Labrador L5 IVDD post surgery

Neurological Disorders Resources. Treatment and care for pets having pain or trouble walking or standing due to spinal injuries or neurological disorders like IVDD, FCE and DM.
Lolalab
Posts: 9
Joined: Sat May 25, 2019 7:03 pm

Labrador L5 IVDD post surgery

Post by Lolalab » Sat May 25, 2019 7:15 pm

Hi all, I think I’ve read almost every post, this site is very helpful. Wondering if I can get some opinions on my dog’s recovery process. Lola is a 90 pound black lab, 7 years old, very healthy. 3 weeks ago she became kind of slow, in the middle of the night she squealed and had some wobbly walking and refused to move once I laid her down. the next afternoon I took her to neurosurgeon, she had knuckling and hind leg paralysis...kept her overnight, she seemed to do better that night “almost normal” and the following morning she had deteriorated. CT showed ruptured disc and hematoma to L4, had deep pain perception and had surgery at 11am. Came out without DPP, stayed in hospital for 10 days, that day she regained right hind foot DPP, home with indwelling catheter. A week later she has both hind feet DPP. With a help em up harness she can balance on her feet for a second. We go back this week for neuro follow up. I have her on crate rest, take her out 2 times a day for a short “walk”, and am doing range of motion exercises but her right hind leg seems tight...likely from iliopsoas muscle contraction from *too* much rest. She hates hip extension but I’m doing more massage and exercises. I know that nerve regeneration takes about 1 inch per month, and with this tall dog (she may be part Dane, 90 pound but not overweight), I’m wondering what I should expect with her prognosis. Seems as though she does not have motor reflexes, not tail wagging. She lets me know if she has to poo, unsure if she has bladder control because of the catheter. Are big dogs likely to recover from this? I appreciate any help!
Attachments
AC53DAC6-0801-451D-8822-9FC2348A497F.jpeg

User avatar
critters
Founding Member
Posts: 13237
Joined: Sat Apr 28, 2001 7:00 pm

Re: Labrador L5 IVDD post surgery

Post by critters » Sun May 26, 2019 6:12 am

Lolalab wrote:
Sat May 25, 2019 7:15 pm
Hi all, I think I’ve read almost every post, this site is very helpful. Wondering if I can get some opinions on my dog’s recovery process. Lola is a 90 pound black lab, 7 years old, very healthy. 3 weeks ago 3 weeks is still VERY early on.she became kind of slow, in the middle of the night she squealed and had some wobbly walking and refused to move once I laid her down. the next afternoon I took her to neurosurgeon, she had knuckling and hind leg paralysis...kept her overnight, she seemed to do better that night “almost normal” and the following morning she had deteriorated. CT showed ruptured disc and hematoma to L4, had deep pain perception and had surgery at 11am. CIame out without DPP, stayed in hospital for 10 days, that day she regained right hind foot DPP, home with indwelling catheter. A week later she has both hind feet DPP. With a help em up harness she can balance on her feet for a second. We go back this week for neuro follow up. I have her on crate rest, take her out 2 times a day for a short “walk”, and am doing range of motion exercises but her right hind leg seems tight...likely from iliopsoas muscle contraction from *too* much rest. Spinal cord injuries themselves can cause contractures, too, but I suspect 3 weeks is far too soon for that. I suspect maybe she's just spastic from the spinal cord injury.She hates hip extension but I’m doing more massage and exercises. I know that nerve regeneration takes about 1 inch per month, and with this tall dog (she may be part Dane, 90 pound but not overweight), I’m wondering what I should expect with her prognosis.Nerves do heal slowly, but it seems to me that the distance would be related to how much spinal cord was damaged, not how tall she is.The nerves in her legs are fine. Seems as though she does not have motor reflexes, not tail wagging. She lets me know if she has to poo, That's a good start.unsure if she has bladder control because of the catheter. Are big dogs likely to recover from this? I don't know that big dogs or smaller ones are more or less likely to recover; plenty of each do. Even if recovery is partial or not at all they can do VERY well, but it seems to me that most dogs recover at least partially.I appreciate any help!
:blink: It sounds to me like she's doing pretty well for 3 weeks out!

