Marley - Chow, IVDD type 2 at T9-10, just had surgery.

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Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby MarleysDad » Sun Mar 29, 2009 4:22 pm

Marley - 13 yr old black neutered male chow chow.

1.5 months ago I took Marley in for his rabies shot - mentioned to the vet that he's been a bit weaker in the rear legs but still got around fine. Vet showed how he had proprioception problems. Decided to start him on previcox as his front elbows were starting to give him problems (elbow dysplasia diagnosed 3 yrs prior) to help him get around.

Took him to the vet 3 weeks later (after a vacation) for a blood draw to start previcox. The trip and visit resulted in him being noticeable lame in the rear. Sort of cleared up the next day and he was able to ambulate on level ground. Scheduled an appt to find out what was going on.

Following weekend, x-ray of back didn't show anything, but this trip made Marley pretty much 90% lame in the back legs.
Right rear leg was weak, left leg strong, but he didn't know where to place them. Got referred to a local orthopedic surgeon.

Visited orthopedic surgeon, got referred to a neurologist.

Visited neurologist, referred to another place with a high field MRI. MRI showed moderate-severe herniation of T9-T10 disc but evidence that this has been going on for a while since the spinal cord was reduced in size. Neurologist put his prognosis at 50:50 to walk again.

His pre-surgery condition was that deep pain perception was there, he would move his feet away and look at me when I would tickle his foot. He could stand on his own maybe 2-3 times during the day and even walk a few steps, but most of the time he found it easier to drag himself around. I put carpet down everywhere in the house and leading out to the back lawn. He still had bladder and bowel control though he would only pee when we would sling him around - too shy to poop in front of us. He was still a happy dog, getting around pretty well for a 56pound chow though his back feet were taking a beating. Lots of life left in him, great labs on his bloodwork. I thought it would be great if he could walk again but I really didn't want him to further decline and I think he would do well in a cart.

I decided to go ahead with the surgery since doing nothing he would continually get worse. His surgery was last Thurs (3/26), the T9-T10 disc was completely removed but no fusion.

What I wasn't prepared for was his condition after surgery. Post surgery he has no voluntary control of his rear legs, he is still on a catheter, DPP is minimal but present. Doesn't really acknowledge that I'm touching his tail, or rear feet. No bowel movement yet.

I know it's only been 3 days since the surgery but I'm going nuts. I just started a new job and have already missed days due to taking him around to visit specialists. I can't take anymore time off and my job is 1 hour away from home. In a bit of time Marley will be released and my wife is going to have to tend to him during the daytime - a 56 pound dog that is half my wife's weight.

I was really hoping for a sore dog but with the same motor/neurological condition post surgery. At least then my wife can get him around. Hopefully he is continent.

Does anyone have any personal surgery story (older dog, type II IVDD) that can tell me what their timeline was for recovery?
Is the decline post surgery very common or not so common? Again this is for a progressive, type II IVDD surgery.

TIA,
Dave
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby MarleysDad » Sun Mar 29, 2009 6:59 pm

Update!

I just got done visiting Marley.
- His DPP is much better today! The past 2 days he didn't do anything when I pinched the webbing in-between his toes. I had to take the word of the interns saying he still had DPP, but tonight I didn't have to pinch too hard and he had a response! In fact when I held the pinch, the leg was continuing to pull away!!
- He moved his leg away when I was tickling his right rear leg!! So I think his feeling is coming back AND his voluntary muscle control is coming back!
- His attitude was better today - he tried to get in a sitting position - got part of the way up. It's a lot of work for him.

I really hope this is the first of a long string of positive occurrences!

Yay! I'm so much happier! (and still praying a lot)
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby CarolC » Sun Mar 29, 2009 7:13 pm

Hi Dave,

I have not had your exact situation but would like to offer a few thoughts where I can. I am about the same weight as your wife and have been caring for a golden retriever of similar weight since August. It helps to consider how much weight you actually have to lift if you lift a dog's hindquarters. The average dog carries 60% of its weight on the front feet and 40% on the hind feet. So if you are helping a 56 lb dog, you are actually handling around 22 lbs as long as the dog can support his weight on the front feet. Chows are kind of big in the chest and small in the rear, so it may be a little less with your dog's breed. Anyway, I find it much easier mentally to think I am assisting about 22 lbs than to tell myself I am lugging around 56 lbs all day. If you share this with you wife, it is realistic and may make things seem more do-able.

