What to do with Oscar... (long!)

[Debbie-Spain]

Oscar needs some kind of a wheelchair/cart/mobility aid. At any time I have a garage full of different carts that we use for our foster dogs and lend out, when we buy new carts we generally buy Doggon and are very happy with them.

But Oscar is a challenge, he's not like any of the other paralysed dogs we've had and I don't know what to do with him. It's a complicated case so here's a bit of background:

He was abandoned and hit by a car last July aged approx 8 months and spent 3 days on the roadside. A bus driver stopped each day and gave him water. On the 4th day he called the local shelter (that's Spain for you!)

Oscar came to me in August with diagnosis of 2 spinal cord fractures, both with displacement, and bad wounds on his legs. He arrived ill and it turned out to be parvo. Nobody thought he would pull through, he was extremely ill for about 12 days. When hit by car he was 17.5 kg, when he started to recover from parvo he was 11.5 kg. He has remained very thin, his rear end painfully so. Just as he started to recover from the parvo, one of the severe wounds on his legs opened up and the saphenous vein split, we found him with blood spurting about 4 feet into the air, I still can't quite believe we managed to get him to the vet in time (half-hour drive) and he managed to stop the hemorrhage, and the extra blood loss on top of the parvo didn't kill him. So Oscar does seem to have a will to live!

Either Oscar (or his x-rays) have been seen now by about 10 vets and a couple of neurologists (there aren't many in Spain) and traumatologists at 6 different clinics and hospitals. Nobody wanted to touch him. I said I wasn't bothered about him recovering any function, just wanted them to try and stabilise his spinal cord somehow so he wasn't in pain. Still no takers. Even our favourite acupuncture vet who has helped us with so many difficult cases said all he could recommend was to give him strong painkillers. Nobody expected him (or me) to keep going...

Anyway, Oscar wasn't doing very well, he didn't seem to be in great pain but was getting thinner and thinner even though he ate well, to the point where I decided he was going to die on me. I thought I would try and make what little time he had left a bit more fun and started making him "Oscar cakes" which were just some cakes with lots of apple and carrot in and a bit of banana and some sponge cake to hold them together. And they seemed to change his life ) He started getting better and better, happier and happier, lol. I can't really explain that.

So, now he is very happy and bounces constantly. He doesn't appear to be in any pain, as long as he is in control of his movements. We have a kind of tacit agreement whereby I pick him up in a certain way each day to put him in the bath and shower him. If I try and move his legs for any kind of rehab, he screams. If you put him in a wheelchair and manage to do it in one smooth movement, he is okay, but if you accidentally catch his legs on the saddle or the frame, he screams, same as if you catch them on the edge of the bath. He does sometimes move his legs but it seems to be involuntarily. I have to do acrobatics to put any kind of cream, spray on his skin etc. He is not an easy dog to deal with, very nervous, quite afraid, whenever he feels he is not in control. People think that when he screams he is "putting it on" but I worry that it is because he can suddenly feel his legs. From all the other cases I have seen, my guess is that he has slight or occasional sensitivity due to the unstable fractures that none of the vets want to touch, agh! In all the time he has been bouncing, I have never seen him hurt himself though, and he really lands hard on his legs sometimes...

The main problem is that if you look at him sideways on, he is in the form of a letter Z, the top bar being his head, the downstroke his body, and the bottom bar his legs. His back legs are always horizontal, if you lift him from the floor they don't hang down, they stay horizontal to his body, as though hugging his chest with his knees, and his toes point backwards. I can't extend those legs, just trying has him screaming the place down, so I'm not even going to try any more.

I am fostering Oscar. I know he will never be adopted, because apart from being a very complicated case in terms of how to handle him, his incontinence is of the worst kind, he just loses pee and poop incessantly and has skin problems because of it, even Cavilon isn't strong enough to protect him. Fortunately his intermittent sensitivity doesn't appear to reach skin level. Expressing him is impossible, he screams if you try that too... and being able to express him would make life so much easier...

He needs some kind of special cart or chair. Or possibly something like what you have been talking about for indoor carts. I don't know, but he seems to be uncomfortable with his back horizontal. His legs are in the right position, once he is actually in the wheelchair, to hang them from the back bar, but the problem is getting him into the wheelchair or getting a harness onto him even (I have nobody here to help). Also, I worry that with his legs just hanging he is going to worsen the state of his spinal cord. Not sure if anyone has any ideas, I really need something like a bag on wheels The Dog Mobile from the UK is for dogs that simply rest on the saddle but the feet need to be pointing forwards, not backwards, and also the one we have here is very heavy for its size, he needs something much lighter.

Anything I put on him such as trousers gets so dirty straight away that it is not worth the effort of getting them on him. Just getting a diaper on him is a major task.

