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Post by Dennis & Gus on Dec 16, 2020 11:53:56 GMT -7
Hi all, my dog gus went down with a serious episode late on sunday, 12/6/20. He was diagnosed as having a T12-T13 disc extrustion with no deep pain sensation and went into surgery mid-morning on Monday, 12/7/20. Fortunately, he regained sensation quickly post surgery but has not yet shown any strong signs of movement in his rear legs, bladder or tail. (He does straighten his tail out, but no wags. He also almost seems able to support himself on his hind legs when I have him in the yard but he is not able to move them). He came home with me that Thursday and has been on strict cage rest since, with the exception of me bringing him to the yard to try and get him to go to the bathroom. Unfortunately, thus far he has not peed on his own. Per the vets instructions, we have been catheterizing him twice daily to drain his bladder. He did poop in the yard twice, but generally has been going in the cage and not when we bring him out. He is eating well and his demeanor is almost like normal, he is raring to go and get out of his cage. ★1 35-40 lbs- Prednisone 10mg, twice daily for 7 days, now on once daily for addl 7 days, then 3 doses every other day - Gabapentin 100mg twice daily for 14 days, then once daily for 14 days - Trazadone 100mg as needed up to once every 8 hours. Giving on average 1/day but may increase as he seems to be eager to leave the crate [Moderator's Note. Please do not edit 35-40 lbs Prednisone as of date?: 10mgs 2x/day for 7 days gabapentin 100 mgs 2x/day trazodone 100 mgs 1x/day needs GI tract protector, Pepcid AC, on board w/prednisone] ★2 - Dogs name is Gus, he is a terrier mix but quite long and low ★3 - Diagnosis of acute T12-T13 intervertebral disc extrusion - Surgery was T12-L1 hemilaminectomy on 12/7/20 ★5 Is there still currently pain - - Seems to be no pain at all. Very alert and wants to move. Almost seems like "normal", except that he cannot move his hind legs ★6 - eating and drinking very well, voraciously as usual! Poops are all firm and look healthy, though he has only managed to poop in the yard twice when taken out and generally is going overnight in his crate★7 wobbly walk?- No. He does move his tail when he shakes himself out, and has stretched his legs out a couple of times but that is all ★8 -No, he does not seem to have any bladder control. We are catheterizing him twice daily at the vets instruction. She indicated that if he had not regained control by the time of his follow up, she would have us begin expressing him vs. the catheter. This is my biggest concern, is there anything we can do to help him with this? How long does bladder control typically take to return (if it is going to) in a dog that went down without DPS? Our vet has been very optimistic that he will get it back given that he has sensation in tail and feet, but that it may take some time.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Dec 16, 2020 12:51:23 GMT -7
Welcome Dennis! The good news is with your surgeon now having identified that DPS is now present, that bodes well for more nerve function to return. It is probably best to think more in terms of months rather than days/weeks for this slowest department of the body to self heal. See the normal order nerves self repair in and be watching for the happy tail wag when you specifically do some happy talk or show Gus a treat is coming is way. Nerves heal typically in the reverse order of the damage to the spinal cord:1. YES! Deep Pain Sensation: the first neuro function to return. DPS is the critical indicator for nerves to be able to self heal after surgery or with conservative treatment. Trust only the word of a neuro (ACVIM) or ortho (ACVS) surgeon about this very tricky to correctly idenfiy neuro function.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. Leg Movement, and then ability to move up into a standing 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.htmIs the cath in dwelling or that you insert it 2x/day? Since no one can tell you time when bladder control will come back, most surgeon send their patients home by giving the owner a must have lesson on expressing. Do read over the info we have on expressing AND also how you can express for poop! dodgerslist.com/2020/05/05/bladder-bowel-care/Has his bedding been staying dry---no urine leaks there? Does he leak on you when lifted?
At HOME PTWhat did the surgeon direct for number of weeks to be on supervised post op rest inside of a recovery suite? Many say 4 or 6 weeks depending on the surgery case. Let us know.What did the surgeon direct for at home PT for the paralyzed legs? Any of the ones in the video below?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. Also keep joints flexible and able to bend.
