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Post by Natalia & Mel on Mar 31, 2020 6:58:30 GMT -7
☀︎1-- Mel is a Dachshund, 4.5 years old. My name is Natalia and we live in Ireland. ☀︎2-- 10kg [22.5 lbs] ☀︎3-- Diagnosis says Thoracolumbar Disc Extrusion Surgery was performed in Dublin/Ireland by Dr William McCartney (MVB, Dipl ECVS, DSAS (Orth), PhD, MRCVS)
☀︎4-- Mel went on surgery on [Mar 24] 24/03/2020 and she came home on [Mar 30] 30/03/2020. Doctor said she should be strictly rested, but not cage confined. She spends the whole time in a playpen, but goes out to potty.
☀︎5-- We are doing home PT as vet is quite far from our home and we have no car. PT is done every 1,5H for 5 minutes, which includes: assisted standing / flexion / extension We bought a small swimming pool that should arrive on [Apr 2] 02/04/2020 to do shallow water standing and hydrotherapy.
☀︎6-- crate rest including his directives for supervised and controlled PT? 4 weeks - then we should return to the clinic for his analysis. ☀︎7--No pain at all.
☀︎8-- Medicines started on [Mar 31] 31/03/2020: - Kesium [Amoxicillin/Clavulanic] 250mg 2x day for urinary infection which developed while she was hospitilized (for 5 days) - Carprodyl [carprofen] 50mg (for 4 days)
☀︎9-- Her legs don't move at all, and she's also not wagging her tail. A few times during PT, she wags her tail and stretches her legs for a few seconds. ** She had wobbly walking when we took her to the vet hospital for the surgery, but now she has no movements ** ☀︎10-- Yesterday she peed outside, and then another time during PT. ☀︎11--Eat/Drink OK - Poops OK
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 31, 2020 7:32:30 GMT -7
Welcome to Dodgerslist, Natalia. So glad you’ve joined us all. We’ve got valuable information we’ve gleaned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you! **Disc disease is not a death sentence!**Struggling with quality of life questions? Re-think things: www.dodgerslist.com/index/SDUNCANquality.htmDo know that the swelling from the surgery can cause a worsening of condition at first. That swelling can take a couple of weeks to go down so don't get discouraged. PEPCID AC: Anytime a dog is on an anti-inflammatory such as Carprodyl, stomach protection MUST also be given. IF Pepcid AC is not available in Ireland, do ask for another stomach protector. Ask if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesn't need it, we wait til there is problem…are NOT answers to your question!) If you get a "no health" issues answer,then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine). Doxie weight dogs: 5mg Pepcid (famotidine) every 12 hours. NOTE: Pepcid AC (famotidine) for dogs is 0.44mg per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory. www.1800petmeds.com/Famotidine-prod11171.html A urinary tract infection can cause leaking. Glad to hear that she was able to release urine when carried outside. What you want to look for with movement of legs and tail wagging is a brain to nerve connection. Mel is given a treat or spoken to with a happy voice or someone she knows walks into the room and she wags her tail. Mel moves her legs in an attempt to walk or re-position herself in the crate. Neuropathic pain is not common but is something you should be aware of. This kind of pain is abnormal, phantom pain sensations with severe spinal cord damage. 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.pdfCheck with surgeon before starting - If there is great pain or severe neuro diminishment, acupuncture or laser light therapy can be be started right away as an adjunct to pain meds and to kick start nerve cell energy production. Options: Acupuncture vet who does home visits to avoid back moving during transports. For transport to necessary visits, pad out the recovery suite extra space with a rolled up towel/blanket to prevent body shifts during braking or cornering. CAUTIONS: ~~ Laser light therapy is contra-indicated with tumors which are detected via x-ray. ~~ Why Chiropractic is not recommended for IVDD dogs: www.dodgerslist.com/literature/chiropractic.htmAlso water therapy can be performed after the stitches/sutures are removed. Some of these exercises can be done right in the bathtub. Many members have found underwater treadmills to be very helpful in regaining their dogs' use of their legs. Please check with the surgeon before starting any of these. www.dodgerslist.com/literature/watertherapy.htmKnowledge is the power to fight the IVDD enemy and win!!
