Marcia's Bennie 8/10 conservative heart NECK; GRAD 10/5

M, welcome.  I'm Paula what's your name? No wonder you are beside yourself...so much new to learn, routines to establish and figuring out which vet knows what.  You have come to the right place to quickly get up to speed on the things you need to know about.

1. Only a board certified specialist (Neuro ACVIM) or (ortho- ACVS) are qualified to tell  you if/when a surgery can be a consideration. So if your budget allows, PHONE- followup asap now, first thing in am.  Hours matter in getting to surgery. If surgery is not an option whether financial or if specialists says heart would be an issue, then know Conservative treatment is the best option!
    Find and call specialist to get in tonight
        1) Find an ACVIM board certified neuro surgeon:
vetspecialists.com
        2) Find an ACVS board certified ortho veterinary surgeon:
online.acvs.org/acvsssa/rflssareferral.query_page?P_VENDOR_TY=VETS

This chart is to help you zero in on where Bennie is neurologically. You have reported conflicting information so at present, so don't know where Bennie is currently on this list with front and back legs,  bladder control.  I've √'d what appears you wanted to report. Please correct if marked wrong.... Also....If She still has bladder control THEN SHE HAS DPS!
MONITORING NEURO FUNCTIONS
As damage to the spinal cord increases, there can be a predictable stepwise deterioration of functions due to excessive back/neck movement for example.
1. √8/10 Pain with initial tear of disc and ensuing swelling
2. √8/10 F&R:Wobbly walking
    √8/10 F&R: legs cross
              √ 8/12 frnt legs do not cross
3. √8/10: Nails/toes scuffing floor
4. √8/10 F&R: Paws knuckle under.
            √8/12 left frnt paw can now right itself 👍🏽
            √8/12 rear paws knuckle
5. √8/10F&R: Weak/little leg movement,
    √8/10   R: can't move up into a stand
6. √8/10   R:  Legs do not work at all (paralysis, dog is down)
7.  ____   Bladder control is lost. Leaks on you when lifted? 
                Can no longer sniff and then pee on that old urine spot outdoors?
8. ___  Tail wagging with joy is lost
9. ___  Deep pain sensation (DPS), the LAST neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. If surgery is not an option (for whatever reason) then the best option is conservative therapy.
    Surgery can still be successful in the window of 12-24 hours after loss of DPS. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance.
    Precious hours can be lost with a general vet who gets DPS wrong.     Trust only the word of a neuro (ACVIM) or ortho (ACVS) surgeon about DPS.
  
This page is for you:  A quick overview of conservative treatment vs. a surgery:
dodgerslist.com/2020/02/10/surgery-vs-conservative/

BLADDER CONTROL
If Bennie can sniff an old pee spot outdoors and then release urine, she has baldder control and does not need you to manually express her bladder www.dodgerslist.com/2020/05/05/bladder-bowel-care/
    If you find leaks in bedding or leaks on you when lifted, she needs you to express her bladder. This is a health issue to prevent UTIs. Go in for another lesson tomorrow.

SLING
Use both a front end sling and rear sling to save your back and keep her body from tipping over.
  1) DIY sweatshirt sling...can be used for front or the back legs. Use same concept with cut out leg holes in a long strip of towel: www.lyonpuffpetsit.com/htmlslp/sling.html

2) DIY figure-8 sling:
 
   POTTY TIME OPTIONS
    1.  Place a pee pad adjacent to her recovery suite. This way you only need lift and carry her to the pad.  Scent pee pad with some of her old pee or another dog's pee to encourage her that it is ok to pee in the house!  Command "go potty" and when she releases urine praise her so she knows the pee pad was an OK place to go.
   2. If you can, safely for your back and for her, carry her to an from an outdoor potty place that would be the best to confirm if she still has bladder control.  Relax the sling near her belly so it is not pressing/expressing urine when you are observing for a sniff and then a urine release.

