Really disheartened and could use some advice...

[ScotchysMon]

Hi everyone,

I know that you may not remember me, but I was an avid poster when our 5 year old Pekingese, Butterscotch, was diagnosed with IVDD in 2006. I won't bore you with all the details--I know many of you are all too familiar with the problems caused by IVDD. In November 2006, Butterscotch had a second bout, was paralyzed from mid-back down, and had emergency surgery by (in our opinion) a great veterinary surgeon (Ken Moore at Coral Springs Animal Hospital in Coral Springs Florida).

Generally, the outcome was good. She regained the use of her legs, and was probably functioning at 85-90% on carpeted surfaces. She still struggled on tile and other slippery surfaces, but we were pleased with the progress she had made, and felt that the surgery had been a good decision. Since the surgery, she has had two more bouts with the IVDD. Both were able to be treated with anti inflammatory meds and crate rest.

Over the weekend, we noticed some lethargy, reluctance to walk, and weakness in her hindquarters. We crate rested her immediately. Yesterday she had a shot of prednisone and is back on all the anti inflammatory meds and muscle relaxers. As of this morning, she appears to be completely paralyzed (no tail wagging, which is a huge red flag for us) from mid-back down again.

My husband is on the way to the vet with her right now, for admission, evaluation, and to start a course of IV steroids. However, both he and I are of the mind that they may very well recommend emergency surgery as they did before (pending, of course, the neurological workup).

We are on the fence about more surgery. It seems that her IVDD has continued to progress rapidly, and we have several concerns--one is overall quality of life, as she had a long, uncomfortable, protracted recovery from the first surgery, and we don't necessarily want to subject her to that again. Additionally, the surgery is no guarantee that she'll regain function...and if she does, she may still need yet another surgery down the road due to the progression of the IVDD to other discs (and she's only 5!). Finally (and this is actually the least of the concerns, but bears consideration as well), the cost of the first surgery and associated care was right around $5000, and I would assume another surgery would be in the same ballpark. It's a consideration for us, particularly because an additional surgery does not mean that will be the end of the IVDD.

I guess what I'm really looking for is advice/opinions from folks that have dealt with multiple bouts and/or surgeries. I also know that many folks here have had great success with their pets using carts when surgery isn't an option, or if it fails. However, (and I know I won't necessarily be making friends with this statement) we had a Peke with special needs before we got Butterscotch, and I'm not sure we're ready to make the long-term commitment to having another special needs pet. I realize that's not a totally fair statement, since IVDD is a long term degenerative disease, but dealing with activity restrictions, crate rest, and meds is very different from dealing with a pet with paralysis and the associated sequelae (incontinence, major mobility issues, etc.).

So any advice you could give me would be MUCH appreciated...

Thanks,
Joanne
(Scotchy's Mom)

[Cindidoxiemom]

I have a dachshund that has undergone two surgeries for IVDD and is doing very well at age 14 1/2.
I also have a dachshund that is paralyzed due to IVDD. I would do 100 surgeries if there was even a 20% chance of recovery. While caring for a paralyzed pet is perfectly doable, it is a commitment, and having to express three times a day can limit your life to a certain extent.
Wait and see what the results of the evaluation and tests are before making your decision.
If it were me..I would do any and everything I could to avoid the dog becoming paralyzed.
Cindi

[Paul Coover]

Surgery is always the best option. It is difficult, for sure. But Cindi is right, caring for a completely paralyzed pet is not always easy. If surgery could repair the damage, it is always the best option.

We have 9 dachshunds total.

We have 2 dachshunds that are paralyzed and use wheelchair carts. We also have Riley, a dachshund that we adopted as a downed dog but he recovered. Here is his story:

http://www.handicappedpets.com/gallery/riley11/

We also have Johanna, a dachshund that was left paralyzed from an attack with a baseball bat.












Here is a link to when Johanna and I were on the news in Boston in August 2006.

http://www1.whdh.com/features/articles/specialreport/BO25472/

Pork Chop has a slipped disc in his neck that has left him paralyzed.













Handicapped and disabled dogs can live very happy and healthy lives, as I hope you can see. Remember, being disabled doesn't mean being destroyed!

It is important to keep a good, positive atitude right now. I know it is very difficult, but it is so important right now. Your dog will feed off of your energy, and you want to give them the best possible chance to recover as quickly as possible.

If you have any questions, please feel free to ask. Good luck!

