Yvonne's Bowie 2/22 surgery6wks - Cushings, stones; GRAD 4/5

Bowie weighed approximately 17lb when he went to his primary vet back in Dec 2020.  I am not sure what his weight is now.  He may weigh a bit less now. 

His thyroid medication name is "Thyro-Tabs Canine", levothyroxine sodium, 0.1mg tablets.
  
Did the surgeon believe he had bladder control upon release 2/25?  He did not say whether or not Bowie had bladder control.  Only that we should express his bladder until he can urinate on his own.

Or were the expressing lessons intended for you to express at home? Yes, they were.

Has the increase in Prazosin made it easier to express?
  No. We took Bowie back to the ER last night and they did xrays, Bowie has 3 small stones in his bladder.  They do not believe that the stones are big enough to prevent his bladder from being expressed but they are worried that too much pressure could cause a stone to puncture his bladder. 

The ran a test to see if there is a UTI that could be causing the bladder to not be easily expressed.  We are still waiting on the test results.  The neurologist called today and requested we bring Bowie back in.  They are keeping Bowie overnight.  They put him on a catheter and may give him valium to help him relax.  There is some good news, Bowie has regained some movement in his left rear leg. 

Have you tried expressing for poop?  No, Bowie had been pooping on his own after surgery but it was runny, so they gave him something to reduce diarrhea before he was released home on Friday.  The paperwork said he may not poop for 2 to 4 days.  The vet said he had a large poop tonight when they took him in.  I do not know whether they expressed it or Bowie did it himself; I will ask them tomorrow if the neurologist calls me.

We gave Bowie one teaspoon of pumpkin with his Dinner on Saturday.  He had difficulty swallowing his pills after that, so the vet said we should discontinue the use of pumpkin, as Bowie may be allergic to it.

We will keep you pear suggestion in mind.  I did not know of an alternative to pumpkin so I was going to start looking on the internet.  Thank you so much.

Thank you for all your help!

Hi,

Bowie is still in the hospital.  They did an ultrasound on his bladder and the initial reading is that there was nothing notable that they could see that would cause the issue.  The report came in late, so the neurologist will read it tomorrow morning.  They have not gotten the labs back yet from the UTI test.  So Bowie is still on the UCat but they will likely try and remove it tomorrow and see if he can urinate on his own.

Some very good news though.  Bowie has been pooping on his own.  They say he now has some movement in both legs.  I am over the moon happy about this news.  So if they can get him to urinate on his own and the labs do not come back with any bad news, he will likely be coming home tomorrow.  =) 

 Regards, Yvonne

Bowie came home yesterday. Bowie has cushings, which caused his bladder to be thick and larger. He is difficult to express, even some of the vet's and many of the lab tech could not express Bowie's bladder. Also because he has stones in his bladder they do not want us to express it all the way. They modified his medications. He is taking:
Diazempam 5mg 3x/day
Tamsulosin 0.4mg 1 capsule every 12hrs  
Along with his Thyroid and cushings medications.
We are now able to express his bladder but he leaks all day. Poor sweetie. He does not like urine, before his back issues, he would pee and them cover it like a cat.

[Moderator's Note. Please do not edit
17 lbs.
Diazempam 5mg 3x/day
Tamsulosin 0.4mg 2x/day  (relaxes the muscles in the bladder neck, making it easier to urinate or be expressed.)
Thyro-Tabs Canine, levothyroxine sodium (thyroid supp)
trilostane for cushings
gabapentin 100mgs 2x/day - STOPPED
codeine 7.5mgs 3x/day - STOPPED
Prozosin 0.5mgs 3x/day - STOPPED
omeprazole 10mg/mL: 0.8mL 2x/day - STOPPED
ofoxacin eye drops - STOPPED
Amoxicillin 125mgs 2x/day - STOPPED]

He wagged his tail today and is taking steps with his legs but still does not have the strength to support his weight.

We are doing his physical therapy 3x a day.

Also the Gabe us a back leg harness to take him outside for sniffs in his potty area with hopes that will stimulate his to urinate on his own.