In my case, I work and my dog is incontinent, and I can tell you male wraps are my new best friend.

Image

This article talks about male wraps and gives sources of where to get them, or make your own. If your wife wants more links on sewing your own, I think I may have another link somewhere. Anyway, it is great to have the incontinence covered if you have trouble lifting the dog or are not sure how often he needs to go out.

http://handicappedpets.biz/wiki/index.p ... male_wraps

I am not surprised to hear he seems to have less feeling now than before the surgery. Right now he'd be expected to have a lot of swelling in the area of the surgery, which is going to press on the nerves, and anytime you have a senior dog who just had surgery, he needs a little extra time to bounce back. I do not think what you are describing is anything unusual. Surgery is never a guarantee, but since he had deep pain sensation going into surgery, he has the best chance of recovery.

I would like to give you a couple more links to look at, in case you need the information later.

http://handicappedpets.biz/wiki/index.p ... dog_or_cat
http://handicappedpets.biz/wiki/index.p ... inent_pets

He does sound like a good candidate for a cart from your description, but I imagine the surgeon will have him on strict crate rest for a few weeks after the surgery. For your wife's sake, I'd recommend not using a dog crate, but rather getting an x-pen or baby fence to set up around him. It will be a lot easier for your wife to tend him if she just has to open a fence and walk in, compared to leaning into the door of a crate and pulling him out, etc. It will be better for him, too.

I think you are going to want a rear harness. Does the referral hospital send dogs home with a harness? If not (many do not) you can order one through this website, just click Products at the top. We also have a list of links to make your own harness if you want them. It seems like vet clinics often tell people to lift the dog by using a bath towel as a sling under his waist. If you ask me, that's not easy to do. It is hard to grab a handful of towel and lug a heavy dog--a harness is much easier. Or at least a baby crib sheet instead of a thick towel that is hard to grasp.

I'm hoping you'll see good things from this dog, but you may have a few weeks of down time while he is on crate rest recovering, so I suppose it is best to plan for that. Right now I'd be thinking about a soft, wrinkle-free bed for him, an x-pen to go around him, and seriously consider ordering or making some male wraps.

I hope you will update on how he is doing. There have been many people here with big dogs with back problems, they have come up with ways to deal with just about everything! :)

:slant:
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby Bobbie » Sun Mar 29, 2009 7:56 pm

Another thing to consider is that a dog may not respond to deep pain stimuli if he is already in a lot of pain from surgery- so it might be he only seemed to have no feeling.

I'm glad he is doing better.
Bobbie Mayer
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby MarleysDad » Wed Apr 01, 2009 12:10 am

Marley is doing even a little bit better.
I don't have to tickle his foot much for it to pull away - and to continue to pull away when I tickle it.
One legs is more sensitive to the other.

His tail is moving a little now. Intern says his butt and tail 'tone' is better today though neurologically she thinks he's still status quo from post surgery. I don't agree but I am biased. She says no voluntary motor control and that what I'm doing is superficial sensation and likely reflex motion.

Still I'm happier compared to day 1 and 2.

Yesterday the Fentanyl patch came off. Today his catheter was removed and they said he pee'd when he was carted out into the yard. Yay! Also had a BM yesterday and today - Yay! though I couldn't quite get out of them if it was voluntary or involuntary.

Marley was sitting up when I arrived tonight for a visit. I brushed him for a bit as he was starting to look pretty ratty.

Tomorrow we have a pow-wow with the surgeon to go over anything and everything. I mainly want to know where he is on timeline of being released. Here's a picture of my boy from his younger days (though he's still pretty good looking -hasn't gone gray in the face at all yet).
Image
Image
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby GabrielDeafBlindPupFamily » Wed Apr 01, 2009 4:45 am

That face, that face, that wonderful face! He looks like he is actually smiling!
We are probably one of the few places on earth that celebrate the voiding! Congratulations.
People don't understand the things that make us silly happy.

Keep in mind that you will see things that even medical professionals won't. You know Marley better than anyone.
I was told my big guy would never survive, nevermind walk. And the hospital thought he was miserable. They couldn't understand his smile and wag of a broken tail. So keep your faith and your heart is the biggest gauge of Marley's progress, in addition to the progress that everyone can see. He may be making teeny tiny strides that only you can see. And those are the ones we love to celebrate.
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby MarleysDad » Fri Apr 03, 2009 10:41 pm

Marley's home!
The Weds session with the surgeon ended up also being the time he was discharged since he was doing so well.