The very best thing you can do for YOU, the caregiver, and for your dog is to get up to speed on IVDD as soon as possible. Begin absorbing the must-have overall sense of meds, care and how the treatment works. Your dog will be depending on your ability to learn: www.dodgerslist.com/literature/theater.htm --- PRINT OUT this link and tape to your fridge: www.dodgerslist.com/literature/healingpage.htm --- use the printout as your roadmap to avoid dangerous detours in your dog's care --- make notes/highlight to keep yourself on track --- follow all the links in the next days to become the IVDD savvy pet parent your dog needs. Use the “search box” to easily locate topics over at our Main www.dodgerslist.com website: www.dodgerslist.com/index/searchBOX.jpgHealing prayers for Mel. Please keep us updated.
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Post by Natalia & Mel on Apr 1, 2020 5:23:13 GMT -7
Hi Marjorie, Thank you for your valuable advice Some updates from today (Apr 1) - 8 days after the surgery / 3rd day at home: - Mel started taking ✙Pepcid AC- She released urine outside again close to her favorite spot- Still no movements on her legs/tail- No sign of pain nor neuropathic pain (but I'll keep an eye on the signs you mentioned) - Hopefully, she will start laser therapy next week [Moderator's Note. Please do not edit Kesium (Amoxicillin/Clavulanic) as of Mar 31: 250mg 2x day for 5 days Carprodyl [carprofen] as of Mar 31: 50mg for 4 days ✙Pepcid AC: ?mg ?x/day ]Overall she is fine, pain-free and happy chewing her favorite toys. Will send updates soon. Thanks again, Natalia
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,587
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Post by PaulaM on Apr 1, 2020 7:08:44 GMT -7
Natalia, thank you for sharing such a good report. Love to hear how happy Mel is. Maintaining positive spiriit when healing is important. 8 days after surgery is very early in the nerve healling department. Having bladder control bodes quite well for more nerve healing to take place. The typical order is known, but no one will be able to give you a date when. Some dogs do, however, have a little bit different order. Could you confirm the bladder control. Did she either sniff the old pee spot or circle and then made the decision to release urine. Just want to make sure urine did not come out by reflex if you had the sling pressing on her bladder as that would be kinda like expressing the bladder. Nerves heal typically in the reverse order of the damage to the spinal cord: 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. __ Some leg Movement, and then __ ability to move up into a stand 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.htmQUESTIONS~ How many mgs of Pepcid AC (active ingredient famotidine) does she take every 12 hrs? ~ In Ireland is famotidine without prescription or did the vet need to write you an Rx for it?
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Post by Natalia & Mel on Apr 3, 2020 4:05:01 GMT -7
Hi Paula,
Mel is having Pepcid AC 5mg every 12 hours. I could buy it in a local pharmacy without prescription.
Today she will take the last Carprodyl, should I give Pepcid AC for a few days more?
Regarding the bladder control, I can see now that this was just a reflex, it doesn't seem to be a voluntary release of urine.
Also this morning for the first time [April 3] she wagged her tail 3 times when she saw us for the first time in the morning and while talking to her in a sweet voice.
We keep doing PT every 2hr and we're happy with her progress so far, even tough it seems to be very little.
Thanks Natalia
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Apr 3, 2020 4:52:01 GMT -7
Wonderful that you've seen that happy tail wag, Natalia!
If Mel indeed cannot release urine on her own when taken to a spot outside, then she needs to have her bladder manually expressed. Urine that lies for too long in the bladder can lead to a urinary tract infection. Normally we recommend getting a hands-on-your-hands demonstration on how to express the bladder but in these days of coronavirus, that wouldn't be advisable. I myself did not get a hands-on-your-hands demonstration and learned from watching videos and practicing so I do know that it can be done. Here is our page on how to express the bladder with many tips and an excellent video. Please review all of the information on that page and then ASAP start expressing Mel's bladder. You need to feel the bladder and keep pressing on it until it feels flat, almost like your fingers are touching. As the bladder empties it will get smaller and sometimes can slip away, usually back by the pelvic area so you'll need to find it again. Please keep us up to date on how you are doing expressing the bladder.
You can also express for poop but that is not a health issue and only helps prevent accidents. Poop will release by reflex. With the bladder, the bladder overflows with urine so doesn't empty out.
