position. When she's in a lying position and I perform the joint reflexes, it sometimes makes her want to switch positions or get away from me, and on occasion she will look back to see what's going on there. Maybe her wanting to move away is another involuntary reflex (where her body thinks she's in motion?). I also do the tickling of her paws and between toes and the involuntary reflex for that is very strong because her paws or legs will retract quickly and try to get away from me.  I'm aware of potential for neuropathic pain and keep an eye out for something that looks like that. She will sometimes lick her back paws for about 5 minutes and then stop - but I would say at this point that only happens maybe once a day. It hasn't escalated to an obsession or chewing, thankfully. I like the idea of crunchy snacks like frozen green beans, and frozen broth cubes, thanks! Follow-up questions: 1) I know that Dodger's List provides a specific order of signs of nerve recovery (first, DPS, then tail wagging, then bladder control, etc...) Is this something that is accepted by the neurology veterinary community? I was wondering if this is not always the case because of the variances of where nerve damage can happen and the complexity and intricacies of the nervous system, so that each dog may recover in different orders depending on severity and areas of damage...I would agree though, and it makes sense, that DPS would be the very first sign...I was just curious about the other parts.... 2) one new thing she start doing this week, 14 days post-surgery, is as soon as we we squeeze her bladder, her legs go into a crouched position and her left hind leg lifts - the same exact way she used to pee on her own. She wasn't doing this the first week, where her legs would just hang and dangle and we would try not to get them wet during expression. Now we don't even need to worry about getting them wet because the legs bend in a squat and one leg lifts on its own. Perhaps this is a new involuntary reflex that's finally back? I suppose I'm just hoping for signs of progression/improvement. I know that it is said that we are waiting for brain to limb nerve signals but could improvements with involuntary reflexes be a sign that things are repairing itself? |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Oct 8, 2018 15:18:33 GMT -7
Camile, our wording on order of nerve healing is: Nerves heal typically in the reverse order of the damage to the spinal cord. There are cases where a dog does not follow the typical order such as legs coming back before bladder control. Deep pain sensation comes back first and bodes well for there to be even more nerve healing to come.
It is difficult for us human's to decide what is brain directed and what is reflex. We have to see some sort of head level involvement with the tail, with a limb or with release of urine so we know the movement was done with purposeful thinking. Here are some examples of head level involvement.
--- Sniff (head level nose) then release of urine would be brain directed.
--- Hear (head level ear) you doing some happy talk and then tail wags is brain directed. Tail movement during potty time can often be a reflex
--- Itchy sensation at at neck and then tries to scratch would be purposeful movement. Tickling paws, etc can cause reflex leg movements.
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Post by Angie & Theo on Oct 9, 2018 9:30:09 GMT -7
Hi- I purchased the Gingerlead sling and we really like it. We also purchased a jogging pet stroller from Amazon. We got the jogging kind because it is supposed to be a smoother ride. We use it in the house, the top latches closed. He likes to watch me unload the dishwasher and do chores. So I roll him to where ever I’m working. We have been taking him on a stroller walk once a day on the sidewalks around the block. It’s a very smooth ride and we take the stroller out to sidewalk and then put him in it.
We are on day 26 since surgery/injury. Theo stood up one time for a few seconds when I was trying to get him out for potty time. A few days later (exactly 3 weeks after surgery) he started wagging his tail. We went to rehab yesterday and they said he has deep sensation back in his feet, but not in his tail. I guess it’s just wagging on its own? He still doesn’t have bladder control.
I’m sorry this has happened to your baby. It is very stressful! But, thank god for this site. It has helped me more than any of the vets I have seen (four! Theo has four doctors!)
It sounds like your baby will probably get better! I read all your posts and it’s almost exactly what happened to Theo.
