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Post by Justine & Auggie on Sept 8, 2021 18:19:37 GMT -7
☀︎1-- Auggie is shih-tzu and bichon. His stressed out owner's name is Justine. ☀︎2-- He approximately weighs 11 pounds. ☀︎3-- Not sure the type of surgeon. Surgery was at University of Illinois. During the surgery they knicked his spinal cords and given opiates. The opiates upset his stomach and he acquired pneomonia. This delayed therapy for several days. ☀︎4-- Surgery was July 9th. We do mostly crate rest. We've recently been released to some supervised couch time. ☀︎5-- He did two weeks of intensive therapy at U of I. This included laser therapy, and water treadmill. We currently go to another therapist weekly for accupuncture, laser therapy, and water treadmill. At home, we do massaging, supported standing, squats, some standing rocking and TENS unit for 20 minutes. ☀︎6-- 6 weeks of crate rest☀︎7--I don't believe he's still in pain. He does whimper when massaging his right thigh.☀︎8-- Auggie was diagnosed with a UTI on 9/5. For this he takes 125mg of Clavamox twice a day for 2 weeks.☀︎9-- He cannot currently walk. He will tuck his legs underneath him when laying on his sides. He's wagged his tail a few times unprompted. He will wag the tail when I pinch the tip. After I pinch it a few times, he will voluntarily move it several times. ☀︎10-- He does dribble multiple times a day. Since we've started Clavamox, today is the first day this is less frequent. ☀︎11-- Eating, drinking, and pooping are unaffected. At this point, I'm mostly concerned about his extremely slow progression. Pottying is also issue as he's a dog that deems it necessary to smell other dogs. I tried the fake urine and he decided it was unworthy after the first time. |
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Sept 8, 2021 19:31:34 GMT -7
Justine, welcome! 6 weeks post op is not a long time in terms of nerve healing. More often we need to think in terms of months rather than days/weeks for this slowest to heal part of the body. Can you give us a bit more specific idea of his neuro function. --- Do you manually express his bladder? If yes, how often do you express? or... --- Can Auggie sniff an old pee spot in the grass and then decide to release urine there? Collect another dog's pee or even Auggie's own urine on a piece of paper towel. Store in a zip lock back until time to do the Sniff and Pee test. Let us know more about urine is either manually expressed by you or if Auggie can purposefully release in an appropriate place outside or on an adjacent to the recovery suite pee pad. 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 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. 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. Useful review of bladder and poop expressing. Video, review tips : dodgerslist.com/2020/05/05/bladder-bowel-care/ -- Can he wag his tail when you very specifically do some happy talk?-- In addition to being able to pull his legs under his body when lying on his side... have you: 1) seen him attempt to scratch an ear?
2) seen him make an attempt to push up with back legs to try to stand?
-- When is the last date a surgeon has seen Auggie to tell you if he has deep pain sensation ability or doesn't yet have?WHEELCHAIR Has the PT person mentioned if at this time a wheelchair might be something to consider? Or does the PT person feel there has been some indication even if slight of back leg t with underwater treadmill? GRADUATION, A SLOW RE-INTRODUCTION In addition to being extremely caution of the danger of couch time, have you started introducing Auggie back to regular family life? It's a supervised and slow introduction to having some free time to scoot and check out his home, watch you cook, etc. There is a sample slow and gradual schedule, plus ideas to make your home back friendly with gates, furniture blockers, protective scoot garment for Auggie and more: Sample schedule to slowly introduce your dog back to family life and physical activity: dodgerslist.com/2020/06/15/back-friendly/?highlight=sample%20scheduleMake your home back friendly with ramps instead of stairs, blocking off furniture and training to keep all four paws on the ground: dodgerslist.com/2020/07/09/home-protect-ivdd-backsLots more ideas and tips in living with an IVDD dog: dodgerslist.com/living-with-ivdd-tipsYou will want to consider how you will prevent rug burns from scooting. Here are some sew and no-sew garment options: dodgerslist.com/2020/06/13/garment-skin-uti-protection/ |
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Post by Justine & Auggie on Sept 10, 2021 18:25:59 GMT -7
I haven't had to express him for a few weeks. He can smell others dog's urine which leads me to carry him to the corner almost every potty break. There isn't always a scent there for him to cover. I noticed the t-shirt sling link you provided. I think we'll try to make that and hope it helps when searching for a spot. Also, I'm a teacher and I leave for work fairly early. I can get him to pee some before school, but by the time I get home at lunch he gets so excited it just comes out. I noted in my initial entry the dribbling had decreased. We're noticing when he scoots a few feet he loses control of bladder. Should Clavamox have addressed this by now or his bladder still just weak?
I saw him wag his tail once a couple of weeks ago out of excitement. I have also seen him attempt to get up a few times using his back legs. A surgeon saw him 8/13 and at that time the surgeon only detected deep pain sensation in his left leg. His therapist doesn't agree and believes he has all feeling back. When I'm pinching in between his toes, he definitely knows I'm touching them and isn't happy about it. While waiting on him to urinate, I have seen him move his left leg as if he's going to walk. On two occasions, he's moved it three times. I feel like there's good muscle on his thighs, but I don't know if I'm just talking myself into it. With the squats, standing time, and tens, I feel like he should be building more than he is. We did our tens unit last night 9/9 on the left side and I noticed while he's sleeping there's some thrashing of that leg. After tens unit on right side tonight I have not seen a little. When i even touch his paw as if I'm going to pinch in between his toes he really kicks.
