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Post by Mariska & Coco on Dec 12, 2022 9:51:32 GMT -7
[Original subject line:Coco 6 year old Miniature Dashund post op ] Hi. Coco is our 6 year old Miniature Dashund. Weight 5.2kg. He was diagnosed with IVDD on Sunday 4 Dec after total loss of movement in hind legs. He was taken to vet and with little to no deep pain and confirmed scan on midback discs in 2 places operation was done immediately. 1 week post op and came home today. Crate rest for another 3 weeks. Stitches to be removed in 2 days I am struggling to express his bladder Meds : Twice per day Gabapentin 100mg At night Paracetamol 50mg Half on morning Rimadyl 25mg [MED LIST/HISTORY- Moderator's Note. Please do not edit
5.2kg / 11.46 lbs 6 y.o.
Rimadyl as of 12/11: 12.5mgs 1x/day ]
gabapentin 100mgs 2x/day
paracetamol (Acetaminophen) 50 mgs 1x/day
Coco needs acid suppressor such as Omeprazole for duration of Rimadyl]No bladder or other control Some reflex return in one back paw Physio 3 times per day at home Country: South AfricaNot sure what else? I am so worried I don't express his bladder correctly or don't do physio correct  Poor baby. I tried my best twice today but when I checked in on him now he started leaking and tummy was round. Took him out again and expressed a lot of fluid. Hoping we get better at this as I think we both hate it |
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Dec 12, 2022 11:56:55 GMT -7
Welcome Mariska! Good job on expressing. It is a new skill for you to be able to feel the bladder until it get almost empty. The goal to is express often enough so there is no leaking. While learning you likely will need to express every 2-3 hrs. As you perfect your skill to feel the bladder and get it pretty empty you can move up to every 3-4 hrs, then every 4-6 hrs as you see he stays dry between expressing sessions. Eventually you will find he can sleep at night for 8 hrs staying dry. You then express in the morning first thing. I know on discharge day there is a lot of information to absorb and remember. See the links pointed out to you for helpful aids to instructions presented on discharge day. EXPRESSING Good video and extra tips in expressing for urine. Also how to express for poop which is not a health issue but more to prevent Coco from anxiety of finding poop where he sleeps: dodgerslist.com/2020/05/05/bladder-bowel-care/STOMACH PROTECTION How long will he be on Rimadyl? Discuss with your vet if an acid suppressor for the duration of Rimadyl is to be considered. Read why here: dodgerslist.com/2020/05/06/stomach-protection/ In the US, Pepcid AC is mentioned often. I do not think Pepcid AC is available in S. Africa, but omeprazole is. RECOVERY SUITE You'll be interested in the tips and ideas to get the recovery suite set up to make things go smoother for the rest of the 3 weeks of post-op rest: dodgerslist.com/2020/05/14/strict-rest-recovery-process/
QUICK IVDD OVERVIEW
It's not a bad idea to get an overall sense of the disease your Coco was born with. ▶︎ Get an over all understanding of your dog's disease for now and for living many happy years ahead with him. Shortcut Thru IVDD: dodgerslist.com/2020/06/26/time-and-ivdd/POST OP EXERCISES Check out this video on post-op exercises to find the ones you were instructed to do. Appropriate physical therapy can help maintain those muscles with lost nerve connection and keep the joints flexible while nerve cells regenerate.
Is his pain fully in control with the two pain meds (paracetamol and gabapentin)?
On discharge from the surgery, did the surgeon say if Coco had deep pain sensation today?
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Post by Mariska & Coco on Dec 12, 2022 12:18:35 GMT -7
Thank you for all the tips
Pain - He seemed ok today. Was a bit anxious being in pen when we were not in sight and was shaking a bit but was short-lived so I think meds working. Today was adjustment for both of us.
The vet was not in today but nurse showed reflex in left paw, right was still slow. He had almost no deep pain at admittance
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Dec 12, 2022 12:30:12 GMT -7
Mariska, it sounds as if you are reporting on back paw knuckling under? Can you be more descriptive about the paw movement thing?
Can Coco wag his tail if you SPECIFICALLY do some happy talk to him?
Do you see Coco attempt to use his back legs to reposition his body in the suite?