[kristenv]

Hi Joanne,

I am so sorry you are going through this again..and know that you must feel so overwhelmed right now!!!
Like you and Scotchy my Samy and I have been going through a similar scenario. Surgery (T-11-12 with fenestrations))on March 30, 2007. Full recovery walking 1 mile a day etc.
He went down again in and had his second surgery (T 12-13) November 30,2007 and again had a full recovery.
He was doing well with walking again as his rehab etc.
April 18, 2008 down again, only not so far down Weakness in the hind leg and pain in both the lumbar(new) and thoracic area.
Was in the ICU for 1 week, the vets felt he had a good shot at recovery without surgery (but did say if this was his first episode they woudl have elected for surgery) then transistioned to rehab than home, than back to rehab, then home and is now on his 7th week of crate rest and doing well.

The surgeries and associated care were around $5000 each, and I have already mentally resigned myself to the possibility of a third in his future. He is my baby and my inspiration!!To look at him today, you would be amazed. He has recovered so well again (dodged another bullet so to speak) that I cannot help but feel that we have been hugely blessed, and (just maybe) that I have made some of the right decisions!!

You will know in your gut what is right for your baby, and I am ceratin the vets will help give you the inofrmation to make the best decision.
BTW
I found out during the last episode that they can do up to 6 hemilaminectomies...yet with each surgical correction it places further stress on other areas of the back so obviously not a cure all either!!!

Please know that you and Scotchy are in my thoughts!!
Kristen and Samy

[ScotchysMon]

Hi everyone,

Thanks so much for the kind words and advice.

Scotchy had a neuro exam last night at 10:00, and we spoke to the vet who told us that her condition was unchanged (deep pain response present, and minimal movement in response to 'tail-walking').

She had another neuro eval this morning, and she's again essentially the same. Two of the three surgeons who have evaluated her are taking a conservative stance at the moment (watch & wait for another 24 hours), and one is taking a more aggressive stance (surgery now, if we want it). Since Ken Moore, who did her previous surgery, is one of the conservative opinions, we're going to watch and wait.

My husband and I talked last night, and we agreed that we would go ahead with the surgery if she needs it. However, we also decided that this would be the last surgery. We can't see putting her through a 3rd surgery (it takes a huge toll on her, and us), and if we reach that point, we'll consider other options.

Since it seems I'll likely be posting more frequently here in the coming weeks as Scotchy recovers in some form or fashion, I decided to include a couple of pictures so that you all can see who you're rooting for!

Again, my husband, myself, and Scotchy all appreciate the support and advice!

Joanne
Scotchy's Mom

[SandyNY]

hi Joann. Sorry I do not know anything about ivdd and related surgeries. i understand your desire to not put her thru so much - it is so hard to judge if it is worth it when you do not know what the end "it" will be...and then, how soon before we are right back in the same situation. I do hope things go well for you and her both. Maybe her recouperation can be handled differently? can she maybe be home vs the vet office? I don't know/ remember exactly what involved in her post-surgery recovery but i know you said it was not pretty for her. Best wishes for you and the family.

[kristenv]

Joann,

First off what a sweet little face, thank you for sharing some pics!!!!
I know you must feel shell shocked now, like how could this happen again. I know I did too!
However amazingly I found Samy did better during his recovery of his second surgery than the first.
I knew what to expect, and we intervened on those issues that were problematic after the first surgery such as pain control (switched from fentanyl to tramadol) and urination retention (phenoxybenzamine is our freind). I also took him directly from Purdue to a rehab center as the discharged him both time 36 hours after surgery, and the vet at rehab is incredible. Samy was nuts about her.

Think back to what worked before, and that which did not work so that you can optimize recivery should it become necessary. I hope he does not need it though!!
Take care and keep us posted!!
Kristen and Samy

[ScotchysMon]

Hi Sandy and Kristen,

Thanks so much for your thoughts! The last time that Butterscotch had surgery, we didn't even know how well her recovery would go--we had only had her about 6 months when the IVDD forced the first surgery.

I was just looking back to the old posts I had made at the time of Scotchy's last surgery, and we definitely had some problems with pain management. Our vet is great and I have ZERO complaints about the care (including pain meds) she received, I think she just has a low pain tolerance (fentanyl patch + morphine shot + muscle relaxers + valium essentially did NOTHING to reduce her discomfort, or even chill her out, really). At one point, we took her back for the shot of morphine...and even THAT didn't really facilitate sleep, but just zoned her out and made her loopy. I remember at one point, even after all the meds, she was literally falling asleep sitting up, and would nod off and then snap back to attention (much like we all do in boring meetings sometimes *lol*)...I remember thinking how much better off she would have been if she had just been able to get some sleep! She also had a lot of discomfort and itching around the incision, and we had trouble getting her to take her meds (a function of poor appetite, I'm sure)...all of which I know are normal and expected after this kind of surgery.

