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Post by Greg & Hector on Jan 2, 2023 14:30:53 GMT -7
No pain
19 lbs/4 years old Meds: Carprofen - 75 mg - 1/2 caplet every 24 hours until gone (started 12/25)
Trazodone - 100 mg - Give 1/2 or 1 tablet every 8 hours as needed (started 12/30)
Gabapentin - 100 mg - Give 1 capsule every 8 -12 hours as needed (started 12/25)
No signs of stomach damage. Hector is eating
Hector is a Lhasa Apso. My (owner) name is Greg. Hector was initially diagnosed with IVDD by an ER vet and later confirmed by a vet neurologist.
We initially saw an emergency vet on 12/25 while traveling. They suspected IVDD and prescribed Carprofen and Gabanpentin. I followed up with my normal vet on 12/27 (they were closed on 12/26). They asked me to travel back to see them that sane day and tested Hector for deep pain, which was present. The next day on 12/28, we took Hector to a local vet neurologist where IVDD was confirmed and a T10-12 hemilaminectomy was performed. They also performed fenestration on other discs as preventative care. We brought him from the hospital on 12/30. A follow up appointment for re-evaluation and staple removal is scheduled for 1/11.
Hector needs to have his bladder expressed. The first few days we were finding that when we took him out for expression, he had already gone to the bathroom on his pee pads. We could still get some out though. Hector defecates in his crate usually. Last night, we tried to time up taking him out to when we thought he was ready to go, but we were not able to coax him into defecating. He defecated in his crate soon after.
As of today, Hector currently cannot stand or walk and has no use of his back legs. He has not wagged his tail. Per neurologist's instructions, we are doing some PT at home with him, which consists of shifting weight from side to side while propping him in a standing position, doing bicycle motions, and massage. Today we noticed that his hind legs were less stiff, which we hope is a good sign.
Overall, Hector seems in good spirits since surgery and has been eating OK. He is a little picky about his kibble, but he will eat rotisserie chicken mixed in and take certain treats.
Today, which is Day 5 since surgery, [1/2/23] he has drank very little. I successfully expressed his bladder around 7 am; I tried again around 12:30 and could not get any urine. I tried once more around 3 PM and got a little bit of urine. he has also not defecated today, which has me a little worried.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 2, 2023 15:51:50 GMT -7
Greg, welcome to the Forum. And thank you so much for registering. Hope you will activate automatic email alert when there is a reply waiting for you. I see you mention about Hector's eating. There is always concern about extra stomach acids when any anti-inflammatory (Carprofen) is on board, the dogs has had big changes in routine (stress) and there is neuro impairment. All of these causes extra acids. Hector doesn't need another potential problem of bleeding ulcers on top of healing from a surgery. Read up on why Pepcid AC (famotidine) from the grocery store or another acid reducer and discuss with your vet: dodgerslist.com/2020/05/06/stomach-protection/Did the surgeon indicate for how many weeks he wants for post op rest to heal the areas involved in the surgery? Often it is 4 weeks, but depending on the case it can be 6 or 8 weeks. Learning to express the bladder is a new skill to learn. After a weeks worth of expressing you will be a pro, too! When learning you may need to express every 2-3 hours. Once you are fully emptying the bladder the sessions can stretch to every 3-4 hrs and then 4-6. Plus at night when the body creates less urine, you may be able to go 8 hrs until expressing in the morning. Don't hesitate to go back to the vet or vet tech and get another hands oon your hands type of expressing lesson. Get more out of the refresher lesson by first viewing and reading these tips: dodgerslist.com/2020/05/05/bladder-bowel-care/ Expressing for poop is the not health issue bladder expressing is. Poop expressing is easy, you don't need a hands on lesson. Watch this video:
Expressing for poop is so that before mother nature would just let it plop out anywhere, you get there first to encourage poop to clear from the digestive tube to plop out where you desire. Most of us express on the toilet: upon awaking in the morning, maybe at 1-2 pm during the day and again before bedtime. First you should make a chart of eating, poop plopping times and try to figure out when you should be expressing. PT at home Sometimes those vet visit go so fast with alot of information to keep in mind. You may like to see which exercises were explained and get a refresher on doing them for Hector: 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: |
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Post by Greg & Hector on Jan 2, 2023 18:02:03 GMT -7
Hi Paula,
Thanks so much to you and the other admins and moderators for this forum. It's been overwhelming going from never having even heard of IVDD this time 10 days ago to thinking about nothing but it. This site has been a good resource, and it's especially heartening to read about all the success stories!