He does watch me cook and get ready in the morning. During the day, I keep him confined to a 3x3 square in the kitchen with dividers and random household items.
Therapist at U of I sent him home with a temporary wheelchair with hopes it will keep him motivated. He still very much wants to move on his own as he's always been an extremely active dog. When he's in the treadmill he moves his legs mostly on his own. She said he occasionally locks them up maybe when he's annoyed with her.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Sept 10, 2021 20:51:41 GMT -7
Justine, I think that sling you make will be helpful in introducing him back to walks in the back yard. Did he take to the wheelchair to walk in the grass? What brand is it?
Scooting might cause his tummy muscles to tighten up, kinda expressing his bladder. Especially if the bladder is pretty full, urine might escape to the floor.
No need to do any hard pinching to the extent Auggie doesn't like it. However some tickling between the pads will cause a reflex reaction of pushing out /withdrawing. Excellent exercise for his back limb muscles.
Sounds as though since 8/13 neuro exam, Auggie has been busy self healing his bladder control and also his limb nerves to be able to move both back legs in the underwater treadmill. Nerve healing can be quite a slow process for us impatient humans, something that can't be rushed.
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Post by Justine & Auggie on Sept 11, 2021 15:48:58 GMT -7
Thank you so much for your help! I can't imagine the time you invest into this selfless work. I had an incredible, dog loving aunt that passed 20 years ago. She took in all the, what we considered as kids, "defective" dogs. I imagine she'd be doing something similar if she were alive today.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Sept 11, 2021 16:25:55 GMT -7
Justine, well thank you for such a kind comment. We are but a handful of volunteers here on the Forum. Our passion is to help dogs and their owners. Hearing your words makes the daily tapping on our keyboards worthwhile to know we are giving good support.
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Post by Justine & Auggie on Sept 18, 2021 19:28:57 GMT -7
At what point should I be concerned with lack of voluntary urination? He, typically, goes on his own every 4 -6 hours, but can stretch to 8 to 12 hours. How long passed this point is it an issue? One of my biggest concerns is an undetected UTI. I, most often, have him in a belly band when I'm with him just to avoid messes. I check it at least every hour.
I've also noticed quite a bit of leg movement when he's asleep. Is this a sign of hope? His muscles are building? I've also noticed that when he's extending his hind legs while laying down he will curve them upward almost making them resemble a ski. This doesn't seem natural to me, so I assume it's not a great sign.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Sept 18, 2021 20:13:49 GMT -7
Justine, head level involvement with leg, tail, and bladder are brain directed. Dreaming is head level, so seeing leg movement when sleeping shows neuro function. Do the legs move more often since you last reported seeing him move his leg when asleep on 9/10? Has he attempted since then to try more often to move up into a stand position by himself? If you have a suspicion of a UTI, might want to discuss if a sample of urine can be brought in to the vet for a urinalysis. During the day peeing every 4-6 hours is what most dogs do. At night dogs can sleep thru the night 8 hrs or more til owners awake for a morning potty break. FYI: Some UTIs will have observable signs of foul odor, change in color/cloudiness that could alert you to be suspicious. On the other UTIs do not have any observable signs and could only be proved by a urinalysis. Would you be able to upload some video of his leg position when lying down. Video would be helpful to a vet too. You will need a Google account which is used to sign in at YouTube (see below if you do not have one) YOUTUBE 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 into a Forum post. —How to details for mobile devices and computers: support.google.com/youtube/answer/57407?hl=enHow to get a Google Account: —Use an existing email address —Go to the Google Account creation page: accounts.google.com/signup/v2/webcreateaccount?flowName=GlifWebSignIn&flowEntry=SignUp—Enter your name. —Choose to use 1) current email address OR 2) Create a new Gmall address. —Enter your current email address. —Click Next. —Verify your email address with the code sent to your existing email. |
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Post by Justine & Auggie on Sept 24, 2021 19:45:47 GMT -7
I haven't seen much of the awkward "ski" leg I'd referred to prior. I am seeing quite a bit more leg movement, which gets me excited! Still not able to stand on his own. He always curves to his right and falls down. I, unfortunately, attribute that to the spinal injury acquired during surgery.
