Dawn’s Arnie 1/15 surgery4wks - Canada- GRAD 2/12

Dawn, good news that Arnie had the neuro function of deep pain sensation ability just prior to surgery.  Having the neuro function intact bodes well for the body to self repair more nerves as has been reported by the surgeon of some back leg movement!!!  While no one will be able to give you a date for when the next neuro function will come back there is a classic textbook order.    If the neuro observed back leg movement then very likely bladder control has begun to return, too.

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.   √ YES!  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.htm

Predominantly, surgeon's give a hands-on-top-of-your-hands type of expressing lesson if bladder control has not fully come back by discharge day.  You will get more out of the lesson by first reading and viewing the expressing video at this page for both poop and for bladder expressing:  dodgerslist.com/2020/05/05/bladder-bowel-care/ 

SNIFF and PEE TEST
The only way for humans (you and the vet) 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 bladder express check to verify there is full voiding until you are certain it is consistently happening. Let us know if the surgeon gave the S&P test and feels he fully voids. Maybe then you won't need an expressing lesson. 
     NOTE: When the bladder is full, it fills the entire abdomen area so any pressure should 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.

I bet your mind is flooded right now with concerns, questions. Now is the time to jot those things down. Here's a starter list of questions to which you can add some of your concerns to ask your surgeon: dodgerslist.com/2020/06/03/discharge-day-list/

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This 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. dodgerslist.com/2020/05/12/dr-isaacs-surgery-answers/

See if there are any other things you can do to make post-op crate rest go smoother with these very useful tips and ideas:
dodgerslist.com/2020/05/14/strict-rest-recovery-process/

As you learn more from the hospital, do keep us updated. Hopefully by discharge day, it will have been proved that bladder control returned.

I'm so glad to hear that Arnie is home and doing well, Dawn. And such wonderful news on the bladder control!

I would check with the hospital as to the need for the e-collar. Ask if he was showing signs of neuropathic pain. Neuropathic pain is abnormal nerve sensations. Everyone has experienced numbness or pins and needles tingling in your legs when sitting in a bad position for too long a time. With neuropathic pain, it could start with mild pins and needles to quite painful burning, on-fire feeling that makes them bite to stop the pain. It's not common but you do need to be aware of it as dogs have tragically chewed off body parts to stop the pain if it gets bad enough. Gabapentin helps with that kind of pain. Possibly Arnie was trying to get to his stitches so they put on an e-collar. But do check as to why. More info on neuropathic pain: www.dodgerslist.com/literature/neuropathy.pdf

What type of therapy was prescribed? You might want to take a look at our page on post-op exercises that can be done at home and see if there are any that you'd like to run by your vet to get permission to start.
dodgerslist.com/2020/05/27/surgery-dog-pt/

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: dodgerslist.com/2020/04/22/chiropractic/?highlight=chiropractic

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.
dodgerslist.com/2020/05/28/surgery-dog-water-therapy/?highlight=water%20therapy

Please keep us updated on Arnie's progress.  Healing prayers for Arnie.