Here is some video of Oscar on grass nearly 2 months ago:

http://www.youtube.com/watch?v=QGQINI3tC4U

Below is the photo of him when he was on the road, and another of him in April (in his "A" shape which is for when he balances himself, his legs go further forward to actually move but still remain a little to the side). You would hardly recognise him as the same dog, but while I really had my doubts about continuing with him during the first few months, he is so happy all the time now that we have to find a way ahead... recently we took him to a "dog adoption day" and he was bouncing around on the grass and even the non-believers were coming up and saying "I have to admit, he does look very happy"...

If anybody has any ideas, or knows if any of the cart manufacturers have done something similarly complicated, I would be grateful for any help,

If you want to see his (hideous) x-ray, it can be downloaded from the url below, for some reason I can't upload it here...

http://www.sendspace.com/file/g86vn2

Thanks

Debbie

[kristenv]

Hi Debbie,

I wish I had just the right thing to suggest, it almost seems like you need a low dolly (small platform) on wheels to help Oscar stay in the position he is comfortable in and be able to move. I wonder if you contacted any of the wheelchair companies (I have previuosly spoken with Leslie at Eddie's wheels and she was so helpful) if they could perhaps develop something for Oscar's special needs.

There are way more experienced people on the board who I am certain will be along to offer their suggestions....but I wanted to commend you for taking Oscar on. Your video and pictures brought tears to my eyes, and I hope that you are able to find all you need to continue to care for him. What a sweet baby!! Parvo and this too, yes he does have a strong will to survive!!

God bless,
Kristen, Samy, and Dottie

[Christine]

Oh my goodness, Debbie...what an amazing story. I am beginning to think you and Karen are twin separated at birth! This sounds a lot like Jude's story. I wrote a reply this morning and promptly did not send it.

I had a couple of thoughts: Wondering if Mark's new wheelchair line might have something that would work or perhaps they could come up with something new.

That video of him is unreal! The mystery of his screaming is even more so watching him bounce around. Could it be a nerve that is being pinched because of some tiny unknow movement that he knows not to do? It could even be psychological, as I am sure you have thought. Have you ever been able to touch him without his seeing you do it to perhaps test that?

I love the part about the Oscar Cakes. They should be renamed Oscar Miracle Cakes! Hoping there is a solution for this obviously happy boy. You deserve so much praise for giving another "lost cause" a chance and love.

[Dianne]

Debbie what about sitting his rear on a wooden plant stand?

It breaks your heart the way people can be so heartless with animals.

[Debbie-Spain]

Thanks for the replies and ideas. Would you believe I have spent weeks looking at plant stands on wheels but they are all either too small, or too round. If I were just the slightest bit "handy" I would try and make something myself on casters but I did try and do a little "trailer" for the back of Bombon's cart once and the result was really pathetic and laughable

I think I need to try and keep him still (impossible when I'm next to him) and draw around where his legs rest on the floor, make some kind of a template that size and put it on casters. The problem is that as soon as you raise the height you make him stoop even more to reach the ground.

There are some plant stands that are rust-proof and supposedly can take "a man's weight", e.g.: http://www.mercurypots.co.nz/plant-stands
But I need a way of attaching him to it that is easy, doesn't require much manipulation etc. Also a kind of oval or rectangular shape would be better and I haven't found any, only round or square or very long and thin.

I even looked at things like the Dyson vacuum cleaner "ball" (if you don't know what it is see video at http://www.dyson.co.uk/ ) thinking if you could have something like that touching the ground kind of in between his knees and have two channels on either side that would hold his legs just a cm or so off the ground...

I think that's the problem, I have thought of so many things and gone over so many ideas in my mind that now I don't know what might be feasible and what won't be.

Hmmm, back to the drawing board...

Thanks again, all the input helps!


Debbie

[critters]

Have you emailed RichB? Like send him this link and see what he thinks? He's a supercreative guy.

I wonder if his screaming is from nerve pain that gabapentin would help? Haven't watched your movie yet; movies don't play well with dialup.

[k-9cart]

The way you are describing the pain, I would think that Oscar would be a good candidate for Tramadol. I don't know what the brand name is in Spain, but it seems to do wonders in osteosarcoma patients. In any case, it would perhaps make him more tractable to consider for a candidate for some rearlimb support or mobility.
K9 Carts

[CarolC]

Hi Debbie,

I had to wait to use another computer to view the video and x-rays. He looks like a candidate for a body cast, at least on the upper fracture. At this point I would be crating him to avoid having those fractures moving. I am sorry, it is easy for me to say and you have already talked to lots of vets, but it seems like the continued inflammation that could be caused by the fractures moving could result in irreversible deterioration of the spinal cord. I am not a vet, maybe I am wrong. What is their reason for saying no?