Today was his 1st full day home and it went well. He is in good spirits but still I think a little sad because he probably doesn't understand why his legs are not working. He did enjoy barking at some of the animals on animal planet and giving his buddy, our other doxie kisses.

It's been 2wks and 2 days since his surgery.

Thank you so much for the suggestion to use brewed decaf green tea to help remove the urine spell.  This works wonderfully. 

I have tried to contact the neurologist he will not be back in the office until Tuesday and Bowie's primary vet is booked until middle of March.  We have an appointment at his back up vet for Monday.  Poor Bowie licked his penis until it was bleeding. So now, we keep a cone on him when we are not in the room with him.  He starts licking himself when [LEAKING] his bladder expresses itself.  I think that he is not really leaking but has no bladder control, likely from the medication that he is taking.  We are able to express him now; so the medication is helping with that. It seems that as soon as he gets any amount of liquid in his bladder, he freely releases it.  I sent an email to the neurologist;

I wonder if perhaps his dosage of Tamsulosin is too high.

For P.T., we are doing the bicycles, with massaging and stretching. He can support his weight on his legs without walking for a little bit of time.  I try to have him stand when I'm wiping him down with the green tea; sometimes he can not stand. We also take him out to smell and walk a bit with his back leg harness, a few times a day.  I have a call into a P.T. place near us called the Zen Den.  They do post-op therapy and when he is able, they also do water therapy.  

Bowie has one other medical condition, besides the stones, that is complicating his bladder issues.  He has to drink a lot of water or he can easily dehydrate.  They think that he has canine primary hyperparathyroidism (PHPT), which is likely what caused this stones; since he has high calcium levels in his blood.  We will be getting him tested in a couple of week.

Thank you for all your help.  Without your help, we would feel completely alone this weekend.

Regards, Yvonne

Yvonne, any vet who has access to Bowie's file at the hospital where the surgeon operated could adjust the Tamsulosin. At the hospital there are other vets on duty, ER vets, etc.  See if you can get in a call tomorrow about the Tamsulosin dose which may be relaxing the muscles in the bladder neck too much.

TERMS for communicating with clarity:
Leaking urine happens due to reflex when the brain can no longer direct the bladder to release urine at an appropriate time and place. Bowie's bladder leaks.

Leaking can also happen until the right dose can be found when bladder relaxing meds are on board.

Another reason for leaking urine could be due to a bladder infection. I'm not saying Bowie has an infection, but as a thing to bring up with the vet. At the Monday, vet visit, discuss a urinalysis to rule out an infection.  Also dogs who have an infection can smell it and often lick at the genitals.  

Expressing is an action that owners do when a dog has lost bladder control.

How often does Bowie leak urine?
How often do you express his bladder?

I'm glad to hear that Bowie is feeling better, Yvonne. Please continue to keep us updated.

We would love to see a video of Bowie's water therapy. You can share the video with us through YouTube:
—First upload your video to YouTube.com
—At the top of your browser when viewing your uploaded video you will see a "share" button below your video window.
— Pressing it will expand to reveal the URL (it starts with <http...> ) you can paste URL into a Forum post.
—How to details for mobile devices and computers: support.google.com/youtube/answer/57407?hl=en

Hi, Yesterday Bowie did his first sniff and pee since his surgery. I cried happy tears. He started to walk away before he was done (walk with a back leg leash). So he does not feel when he he is done. It seems that his incontinence is less severe after he wakes in the morning. As his legs grow tired towards the evening, he reverts back to incontinence.

He is now bringing himself to a standing position to drink water. Although when he gets tired, he will sit.

Here is a link to his hydrotherapy on March 13th:


On March 28th, they increased his time to 3mins and the therapist did not have to enter the tank with him. Here is the video from March 28th:


The neurologist thinks Bowie will walk again. It will take time but he is progressing. Baby steps and lots of determination.

Wow! What great improvement on that back left paw of not dragging. Bowie is on a roll in nerve repair. I image by graduation day of April 5, you might even see other changes in nerve function. Please keep us updated on Bowie. We have lots to share with you on graduation day!.

