Help Needed: Post-surgery care

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Marni
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Help Needed: Post-surgery care

Post by Marni »

Simon had surgery one month ago and is eager to leave captivity. Can he roam the house --- no stairs-- and garden safely under supervision? He cries alot when we are somewhere tha he is not. He is paralyzed and I do not know if he will improve. I will probably look into carts one of these days.

Thanks for all the help and advice.
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Dianne
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Post-surgery care *LINK*

Post by Dianne »

Hi Marni,
We wondered how your doxie was progressing. Have you been given post surgery instructions about crate resting following spinal surgery? I know that you posted before, but I can't remember if you were given the instructions.

http://dodgerslist.com/lit/After_Surgery.htm

Sorry to hear that your pup has not yet responded to the surgery. That doesn't mean that he is NOT healing very slowly. Have you noticed any small improvements in his tail wagging, standing, incontinence?

It is NOT the end of the world if he isn't walking. I'm well into the 8th month of paralysis with my doxie; he will probably never walk without a wheelchair, but he is VERY happy with his life, and we are very happy he is still in our lives.

Could you further describe his health?

Best wishes, Dianne


http://dodgerslist.com/lit/After_Surgery.htm
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CarolC
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Re: Help Needed: Post-surgery care

Post by CarolC »

Hi Marni,

How long did the surgeon tell you to keep him crated? I wish I could find the website again (will have to look) where it says it is impossible to crate them too long but easy to crate them not long enough. If in doubt I'd err on the side of caution.

I had the same problem with my dog being unhappy and whining if I was out of sight. The solution was playpens. I got a really nice one for $20 at the thrift shop and an excellent one for $40 at Target. Playpen in the bedroom, one in the sunporch, and a crate in the kitchen. That way my dog can always be in the middle of things.
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Dianne
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Post-surgery care

Post by Dianne »

We use a small swimming pool (no water) as a playpen on the porch, or even in the kitchen. Later, you can use the pool for hydrotherapy. There may still be a few leftovers at Wal-Mart(Wally World).
Marni
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Re: Post-surgery care

Post by Marni »

Hi Dianne,

Thanks for the response. Simon was not at all intersted in eating nor drinking when I got him home from surgery. I was given post-op instructions to crate him but the instructions did not say for how long. I was also given Prescription a/d to add to his water so he would drink and get some nourishment at the same time. I switched to homemade chicken stock. I throw a whole chicken into my pressure cooker and give him the broth as his water. So far, he drinks copious quantities but refuses plain water. Both are in his pen. He does eat his regular food now. Prescription t/d and Iams Less Active. He weighed 19 lbs when he had surgery and now weighs 17. His mom was a tiny fullsize dox and his dad a mini. He could probably weigh around 15-16 as his ideal weight and he is nine years old..

Generally, his health is good. His coat is great. He is very happy --when he can be with his people-- and his local vet says he looks terrific. I am cathing him once or twice a week. Mostly, I just express. If I am not getting his urine, I'll cath. I've been recording what he drinks, what I express and what I cath. Of course, many times I will pick him up and he starts spraying. Can't account for all that comes out. He had a urine culture 9/6 and it was clean.

Also, the post-op instructions I received said to conduct hydrotherapy and pt with him 2-3 times daily. Twice a day is usual for him; three times is only about once or twice a week. Again, I do not know if I am supposed to keep this up indefintely or for some specified period of time. The surgical practice said they would call me every week to see how he is doing. They called twice but not since 9/9.

We have another dox, a 14 yr. old female and a 14 yr. old male vizsla. The dox had interspacial disc disease and cervical spinal surgery 8 years ago and she came home with a transdermal patch for pain has was not paralyzed at all. She rested post surgery for a bit and went to pt and hydrotherapy 2-3 times a week for a month. How things have changed!

I have noticed that he gets around pretty darn well on two legs when I have him out of his pen. He does not stand at all and I express him on a table or lounge because it is very hard for me to hold him upright. I have MS and have really done in my shoulder lifting hime and carrying him around these past three weeks. He lifts his tail sometimes when I express and sometimes when he poops. He poops in his bedding or in the hydrotherapy, usually. If I rub his anus, I can get him to poop at night before we retire, if I'm lucky. If I am petting him/massaging him he stretches out to make sure I don't miss a spot! Other friends who have seen him say he looks a lot better to them than he did a few weeks ago. He is quite alert. Still barks at the neighbor kids/birds/etc. He's a very sweet guy and the other dogs here are really interested in him, especially the viz. If Simon is crying and carrying on in his pen, the viz is right there. He tries to get me to do something. It is interesting.