If you see any sign of pain with the stopping of Carprodyl, immediately alert your vet so the Carprodyl can be restarted for a bit longer. Yes, it would be a good idea to continue giving the Pepcid AC for a couple more days as Carprodyl does stay in the system for awhile.
Please let us know how you make out expressing and if you have any questions.
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Post by Natalia & Mel on Apr 3, 2020 5:54:16 GMT -7
Hi Marjorie,
Forgot to mention that I'm expressing her bladder 3/4 times a day successfully.
And in case I notice that she's in pain after stopping Carprodyl, I will contact the vet immediately.
Thanks for these tips.
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Post by Natalia & Mel on Apr 7, 2020 14:30:21 GMT -7
Some updates from Mel (14 days post-op / 8th day at home): Tail wags are getting more frequent every day, but still far from being 100%. She also improved her bladder control. She now barks when she wants to pee, so I take her outside with a towel supporting her body, she raises her tail a bit, pees and just try to move when it's completely finished. I didn't have to express her bladder in the last 2 days. Regarding her legs, she still have no moment, but I noticed that they got slightly stronger and it makes the PT easier to be done. We keep doing PT every 2 hrs.... this covid lock down came in a good moment for us as we can give her 100% attention and love I have a question regarding the legs movement, when she stretches her full body after long naps, she also stretches her back legs. Can I consider this as a voluntary movement? Mel is very happy and pain-free. It will be a long journey but I'm very optimistic of her recovery.
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Post by Romy & Frankie on Apr 7, 2020 15:03:55 GMT -7
Mel is doing very well! I know that you have seen the stages of healing beofre, but it may help you see the progress she has made.
Nerves heal typically in the reverse order of the damage to the spinal cord: 1. Deep Pain Sensation (Only correctly identified by a specialist.) YES2. Tail wagging with joy at seeing you or getting a treat or meal. YES3. Bladder and bowel control verified with the "sniff and pee" test. ?4.Some leg Movement followed by
ability to move up into a stand position,
wobbly walking
5. Being able to walk with more steadiness and unassisted and perhaps even run
Some stretching may be reflex. Does she move the legs at all besides this?
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Post by Natalia & Mel on Apr 9, 2020 11:16:00 GMT -7
So far she has no movements on her legs at all. Just stretches.
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Post by Romy & Frankie on Apr 9, 2020 13:25:37 GMT -7
She is still early on in her recovery, and she has already made quite a bit of progress. Are you doing the water therapy with her now? I know you bought a small pool for her. Water therapy is what helped the most with my dog's recovery after his surgery.
How is she doing with the bladder control now? Is she pooping outside also?
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Post by Natalia & Mel on Apr 12, 2020 12:59:27 GMT -7
We are still waiting for the pool to be delivered. Just the life vest arrived.
Yes, she's is peeing only outside now and seems to have 80% of bladder control, but she pooped on the carpet a few times this week.
Tail wags keeps increasing!!!
I also had a vet closer to my house that has laser therapy, but due to the lockdown, they are just accepting emergencies in the clinic.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,587
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Post by PaulaM on Apr 12, 2020 13:16:02 GMT -7
Natalia, until the pool arrives, do know that you could use your bathtub. Not only is the warm water soothing to muscles, if there is any ability (if there has been nerve healing) you might see some attempt to move those back legs. The buoyancy of water makes even very weak legs able to have some movement. More on water therapy at home: www.dodgerslist.com/literature/watertherapy.htm Let us know how that goes for you and Mel.
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Post by Natalia & Mel on Apr 14, 2020 3:28:37 GMT -7
Hi Paula, unfortunately we don't have a bathtub at home. But we keep doing normal PT until de pool arrives.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,587
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Post by PaulaM on Apr 14, 2020 8:19:34 GMT -7
Natalia, the at home PT is a very helpful. When the pool comes, that will just be an addition to the good work you are already doing. Let us know if these are some of the types of Post-op exercises you do for Mel's back legs.
Appropriate physical therapy can help maintain the muscles with lost nerve connection. Therapy keeps muscles in optimal condition while in wait to receive regenerating axon terminals.
