9 yr old Weim care, possible stroke.

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Christy.F
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9 yr old Weim care, possible stroke.

Post by Christy.F »

Hello all,
Desperate for some advice on how to help my little lady post recovery. It's been 3 days post stroke/epileptic episode and she's gradually improved each day. Vet suggested possible tumor or perhaps vascular stroke. We opted not to invest in MRI :( She has regained strength in all limbs, but still cannot weight bear. (She can now sit up unassisted) Eating/drinking well, but pretty much bound to where she lies at the moment. I want to give her time to hopefully recover and gain strength, but I cannot seem to get the hang of expressing bowel and bladder. She has gone pee a few times since, but not enough. Has not had BM since incident. I've tried qtip/vaseline, massage, ice cube, to no avail. I know she's nervous and does not want to use the pads. She really wants to go outside... unfortunately, she's almost 90 lb and I can't lift her alone. (At least until she can help a little) I appreciate the time that can be given for this. Would feel so much better if I knew her bathroom needs were addressed completely while she tries to recover.
Thank you!
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CarolC
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Re: 9 yr old Weim care, possible stroke.

Post by CarolC »

:confetti:

Do you happen to know if they were able to express her at the vet? If they could not do it either, then you might want to ask for medication to make expressing easier. If they were able to do it, then they probably had some advantage, such as a partner to help, or someone strong to do it, or just more experience. But that doesn't mean you can't do it at home, perhaps in a different way.

If you can't lift her (I don't blame you, 90 lbs is a lot), then she's going to have to piddle indoors even if she would rather not. But when she does, if you praise her, then hopefully she will relax and be more willing to do it next time.

You may have already seen this, but there is an article with a bunch of videos at the end, showing different ways of expressing. If you are having no luck with one method, then perhaps try another. If she is totally unable to stand, even with assistance, then I would try some of the methods lying down. The "closed fist" method is supposed to be good for a large dog, it allows you to focus the pressure even if you have small hands or are not strong. Here is the link, you will see the videos when you scroll to the bottom.

viewtopic.php?f=5&t=16027

It may be that she doesn't want to potty indoors, or it may be that she just doesn't want to go lying down because she will get wet. You mentioned she can sit up now but can't stand and bear weight. Do you think there is any chance she can bear weight on her front legs if you help hold up her rear? The average dog carries 60% of her weight on the front legs and 40% on the hind legs. So to hold up her hindquarters, you are lifting 36 lbs, which is still heavy but it's better than 90. So if you think she can stand on her front legs, and you think you can safely support 36 lbs, then you might be able to stand her up indoors on one of the pads. I would try it without any pad under her front feet, you don't want her to slip, just one under her hind feet.

In addition, if you stand her up by putting something under her belly where it meets the thigh, that will put pressure on her bladder when you go to lift her. This is actually one technique for expressing a large female dog. You need something that is wide enough to be comfortable, I would think maybe 4" wide would be pretty good. If you get something too wide, it will usually just bunch up. Something like a horse saddle girth might be good. They often say use a bath towel. That is fine if you have a good grip in your hands and can hold a fat handful of towel and support the weight for several minutes. To me it is hard when there is a lot of bulky fabric. Someone suggested a cotton baby sheet. That is a good idea and may be easier to hold because it's less bulky. Or if you have a shawl or a wide eternity scarf...something you might have around the house...whatever you can think of. This is silly, don't know why I just thought of it, but I'll bet a polyester shower curtain liner would make a good strong belly sling and be easy to grip.

Another idea is to take a canvas grocery bag and cut the sides out of it so it becomes kind of a canvas sling with handles you can hold.

It sounds like she is recovering pretty quickly and maybe this situation won't last much longer. If you think she is going to be down for more than another week or two (doesn't sound like it but I am not a vet) then you probably want to get a body harness to help you handle her. As a temporary measure, you might get a cheap nylon chest harness she can wear 24/7. That way you could perhaps ask someone to help, where one person steadies her in front by grabbing the chest harness, and you support her hind end holding some kind of makeshift sling, and by teamwork you could get her outside.

I agree it would be good to try to get her to empty her bladder fully if you can. After a number of days of not emptying completely, she could get a bladder infection. They are usually treated pretty easily with antibiotics, so it's not the end of the world, but if you can avoid it that is preferable.

As for not going number two for 3 days, the vet probably has some kind of stool softener you could give her, if they are open tomorrow morning. Or they might say she will be OK until Monday. You might just give them a call and explain the situation and see what they say.
Christy.F
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Joined: Fri Oct 26, 2018 8:25 am

Re: 9 yr old Weim care, possible stroke.