Anyway, I think that covers your question but if not let me know what else would be helpful to know. Thanks for caring.

Marni
Marni
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Re: Help Needed: Post-surgery care

Post by Marni »

Great idea! He cries in his pen in the living room and also in the one in our garden. So maybe a few more would be good. Couldn't hurt.

I was not told exactly how long to keep him confined. I hope to find out more from the surgical practice later this week.

Thanks!
Marni
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Dianne
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Quick note

Post by Dianne »

Hi Marni,

Sorry that my answer must be brief tonight but my teenager is waiting to use the computer.

"Of course, many times I will pick him up and he starts spraying."

I have a stack of old white washcloths (ragged, worn, not for human use anymore) that I use when I pick up Schnitzel in the morning, or when I need to express him. I slip a washcloth under him before I pick him up from his bed to avoid leaking. Immediately, I stand and hold him over the toilet (rear aimed toward the wall) and gently massage his anus. You can actually feel if it is full and ready to poop. I do this at least 3 times per day, and have drastically cut down on clean ups.

Then I "stand" him on top of my dryer (good height for me) to express. It is easily cleaned with Windex spray. The used "weedle" cloths go into a small bucket with lid set up as a diaper pail. There is Clorox, and borax in the water in the pail. No smell! Dump the water; launder with whites. Most of the washcloths are very white because of the bleaching process in the pail.

Paralyzed doxies really don't seem to know that they are paralyzed. Mine can run faster on 2 legs than I can. He has charged after rabbits on the lawn, so that I was unable to catch him. These little guys laugh just as much as their able bodied species. My next goal is to get him into a wheelchair.

I have a friend who is a vet tech who predicted that I would NOT be able to keep Schnitzel alive very long. Her vet employer said the same thing. She was suprised how healthy he looks every time she sees him. She didn't know that paralyzed pets could lead happy lives, too.

I suspect that your doxie is still slowly regrowing nerves, and will probably walk. It is still too early to think that the surgery was not successful. I would continue to crate him at least 8 weeks post surgery or even longer.

Dianne
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CarolC
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Re: Quick note *LINK*

Post by CarolC »

Below is a link to how to make a diaper pail. Dianne, that's funny about Schnitzel tearing off across the yard like that. My dog did the same thing when I first had her and was expressing her outdoors in the grass. She charged out from between my legs after a cat she saw on the other side of the fence, on her front feet and her knees! I couldn't believe how fast she was. I've actually resorted to a football tackle (think greased pig) to catch her when she went after another dog. :)



CLICK HERE how to make a diaper pail
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critters
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short answer...

Post by critters »

I'd keep up the exercises until he can walk well on his own. I also think I'd want to start weaning him off the chicken broth a little at a time--making the mixture a little weaker every day. Cograts on his weight loss!
Marni
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Thanks Dianne, Carol & Crittters

Post by Marni »

Thanks, all, for your help and suggestions. I'll make a diaper pail and use those small white wash clothes. I try to have one in hand when I pick up Simon but I don't always have one. That's when I'll get him spraying. Naturally.

You all imply that he may actually walk some day. What if he doesn't? I am optimistic that he will improve but I am not prepared to keep him crated for six months, for example, if he is still not able to walk by then. And the same goes for hydrotherapy and physical therapy. It's been twice a day or three times a day for just three weeks and I'm not able to do anything else. His surgery was 8/15 and I got him home on 9/1. In addition, my spouse was hospitalized om 7/22 and I got him home on 8/12 -- two days before Simon went down. My husband requires pt, home health nurse, etc. He is homebound so all my patients keep me busy. I've been on a leave of absence from life since July 22--work, volunteer things, etc. -- but I need to get on with things too. Have any of you ever found a way to take a trip? I could take Simon with me in a car and drive across the country but my spouse can only fly direct flights because he's on oxygen. None of the care places here would be able to care for Simon. I would not trust them with him and none of our vets do any tending. Any respite care ideas? I think I'll start a respite program for caregivers of injured pets. Right!

Thanks for the help. One more question -- I already dilute the chicken broth , one part broth and two parts water. No salt or other additives. Why should I cut him back?

Thanks again!

