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Post by Victoria & Brodie on Oct 2, 2022 19:45:00 GMT -7
Hello! Brodie’s parents here. Total newbies so please forgive any formatting issues/rule breaking. Brodie is a 12 year old Boston Terrier who had a central slot for a herniated disc at C2\C3 on 9/26. Preop he had deep pain in all 4 limbs. ★1 How much does your dog weigh? - 22lbMeds: 5:30AM- 2.5mg Diazepam 7:00 AM - 200mg Gabapentin 8:00 AM - 5mg Prenisolone The prednisolone will be 1x daily starting 10/4 for one week, then every 48h 12:00 PM- 10mg Famotidine/Cefpodoxime The Cefpodoxime will be done 10/3 1:30 PM- 2.5mg diazepam 3:00 PM- 200mg Gabapentin 8:00 PM - 5mg Prednisolone 9:30 PM- 2.5mg Diazepam 11:00 PM- 200mg Gabapentin [Prednisolone as of 9/29: 5mgs 2x/day for 5 days then 10/4 taper
gabapentin 200 mgs 3x/day
cefpodoximen 10 mgs 1x/day
Valium (Diazepam) 2.5mgs 3x/day
famotidine 10 mgs 1x/day]
★2 Boston Terrier, Age 13 Brodie.  Eric and Victoria ★3 Diagnosed disc herniation at C2/C3 by a neurologist ★4 Date of surgery was 9/26, symptom onset was quadriplegia on 9/25★5 currently pain? Yes, shivering, neck spasming, can’t find a comfortable position.He initially completed the Valium 10/1, but after it ran out, he was clearly uncomfortable so we called the Vet and they refilled the Valium. He’s more comfortable now, but it’s not consistent until the next dose. ★6 Good appetite and thirst. No poop yet, vet said he will need pumpkin tomorrow, but passing gas frequently. ★7 He cant walk, but he spontaneously moves the hind limbs, will try to stand with the harness and the left forelimb reacts to some light touch. He moves both forelimbs, but still quite weak. Per our surgeon, we do forced standing with a chest harness and rear harness and he does try to help stay up. ★8 He can’t stand, but he voids large volumes every 4-6 hours. No leaking in between and we are checking hourly and changing the padding right away. When we take him to do forced standing physical therapy, he will urinate when we help him stand up. We appreciate any help/support you guys can offer us. We’ve been emotionally wrecked this week. |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Oct 2, 2022 20:44:19 GMT -7
Victoria, welcome to the Forum or is it Eric who is doing the posting? IF you are observing pain with two pain meds (gabapentin for nerves and Valium for muscle contraction pain) then the meds are not yet right. The surgeon needs your feedback that pain is surfacing nearing the next dose. For some dogs Valium is not as successful as METHOCARBAMOL. Discuss methocarbamol for muscle contraction pain and traMADol as the overall general analgesic could help Brodie. Can Brodie move up into a stand all by himself with: --- back legs? --- with front legs? Do you see Brodie try to reposition himself in the recovery suite -- with back legs? -- with front legs? Did surgeon say Brodie had DPS on discharge date of _ ?__ Did Brodie have bladder control on discharge day? Discuss moving Pepcid AC (famotidine) to a 2x/day dosing at 10 mgs each dose to help with GI tract upset/gas for a 22 lbs dog. Are you taking Brodie out of this crate so he does not have to release urine where he sleeps? You can take him outside to sniff an old pee spot. If he then makes a decision to release urine there, that is a sign of bladder control. While on prednisone where his thirst is increased you may need to get him out to pee every 3-4 hours so he is not having to release body waist where he sleeps. If carrying him outdoors is too much weight for you to safely carry, place a pee pad outside of his recovery suite on the floor. Scent the pad with some of his old urine saved on a paper towel and stored in a zip lock bag. Encourage him to "go potty" when you see him sniff. Soon he will learn it is ok to pee in the house on the pee pad adjacent to the recovery suite. Confirm for us if Brodie can sniff and then pee. It sounds as though he does not have bladder control and you should be expressing his bladder. Did you get an expressing less on discharge day? More about expressing for poop and for pee: dodgerslist.com/2020/05/05/bladder-bowel-care/Check the info provided in setting up the recovery suite mattress system. and lots of other good ideas to make the crate rest time go smoother.https://dodgerslist.com/2020/05/14/strict-rest-recovery-process/ For how many weeks does the surgeon want for post op rest? What did the surgeon directed for at home PT? Any of those demoted in the video? Appropriate physical therapy can help maintain those muscles with lost nerve connection and keep the joints flexible while nerve cells regenerate.
