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Post by Rachael & Lentil on Oct 24, 2020 16:35:05 GMT -7
Hi everyone,
I am brand new to these boards which were recommend to me by the surgeon who just operated on my pup Lentil. Lentil is a mutt but his DNA test showed chihuahua, dachshund, and min pin. He is 6.5 years old and weighs 13.6lbs. On Tuesday night 10/20 around 7pm, Lentil was in the bedroom (I was on the couch) and out of nowhere he started shrieking. I rushed to him and found that he couldn't move his back legs at all and was dragging them frantically on the ground. We rushed him to an emergency vet but they had a 4-5 hour wait, so it was after midnight before they called and told us that with specialty hospitals being so full due to COVID, they wanted to try keeping him on IV pain medication and rest. They called back around 6am and let us know that he seemed to be declining slightly so they referred us to a specialty clinic where he had an MRI and his surgery on Wednesday 10/21 around 11am. We were able to take him home yesterday (Friday 10/23). I will copy and paste his discharge instructions here which includes his medication dosages.
We have him set up in his suite and he seems comfortable although very sedate today. He has not been able to urinate on his own yet but we have easily been able to express his bladder. We are pretty sure we got a tail wag when we were happy talking to him earlier, but not positive that it wasn't just a reflex so we'll be keeping an eye on that but hopeful! So far no movement has returned to his back legs.
DIAGNOSTIC TESTING PERFORMED:
Neurologic evaluation
Thoracic radiographs: unremarkable thorax
Spinal MRI: Extradural spinal cord compression that is ventral and right-sided at T13–L1 from extruded
intervertebral disc material
DIAGNOSIS:
T3-L3 myelopathy secondary to T13-L1 invertebral disc herniation - corrected via T13-L1 right-sided hemilaminectomy
TREATMENT & FOLLOW-UP:
Lentil was taken to surgery following his MRI where a right-sided hemilaminectomy was performed encompassing
the T13-L1 disc space. During this procedure a window is created in the bone surrounding the spinal cord and nerve roots so pressure can be relieved and the disk material within the spinal canal can be removed. Lentil did well under anesthesia, surgery went well and he woke without complication. Since surgery, Lentil has been comfortable on oral medications. At the time of his discharge, Lentil has a small amount of purposeful movement
in his back, but is unable to urinate on his own. We cannot guarantee the rate or extent of his ultimate recovery.
By following the instructions below you can minimize the chances of him experiencing a set back and optimize his further recovery.
Monitoring and Care:
Lentil needs strict exercise restriction for the next 4-6 weeks. Though this may seem harsh, it is the most
important part of his recovery.
There is currently a hole in the outer layer of Lentil’s diseased intervertebral disc that will take 4-6 weeks to heal. If he becomes too active too quickly he could herniate more material causing additional compression of his spine, potentially requiring a second surgical intervention.
Restricting Lentil’s activity will become most important as he starts to feel better and wants to be active. Please keep him confined to a dog crate when he is not being directly supervised. Additionally, you will need to prevent any jumping, running or rough play.
When taken outside to eliminate, Lentil should be on a short leash at all times with a sling/towel used to support his hind end. After the initial 4-6 week period, Lentil can begin to be slowly re-introduced to his regular exercise
regimen, as he is able.
In the long term avoiding high impact activities such as jumping on or off furniture and trying to keep Lentil at a lean body weight (he is currently ideal for his body size) are things that may help reduce the risk of recurrent back pain or weakness.
Unfortunately, Lentil has not been urinating on his own in the hospital. It is imperative that he have his bladder emptied at least once to twice per day to prevent any damage to the bladder. Lentil will need to have his bladder
expressed or catheterized for evacuation until he begins to urinate on his own.
We have found a few helpful videos that explain how to express the bladder and have included links below:
If you note a foul odor or color associated with Lentil’s urine during expression, then he should be seen and his urine re-evaluated as this could indicate he has developed a urinary tract infection. Also, if Lentil does not pass any urine in 12 hours, or you are having difficulty expressing, please contact us or your local veterinarian.
If Lentil begins leaking or dribbling urine it means he needs to be emptied at that time. Most dogs begin to urinate on their own between the time they regain sensation and movement in their pelvic limbs; if Lentil does not recover
additional neurologic function it is possible that he may require life long bladder management.
