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Post by Julie & Perry on Oct 19, 2019 21:07:13 GMT -7
My dog started having trouble sleeping and I asked my vet about melatonin. It really helped.
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Post by Jaclynn & Willow on Nov 29, 2019 11:50:26 GMT -7
Time for another update. Nothing too exciting to report. Willow's happy tail wag isn't back yet. He can still support his back end if I prop up his legs and then hold his front end. Sometimes he locks his front legs but not very often. I have been taking Willow for rehab one every week or every other week. During rehab our vet tech does various exercises with him and has been recently doing a bit of "patterning" on the treadmill (no water) where I support his front end while she makes walking patterns happen with his back legs, then the front while supporting his back end. We have been doing the laser therapy with each visit. His shoulders and neck are still very stiff and trembling. We hoped the 3x/laser treatment this week would help. His main method of moving himself involves him dragging his body using his nose as a leg sort of, if that description makes sense. I try to encourage leg movement through exercises. He is now on ✙ methocabamol 50 mg 3x/day (every 8 hours) as well as ✙ meloxicam dosed for 3.5kg once daily. This seems to help a bit, as he's not trembling/muscle spasming non stop anymore but it still does happen sometimes. [Moderator's Note. Please do not edit 7.3 kg/ 16.09 lbs ✙meloxicam 3.5kg dose 1x/day ✙methocarbamol 50mgs 3x/day famotidine? 5mgs 2x/day?]To reply to some earlier questions: Shivering/trembling is the only sign of pain, no yelping or arched back, still happily eating all his food. He is sleeping a little better through the night but there are still some difficult nights. I've borrowed the "hold em up" harness from our vet clinic to be able to put Willow in the bathtub sometimes. our vet tech told us that water is very beneficial for nerve healing due to the stimulation. I only do short sessions of 10 minutes or so in the bath every few days but I'm working towards increasing that. When in the bath I put him in the sphinx position (low water level) and let him rest his chin on my arm. I tickle his feet and he kicks them. If I put the water level higher I just kind of swish him gently around in the water. It's hard not to be discouraged with his slow progress but I am hopeful he will walk again one day. I miss going for walks with him and I feel so useless when I cannot figure out what he wants sometimes. I'm sure he's tired of not walking too. It's been a hard journey since August. His right front side is still extremely weak although he is gaining muscle in it (this was the problem leg where it all began). Our rehab vet tech said she is hopeful that leg will be stronger by Christmas and to keep doing what we're doing. She has been very encouraging and kind. I am looking into getting a stroller to be able to take him outside a little easier. Currently I bundle him up in cozy blankets so he can get some fresh air and sunshine and bark at squirrels. I've traded shifts with as many coworkers as I can so I can be home with Willow in the mornings, and then go to work in the late afternoon. My partner works regular hours and is home with him when I'm at work. I still don't feel comfortable leaving Willow at home alone for 8.5 hours when he cannot roll himself over or move on his own much at all.
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Post by Julie & Perry on Nov 29, 2019 13:26:04 GMT -7
Just a thought, maybe a quad cart could give some independence and movement while he's healing.
It does sound like he's making progress.
I can tell how much you love Willow and how hard you're working.
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Post by Romy & Frankie on Nov 29, 2019 14:30:41 GMT -7
Thanks for the update on Willow. What does the vet think is currently causing the stiff and trembling muscles? I see that Willow is on Meloxicam, an anti-inflammatory. Does the vet think there is still spinal cord inflammation or something else? It is great that you take him out to get some fresh air. A stroller would definitely make taking him out easier. As Julie suggested, a quad cart is also something to consider. This would let him move about on his own outside.
During my dog Frankie's aqua treadmill therapy the rehab specialist also used patterning. He moved Frankie's legs in a walking movement in the beginning. Later he would just help Frankie reposition his feet. I think this kind of therapy is useful in teaching the body how to move again.
It can feel discouraging when healing is going slowly but nerves are slow to heal and Willow is making progress. Your rehab tech thinks so too. Try to be encouraged by every little sign of improvement he is making. It can take months for neuro function to return.
