Spinal Subluxation at T13-L1

[Maxissonice]

Our Max, an 8 year old Wheaten Terrier, was hit by a car last Monday night.

We've had a rough week. He is home and resting comfortably.

He is paralyzed in his hind quarters as well as incontinent and cannot move his bowels on his own.

It is a 99.9% probability that he will never have use of his hind quarters or regain his bladder/bowel control.

He is otherwise fine, no internal bleeding or organ damage.

My husband and me having been engaged in the expected back and forth regarding next steps.

We and our 5 kids love Max with all our hearts.

It has been a truly heartbreaking experience.

We are at a crossroads at this point.

On the one hand, we are inclined to euthanize him. On the other hand, we don't want to lose him forever.

Regarding the two choices, we have compiled a list for each and turn to this board for any insight or guidance.

Thank you.

Euthanize

- Max's dignity as a dog is severely compromised due to his injuries and incontinence.
It seems like we would be ignoring this basic level of respect for living creatures to make him continue to endure this condition.

We are all taking turns watching him, but due to his incontinence, he needs to be expressed and washed due to ballder leakage/overflow, many times daily. His hind quarters are hardly ever dry, expect a few hours at night.

As I understand, dogs abhor being in or near their urine/excrement, even with extreme care, this is inevitably going to occur with regularity.

- Max has only been ill once in his entire life previously with a digestive ailment that was resolved after one week's time. It was a difficult week due to his diarrhea, but we muddled through.

Max will require almost 24/7/365 assistance for the rest of his life. While one could argue that it is our responsibility, we all have lives we must lead and do not want our continued relationship with Max to result in resentment and conflict between any of us.

- Max would be prone to continued life threatening illnesses such as bed sores, UTIs, and any other issues that come along with a paralyzed lifestyle.
It seems cruel to subject Max to further pain and suffering should he develop these illnesses, which most vets say, is a when, not an if.

- It is unnatural for a dog to continue life paralyzed. Max's greatest joys are running in the park, looking out the window for other dogs, and taking walks. He also loves to eat, but more about that in the other category.

- We think if Max could tell us what he wants, he would tell us to let him die with grace, in the best health he will be from this point forward, not in pain, and with no suffering.

- We are also concerned that the longer we delay the decision to euthanize, the harder committing to that decision will be.

- In Summary: Max's quality of life as a dog is severely limited to only eating, drinking, and being loved and showing love and affection. These are important parts of quality of life, but 80% of his quality is non-existent.

Not to Euthanize

- We don't want to lose Max. Is that selfish of us?

- Max is in general good health and it seems premature to snuff out his life with the possibility of a few "good" years ahead of us.

- Max has a younger sister, a 3 year old Havanese, Ruby, that looks up to him and used to follow him around wherever he went.
She is depressed as well and is obviously experiencing these issues along with the rest of the family.
Could it be possible that Max and her can continue to keep each other company ant times when they are alone?
Currently, Ruby, will occasionally sniff at Max, but appears scared to interact with him at any level.

- There is a possibility that Max will recover sufficiently to try to have him walk with a wheelchair device.
However, from what we've read, larger breeds (Max is 45 lbs of solid weight) do not take to these devices.

[Bobbie]

Okay- let me start near the end. Large dogs do FINE in carts. One climbed Mt. Washington. The major differences between large and small dogs is that small dogs can use the cart in the house and usually large dogs can't unless your house is very open. With larger dogs putting them into the cart can be tricky, but you really only have to lift the hind end- it isn't that hard at his size.

I think you are anthropomorphizing Max's dignity. He won't care that he can't walk if he can still move- the cart will give him that freedom. He won't care that he is incontinent. He can wear a belly band inside. Keeps him clean, makes clean up easier for you. How do I know? Oliver, who is nine, has been in a cart for more than three years. He's a tough, bossy Cardigan corgi who dares anyone to say he isn't dignified. He hikes, swims, plays ball, you name it. He has WAY more than 20% quality of life. He did a 5K last year.

You can learn to express Max's bowels (he won't feel it so he won't care) and by doing that and feeding a good food on a regular schedule, he'll stay much cleaner. Getting the hang of how to handle pee/poop takes time, but once you do, it takes about five minutes a day. If he isn't just leaking constantly you can also learn to express his bladder (in some dogs, what happens is that the bladder fills up and then overflows by itself- but it will hold for a few hours as long as you can express it as needed.)