Physical Therapy: It is recommended that you provide Lentil with passive range of motion to help keep his muscles and joints relaxed and flexible. The exercises are described below and you may also visit the Purdue
Veterinary Teaching Hospital Website (https://www.purdue.edu/vet/vth/small-animal/rehab.php) and view their instructional videos:
-Start by flexing and extending each leg 10-12 times. The goal is to make sure that you are manipulating each
joint.
-Next, move the leg in a bicycle motion as if Lentil were walking on his own. Only move the leg in a forward motion. Do this motion 10-12 times.
When performing range of motion exercises, please perform joint compressions of all joints including the stifle (knee), hock (ankle), elbow and carpus. To perform these exercises, simply compress the bone above and below
each joint together to help supply nourishment to cartilage and to stimulate nerve receptors in the joint capsule.
Compressions should be gentle and should not cause any pain. These exercises can be performed as often as possible to help improve Lentil’s rehabilitation outcome.
Incision Care:
Please check Lentil’s incision two to three times a day for any progressive redness, discharge, or swelling. If you notice any of these things please call us for advice. Lentil’s sutures need to be removed in 10-14 days from the
surgery. This can be done at the Veterinary Specialty Center (at no charge) or with your local veterinarian.
Update:
Call or bring Lentil to a veterinarian immediately if he is showing signs of neurologic decline such as weakness in his front legs, loss of strength in his pelvic limbs, progressive pain, or if he has any vomiting, diarrhea, lethargy,
decreased appetite, or trouble breathing.
RECHECK:
Suture removal in 7-10 days: We would like to see Lentil back, in 7-10 days to have his sutures removed and re-evaluate his neurologic status. This can be done either at VSC, or by your primary care veterinarian. If you are
coming back to VSC for re-evaluation and suture removal, please call to schedule an appointment, there will be no charge for this appointment at VSC.
4-6 weeks: We would like to see Lentil back in 4-6 weeks after surgery to re-evaluate his neurologic status and discuss his gradual return to normal exercise. Please call to schedule this appointment. *Please note that there is
a small fee that will be associated with this examination.*
MEDICATIONS:
Date/Time Drug Name Quantity Instructions Dispensed 10-22-2020
Gabapentin Oral Solution 50mg/mL (Per mL) 50
Give 1 mL by mouth every 8 hours for 7 days, then give 1 mL every 12 hours for 7 days, then give 1 mL every 24 hours for 7 days, then discontinue. May cause sedation. NEXT DOSE DUE: 4 PM this afternoon 50
10-21-2020 Codeine 15mg C-2 (Per Tablet) 21
Give 1/2 tablet by mouth every 8-12 hours for pain. May cause sedation. *CAUTION: Federal Law Prohibits the transfer of this drug to any person other than the Patient for whom it was prescribed* NEXT DOSE DUE: 4 PM this afternoon 21
10-21-2020 Trazodone 50mg
(Per Tablet) 30
Give 1/2 tablet by mouth every 8-12 hours as needed for anxiety. May cause sedation. NEXT DOSE DUE: 4 PM this afternoon
[Moderator's Note. Please do not edit
13.6 lbs 6.5 y.o
gabapentin 50mg/1mL: 50mgs (1mL) 3x/day
codeine 7.5mgs 3x/day
trazodone 25mgs 3x/day ]
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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 24, 2020 18:04:55 GMT -7
Welcome Rachel! Very excellent that already you are finding it easy to express the bladder. As long as he is staying dry expressing session to session, then you are indeed doing a good job. Often when folks are just learning this new skill, it may take expressing every 3-4 hrs to prevent an overflowing bladder and then moving up to every 6 to 8 hrs as dog stays dry between sessions.. You can also express for poop. It is not the health concern that urine is. But rather to prevent Lentil anxiety of finding poop just plopping out where he sleeps. You will not even need a lesson to express poop, it is so simple. Just watch the video and read the tips at this link: dodgerslist.com/2020/05/05/bladder-bowel-care/If you don't live in a cold part of the country, you could take him outdoors to express urine. Most folks do express indoors, though on a pee pad or in the shower stall with a non-slip traction mat on the floor there. It is so very early in the nerve healing department. Best to think more in terms of months for the slowest part of the body to self heal rather than days/weeks. Your surgeon's discharge instructions contain really excellently explained information.... the best I believe I've seen! Let us add in some helpful at-home care tips and supplies to make the next 4-6 weeks of STRICT rest go smoother for you guys. How to set up the mattress system and lots more---check it out here: dodgerslist.com/2020/05/14/strict-rest-recovery-process/Is Lentil's pain fully in control at home? If you got a tail wag when you specifically did some happy talk to him or showed him a yummy treat, that happened because the head level eyes directed the brain to send a signal down to the tail to wag. That bodes well for more self-healing nerve function to return at some point! ! ! For us humans to be able to distinguish between reflex and brain directed, 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. --- Sniff (head level nose) at an old pee spot in the grass, then release of urine would be brain directed. --- Tail movement during potty time can often be a reflex --- Itchy sensation at at neck and then attempts to scratch would be purposeful movement. --- Tickling paws during range of motion pt, etc can cause reflex leg movements. But the firing of reflexes is a good thing in helping to stimulate muscles, etc. |