So now it's just a waiting game...and I'm actually really glad, Kristen, that your post prompted me to look back at my old posts. I've been feeling so down about this, and I think it was good for me to read the old posts...I talked a lot about the progress she made, and saw how well she really did do after the last surgery, all things considered. I guess our memories all become somewhat skewed, thinking back--I know mine have, as I've been focusing a lot on the sad and difficult aspects of her last recovery, and omitting a lot of the really good memories (her first steps, how good her attitude was once the pain was under control, seeing the day by day improvement, etc.).

Tomorrow morning will tell the tale, so to speak...we'll get the report on tonight's 10pm neuro exam, but tomorrow morning will really be crunch time, as that's when we and the vet are going to make a definitive decision on the surgery.

Please cross your fingers for us!!!

Joanne
Scotchy's Mom

[ScotchysMon]

Hi everyone,

Just an update on Scotchy....we spoke to the surgeon this morning, and it seems that they think Scotchy's course has been somewhat atypical. Right now, she has maintained deep pain response and has limited mobility in her hindquarters, and has maintained bowel and bladder control. This is essentially the same as she was on Tuesday morning when we brought her to the vet.

By this time, they were expecting to see a worsening if there was going to be one (i.e. loss of one or more of the above mentioned things), and we were prepared to do another surgery. However, since she hasn't worsened, they have now changed their thinking slightly. They believe that this episode may not be related to an acutely herniated disc(s), but rather an exacerbation of the chronic IVDD.

They are recommending that we take Scotchy home, crate rest her x 4 weeks, and keep her on oral steroids, muscle relaxers, and pain meds. Obviously if she worsens they want her back right away, but if she stays the same or improves, we can put surgery on the back burner for now. All three surgeons seem to be on board with this plan.

So, (crossing fingers) if everything goes well for the rest of the day, Scotchy will be home tonight, and then (hopefully) her recovery process can begin!!!

I will keep you all updated...

Joanne
Scotchy's Mom

[ScotchysMon]

Hi folks,

I hope everyone is getting ready for a good weekend!

Scotchy came home yesterday! She was in good spirits when we picked her up, but by the time we got home, she was ready to just zonk out. She slept most of the evening, went out for a potty, and then snored all night long. I think she was glad to be home, relaxing and sleeping in her own crate.

She's on prednisone, methocarbamol, tramadol, and pepcid for the tummy, and she seems to be tolerating them all with minimal side effects.

She also came home with a leash that one of the surgeons, Dr. Jehn, made for her. It's much better than the sling we were using, and is similar to the Bottoms Up leash sold here. I think that's going to be very helpful in the long run--it makes potty breaks easier on all of us.

As of this morning, she's about the same; but her attitude is good, she was excited to go out, and also excited for the chicken breast we hid her meds in, and seems pretty happy overall. We're going to start doing the PT exercises recommended by the vet tonight, and hopefully we'll start to see improvement soon!

Joanne
Scotchy's Mom

[SandyNY]

Joanne, i am so happy things are going well. maybe this time around will be easier on her because she is established in your home and it is not all 'new' to her - this experiance. so glad she is resting comfortably- it is worth it to miss a part of the summer if she can have the rest of the year+ surgery free and relatively symptom free. keep us updated!!

[kristenv]

Hi Joanne,
I am so glad to hear that Scotchy is home, and that she is doing so well. Hopefully this mix of medications will work better for her as well.. And she is urinating??!! That is awesome.
Is the hind leash kind of a figure eight loking device? If so I use(d) that and it worked very well (slows my little guy down too now as he is feeling better he wants to go go when we are outside).
I am certain all of you are exhausted......but you will get through this. You are better prepared than before. Scotchy is lucky to have you.
Wishing you a quiet weekend!
Kristen and Samy

[ScotchysMon]

Hi everyone,

Thanks for all the encouragement!

Scotchy stood up on her own yesterday! Now, it was just for a few moments, and it was in response to a piece of chicken breast (which had been adulterated with her medication *lol*), but I'll take that in a minute!! Her pain seems to be under control, her spirits are good, and we're hoping this slow improvement continues!

YAY!!!

Joanne
Scotchy's Mom

[Aus Dilecce]

That's great news Joanne. Until Cinders went down I didn't even know about IVDD we sent her for surgery knowing nothing and although it's all only been 2 months and she is now up and walking (albeit a bit funny) I'm paranoid about another bout. If you can get away with the crate rest it would be marvellous.

Sending smiles from downunder, Kate xx