User avatar
CarolC
Moderator
Posts: 12184
Joined: Wed Dec 31, 2003 7:00 pm
Contact:

Re: Labrador L5 IVDD post surgery

Post by CarolC » Mon May 27, 2019 10:07 am

Lolalab wrote:
Sat May 25, 2019 7:15 pm
Hi all, I think I’ve read almost every post, this site is very helpful. Wondering if I can get some opinions on my dog’s recovery process. Lola is a 90 pound black lab, 7 years old, very healthy. 3 weeks ago she became kind of slow, in the middle of the night she squealed and had some wobbly walking and refused to move once I laid her down. the next afternoon I took her to neurosurgeon, she had knuckling and hind leg paralysis...kept her overnight, she seemed to do better that night “almost normal” and the following morning she had deteriorated. CT showed ruptured disc and hematoma to L4, had deep pain perception and had surgery at 11am. Came out without DPP, stayed in hospital for 10 days, that day she regained right hind foot DPP, home with indwelling catheter. A week later she has both hind feet DPP. This is GREAT news! With a help em up harness she can balance on her feet for a second. We go back this week for neuro follow up. I have her on crate rest, take her out 2 times a day for a short “walk”, and am doing range of motion exercises but her right hind leg seems tight...likely from iliopsoas muscle contraction from *too* much rest. She hates hip extension but I’m doing more massage and exercises for the tightness. You might want to ask the neurologist about this when you go for follow-up. Maybe they will give you a referral to physical therapy. A therapist may be able to suggest other treatments or exercises for this. I know that nerve regeneration takes about 1 inch per month, and with this tall dog (she may be part Dane, 90 pound but not overweight), I’m wondering what I should expect with her prognosis. I don't know either, but I would think if she already has DPP in both legs and can even stand for a second with assistance, she will likely be able to regain her mobility. Physical therapy would be a help if you can afford it. For example if she could go once (or twice) a week for hydrotherapy, it would probably be good for her, if you have a facility near where you live. Some places offer swimming, and some have an underwater treadmill, both are very, very good. It is another expense, and there is the issue of getting a 90-lb dog in an out of the car, for sure, and for some people the scheduling might be an issue if you work full time. But if you can manage it, I think it would probably be helpful. Years ago someone gave me a recovery timeline based of the number of centimeters per a certain amount of time. I wish I had written it down but apparently I didn't. It wasn't an inch per month, or I think I would have remembered that. It was told to me by a volunteer where I worked, who bred Papillons, and she got it from her vet, who I don't think was a specialist but she thought the world of him. I never knew if it was right, and I've never heard anyone mention it again since then (15 years ago). In any case, I probably wouldn't be guided by it too closely, just because there is so much variation in the nature and degree of each injury. Seeing that your dog has DPP and can stand briefly is extremely encouraging this early. I wouldn't think (?) it's going to take as long as that calculation seems to indicate? Seems as though she does not have motor reflexes, not tail wagging. She lets me know if she has to poo, unsure if she has bladder control because of the catheter. Well on this, I don't know. It is probably partly neurological, but at the same time, if she had lumbar surgery, I would think it would also be uncomfortable to use those muscles in the tail area, and every wag is going to flex the lower end of the spine. If I just had surgery 3 weeks ago, I wouldn't wag either, I'd probably still be trying not to move. In addition, I don't know how much she can feel the catheter, but it's right there. It seems like there are a couple of possible reasons she isn't wagging a lot, on top of the nerve injury she is recovering from. I am maybe a little surprised she is still catheterized after 3 weeks. I'm guessing the vet thought that with her size it would be easier, just because it is an effort to get a 90 lb dog outside several times a day and a physical fitness test for the owner to bend over and express a dog that size. Expressing can be done lying down, too. When you were looking through the posts, I don't know if you got a chance to see the information on expressing the bladder? It has videos at the end. :arrow: :arrow: viewtopic.php?f=5&t=16027 Having the catheter may have also been a precaution in case she dribbled or wet the bed, to be sure she stayed dry (which is really important). I wonder how long they are planning to leave it. Are big dogs likely to recover from this? Yes, big dogs heal like smaller ones, it's just more effort for the owner to do the daily care and physical therapy. Really, if you could get her into PT (if you can afford it), you may find the personal support of having someone else helping you rehab your big dog is priceless. I appreciate any help! I just want to make one suggestion, that any time you go to the vet or PT, when you arrive ask them to help you bring her in, and put her back in the car. You have enough to do, loading and unloading when you get home, let them help you at the facility, don't be afraid to ask. :wink:
:group:

