Vince's Lala 12/21 surgery6wks -coton de tulearGRAD 2/1

At ER now. They confirmed it's her back. They said she's unaware of her back legs but has a very little movement in them. She said at this point surgery is usually the only thing that will get her back her legs. And most concerning, she hasn't gone to the bathroom yet. So I don't know if she can even pee anymore. What do I do?

We're on our way to get consultation for surgery. It's about an hour away. She has a little bit of movement in one of her legs now but our main concern is that she wasn't able to have her bladder expressed. Thank you for your responses and let me know if there's anything else you recommend for our situation at the moment.

Had to wait several hours at the animal hospital but they finally got her in for evaluation by the surgeon at 3pm.

At least as we were waiting, I could tell her legs were getting stronger. She was able to fold one underneath of her belly and the other was getting a little life too.

Just got a call with an update from the surgeon. He did an MRI and confirmed there was an acute rupture in one disc and also saw several other older injuries which were the ones we were able to heal conservatively over the years. He did the surgery and he is happy how it went. He thinks she has a good chance of walking again and will provide another update tomorrow. He was able to express her bladder while she was knocked out but hopefully as she starts healing tomorrow, she'll be able to go on her own.

I'll keep you all posted. Thanks for your concern.

Thanks Paula! I appreciate the info on preparing for post-op. As far as how her legs improved a little after the ER visit, I'm not sure. They gave her a pain shot but I don't believe she had any anti-inflammatories until I gave her some carprofen they prescribed after we got. But even before that, I noticed that her left foot was able to resist some pressure a little bit.

Got an update [12/22] from the hospital this morning. They said that she is doing well after the surgery. She was alert this morning and ate. She can move her left leg still and has feeling in her right. He said he had some trouble expressing her bladder but was able to a bit. He said that is usually a sign that she has control over the muscles involved and wants to be in charge of when she pees so that's potentially a good thing. After we spoke, he called right back and said when he returned to her crate, she had peed on her own and he was very happy about that. He said that if she's eating and drinking and peeing that he would feel comfortable with us picking her up tonight, a day earlier than expected. I'm going to call back this afternoon to see how she's doing and if we're still ok, then we'll go pick her up.

We brought her home about an hour ago.

Yes, I'm still concerned about her bladder. She still hadn't gone since the puddle this morning at the hospital but the doctor and vet tech assured us she was fine to go and would be able to pee when she was ready. When we got home, we took her to her normal spot and held up her back end a little but she didn't go. She ate a small dinner we gave her of her normal food wetted down to make it easier to digest and pass. Gave her some pain meds and then tried bathroom again just now with no success. I have my vet on standby tomorrow if we still haven't gotten her to pee or poop by tomorrow, we'll go in to see him. I'm worried this winter storm might cause them to close the office though. That's why we picked her up tonight from the hospital. It's going to be difficult to drive an hour away tomorrow and Saturday. And I was trusting the judgement of the surgeon. Now I'm having second thoughts.

Her left back leg seems weaker than it was when we brought her in and her right leg is still limp but they said she had feeling in both. It's hard to have her at home with us because she's whining in her crate and struggling to move around in it dragging her legs. I gave her a muscle relaxer too to calm her down as prescribed by the ER. But it's been a rough first night home. Tomorrow, we might have to figure out the bladder expression.

Thanks for the reassurance Paula. It was much needed last night. After observing her and feeling her last night, I concluded that Lala wasn't just frustrated by not being able to move her legs. She was in pain! She was trembling and couldn't get comfortable. The hospital didn't send us home with anything other than what the ER gave us (rimadyl, gabapentin, and methocarbamol) and the pain meds weren't cutting it. I remember in a previous episode, tramadol seems to work really well for her. I still had some from a hernia surgery she had last year. I verified it's safe to use with the other drugs and gave her a 25mg dose of it. After an hour, it finally kicked in and she was comfortable enough to fall asleep. She woke up again at 5am and was trembling again so I gave her another 25 mg dose since it had been 6.5 hours and it worked within 10 minutes. My vet ended up calling me this morning even though his office was closed to check up on how she was doing. (Yes he's amazing and 10x better than any human doctor I could find for myself). I confirmed with him that that combination is ok and he agreed and said I could even give her up to 50mg if she was in acute pain.

So her meds now are:

Rimadyl 25mg once per day - Anti-inflammatory
Gabapentin 100mg twice per day - Nerve pain
✙ Tramadol 25mg every 6-8 hours - Severe pain
Methocarbamol 125mg twice per day - Muscle relaxer
(I will be requesting pepcid from my vet on Monday when the office is open)

[Moderator's note: please do not modify
15-16 lbs
Rimadyl 25 mg 1x/day
✙Tramadol 25mgs 3-4x/day
Methocarbamol 125mg 2x/day
Gabapentin 100mg 2x/day
Pepcid AC 5 mgs 2x/day ]

She's 15-16 lbs.