Post by Christy.F »

Carol,
Your information and knowledge is greatly appreciated! Since my original post, we have, with some success, been able to get her to piddle a handful of times. It's not enough, (averaging every 10 hrs or so) but she is voiding. I will be contacting our vet again on Monday for an atb, mostly as preventative, until I know she can routinely go every 4 hrs at least. Unfortunately, I've tried many times lifting/assisting her to a stand position, but her front legs (where she does seem stronger) seem to lock up. Back legs are not gaining the strength I would like to see, but there is movement and flexion when she's lying down, so I'm hoping it's just a slow go. She's a very happy girl otherwise; still has a great appetite, drinks and appears comfortable. (Minus the frustration of not be able to chase our kitty) :(
The videos are very helpful; I just can't seem to express her bladder as much as I try. Vet suspected Cushing's, which I tend to agree based on symptoms, so she does have a sort of "pot belly" abdomen. Perhaps that adds to the difficulty. We were just beginning to explore that when the episode happened.
A couple questions, if you or another would be so kind:
1. Does this retention of bowel and urine tend to resolve as nerves begin to heal? With her size, I'm worried that will be the biggest setback in her recovery.
2. I've given a couple days for rest and healing, but yesterday we began really focusing on getting her strength back. She is able to now crawl towards a treat (not too far), and can lift her head/front up from both sides when laying. With my husband at work [and me 8 months pregnant] I can't even begin to consider outside therapy until I'm able to safely move/guide her. We're looking at some adaptive equipment to make that happen. In your experience, and based on the little bit you know of the situation, do you think our Sage would benefit from a wheelchair? Do we focus first on rehabbing enough to stand with support?
I was more optimistic earlier in the week, given how quickly she was improving. Now, I feel like though all of her faculties have returned, her legs are not progressing as I'd hoped. (Especially given it looks like all 4 were affected) I'll remain hopeful, though, that our pooch is able to at least have some mobility again, either with her own legs or other devices.
Thanks again for the time. :)
*Also, I'm new at this and not sure how to move posts; apologies if this is in the wrong location.
Christy.F
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Re: 9 yr old Weim care, possible stroke.

Post by Christy.F »

One more question, sorry!!
Does it matter which side the dog is lying down on when trying to express? Not sure if other anatomy would be in the way on one side or the other. Haven't been able to find that answer in the tutorials.
Thanks again
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CarolC
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Re: 9 yr old Weim care, possible stroke.

Post by CarolC »

Please see comments in blue...
Christy.F wrote:Carol,
Your information and knowledge is greatly appreciated! Since my original post, we have, with some success, been able to get her to piddle a handful of times. It's not enough, (averaging every 10 hrs or so) but she is voiding. I will be contacting our vet again on Monday for an atb, mostly as preventative, until I know she can routinely go every 4 hrs at least. That is a good idea about the preventive antibiotic. They call it "antibiotic cover". Honestly, they say emptying the bladder every 8 hours is enough. If you think about it, many dogs hold it for 9 hours while the owner is at work. If the dog is on steroids and drinking extra water (or maybe she drinks more with the Cushing's) then more often might be needed. Maybe you could get away with every 6 hours. I'm just thinking, you need your sleep, too. Unfortunately, I've tried many times lifting/assisting her to a stand position, but her front legs (where she does seem stronger) seem to lock up. Do her front legs every lock up when lying down for no reason? Back legs are not gaining the strength I would like to see, but there is movement and flexion when she's lying down, so I'm hoping it's just a slow go. That sounds encouraging. You might consider doing some range of motion with her and light resistance exercise. Also massage her legs and ankles and tickle her toes and pads to provide stimulus. I would do it several times a day. The body needs to remap the pathways between the brain and the feet, and the more you give it to work with the better. She's a very happy girl otherwise; still has a great appetite, drinks and appears comfortable. (Minus the frustration of not be able to chase our kitty) :( That is great. It always makes me feel better about the dog when the dog seems happy, like they somehow know this is going to turn out OK.
The videos are very helpful; I just can't seem to express her bladder as much as I try. Vet suspected Cushing's, which I tend to agree based on symptoms, so she does have a sort of "pot belly" abdomen. Perhaps that adds to the difficulty. Oh yes, I would think that would make it harder if it means you can't feel the bladder. We were just beginning to explore that when the episode happened.
A couple questions, if you or another would be so kind:
1. Does this retention of bowel and urine tend to resolve as nerves begin to heal? With her size, I'm worried that will be the biggest setback in her recovery. Yes, it tends to resolve. There is no definite timeframe, and no rule about which will come back first.
2. I've given a couple days for rest and healing, but yesterday we began really focusing on getting her strength back. She is able to now crawl towards a treat (not too far), and can lift her head/front up from both sides when laying. With my husband at work [and me 8 months pregnant] OH BOY! :D I can't even begin to consider outside therapy until I'm able to safely move/guide her. We're looking at some adaptive equipment to make that happen. In your experience, and based on the little bit you know of the situation, do you think our Sage would benefit from a wheelchair? Do we focus first on rehabbing enough to stand with support?
If I say cart or wheelchair, they are interchangeable, same thing. There are 2-wheel carts, 4-wheel (quad) carts, and 2-wheel carts where you can add on front wheels if needed. If you get a standard 2-wheel cart, it will help but you're right, she needs to be able to stand with her front legs. A 4-wheel cart is an option, but not an easy option with a 90-lb dog unless your are super strong. My dog who needed a quad cart was 63 lbs and I used a converted engine hoist to get him in. Here is a link, in case your husband has an engine hoist he could temporarily convert as a dog lift. If you research wheelchairs, it helps to focus on how to install the dog in the cart, as they are not all the same. So anytime you look at a 2-wheel or 4-wheel cart, you might just ask yourself, "OK, how do you get the dog into this?" If you have a way to get your dog into a quad cart, then simply being in an upright position and letting her get some circulation etc is a good thing, even if she can't walk yet. Gosh, here you should be shopping for baby blankets and you are thinking wheelchairs. It's not just the physical situation of being 8-months pregnant, but upcoming expenses, too. Although that being said, there's never a good time for a big dog to go down, but this one sounds hopeful from what you say.
:arrow: :arrow: http://www.handicappedpets.com/mediawiki/index.php?title=Engine_hoist_for_a_heavy_dog
I was more optimistic earlier in the week, given how quickly she was improving. Now, I feel like though all of her faculties have returned, her legs are not progressing as I'd hoped. (Especially given it looks like all 4 were affected) I'll remain hopeful, though, that our pooch is able to at least have some mobility again, either with her own legs or other devices.
Thanks again for the time. :)
*Also, I'm new at this and not sure how to move posts; apologies if this is in the wrong location. I think you posted in the best place. Having a 90-lb dog suddenly go down is an emergency. If she starts to improve, the post won't need to be moved, it can continue here where it started just fine.
Christy.F wrote:Does it matter which side the dog is lying down on when trying to express? Not sure if other anatomy would be in the way on one side or the other. Haven't been able to find that answer in the tutorials. It should not matter. Whichever side is more comfortable for you should be fine, unless she seems restless on one side and has her own preference. Some dogs seem to like to lie on one side more than the other.
This has made me think of some other things that I will put in a separate post since this is already long and I'm afraid I'll accidentally delete it or something. So will double post the other bit in a few minutes.
Christy.F
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Joined: Fri Oct 26, 2018 8:25 am