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Post by Camille & Bean on Oct 10, 2018 17:15:42 GMT -7
Hey Angie, I've been following your thread for Theo as well! I just want to first say you are an amazing mom for deciding to stick it through for Theo considering you just recently adopted him. I know how heartbreaking this must have been for you when you open your home to a new pup and unfortunately find that they have a chronic condition like IVDD! Theo is extremely lucky to have you.
We got the mini Gingerlead sling but I don't think she really likes it because she keeps looking back at it and squats thinking she has to pee (it pushes on her bladder?). She's 11 lbs and the small seemed too big for her but the mini's padding area that goes under her is way smaller than that of the small. What size do you use? Also is it okay to hold it in a way that has her legs hanging above ground, even if it makes her walk at an angle (butt higher up in the air than the front)?
Please let me know which stroller you purchased - there are so many and so expensive too. I would want something lower to the ground so she can sniff, and of course enclosed so she doesn't jump out.
Congratulations on seeing Theo stand up and the tail wagging! So exciting and funny how we celebrate the tiniest improvements. I'm rooting for Mr. Theo for full recovery! (By the way, did he have deep pain sensation prior to surgery? Thats the part that concerns me in terms of likelihood of full recovery as Bean did not have it by the time she went under).
Today is Day 18 and we can see that she has regained alot of her strength and tries to move alot more in her pen than usual. She's also lifting her lower back a little more when she eats or drinks water from her bowl. She's trying very hard and is a trooper. She is also seeing several vets: holistic/acupuncture, the neurologist, and DVM for PT. It takes a village and I'm so very thankful we have resources to give her the best care. Thanks so much for your support Angie. Hugs and kisses to your Theo.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
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Post by Marjorie on Oct 11, 2018 4:56:06 GMT -7
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Post by Angie & Theo on Oct 13, 2018 8:53:09 GMT -7
I bought the stroller from Amazon: Pet Gear No-Zip NV Pet Stroller for Cats/Dogs, Zipperless Entry, Easy One-Hand Fold, Air Tires, Plush Pad + Weather Cover Included, Optional Divider www.amazon.com/dp/B00CGYE0NG/ref=cm_sw_r_cp_api_UoHWBbP7CC6DQThey had a returned one, so we paid $160 for it. It was only missing the instructions on how to assemble, found them online. It’s a great stroller. I think the air tires are very important because they make the ride very smooth. He loves it. We use it as much as the crate. He likes to look out different windows & this morning we strolled him over to the breakfast table so he could sit there with the other two dogs & stare at our eggs. It also seems a lot more cozy than the crate. |
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Post by Romy & Frankie on Oct 13, 2018 13:27:06 GMT -7
That sounds like a great stroller. During crate rest the stroller should only be used indoors with supervision. It sounds like it is giving Bean a nice change of scenery.
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Post by Camille & Bean on Oct 14, 2018 11:23:28 GMT -7
(Thanks Angie - I've seen good reviews on that stroller too. Hope to get a used one as well, great idea.) It is Day 21 post-surgery and I believe we've seen tail wagging from Bean especially today. This morning I took her out of her crate, greeting her with an excited, happy good morning, and saw her tail go up and wag a couple times. To be sure it wasn't a reflex from picking her up, I put her on the floor in a standing position and called my husband to come into the room to greet her and sure enough her tail gave about three slow whips. Does this suffice as a tail wag? I feel like everytime I see progress or something new, the vet or others with experience tell me it's just a reflex so now I've become skeptical of what is progress versus false hope. So when we're talking about tail wagging - is it quick whipping from how she used to wag beore, or can we have hope from seeing a couple whips, certainly triggered by a happy moment? We also saw PT DVM on Friday who advised us of good exercises to perform daily, she also received laser therapy. She has also received 2x week acupuncture her first and second week home from the hospital. For the next couple of weeks, she will be getting acupuncture 1x a week and PT 2x a week (including laser therapy). [$$$  !] |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Oct 14, 2018 12:16:11 GMT -7
Head level "saw" and then tail wagged. Brain directed!!!