As long as his front legs are good he'll drag himself around inside. (He'd do it outside, too, but then he would get sores.) Give him a good bed with a clean cover that you can wash and he shouldn't get bed sores. He's not going to be immobile.
He's not going to have a 20% life.

If his front legs were gone, I'd probably agree with you, although you could rehab him, it would be much more difficult to manage all of this. But really, hind legs are not a big deal. Neither is incontinence.

If you are on Facebook, look for "Friends of Oliver" and you can see some of his videos and see what he can do.

[Maxissonice]

Thanks a lot for your quick response.

I hear all that you wrote.

I cannot agree or disagree because, we don't have specific experience, and, each dog is different.

I failed to mention that he is a hyperanxious dog that is generally frightened of anything new.

For example, he walked very nicely around our block but even the slightest indication that we would be taking him off route resulted in severe pulling on the leash until the original course was resumed.

This hyperanxiety tendency of his makes me fear that he will have nothing to do with a weelchair harness device.

You did not address our concerns of the level of effort required to maintain his quality of life or how that might cause our family resentment.

I understand that he is our responsibility but we need to consider the well being of our human family unit to a higher degree.

We are also concerned with giving the children the distinct impression of supporting his handicaps only to find ourselves in the unfortunate position of making the choice in the near future and having to restart the entire process of saying goodbye and mourning our loss.

The children have not been in school all last week.

I am sure you understand the issues, I am really frightened of the level of commitment necessary to keep him comfortable and healthy, and the toll it will take on our family.

We both work and the children range in age from 23-15, all with full time school, College, and other work related commitments.

On average, Max is left at home alone for 7-8 hours a day.

I don't know if that is feasible now.

It would be a real disservice to Max and the family if he became such a burden as to turn our love for him into resentment.

To our minds, that is a much worse scenario to saying goodbye now with love.

[slshepherds]

Sorry to hear about Max. I'm Joanne and I have 4 paraplegics (all adopted), ranging in size from 30lbs to 70lbs (a Labrador). Yes, each dog is different, but ALL of my guys are happy, healthy and have no clue that they are any different to any other dog (Unlike us humans, dogs live day to day and go with what they have got). They have a GREAT quality of life and are pain free.

As you have found out, the first few weeks living with a paraplegic are tough (for you more than your dog). I lost count of the loads of laundry and baths I had to give Carl, but within the month I had found a belly band and diapers that worked, learned to fully express a bladder and set a schedule that worked with my own schedule. It now takes me about 30 minutes three times a day to express and change diapers on all 4 of my paraplegics. Aside from that they are just like any other dog and I have the same expectations as I would a "normal" dog.

Bed sores - shouldn't be an issue as long as Max has comfortable, dry bedding and boots for his feet to prevent friction damage. Yes, UTI's can be an issue as obviously a paralyzed dog can't empty their bladder, but with appropriate bladder expression they can be minimal. Day to day activities for my guys include all the things you say Max enjoys. I have video of my guys running in their carts (Carl, my 70 lb Lab has broken 4 wheelchairs he is so excited and active in them), barking out the window at the UPS man and going for walks.

Looking after a paraplegic dog is a commitment and not for everyone, but it is also not a burden unless you let it be. I am fairly certain that Max can have a great quality of life, the question I would ask is this something you can, and are willing, to do? If it is not then euthanasia might be the kindest option.

regards
Joanne

[Maxissonice]

Thanks Joanne for your reply.

I hear you too.

My husband and I are very concerned with the disruption in our family's daily schedule.

Also, very concerned with complications.

I sense Max is upset that he cannot go anywhere on his own.

As I mentioned, our Havenese is doing all the things they both did, and while we try to take her for walks quietly without alerting him, we still let her out in back to do her thing and he is right at the back door and hears all the "keywords" we've used all these years that he knows the meaning of oh so well -- Very sad for us and him.

He is also very sensitive to beeping from microwaves, and any other sudden noises.

I suspect this comes from his knowledge of his inability to run away from things that scare him.

This is also why he is likely much more anxious and fidgety at night -- he needs and extra strong sedative to settle down at all.

He pants frequently and doesn't sleep at night, only during the day.

We are very concerned that all of us will not be able to focus on our daily commitments and activities out of the house wondering what he is up to all day.

Is he hurt?