LIFT and CARRY (support both ends, keep back horizontal to the ground)

Marcie, EXCELLENT info about neuro function return of one front paw to no longer knuckle under as of Sat 8/12. The detail of date, body area is important with communications. Which front paw (left or right) no longer knuckles as of Sat 8/12?
    There is no need for you or any DVM vet to be doing the pinch test. Bennie could not right one of her front paws, she could not attempt to move up into a front leg stand if she did not have deep pain sensation (DPS).  Only a specialist would do the DPS hard toe pinch if he could not observe any neuro functions. Bennie HAS neuro functions!  Avoid tickling her paws, pinching toes or skin between toes.  Avoid things that can cause too much movement of the neck/back. When off of all meds and you have proof of no pain, then we can share with you the safe way to do some least aggressive range of motion for Bennie.

SNIFF and PEE
The "sniff and pee test" is the only way for humans to determine whether bladder control exists. Carry the dog outdoors, set her down on an old pee spot for a sniff. Make sure that neither the sling nor your hands are on the stomach region as this could put pressure on the bladder. If urine comes out after sniffing, bladder control exists. Tell us what you observe.

MEDICATIONS
How much does Bennie weigh?
Carprofen rx'd  Thurs 8/10 is to be given for how many days?
PROTECT Bennie's GI tract with a GI tract protector.  Read, learn, and advocate for.   Three reasons Bernie needs protection and more detail here :   www.dodgerslist.com/2020/05/06/stomach-protection/

PAIN
Is any pain surfacing nearing next dose of the two pain meds (gabapentin ever 12 hrs, methocarbamol every 8 hrs) or when attempting to move? Pain meds are effective for 8 hrs.  Have no patience if there would be pain.  Phone vet to avoid a risky to the disc car transport. Vets who know IVDD understand the need to maintain STRICT rest and handle things like med adjustments over the phone.

Marcia, thanks for filling in many details!  

Please, verify she is not getting a bath. Baby wipes, etc, can be used to clean skin/fur. Baths are too dangerous for the healing disc. 
TiP  To quickly clean up urine/feces, use unscented baby wipes.

Marjorie's tip: Brew up a pot of decaf green tea. Let it cool. Then use a tea dampened washcloth to gently wipe belly and legs. Tea is mild with acidifying, antibacterial properties. It neutralizes urine on skin and fur to avoid urine scald rashes. Store tea in fridge and slightly warm before use.

Add a hand sprayer to white vinegar bottle to disinfect. Vinegar removes the urine ammonia smell from floors and fabrics. 

RECOVERY SUITE now, today 8/13!!
There is only one way to assure the disc will have  a good opportunity to heal. ALL DOGS do the unespected in a blink of an eye, even paralyzed dogs! The suite is their protection. Lots of ideas and tips on setting up the mattress system and other things to make the 8 weeks of rest go smoothly.  dodgerslist.com/2020/05/14/strict-rest-recovery-process/   Let us know which type of recovery suite you have Bennie in now (baby's Pac N Play, wire crate, wire 8-panel ex-pen)? 

There is only one very particular way to communicate about bladder control or no bladder control.
    We need for you to be able to observe, when you carry her out to the potty place, that you see with your eyes she as sniffed. And then you see she has released urine. Can you do the sniff and pee test outdoors today? It is important to know ASAP for health reasons if she has lost bladder control.  Give her a drink and wait an hour or so when you know she would have to pee, then give the Sniff and pee test.
     You could do the test on a pee pad adjacent to her suite. Use another dog's urine or some of her old on a paper towel set on the pee pad. See if she sniffs the old urine spot and then releases urine.  The words "Peeing on her own" does not confirm anything.

