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Post by Sarah & Lou on Dec 4, 2023 15:18:23 GMT -7
[Original subject line:5 WEEKS POST OP IVDD SURGERY ]
★1 My dog Lou weighs 19lbs. He is a standard. Currently on Gabapentin, methocarbamol, trazadone. I apologize as I do not have the dosage. Meds are done at every 8 or 12 hours every day.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
19 lbs 4 yrs
as of Oct 31, 2023:
Carprofen, stop date?
gabapentin ?mg ?x/day
methocarbamol ?mg ?x/day
trazadone ?mg ?x/day ]
GABAPENTIN, METHOCARBAMOL, TRAZADONE
UNSURE OF DOSAGE AS I AM NOT AT HOME
MOST MEDS ARE 2X A DAY (EVERY 8 OR 12 HOURS)
STARTED 10/31
★2 My name is Sarah. My dog's name is Lou. He is a standard dachshund. He is 4 years old. ★3 He was diagnosed with IVDD on 10/30. -- DVM, surgeon. Does not specify if she is a specialist on the site. ★4 10/31 was surgery at emergency vet. ★5 Some muscle spasms on sides, we addressed a week later after surgery when this occured. Not in any pain since being on the methocarbamol. ★6 Eating and drinking OK? Eats and drinks just fine. But still incontinent. ★7 No tail wagging, no walking, excitement is within his upper half with happy talk. ★8 He is still incontinent and we are having to express his bladder or change his pee pad.
My dog is currently 5 weeks post op from surgery. He had a ruptured disc, and one that was about to rupture, both repaired. Surgeon noted bruising on spine at the time of surgery. We took him in a couple of hours after we noticed his head being held up high and his walking was wobbly.
Today in therapy, he did not have any deep pain sensation, where previously he did have it and it was shown in his pupils as they dilated. However, therapy tested for DPS, where before it was the surgeon. He has been going to therapy weekly (water therapy, laser treatment). We are starting acupuncture later this month and also signed up for additional time with therapy.
He currently is in a laundry basket with me at all times (at work), and at home he is in his crate in our living room, or in my daughters old pack n play in our bedroom. We have used the harness to take him out to potty but it's hit or miss.
On Saturday evening, I failed to secure the crate door and he [12/1] managed to drag himself about 7 feet to where I was. I turned around and noticed him and quickly but safely picked him up and returned him to his crate. He is so eager to join his other doxie brothers (we have 4 in total).
I am hoping to hear success stories with similar situations.
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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 4, 2023 19:29:14 GMT -7
Sarah, welcome to the Forum! 5 weeks is not long when it comes to the slowest part of the body to heal.....nerves. Think in terms of months rather than days/weeks. In the meantime see about using a safer recovery suite than a laundry basket. Those things can tip, putting excessive stress on the surgery areas. Lots of tips to make the crate rest time go safely and smoothly.. Crate, pack N Play are good recovery suites! Check out the other options: dodgerslist.com/2020/05/14/strict-rest-recovery-process/ Was the surgery in the neck or the back?
For how many weeks did the surgeon want for post op rest. That could range 4-6 weeks.
How often do you express? Every 3hr or ? Does his bed stay dry in between expressing sessions. IF not you may need another hands on toipof your hands type of lesson from your own vet or the surgery vet or her tech person. More information to help keep Lou's bladder clear of bacterial infection (UTI): ==> dodgerslist.com/2020/05/05/bladder-bowel-care/Have you tried expressing for poop? 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. You really do not need anyone to demonstrate how to express for poop. This video shows how easy it is: Helpful tips: dodgerslist.com/2020/05/05/bladder-bowel-care/#poopHope the 12/1 escape did not do any harm to the surgical areas. No discomfort observed since then?Is Lou taking an anti-inflammatory? mgs, how often when will it stop? Often it only takes 14 days from surgery til the surgery caused inflammation subsides and then no meds at all are needed. This is a good FYI for you. Not saying anything would happen, but good to be aware it been reported on this Forum in several cases. For dogs the inborn instinct about weakness is for survival protection of the pack as a whole. There are two things that can happen in pack dynamics when a dog has been or is sick. 1. The healthy one may try to eliminate the weaker in the pack. 2. For the sick one, now the weaker in the pack to become more protective and aggressive because they know they are weaker now and may be subject to being attacked. Make sure that Lou feels protected from his best buds when home alone... the crate will be that source of protection. Whenever you leave the house and they are not supervised, it is a good idea to crate them for their own safety. We have had many instances where a deadly attack among best buds could have been avoided by crating. One I recall is of two sisters who had grown up together and never showed any signs of aggression to one another. The two dogs were put in the kitchen while their owners went out to dinner. They came home to find the IVDD dog almost dead from the vicious attacks of the other. With a bit more information from you, we'll be looking forward to sharing lots of info, especially on graduation day from post op rest. Tips and ideas to make the transition from rest to safely adding in family activities and physical exercises. It would be helpful if you identity your surgeon's credentials That information of simply DVM or an advanced surgery degree with DVM, AVCS or DMV ACVIM Is Lou doing underwater treadmill water therapy? These are exercises you can do at home also: 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 Sarah & Lou on Dec 5, 2023 12:16:17 GMT -7
Hi Paula,
I tried to attached part of the surgical report. But I will also answer -
It looks like T12-L1 or L2 (I've seen both in notes).