Marni
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CarolC
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Re: Thanks Dianne, Carol & Crittters

Post by CarolC »

Hi Marni,

Isn't that just always the way--you can't ever have one crisis at a time, right?? Well, I agree about not crating him for 6 months, however there's crating and there's crating. There is crate rest which as far as I know generally won't go beyond 8 or 10 weeks, whatever your vet says. That is the strict crating you are doing now, and that will end. After that there is...I guess you'd call it partial crating? For example, my dog is paralyzed but has relearned to walk, but she also drags at times between walking. Like she'll walk over to a mailbox post to sniff it, stand and sniff it, then sit, then drag herself around it still sniffing. I do not leave her out of her crate during the day while I'm at work, because I don't want her to get rug burns from too much dragging around. In addition, I don't want a lot of extra wear and tear on her front feet from dragging around. Therefore, she is only out of her crate when I can be home to watch her, and when we go for walks. Then if I see her beginning doing too much dragging, I either help her up or pick her up. She seems quite happy in her crate. It is on a table where she can keep a lookout over activity on the street and the backyard. So I am no longer crate resting her so her back will heal, just because of the possibility of dragging. You will have to judge based on where your dog's at when the time comes. My dog had a very severe spinal injury, she was never expected to walk at all.

As far as the travelling, yes I went through that, but without the complication of an convalescent husband. I had to make 2 trips driving cross country when my father died, one for the funeral and the other to get his house ready to sell. I took my dog with me both times. I could have boarded her, but I prefer to be the one to express her bladder. She slept during the drive and we stayed in hotels and had a great time. I expressed her on the hood of the car during rest stops. :)

Since you have to fly, many airlines allow you to board pets for an extra $55 or thereabouts. You are lucky he's a dachshund and not a saint bernard. :)

The biggest problem I've had was when I was called for jury duty. It was downtown, a long drive, and my vet clinic did not open early enough to drop off my dog if I'd wanted to board her for the day and let them express her at lunchtime for me, and they closed before I would have gotten home to pick her up. I actually tried to go home on the lunch break to express her and got back late and held up a huge trial, they could have sworn out a warrant on me.

However, the next day I took her to the PT facility where she was going twice a week and they took care of her. You might look into that possibility. I know at the PT facility here, they do take out-of-town pets and board them for PT, not just local pets. Your PT place may do the same. Schedule him for a PT session every day and let them care for him a few days. Try it for a short trip first and see how it goes.

I don't know for sure, but I think you may currently be doing too much PT (?) and no wonder you are tired. You are doing way more than I did. I think you are doing as instructed by the vet or therapist, and if you have time and energy for all that (NOT!) and your dog is up to it, then fine. However, I would think hydrotherapy once a day would be good. You need to do the range of motion exercises for flexibility twice a day, but that takes 5 minutes each time. It is helpful to stimulate his feet during the day. That just means that during the day, when you walk past his crate, reach in there and give his toes a little squeeze or a tickle or a rub. No big deal. It will help him relearn to feel his feet. From my experience, I did not do hydrotherapy at home because when we tried it my dog was terrified of being in the tub and only wanted out in the worst way. Instead I did daily sling walking with her on her front feet, and manually exercised her back legs each day. She got water therapy only twice a week at the PT clinic on the underwater treadmill, and didn't even start that until 5 months post-op because they wouldn't take her at first. But she learned to walk again.

It is very important to realize that recovery from spinal injury takes time, and consistent steady exercise over a course of weeks or months will be good for your dog, but you probably won't get him walking much faster by an aggressive program of intensive physical therapy. There was a sad case in which a dog owner thought that by trying harder she could speed up the results. She paid for expensive intensive PT for her old dog, and then when the dog didn't improve according to her schedule she gave up on her dog and decided to put him down. Your dog will heal on his schedule, and not the vet's or the therapist's or yours, but healing is occurring a little bit more every day. You have to give it at least 3 months to see if bladder control will return, and 6 to be sure. You're only one month out. I hope you won't judge the future by what you see now, it't still quite early. :)
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critters
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Re: Thanks Dianne, Carol & Crittters

Post by critters »

You certainly have quite a load! You may not HAVE to cut back his chicken broth, but I was thinking more about long-term--it'd be a lot less work for you, I'd think, to not have that special worry. Plus I'm always concerned that they not get too used to special things and refuse all others. Suppose, for instance, you found a way to take a trip, whether your hubby used liquid oxygen and you took the car, or whatever. Will you take chicken broth on the trip? If you board him, will they cook for him? That kind of thing; not implying that broth was damaging him somehow.