Thank you for the videos on PT and poop expressing! I have already put the latter to good use! We are following many of the exercises from the PT video as well. We think his hind legs are getting a little less stiff, but it's difficult to say.
Shortly after I posted, Hector ate some more pulled chicken. He still kind of ate around the kibble. Part of me suspects that he liked the hospital food better and is turning his nose up at his normal food, so to speak. A while later, Hector started to sniff at his butt. We brought him out of the crate, followed the technique in the video, and voila - poop! He also drank some more water after that, which I was happy to see.
If the reluctance to eat kibble continues, I will definitely talk to the vet. My girlfriend reminded me that Hector did eat kibble yesterday and the day before, but we are trying to keep him on a relatively steady schedule. We are putting the food in his rest area for 2-3 hour windows and removing it if he doesn't eat in order to avoid a late night/early morning surprise. So we may not be synced up with his "hungry time" yet. I do feel like he has appetite because he eats the chicken and some treats.
During the above-mentioned bathroom success, we also noticed that Hector's tail bobbed in sync with his anus puckering and unpuckering as he moved the poop out. We haven't really seen him defecate too many times directly since surgery, as it's mostly been happening in the crate. This tail action was enough to get us a little excited, but we aren't sure if this is just reflexive with defecating or not. However, we have also noticed just tonight that his tail has gotten back some of its normal curl and seems a bit firmer rather than limp when we move it. So we hope this is a good sign.
In terms of his suite, we have a dog crate that is long enough for him to lay straight across in. He can also turn himself around. Hopefully he will stand up in the next few weeks, which the crate should allow for. In terms of maintenance, we are using pee pads and waterproof mattress to keep it clean. When Hector has an accident, we remove him and wipe him down with wet wipes and replace the pee pads.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 2, 2023 18:31:55 GMT -7
Hector, love it, you've already had success in poop expressing! You will definitely soon be pros in the bladder expressing department also. Understanding the disease Hector was born with will help in living many happy years ahead with him and better understand the things the vet tells you. Check out this 10 min presentation on IVDD: Shortcut Thru IVDD
No doubt about it, it is difficult to decide what movements are automatic reflexes or if brain directed. 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. EXAMPLES: --- 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 or leg movements during potty time can often be a reflex --- Itchy sensation at neck and then tries to scratch with hind paw would be purposeful movement. --- Tickling paws etc. cause reflex leg movements of pushing in or out and are GREAT for your at home PT. They are demoed in the PT video in prior post. |
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Post by Greg & Hector on Jan 2, 2023 18:58:40 GMT -7
Thanks, Paula. I also realize I missed your question before. The surgeon said that he will let us know about next steps at our two-week followup, but he previously indicated 6-8 weeks of crate rest would be likely. So I’m not sure exactly how long Hector’s tenure in the crate will be just yet. Overall, he has been pretty good about crate rest.
We did notice that Hector occasionally looks back at his tail and stares at it, almost as if he feels it but maybe doesn’t fully control it. We’re hoping this is movement in the right direction!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 2, 2023 20:12:35 GMT -7
Hard to know what looking at tail means. If you touch his tail, then do you see a head level involvement of: turning head to look at tail?
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Post by Greg & Hector on Jan 3, 2023 5:55:39 GMT -7
[6:00am]
It’s a bit hard to tell. He definitely has some sensation in his butt, so I’m not sure if moving his tail triggers that or the tail sensation.
One question about bladder expression. I tried to do it this morning when I woke up but was not able to get any urine out. We were able to get a decent amount at 10 PM last night before bed. Is this a concern? I don’t think he drank much water in the night. His pad was dry this morning.
Thank you!
[9am ] Edit to add: I tried again just a bit ago and was way more successful (got a lot of urine - his bladder was certainly not empty). We think maybe he’s just more tense in the morning.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 3, 2023 10:17:07 GMT -7
Greg, could the muscle tenseness be related to pain?
--- When was the last pain med gabapentin dosed last night?
--- When was the next morning gabapentin dosed?
--- What is your current gabapentin dose in mgs and how often do you actually dose?
-- Pain med are effective for about 8 hrs.
