Nikki's Finn 7/1 surgery6wks -beagle mix; GRAD 8/12

Welcome Nikki!  Very positive report about nerves.  If he had lost DPS and now he can wag his tail that shows a good pathway to healing more nerves!!!!

While no one will be able to tell you a day for bladder control return, you CAN KNOW the order of return. Nerves heal typically in the reverse order of the damage to the spinal cord:

1. YES 7/2!_ 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. YES 7/2 ! 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. ___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 knuckled under paw.
6. Ability to walk unassisted and perhaps even run.
LEARN MORE: dodgerslist.com/2021/02/06/nerve-healing-after-disc-episode/
Knuckling:
thumb.ibb.co/k3dqRS/Knuckling.jpg

PREDNISONE
This med causes thirst and drinking  more water.  While on prednisone AND you are learning a new skill of expressing, naturally  expect to express every 2-3 hours to keep him dry.  Let us know the current dose of pred/frequency given.  Expect it may take a weeks worth of expressing til you  perfect your ability to fully void the bladder and ability to feel the bladder.  Don't hesitate to go either to your local vet or the surgery hospital to get another HANDS on top of your hands type of lesson.
  Before you get another lesson, re-review the tips and the video so you get more out of the lesson:  dodgerslist.com/2020/05/05/bladder-bowel-care/

No doubt having Finn home is a big change in your routine.  Routines once established reduce the need to "think" about things.. routines are well, routine. So give yourself a break to learn caring for Finn and get things at home organized for your patient.  
-- See if your employer will aid you in allowing off setting hubby's and your schedules to help with expressing.
-- See if a neighbor or friend can be hired to stop by to express mid day.
-- Maybe board Finn at local vet til your expressing skills are perfected. Who knows how fast bladder control might come back in...maybe soon than you think (fingers crossed!)

EXPEN flexibility
You can express on a pee pad right outside the recovery suite (ex-pen or crate) to save having to lift and carry 30lbs outside.
    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.

PAIN
If you are seeing pain, report to the surgery hospital what you observe. Most pain meds last for only about 12 hrs.  Thus the need for pain meds to be Rx'd every 8 hrs.

Good news that Finn may have peeded on his own. Since Finn can wag his tail, typically the next neuro function to return is bladder control.

Is his pain completely controlled with the current medications? If not, let the vet know as soon as you can. Finn should not be in pain. Pain will only slow the healing process.

I am glad that the vet agreed to increase the frequency of the pain meds. These meds do not last very long in the body and often have to be given 3x daily to provide complete relief. Finn should be able to heal in comfort now.

So you observed a sniff and then a pee? After he's peed on his own. Do press on the bladder to see if you can express any more urine out. Stale urine sitting in the bladder can invite bacteria to breed (UTIs). Do a little express check until you are satisfied he is fully able to void his bladder on his own each time..

Sounds like with pain fully in control with pregabalin now 3x/day, Finn will be able to continue to heal in comfort!!!

Prazosin decreases the internal sphincter tone. This makes it take less pressure of a full bladder or your hands expressing to allow urine to come out. Keep your vet in the loop when bladder control comes back. As Romy pointed out could be one less med for Finn, if your surgeon says he no longer needs it.

Nikki, so glad to have confirming proof of see a sniff & pee!! Finn is doing so well post-op in healing those nerves. So happy to hear your report this morning.

So today I was doing his physical therapy stuff and when I was holding his rear paws I felt him pull back ever so slightly. He did this on both sides. My question is, is this possible? He doesn’t seem to have a super good grasp of bowel control yet. Like, he mostly goes when we take him out (he’s had a couple of accidents) but he doesn’t seem to be super aware that it’s happening. His bladder control seems to be back 100% now though.

It definitely could have been a reflex then. We’ll keep an eye on it and hopefully we’ll know more definitively soon!

Maybe at poop time you can use your hands to steady his thighs to keep him from tipping over if he doesn't like the sling?

Reflexes are a good thing...they cause the muscles to fire and stay strong. Should be a part of the daily exercises routine.

Since you don't know if it is reflexes or brain directed, look to observe leg movement where you can correlate a head involved with the limb movement.

Nikki, this is great that off pain meds and no pain showing. Also tickling his toes provides an opportunity for the muscle to fire and keep in shape....that is good you got a good reflex action.

It is still early in the nerve healing department. So keep up the good work of the daily PT until he can do that on his own.

Sleeping, dreaming (head level) then leg movement. Sounds very much like you observed purposeful (brain directed) left back leg movement!!

Nikki,  Finn sounds like a good candidate for underwater treadmill therapy since he can move his legs when his weak legs do not have to fight gravity.   Do discuss this kind of therapy with the PT people.

The movement of the hip joints and muscles and the changes in pressure on the paws from the underwater treadmill triggers spinal cord communication with the brain. Water bouyancy makes it easier than leg movements against gravity. There is not only the potential to regrow damaged neuronal pathyways but also for neuron to muscle re-education to learn the art of walking again.

Very interested in what the PT will advise on Monday!

The underwater treadmill helped my dog Frankie a lot after his surgery. When he started, he could not even stand on his own. The buoyancy of the water held him up. Over time, the movement of the treadmill seemed to help him remember how to move his legs and feet. I don't think he would have recovered nearly as quickly without it. I hope Finn will see a similar benefit.

Finn is showing his nerves are a-healing now that he can move himself up into a stand! You've chosen the best therapy for this point in time- underwater treadmill. Can't wait to hear about his first session and how that goes. The treadmill and water combo has expedited learning to walk for so many dogs.

Nikki, so happy to hear Finn's first underwater treadmill was such a positive experience. The Help 'em UP is an excellent harness.

If possible can you take a picture or a movie of Finn in the treadmill tank. We'd love to see his progress as time goes by. It is also good inspiration for other owners to see nerves can heal.