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Post by Jaclynn & Willow on Dec 1, 2019 14:27:20 GMT -7
A quad cart is a fantastic idea! I found these ones online. I found this in my pet insurance: I will definitely bring this up to my vet, we are under rehab care now, no longer under surgical. I bet this cart would be covered for Neurologically deficient limbs, paralysis and recovery for surgery. Reading more about the carts it looks like they help motivate dogs to move more, so maybe this will help Willow's legs move Thanks so much for the suggestion!
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Post by Judy & Vesper on Dec 1, 2019 23:59:29 GMT -7
Jaclynn, a quad cart will definitely also help him to get stronger. Remember to place his feet correctly when he is in it, you want to bring back muscle memory. I have a dachsie that has had unsuccessful back surgery and successful neck surgery. She uses a cart and in the first year of using it started using her hind legs. She has a spinal walk in her cart as she has no deep pain sensation. Unfortunately she had too much damage, and her muscles on her left side cannot sustain her walk. There is always hope, but you must be patient. It took two years for her to get her walk back, it takes time for the muscles to get stronger. Also remember that dogs can be quite happy in a cart, mine runs around on theirs, playing, chasing, they are just living life as a normal dog.
Just a few reminders on the process of healing Nerves heal typically in the reverse order of the damage to the spinal cord: Yes? Deep Pain Sensation (Only correctly identified by a specialist.)Please let us know if your surgeon confirmed DPS _Not yet_ Tail wagging with joy at seeing you or getting a treat or meal. _?_ Bladder and bowel control verified with the "sniff and pee" test. __ Leg Movement, and then ability to move up into a stand position, and then wobbly walking. __ Being able to walk with more steadiness and properly place the feet. __ Ability to walk unassisted and perhaps even run.
Muscle memory is important which is why you place the feet in the correct position and do the exercises, its not only to build up strength. So carry on with what you are doing, you will see results. Even if like with Vesper, it is only running on all fours in her cart.
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Post by Jaclynn & Willow on Oct 28, 2021 16:26:00 GMT -7
Hi everyone, It has been a long time since I've given an update. Unfortunately this is not a happy update. My last update was from December 2019.
We continued going to WAVES for rehab/physical therapy almost every week until a few weeks ago. He still has no control over his leg movements or bladder/bowels. His front leg muscles are incredibly atrophied and there is considerable damage to his spinal cord.
We have tried two different quad carts for him over these two years. One from Eddie's Wheels, and one from Handicapped Pets Canada. Both have their pros and cons. The only way we can get him to start moving his back legs in the cart is to play with the tip of his tail or stroke his back in the hip area.
He's on Metacam once daily (3 kg dose, although I am struggling to figure out the actual amount in mg) and gabapentin liquid twice daily (20 mg I believe). These medications are all liquid.
His eyelids have not returned to normal and still up.
We never received any follow up with Dr. Bolliger regarding Willow's condition and expectation of improvement. I was told he said that Willow was "rehab's patient now". The rehab team has been absolutely fantastic with us and cares very much about Willow. Our main rehab tech that has been with us since the beginning has a great relationship with Willow.
Over the summer WAVES opened a neurology department with MRI machine and veterinary neurologist and neuro team. Our rehab vet tech Trina advocated for Willow to be an early neuro patient and have an MRI to follow up on what's going on within his body 2 years post-op, with such little improvement. The neuro team agreed and Dr. James (neurologist) took him on as a patient.
We had a consult with Neurology Sept.20, 2021. Willow had his MRI booked for Oct.21 2021. I was unsure of what to make of the initial MRI results that we received the same day (evening), but followed up with Dr. James the following Tuesday. In summary, the damage and atrophy caused to his spinal cord is incredibly bad. I understand that he has very little spinal cord left where the surgery was done. They believe that any leg movement is not coming from brain signals but are just reflexes. Any improvement we have seen over these 2 years is due to those reflexes. He still can't roll himself over or move himself without pulling himself with his nose. We express his bladder and massage for poops. We put him in his quad cart to eat his meals. He still tries to navigate by pulling himself around with his nose. We sit him upright "sphinx" position with a blanket roll on each side of his body and a little blanket underneath his chin. We put him on his side and rotate through these positions frequently. we have done a ton of exercises at home with him over these two years. He did gain a lot of muscle back compared to when we first took him home from the vet hospital post op (he was all skin and bones and could barely move his neck).