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Post by Greg & Hector on Jan 3, 2023 10:52:13 GMT -7
Hi Paula,
We are doing 100 mg Gabapentin every 12 hours. Last night he took it a little after 11 PM before I went to bed. So this morning’s dose was about 12 hours later.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
19 lbs 4 y.o.
Carprofen as of 12/25: 37.5mg 1x/day
traZODone 50-100 mg 3x/day
Gabapentin 100 mg 2x/day]
He wasn’t giving any signs of pain otherwise, but this was around 7 AM, so it’s possible it could have been starting to wear off.
Side note: He did eat some kibble this morning after the failed bladder expression without any rotisserie chicken appetizers, which was good to see. Later today at lunch, he also barked at me as I ate some pizza for lunch (he always barks for pizza), which was nice to hear. So I’m becoming less concerned about his appetite.
Just hoping for that tail wag sometime soon!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 3, 2023 15:38:12 GMT -7
Greg don't be chinzy on the gabapentin. The temporary pain caused by the surgery can last for about 14 days. So better to assume pain and give the gabapentin every 8 hrs to be assured Hector is in the comfort he deserves while healing.
Excellent to hear his appetite is getting back to normal!!!
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Post by Greg & Hector on Jan 4, 2023 7:37:04 GMT -7
Hi Paula,
Noted. We are doing the ▲Gabapentin about every 8 hours.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
19 lbs 4 y.o.
Carprofen as of 12/25: 37.5mg 1x/day
traZODone 50-100 mg 3x/day
Gabapentin 100 mg ▲3x/day]
I’m still having difficulty with expressing him. Yesterday morning, I couldn’t get it around 7 AM, but was successful at 10:30 AM. I tried again at 4:30 and 7:15 with no luck. Finally at 10 PM I got some. But I checked his pee pads again around 11:15 they were wet. So I expressed him again and was successful.
This morning, I’ve tried three times over four hours already with no luck. It’s getting kind of frustrating and stressful. Sometimes it comes easy and I feel like a pro. Other times it feels impossible and I worry I’m hurting him.
On the poop front, he didn’t go at all yesterday despite eating pretty well and me trying to massage his anus as in the video you shared. I tried again this morning, using the ice cube method I read about on another forum. This did work, but I’m concerned that it was nearly 36 hours between poops.
On a positive note, Hector is continuing to eat well.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 4, 2023 8:49:22 GMT -7
Greg, what prevents "promptly/on time" giving gabapentin every 8 hrs rather than "about ever 8 hours"?
Could you try: specifically do some happy talk and then see if the tail/butt does some wagging/wriggling.
The reason is: After happy tail wag function returns, the next function would be bladder control returning.
Either you are still in need at some sessions more expressing practice to be consistently a pro..... Or MAYBE some degree of bladder control MIGHT be now coming back. When that happens a dog will not like you expressing and resist.
How about doing the SNIFF and PEE test so we can figure out if bladder control is starting to come back.
SNIFF and PEE
The only way for humans to know if there is bladder control is with the “sniff and pee test.” Carry outdoors, set them on an old pee spot to sniff. Make sure the sling or your hands are not on the tummy area as that can press on the bladder.
See if they will release urine on the old urine area.
If urine comes out after sniffing, bladder control is returning.
You should continue to do a quick express check to verify there is full voiding until you are certain it is consistently happening. Let us know what you observe.
REVIEW 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.
Don't you just love how we ask a lot of questions? LOL You are our eyes and ears to know what's going on at your house.
What does the 36 hour poop look like? normal firmness? Or too hard (constipated)? If normal firmness, wouldn't worry too much as poop is not a health issue. The body CAN push out the poop on its own. Your expressing is just for convenience to make it plop out when/where you chose.
Good to hear Hector continues to have a good appetite!
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Post by Greg & Hector on Jan 4, 2023 9:32:18 GMT -7
[1/5 at 9:32am]
Hi Paula, We are adjusting [to Gaba 3x/day] from the 2x 12 hour schedule. So yesterday I gave it to him at the normal time (around 11 am) and then adjusted to 7 PM last night. Ideally he would have gotten it at 3 AM today, but we ended up doing closer to 6. So now we’ll do 2 PM this afternoon, and 10 PM tonight. I think this will work best for our schedule. I don’t think he’s in any pain though (other than maybe sick of me squeezing on him to go pee!)
Tried the happy talk and no wag, sadly. He did perk up, so I know he was excited.