The description of hugging his legs to his chest when being moved is exactly what Dolly was doing due to her broken hip. The vet saw the broken hip on the x-rays, but he said it was luck, there are many times you can miss a broken hip on an x-ray due to the angle it is taken.

[Debbie-Spain]

Thanks all. Lol, I replied explaining how vets in Spain are 10/15 years behind the US in terms of expertise (their own words) but about 150 years behind in terms of attitude towards animals and quality of life, but it ran to 7 pages, so I rewrote it and now it's down to less than 2.5. In short, the general attitude here is that if it's complicated, best to "euthanise" and buy a new one... we had many cases like that, a couple of which went on to walk. And we work with some of the most forward-thinking vets here. Some still recommend "euthanasia" for animals born deaf, or with operable problems, because it's cheaper/easier to get a new one. The vets with the greatest expertise (in theory) are usually not very sympathetic, and the most sympathetic usually don't have a great deal of expertise, it's very hard to find both combined. I consider we work with some of the best, most of our animals attend different clinics at different times, all of them have had at least 1 PTS recommendation, often several.

I wasn't clear enough about Oscar. The X-ray is from end of last September, 3 months post-accident, we had just tried him in a wheelchair and everyone raved but I wasn't convinced he was comfortable, so I had the X-ray taken. But apart from that he was crated from 2 August until late February, supposedly in July too but I fear then he was not under good control - I found out he escaped onto the street twice, and his original x-ray had only showed one clear fracture The second fracture may have been hiding, may have been caused by his escaping onto the street, or may even have heen caused during the rush to the vets when he was bleeding, though I can't see how, we were extremely careful but his life was in danger. The video was taken 7 months after the x-ray, less than 2 months after he stopped being crated and was the first time he had left the house/garden except for vet visits. When things are less strained with my vet (angry with me because the feral cat I rescued bit him badly and he couldn't operate for 2 weeks - and he is the best I've got!) then I'll try to get a new RX done. But it will mean being told again to euthanise him (this is from the vet who adored Bombon) and being made to feel I'm the mad Englishwoman who only keeps animals alive to watch them writhe in pain. If they always euthanise how are they ever going to make any progress? My acu vet is has excellent contacts (he teaches post-grad vets at the university here) and he said that if I found anyone here to agree to operate on Oscar it would be the first time they had attempted anything similar and "they would be practising".

Oscar is not in pain generally, I know because of the way he behaves. I have seen him when he was seriously ill and in pain. He is a completely different dog now with a great sense of humour. He wants to follow me everywhere. But we are a tiny association and can't afford to take Oscar abroad where he might find someone willing to operate on him. I forgot to add, he has food intolerance, he is on hypo-allergenic food and I have to be careful with any oral medication because he gets diarrhea fast. Not sure if that's a legacy of his parvo. The other problem with sending him anywhere is that few people would cope with Oscar's incontinence, it is the most severe I have seen. He is dirty every 5 minutes, 24/7, no matter how much you clean him, it just constantly seeps out, pee and poop.

We managed to get treatment for a lot of paralysed animals here in Spain, many people call us because they can only get PTS recommendations from their own vets. We have taken in over 30 paralysed animals ourselves and worked closely with maybe twice that number or more, and all came with a recommendation to PTS. So please understand that if I say there is nobody here who will operate on Oscar, it's because there really is nobody here who will operate on him (let alone anybody trustworthy), even though I've said that I don't care if he doesn't improve and understand he could die during the surgery and they won't be at fault if he dies, that I just want them to try and stabilise his spine... all our money goes on veterinary bills and we will skimp anywhere except there. But Oscar is the third case we have had that vets refused to treat except to give him the final injection. Turko, the first, was a quad GSD from distemper, Spain's best neurologist said he would never move more than his head and that his spinal cord could never recover. Turko lived for 4 years with one of our foster homes and recovered enough use in his front legs to use his Doggon quad cart. Yuki was the second, at autopsy they confirmed he had lower motor neurone disease and while it was a wasting disease they confirmed he was in no pain (as we suspected), and said it was impossible for him to have lived for 18 months (I had him PTS the day he stopped "smiling") - until we proved it with documents - then they said he was a fascinating model for study for human versions of the disease for which there is no cure - I provided them full details of his diet, supplements, etc.). We're not much luckier when we can operate. A shelter here took in a dog with spinal cord fracture (we have her now in a foster home) and found a renowned surgeon willing to operate on her to stabilise her spine. Later our vet had operate for hours to remove the wire they had put around her spinal cord as it was causing her pain and had twisted her body, she was worse than after her original accident (she can't use a wheelchair either but plays quite happily on her own territory). We recently took a dog to another "renowned" traumatologist in Madrid for operation on deformed legs due to untreated luxating patellas, he had said he would get her walking "normally". She bounced into the operating theatre making friends with everyone on the way then died on the operating table within an hour. I'm normally okay with those kind of things, I know they can happen and we have lost at least 6 animals on the operating table (not life-or-death surgeries) but in this one case we do believe they were negligent (vets aren't sued here though!). You just have to forget it and move on.