According to the MRI results and the neurology department, the best that we can hope for is that Willow won't get worse or that his spinal cord won't degrade to the point of him being unable to send signals to breathe. There is no hope of him ambulating or improving. There is too much damage to his spinal cord and that space is now filled with fluid. The nerves are dead and cannot grow back.
Over these 2 years I have held onto the hope that he will regain some independence or get better at ambulating in his cart. When I pinched between his toes he pulled back. But the neurologist said that Willow did not look at her when she did that. That it was a reflex.
I am very grateful that we were able to have this MRI and get a realistic view and expectations. We have just been carrying on these years with so much hope and no one to tell us otherwise. It was incredibly hard to hear.
I asked about Willow's quality of life. He is just a little dog head on an unresponsive body. He is completely dependent on us. We have spent an incredible amount of time and effort on trying to get his condition to improve. We have become pros at expressing his bladder - he has never had a UTI. We have never spent a day apart from him since his surgery. We had pet insurance but it hasn't covered rehab visits. It was devasting to find out that no matter how hard we have tried he cannot improve.
We are making the difficult decision to have a veterinarian come to our house for end of life care. We don't know what date yet. We want all of our friends that love him and that he loves to be able to say goodbye. It's such a hard case. His condition hasn't rapidly deteriorated. He is exactly the same as he has been. But without the glimmer of hope of improvement this is just no way for him to live. No mobility whatsoever and so little control over his life. it's so hard. He still plays with his squeeky toys. Loves eating his food. Loves treats. Snuggles with my partner and I. He loves to lick one spot on my leg or arm for about an hour straight (same as pre-surgery). This is the most difficult choice I have ever had to make.
I wish all the best to everyone else on this forum that is going through this heart breaking disease. Surgery and recovery has a 95% success rate but we were that unlucky 5%. Maybe things would've been different if we left our island and got an MRI and neurology team right away. Maybe they wouldn't. We did the best we could.
Here is a bit of his latest discharge notes post-MRI:
Willow (8yo MN Dachshund) was presented to the WAVES Neurology Service on October 21, 2021 for a scheduled MRI of the spine. On Aug 8, 2019, Willow had an acute progression of neck pain, right thoracic limb lameness, and right sided weakness. He was diagnosed with a right lateral calcified intervertebral disc extrusion at C5-6 via CT (Aug. 10, 2019) and treated with a C5-6 ventral slot decompression (Aug. 12, 2019). He was non-ambulatory following the surgery. Repeat CT (Aug. 19, 2019) showed residual lateralized disc material. A repeat ventral slot decompression was performed (Aug. 20, 2019)and a post-op CT showed removal of more disc material with some still remaining. Following the second surgery, he developed an abnormal appearance to his eyes (bilateral third eyelid prolapse). Willow has never recovered the ability to ambulate since the time of surgery. He has been a patient at the WAVES rehabilitation clinic for the past 2 years and has made some improvement.
Musculoskeletal: Muscle atrophy over thoracic and pelvic limbs, more pronounced in thoracic limbs - severe over both scapula, interscapular, both triceps, both biceps (neurogenic atrophy); more generalized in pelvic limbs from disuse atrophy Gait/Posture: non-ambulatory tetraparetic; owners and rehab report that he has movement in pelvic limbs (and some seen on video); none seen today Postural Reactions: thoracic limbs - absent placing and hopping bilaterally pelvic limbs - absent placing and hopping bilaterally Spinal Reflexes: thoracic limbs -severely decreased withdrawal reflexes bilaterally pelvic limbs - normal patella reflexes, slightly decreased withdrawal reflexes bilaterally (due to muscle atrophy/weakness rather than normal cutaneous trunci normal perineal reflex Sensory Exam: tense cervical muscles with decreased ROM neck; does not have obvious repeatable pain sensation in pelvic limbs
Problem List: 1. Ongoing tetraparesis + bilateral horner's 2. Muscle/joint contracture/fibrosis bilateral elbows and shoulders Assessment: At the site of the previous surgery (C5-6), there is a large fluid filled area within the spinal cord and the surrounding rim of remaining spinal cord is very thin. This finding explains his clinical signs of severe neurological deficits to all 4 limbs and bilateraly horner's sydrome (elevation of third eyelid). I suspect that the movement seen in his back legs sometimes is "spinal walking" as I can not get repeatable pain sensation in the back legs. Unfortunately, there is little prognosis for recovery with this degree of spinal cord injury. Some academic centers are doing research with stem cells for complete spinal cord injuries such as this but this is not available as a routine treatment. Continue to routinely assess him for bladder infections as this is a common complication in paralyzed dogs that do not urinate normally. There is no evidence of a bladder infection at this time.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Oct 28, 2021 18:32:55 GMT -7
Jaclynn, I'm glad to hear Willow is not in pain, has not deteriorated and loves toys, eating and snuggling, licking. People think one way and dogs think another about life. Love on Willow as much an often as you can. Note the positive things in a day and take delight in them, and store them well in your memory bank. Only you have experienced daily life with Willow and will know when it is truly time. A strong and great bond of trust has surely developed over these years between you all. Willow will trust you to do the right thing.