Do those sound right? Do you think I should give her the muscle relaxer on top of the others? I skipped it today since I added in the tramadol and that seems to relax her pretty good as it is.

So my biggest concern was still her bladder. As I feared, my vet's office closed today due to the weather so I felt very alone this morning not being able to get help if needed to express her bladder. However, when I looked in her crate at 8am, she had soaked the pee pad in it and scooted herself off of the wet part and was sitting up. So that was a relief. I was still wondering if she had control or if it was just a reflex but it seemed like she completely emptied it. After breakfast, I brought her outside (in the blizzard) for a few minutes. I supported her back legs and I could feel a little strength, especially in her left leg. Then, she lifted up her tail and peed a little and pooped a little. I was so happy to see that control. Just an hour ago, we brought her out again the same way and she did a good pee and moved her tail again.

She took a nice nap today and woke up alert and sat up when her mom was opening up a bag of snacks like she normally does. I'm so relieved that I know she can pee on her own now. Now we can just focus on resting and doing a little therapy and patiently waiting for her to get her legs working again. I watched those videos on some therapy we can do. The hospital just told us to try to make her stand and help her with a towel under her belly at first. I've been massaging her legs and moving them but I'll try some of those exercises as shown in the video.

Thanks Romy. I started giving her the Methocarbamol again per your advice. I'll be going out today to brave the cold and icy roads to get some supplies so I will try to get some Pepcid while I'm out.

Lala is still progressing little by little. We've had a couple of good potty trips last night and this morning where she's peeing well.
    My wife discovered that when we support her mid section and let her walk a little on her front legs, it feels more natural for her and she even tries to move her back legs a little. That relaxes her enough to go potty. She had a good poop this morning too for the first time since her injury so I was happy to see her systems getting back to normal. There was no puddle on her mat this morning so she is holding her bladder now and only going outside. I think she may have never really completely lost bladder control but now she's comfortable enough to go on command.

I still feel a tiny bit of strength and movement in her legs, even a little in her right leg which is mostly limp. Today, she has been very alert and she has that look in her eyes like, "I really want to walk around." She slept through the night and pain seems to be well under control now. Every bit of progress give us a little more hope.

Quick update on Lala. She seems to be progressing well. Still pain free and getting more and more back to herself and her personality. Potty trips have been consistently successful and no accidents inside her crate. She's eating and drinking as normal.

I'm noticing more and more signs of leg control. She will reposition her legs occasionally while she's laying down. Today I saw her lift up her left rear leg a bit while she was grooming herself. It was about half way of what she would normally raise it. When we bring her outside, we're still supporting here mid/rear section but I can see both legs trying to take steps before she goes potty and she is requiring less and less support. She even squatted this morning with both legs stretched outward.

I appreciate the reminders to limit her movement and steps and keep her stable so she doesn't interfere with the healing in her back and we're doing our best to protect that. She's not strong enough yet to move too much when we're setting her down but I'm hoping to have that challenge in the future when she gets her legs working better.

The next milestone I'm hoping to see is a tail wag. We've seen some movement in her tail when we greet her but not an official wag yet. Haven't really heard a bark yet either but that's probably coming soon.

I forgot to mention that I have been giving her ✙pepcid ac [? mgs ?x/day] since Sunday morning ahead of the NSAID so we're all good there.

And you were right about the tail wag. I just got back from the store and I was greeted with a strong bark and equally strong tail wag. I guess we hadn't gone anywhere for a few days so she didn't have an opportunity to get excited. Now moving on to the next milestone, standing up! That one is going to bring some tears of joy when it happens.

I'll try to contact the surgeon tomorrow morning to see if they have any advice on exercises. I'm a little disappointed they haven't taken the initiative to call us for the past 4 days but the holiday may have been a part of that. The local ER we went to first called this morning to check in.

Vince, weight bearing standing is good for bone health! Good to hear left rear leg function allows her to push when scooting. 

Could you tell us more about the standing from a neuro function perspective.
    -- Can she move up into a stand by herself with back right leg even though the paw often remains knuckled under?

For how many weeks does the surgeon want for post-op rest to heal the surgical sites?  Often it is 4 weeks. But depending on the case, a surgeon may want 6 weeks or more.  We look forward to learning Lala's graduation date. We have lots to share on graduation day about transitioning her back to family life and living many happy years ahead.