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Post by Rachael & Lentil on Oct 24, 2020 18:14:53 GMT -7
Hi Paula, thank you so much! We live in Seattle so it has been getting chilly but so far we have been taking him outside to express. Good point about the shower though because he definitely doesn't love the cold. So far we have not noticed any wet bedding, but this morning when my husband lifted him out of his ex-pen to take him outside, some urine overflow did start to happen but this was after an overnight. So far today we have taken him outside 3x (it is 6pm) and no leaks in between.
His pain does seem to be under control for the most part. I have noticed that he doesn't seem to love being lifted up out of his ex-pen for potty time. He gets a little stiff as though he is in a bit of pain. He also seems to have some pain in his front right leg/paw, though this is where the IV catheter was inserted at the hospital so we're thinking it could be that? We have been in touch with the surgeon and if he still seems a bit uncomfortable tomorrow, she will prescribe some carprofen. She was reluctant to do so because of the potential for GI issues. So fingers crossed he doesn't need it, but we will use it if we have to of course.
So far I am not 100% certain if his tail wagging is a reflex or not. We have only seen it when we lift him up and place him down to try standing (with the sling), and it quickly goes back down to between his legs. Fingers crossed and we will keep an eye on it.
I'm glad to hear that the instructions we got are thorough!
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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 24, 2020 20:28:16 GMT -7
Which do you actually give codeine? every 8 or every 12 hrs? Wouldn't hurt to go as Rx'd every 8. A lot a dogs do take about 14 days before all of the surgery caused painful swelling subsides. All anti-inflammatory drugs including carprofen, a non-steroid anti-inflammatory —NSAID, increase stomach acids. Ask the surgeon if there are any health issues such as kidney or liver, that Lentil may need lower dose for counter Pepcid AC (famotidine). Ask if any heart murmur issues, then a different acid suppressor would be chosen. If no health issues Pepcid AC is available at the grocery store Dogs don't speak up at first signs of stomach damage like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach.
E xcellent reading about use of anti-inflammtories and stomach protection: dodgerslist.com/2020/04/18/steroids-vs-nsaids/ Let us know when you have circumstances specifically of hearing (head level) your happy voice or seeing (head level) a yummy treat coming his way and then you got a happy wagging tail. Even if just a weak wag that is what you look for. It can take time for nerves to self heal. So don't devote your days watching if the pot is going to boil. One thing for sure is at the end of his 4-6wks strict rest, he's going to get back to living life enjoying family activities! |
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Post by Rachael & Lentil on Oct 25, 2020 10:38:57 GMT -7
We are giving the codeine and gabapentin together every 8 hours. After speaking to the vet yesterday, we are giving it a try to decrease his ▼ trazodone to every 12 hours instead of 8 because yesterday he was very sedate and didn't quite seem himself. [Moderator's Note. Please do not edit
13.6 lbs 6.5 y.o
gabapentin 50mg/1mL: 50mgs (1mL) 3x/day
codeine 7.5mgs 3x/day
trazodone 25mgs ▼2x/day ]He already seems to have a little personality back today for better or worse--my husband is currently outside with our other dog and Lentil is NOT happy about it.  We expressed his bladder in the shower a few times last night, thank you for that tip! We also were able to express a bowel movement last night before bed and he had another one this morning. So far still can't confirm if we've seen meaningful tail movement but doing our best to stay positive. He does not seem to be in any pain today. He doesn't love us touching/trying to manipulate his front legs for his PT, but it seems to be more annoyance than pain. Keeping a close eye on it. |
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Post by Ann Brittain on Oct 25, 2020 10:54:44 GMT -7
Glad to hear you were able to talk to the vet and get Lentil's meds adjusted. Hopefully they will keep him pain free but not make him so listless.