For us humans to be able to distinguish between reflex and brain directed, we have to see some sort of head level involvement with the tail, with a limb or with release of urine so we know the movement was done with purposeful thinking. --- Sniff (head level nose) on an old pee spot, then release of urine would be brain directed. --- Hear (head level ear) you doing some happy talk and then tail wags is brain directed. Tail movement during potty time can often be a reflex --- Itchy sensation at neck and then tries to scratch would be purposeful movement. Tickling paws, etc can cause reflex leg movements of pushing in or out. Nerves heal typically in the reverse order of the damage to the spinal cord: 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. 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 place the paw. 6. Ability to walk unassisted and perhaps even run. LEARN MORE: dodgerslist.com/2021/02/06/nerve-healing-after-disc-episode/Make sure you do not observe shaking any other signs of pain showing nearing next doses of pain meds nor when having to move his body. Pain showing thru would indicate pain meds need adjusting
SIGNS OF PAIN: ⚙︎ shivering-trembling ⚙︎ yelping when picked up or moved ⚙︎ tight tense tummy ⚙︎ arched back, ears pinned bac ⚙︎ restless, can't find a comfortable position ⚙︎ slow or reluctant to move in suite such as shift positions ⚙︎ not their normal perky interested in life selves |
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Post by Mariska & Coco on Dec 12, 2022 12:36:14 GMT -7
Wow thank you for such detailed feedback
Will lookout tomorrow for possible pain signs
There was only some DPS. There is none of other signs yet.
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Post by Mariska & Coco on Dec 12, 2022 19:19:53 GMT -7
Hi. Woke up to a 'crying pup'. Coco slept in his cage in room next to ours. He destroyed his cage. He did 'sleep' 7 hours. Expressed bladder and cleaned everything. He feels warm to me - is this just maybe night time warm?
Will do breakfast and meds in 2 hours so we have a rhythm and more in a every 12 hour cycle. Will also do physio. It's very early in SA - I forgot what it feels like to have a baby 😂
How do we help with boredom? Going back to full time work in a month so he will also need to be ok being alone. We are keeping him from his 'sister' while healing so assume that will also help if back together
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Dec 12, 2022 19:34:25 GMT -7
Mariska, it is ok if you put his crate next to your bed on the floor so he can feel near you and waken with anxiety.
Why was he crying...did he leak urine in his bed? When was the last time you expressed him before bedtime? Sleep 7 hrs sounds pretty good to me. Maybe you'll need to set an alarm for mid way during the night to express if he had leaked in his bedding.
If you believe he is in pain, then call the ER at surgery hospital and report what you observe as being in pain to see if pain meds could be adjusted. Pain meds are effective for about 8 hrs and the reason many times they are Rx'd for every 8 hrs (3x/day). Rimadyl is an anti-inflammatory and is normally Rx'd 1x/day.
The normal temperature for a dog is: 101.0 to 102.5°F (38.3 to 39.2°C)
At graduation day on 1/1/2023 we will have lots of tips for getting Coco back to family life. What date do you return to work?
From now on when you leave the house, it would be safer for Coco to be crated/separated from other dogs. We can explain the why of that at graduation day.
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Post by Mariska & Coco on Dec 12, 2022 21:20:09 GMT -7
Thanks. Layed next to him and was calm. Is it too soon to be excited for graduation day 😁
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Dec 13, 2022 9:21:13 GMT -7
Mariska, please do confirm if we have the graduation date correct.
Surgeon wants 4 weeks of post-op rest to heal all the surgical sites. The 4 weeks of rest includes his directed at home exercises which are carried out under your supervision and to make sure he does not overdo things or escaping or darting off to something or other.
Surgery was on 12/4. Four weeks later will be on 1/1/23. On graduation day, 1/1/23, will be the time to begin a gradual re-introduction back to family life and activity.
What date do you go back to work?
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Post by Mariska & Coco on Dec 13, 2022 11:14:26 GMT -7
Hi.
I think graduation is correct. Will check tomorrow when we remove stitches but sounds right. Took him back to vet today to help with expressing bladder and he had such a nice and calm day. We struggled again later but think we did OK. Also had a poop.
Keep hoping and checking for improvements. He had some attitude when he tipped over his kebbles - seems he only wants soft food. Will keep trying.
Sorry also. Some posts talk about walking dog on leash and with sling under belly. When I asked vet nurse she said not yet as there is no movement and he is still on rest. So we take him out to express bladder, exercises and cuddles but mostly in pen?
Sorry saw question now. Around 9 January back to office
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Dec 13, 2022 11:38:37 GMT -7
Mariska, it is your surgeon who directs what the at home PT should be. You are right a surgeon may know that a sling walk is appropriate for that specific dog. Your surgeon knows what is the right PT specifically for Coco. Each dog is different.
If he prefers soft food, rather than changing foods, how about soaking his kibble in some yummy salt free/no onion meat broth.
Simmer up a hamburger patty or a chicken part.
Cool and discard fat disc at top and any skin or bones.
Freeze broth ice cubes to lick on during the day as a lo cal treat.
Soak kibbles to soften. Use a teaspoon of crumbled meat to top off for extra yumminess. 1 teaspoon will not unbalance the kibble formula ingredients.