Lolalab
Posts: 9
Joined: Sat May 25, 2019 7:03 pm

Re: Labrador L5 IVDD post surgery

Post by Lolalab » Mon May 27, 2019 2:15 pm

Ah that makes sense that the nerve regeneration is on the spinal cord itself, not that those nerve roots necessarily are injured. She has had PT twice, but we are going to do 2 days a week from now on. She had trust issues the first time she went, but she seems better that last time. I think she has indwelling catheter because the surgeon was worried about me being able to hold her up for expression, we are almost the same size. Thank you for your advice! Hoping I can get some questions answered on Wednesday at our follow up. It seems as though most successful dogs are walking a little by now, or at least have some voluntary movement. I’m hoping things start progressing now that she’s had improvement this week.

Lolalab
Posts: 9
Joined: Sat May 25, 2019 7:03 pm

Re: Labrador L5 IVDD post surgery

Post by Lolalab » Tue May 28, 2019 10:16 pm

Looking for advice on PT. Lola HATES when I try to do passive ROM on her legs. She will let me massage them, but as soon as I try to move them she puts her front paws on my arms and stares intensely at me. Or she’ll push me away with front paws and lay her head on her feet. I’m scared she’ll get too stiff. I’ve tried massaging the front and distraction and treats, too.

User avatar
CarolC
Moderator
Posts: 12184
Joined: Wed Dec 31, 2003 7:00 pm
Contact:

Re: Labrador L5 IVDD post surgery

Post by CarolC » Tue May 28, 2019 11:04 pm

That's kind of strange. It is bothering her for some reason. I wonder if it could be the catheter. I've never heard of a dog doing that. You might see if the vet (or a physical therapist) could do it without her objecting, in case it's just an alpha/self-protection thing. Some dogs will behave better for a vet than when they are on their own turf at home. But if she is normally cooperative, then it makes you wonder if it is uncomfortable for her. Perhaps the vet or therapist can find an alternative way to do it that she won't object to. Sorry, this isn't much help...
:thinking:

Lolalab
Posts: 9
Joined: Sat May 25, 2019 7:03 pm

Re: Labrador L5 IVDD post surgery

Post by Lolalab » Wed May 29, 2019 12:03 am

Thanks for replying so quickly :) I think I can get more movement out of her than the PT, from what they’ve said. She goes back tomorrow. She’s a big baby. Chillest/laziest dog. Which is why I don’t want to get wheels unless we have to; if she finds out she can get around easier with wheels I can see her thinking “GREAT! We do this now!”

User avatar
CarolC
Moderator
Posts: 12184
Joined: Wed Dec 31, 2003 7:00 pm
Contact:

Re: Labrador L5 IVDD post surgery

Post by CarolC » Wed May 29, 2019 11:00 am

They all have their own personalities, don't they! :lol:

Lolalab
Posts: 9
Joined: Sat May 25, 2019 7:03 pm

Re: Labrador L5 IVDD post surgery

Post by Lolalab » Tue Jun 04, 2019 12:59 pm

Last Wednesday at the follow-up the surgeon saw that she has some voluntary left leg movement (she kind of kicks her left leg forward when she is walked slowly, but then immediately knuckles). She definitely has some tail movement, although it's subtle..it does seem to be voluntary. Surgeon said wait for a full 9 weeks post-op to decide if we should get wheels or not. So we are 4.5 weeks post-op. Any stories of dogs eventually recovering >80% if they have been similar at this stage post-op?