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Post by Julie & Perry on Oct 14, 2018 16:04:37 GMT -7
Don't let anyone discourage you Camille. You know Bean best and I'm sure you are seeing progress.
For some reason vets seem to be pessimistic about IVDD dogs.
My response to negativity would be, " I'm working and believing that a full recovery
Is going to happen for my dog. Please support me in this."
That's terrific Bean wagged her tail!!
I'm doing my Snoopy happy dance for you both 😀
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Post by Camille & Bean on Oct 19, 2018 16:12:37 GMT -7
Today Bean is 28 days post-op (9/22) and one month anniversary since her flare-up (9/19). I thought it would be helpful to give a quick timeline of what we've done this past month and her recent progress from the week.
[Duplicate information posted previously:]
Week 1 post-op (9/23)
- In hospital for 6 days
Week 2 (9/30) - 1st week home
-strict crate/pen rest for 4-6 weeks,
-metacam for five days and trazadone for anxiety (stopped after 2 days post-discharge as it was too strong for her and not needed), supplements (see above)
-immediately started passive range of movement exercises every day 2-3x day, per neurologist advice;
-acupuncture 2x a week
- no pain, no deep pain sensation, no bladder/bowel control, no control of hind legs
Week 3 (10/7)
- same as above but no more meds, just supplements and daily exercise 2-3x a day
- 2 acupuncture sessions
- 1 laser therapy session
- PT DVM also recommended I hold her standing up every time she eats
- progress: no pain, no deep pain sensation, getting stronger and more restless being in crate rest; starting to bounce to get attention, lifting of left leg while I express her bladder and both legs started squatting on their own upon squeezing of bladder; slight and slow tail wag upon mentioning treats or greeting; standing on her own longer with less support (5-10 seconds long before collapsing or leaning).
Week 4 (10/14)
- supplements and daily exercises 2-3x/day
- 1 acupuncture session
- 2 laser therapy sessions, one session on treadmill
- progress: no deep pain sensation but can feel pinches further below the line drawn on back (to mark potential myelomalacia post surgery), tail strongly wagging now in response to treats, meals and person greeting;
and the newest updates from this 4th week:
- started standing up on her own in her pen when excited.
- Standing on her own longer while eating (30-60 seconds) needing less support to keep her propped up
- took outside for potty break with verbal command to pee and lifted leg, squatted and some pee came out without my expression (I had to express the rest)
I've seen pretty significant progress in the 4th week so I don't know if the nerve repair is getting better or if laser therapy really helped her along. whatever the cause we have been celebrating the tail and the standing.
Next week (5th week) we will be trying water treadmill since regular treadmill was hard for her; one acupuncture session, and two sessions of laser therapy.
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Post by Camille & Bean on Oct 27, 2018 10:10:14 GMT -7
Hello all, updates on Week 5. Today is Day 34 post-op. Bean has had two sessions of the water treadmill/aquatherapy and was able to walk in it unassisted. Her right leg is a bit weaker than her left so there was still a bit of knuckling on her right paw, but the left leg was pretty strong with barely any knuckling. (See the gif video I made of her from the front: Bean on Water Treadmill) She still can't walk outside of the water tank even if assisted with a sling but the doctor was impressed with her progress. Because we can't get water therapy twice a week every week, the PT DVM (board certified in rehab/sports medicine) suggested we try having her walk in the bathtub too. On land, it is getting easier for her to standup and we see a bit of motor movement of her upper thighs in both legs. The lower part of her legs aren't quite there yet. We continue to do 2-3x a day of bicycles, squats and passive range of movement stretches and her supplements. On potty breaks outside, most times she will squate and lift her left leg (what she used to always do before her injury) and let out a couple drips or a small stream (about a tablespoon), and I express the rest. Also, since we are starting to leave her at home for longer periods of time (3-4 hours), we decided to build an elevated floor for her pen that partially looks out through the living room window so she can see outside like she used to. It's 4 feet by 4 feet of wooden planks, topped with foam padding, and we bought a taller grate that is the equivalent of that around and about 36 feet high (about $50 on Amazon). I've attached the photo in case it might help people with ideas. (She's standing on her own here and trying to get out!)  |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Oct 27, 2018 10:23:13 GMT -7
Camile, wonderful to hear in the underwater treadmill she CAN walk. Just use the same principal of height of water as they do for the treadmill in your bathtub. Make it a fun game of walking towards a small treat or a toy in the tub. Do you have a life vest to use at home? More on at home water therapy between the times she can go to the rehab clinic. Water therapy: www.dodgerslist.com/literature/watertherapy.htmThe penthouse suite with a window view is fabulous! Nice to see her having moved up into a stand by herself in her recovery suite. |
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Post by Camille & Bean on Nov 11, 2018 14:26:46 GMT -7
Hi all, has been awhile since my last update and I'd love to hear from folks on my questions: Bean finally had her 6-week post-op follow-up with the UC Davis neurologist on 11/2. **  After all the great progress we had seen over the course of six weeks we were disappointed to find out that she still had no deep pain sensation. As many of you know, the veterinary/medical community uses the average timeline of 4-6 weeks to recover DPS so if the dog is still deep pain negative at that time, the prognosis is that they will not ever gain it back, and it is highly unlikely it will come back. They told us this very prognosis, recommended continued PT for her now considered "spinal walking," that we start getting her used to a cart/wheelchair, and even gave us a free (though too large) cart for her to start on, and sent us on our way. I have high regards for UC Davis and their wonderful neurologist department, and the doctors were compassionate and knowledgeable (this particular neurologist [resident] however is not Board Certified in Neurology and has a BVMS [UK's BVMS = USA's DVM]). But I can't help but find it inconsistent with the progress over the course of 6 weeks including: - Tail wagging for meals, treats and greeting loved ones
- Urinating on her own, sometimes almost fully, with a wobbly squat
- Taking her to a park to sniff other dogs' scents, then immediately seeing her left leg lift and mark (several times in fact after each sniff in various spots)
- Wobbly walking around the house now with a weak right leg but unassisted nonetheless!
- Increasing time and improvement in water treadmill
- Standing on her own for several minutes
So aside from what neuro has said that she is "spinal walking," how does one explain the urinating and tail wagging - is that spinal peein'g or spinal tail wagging? LOL.
I've been trying to come to terms with her prognosis the past week but I really can't help but think that there is something more, or something happening between no DPS and DPS. Or even some hope that maybe next month she'll regain DPS. How long do I hold out hope for DPS? I know that we can still have a perfectly happy dog who spinal walks but what I want most for her is unsupervised independence, like the ability to go out to the backyard and let herself sunbathe (her favorite pasttime), and go out for short walks with her brothers. I'm not comfortable letting her free range the house with the way she wobble walks now.
On the other hand, the neurologist/BVMS told us that she is one of the best cases she's seen considering her Stage 5 IVDD because of the fact she did all of the above and looks very healthy, alert and strong spinal walking.
So many people are saying that their dogs learned to walk months/years after the prognosis, but was that all spinal walking? Does anyone have first hand experience, or can direct me to success stories on here or elsewhere, where DPS came after the 4-6 week mark?