I've started him back on a little ✙Tamsulosin [ relaxes the muscles in the prostate and bladder neck] in the last couple days and we're mostly successful 3 out of 4 times. I put a belly band on him while I'm at school so he doesn't have to lay in urine if there is an accident and because he gets so excited when I get home he can't contain it. I don't feel like he sits in a soiled band for anything longer than an hour and that's rare. I only put him in that if he's urinated before I leave. I realize now that wasn't probably the most logical thinking. He now has a pretty red blister on his waist. It doesn't seem to be painful. My vet warned me of belly burn, but I thought I was conscientious of that. I can visit my vet in the morning, but is there something over the counter I can use instead?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Sept 24, 2021 21:09:26 GMT -7
Justine, good to hear there is more leg movement going on. Open and abraided skin should be protected from bacterial infections. You can find OTC antibiotic Neosporin at the grocery store. If not healing properly do contact your vet.  IF it is a matter of urine scald, check your grocery store for a non-zinc ointment as a barrier cream such as: 1) Aquaphor Baby or Aquaphor regular Healing Ointment 2) Bayer's A+D® Original Ointment IF it is a matter of fabric friction on skin, other options to keep the pad in place while not rubbing Auggie wrong: justhappydog.com/store/dog-diapers/ female with hole for tail- commercial product tinkletrousers.com/ claims not to pull down their rear end! www.joybies.com/petstore/ piddle pant Peekeeper: peekeeper.com/ Advertised not to pull down Happy Jack belly band with non-slip chest strap |
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Post by Justine & Auggie on Apr 7, 2022 17:45:12 GMT -7
So we're 9 months out. He will stand for about a minute after I have propped him up. I feel like I have figured out how to manage it all, but I'm still hoping he'll walk. When he goes on water treadmill, I see progress. It isn't even for my convenience anymore. I want to see him enjoy life close to what he used to. At our last visit to therapy, assistant told me not to get my hopes too high. Up until then, they thought for sure he'd walk again. Our prior visit had been 6 weeks earlier.
As I'm writing this he's crying so he can go to the yoga mat, do his exercises, and work for treats. He's still a very motivated dog. He scoots around the house while I'm cleaning, especially cooking. He's developed a great pattern in his cart and, at times, I have to do a VERY swift walk to keep up with him. I feel like I've seen a lot of improvement in the last three months, but I also know that's still far out of surgery. When we do his pedaling on his back, there are times I can't move his legs. I hold steady assuming he's building muscle fighting the little resistance I'm giving. Therapist told me to discontinue this practice. That surprised me. We've done all of the exercises and then some! I'd really like to see him sit to stand, as I think when this happens he'll be unstoppable. I think I see and feel him push up sometimes. If I had more time on my hands, I'd wait for it every time.
I understand dogs in this situation will plateau at some time. Just wondering if I should be more accepting of the inevitable.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Apr 7, 2022 18:31:18 GMT -7
Justine, sounds very much like you and Auggie have developed a new normal routine. Auggie clearly is enjoying life in earning treats and seeing his neighborhood at quick pace. Probably loves feeling the wind in his flapping ears as he rolls along. The answer if will Auggie walk again is solely held by Auggie's body to see how much self repair of nerves can take place. As long as Auggie can't move his legs himself, it is important that you do continue those leg and joint exercises. Stiffness in joints is familiar to me about the times when the range of motion bicycles were hard to get the knee flex/bend. Use your hand to put a bit of pressure behind the knee to cause them to kinda reflexively bend. Maybe then you can get in some sets of ROM exercise. Keeping the joints flexing is important so they do not freeze up permanently. The variety of daily leg exercises are also important to keep muscle circulation up and keep bones strong. I did the exercises every day even though my dog never walked after surgery. It is not clear why your PT person does not consider it a health issue to continue with knee flexing (range of motion exercises). --- weight bearing keeps bones strong --- tickling toes for reflex action and massage keeps blood flowing in the muscles. --- Back leg range of motion maintains joint flexibility. Try a variation of this exercise with him standing. See demo in video below: Post-op PT for the paralyzed IVDD dog:  -- Let me know exactly what you observe with "on water treadmill, I see progress."
-- Does he still move his back legs when dreaming?
-- Does he have full bladder control? How often does he let you know he wants to go outside to pee? Can he sniff an old pee spot and then make the decision to release urine? Does he leak on you when lifted?
Do you see any head level involvement (brain direction) with...
--- Feels an ear itch and then makes an attempt to scratch?
--- Sees a treat and makes any attempt (even if small or weak) to try and push up with back legs to reach the goodie?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Apr 7, 2022 18:36:50 GMT -7
Are you getting ready for Spring/Summer? Some ideas to help Auggie be in control of what he wants to enjoy with some small modifications at your house. A perfect summer day is when….. As Helen Keller says "When one door of happiness closes, another opens; but often we look so long at the closed door that we do not see the one which has opened for us." This pup didn't waste a moment finding the other open door. He loves life and and enjoys every moment. It's not the manner in which you get from point A to B, it's that you CAN get there.
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Post by Justine & Auggie on Apr 7, 2022 18:40:12 GMT -7
He can definitely move his legs himself. When in treadmill they decrease his supports every time. The last time they did not send me a video and aren't allowing human clients in yet. The time before that, he was making good contact with the ground with almost every placement. He moves his legs when dreaming quite often. I see it more often when we're able to go around the block in cart. He has had some ear issues and I'm trying to reteach him how to scratch. When I scratch an itch on his hind leg, it goes crazy. He has the ability, he just doesn't know it.
He would normally lock up his left leg, the one he says he has the most feeling in, after 3-4 minutes of pedaling. That told me he go annoyed with it.
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