User avatar
FYI
Posts: 689
Joined: Tue May 15, 2007 2:16 pm

Re: Labrador L5 IVDD post surgery

Post by FYI » Tue Jun 04, 2019 1:09 pm

Lolalab wrote:
Tue Jun 04, 2019 12:59 pm
(she kind of kicks her left leg forward when she is walked slowly, but then immediately knuckles).
viewtopic.php?f=4&t=20403&hilit=knuckli ... 45#p103941

Lolalab
Posts: 9
Joined: Sat May 25, 2019 7:03 pm

Re: Labrador L5 IVDD post surgery

Post by Lolalab » Tue Jun 11, 2019 9:30 am

My 85 pound dog has been on gabapentin 300mg twicy daily for 5.5 weeks; my vet said we can stop this med now. I keep reading that we need to taper this dose. Vet says "that's only true in humans". I trust him, but does anyone have more info about if it is necessary to taper?
Lola has very small movement in her right toes occasionally when sleeping, not sure if it's voluntary; seems more likely reflex stretching. She does wag her tail more lately. The progress is so slow, it's hard to imagine how she'll move those huge legs out from under to to pull to a stand. Her stomach is about 17 inches from the floor when she's standing. That's so much dog :|

User avatar
CarolC
Moderator
Posts: 12184
Joined: Wed Dec 31, 2003 7:00 pm
Contact:

Re: Labrador L5 IVDD post surgery

Post by CarolC » Tue Jun 11, 2019 12:07 pm

That was a good question that I don't remember anyone asking before. I am not a vet but I looked it up and do find several sources recommending tapering gabapentin for dogs. I will post screenshots and links below. I should also mention I found what appears to be a highly credentialled source where the doctor does not mention tapering. If your vet is subscribing to the Plumb's Veterinary Drug website or owns a current copy and is going by that, I would trust that. I have an older copy but it is not up to date. Gabapentin is fairly new in being used for pets and they are still learning about it. Whatever Plumb's says, I would trust that.
gabapentin_dodgerslist.PNG
http://www.dodgerslist.com/literature/drugs.htm#Neurontin
gabapentin_veterinarypartner.PNG
https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4952756
gabapentin_wedgewood.PNG
https://www.wedgewoodpetrx.com/learning-center/professional-monographs/gabapentin-for-veterinary-use.html
gapapentin_petmd.PNG
https://www.petmd.com/dog/care/gabapentin-dogs-what-you-need-know
Yes, you are EXACTLY right. You said it well. The progress does seem slow. Here people often refer to it as baby steps. She is healing a tiny bit more every day in the background where you can't see it. The thing to keep in mind is, the nerves continue to heal for months and literally years. You've got the disk taken care of, that was the first thing, now the recovery continues. If she is wagging her tail, that is very encouraging. In my experience and the experience of some other people here, you go through a time of seeing what appears to be very slow progress, but then when it gets to a certain point, things start to happen more quickly.

I really hope you can hang in there. Nobody is in a position to question you when the dog is nearly as big as you are and you are doing it alone, we can only do as much as we can do. Usually seeing the little signs of improvement along the way is what keeps us going, but if you are 110 lbs and the dog is 85 lbs, it isn't like taking care of a dachshund. I was about 113 lbs when I cared for my 63 lb golden retriever for 8 months (he was old, not a disk problem). One thing that helped me was a way to think about it. A dog carries 60% of their weight on the front feet and 40% on the hind feet. That means with an 85 lb dog, when you help her up with the sling, you are lifting about 34 lbs. That is certainly a great plenty, but just thinking about it that way somehow makes it seem more doable than thinking, "I'm lifting an 85 lb dog all day." The lifting is the same, but you feel better about it. I don't know, it helped me. :) I think you have reason to be optimistic, if you are able to do it physically.

Lolalab
Posts: 9
Joined: Sat May 25, 2019 7:03 pm

Re: Labrador L5 IVDD post surgery

Post by Lolalab » Tue Jun 11, 2019 12:40 pm

Thank you for doing all that research! Is there a guide on how to taper? I'm assuming I would bring it down to 300 mg once daily for a few days, then to every other day for a few days? I think I'll just give the dose at night, since it may have some sedating effects.

One other question (for the day): she gets very distressed when she has to poo. She whines and paws at me, and I know to check, just putting a little pressure on the outside of her bum I can feel that her rectum is full. So I use a baby wipe and gently help her to poo. I've tried the ice cube and the q-tip, and it didn't work as well. At least now while she's down....am I doing any damage by assisting her like this? I can tell she has anal tone but I just don't think she has the lower abdominal muscle control to push with enough force?