Thanks again for everyone's support. In some ways hearing the final prognosis from the vet was not as difficult to hear than when we first had to take her into surgery, mostly because we now know how it's been with a paralyzed dog and what it entails. But in other ways, getting the prognosis was also like a life sentence, and is really now forcing us to reevaluate our lifestyles, the layout of our home, and our new and permanent limitations as a family. But I'm still hopeful.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Nov 12, 2018 8:43:30 GMT -7
Camille, the BVMS vet you saw likely got his degree in the UK. BVMS equals DVM here. He is doing his internship at UC Davis working towards being a board certified neuro surgeon. Spinal walking is due to the "crossed extensor reflex" in a dog who no longer has deep pain. Some dogs with no deep pain sensation can learn to make use of reflexes to spinal walk. By definition a dog who can do a happy tail wag, who can sniff an old pee spot and then make a decision to release urine there would have to have deep pain sensation. I would say do not let anybody place a sentence on Bean or put a damper your world. I can't tell you how many times we hear of dire percentages of future nerve repair only with time to have a dog proving statistics wrong. He is a happy boy right now for you to take daily joy in. Additional nerve repair would be icing on an already wonderful cake! It is mother nature and Bean's body who will tell the story of how much more nerve repair will take place AND how long that will take. The job of surgery was to remove offending disc material pressuring the spinal cord. Bean's job is to self repair nerves to the degree possible. In the nerve healing department it is still early at 7 weeks post op! A dog who spinal walks does not have the finesse as does brain directed walking has to be able to turn corners with a fluid motion. Spinal walkers in order to change directions will stop or sit and then change directions. Spinal walkers have jerky or motorized looking leg movements. You can watch a video from Dr. Clemmons, UF Associate Professor Neurology and Neurosurgery Department of Small Animal Clinical Sciences, U of Florida to see a spinal walking doxie here: www.dodgerslist.com/literature/IVDDcourse/spinal_walking.htmlCongratulations on Bean being graduated! Determining how you are going to ease back into more normal activity at graduation. The idea is to gradually give more freedom under controlled conditions. Not free reign of the house and yard immediately! LOL Take a look at our information and then come up with a plan to gradually increase activity over about a month's time following the end of crate rest. Also check out how to teach four paws on the floor! www.dodgerslist.com/literature/AfterCrateRest.htmNow is the perfect time if you haven't already to make those home modifications so that you can reduce the stress on the spine in the future. No more stairs/steps, use ramps up and down from furniture, or blocking furniture all together. All those ideas and more are in this link: www.dodgerslist.com/literature/protectback.htmwww.dodgerslist.com/literature/aftercraterest/furniture-blocker300.jpgWe invite you to hop on to our educational bandwagon team. Education about disc disease is our number one mission! We wish we did not have to hear of another dog that was put to sleep because of disc disease nor one denied the correct principles of crate rest to help them heal. We would like all of our members to pay forward for the help they have received with their dog by helping us educate!
We depend on you. Here are many ways to help... -- "Share" our FB posts www.facebook.com/Dodgerslist-- Hand carry our literature to your vets. When in conversation at the grocery store line or wherever you may meet breeds most prone to IVDD (Dachshunds, Beagles, Poodles, Spaniels, Shih Tzus, Pekingese, and Chihuahuas) give out our little cards. Ask Linda to send you a free packet: www.dodgerslist.com/literature/litorder.htm-- Would you consider helping another trying to make decisions… We have a directory where you can share surgical info. Here is the link were you can share your dog's info: dodgerslist.boards.net/board/10/guidelines-postingState: Hospital: Address: Cost: Date of surgery: What was included in cost (MRI?, days stay, ER? PT? meds for home, sling, etc.) Comments: Please do continue to keep us updated on how Bean is doing time to time....we LOVE updates as they are so inspiring to those just beginning a scary journey. |
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Post by Julie & Perry on Nov 12, 2018 23:49:21 GMT -7
Bean is doing great, don't let anyone tell you differently!
Many doctors don't follow up long term on how well dogs can heal.
Sure you may need to make a few adjustments, like blocking furniture and not letting Bean use stairs but it's doable.
Did you know that according to engineers bees aren't supposed to be able to fly? Nobody told the bee!
Keep believing in Bean's recovery!!
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Post by Camille & Bean on Nov 13, 2018 9:35:20 GMT -7
Thank you for all that literature Paula. Interesting factoid on the bees Julie!