Post-op PT for the paralyzed IVDD dog:
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Post by Natalia & Mel on Apr 18, 2020 7:38:43 GMT -7
Hi everyone! The pool has finally arrived, so we could do a few exercises today. I also recorded a video of Mel's progress and I have a few questions... 1) Bladder control: as I mentioned before, we didn't have to express her bladder anymore, she just pees outside and no wet bed so far. In the video, you can see that she lifts her tail and leg while peeing. Can I consider it as a voluntary movement and that she has full bladder control? 2) PT session: when Mel first came home after surgery her legs looked like jelly, couldn't bear her weight at all. But now she can stand for a few seconds and we just have to give a little help on her balance. Is this a real indicator of progress? Also today, as shown in the video, seems that it was her first attempt to move her leg, she had never done this before. Kindly, share your thoughts on her progress Regarding the previous post, we are doing the Stand / Bike movements 6 times a day for 5 min. And I'm also doing the massage 2 times a day. Thanks, Natalia
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Post by Ann Brittain on Apr 19, 2020 7:15:50 GMT -7
Thanks for sending the video!
We noticed improvement in our Buster when we started him on "bathtub" therapy. I would encourage him to swim around by giving him a piece of kibble as he completed each lap. I also reinforced the PT exercises while he was in the tub. I hope Mel Mar responds to it like our boy did.
It looks like Mel Mar is empting her bladder when she pees, but you can check by feeling her bladder. If it feels kind of spongy not firm, she may not be totally eliminating. You should continue to check the color of her pee to be sure it's not cloudy or dark in color. Also be aware if it gives off a strong smell. If you have any doubts, check with your vet to be sure she doesn't get a urinary tract infection. It is a positive sign that she's not leaking.
It certainly appears that Mel Mark is making good progress. She's wagging her tail and starting to be able to bear weight. She also looks happy and not in pain. I'd say you're doing a great and dedicated job with the PT. That is the key to helping her regain her strength. It is a process that takes patience and time for nerves to heal. Keep up the good work!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,587
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Post by PaulaM on Apr 19, 2020 10:27:36 GMT -7
Natalia, I, too see the improvement in nerve control!
At potty time the clue for bladder control is that a message went from brain to bladder. I saw her sniff (head level) and then urine was released. Any movement of tail and legs can be a reflexive movement or it can be actual brain direction. It is hard for us humans to know which. So generally we ignore limb or tail movement at potty times.
At PT time I saw the legs as her body was lowering due to limb weakness, the thighs were able to pull in helping to keep the paws underneath the body. When there is no nerve control the legs stick straight out as there is no control to tuck the legs in as a normal sit position.
It is really very early in the nerve healing department when most nerve healing might take months rather than days/weeks. Yet you are seeing nerve improvement. This bodes well for even more nerve healing to take place.
Keep up the good work you are doing with PT. So looking forward to your next update on pool work and a video! For best lighting on Mel, make sure the sun, a window, or any other light source is positioned behind the camera person.
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Post by Judy & Vesper on Apr 20, 2020 0:13:34 GMT -7
Hi there Natalia, I have just watched your pt video. It looks very good. 1.An extra exercise would be to lift one hind leg paw off the floor, he now needs to concentrate on activating the muscles in the standing leg to stay upright. It helps with his core muscles. N0 movement when you are doing this, just lift the paw and help him stay upright. 2.When he sits down, help him to get up and stand. Very slow and not to many. you don't want him tired and sore. 3.When you use the pool, remember the water must NOT be cold and to keep the sessions short. Once around, break. As he gets stronger the sessions can be lengthened. He must never get tired.
Check for stiffness afterwards, remember he is like an athlete that has been out of practice for a while. It takes time. So take it very slow. If he has an off day, let him rest.
Good luck
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Post by Natalia & Mel on Apr 20, 2020 4:46:56 GMT -7
Thank you all for the tips and comments on her progress! It's been really good having this forum to help us during this time of recovery. I'll send more update soon and also new videos. Thanks again, Natalia Graduated April 21 **
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Post by Natalia & Mel on May 1, 2020 2:43:39 GMT -7
Hi everyone,
Just an update from the Week 5:
Mel started having some leg movement, especially on the right leg, but still not able to stand or walk. We should visit the vet next Tuesday, do you have any suggestion of questions that I should ask him?
Thanks, Natalia
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on May 1, 2020 4:08:56 GMT -7
Natalia, what type of leg movement are you seeing? Is Mel moving her legs to re-position herself or trying to scratch her head or trying to take steps?