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Post by James & Brie on Oct 31, 2021 21:49:42 GMT -7
Hi Jaclynn & Willow- Our name is James & Brie, it's been a long time since I have posted on Dodgerslist dodgerslist.boards.net/thread/5067/james-brie-surgery-spaniel-russell?page=3 also. I just had to reach out to you as your story is breaking my heart. Again! I know how hard it had to be to make that decision. I came back to this web site looking for something, sympathy, help, someone to say no. I don't know. I don't even know how to use the site anymore. It took me awhile just to get here. I joined this site in 2017, thinking I'll do whatever it takes to get my baby Brie walking again. And I got a lot of help here, more than any other site or person, DR. could give me. Brie had a disk, from IVDD, blow out in May of 2017, she also ended up in that 5% range. She was almost 3 years old at the time, she is my first dog. Brie was loved and spoiled very much by my Wife and I. And we both did everything we could to see her walk again. She could get around with her wheelchair, we also got the water, (swimming), exercises, and acupuncture. Nothing worked. That's ok though, we love her anyhow. I was, am, the one who expresses Brie and I read everything I could to make it painless for her. Unfortunately, this female is very difficult to express her urine. Because of that the last 3 years of her life has been one UTI after another. It has been a really tough time for her. She is resistant to most treatments now and it's getting harder and harder for me to express her. It's me and her now as I lost my wife to Dementia and Cancer in March. Last night when I tried expressing her and got very little pee, I got really worried because everything is closed. What really hurt though was after I put her in her bed, she wouldn't let me touch her again, she would snap at me when I tried. The vet told me this day would come. Then when I read your post it really hit home. I have to make that decision. I wish I was a pro at expressing, but the vets say they have to use a needle to extract, because she is difficult. This will be the most difficult decision I will ever be faced with, as I don't plan on getting another dog. My heart can't handle anymore heartaches. If I can't express my dog I have no alternative and i'm dying inside. I feel for you Jaclynn. You tried for 2 years, whereas a lot of people would be done "before" the surgery. I still have to make that terrible decision. But over the years I've had to put pressure on that little bladder and now it's just too sore for her, she doesn't hate me, I know, she's just tired and hurt. Best of luck in your future endeavors and sorry I got carried away.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Nov 1, 2021 9:20:06 GMT -7
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Post by Jaclynn & Willow on Nov 2, 2021 10:44:36 GMT -7
Paula, thank you so much for your thoughtful response. I truly appreciate it. James, I am so sorry you are also going through this awful situation. It sounds like you love Brie very much. I'm sorry she has been so hard to express, I suppose that is the one thing we were lucky with in that regard. No need to apologize for your lengthily reply. We are not alone in this. I am so sorry for the loss of your wife. Dementia and cancer are so awful. Sending lots of love your way!
I also don't know if I'll ever be able to have another dog. Maybe one day. But I refuse to ever get another dog prone to IVDD. It's very hard to breed out for future liters and I just cannot perpetuate this cycle. My heart is breaking going through it already, and these dogs didn't ask to be bred to have these long backs and the health problems that come with them. They have such amazing personalities and are full of love but I just cannot do this to them. Just by normalizing having this breed feeds into this cycle, I think. I'm not trying to shame others that already have these dogs. Some people are lucky and never have to go through this. I just can't do it.
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