It is Day 52 post-op and yesterday we had a water treadmill/laser therapy appointment with the PT. We've been seeing a board certified canine rehab specialist at Sam's Clinic in Mill Valley, CA, weekly, since Bean was two weeks post-op. They are fantastic. Anyway the rehab specialist was amazed at the progress of her walking in the treadmill but it was also the first time she saw her walking on her own on land. She believes, because of the way she was walking and moving her legs she thinks there is something more going on beyond spinal walking but not yet quite normal walking. Because her legs don't cross, the paws don't knuckle, and her legs somewhat are even in sync with her front (though according to her that's not necessary even with normal walking), she advised to continue PT to see how much further we could go. Basically we are doing it until we stop seeing signs of progress. I was really glad to hear this especially because this vet has also been a bit on the conservative/practical side so I was glad to see her optimistic.
Bean on the other hand is ready to go places but we continue to monitor her closely and take things slow. The rehab specialist also believes full healing of the spine should be more like 8 weeks rather than 6 and recommended that we still keep her walking to a minimum to avoid injury and only do so when we have her on a sling for support and/or watching her in a small area, as opposed to having her running around the house (we're not doing that). She doesn't seem to mind continuing to spend time in her elevated pen (penthouse suite) since it's by the window and very comfortable.
Our next steps for this month:
* Continuing 2x day passive range of movement exercises (bicycles, pulse squats, ladders -- this is where we have her walk over a broom stick or several sticks on the ground)
* 1x week Water treadmill and laser therapy for another month
* Controlled walking in small areas of the house and assisted with sling if longer or in backyard
* No cart/wheelchair just yet (especially because she doesn't move her legs when they're in a figure 8 sling or cart)
*1-2x week stroller rides with brothers at quiet no-stress park areas (no dog parks)
*Still on supplements (Ligaplex II, Gotu Kola, Dok's Formula, Omega-3 fish oil) and CBD oil for anxiety
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Post by Romy & Frankie on Nov 13, 2018 14:16:18 GMT -7
Nerve healing is slow. At 52 days post-op, Bean seems to be recovering nicely with tail wagging and standing. At the 52 day mark after surgery my Frankie did neither of those things. It took months, but Frankie regained his ability to walk and bowel and bladder control. Walking on an underwater treadmill is what helped Frankie the most so I am glad to hear that your Bean is also doing this.
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Post by Camille & Bean on Nov 13, 2018 14:30:04 GMT -7
Thanks Romy that's comforting to hear about Frankie's timeline. I thought I was a patient person but this has really tested more of it. Did Frankie ever lose/gain deep pain? I know not to get hung up on it when she has other abilities like bladder control/walking, but I'm curious to know how long DPS could take to come back if at all...or if DPS needs to be present even if dog has bladder control and walking. As time goes on, I'm feeling like there are no hard rules on anything and so much variability because of the complexity of the nervous system.
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Post by Romy & Frankie on Nov 13, 2018 15:24:08 GMT -7
Unfortunately, there are no hard rules as to how the healing takes place. Some dogs take months and in rare cases even a year to recover function. Frankie was walking very wobbly at about 4 months. Bladder control came back about the same time but bowel control took longer. Usually both take place about the same time but every dog is different.
DPS is an indicator that the brain can communicate through the spinal cord to the rest of the body. When a dog can stand by himself or wag his tail in response to treats there is no doubt that the dog has DPS. At this point DPS is not relevant.
It works like this, dog sees a treat (brain level) dog wags his tail in response to seeing the treat. (body level) When a dog does not have DPS (which is the last neuro function to be lost) the brain signals cannot reach the body through the spinal cord because the spinal cord is too damaged.
When I was first learning about DPS I was told it was like electricity. The spinal cord is like an electric cord made up of of a number of wires to carry electrical current. In the spinal cord the nerve wiring system is in groups depending on their function. The nerves on the outer edges of the cord run from the brain to the legs to send messages about the position of the leg in space. These are the first to be affected when a disc pressures the spinal cord. We observe this pressure as the dog wobbly walking and knuckling their paws.