Post-op PT for the paralyzed IVDD dog:
Look foward to your answers so we get a better understanding of Brodies neuro functions. |
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Post by Victoria & Brodie on Oct 2, 2022 23:32:36 GMT -7
Hi Paula,
Thanks so much for your response.
move up into a stand all by himself with:
--- back legs? No
--- with front legs? No
try to reposition himself in the recovery suite
-- with back legs? Yes
-- with front legs? No
Did surgeon say Brodie had DPS on discharge date of 9/29-yes
Did Brodie have bladder control on discharge day? Yes
Yes, we take him to his usual spot and he will usually release urine there.
expressing less on discharge day? Yes, we got a lesson, but will review.
how many weeks does the surgeon want for post op rest?
We do 15 bicycles forwards and backwards on each limb three times per day as well as assisted standing with a chest harness and back harness three times per day. He will be seen in two weeks 10/10 for his postop visit and further PT recommendations will be discussed then. If there are specific therapies that people found very useful, we’re happy to ask about them. Aside from his PT, he is on crate rest.
We have actually brought him back to the ER for re-evaluation so we can hopefully get him more comfortable.
Thanks for all your help.
-Victoria
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Oct 3, 2022 8:17:10 GMT -7
Victoria, do let us know the details that ER has done to adjust meds (name, mgs, ?x/day) to provide full comfort from pain. It often will take about 2 weeks before all of the surgery caused swelling to subside. Til then pain meds provided needed pain relief. It would be a good idea to do a quick express check after Brodie has released urine outdoors. He may be able to start a stream but not fully void the bladder and thus fills again to the top sooner. Do the quick express check until you are satisfied each time the bladder is consistently pretty empty. While on prednisone, you may need to give him a potty break every 3-4 hrs. Test out the frequency based on Brodie not having to release urine in his bed, but can stay dry til you get him outdoors. Maybe it could be every 2-3 hrs, let us know what works for Brodie staying dry between potty breaks NOTE: for dogs who do have good bladder control, they may not like you pressing on their tummy to express urine out. Do let us know for how many weeks the surgeon wants post-op rest. Many say 4 weeks while for other dogs, other cases a surgeon may want 6 weeks. Underwater treadmill is the primo PT where there is indication of weak leg movements such as you describe for Brody. This video shows you how it works and why it works: 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.
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Post by Victoria & Brodie on Oct 4, 2022 9:43:18 GMT -7
Paula, thank you again for your advice for Brodie.
Brodie was seen in the ER on 10/2. He was started on a fentanyl drip and was comfortable overnight and seen by his Neurologist the following morning.
She does not think that his neck movements are consistent with spasms or pain, but rather, he is trying to move around.
To be sure, she extended the diazepam (2.5mg TID) and instead of stopping it cold turkey, we will taper to BID starting 10/7 x2 days, and then daily x2 days.
[weight? 13 y.o.
Prednisolone as of 9/29: 5mgs 2x/day for 5 days then 10/4 taper
gabapentin 200 mgs 3x/day
cefpodoximen 10 mgs 1x/day
Valium (Diazepam) 2.5mgs 3x/day, 10/7 tapering 2x/day, then 1x/day
famotidine 10 mgs 1x/day]
She said on her exam, he
-- continues to have DPS in all 4 limbs and
-- has bladder control.
He had a bowel movement while at the ER, which was formed. We brought him home 10/3. He's been VERY comfortable since we brought him home and seems more himself than before!
We are doing express checks on Brodie after voiding.
His surgeon would like 6 weeks of post-op rest.
Thank you,
Victoria
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Oct 4, 2022 10:04:16 GMT -7
Victoria, that is the best news to hear Brodie is now feeling more himself and very comfortable!
Hope to hear at some point you are seeing he consistently voids the bladder with your express checks and won't need to continue on with that. The pred taper begins today, that should help with his thirst and wanting extra water consumption too.
Nov 7 is graduation day then..... we'll have lots of ideas and tips for introducing Brodie back to family life and physical activity in Nov.
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Post by Victoria & Brodie on Oct 27, 2022 21:58:31 GMT -7
It’s been 4.5 weeks since Brodie’s surgery and we’ve had some bumps in the road.
1. Constipation - Brodie was initially pooping after surgery once every other day and easily passing gas but last week, [week or 10/1] he started getting more uncomfortable and seemed to have trouble passing stool and gas. We added 1 tsp of pumpkin to his diet twice daily with no luck. He saw his regular vet and when they checked his rectal temperature he had a large bowel movement. An XR showed he still had about a foot (!) of stool burden so we started Miralax and laxatone. He still seemed uncomfortable (wanting to change position, barking at us), so an ER visit and two enemas later he finally pooped and things seemed to be better until today. He is still having firm stools and seems uncomfortable. Once he poops he falls asleep so I don’t think he’s having pain from something else, it seems very colicky.
Current bowel regimen:
1/2 tsp of ✙Miralax twice per day
2in of ✙laxatone twice per day
1 tsp of ✙pumpkin daily
[ Moderators MED HISTORY. Please do not edit
8.76kg/19.31 lbs 13 y.o.
