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Post by Dana & Mickey on Oct 16, 2019 21:30:25 GMT -7
Our almost 15 y old Bichon Mickey lost movement in his back legs after being to the groomer. We didn’t even know he had disc disease. He’s had his MRI today and the Neurologist are recommending surgery but we’re scared. There is a significant degree of compression on the spinal cord of the one disc. The vet is saying that there is 90-95 % change of good recovery. Our dog is older though otherwise in good health. Has some mild kidney disease but doing well on a renal support diet. We left him at the vet over night for IV hydration in case we decide to proceed with surgery tomorrow. He’s also having trouble urinating. Any advice is appreciated .
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Post by Judy & Vesper on Oct 17, 2019 0:44:52 GMT -7
Good morning, if the compression is as severe as stated, 90% are good odds to carry on with surgery. That said, as with human surgery, nothing is ever 100% certain. Your concerns regarding his age however should be addressed by your specialist, whether he will survive his surgery, is he healthy enough? Please remember to follow your vets instructions to the letter when Mickey is released. Crate rest will definitely be part of it, so get the area ready where he will have to come home too. It is all about quality of life, if he is in severe pain and his chances are good with surgery go for it. If his health does not allow surgery, follow the conservative path. Super tried and true tips for setting up the recovery suite, the mattress and more! —> www.dodgerslist.com/literature/CrateRRP.htmSTRICT means: - no laps - no couches - no baths - no sleeping with you - no dragging or meandering at potty times. - no PT - no chiro therapy I hope it helps, are there any other questions you want to ask? |
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Oct 17, 2019 4:43:19 GMT -7
I'm sorry to hear that your Mickey also has IVDD, Dana. We have seen many older dogs that are otherwise in good health do well with disc surgery. We have also seen older dogs do well with conservative care, which you're familiar with from Okie's neck injury. When surgery is a consideration• If your dog can't walk OR with STRICT crate rest, neurological functions worsen and are lost (legs and bladder control) • STRICT crate rest is employed and after several attempts to go off of the anti-inflammatory, the pain returns • If 100% STRICT crate rest has been employed and pain medications have been adjusted (dose, frequency, and mix of pain relievers) yet the pain can’t be brought under control • if a dog is experiencing similar signs of neck or back pain, or mild neurological deficits for the 3rd or 4th time, meaning it may be the same disc is involved. As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order. 1. Pain caused by the tearing disc & inflammation in the spinal cord 2. Wobbly walking, legs cross 3. Nails scuffing floor 4. Paws knuckle 5. Legs do not work (paralysis, dog is down) 6. Bladder control is lost 7. Tail wagging with joy is lost 8. Deep pain sensation, the last neuro function, a critical indicator for successful surgery. After a dog is paralyzed, the existence of deep pain sensation is an indicator that surgery could STILL be successful. That window of time is 12-24 hours from losing deep pain sensation (DPS). Even after that window of time, surgery is often successful. The spinal cord is very fragile, the more hours after the window, the less chance of a complete recovery. Unfortunately, general vets do not see enough cases of IVDD daily, to become really proficient in giving the neuro exam and correctly interpreting what they see. Therefore precious time can be lost in wrongly identifying deep pain sensation. Only take the word of a board certified neuro (ACVIM) or ortho (ACVS) about DPS. No- or low-interest credit for veterinary costs can be obtained from Care Credit. You find out online if you qualify. SURGERYThe purpose of surgery is to take the pressure off of the spinal cord by removing the disc material causing the compression. Surgical decompression allows a normal blood supply to return to the compressed spinal cord and for neurologic recovery to begin by the body self-healing nerves. CONSERVATIVESeeks to relieve swelling/compression of the spinal cord with an anti-inflammatory. Over time the hope is that disc material where it should not be will shrink back enough so that pain resolves and nerves can start to self repair. Reference reading conservative vs. surgery : www.dodgerslist.com/literature/healingsurgery.htmMore reading on surgery: www.dodgerslist.com/literature/surgery.htmIf you decide to do conservative care, it sounds as though Mickey may have also lost bladder control so you'll need to get a hands-on-your-hands demonstration on how to express Mickey's bladder before Mickey comes home. Healing prayers for Mickey and for you and the vets as decisions are made. |
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Post by Dana & Mickey on Oct 17, 2019 13:18:43 GMT -7
Thank you both for responding. We decided to go with surgery. Mickey is in surgery right now. It was a tough decision. Vet reported that he did pee over night on his own and we thought about bringing him home. Then we’re scared with the weekend coming if he deteriorated further over the weekend what would happen and decided to proceed with surgery now vs waiting. Praying everything goes well. Our Okie passed away three weeks ago from heart failure during an echo. He had an atrial tear. He’s was doing well with his IVDD but the heart failure was severe. This makes this even harder. To say that things have been hard it would be an understatement.
