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Post by Dani & Stevie on Sept 18, 2021 7:24:32 GMT -7
Stevie is a 3 year/11 month old 55 lb female Beagle/Shepherd mix. On 9/6 while playing in the backyard with a puppy we were watching, Stevie suddenly seemed to lose interest in playing and laid down in the ground. When we came inside, she was unable to jump up on the couch. As it was Memorial Day, I called an emergency vet who advised that unless it was a true life threatening emergency, she wouldn’t likely be treated if vitals were stable so waited until the following day to visit regular vet, who diagnosed a sore back and sent her home with Previcox and Gabapentin. By that evening, she seemed somewhat better at first, but within hours, collapsed with rear leg paralysis. I called the vet in the morning, who referred to emergency neurologist (ACVIM). We were able to get in within hours, an MRI was done, followed by emergency surgery for ruptured T13-L1 disk. Stevie was able to return home 9/13/21 and has been in strict crate rest since then. We return for post op appointment on 9/23. Stevie is prescribed 300 mg Gabapentin every 8 hrs, 100 mg Tramadol every 8 hrs, and 20 mg Valium prior to bladder expression. We also added Trazodone to calm her down, as she seems restless and anxious and I feared she would injure herself trying to escape her enclosure, especially while I am at work.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
55 lbs age?
gabapentin 300 mgs 3x/day
traMADol 100mgs 3x/day
valium 20mgs ?x/day
traZODone ?mg ?x/day ]
She did manage to get out the first night and scooted approximately 10 feet before I woke up (hearing her at 3 am whimpering) and was able to get her back into her enclosure. Stevie is still paralyzed in her back legs and does not seem to have deep pain sensation. Vet says prognosis is 50/50 for recovering ability to walk again. Bladder expression has been a learning experience. I had to return to vet twice for help, but now I am feeling more comfortable with our routine and doing it 3-4 times per day. Last night, Stevie had leakage, even though she was expressed right before bed, and smells as if she may have had more leakage this morning, although I’m not sure if the dampness on her bed and fur are from the clean up or leakage. I put a pee pad under her to see if there is more leakage. I’m not sure I am fully emptying her bladder and if I should also be concerned about the smell. I am not sure what is considered “typical” or what should be concerning. I did leave a message for the vet and waiting in a return call.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Sept 18, 2021 7:48:30 GMT -7
Dani, welcome to the Forum! While learning to express to reach a good proficiency level (dog stays dry, bladder is emptied at each session), dogs can develop a UTI. How often do you express during the day, every 3-4 hours or sooner. At night you may be able to express right before bedtime and she'll stay dry til morning OR you may have to express mid way during the night. Let us know what you do. Some UTI will have signs you can observe. Change in color, foul odor. Other UTIs don't show observable signs. A urinalysis taken at the vet's clinic can proove for sure if a bladder infection has developed. What kind of recovery suite are you using? This page has very good tips and ideas for the recovery suite and caring for your dog during the post-op directed weeks (calming music, cleaning fur of urine, etc). dodgerslist.com/2020/05/14/strict-rest-recovery-process/F or how many weeks did your surgeon direct for post-op rest the included his directed at home PT. Depending on the dog's case, a surgeon might say 4weeks and for other dogs it could be 6week. What did your surgeon direct for at home PT? Any from 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.
Post-op PT for the paralyzed IVDD dog:
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Post by Dani & Stevie on Sept 18, 2021 12:31:53 GMT -7
Hi! Thanks for the welcome! I am still waiting on her vet to call me back. I am concerned about UTI. They said to express 2-4 times a day, but sounds like it may need to happen more often, especially since I am not sure I am fully emptying her bladder. PT was briefly discussed as an eventual consideration but I wasn’t advised to do anything at this time. I assumed we would discuss further when she has her appointment to have staples removed next week. I have made 2 rest areas for her, both are about the size of a large crate…roughly 2 1/2 x 3 1/2 with her crate bed for a base. I used furniture to make a space in the spare bedroom ( where I have also been sleeping) and also a baby play pen type thing in the living room. I came home from errands this afternoon to find that she had had diarrhea and no matter how much I try to clean her with wipes, she smells terrible and I don’t feel I’m cleaning her well enough. She is now squirming when I try to express and I can see on the pee pad she is leaking.