It's great that you are able to get him expressed properly. That's so important to keep Lentil comfortable and to prevent urinary tract infections.
Healing is tricky and the time it takes to recover isn't precise. Once the swelling is reduced, he could start making more progress quickly or it could take a while. Make sure you follow through with physical therapy as recommended by your vet.
Our Buster took several weeks to start walking and it took a while longer for him to become strong enough to move around totally on his own.
Patience is the key to helping Lentil heal.
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Post by Rachael & Lentil on Oct 25, 2020 11:44:33 GMT -7
If he is not having any accidents in bed, is it safe to assume that we are fully expressing his bladder? Sometimes it's a little hard to tell if it is completely empty and I don't want to leave urine in there. He has not had any leakage in bed--just a little bit yesterday morning when my husband picked him up (so he may have inadvertently squeezed his stomach).
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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 25, 2020 11:53:35 GMT -7
It seems you have reached the level of expressing proficiency needed! ⭐️
That proficiency goal is to stay dry session to session, not find urine leaks in bedding.
Lifting a dog when the bladder is full and ready to be expressed, can actually be bit like expressing. Any pressure applied to the tummy area with a full bladder is very easy to express and cause leaking on you.
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Post by Rachael & Lentil on Oct 25, 2020 15:49:41 GMT -7
Happy news! Lentil absolutely loves our landlord because she always keeps treats nearby for him. She was just outside so we carefully carried him out to say hello for just a minute, and we got a little happy tail wag! It was small but definitely there and responding to seeing her with her treats. Yay!
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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 25, 2020 16:54:02 GMT -7
Rachael, that is good proof that there is very likely to be another degree of nerve healing and return of function in the future!
Nerves heal typically in the reverse order of the damage to the spinal cord:
1. √Deep Pain Sensation: the first neuro function to return. DPS is the critical indicator for nerves to be able to further self heal after surgery or with conservative treatment.
2. √Tail wagging with joy at seeing you or getting a treat or meal.
3. __ Bladder control verified with the "sniff and pee" test. Bowel control usually comes back about the same time.
4. __ 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.
So periodically every couple of days, give the sniff and pee test to see if bladder control's starting to return. When it begins a dog may not like you expressing. There is no certain length of time for a nerve function to come back. All that can be said is the typical order that nerves heal in .
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 after he pees/marks on his own. Check to verify there is full voiding until you are certain it is consistently happening. Let us know what you observe.
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Post by Rachael & Lentil on Oct 27, 2020 7:27:14 GMT -7
Little update on Lentil this morning. We have two recovery suites, one in the living room and one in our bedroom that we move him between. This morning, I opened the door to his crate in the bedroom to grab his food and water dishes and move them into the living room. When I went back for him, he was halfway across the room walking on his wobbly little legs! So first an important reminder for me not to leave the door open anymore but also, I'm assuming this is good news? His legs were definitely shaky and sort of crossed over, and his paw was still knuckled under. But he was definitely standing on his own which he hasn't done yet!