That could range 4-6 weeks. - They noted 4-6 weeks, and I have been told 6-8 weeks at a follow up appt.
We express every few hours. His bed does stay dry, except at night time he does leak. We noticed he tends to get restless if he has peed (I believe he is aware he has peed/poop).
No discomfort since this escape.
He is on Carprofen. They have not told us when to stop. Every 12 hours he gets this. I do not see the dosage on the notes but will check at home later today
D.V.M., DACVS-SA is what is noted on her notes.
He currently is on his 5th week of underwater treadmill therapy. Will be assessed for acupuncture on 12/19.
To note - Lou is kept separated from his brothers when we are not around, otherwise he travels with us to work or any outings we go on. Otherwise we do have someone who comes to the house to stay with the dogs if we know we will be gone long and it's not dog friendly. I treat them and care for them like they are my own children 
We do bonding time with the boys and allow them to come and sniff and visit their brother in his recovery suite, but my husband and I are sitting with them as we do this to ensure no one is rough or aggressive.
I appreciate the tips and tricks on expressing both bowel and bladder. I had no idea the bowel could be expressed.
I will get the dosage info out right away!! Here are notes from report -
FINDINGS
Study: Computed tomographic images centered on the thoracolumbar vertebral column acquired in bone and soft tissue algorithms before (from the level of the caudal C7 endplate to the sacrum) and after (T2-S) attempted caudal lumbar positive-contrast myelography (slice thickness 0.13cm), and in a soft tissue algorithm only after intravenous contrast medium administration (T2-S; slice thickness 0.25cm) on 30-Oct-2023 (2,141 DICOM images)
Findings:
SURVEY
Mineral is present in situ at the level of the nucleus pulposus of the T13-L1 intervertebral disc, with a small amount of gas cavitation at this level. Immediately dorsal to this intervertebral disc space and extending a short distance caudally
(approximately to the level of the mid-body of L1) and a longer distance cranially (nearly to the cranial endplate of T13), large amount of mineral is in the vertebral canal to the right of midline, occupying approximately 50% of the cross-sectional area of the canal at the most severely affected region (dorsal to the mid-body of T13). This mineral effectively causes right-sided T13-L1 foraminal stenosis, in addition to severe compression of the spinal cord at this level. The severity of spinal cord swelling or intramedullary changes cannot be assessed from the current study.
Mineralization in situ is present at multiple additional intervertebral disc spaces (C7-T1, T1-2, T2-3, T6-7, T8-9, T9-10, T10-11, T11-12 [severe], T12-13, L1-2, L3-4, L5-6, L7-S1). There are mild right ventrolateral spondylosis deformans at T10-11 and adjacent costovertebral osteophytosis at the head of right rib eleven, without appreciable foraminal stenosis.
The tip of an endotracheal tube extends to the level of the thoracic inlet. The included dorsal lungs are normal. A moderate volume of ingesta, including disorganized mineral, is in the stomach. Limited remaining evaluation of the abdomen is normal.
LUMBAR MYELOGRAM
A lumbar injection of positive contrast material has been attempted at the level of L6-7 from the right side; however, appreciable subarachnoid injection is not detected, and this material is extensively subcutaneous and in the epaxial musculature. A small volume of positive contrast material is also dependently in the lumen of the urinary bladder and segmentally in the ureters.
POST-INTRAVENOUS CONTRAST
No additional abnormality is detected in the dorsal thorax or abdomen after intravenous contrast medium administration. No abnormal spinal cord contrast-enhancement is detected, though this evaluation is limited.
CONCLUSIONS/IMPRESSIONS
Diagnosis: 1. Herniation of mineralized intervertebral disc material, T13-L1, with severe secondary right-sided and ventral extradural compressive myelopathy from the cranial aspect of T13 to the mid-body of L1. This likely explains the reported clinical signs, and correlates with the reported neuroanatomic localization. Spinal cord evaluation is quite limited with this modality. Urgent decompressive hemilaminectomy is recommended at this site to minimize further spinal cord injury.
2. Multifocal non-compressive chronic intervertebral disc disease otherwise.
3. Unsuccessful lumbar myelography.
4. Normal limited evaluation of the dorsal thorax and abdomen. |
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Post by Romy & Frankie on Dec 5, 2023 14:35:46 GMT -7
Deep Pain Sensation (DPS) is hard to determine. It takes a very practiced eye to notice the subtle signs that would indicate DPS is present. Generally, a board certified ACVIM or ACVS are in the best position to know if a dog has DPS. In many cases, a general DVM or other veterinary specialist could get that wrong. What we pet parents can look for is a happy tail wag in response to a treat or seeing his favorite people. Keep an eye out for it. This would be a clear sign that DPS is present.
If Lou is leaking overnight, but not during the day, you could try removing his water about two hours before his bedtime. Lou should have free access to water during the day.
After my dog Frankie's surgery, he was also paralyzed and incontinent. Like Lou, his therapy was walking on an underwater treadmill. This therapy worked very well for him. Even so, it took months before Frankie regained his ability to walk and bladder and bowel control. Nerve healing is just slow. |
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