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Post by Romy & Frankie on Sept 18, 2021 13:40:35 GMT -7
It is tricky learning to express and can take a while to become truly proficient. I had to have several hand-on lessons from the vet and vet tech before I learned to express. During the learning period, you may have to express more often to keep Stevie dry. This may be as often as every three hours. After you become more confident that you are getting all the urine out, you can express less often. You will know you have gotten it right when you get a steady stream, and she stays dry between expressing sessions. Eventually you will likely need to express only as often as you used to take her outside to go.
If you are concerned about a UTI ask the vet if you can bring in a urine sample to be tested for bacteria. Dogs that cannot empty the bladder by themselves are more likely to get a UTI despite our best efforts.
You may have seen this already, but if not, try cleaning Stevie with decaffeinated green tea. Green tea neutralizes the acidity of the urine and helps prevent urine burn/scald and leaves a nice fresh scent. Just make up a pot of green tea, let it cool down and gently pat her belly and legs with a towel or sponge that has been dampened with the tea. Use white vinegar in a spray bottle to kill the bacteria and the odor they cause on floors, bedding, etc.
Pumpkin, with its high fiber can firm up stools and help with diarrhea. Add 1 teaspoon of pumpkin for every 10 pounds of body weight, 1x a day to kibble. I tried this with my dog and, to my surprise, he loved the pumpkin. If Stevie does not like the pumpkin, try really ripe mashed fresh pear, just take the peel off or microwaved and mashed peeled sweet potato.
The size of the crate should be just large enough for the dog to stand up, turn around and stretch the legs fully while lying down. If any of the recovery suites are larger than that, pad out extra room with a rolled up blanket or towel.
What helped my dog the most after his surgery was water therapy where he walked on an underwater treadmill. This type of therapy can usually be started after the staples/stitches are removed. You can ask your surgeon about this. We have some more info about that here: dodgerslist.com/2020/05/28/surgery-dog-water-therapy/ |
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Post by Dani & Stevie on Sept 18, 2021 22:49:46 GMT -7
What I thought was bladder leakage may instead be bowel leakage, or it’s possible she is leaking from both bladder and bowels. There is a very foul smelling brown watery discharge on the pee pad and when I changed her bedding earlier, one of the underlying pads was soaked with it. I am not sure if this could be a result of stress or related to meds. Until today, stool had been solid and nothing in her diet has changed. Not sure if I should be concerned and reach out to her vet again [SUN 9/19?] tomorrow.
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Post by Ann Brittain on Sept 19, 2021 7:07:40 GMT -7
Hi, I'm sorry to hear Stevie is having 'leakage' problems. The brown color of the discharge indicates there is something besides urine being leaked. You previously mentioned that she had had diarrhea and leaking poop would smell bad.
No question, medications can upset a dog's stomach. Pepcid AC (famotidine) may help settle Stevie's stomach. Here is a link that discusses the benefits of adding Pepcid to your dog's routine.
Romy, in an earlier post, also mentioned feeding Stevie puree pumpkin to help with stomach upset.
Since you're seeing the vet today be sure to mention it and discuss what may be going on and if including Pepsid with Stevie's med is recommended.
Let us know what your vet says.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Sept 19, 2021 9:57:22 GMT -7
Dani, do not wait, call the surgical hospital today (Sunday 9/19) and explain the signs of very foul smelling brown watery discharge on the pee pad.
Let us know what the surgical hospital thinks the discharge is (possibly UTI or poop related watery stool). Tell the hospital if you gave pureed pumpkin or any other changes in diet.
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Post by Dani & Stevie on Sept 20, 2021 19:46:59 GMT -7
Stevie is being treated for UTI with antibiotics. Bowel movements have been regular and solid, no diarrhea since Saturday. We are back on track with bladder expression, no leakage or overflow for the past 24 hours, and she seems to have a little spark back. Still doesn’t seem to have deep pain sensation when I squeeze her toes, but does jerk her leg away. It’s hard not to get my hopes up a little bit by this, although I do understand it’s an involuntary response.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Sept 20, 2021 19:56:32 GMT -7
Dani, so glad it was determined if a UTI and then an antibiotic RX followed.
What is the name of the antibiotic, dose in mgs?
Good to hear diarrhea is now gone. Whew!
Gently pressing or tickling between the toes is a good reflex thing. It causes movement of the joints. Makes the muscles fire. This is good PT to help Stevie maintain health of joints and muscle. Make it a part of your daily PT routine if not already doing it.
Thank you very much for the update!!!