I've very much enjoyed watching the videos you've shared with us and seeing the progress Mel has made. You're doing such a good job rehabilitating her.
As for the visit with the vet, I would just discuss PT with him to see if there is anything else he might suggest doing to help strengthen Mel's legs and fire those nerves to regenerate. I'm sure he's going to be very pleased with Mel's progress.
Keep up the great work!
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Post by Natalia & Mel on May 1, 2020 7:07:18 GMT -7
Thank you, Marjorie! Really good to hear this from you. This forum really keeps us motivated and confident on Mel's recovery I will discuss the PT with the doctor next week so. Movements I've seen so far is her legs paddling. Instead of just dragging her legs completely as she was doing before, she pulls her legs while moving, like a baby crawling... but this doesn't happen always. We also started giving her YuMove (joint supplement) 1 tablet per day.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,587
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Post by PaulaM on May 1, 2020 7:18:42 GMT -7
Natalia, nice report to learn those back legs are doing some purposeful movement. Has it been warm enough to use your pool.? Water buoyancy would allow Mel to move those weak back legs more easily in water.
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Post by Natalia & Mel on May 1, 2020 7:54:32 GMT -7
Hi Paula,
Yes, we did water therapy for 3 days using warm water. It's still very cold here in Ireland, so we had to bring the pool inside the house and get warm water from the sink hehe... but it worked great. We will do it again this weekend. Actually her leg movements outside the water started 1-2 days after we did the water therapy, so I guess this [water therapy] really helped her in some way.
Here is a very short video during water therapy, she was doing this movement while my husband was trying to give her a treat:
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Post by Romy & Frankie on May 1, 2020 12:58:27 GMT -7
Love this video. Her little legs are really moving!
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Post by Natalia & Mel on May 11, 2020 5:42:41 GMT -7
We went last week (Week 6) to the follow-up consultation with the vet. He was happy with Me's progress and told us that having bladder control at this point is really a great achievement for her. He gave a shot on her left leg to strengthen the muscles as it is not as good as the right leg. Recommendations from him: - Water therapy 3x week
- No need to be in the pen anymore
- Free to play/exercise as much as she is willing to
- Follow-up consultation in the next 4-6 weeks
For the weaker leg, we are doing one extra exercise suggested by Judy, to lift the right leg off the floor so she has to concentrate on standing with the left leg only. Weekly Summary: Week 1 - hospitalized Week 2 - no movements at all / no bladder control Week 3 - tail waggling / no leg movements at all / some bladder control Week 4 - same as week 3 Week 5 - some movement on the right leg / left leg mostly dragging / full bladder control Week 6 - same as week 5 Week 7 - able to walk during WT with movements on both legs
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,587
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Post by PaulaM on May 11, 2020 7:04:01 GMT -7
Natalia, very good news of more nerve healing. Very awesome to see both of the back legs doing walking movements!!
What was the name of the shot in the back leg?
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Post by Natalia & Mel on Jun 29, 2020 6:11:38 GMT -7
Hello,
It's been now 3 months since Mel's surgery and she shows a lot of improvement. She can wobbly walk now, specially when she's on the backyard, but still drags most of the time when she's inside the house. Water therapy was definitely the best thing for her.
But even having wobbly walk, I thought of buying a wheelchair for her, so she can enjoy the parks on her own. We tried to take her for walks using a harness but it looks like she doesn't enjoy it that much, as she wants to walk by herself and feel free. Would this be a good idea to get her a wheelchair at this point?
This is a video from last week, she can enjoy the backyard, but it still not good enough to go out to parks: Quality of this video decreased after uploading in youtube.
Thanks Natalia
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jun 29, 2020 6:33:27 GMT -7
Hi, Natalia. How wonderful to see how well Mel is doing! My Jeremy has trouble walking for any distance. His legs start to give out after a few blocks and his hips fall to the side. So for walks in the park or for any distance, he uses a cart. So yes, a cart would be great for Mel and would give her that extra freedom of movement. Carts are also used for therapy. Adjust the cart so her feet just touch the ground so it will encourage her to move those legs in a walking motion. Here's some info on features to look for in a cart. www.dodgerslist.com/links/cart.htmThanks for the encouraging update!
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