Getting Oscar this far has been a slog and at times it would have been easier to take their advice and times when I felt it might be better to PTS, and I don't like working without veterinary backing. But he has improved greatly in recent months and I am sure he now has acceptable to good quality of life. I would like to improve it further with some kind of a mobility aid. I understand that you all want to see him operated and rehabilitated. But unless anyone in the US wants to adopt him or we find some new surgeon with a different attitude, I can't see surgery as a possibility for the time being... . Carol, I understand that when that X-ray was taken there was a risk of myelomalacia, and I guess there always will be with some SCIs, but he is so much better now than he was back then that I guess he must have stabilised to some extent. He is a very vocal dog and I think he screams just when you're touching him and he feels something, but because you don't know, it is very difficult to work with him. He is happy as long as I'm not trying to mess with him to I have given up...

So thanks for all your input. I'm grateful for your advice and will keep it all in mind and continue looking for possibilities, but am going back to my original proposal which was to try and find him a mobility aid, because he loves going outside but needs something to protect his legs which were severely wounded in the orignal accident and have weak skin, and help him get around.

We were awaiting 3 new paralysed animals this week, one (dog) has died before we could get him out, it took us 2 days to get him from 800 miles away but it turns out he had been lying there for 2 weeks. The other two are more than paraplegic (cat with "brittle bones", can't walk on any leg, not sure if diagnosis correct, and a cat with rear end paralysis, missing a front leg and its tail, both have been left untreated for months until we found out about them) and I know I can get treatment for them, at least initially, so please understand that Oscar is a special case, I'm not neglecting him, I'm trying to keep him alive against all the odds because the vets only look at his x-rays and bones, not at his face and his eyes. Despite how it looks, he is lively and happy, and many people have met him recently and are amazed by him...

Thanks,

Debbie

[CarolC]

I'm sorry, Debbie, it wasn't you not being clear, it was me. You did say July in your post. I would never for an instant doubt that you're moving heaven and earth to work miracles in the face of impossible odds, I don't know how you do it. I'm sorry my post made you spend valuable time writing a long email, although it was very enlightening. If I see anything that might work for a cart, I'll let you know.

(I'm going to wear out this smiley at the rate I'm going.)

[Debbie-Spain]

Lol, don't worry, it really did me good to get it off my chest Most of the time since that X-ray, Bombón was ill and having seizures so often that I hardly wrote anything for ages and sometimes it helps...

I did think perhaps it wasn't clear, the time difference, and I was worried that people might think I was just plodding along with him with the X-ray like that. When the X-ray was taken Oscar wasn't bouncing around like he does now, and that's when we went around all the specialists and none of them would operate. It took us weeks, and I started seeing the first signs of hope in December.

Now every time he bounces I think he's going to break everything again but I can't stop him, he does it every time I go near him and I've never ever encouraged him

Hugs, thanks for your interest always (does that cancel out the other smiley???)

Debbie

[critters]

Hey, would a skateboard work? I've seen them from VERY skinny to VERY fat and quite oval-shaped. I understand what you mean about a ball between his knees, but I couldn't begin to know of anybody who could pull off making one.

[Debbie-Spain]

I've been thinking about that. I guess somebody somewhere might even make custom skateboards in different shapes? Would need to find very low wheels...

Will start looking up, bet I'm not their typical customer though

[critters]

YES!!!! Is skateboarding popular in Spain? I'm NO expert on it, but I think you'd want a change of trucks, too, because normally skateboards are steered by shifting your weight. Inline skate wheels come in TONS of sizes and types, which is what I'd use. I once had a pair of skates that were weird; I can't remember now if they were for stunts or what, but they had little bitty short wheels.

Another thought--have a PT or orthotist/prosthetist mold a platform to his legs out of thermoplastic and mount an inline skate wheel or 2 to the platform. You could even try a fixed caster (or 2) with a rubber wheel; I considered rubber ones when I was making Ari's cart because they're more shock absorbant, kind of like polyurethane.

[Debbie-Spain]

Sorry, just had an image of Oscar all kitted out in skateboarding gear, hahaha

Will look into it and see what there is here, there must be something that would work, I can see him skating round to Beach Boys songs

Will let you know if I come up with anything!

Thank you

Debbie