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Post by Dani & Stevie on Sept 20, 2021 19:59:46 GMT -7
✙Augmentin 125 mg, twice a day for 14 days.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
55 lbs age?
gabapentin 300 mgs 3x/day
traMADol 100mgs 3x/day
valium 20mgs ?x/day
✙Augmentin 125 mg 2x/day
traZODone ?mg ?x/day ]
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Post by Dani & Stevie on Sept 24, 2021 5:19:02 GMT -7
Stevie had her 2 week post op visit. Her incision has healed, staples removed and the best news of all is that she has regained deep pain sensation in her rear legs and tail. Vet has advised to back off bladder expression to 2x per day and start taking her outside to try to pee. The help em up harness is a life saver for getting her outside and sniffing around a bit. He has also cut back on meds to just ▼gabapentin every 12 hours.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
55 lbs age?
gabapentin 300 mgs ▼2x/day
traMADol 100mgs 3x/day
valium 20mgs ?x/day
Augmentin 125 mg 2x/day
traZODone ?mg ?x/day ]
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Post by Romy & Frankie on Sept 24, 2021 13:13:33 GMT -7
Very, very good news the surgeon has confirmed Stevie now has DPS. DPS is an indicator that the brain can communicate through the spinal cord to the rest of the body. DPS is as indicator (only an indicator) of the return of other neuro functions.
Giving her an opportunity to go outside and "sniff and pee" is a good plan at his stage. If, when taken to an old pee spot, Stevie can sniff and then release urine, bladder control is returning. You will still need to do a quick express check after urination until you are satisfied Stevie can empty the bladder fully.
Also keep an eye out for the happy tail wag. This is the first sign of returning neuro function that is easily seen by the pet parent.
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Post by Dani & Stevie on Sept 25, 2021 12:43:48 GMT -7
I’ve been able to express her bladder while standing and supporting her rear outside, but she is not yet doing a sniff and pee. Although once we are outside she thinks we are going for a walk and is ready to go. She has never been one to pee in the backyard, only on the leash during walks so we’ve been going a short distance to the corner and back. She seems to be able to hold a little weight on her back legs with some support. The last time I expressed her bladder while lying on her side, she actually lifted her leg up, so it seems she might be getting the idea. Pooping has been a rather messy issue. It just seems to happen frequent and in small amounts and she then sits on it. The vet suggested I might try feeding her 1x per day, but it seems like she might be hungry, as she is used to 2x per day??
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Post by Romy & Frankie on Sept 25, 2021 13:47:15 GMT -7
Good news that you are able to express her bladder. Is she now staying dry between sessions? Holding some weight on her back legs is also good news.
After surgery, some vets prescribe a little walking as a form of PT, but has to be slow and controlled. Did your vet mention this? When our dogs are feeling better, they do feel they are ready to go. This is when we have to be particularly careful to avoid too much movement.
Keep giving her the opportunity to sniff and pee, one day she may surprise you.
It is possible to express for poop. The first step in this is to figure out her schedule. We have more information about this here: dodgerslist.com/2020/05/05/bladder-bowel-care/ |
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Post by Dani & Stevie on Oct 5, 2021 15:43:14 GMT -7
Update on Stevie: Still recovering with rear leg paralysis. With the use of a ramp and Help Em Up harness or sling, we are getting outside to do bladder expression 3-4 times per day. She will now only allow me to express her outside standing up, which I am starting to get the hang of. We had our 1st rehab vet appointment last night. I have questions about the efficacy of their therapy recommendations. They did an initial cold laser therapy session with acupuncture and are recommending continuing that 1x per week at $170 per session. I’m not finding much objective information, or even anecdotal info, to help me determine whether or not this will be money well spent, especially after spending a small fortune on surgery. Are there any dog owners here who can offer some input or share their experience, good or bad? The vet also prescribed homework to help her sit, as well as toes tickles and pinches to strengthen the thigh muscles. She also sent a list of recommended supplements. They are going to fit her with a cart next week as well.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Oct 5, 2021 21:35:16 GMT -7
Dani, prior to expressing her bladder, do you give her a chance to sniff an old pee spot outdoors and maybe can release some urine before you try expressing? What do you observe? Laser light facilitates the cells to produce the energy they normally would if healthy (not damaged) so they can function as they normally would. Laser light then is a means to kick start nerve cells to self repair and encourage axonal sprouting. For severe nerve damage the combination of acupuncture and laser light is often used. World renowned Dr. Downing has an article touching on many things of interest to you: ivcjournal.com/laser-therapy-veterinary-medicine/ You know your budget best and if laser light and acupuncture is a financial option for your family. Which brand wheelchair did you select? |
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