REFLEXES or 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 and not reflexes.
--- Sniff (head level nose) on an old pee spot, then release of urine would be brain directed and indicate there is bladder control
    ⚠️ Just a release of urine may "appear to be peeing on their own"  or a reflex action if bladder control has been lost.
        Reflexes can allow a bladder to OVERFLOW. The problem is reflexes release some but not all urine. Bacteria can very quickly infect the bladder (UTI).  Please let us know Bennie is not overflowing in her bedding.  Let us know whether she can pee by you observing for the sniff and then a release of urine.
--- Hear (head level ear) you doing some happy talk and then tail wags is brain directed. Tail or iimb movement during potty time can often be a reflex.

PAIN
Phone vet today and get pain meds adjusted!
Sounds as though Bennie is in pain nearing next dose of pain meds.  The anti-inflammatory drug Carprofen may take 7-30 days to resolve all the painful inflammation.  It is the ACTUAL pain meds (gabapentin and methocarbamol) which give comfort til Carprofen can finish the work of ridding of inflammation. Gabapentin lasts for 8 hrs, Rx has her only taking it every 12 hrs.

HOMEWORK
With any STOP of carprofen, it is always good to have worked out in advance a "PLAN B" should pain re-surface at night or on the weekend when your vet is not open. Could be an emergency RX script you could fill at local 24 hr pharmacy or some extra pills at home til the vet opens again. An ER visit is very expensive, a "Plan B" is free!
    Read up on how carprofen is used during a disc episode. You will need to be prepared days before Thurs 8/24 Carprofen STOP date and as well, we'd like to know what Plan B you and your vet have decided on. Here is the link to get up to speed on carprofen, Plan B, why stopping OR backing off of pain meds on,  8/24etc.     ==> www.dodgerslist.com/2020/04/18/steroids-vs-nsaids/

Marcie you have not given proof of having bladder control, the abilty to "pee". I'm worried if she is developing a bladder infection and needs an antibiotic. This is serious and needs to be sorted out if she can sniff and then release urine.
   Reports of no dribbling or leaks when moving her do sound promising she may have bladder control. Save some urine on a paper towel in a ziplock bag. Can you set up a urine scented paper towel on the pee pad and when you believe she must have a very full bladder and need to release urine, do the sniff and pee test on the pee pad.  Or better if you can do it outdoors in the am where you could use another dog's pee for her to sniff or her own urine?
   If a dog has control AND needs to release urine it should only take a couple of minutes.

TERMS
"Peeing" is when the brain directs urine to be released
"Overflowing" is when the bladder is filled to capacity, reflexes kick in to release some urine. The brain is not able to command the bladder to release urine. A reflex is not something one need to think about. Such as touching a hot  stove, you don't think, reflexes automatically kick in and you draw back. 

Marcia, job well done. And wonderful way to report confirmation of "peeing" aka bladder control....you saw a sniff and then a release of urine!!!
What a relief to know Bennie won't be likely to get a UTI. Of course timely emptying of the bladder is always a help to keep UTI's away. May her lengthy intervals of peeing be reduced by an approach to a more normal every 4-6 hrs. How about continued use of the "urine scented" pee pad piece everytime you either take her outdoors or on a fresh pee pad near her bed? Prednisone affects her immune system's ability to fight off infection/bacteria, so that is the reason to encourage peeing a bit more often now.

This is very good news, Marcia. Happy to hear it.

Update!

⚠️  ⚠️   ⚠️

As of today. 09/29/2023 Bennie is much recovered!
She stopped knuckling in all 4 legs  [±9/15] about 2 weeks ago, and is walking well with the aid of a sling since last week (at first she would tire quickly, but she has gained a lot of stamina and strength since we started using it). Today, she stood to a half-crouch from her bed and walked unassisted for about 12’ all on her own, and even corrected herself from falling over twice.

She remains weaker in her back right leg than in any of her others, and is wobbly on her own, but she is now strong enough to walk around with the sling support without getting tired for close to her usual yard-roaming time.

Thank you for all the advice given during her initial stages. It was such a scary time for me, and I desperately needed the help you provided.

The vet believes she’ll be able to regain full normal mobility within the next month, and I’ll be checking into physical therapy for her to help her do that. Thanks again!