Prednisolone as of 9/29: 5mgs 2x/day for 5 days then 10/4 taper; ends 11/10
gabapentin 200 mgs 3x/day
Valium (Diazepam) 2.5mgs 3x/day, 10/7 tapering 2x/day, then 1x/day
✙clavamox as of 10/28 125mg 2x/day (recurrent UTIs)
✙pureed pumpkin 1 tsp 1x/day
famotidine 10 mgs EOD]
2. Recurrent UTI. He completed a two week course of clavamox on 10/24 after growing E Coli in his urine. Today he was peeing every hour and was urgent about it. We talked to his vet and he was restarted on ✙clavamox for another 10 days. It seems to already be helping as he’s peeing less frequently.
3. Weight loss. Brodie started out at about 10 kg preop and is down to 8.76kg. We spoke to his neurologist who thinks it’s steroid related as he’s lost muscle mass. We increased his diet, but he’s not gaining and part of it may be the constipation. We’re currently feeding him 1 large Stella and Chewy patty per day and supplement with Royal Canin recovery diet, but he doesn’t like it much. Sometimes we feed him chicken as well.
Current medication regimen:
Prednisone 5mg every other day to end on 11/10
Famotidine 10mg on days he gets prednisone
Clavamox 125mg twice daily, end on 11/6
Miralax 1/2 tsp twice daily
Laxatone 2in strip twice daily
As far as Neurologically he is improving a little bit each day.
He spontaneously moves all limbs and is doing so more frequently.
He is able to bear weight on his back legs for almost 10 second and his front legs are starting to participate more in standing exercises and he can hold his front legs in extension longer and longer.
He will start physical therapy/underwater treadmill with the approval of his neurologist on Monday which we think will help with muscle mass, weight gain, and hopefully the movement will help him with constipation as well.
We’d appreciate any thoughts you have on any of these issues: keeping him more regular, preventing UTIs, and helping him gain weight.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Oct 28, 2022 10:37:07 GMT -7
Victoria, good news you are seeing purposeful (?) movement in all legs. Then for sure getting started Monday on Underwater Treadmill would be the best PT mode to help Brodie. With muscle use not having to fight gravity, they can bulk up again via exercising in buoyant water. Keep us posted on the underwater treadmill. A photo or a video would be lovely for us to see. The Stella and Chewy patties: Very good to see the 1st four ingredients ARE specific proteins and NOT mystery "meat" (Beef, Whole Ground Salmon, Beef Heart, Beef Liver, Beef Bone, Pumpkin Seed, )!
What country are you in?
CONSTIPATION Pumpkin work when it's high degree a fiber is also accompanied by extra water. Without extra water in the diet, pumpkin can help to firm up loose stools! Not what Brodies needs. RECURRENT UTIs See if these pointers give you info to help you at home and bring things up for discussion with the vet. • recurrent UTIs: dodgerslist.com/2020/06/09/recurrent-uti/ • Dr. Nancy Kay's article on managnaing UTI's: speakingforspot.com/blog/tag/methenamine/ |
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Post by Victoria & Brodie on Oct 28, 2022 23:07:15 GMT -7
Thank you for the links!
We are in the US.
Brodies movements are definitely purposeful! He is using his back legs to try to reposition, but it’s hard with the front legs so much weaker. He also lifted his back leg once when he was in an assisted stand so he could urinate.
Front legs also stretch out when he wakes up from a nap or when one of us comes home, he does kind of a whole body shake, which is so nice to see! We’ve been missing his sweet personality. If he’s feeling energetic he holds himself kind of like a sphinx using his front legs.
Can’t wait until his PT consult on Monday. Would appreciate hearing about anyone’s experience with acupuncture as it seems that will also be a part of his rehab.
Thank you!
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Post by Romy & Frankie on Oct 29, 2022 14:58:11 GMT -7
Happy to hear that Brodie is doing so well.
I did not have acupuncture as part of my dog's therapy after surgery, although many of our members did. The therapy my dog had was walking on the underwater treadmill. This worked very, very well for him. I do not think he would have recovered nearly as quickly without it. I hope it will work as well for Brodie.
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Post by Victoria & Brodie on Nov 4, 2022 3:09:22 GMT -7
Hello,
Would love some help from you all regarding Brodie.
Pooping has been a challenge for about two weeks now and we’ve done everything we can think of including a visit to his vet and three visits to the ER. Brodie has been on Miralax (1/2 tsp BID) and lactulose (3cc TID) and stools are like yogurt but he still cannot poop unless manually disimpacted or given an enema.