Did he get into some uncomfortable position that he can't right himself from?

Is he wet or did he soil himself?

Also, what about winters, we live in the Northeast and after last winter, there is no way a cart will be practical in the repeated snow and ice that gets hard like a rock.

Please keep the info and encouragement coming.

I do feel better having read your specific replies.

Thank you.

[CarolC]

Euthanize

- Max's dignity as a dog is severely compromised due to his injuries and incontinence.
It seems like we would be ignoring this basic level of respect for living creatures to make him continue to endure this condition.

If you treat him with the same respect as before, he will still have the same dignity. If you treat him like he is less or deficient, he will know it.

We are all taking turns watching him, but due to his incontinence, he needs to be expressed and washed due to ballder leakage/overflow, many times daily. His hind quarters are hardly ever dry, expect a few hours at night.

What you are seeing right now is not how it is for people who have chosen to care for their paralyzed pets. If what you are describing was the normal life for a paralyzed pet, I agree it would be kind of inhumane. But it is NOT like that. In a fairly short time you have a routine that keeps the dog clean and dry. PLEASE do not judge a normal life of a paralyzed dog by what you are seeing right now, a dog soaked with urine and having diarrhea. There are several ways of handling the urine incontinence that are quick and easy to do, it is just that most people do not come into this situation with the knowledge of how to do it. As Bobbie said, he can wear a male doggy diaper and he will be dry. You can also express his bladder if needed. Those of us who have paralyzed dogs do not live in dirty houses with dirty smelly dogs. Our dogs are as clean as any other! I'll put my house up against most houses as far as cleanliness and I don't spend my life doing chores. My dog is clean and sassy. My carpet is clean. The house smells clean, like any other. Please see the photo below of one of my paralyzed dogs, the house, and the carpet. This is how it really looks. It is very important to note that diarrhea is not part of being paralyzed. Perhaps they have him on some medication that is causing this, and it is making things miserable for all of you, that is understandable, but that is not a normal part of paralysis.

As I understand, dogs abhor being in or near their urine/excrement, even with extreme care, this is inevitably going to occur with regularity.

- Max has only been ill once in his entire life previously with a digestive ailment that was resolved after one week's time. It was a difficult week due to his diarrhea, but we muddled through.

Max will require almost 24/7/365 assistance for the rest of his life. While one could argue that it is our responsibility, we all have lives we must lead and do not want our continued relationship with Max to result in resentment and conflict between any of us.

No, at least mine haven't. They can be left alone for 8-10 hours. By that I mean 8 hours normally, and 10 hours once in a while in a pinch. Certainly no 24/7. Right now I assume you are saying that because he is incontinent and you don't have him in a male wrap and you haven't got a treatment for the diarrhea and you are doing constant cleaning. Please talk to the vet right away about the diarrhea, it sounds like a medication is disagreeing with him. Some of the strong steriods can cause GI problems and it's very important to report that asap. But when you are using malewraps and/or expressing urine, and he is having healthy stools, he can be left alone about as long as you normally would any dog.

- Max would be prone to continued life threatening illnesses such as bed sores, UTIs, and any other issues that come along with a paralyzed lifestyle.
It seems cruel to subject Max to further pain and suffering should he develop these illnesses, which most vets say, is a when, not an if.

I never had any problem with bedsores in my 4 down dogs, except when they got a urine burn being boarded at the vet. The weights of the dogs are/were 63 lbs, 37 lbs, 7 lbs, and 6 lbs. UTIs are infrequent in my experience, but it varies from pet to pet. In my experience we get one in this house maybe once a year and a round of antibiotics cures it.

- It is unnatural for a dog to continue life paralyzed. Max's greatest joys are running in the park, looking out the window for other dogs, and taking walks. He also loves to eat, but more about that in the other category.

- We think if Max could tell us what he wants, he would tell us to let him die with grace, in the best health he will be from this point forward, not in pain, and with no suffering.

- We are also concerned that the longer we delay the decision to euthanize, the harder committing to that decision will be.

- In Summary: Max's quality of life as a dog is severely limited to only eating, drinking, and being loved and showing love and affection. These are important parts of quality of life, but 80% of his quality is non-existent.