Post-op PT for the paralyzed IVDD dog: EMAIL ALERTS Please do set up email alerts as timely interaction/communications is needed when helping your dog. How to set up: dodgerslist.boards.net/thread/7353/register-bookmark-dogs-post-thread
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Post by Dennis & Gus on Dec 18, 2020 8:49:38 GMT -7
Cath is inserted twice a day, NOT indwelling. I am going to begin expressing him today
No urine leaks, we've gotten him onto a good routine and have been able to remove with catheter
Directed to do no PT other than range of motion until the 2 week follow up appointment. Up to that point she wants him on strict rest only going out to the bathroom
It's very difficult to see DPS in his feet, makes me concerned but the surgeon told me that he had it [DPS] post-operatively. We are able to see clear sign of it in the tail, however.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Dec 18, 2020 9:36:25 GMT -7
Dennis most general vets have difficulty correctly IDing deep pain sensation. So you likely will not learn anything if you squeeze toes, you'd be only causing Gus pain. You can only trust the word of your specialist surgeon on DPS neuro function.
What are the specific observations about a happy tail wag, so we, too, can know for sure tail function is back? Details are important in communication about neuro functions. Did you do some happy talk and then Gus wagged tail? OR did you show him a yummy treat coming his way and then he did a happy wag? Any leg or tail movement during potty time are likely reflex and not purposeful brain directed movements.
By definition a dog would have to first have DPS before the next neuro function could exist— that means first DPS, then next comes happy tail wag. And your neuro had already confirmed that Gus has DPS.
We are very interested in the results of the sniff and pee test. Give it periodically maybe every other day or so just to check if bladder control is returning.
SNIFF AND PEE TEST The only way for humans to know if there is bladder control is with the “sniff and pee test.” Carry outdoors, set Gus 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 Gus 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 check to verify there is full voiding until you are certain it is consistently happening. Let us know what you observe. NOTE about expressing: When the bladder is full, it fills the entire abdomen area so any pressure would release urine if bladder control is not yet back. You may need to hold the pressure for a little longer than you think you would. As the bladder empties, it gets smaller and can slip away from you. You’ll need to find it again. Sometimes it moves back by the pelvic area. Keep pressing until the bladder feels flat, almost like your hands are touching.
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Post by Dennis & Gus on Dec 18, 2020 11:37:15 GMT -7
Thank you for all the information!
I do not think what I see is a "happy tail" wag, unfortunately. What he will do is when he "shakes" his body out, like he is shaking water off, he shakes his tail like he would before his injury
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Post by Romy & Frankie on Dec 18, 2020 15:13:16 GMT -7
A happy tail wag would be in response to you speaking to him sweetly or a treat. That would be brain directed activity. It works like this: Hear (head level) you doing some happy talk and then tail wags is brain directed.
It is still early in the healing process. Lots more healing can still take place
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Post by Dennis & Gus on Jan 18, 2021 6:24:14 GMT -7
An update and another question for you all, First of all thank you for all of the advice! Gus is healing well, he has great mobility back in tail and legs and is going to the bathroom on his own! We are going for walks and doing pt as recommended by his neurologist. He pretty much supports his own weight at this point, and we are using the sling mostly for side to side balance.
** That said, he is starting to seem like he is enjoying laying in his bed. Gus has always been VERY active but now he seems less motivated, almost like he’s gotten used to laying around. How did you all go about motivating them to remain active, while respecting their need to heal and rest?? Just something that will come back with time?
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
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Post by Marjorie on Jan 18, 2021 8:42:05 GMT -7
Such wonderful news on all of the nerve healing that you're observing, Dennis! So happy to hear it. Surgery can take a lot out of a patient. It may just be that Gus needs more time to rest and heal. Do be aware that not wanting to move can be a sign of pain. Do you see any other sign of pain such as: ◻︎ restless, pacing, can’t find a comfortable position ◻︎shivering-trembling ◻︎yelping when picked up or moved ◻︎slow to move ◻︎tight tense tummy ◻︎arched back, ears pinned back ◻︎ head held high or nose to the ground. ◻︎looks up with just eyes and does not move head and neck easily. ◻︎ not eating due to pain of moving jaw with a neck disc or pain of back disc ◻︎ holds front or back leg flamingo style not wanting to bear weight ◻︎not their normal perky selves If you do see any of the above signs of pain along with reluctance to move, do advise your vet ASAP. Sometimes it takes seeing two signs of pain to confirm pain as dogs can be good at hiding their pain. What type of sling are you using? It may be that Gus doesn't like the sling. Most male dogs prefer a Figure-8 sling. •Here's one you can make from an old sweatshirt www.lyonpuffpetsit.com/htmlslp/sling.html •Kristen's figure 8 sling made from two leashes i0.wp.com/dodgerslist.com/wp-content/uploads/2020/05/Figure8.jpg?resize=320%2C391&ssl=1
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