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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, 2020 8:16:46 GMT -7
Oh my Rachael. As the nurse at home, you have found out why the need to always be one step ahead of our charges in keeping them safe. In a blink of any eye they do the most unexpected things. Wonderful news that he CAN walk even if wobbly with those back legs. So according to doctor's orders whenever he is out of the recovery suite, he needs to be under your supervision. A back end sling to prevent falling cause his is not steady with those wobbly legs. Do take him outside for a "sniff and pee test" to see if now he has some bladder control beginning to return. Let us know what you observe. If he can now pee or mark on his own, continue to do a quick express check afterwards until you are satisfied he voids his bladder fully. As bladder control starts to come back, you will likely find he no longer likes you to express him. Carry him to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog’s back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. An ex-pen in the snow is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on! IF you have enough snow on the ground you can build up a wall of snow to make kinda of a fenced in area. **  Male dogs prefer a figure 8 type of sling at potty times where the support part is not touching the penis as a long scarf would.  Share the new wobbly walking function return with your neuro. You may find Lentil will no longer want you doing the range of motion PT any more. Depending on things about the surgery your, neuro may indicate it is OK at this point for the at-home PT to be a well controlled (with leash, harness and sling) slow walk to and from the potty place. |
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Post by Rachael & Lentil on Oct 27, 2020 13:11:42 GMT -7
Yes, it certainly caught me off guard since up to that point, he has had no interest or ability in using those back legs as far as we can tell! Won't be making that mistake again. I did take him outside today to see if he would pee, but no luck. That being said he doesn't seem to like being expressed either. He doesn't put up too much of a fight or anything, but he definitely seems annoyed by it. So, hopefully he will start going on his own shortly!
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Post by Romy & Frankie on Oct 27, 2020 13:20:46 GMT -7
Dogs can become difficult to express when they are getting bladder control back. Since he is now walking, even if wobbly, bladder control may be returning.
Continue taking him out to "sniff and pee". He may soon suprise you.
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Post by Rachael & Lentil on Oct 29, 2020 7:10:10 GMT -7
Still no luck with urinating on his own. We are trying outside at least twice a day. The vet recommended that we challenge him and wait a little longer between expressing him to see if he will go on his own. Fingers crossed! He has not really tried to walk again either, although this morning he was able to get himself up and out of his crate (with my close supervision) and he was using his back legs though not much.
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Post by Rachael & Lentil on Oct 29, 2020 17:16:26 GMT -7
Good news! Lentil passed the sniff & pee test today. He peed on his own after sniffing around the yard. He didn't seem to really know it was happening because he was continuing to walk, and obviously he didn't lift a leg. But it definitely was not just his bladder overflowing. |
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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 29, 2020 17:37:20 GMT -7
Let us know when you see him sniff an old urine pee spot. And then see him mark or release urine on the spot.
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Post by Rachael & Lentil on Oct 30, 2020 13:42:29 GMT -7
Interested in insights from you all... so as I mentioned earlier, Lentil hasn't had any accidents or leakage since we brought him home from the vet. He also peed on his own outside yesterday, but now I am wondering if that was a fluke because he hasn't done it again. He's also now had two accidents in his bed yesterday and today. Yesterday it was a lot of urine, like much more than just some leakage, and it wasn't long after he had been expressed. Today it was not quite as much and it had been awhile since expressing him. Is this any reason to be concerned? Is this sort of regression/non-linear recovery normal? He is still wagging his tail pretty vigorously, does not seem to be in pain, and he is using his legs more. He isn't walking but he is able to stand up in his crate though he is still pretty wobbly.
His anxiety is also off the charts now that he is starting to feel better and still confined to his crate or ex-pen. He barks and cries all the time and it took him two hours to settle down last night to sleep. I've reached out to the vet to ask if we can safely increase his trazodone dosage, but I'm at a loss in the meantime. I know this is to be expected as they start to feel better, but it has been an awful few days.
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Post by Romy & Frankie on Oct 30, 2020 14:07:18 GMT -7
I do not think there is cause for concern. Healing is not linear. Lentil seems to be regaining bladder control but it is far from complete. Just keep taking him outside and give him the opportunity to empty the bladder by himself. If he does this, do a quick express check to make sure all the urine is gone. Sometimes as bladder control starts to return our dogs are not able to completely empty the bladder. If the trazadone is not relieving his anxiety and the dose cannot be increased, consider talking to your vet about using a different anti-anxiety med like ACEpromozine. Different dogs react differently to meds. There are also some natural methods of calming you can try. We have information about this here: |
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Post by Rachael & Lentil on Oct 31, 2020 8:15:47 GMT -7
He has now peed in his bed 5 times in the last two days. Every time it happens, it is when he is freaking out with anxiety. Even though he doesn't seem to have bladder control back yet, is it reasonable to assume that his anxiety is causing this? He didn't have a single accident in bed for the entire first week we had him home, and as soon as he started feeling better enough that his anxiety kicked back in, this has been happening.