It usually takes about 14 days for all of the temporary surgery-caused painful swelling to be gone. I would say not to jump the gun and take her pain meds away unless your surgeon has directed to do that.

If Lala needs some help to be able to relax in her recovery suite, then so be it.  While prescription traZODone can help, you may wish to first try an oral calmer in combination with a Pheromone diffuser.  It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives (ACE, alprazolam or traZODone). Of course always keep your vet in the loop on all things you give your dog.

Place a DAP pheromone diffusor at floor level where the recovery suite is:
--DOG Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/

Use diffusor with one oral calmer from below:
1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed www.virbac
2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine.
www.vetriscience.com/composure-soft-dogs-MD-LD.php

It is possible to roll her suite into the kitchen area so Lala can be involved in kitchen activities?
dodgerslist.com/2020/05/14/strict-rest-recovery-process/


Add crate casters to wheel a crate from room to room.

Vince, very good news with sling support you see continued improvement on her legs moving in a walking motion and now scratching an ear with right hind leg!   Lala is on a roll with nerve healing!

Hope to hear at the Jan 9 neuro appt, he will recommend some sling walking. Often when a dog can do walking motions, the PT is then sometimes a walk to and from the potty place.
Also discuss the soonest an underwater treadmill clinic could be contacted if in your budget. Here is why:
    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 buoyancy makes it easier than leg movements against gravity on land. There is not only the potential to regrow damaged neuronal path ways but also for neuron to muscle re-education to learn the art of walking again.

it is important to keep Lala's movement to a minimum until the surgeon says otherwise. It is still quite soon after surgery and the surgical sites are still healing.

Definitely consider speaking with the surgeon about underwater treadmill therapy, as Paula suggested. My dog had this form of therapy after his surgery, and I was very pleased with the results. I don't think he would have recovered nearly as quickly without it.

Vince, thank you for sharing your neuro's report. Going out for potty where several times a day she can take footsteps will be her exercise, it sound like. At graduation on Feb 1, then we'll have lots of ideas for safely and slowly introducing family life again and more physical activity.

Vince, congratulations on Lala's graduation. You did it!
    Your newly gained perspective is something to share with new members just starting the scary IVDD journey. It is hard to see the forest for all the trees when dealing with the details of worry and learning new care techniques, etc. For dogs, it is in the cards for each get back to leading a joyful life after surgery or conservative treatment.

GRADUATION, A SLOW RE-INTRODUCTION
     Determine how you are going to ease her back into more normal activity at graduation from rest. The idea is to gradually give more freedom under controlled conditions. Not free rein of the house and yard immediately! LOL
      Lala's muscles are soft and out of shape after the rest period. Gradually build up the muscles and lungs.
    Take a look at our information. Gradually building your dogs muscles and stamina over a couple of month's time will have her 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%20schedule

DIY back PROTECTION around the house
   
1) Good ideas in making your home back friendly:   dodgerslist.com/2020/07/09/home-protect-ivdd-backs/

2) Additional ideas to your rugs with products to provide improved traction for wobbly dogs on your homes slick floors: dodgerslist.com/2022/10/08/traction-solution-improvements/

3) Teach your dog to be safe and not jumping up or down, but to use a ramp whether over steps leading outdoors or to furniture in the house.
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."

HAPPY DAYS AHEAD
Lots more ideas and tips in living with an IVDD dog such as dentals, nail trims, safe ways to have fun together, and more:
dodgerslist.com/living-with-ivdd-tips-2

PT THERAPY AT CLINIC or HOME
     Safety first. You should always consult with a veterinarian before starting any exercise program with your dog. 
-- Strengthening core muscles.
This applies not just for humans, but REALLY applies to the IVDD dog: "...improve the strength and coordination of the muscles that surround the spine so they can act like the world's greatest back and neck brace." www.spineuniverse.com/conditions/spondylosis
    Core exercises don't require specialized equipment. Here are 5 exercises you can do at home: totofit.com/five-basic-exercises-essential-to-building-core-strength/

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....
 Here are some ways to help..
               **
-- Please celebrate Lala'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

-- When in conversation at the grocery store line or wherever you may meet breeds most prone to IVDD (Dachshunds, Beagles, Poodles, Spaniels, Shih Tzus, Pekingese, and Chihuahuas, Frenchies) give out our free little wallet cards.
Hand carry our literature and print out our letter of introduction for your vet.
           ►ORDER BROCHURES & cards, they're free!◀︎] 
          for your vet & wallet cards for you

-- 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, Vince, 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 Lala 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 Lala could be insanely supportive and inspiring in a time of need!