I took him out to a normal pee spot. He did sniff around but didn’t pee.
However, I was able to express him out there and got what seemed to be a lot of urine out. It felt like I was pressing for a pretty good amount of time until the stream ended. So I think it was still a success! At the very least, I don’t have to think about dog pee for several hours.
The poop seemed pretty normal to me. I was just getting worried as the delay from the last one seemed abnormally long. We tried to coax him to go last night with the techniques and failed. I was certain I’d wake up to a mess today, so I got a little anxious and when I did.
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Post by Greg & Hector on Jan 5, 2023 6:18:31 GMT -7
Small update from [1/4]last night:
When my girlfriend and I got back from the gym, Hector seemed eager to want to come out. We brought him out of the crate to try to use the bathroom and he pooped right away. I’m wondering if he does have some bowel control and was trying to hold it to avoid a mess in his crate. This was around 7:15. He had eaten around 4:30, so it may have just been good timing.
Also, we are pretty sure we saw him pull his back right paw back while either asleep or just starting to wake up from a nap last night. It may have been reflexive, but it was the first time we’d seen it move without being pinched.
Overall, still having a hard time with bladder expression. After the 11 AM success yesterday, I tried three more times unsuccessfully. Finally we got some around 11:30 PM last night. I tried again today at 7:30 and got nada. This is similar to the day before. I’m starting to wonder if this is just the schedule we’re going to be on. His pads have at least been mostly dry.
Appetite continues to be good.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 5, 2023 10:38:26 GMT -7
Greg, watch for leg movement when you definitely know he is sleeping.
Humans need to see some sort of head level involvement with any tail, bladder or limb movement to know it is brain directed. Reflexes can make it appear a dog's brain is controlling movement.
Reflexes can appear to be the brain doing it. However "appear" is not the needed proof positive we must have. Look for some head level action (dreaming, turning to look, hearing, smelling, etc.) to go with a movement.
Examples:
-- Dreaming (head level) + back leg movement = brain directed nerve function.
-- waking up (no obvious head level involvement) + back leg movement can likely be reflex.
-- Sniff (head level) + release of urine = brain directed nerve function
Two health reasons to continue to express the bladder until you have proof positive (Sniff and pee test):
The body has a safety feature built in if bladder control is lost. When a bladder is overstreched and filled with urine, reflexes will allow some urine to escape (called overflowing bladder). Why an owner needs to manually express the bladder:
1) Avoid permanently ruining bladder wall tone with constant over stretching the detrusor muscle. Then when the brain can again connect to the bladder, it may not be able to work properly.
2) Urine in an overflowing bladder not removed will quickly become a breeding ground for a urinary tract infection (UTI) in a matter of days. Infection is a danger if not promptly treated with an antibiotic.
So keep your normal every 4-6 hrs of expressing to make sure his bedding is staying dry. If not staying dry express more often ( every 3-4 hrs.) Bedding staying dry means that bladder is not "overflowing because you are expressing often enough."
Try to get proof of bladder control. Do the "Sniff and Pee test" when you know Hector should have to pee. Take him outdoors, let him sniff and see if he pees. If not then you express his bladder. If you are NOY to able to express any urine out. Then try again in 1-2 hrs.
Poop is a different thing. The body's reflexes will push out all the poop. So there is no danger as with urine of getting a bacterial infection.
When a dog has bowel control, it means they are able to stop the body from pushing out poop. They can hold it in until at an appropriate place. No dog want to poop where they sleep unless they simply have not been let out in a timely manner or if they do not yet have bowel control.
Hope this info will help you to zero in on observing Hector's movements and for you to figure out what going on with bladder control.
Your neuro appt 1/11 for staple removal will be interesting to have your neuro surgeon's current assessment of Hector's neuro function.
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Post by Greg & Hector on Jan 5, 2023 11:05:09 GMT -7
Thanks Paula. I’m actually taking Hector to our regular vet this afternoon to help with expression and hopefully get another lesson. I’ve tried several times today and haven’t gotten anything, which is concerning since he has urinated since we successfully expressed him around 11:30 last night. The bedding was dry today, so I don’t think he has overflowed.
We’ll continue to keep an eye out for movements. I was hoping we’d have some more signs by now since we’re about a week out, but I understand there is no set schedule.