Tonight will be his 3rd night home. Each day he gets a tiny bit better. Still not as good as before he went into surgery- but pretty close!
We've been doing a lot of PT on him, range of motion, ball excersises, weight bearing. He has bladder control (Yay!) and he's had a couple of voluntary bowel movements too (also YAY!). His tail is much more functional and stands about 45 degress in the air now instead of hanging down. No walking yet, and only minimal voluntary muscle control, but I feel good about his progress as it's come pretty far for only 1 week post surgery.

His days and nights are goofed up, likely because the surgery place is a 24/7 operation, so he's been getting up early and having a hard time falling asleep. Of course being penned up in a room away from us isn't helping either (he usually checks on us several times during the night every since he's been deaf).

It's good to have him home!

Tomorrow we have an appt for PT at the surgery place and it may end up being on the underwater treadmill.
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby CarolC » Fri Apr 03, 2009 10:51 pm

That sounds really good. If he has bladder control, I personally would be very optimistic about the walking. I had to stop and think what angle 45 degrees was. I used to have a red chow mix, her tail was up and curled over her back and the fur was so long it was like a waterfall. In my experience, the underwater treadmill is great therapy, I would consider it money well spent. Recovery will have to happen on its own schedule but the PT can help him make the most of it. Congratulations! I'm glad he's got so much function so soon!
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby MarleysDad » Sat Apr 04, 2009 12:05 am

CarolC wrote:That sounds really good. If he has bladder control, I personally would be very optimistic about the walking. I had to stop and think what angle 45 degrees was. I used to have a red chow mix, her tail was up and curled over her back and the fur was so long it was like a waterfall. In my experience, the underwater treadmill is great therapy, I would consider it money well spent. Recovery will have to happen on its own schedule but the PT can help him make the most of it. Congratulations! I'm glad he's got so much function so soon!


Yeah, he 'had' a beautiful tail that used to be up on his back, but over time it was more horizontal the other way and more ratty. He still has a bad lumbro-sacral disc, but they all said that he's not in pain and it isn't causing his lameness. After surgery his tail was down, and motionless.

Going into surgery he still had bowel and bladder control, could get up on all fours infrequently, and had DPP. I was surprised as to how bad he got after surgery but am really happy he's getting back to where he was.

I wonder though that as/if his neurological functions get much better that there will be more pain. He's got 2 bad hips and blown out knees and we never knew it. Not sure if it's his stoic-ism or this T9-T10 disc herniation.
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby MarleysDad » Sat Apr 04, 2009 7:56 pm

Marley had his first session on the underwater treadmill. He did great for a dog that hates water. I guess he only hates cold water - this water I think is ~ 88F. He spent 20 mins in the tank and thought it was great that there was so much water to drink :roll:
The therapist said she felt a couple of times that he would try and move his right leg.

It's been 9 days since his surgery.Image
Daughter is on the left, wife in foreground, me behind the tank manning the controls, therapist in the tank with Marley working his rear legs.

Dave
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby CarolC » Sat Apr 04, 2009 9:33 pm

What a first rate picture, and no wonder Marley enjoyed his swim with so much attention! Very cool! Yes, my dog always "drinks the pool", too. I bring her home from PT about 9 am and at 11 am we have a big express! :wink:

I went back and found an old message I posted March 21, 2006, because I was trying to remember how long my dog went to PT before she started moving her feet on the treadmill. Here it is:

Just because they walk or swim with their front feet doesn't mean they will automatically move their back feet too. My dog didn't. We put her in the exercise tank and she moved her front feet but not her rear. The therapist got into the tank much as you see here and took hold of her ankles and made her back feet move. The back feet didn't even move in time with the front feet, they just moved. She did this for about 8 swim sessions and then one day, lo and behold, my dog started moving her back feet! You should have heard the cheers of celebration that day! And once they start doing that, as far as I know they never stop. It's back to stay. When you hold the dog's ankles and "walk them" through the motions, it's like priming a pump. You may have to pour a glass of water down that old pump a number of times before you see results, but once it's primed it works. (Sorry if you have no experience with hand pumps.)


