Mike's Buddy 2021 surgery5wks

Mike, welcome to the Forum. We are glad you are here.

First thing note you report is Buddy IS in pain and needs meds adjusted (reluctant to move, slow, ginger movements).
      You are your surgeon's eyes and ears at home— phone the surgery hospital tonight or first thing in the am to report your observations of pain, so he knows the meds prescribed need some adjusting. There are other vets there at the hospital who have access to Buddy's file and they could adjust meds over the phone.
     Grapiprant is an an anti-inflammatory to aid in getting swelling down. But that could take a couple of weeks. 

Let us know what the surgeon prescribes to give to give full comfort from pain.

--Did the surgeon say Buddy had deep pain sensation (DPS) upon discharge from the hospital? 
--Have you seen Buddy give a  happy tail wag if you specifically so some happy talk or he sees you approach?
-- Has buddy been able to move up into a stand by himself?  Can he use his back legs to try to itch his neck?
-- How much does Buddy weigh?

EXPRESSING
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 check to verify there is full voiding until you are certain it is consistently happening. Let us know what you observe.

-- When bladder control is coming back a dog can be more difficult to express.
-- If there is a bladder infection (UTI) it could feel painful to have the bladder pressed on. When first learning to express, a urinary tract infection (UTI) can happen. The goal learning to express is preventing UTIs. Express often enough that here is no leaking in bedding. And express til one hand can almost feel the other other hand's fingers because the bladder is so flat.
-- IF Buddy still does not have bladder control, you will get more out of a hands-on-top-of-your-hands type of review expressing lesson by first reading and viewing the video at this page:  dodgerslist.com/2020/05/05/bladder-bowel-care/  NOTE if need be, you can express for poop (not as a health issue) but to avoid poop just plopping out anywhere. Dogs become anxious when finding poop where they sleep.

TYPICAL ORDER of NERVE HEALING.  Where is Buddy on the list?
1. ?   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. ?  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

IF the sniff and pee test proves Buddy does not yet have bladder control, you might discuss if Prazosin needs adjusting. This med relaxes the neck of the bladder to make expressing easier. 

For how many weeks does the surgeon want for post-op rest + the directed PT?  Some want 4wks others 6wks  dependent on the surgery.

What is the PT at a clinic or at home?  Similar to the at home PT in video below?

Look forward to your update and pain in control. With your answers, we'll be able to best support you and Buddy.

Mike, excellent report. With that happy tail wag, won't be surprised if soon you are reporting Buddy can pass the "sniff and pee" test!

For how many weeks does the surgeon want for post-op rest + the directed PT? Some want 4wks others 6wks dependent on the surgery.

You know we are, of course, curious — What is the name of the hospital where the surgeon was done?

Keep us the good work of nursing care at home! And let us know what changes to meds have been made (mgs/frequency, etc)

Pain can make one tired being all tensed up. So add in a med that will relieve pain and can cause drowsiness, well you have a relaxed sleepy dog. Sleep is good for healing. IF there is too much drowsiness where his muscles are too relaxed, then don't hesitate to report to the surgeon and see if still more adjusting is needed.

Pinching toes may not be a good idea as it can hurt, put too much pressure on tissue. Better idea is TICKLING the paws. That is good because it should cause the muscles to fire and leg push out as a reflex response. Good to include in daily at home PT.
BTW, pinching is what highly trained surgeons do to identify deep pain sensation. This is quite a tricky neuro function to correctly identify. Many general vets get the identifying wrong. So owners likely won't learn anything and may cause pain or hurt skin tissue. AND in Buddy's case, you have proof there is deep pain sensation because he can do the happy tail wag thing. So from now on tickle at PT times!

Thanks for letting us know right away pain has been attended to and Buddy is comfortable now.

Mike you are doing a good job in care of Buddy. Good to hear your update to the vet allowed for fine tuning the gabapentin dose to provide a pain free state but not a drowsy dog.

Myelomalacia is a disease where in some rather few cases it will follow with a dog that has no deep pain sensation function. Deep pain sensation (DPS) is the last function to be lost with spinal cord nerve damage and the first to return as nerve healing takes place. Buddy had DPS before surgery and still had it post op. So he can't be at risk for Myelomalacia.

Thank you for sharing what worked re: the timing of Prazosin and ease of expressing. When you can every couple of days, try the sniff and pee test. The next neuro function to self heal after ability for happy tail wag is bladder control.

Mike, what a wonderful discovery, bladder control has returned! Continue to do a quick express check after Buddy has sniffed and pee until you are confident he is consistently voiding his bladder. Thank you very much for sharing.

Mike, your Buddy is really doing quite well to hear he is now walking with only slight wobbly so that he really doesn't need a rear sling. WOWEE!  

Well, then very excited to learn what your surgeon will say about that good news!  Maybe he will have an update on 5/27 as to how long he would want for strict rest + PT walking at potty times.  

When your surgeon directs the date of graduation (end of strict rest) then we have lots of information to share with you in easing Buddy back to normal family life and activity.

Thank you so much for the happy news.

This is very good news. Going forward, Buddy can do most of the things he used to do but there are some things that should be avoided forever:

No more stairs or steps. Use ramps indoors
No more jumping up or down, those activities increase impact on the spine. T
No tug-o-war, pulling games.
No shaking toys.
No zig zag running.
No rambunctious playing with other dogs.
Teach your dog to not pull on the leash
No sitting up or standing on back legs.

Teach your dog to sit down rather than jump

AND keep all four feet on the ground

There are lots of things you can still do with Buddy that will be safe for his back. Information about that as well as a schedule that can be used to reintroduce him to activity is here:
dodgerslist.com/living-with-ivdd-tips

Thank you, Marjorie! That makes a lot of sense, and the hunch has been more noticeable after we gave Buddy a haircut. Thanks again for all the good work you and everyone have been doing at dodgerslist. It really helped us a lot to get through the tough times. I will keep posted on Buddy.