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Post by Romy & Frankie on Jan 5, 2023 14:13:21 GMT -7
Getting another lesson in expressing from your vet is a good idea. Learning to express can be tricky. Before my dog regained bladder control after his surgery, I had to go back to my vet's office more than once before I became proficient. As you practice, you will get better at expressing. After that, caring for Hector will be much easier.
Also, keep giving Hector the opportunity to sniff and pee. That way, you will know if bladder control is starting to return.
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Post by Greg & Hector on Jan 5, 2023 17:56:29 GMT -7
Thanks, Romy and Frankie! Nice to meet you.
The vet gave me some good tips. It was actually pretty easy to do at the vet because Hector’s bladder was very full at that point. I’m not convinced I’ll be able to do it consistently yet. Apparently male dogs are a bit tricky when they don’t have full bladders. Hopefully their advice helps…otherwise that was an expensive pee!
We have a wag! When we came back into the apartment tonight, Hector greeted my girlfriend and I with a wagging tail and a friendly hello bark!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 5, 2023 18:13:29 GMT -7
Greg, now we know with that happy tail wag for sure the next neuro function to return will be bladder control. It may be starting to return or you may need to give Hector more time to self this function. Do the sniff and pee test periodically to give Hector a chance to show you any new nerve repair.
Would you be able to share the expressing tips you learned about. It may help another member.
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Post by Greg & Hector on Jan 5, 2023 18:31:34 GMT -7
Hi Paula,
The advice is a little specific to Hector. Basically the vet said the best place to put my hands was even with his last staple. He also demonstrated the hand shape - basically holding them in a prayer position on either side of the belly even with said staple and squeezing inward and toward the rear. We’ll see if this helps me as I think Hector’s bladder was pretty full at that point and much easier to express. The vet also said that expressing twice a day may be fine for Hector as he is not a “heavy drinker” (even before he fell ill).
We will definitely start to try the sniff and pee test. Hector isn’t really wagging now, even with happy talk. It seemed to coincide with his excitement at us coming home. It was the first time he has greeted us like that since all this began and a joy to behold! So we’ll take it for now!
Update for 1/6: I was still having difficulty expressing Hector today and getting nervous as it was nearing about the 21-hour mark since his last pee. I decided to give going outside another shot and brought his sling with me. It felt like a long shot after several other attempts, and so I planned to call the vet right after what was bound to be another disappointment.
This time was a little different. After I placed him by his normal tree marker, he sniffed around as usual, but the sling gave him a little extra freedom to point us in a direction of his choosing. He led us down the sidewalk to one of his many old pee spots (my complex has a ton of green space), dropped down, and…yellow gold! I had taken him outside earlier, but maybe I just needed to give him a little bit more range to find the preferred spot.
I’m so happy he’s showing signs of bladder control, but I don’t want to overdo it in the sling. He led us about 100 feet and then I just carried him back to the crate. Any tips or advice on this?
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Post by Romy & Frankie on Jan 6, 2023 15:17:58 GMT -7
Good news that Hector was able to sniff and pee! It would be a good idea to give a quick express check after he goes until you are sure he can completely empty the bladder on his own. Often when dogs start regaining bladder control, they object to being expressed. In this case, just give him multiple opportunities to go outside.
Twice a day may not be enough during this time as Hector is just regaining bladder control.
We usually see happy tail wagging as a first sign that nerves are starting to heal. Since Hector is regaining bladder control, we already have a sign that his nerves are healing.
You are right to be concerned about the risk of too much walking while trying to find a potty spot to Hector's liking. One idea to try is to place a paper towel with his own or another dog's urine under a rock or something on a spot you think he might like. Then carry him to that spot. The scent of the fresher urine might encourage him to go with less walking. I did something similar to this to get my dog to use a pee pad during his crate rest. |
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Post by Greg & Hector on Jan 8, 2023 15:50:07 GMT -7
Hi all,
This has mostly been a positive weekend. Hector peed on his own on Friday afternoon and Friday evening. On Saturday, he went multiple times. He's also been wagging his tail a bit more, especially at people outside on our potty breaks.
Today has been a little more mixed. I tried to take him out around 8 AM morning. He meandered a bit but never really settled down and did not pee. So I brought him back inside, mixed some water with his kibble. We tried again around 9 AM. I took him to the spot we used Friday and all day Saturday. Same story. However, I took him to a different old spot and he did end up going.