User avatar
CarolC
Moderator
Posts: 12184
Joined: Wed Dec 31, 2003 7:00 pm
Contact:

Re: Labrador L5 IVDD post surgery

Post by CarolC » Tue Jun 11, 2019 7:22 pm

I tried to find a schedule for tapering and I don't see one. I'm afraid I only see general guidance. Is this something where you could say to your vet, "It might seem unnecessary to taper, but it won't hurt anything to do so, right? So in that case, how would you do it if you were going to? Because I just want to be as safe as possible." I understand hesistating to ask after he already said it's unnecessary, and for all we know he may be right. It doesn't seem to be firm one way or the other at the present time. That's rough for you, when you're only wanting to be sure you're doing the best for your dog.
https://veterinarypartner.vin.com/defau ... id=4952756
Gabapentin should not be abruptly discontinued after long-term use as seizures can be precipitated. Instead, gabapentin should be gradually tapered off over a couple of weeks.
https://www.vetsmall.theclinics.com/art ... 0112-5/pdf
Abrupt discontinuation after chronic administration ofgabapentin may result in withdrawal and seizures. It is suggested to taper the doseover the course of 1 week when discontinuation of chronic administration is needed.
https://www.wedgewoodpetrx.com/learning ... y-use.html]
Gabapentin should not be discontinued abruptly because withdrawal may precipitate seizures or rebound pain. The dosage should be decreased over the course of two to three weeks.
Here is some good advice from Tripawds:
Lately there’s been some controversy in our Forums and elsewhere about how to stop giving Gabapentin. Some veterinarians say it’s OK to stop Gabapentin suddenly if a Tripawd isn’t taking it for pain. However we’ll take Dr. Petty’s position who says Gabapentin should never be stopped suddenly.
“Forgetting to give a few doses can cause something called rebound pain, which can be as bad or worse than the original pain you were trying to treat.” — Dr. Petty’s Pain Relief for Dogs
As you know, we aren’t veterinarians so please don’t take our word for it about Gabapentin: always talk to your vet and make sure they’re up on the latest Pain Management Guidelines for Cats and Dogs.

On the potty question, your "little pressure on the outside of her bum" is one of the 'standard' methods of helping the dog eliminate. It's a good one. You can find it described in this article on bowel management, and see sample video demonstrations of the "squeezing method" in the videos at the end of the article. :wink:

:arrow: :arrow: viewtopic.php?f=5&t=18586

Lolalab
Posts: 9
Joined: Sat May 25, 2019 7:03 pm

Re: Labrador L5 IVDD post surgery

Post by Lolalab » Wed Jun 12, 2019 9:59 pm

Hi carol! I’m most concerned with the fact that she cannot poop unless I literally manually extract it from her. She will whine for hours if she has to poo and I’m not home (I work 13 hours 3 days a week and I watch her via camera). I’ve tried all the bowel expression tricks and she either eventually has a little nugget but is distressed about it, or I take a baby wipe and scoop it out. I think she has a lower motor neuron I jury because she’s to contracted. I’m a nurse practitioner so I know the risks of a bowel perforation, but I can’t find another way to relieve her. Is this normal for big dogs??
Also I’ve decided to start acupuncture at home (bringing someone in), which is 225/hour. I’ve scanned the posts for results from acu but I can’t seem to find a definitive answer on if it really works.
Twice in the last 2-3 weeks her urinary cath has either mysteriously fallen out or she pulled it out (500$ hospital visit to replace it each time because she needs sedation...she has sensory but no motor).
I also live in a 3 story condo. And am realizing I’ll need to move if she requires wheels. I dream nonstop about her walking. And I sleep on the dog bed next to her every night, so she doesn’t have to wear a cone, and she’ll whine and paw at me if she has to poo.
I was overwhelmed weeks ago. Now I’m just obsessed with researching and I stare at her paws for hours when I’m off work. When I ask PT and her surgeon about their thoughts, I gave the safe answers...”we’ve seen dogs who recover and dogs who don’t, every dog is different”. I wish someone would tell me which path to prepare for.

Post Reply