Natalia's Mel Mar 24 surgery4wks - Ireland; GRAD Apr 21

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.htm

Do 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.pdf

Check 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.htm

Also 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.htm

Knowledge 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.jpg



Healing prayers for Mel. Please keep us updated.

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.htm

QUESTIONS
~ 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?

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.

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.

So far she has no movements on her legs at all. Just stretches.

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.

Hi Paula, unfortunately we don't have a bathtub at home. But we keep doing normal PT until de pool arrives.

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

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.  



 

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
**

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!

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.

Love this video. Her little legs are really moving!

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?