I remember the first session they just put my dog in for 5 minutes, next session 10, next session 15, working up because she didn't like water. During one session I don't know if it was too high or what, but she was actually kind of panicking, and we had to stop the treadmill and take her out and comfort her and let her settle down. But it got to where she loved PT (still does) and will squeal driving into the parking lot. Actually, sometimes she squeals when we turn onto the street going to PT, she's just excited.

I remember I was concerned during the first sessions because the therapist did like your therapist is doing, and got in the treadmill with my dog and held her hind legs and moved them in stepping motions. The problem was, she was little so it was nearly impossible for the therapist to move her feet the right speed to match all the little steps her front feet were taking. It turned out that didn't matter, it was just the fact that they were moving that did the trick. It did take a while for her to suddenly begin moving her feet by herself, but I was ecstatic when she did. After that, it took a long time for her to be able to walk on the treadmill without crossing her ankles and tripping herself, but that was something that came in time, too. And in the meantime, all that exercise was good for her physically and mentally.

I know different clinics seem to do it differently, but my dog had 4 weeks of crate rest after her surgery, with only passive range of motion exercise and no weight bearing. It seems like it might be kind of early to be doing 20 minutes on the treadmill (?) but if the surgeon recommended it then I guess it is his call. I have heard of cases where they start PT while the stitches are still in. I guess if the water level is high, he is not bearing much weight. Just my :2cents: I think I'd want to be careful he does not overdo it right now. Consistent physical therapy over time is the key, being in it for the long haul.

I read what you were discussing about whether he will now begin to feel his other aches and pains more. I don't know...and the only answer I have isn't scientific, but I would say that I've never heard anyone report that happening, but again I don't know. I see what you mean. I would think that doing PT in warm water would be good for his joints, and now that you know he has some age-related joint issues, perhaps your vet can put him on a joint supplement. My dog has a "dry socket" hip (I think that means lack of cartilage and grinding) and he is on Pro-Motion, which is one of the glucosamine supplements. They sell it in flavor tabs my dog considers a treat.
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby MarleysDad » Sat Apr 04, 2009 10:19 pm

Thanks for the nice long reply Carol, especially the part on your experiences with the underwater treadmill. There's one more person there to support Marley but she was behind the camera in that shot. Marley is pretty special in our family and extended family. My brother, sister, dad all ask how he is doing daily. They were even going to show up for visits when he was in the hospital until I told them to wait until he comes home - no need to burden the staff with all the visits all through the day.

Regarding strict cage rest for 4 weeks with no weight bearing, maybe it was the type of surgery Marley had but the surgeon when I asked him specifically what the cage rest was for said it was just to keep Marley from tearing up his back legs from dragging them around. He said his surgery was not 'de-stabilizing' (a mini-hemilaminectomy). The PT person was even having Marley do weight bearing excercises I think the 4th day post surgery. She also did and is having me do excercises with him on a small pilates ball - resting his chest on the ball and rolling him back slowly while getting his rear legs to bend in all the right and normal places. He has a tendancy to hold his legs very straight and stiff otherwise.

Tuesday is his next trip for PT!
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby critters » Sun Apr 05, 2009 5:50 am

What a neat pic!
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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby Caroline » Sun Apr 05, 2009 11:27 am

Welcome!
Chows always remind me of teddy bears lol.
What a cutie pie looks like he is going to be just fine.

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Re: Marley - Chow, IVDD type 2 at T9-10, just had surgery.

Postby MarleysDad » Fri Apr 17, 2009 11:41 pm

Marley update:
Yesterday was 3 weeks post surgery.

He's still not walking but it's still early and he's still making progress. I believe he is now better than he was prior to surgery. I've noticed that sometimes when he stretches he curls his rear toes!! Also tonight when I was tickling his feet and pinching/massaging the webbing between his rear toes that he was moving his rear legs quite a bit, and curling his toes!! He's also able to get up on his rear knees and 'walk' from the hips though the rest of his legs drag. (Note that we don't let him do this - this is just how he's been pooping, he's a poop walker.)

Feeling is still vague down there since if he is asleep and I fiddle with his feet he doesn't wake up but still there's progress and I'm very happy!

Tomorrow will be his 5th underwater PT session at the surgery place. Can't wait to see how he's doing.

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