We tried again about 6 hours later around 3 PM. It was much the same story as 8 AM. He meandered but never went. We came back in and he drank some water at that point, so I tried again around 4 PM. Again, no pee.
So for dinner around 4:30, I mixed more water with his kibble, which he finished he immediately. We just tried now again around 5:30 and still nothing. I did try to manually express him while we were outside, but I didn't have any luck. Rather than just taking him out every hour, I'm going to try again around 8:30 or 9 and maybe give him time to settle a bit more. I don't want to overdo it in the sling by taking him out too much. It doesn't seem like he's really trying to go. After seeing him go several times this weekend, I'm convinced he can. So maybe he doesn't. He did at least poop while we were outside (although he cannot squat as his back legs are still powerless). Not sure if anyone has any suggestions/advice on this?
Overall, I feel like we've seen quite a lot of progress since that first tail wag on Thursday. Bladder control seems to be back, although today hasn't been quite as productive as yesterday. He continues to be pain free as far as we can tell.
Finally, our Carprofen from the neurologist runs out today. We have our follow up on Wednesday (exactly two weeks post surgery). I do have some additional Carprofen from the initial ER vet visit. However, the instructions on the neuro's RX was to give until finished. I'm not sure if it's worth asking the neuro if we should continue to give this to Hector?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 8, 2023 16:20:33 GMT -7
Greg, if Hector's bed stays dry until such time as he goes outdoors to pee, then sounds like he has bladder control. Control to hold in the urine till outdoors. Why he is not peeing every 4-6 hours, I don't know. Is he drinking a normal amount of water for his body to process into urine?
Does the urine have a different color or a different smell? Some urinary tract infections (UTI) won't show us signs of change in color, or smell. A UTI can be painful on urination. It burns and a dog will likely not want to pee as often. Discuss with your vet if he thinks a urinalysis is something to consider to see if there is a bacterial infection developing.
The temporary post-op painful swelling mostly takes around 14 days to resolve. Hector is close to that marker. Stop the carprofen as directed by your Neuro with the dosing ending today. Observe if any discomfort would arise where he may need it a few extra days. Otherwise if you see no pain, there is no reason to give carprofen.
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Post by Greg & Hector on Jan 8, 2023 16:37:28 GMT -7
Thanks, Paula. I haven’t noticed any unusual odor or colors with his urine. His bedding has stayed dry the last several days, so there hasn’t been overflow.
I do feel Hector is not a heavy drinker, even before the IVDD. It would be normal for him to only pee three times a day (and even then, one was usually a very short pee). Yesterday almost seemed normal in that regard!
That said, it seems he may be drinking slightly less since coming home from surgery, but he does still seek out water occasionally. I also having been mixing water into his kibble, which he seems to enjoy because he takes it immediately. Prior to surgery, he would just sort of graze at his dry food until he was hungry enough to finish it. So I feel he is at least decently hydrated compared to normal.
Noted on the Carprofen. We also have Gabapentin, but the instructions are “as needed”. I planned to continue to give that and the Trazodone until we see the neuro on Wednesday.
Update: Hector peed on his own around 8 PM. He didn’t seem to have any difficulty. I might added just another part water to his kibble tomorrow just to make sure he’s getting as much water as he needs.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 9, 2023 9:33:10 GMT -7
Greg, good to hear Hector did pee. Hydration is important for many body functions. So not a bad idea to ensure bysoaking kibble or adding extra liquid to a dry kibble serving.
---- Make some onion free, no salt, no fat meat broth. Simmer up a chicken part or a hamburger patty in enough water to cover. When cool, remove fat disc at the top, any skin or bones.
---- Poor over kibble or soak kibble to add extra yumminess to his meals.
---- Freeze into cubes as a treat for Hector to lick on (will take him longer to consume vs. lapping up liquid).
Look forward to learning what the neuro says this Wednesday, 1/11!
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Post by Greg & Hector on Jan 9, 2023 18:57:54 GMT -7
Hi Paula,
I will definitely report back on the results of the neuro follow up. While we still have a ways to go, I'm excited to report our progress to the neuro and figure out the next steps!
Bathroom has been a bit more consistent today. He went out at 7:30 AM peed on his own, 2:30 PM pooped on his own, 5 PM peed on his own, and just now at 8:30 PM and peed on his own. So I'm feeling pretty good about this bladder control! He seems to enjoy being outside in the sling for pottybreaks, even if it's just a couple minutes to sniff around for a spot. I can tell it definitely wears him out though as he usually seems exhausted afterwards.