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Post by Mariska & Coco on Dec 15, 2022 8:23:20 GMT -7
Thanks sounds like amazing recipe
Hi
We getting used to our daily rhythm. Seeing a rehab next week for assessment and to then decide on hydro therapy/acupuncture.
Two things - stitches were removed yesterday and this afternoon there is a bit of blood on one spot - just a tiny bit? Is this OK?
There is a spot on his inner thigh on tummy that looks bloody - like a place that has been rubbed. It might be when he turned in his pen and almost like a 'carpet burn'. I will look how it looks tomorrow but feel like we need to prevent this and does it need meds?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Dec 15, 2022 11:11:06 GMT -7
Mariska, broken skin should be protected from bacteria invasion. An antibiotic ointment (neosporin or other advised by your vet) plus bandaid. Could the inner thigh be a rash (unbroken skin) due to a bit of urine left after expressing or his leaking a bit in his bedding? Wipe down after potty time with green tea or baby wipes to keep urine off the skin. Might put a pee pad under his butt directly to catch leaking urine droplets.. so it is easy for you to observe if leaking? NOTE usually the pee pad would be stacked on top of his mattress in this order MATTRESS SETUP Top layer: Fleece "bottom sheet" tucked in all around tightly and a bit under the mattress keeps pee pad from shifting. Middle layer: Pee pad on top of mattress Bottom layer: Mattress enclosed in trash bag to protect and avoid having to clean At suite freshening time, dispose of used pee pad, put the bottom sheet in the washer. Having extra fleece bottom sheets means you have them near by and can quickly remake bedding. Fleece is no sew, no worries about raveling just cut one of those cheap about $10 (100% synthetic throws found at target, a large grocery store down to sizes you need. Fleece (no cotton, 100% polyester) is available at almost every fabric store like JoAnns. Fleece washes and dries very quickly. On a warm summer day I even dry mine outside in the sunshine so it smells wonderfully outdoorish for my dog. The tip below and many other good ones, including how to set up the mattress system, comes from our supply list at the Main Dodgerslist web site. dodgerslist.com/2020/05/14/strict-rest-recovery-process/CLEAN UP TIPS Use unscented baby wipes for quick clean up on your doxie. Marjorie's tip: Brew up a pot of decafinated green tea. Let it cool, dampen a sponge or cloth with the tea and then gently wipe belly and legs. Tea is mild with acidifying, antibacterial properties to neutralize urine on skin and fur to avoid rashes from urine scald. The tea leaves a clean earthy fragrance. The remaining tea can then be stored in the refrigerator and warmed before use.  If there is carpet burn from repositioning in the suite, make sure the suite is large enough for him to easily turn around in. Do you actually see fresh red blood or dried black blood on the tummy? Broken skin needs protection (ointment and a bandage). Let us know more about status of the skin issues and what measures you've decided on, how they are are working out. NEURO UPDATE What can his back legs do currently?--- back legs attempt to reposition his body in his suite. --- paws do not knuckle under OR they knuckle but he can slowly correct them --- has made attempt to try and push up on back legs to a stand by himself. If there are indicators showing messages are now able to travel to the hind legs, underwater treadmill would be very timely and a good expenditure of $$. 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 Mariska & Coco on Dec 15, 2022 20:19:27 GMT -7
Hi Wipe him with unscented wipes and has pee pad. Will get an ointment
No change in use of back legs. No movement. His legs and paws are just dormant and lying flat.
Still doing exercises.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Dec 16, 2022 9:50:44 GMT -7
Let us know which ointment you choose.
Will be interested to hear what the rehab folks recommend next week
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Post by Mariska & Coco on Dec 22, 2022 22:39:53 GMT -7
Hi.
So two interesting days. Will say interesting as need to keep hope.
On Wednesday had to take to vet as wound on back kept leaking fluid. Vet [the surgeon?] added two stitches back. It was the first time he saw Coco in almost 2 weeks. He felt that he should have had progress. Still little to no dp. He did say later atleast there is no pain and thus still jope. He didn't feel like we needed to crate rest?
Yesterday [12/21?] we went to see the physio. She also felt there is still a far road. Did acupuncture and seeing her again 5 Jan for Hydro and acupuncture. She felt still taking it slow while totally paralyzed in back would be better. We can start 2min walks with a sling.
This morning his 'wiener' was hanging out but luckily pulled back on own. I am hoping this is a sign of some nerve coming back.
A bit sad that we didn't have better news but we continue exercises and rest for now.
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[Post by Mariska & Coco on Dec 16, 2022 at 10:00am]
We bought a special one [ointment?, bandage? or ?] from shop that we put on his inner thighs. Will check tomorrow if better.