He is able to pass gas, he’s not vomiting, he’s voiding and has bladder control, and he has a normal appetite. He has periods of discomfort with vocalization and straining where he is unable to poop but is attempting to, and once he is assisted he immediately relaxes and is able to go to sleep. I watched the expressing for poop video but we haven’t had any luck with either method. He has great rectal tone, so we really don’t understand why he’s having such a hard time with this.
Our vet seemed to think that once he was more mobile he would start to move his bowels more regularly, but when we met with the physical therapist, they did an initial consult and said they can’t see him for another 3 weeks so we were pretty disheartened.
Anyone with similar symptoms or any advice please?
Thank you!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Nov 4, 2022 10:53:35 GMT -7
What ways do you have at home to increase his mobility? --- do you have a hot tub or a good sized tub where he can swim and paddle front legs and maybe his back legs with a safety vest on? More detail and how to here about water therapy: dodgerslist.com/2020/05/28/surgery-dog-water-therapy/Add a tennis ball or other favorite toy to make it fun.  |
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Post by Victoria & Brodie on Apr 21, 2023 22:15:05 GMT -7
I don't want to jinx Brodie's progress, but I do want to share a little bit about his journey because I used to obsessively read these boards as a lifeline. Brodie was paralyzed from the neck down in September [2022]. It took us completely by surprise. He went down on a Sunday and had surgery Monday and still had deep pain pre-op but not much else. He underwent ventral slot at C2-C3 and post-op didn't regain much function. He always had bowel/bladder control per the neurologist. Postop he had a lot of complications including: Postop pain leading to a prolonged steroid course which lead to: Mulitple UTIs requiring multiple antibiotic courses Steroid delirium Weight loss/muscle wasting (our pup weighed 22 lbs before surgery and got as low as 16 lbs) No appetite Unrelated to the steroids, and more due to his loss of mobility, he had horrible constipation, multiple ER visits for this, enemas at home and at the ER. We were manually disimpacting him twice a day every day for at least a month or two. The first 8 weeks were awful and he didn't improve much.. He could barely hold his own head up and couldn't stand without support. We were finally able to get him in to see a PT who after the initial eval wasn't hopeful he would improve and said it would be another 2 weeks before he could be seen again. In that time, he had two acupuncture appointments, but we were pretty deflated and hopeless. We saw a second PT who said she'd seen doggies as sick as Brodie or worse, and they had improved. He got manual PT, laser, acupuncture, and after 4 weeks of physical therapy, started underwater treadmill. Check out @integrativepetcare on instagram for a video of how Brodie progressed. Today [April 2023], Brodie still goes to PT twice a week, but he walks around the house and he goes for walks around the block. His quality of life is pretty close to what it was pre-op. He has to be lifted on/off the couch/bed and he doesn't play with the same toys, but our 13 year old boy is still with us and is laying in my lap right now. We went on vacation two weeks ago and it was his first time off leash. He got to run around a little bit and he was so happy. I just wanted to share for anybody stuck in those first few weeks of darkness. Some things that worked for us: - We bought a stroller to help us take Brodie outside to urinate. We live in a high rise so this was key and still comes with us for longer walks or to keep him with us when we go to dog friendly patios or errands. - We bought toddler rails for our bed to keep him from getting on/off without us in the middle of the night and this has been huge for me sleeping through the night without panicking that he's moving. They even came with us on vacation! - Myos for weight gain/rebuilding muscle (we still use this) - Cranimals for UTI prevention (we still use this) - "Just Food for Dogs" to help him gain back his weight. Can't say enough good things about this. He loves it, his coat and eyes are super healthy. He was a very picky eater before this and now he's always checking his bowl for left overs. - PT, obviously. Our second PT vet is amazing/wonderful and I get a knot in my throat everytime I think about how grateful I am for all this bonus time they've given us. The first PT vet was pretty negative and I was desperate, but I'm so glad we sought a second opinion and put Brodie's needs first. If you're reading this because your baby is going through IVDD, I'm sending you so much love and hope. Here are the links to products we bought: Toddler Rails for Bed: www.amazon.com/gp/product/B09QGRFJZW/ref=ppx_yo_dt_b_asin_title_o04_s00?ie=UTF8&psc=1Stroller: www.amazon.com/gp/product/B07SKSWGLL/ref=ppx_yo_dt_b_asin_title_o01_s00?ie=UTF8&psc=1 |
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Post by Victoria & Brodie on Apr 21, 2023 22:16:15 GMT -7
Posted too quickly. I also want to say how grateful I am to the moderators for their advice and guidance and to everyone who has shared their story. It gave me a little glimmer of hope when I needed it most. Sending healing vibes to all your babies.
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Post by Romy & Frankie on Apr 22, 2023 13:10:33 GMT -7
Thank you so much for the great update. We are always pleased to hear how our dogs are doing.
An IVDD dog can have a great quality of life, even if they have to do some things a little differently.
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Eric and Victoria 