When doing ROM exercises, I'll occasionally pinch the webbing between his toes, causing his leg to sort of relax. I understand this is reflexive and not intentional; however, tonight it felt like maybe he was resisting the ROMs just a little. I'm not sure because it was very subtle, but it felt a bit different than normal. I also think I caught him readjusting his leg when either napping or almost-napping. I am hopeful that we will have more progress.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 10, 2023 10:28:48 GMT -7
It is good to hear his reflexes are better to now be able to resist. That makes those exercises of tickling the paws for a reflex reaction better for muscle toning!
For sure if you want to know if the brain directed some movement you will need to observe if at the same time the paw, the tail, the bladder did something you also observed head level involvement (sniffing, hearing, seeing, dreaming). If a head level involvement (where the brain is also located), it means the brain could successfully have its message travel down the spinal cord to the tail, the bladder, the leg.
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Post by Greg & Hector on Jan 12, 2023 13:38:47 GMT -7
I just wanted to give an update after Hector’s neuro followup [1/11] yesterday.
The neurologist was very pleased with Hector’s progress so far. He showed us evidence of voluntary leg movement. He demonstrated this by supporting Hector by the base of his tail and letting him walk. We could see his back legs moving with his front. The issue is that Hector still does not have good proprioception and so cannot balance himself from side to side, so he still tumbles over without support.
The good news is that the doctor is very confident this will return over the next several weeks. He said Hector may not be 100% where he was previously, but he fully expects any remaining deficits to be relatively non-intrusive. We will have another follow up in about 6 weeks.
In the meantime, Hector will remain on limited activity for the next two weeks. At that point, we can slowly reintroduce him to low impact activity (short leash walks, walking around the house but still crated when unsupervised). If doing well by
8 weeks post-op (2/22), we can reintroduce him to normal life with moderate restrictions (avoid high impact play, minimize stairs and jumping).
Overall, it was a very positive exam and the doctor is very optimistic about Hector’s recovery.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 12, 2023 16:33:34 GMT -7
Greg, so happy to have the neuro confirm voluntary back leg movement. And that he can do a walking motion when he does not have to fight gravity (supported by a sling). That sling walking in the house and some at potty time will protect him from falling, yet give him needed walking practice/exercise!
When you observe his paw is knuckled under, when possible you can help his brain/muscles understand the correct position by righting it for him.
Thank you for sharing such a wonderful report.
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Post by Greg & Hector on Jan 31, 2023 16:17:36 GMT -7
Hi,
Just wanted to provide a quick update since it's been a few weeks! Hector continues to improve. About two weeks ago, he started to stand a bit while eating. He steadily showed signs of gaining proprioception, such as holding his stand, starting to catch himself as he would fall, and readjusting his back paws and legs for balance when he began to slide. He even managed to get away from him a couple times by walking on his own (although he won't be winning any runway modeling competitions).
This past Friday [1/27], after several weeks of harness walking/supporting him by the base of his tail during our bathroom outings, I felt he was ready for the leash. That's been going very well. He walks on his own to his pee spot and also seems to be improving in his ability to squat when he needs to defecate. He still is a bit shaky on his feet, but I feel his balance is still improving. For example, he'll shake rain/snow off his coat and not fall over, make turns, and he maintain a relatively strong stand as he watches the world around him.
The vet did say that two weeks after the 1/11 follow up, we could start [1/25] to slowly increase activity. I'm a bit nervous to do too much, but we'll walk around my complex for 5-10 minutes during potty breaks. This seems to make Hector very happy and doesn't seem too intense as we normally stop for plenty of sniffs. I'm hoping we can increase this to maybe 10-15 minutes over the next week or two.
We'll have another neurologist follow-up on March 2, about a week after his 8 week crate rest ends. At that point, we should be slowly reintroducing Hector back to normal life, with some restrictions on things like stairs, jumping (this will be tough), and rough play.
All in all, I'm extremely pleased with Hector's progress. It's hard to believe that this time 5 weeks ago, I was driving from Maryland's Eastern Shore to Pittsburgh with a paralyzed dog and no idea what the future was going to hold. Even the bladder expression issues from earlier this month seem like a distant memory after all his progress. We're not out of the woods yet, but I wish I could send a message to my past self to "RELAX!"
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