I've heard GREAT stuff about liquid O2 systems; I went on an all-day bus trip over a year ago with someone using one and who wasn't at all afraid it would run out. It was expensive, but she said it was well worth it.
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Dianne
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A full plate

Post by Dianne »

"You all imply that he may actually walk some day. What if he doesn't?"

Then you would have a very happy but paralyzed dog. However, there have been many stories on this message board about slow healings. I am hoping that your pup is just healing more slowly than anticipated, like Carol's chihuahua.

You REALLY do have a lot of things going on in your life. Wow! An ill family member would take precedence over therapy visits for a pet. An ill husband would take priority.

I've got a teenager, 5 pets, and 4 aged parents that we oversee constantly. My Mother fell in her kitchen 3 weeks ago, was transported by ambulance to the ER, but later recovered. I manage to express Schnitzel a few times per day anyway, but it sure can add to the daily stress.

Try to take care of yourself. As CarolC says, "put the oxygen mask on yourself first", then you can help others.

Dianne
Marni
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Follow-up Thanks Dianne, Carol & Crittters

Post by Marni »

Hi,

I am so glad to have your info. Can you all tell me how long it has been since your dogs were injured? I know I'm in the early part of the curve so having other experiences to gauge mine by is a huge help.

I reviewed the written instructions I received on Simon's discharge and it said to keep him crated for 6-8 weeks post-surgery. We will be completing 6 weeks this week-end.

Simon went to a tertiary care center in Las Vegas 2.5 hrs. from our home for his surgery. We live in Southern Utah and do not have any kind of PT facility here and I do not have any boarding facility that would take a pet in Simon's condition. So, those resources are just not available. That explains some of our situation. When he was discharged, I received 3 hours of training so I could care for him. Obviously, that was a great help, but since I was unprepared to have him paralyzed and need so much care on a daily basis, I still have lots to learn. For example, he frequently leaves his penis out. He is not concerned about it that I can tell --no excessive licking, for example, but I am not sure if this is somewhat normal or indicative of something I should be watching. He did not have this situation before I started expressing him. I always had to push his penis out to catheterize him and then it would retract on its own as soon as I released it and the cath was in place.

He is much happier in his wadding pool shell. I can take it where I am going to be in the house or outside and he can see what's going on. He still cries whenever I am not in sight.

I re-read the PT and hydrotherapy instructions again, and they say to do the hhydrotherapy 1-3 times a day (no swimming) for 5-10 minutes andn also do the range of motion excercises and muscle massage 3-5 time daily for 5 minutes. I will call the center and ask if this is supposed to go on for the 6-8 week post-op discharge period, like the crating, or something else. I agree that it is excessive. He does not mind at all. It is just my time/schedule that is a problem.

He really does prefer the very weak chicken broth to water + a/d. I prepare both and set in his crate and he drinks the broth and leaves the a/d until later. Plain water is also in his pen and he takes a sip now and then.

He does lift his tail now which is new. And would happily drag around the house/garden if I let him, which I don't. He does escape from me once in a while -- answering the phone, door, etc., but I can retreive him pretty easily.
I was curius to see if any of the other dogs would hop into the wadding pool shell and help themselves to his food/water etc., but so far that has not occurred. They also do not hop into the shell to visit him, although the big guy --a vizsla-- stands by anxiously when Simon cries. The viz also stands over him and just wags his tail from time to time. Our little female doxie sniffs at him from time to time, but that's about it.

Well, gotta run and take care of my charges here.

Thanks, again for your help.

Marni
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Dianne
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Ahhh, thanks Marni

Post by Dianne »

Hi Marni,

My doxie became paralyzed about the first week of February 2005. He showed improvement for the first 6 months, but has stopped progressing. I think we are now at the best that he will be, and he is still paralyzed and incontinent. He did NOT have surgery.

"For example, he frequently leaves his penis out. He is not concerned about it that I can tell --no excessive licking, for example, but I am not sure if this is somewhat normal or indicative of something I should be watching."

I really think this is caused by a distended bladder. Sometimes I will have to pull the foreskin forward over Schnitzel's penis. If it stays in the correct position, I know that his bladder is empty, but if it retracts again, I know there is still probably urine that needs expressed.

Supper cookin' here on the east coast. Gotta' run for now.

Dianne
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