He is going to the vet today [10/31] to have his sutures removed so we will definitely be talking to them about options for medication at this point. We've run out of beds and blankets and can't afford to do this much laundry.
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Post by Jessica on Oct 31, 2020 9:34:30 GMT -7
The ups and downs of healing can be quite stressful. I hope the visit to the vet today offers you options to help Lentil's anxiety level. Romy & Frankie's post above has some good notes about medication and natural calmers that's worth exploring. Keep up the good work noting your observations to your vet, and let us know what you hear after your visit today.
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Post by Romy & Frankie on Oct 31, 2020 13:55:11 GMT -7
Another thing to consider is the possibility of a UTI. UTIs are fairly common with dogs that need to be expressed despite our best efforts and may result in an urgent need to urinate. Consider asking the vet for a urinalysis to check for bacteria.
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Post by Rachael & Lentil on Oct 31, 2020 14:42:29 GMT -7
Thanks everyone for your support. Sorry to have been so negative; it was just a rough couple days!
We just got back from Lentil's check-up and suture removal appointment. Overall the vet thinks he looks good, though he is slow to improve but he is improving. He can bear a little bit of weight in his hind legs and they recommend we start adding some weight bearing exercises to his PT. They also said we could start taking him on short (5-10 min) walks 3-4 times a day if he seems to tolerate it well and doesn't get too worked up or try to run. We just took him around the block and he seemed happy as a clam, released urine three times, and now he is totally tuckered out and finally quiet in his crate.
Regarding his bladder, it's very odd because he definitely seems to be returning some bladder function--like I mentioned, he peed three times when we were walking just now, and they were all after sniffing. But, he still is not stopping when he pees. He just continues walking on his merry way like he's not really aware that it's happening. So it's a bit confusing as to whether or not he has control. He definitely doesn't like us expressing him anymore and I know that is a sign that he's regaining some control. The vet prescribed a medication called prazosin and said that he might be trying to pee on his own outside but his urethra could be tightened which I guess is common in dogs with these type of spinal injuries? She didn't seem concerned about a UTI but we will definitely continue paying close attention to any potential signs. We haven't given him the prazosin yet.
They also said we could start having him on our laps while watching TV as long as he remains calm. As of today we are reducing his gabapentin and codeine to every 12 hours instead of every 8 and we haven't noticed any signs of pain. They also gave us the green light to double his trazodone dose and see if that helps with the extreme anxiety. I'm hopeful that between being able to get a little more exercise and the additional trazodone, he will be able to relax some and we'll be able to get some sleep... fingers crossed!
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Post by Romy & Frankie on Oct 31, 2020 15:10:37 GMT -7
I am happy to hear a good report for Lentil. Many vets suggest short walks for dogs post-surgery as a sort of PT.
My dog Frankie did something similar to Lentil. Frankie had surgery after IVDD left him paralyzed. He regained bladder control after three or four months, but he was never able to lift his leg, so he would squat. As soon as we got outside he would squat and start to pee. Then he would continue walking along peeing as he went. He did this for years. In spite of this, accidents were extremely rare. I believe this was a sign that bladder control had not completely returned but his control was good enough. You may see this with Lentil.
The prazoin will help if the problem is tightening of the urethra since it relaxes sphincter muscles. This should make expressing easier. However, if the problem is not caused by that, prazoin will not help and may make it harder for Lentil to control his urine.
I hope the increase in trazadone will help with his anxiety.
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Post by Rachael & Lentil on Nov 6, 2020 21:44:55 GMT -7
Hi everyone! Just thought I'd give an update on little Lentil.
So his bladder control is totally back which is great. He is able to sniff and pee, sometimes he doesn't quite seem to know that he is still peeing and he'll start walking again before he's finished, but he is no longer going in his bed. He can get himself up into a standing position and walk a little bit, but he is very wobbly and isn't able to really stand for long before falling over.