The nerve wiring system deeper in the spinal cord functions to send messages from the brain to move the legs. We observe this degree of nerve damage as leg weakness which can progress to complete leg paralysis.
In the center of the spinal cord, is the wiring system responsible for bladder control and at the very center of the cord is the the final function that carries the ability to sense pain in the limbs and send that message to the brain. If the dog cannot sense pain in the leg the inner part of the spinal cord is damaged and that means no DPS..
DPS is used as an indicator of the return of other neuro functions, but only an indicator. Once other neuro functions, less deep in the spinal cord are regained we know the very deepest function, DPS is there.
I hope this is not TMI but I was confused about DPS after Frankie's surgery.
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Post by Camille & Bean on Nov 19, 2018 15:38:18 GMT -7
Thanks Romy! That is very helpful and way more informative than when vets try to explain medicine in layman's terms. Final question - If DPS must exist because she has that brain to body connection (like bladder control and tail wagging), then why wouldn't a vet find the DPS when they do a neurological exam? Is it because they only test in some areas and not absolutely every area of the body? (For example there may be deep pain somewhere inaccessible in the body from the outside, unlike the toes and skin?)
Another strange thing, the other day after Bean pooped, I brought her back in the house and she scooched her bottom along the carpet - gross but I got excited - does that mean she felt some residue/poo on her behind? This is not something she does regularly/habitually after bowel movements, and really hardly ever, so I thought it was interesting that she did this. Of course dogs don't need their hind legs to scooch so it was easy for her to do it and because she rarely ever used to do it would only mean she felt something back there?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Nov 19, 2018 17:15:23 GMT -7
Camille, hard to say why the resident DVM studying to be a neuro surgeon felt there was no deep pain sensation existing. According to textbook order of nerve healing it follows a predictable step by step order. The first neuro function to come back is DPS thus allow for the rest of the functions to be able to return.
If clearly Bean has head level involvement such as seeing, hearing or smelling a delicious treat or your coming home AND the the tail moves side to side in a happy tail wag he would have to have deep pain sensation existing! You have proof that a message was sent from the brain down to a limb, a tail, the bladder whenever you can observe head level involvement with an action. You do not report any head level involvment with the scooting of her behind on the carpet. Maybe it was brain directed, maybe it was a reflex action...we can never know for sure without head level involvement.
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Post by Camille & Bean on Nov 28, 2018 13:19:48 GMT -7
Hi All, Bean is 9 weeks post-op. She is wobbly walking with her right leg (the weaker one) slowly strengthening. We're still doing 1x week water and cold laser therapy, and every other week acupuncture. I would say that the rehab vet and our holistic regular vet are both pretty amazed at her improvement at this stage, including her strengthening legs, and better proprioception in both paws both in and out of water. We are still doing daily PT exercises at home and built a ladder type thing that she needs to walk over, recommended by the rehab vet, made out of PVC pipe.
She unfortunately is still bowel and bladder incontinent and I would say that after over two months, the hardest part of adjustment for us is coordinating our daily schedule around her bladder and bowels. There have been many middle of the night cleanups and many times coming home to a mess, and lots of coordination about how long we can leave her at home so we can come back to let her out.
Now my husband and I had planned to go away in mid-December before Bean's incident. We still think we need to get away and as guilty as I feel leaving her, we decided that we needed our own self care to continue to give her the love and support as she heals. It has been a long and rough road and I also need time to reflect without being in the space and day to day grind of her care. The amazing news is that we found a fabulous sitter who used to be a vet tech and even has her own dogs with IVDD, so she knows how to express bladders and understands all the issues. Even still, I'm expecting I'll be anxious about leaving her with a stranger (and she's an anxious dog herself with strangers). Does anyone have tips about leaving your dogs post-surgery with sitters and what sort of things should I know or inform them of while we are away, other than the daily care? Was hoping to hear some experiences or stories so I don't make the same mistakes. Any advice would be welcome, and especially some reassurances that she'll be fine.
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