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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 17, 2019 16:57:07 GMT -7
Dana so sorry to hear to hear about the recent loss of your Okie. As you hear more, post op do let us know with the surgeon says. As things come to mind, jot them down so all your questions will get an answer on discharge day. Here's a starter list: www.dodgerslist.com/literature/dischargequestions.htmThis page is good reading by Dr. Isaacs, ACVIM (neurology) as he explains many post-op questions for our IVDD community: meds, crate rest, PT and discharge day. www.dodgerslist.com/literature/surgery.htm |
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Post by Dana & Mickey on Oct 20, 2019 4:19:56 GMT -7
Good morning. Surgery went well , neurologist reported that he’s spinal cord looked happy or happier and that it looked like it has minimal bruising . He stayed in the hospital till yesterday morning .
Day one at home has been really hard. When we got home from the hospital we could tell he was in pain but could not get him all the meds . He took some but we had trouble with liquid gabapentin .
We tried mixing it in some of his favorite foods but still nothing . Then he took half the dose before bed time last night for my husband .
He’s restless at times and won’t always let us pick him up .
My husband picked him up successfully a few times to go to the bathroom or to change out bedding but other times he wants to bite.
His meds are tramadol 3 times a day, gabapentin three times a day , prednisone 1mg two times a day for the next three days, then 3 days once a day and then every other day .
We also have trazodone . I will have to check on some of the dosages.
We found that Mickey was wet all the time , peeing . his bedding needing frequent change , which was also challenging some of the times were he wouldn’t let us pick him up .
As for his legs , he’s got tone and some movement , better on the right . Neurologist felt he may do better for us then her, but I am not sure that the case . I know it’s super early right now and I don’t have any expectations as of yet .
We’re worried when he’s restless or agitated and angry that he’s hurting him self .
I keep telling my husband that it will get easier , but it’s definitely been super hard and it’s only one day.
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Post by Judy & Vesper on Oct 20, 2019 5:08:44 GMT -7
Hi there, its really hard in the beginning Remember he is dealing with surgery pain and had anesthesia, it makes anyone cranky. I use a syringe for fluid meds, see if it makes it easier. Be very careful with the pick up, his back needs to stay straight. Pad his crate. It might be hurting to lie down. He had major surgery and it hurts. Also it helps lifting his food and water a bit, as they sometines dont like to bend their necks to eat. Now, as you have said its early, remember the more you stress, the more he stresses. Once you get onto a routine it will get much better for all of you. Hang in there.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Oct 20, 2019 5:17:12 GMT -7
Dana, please immediately alert the surgeon and/or hospital staff of the pain that Mickey is still in. Any vet in the hospital can look up Mickey's records and adjust meds. Pain hinders healing so have no patience with it. Mickey's pain needs to be brought completely under control within one hour of giving meds and remain completely under control from one dose to the next. Since I don't have the dosages, I can't tell you if they can be increased or not. Please let us know the dosages when you have a chance. Methocarbamol can be added.