His anxiety in his crate has been our biggest concern over the past week. The extra trazodone had the opposite effect and seemed to make him even worse, which our vet said could be a possibility and that he may be overmedicated. We've stopped the trazodone and codeine at this point, and starting tomorrow he'll go down to one dose of ▼gabapentin every 24 hours. We ended up with a ✙xanax prescription and we gave him half of a .25mg tab last night, which seemed to help him sleep better. His surgeon also said we could try taking him on longer walks if he tolerates it well. We also now have him wearing an ✙Adaptil calming collar and are giving him ✙colostrum treats and today has been a bit of a better day, so I'm hopeful we may be turning a corner in terms of the crate training.
[Moderator's Note. Please do not edit
13.6 lbs 6.5 y.o
gabapentin 50mg/1mL: 50mgs (1mL) ▼1x/day
✙xanax 0.25mg tab: 12.5mgs]
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Nov 7, 2020 7:51:18 GMT -7
Wonderful news on the bladder control, Rachael! And excellent news that he's able to push himself up into a standing position and walk a bit. All great signs of nerve healing. So glad to hear it. And good news that he had a better night last night. I do hope that the new regimen of meds, etc. will help calm him. Do check out the link that Romy gave you about natural calmers, too, and other ways to help calm Lentil in the crate in you haven't had a chance to. dodgerslist.com/2020/02/24/tips-to-help-with-recovery-suite/Please continue to keep us updated. And keep up the good work, both of you! |
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Post by Rachael & Lentil on Nov 19, 2020 20:20:23 GMT -7
Hello everyone! Wanted to give an update. Lentil went for his four week post-op appointment yesterday and the surgeon was very happy with his progress! He is now walking although still quite wobbly, and if even able to lift his leg a little bit to pee and he has scratched behind his ears a few times with his back legs. They want us to keep him on rest for another two weeks to be sure that his surgery site has healed, but he has now officially graduated from needing to walk with his sling and he can go on longer walks a few times a day. They did recommend we look into rehab/PT which we have read about here, so we are researching a few options. Not sure if it is in the budget after the surgery but we'd like to do it if we can find something affordable. Lentil is still not very happy when in his crate, but luckily he is well enough now that most of the day he is out and by our side with his leash attached and he is crated whenever we leave the house or when he is unattended. He settles down in there to sleep at night but that's it--any other time he just screams and screams. Overall we are very happy with his progress even though he is certainly not 100% yet. The surgeon anticipates that he will continue to improve although of course we know he may never be back to completely "normal." I will keep updating here but also wanted to thank you so much for all of your help as hopefully we have gotten past the worst of it at this point. |
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Nov 20, 2020 8:03:35 GMT -7
What a truly wonderful update, Rachael! So glad that Lentil is showing such wonderful signs of nerve healing. To have healed as much as he has so soon after surgery bodes well for a complete recovery. Walking is one of the best exercises that you can do for Lentil. Once it's approved by the surgeon, walk Lentil up and down slight inclines/hills, through tall grass, on the sand, at the edge of a pond or lake if available, over different types of textures, concrete, grass, sand. Here's our page on post-op therapy with some exercises that you may want to run past your surgeon to get his approval. They're free, can be done at home and I found them to be very helpful after my Jeremy's surgery. dodgerslist.com/2020/05/27/surgery-dog-pt/There are also water therapy exercises that can be done in the bathtub or a child's wading pool. Always check with the surgeon before starting any type of therapy. dodgerslist.com/2020/05/28/surgery-dog-water-therapy/Keep up the good work! |
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Post by Rachael & Lentil on Nov 25, 2020 19:40:28 GMT -7
Thank you, Marjorie! We are cleared to walk him on inclines and varying terrains so have been doing that as best we can. He seems to be getting a bit stronger since last week although he struggles to hold himself up to go to the bathroom. He's taken to peeing multiple time on our walks but only for a few seconds at a time.
I was wondering if anyone had recommendations or thoughts about some sort of boots or socks to protect his back paws. Since he is still knuckling a bit and we're walking him more, we've noticed that the tops of his toenails are wearing down. It isn't too bad, he hasn't bloodied his paws or anything like that, but just trying to be proactive.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Nov 26, 2020 6:26:07 GMT -7
So good to hear that Lentil is getting stronger, Rachael. Some type of foot ware is a very good idea to protect Lentil's feet. There's a discussion page on this forum about foot ware with suggestions from our members of what has worked for them. Scroll down for all of the suggestions. dodgerslist.boards.net/thread/1564/footwear-harnesses-scooting-garments |
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