Re: 9 yr old Weim care, possible stroke.

Post by Christy.F »

Whew... 8 hrs seems much more manageable than 4. I'm fairly knowledgeable with medicine and health, but the whole thing is pretty baffling to me. Before this week, normal Sage was a bit of a piddler and used to go outside more than most. She actually had some incontinence issues, rather than retention.
Front legs did initially lock intermittently for about 12-24 after the initial episode, back too, but she's since relaxed. That evening when it happened, they were rigid for about 8 hrs straight. Our vet also put her on Keppra as a preventative. (Currently the only thing she's taking)
Great idea on the tickling, thank you. I have been doing frequent massage and range of motion. Also just tested pain sensation and appears she has it in all four limbs.
Great recommendations on the carts. I do lean towards two wheel if necessary; just seems so much more user friendly. (And back friendly) Engine hoist is genius... I've already been browsing craigslist, I'll add that to the list of potential items.
I'm lucky to have had you answer; can't thank you enough. On a good day, this would be challenging. But yes, being pregnant with our second has made this experience very unique! We did, however, just lose our "first born" weim two months ago to lymphoma (even after tx), so I am ready and willing to try anything to keep our lady with us. I couldn't imagine a house right now without a dog in it. :)
Much thanks again. As I said, I'm very lucky to have your answers!
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CarolC
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Re: 9 yr old Weim care, possible stroke.

Post by CarolC »

If you are not sure you can get your dog into a 4-wheel cart, or hesitate to buy one because she may be going to recover quickly without it, here is a picture of a way someone enabled their dog to be upright without a cart. Originally posted by illusha who had a very large dog (he also found a hydraulic lift at Harbor Freight, if you are interested):
dog.jpg
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critters
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Re: 9 yr old Weim care, possible stroke.

Post by critters »

:whale: This all sounds good to me after such a recent event!

I, too, knew a fair amount of anatomy and stuff, but when the time came that *I* had to express, it took me maybe a week or 2 to get it down. Feeling for the "water balloon" and playing "tiptoe through the guts" wasn't something I was used to even though my hands were more knowledgeable than most (I was teaching myself Braille at the time).
ZPolenta
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Re: 9 yr old Weim care, possible stroke.

Post by ZPolenta »

CarolC wrote:If you are not sure you can get your dog into a 4-wheel cart, or hesitate to buy one because she may be going to recover quickly without it, here is a picture of a way someone enabled their dog to be upright without a cart. Originally posted by illusha who had a very large dog (he also found a hydraulic lift at Harbor Freight, if you are interested):
dog.jpg

it seems to be an accurate way to support the pet
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