Speak to the hospital about prescribing oral Gabapentin. Most all pharmacies carry a 100mg capsule (the smallest size it comes in)... jhave your vet call in the Rx. You'll need to divide the 100mg capsule powder into equal parts by dumping into a creased pieced of paper and with a razor blade move the powder into equal piles. The remainder of the powder piles can be stored in one of those 7 day pill boxes with a lid.
It's best not to give meds in food. If he doesn't eat all of his food, he won't get all of the meds.
When you took Mickey outside to potty, could he sniff and release urine on his own? You'll need to take him outside more often while he's on Prednisone - every 2-3 hours. Prednisone causes increased thirst and increased urination.
The early days following surgery can be dreadful and so stressful. Do know that it will get easier. Right now, the surgeon needs to get Mickey's pain completely under control so you can care for him. Please let us know what the hospital says after speaking to them this morning.
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Post by Dana & Mickey on Oct 27, 2019 23:31:32 GMT -7
Hello, I apologize for not being able to get back on here sooner and post an update. We're doing much better than that first day. Mickey's pain has been in a lot better control, he's been taking his gabapentin. We haven't had to switch it to capsules yet, though I will keep that in mind for the future. Mickey can pee on his own, and the first few days we had a lot of accidents but now we have been able to take him outside. Sometimes he stands up and can stand for a few seconds. I hope this is a good sign for his recovery. He hasn't been quite happy with his crate rest. The vet prescribed trazodone, but I think it's making him more restless and agitated. We're going to call the vet tomorrow and see about changing the medication. His follow up is this Wednesday to remove stitches. I am nervous about it , wonder if they give them any sedation before to keep calm.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Oct 28, 2019 5:48:27 GMT -7
I'm glad to hear that Mickey's pain has been in a lot better control but is it completely under control? Do you see any sign of pain at all or is he able to rest comfortably? If you see any sign of pain at all, do speak to the hospital about adjusting the pain meds. What are the dosages of the meds that he is currently on and how much does Sherman weigh now? Good news that he is no longer having accidents and is peeing on his own outside. If he is able to get up to a standing position on his own, that is a wonderful sign of nerve healing, Dana. Excellent! Trazadone can cause an increase in anxiety so I'm glad you're speaking to the vet about that. Do know that there are natural sedatives, too. Using any oral calmer in combination with a Pheromone diffuser seems to work best. It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives such as Acepromazine, Trazodone, etc. Of course always keep your vet in the loop on all things you give your dog. Other product brands may be available in your area or on-line… just shop by the active ingredient(s) on the label and the quantity for best price. Place a DAP pheromone diffuser at floor level where the recovery suite is. Dogs: Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/us/Products/ADAPTIL-Calm-Home-Diffuser with dog pheromones Use a diffuser with one oral calmer from below: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed 2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. 3) Bach's Rescue Remedy is a liquid 5-herb combo to help with relaxation (Star of Bethlehem – Orithogalum umbellatum, Rock Rose – Helianthemum, Cherry Plum – Prunus cerasifera, Impatiens – Impatiens gladulifera, Clematis – Clematis vitalba) Have they given you any PT exercises to do with Sherman yet, Penny? If not, do speak to them on Wed. when the stitches are removed. Stitch removal is not a painful thing and Sherman should be fine without sedation. Once the stitches are removed, water therapy could be started for Sherman. Do you have an underwater treadmill available in your area? Other members have found great benefit from that. Some water exercises can be done right in the bathtub. Please check with the surgeon before starting any of these. www.dodgerslist.com/literature/watertherapy.htmAcupuncture and laser light therapy are helpful treatments that can be very beneficial to assist with re-establishment of nerve connections in the body and usually can be started right away if within your budget. www.dodgerslist.com/literature/healingacupuncture.htmCheck out our suggestions for post-op exercises to see if the surgeon would approve any of these: www.dodgerslist.com/literature/massagepassiveexercises.htmHow many weeks of crate rest have been prescribed? |
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