Also very excited about next week as they seem very clued up and had a lot of success with treatments. Maybe we get a Christmas miracle
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Dec 23, 2022 11:24:31 GMT -7
Mariska, Did the vet (you mean the surgeon? or your own local vet?) said Coco is finished with post-op rest at about 3 weeks. If Coco has now graduated from post-op rest by directive of the surgeon, then we would have lots of information to share with you! Post-op rest which would include surgeon directed PT or from a PT clinic is to allow all the surgery tissue areas to heal.
You can spritz clean water or apply some KY jelly on the penis to help it go back in if this happens again. It is from nerve damage. Nerve damage can self repair.
What was the name of the product you got for Coco? Did it do the job? "We bought a special one [ointment?, bandage? or ?] from shop that we put on his inner thighs."
If there is some little DPS, then that is good news. Having DPS nerve function means even more nerves can heal. When? No one can tell you.
This man puts things in the right perspective about nerve healing!
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Post by Mariska & Coco on Dec 27, 2022 5:08:33 GMT -7
Hi Apologies for slow reply. Our surgeon and vet is one and the same. Yes the Dr said crate no longer needed but also said he will drag himself everywhere and get hurt. We got some pt which we have been doing. The PT we saw also gave as more massages to do and suggested we take it easy still. Almost 4 weeks in, no movement, no bladder control. I have been doing short walks with back legs in sling. Not sure what comes next. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Dec 27, 2022 10:35:28 GMT -7
Mariska, the post-op rest time is to heal the surgical areas. It is a good idea to follow your PT about taking it easy still. Same as recommendations for all post-op dogs. What was the last date you saw the surgeon AND did he say if Coco had the ability to feel deep pain sensations (DPS)?
GRADUATION, A SLOW RE-INTRODUCTION The idea is to gradually give more freedom under controlled conditions (leash harness and sling). Not free rein of the house to scoot around nor use a cart in the yard immediately. Coco's muslces are soft and out of shape after the post-op rest period. Gradually build up his muscles and lungs. Take a look at our information. Gradually building your dogs muscles over a month's time will have your dog safely running and having fun again! SAMPLE SCHEDULE Here is a sample schedule to safely and slowly introduce your dog back to family life and physical activity: dodgerslist.com/2020/06/15/back-friendly/?highlight=sample%20scheduleGARMENTS TO PROTECT You will want to consider how you will prevent rug burns from scooting and protecting bacteria from entering the bladder. dodgerslist.com/2020/06/13/garment-skin-uti-protection/ As Coco begins to heal nerves, check out these ideas and products to provide improved traction for awobbly dogs or cart dogs: dodgerslist.com/2022/10/08/traction-solution-improvements/
Teach Coco to be safe . Dogs are best at visual learning rather than verbal commands. Dog trainer Anna Jane Grossman says “Dogs learn in pictures. Inside your dog’s brain is a very simple algorithm – pleasant images in one place and unpleasant images in another." Even paralyzed dogs CAN learn to use a ramp down from furniture: HAPPY DAYS AHEAD You and your dog have survivied a disc herniation! Learn what you can do from this point forward for nail trims, dentals and having fun! dodgerslist.com/living-with-ivdd-tips-2 WHEELCHAIR While waiting on more nerve repair for the back legs, it may be a consideration to look into a wheelchair. Features to look for in a cart for the IVDD dog: A cart means a new beginning as mobility and independence is restored. Cart features needed for the IVDD dog: dodgerslist.com/2020/06/06/wheelchairs/May we turn the tables and ask YOU for help? Did you know there are less than a handful who volunteer daily to help dogs and their owners? We need helping hands from other Forum members in educating. Education about disc disease is our number one mission! We invite you to hop on to our educational bandwagon team. Too many dogs are put to sleep because owners lack education about IVDD treatment. STRICT crate rest and proper medication have helped many dogs recover. We depend on all members to pay it forward for the help they have received with their dog by helping us educate! Pick what suits you....
We depend on you. Here are some ways to help.. -- Please celebrate Coco's graduation! Add a graduation photo and a short caption to our Gallery to give other members inspiration about your IVDD Survivor! dodgerslist.boards.net/thread/2262/add-dog-dodgerslist-photo-gallery-- "Share" our FB posts www.facebook.com/Dodgerslist-- Would you consider helping another trying to make decisions about surgery? We have a directory where you can share surgical info. Here is where you can share your dog's info: dodgerslist.boards.net/board/13/member-reported-surgery- costs-recommendations State: Hospital: Address: Cost: Date of surgery: What was included in cost (MRI?, days stay, ER? PT? meds for home, sling, etc.) Comments: And finally, don't be a stranger! Stop in periodically. We really do love to hear how your dog is doing. We'd love a short video clip to see Coco in action at home, at PT and living & loving life in spite of IVDD! if you see a new member in a tough spot, give them hope. A brief paragraph about your dog can be insanely supportive and inspiring in a time of need!  |
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