Yvonne, no doubt Bowie will have even more neuro abilities as time goes by.

Consider learning to walk again as it would be for a stroke victim or a baby learning to walk. At first, the steps will be weak and a bit unstable. Relearning to walk takes coordination, building up strength, and lots of patience. It is very normal for recovery to be gradual over the course of months rather than days/weeks. Expect plateaus where your dog doesn’t seem to improve. Inside where you can't see nerves are at work regenerating til the next connection can be made. When the connection is made then on the outside, then you can observe the result!

Relearning to walk and concentration on moving limbs is hard work. Can you do his at home sling walks mornings when he is fresh and best able to concentrate on proper paw placement? Don't be afraid to take a break when you see he tires and paws knuckle under. Athletes in training don't train the same muscle group every day, they alternate. Change things up as necessary from walking PT to sit to stands, weight bearing on one legs, a fun day with at home water therapy and chasing a ball when weather warms, etc.
    Using a sling lightly is kinda like backup to make sure his butt does not tip over causing him to fall. The sling is not holding him up except when you see him start to get tipsy.

At home PT ideas:
--- Buy cheap cut of meat or chicken when on sale as really high value treats. Cook, cut into tiny treats and freeze to use as needed each day.
--- Do all PT where there are no other distractions of kids or other dogs.
--- Do PT slowly so that steps are deliberate- helps to re-train the nerves and muscles to work together in a more normal gait pattern.
--- As pointed out by therapist, need a surface with good traction such as carpet or use of a Yoga mat or rug runners
--- reward always for walking and never ever when dragging.
--- Do therapy at meal times. Feed dinner a few kibbles at a time, for sit to stands and sits. Scatter some kibbles on a non-slippery floor and use sling if wobbly walking to get his food.
--- reward for pushing up from a sit to a stand.
---Use sticks, broom, pvc pipes spaced out on good traction carpet. Dog then will strengthen limbs and learn to lift paws as they walk SLOWLY over each one.
--- Single leg balance for the weaker leg. While standing, lift the stronger leg off the ground for a few seconds-this will force bearing weight on the weaker leg. Lower and repeat with the opposite side leg.
--- Outdoors on leash/harness and if needed a sling. Walk across a gentle slope, walk up and down the slope. Walk on different textures...low grass, higher grass, on sand.

GRADUATION, A SLOW RE-INTRODUCTION
Determine how you are going to ease Bowie back into more normal at home activity at graduation. The idea is to gradually give more freedom under controlled conditions. Not free riegn of the house and yard immediately! LOL Take a look at our information and then come up with a plan to gradually increase activity over about a month's time following the end of crate rest.

Here is a sample schedule to slowly introduce your dog back to family life and physical activity and release from cage rest in the house. Since Bowie is up to 4mins of water therapy, then adjust sample schedule to where Bowie is now.  dodgerslist.com/2020/06/15/back-friendly/?highlight=sample%20schedule

Lots more ideas and tips for ramp training, dentals, and in general living life with your IVDD Bowie: dodgerslist.com/living-with-ivdd-tips

Excellent news about Bowie! He has come such a long way.

Sometimes IVDD dogs will still have an arch to the back after the episode has resolved either with surgery or conservative care. It should not be a cause for concern unless he is showing any other signs of pain.

I am unable to view the videos as they are private. If you could change the permissions we would love to see them.

Hi.

Sorry about that. I have updated the videos to unlisted. I appreciate all of your input.

Should I let him continue to walk around the house? The yoga mats have been a life saver. We have tile floors and Bowie can walk on them but does slip. He does so good on the rugs and mats

I was reading the Ramps section; great information, Thank you.   

We have a ramp to our bed.  For now, we have been preventing Bowie from trying to use the ramp.  We lift him into his doggy bed, which is in bed with us and he shakes his ears when he wants to get down or go outside.  How do you know when is the right time during this recovery journey to teach them or allow them to use a ramp again?