Bobbie takes her paralyzed dogs camping and to the beach, and they have ribbons from competitions (agility or ralley, what is it Bobbie?). I traveled cross country with one of my dogs 3 times. The whole point of a wheelchair is that your dog can get out and walk around the block or go to the beach or whatever they did before. Like Bobbie said, one dog climbed Mt. Washington in a wheelchair.

Not to Euthanize

- We don't want to lose Max. Is that selfish of us?

- Max is in general good health and it seems premature to snuff out his life with the possibility of a few "good" years ahead of us.

- Max has a younger sister, a 3 year old Havanese, Ruby, that looks up to him and used to follow him around wherever he went.
She is depressed as well and is obviously experiencing these issues along with the rest of the family.
Could it be possible that Max and her can continue to keep each other company ant times when they are alone?
Currently, Ruby, will occasionally sniff at Max, but appears scared to interact with him at any level.

- There is a possibility that Max will recover sufficiently to try to have him walk with a wheelchair device.
However, from what we've read, larger breeds (Max is 45 lbs of solid weight) do not take to these devices.

I think whatever you read was talking about really massive dogs. But for example, Rajah was 117 lbs and did great in a wheelchair. Other large dogs like labs and german shepherds do well in wheelchairs. So that does not apply to your dog. 45 lbs is not a large dog. A dog carries 60% of his weight on the front legs and 40% on his hind legs. In order to put him in a wheelchair you will lift 18 lbs, that isn't bad.

Click to enlarge

[Maxissonice]

Thanks Carol for your reply.

I guess it is all possible and you guys are living proof.

After this week's travails, it is very difficult to allow ourselves to imagine and feel like things can continue and get better.

Frankly, we are petrified of the unknown.

I am willing to continue on our current course of action up to and including to the point of when Max will be able to have a cart and work with him to learn how to use and enjoy it.

If things do get back to a point of normalcy, it would be a workable situation, and most importantly, allow us more quality time with our lovable, impulsive, and nervous wreck of a dog, Max.

However, we do fear the possibility that he either deteriorates further or does not take to the cart, either of which, will result in the heartbreak process all over again.

I guess, such is life...

Thank you.

[Bobbie]

Carol is absolutely correct that you can't judge your future life by the past week.

Here's a day in the life with Oliver. (And I had another paraplegic in a cart when I got him- Candy died in 2013 after 9 1/2 years as a paraplegic.)

AM- one of us wakes up first, usually me. I get up, go to the bathroom, then come back and lift Oliver off the bed. I put him in his cart and we go out and I express him (urine and usually bowel, too). That takes less than 5 minutes total. I just retired, but when I was working after about an hour I'd put his belly band back on, take him out of his cart, and leave. He could drag around in the house during the day but I suspect mostly he slept. I'd get home, put him in the cart, take him out again. (Another 3 minutes.) Repeat at least one more time during the day. He goes through 1-2 Poise pads a day as mostly it is just leaking a bit and most of his urine is expressed outside in the yard.

We usually go for a long walk or he plays ball (retrieves) as long as I will keep throwing. On walks he outdoes my able-bodied corgi, Jack. And me. He is tireless.

He has had one UTI in over four years and that was trivial. No sores since the dragging sores on his feet that he came with were healed. (He wears boots or has his feet up in stirrups in the cart.) He's just a normal dog. The only additional work of having him not walking on all fours is that I have to lift him into his crate in the car and out. I get a little more tired on vacations when we are traveling and I do a lot of that. I do have a ramp to the three-foot high porch so he wheels himself up.

We don't get much snow but he does just fine in what he's seen of it.

I don't want to say there aren't issues but you will figure out how to deal with them easily enough.

Now- the downside from my viewpoint- if you have small children who are on the floor all the time, it could be more of a problem. He may poop without knowing it and then you have a kid crawling over poop. Pee can drip out on occasion. That would be more of an issue and unless you know you have a place to keep him separately from where the little ones play, not easily solved.

But the other side of the coin is what the kids learn from living with a disabled pet. One camping trip this summer, the kids at the campground were calling Oliver the "all-terrain dog" and were really impressed by what he could do. Learning to treat a disabled pet as normal goes a very long way towards learning to treat disabled people as normal. Your kids will have more empathy and understanding than most.

The timidity might be an issue. No way to know without trying, but I think if he can't walk without a cart, he'll end up accepting a cart. He's young and isn't going to be happy being left behind.

[mud99]

The best piece of advice I have is to take things slow. Give things a chance to improve and to adjust to it. It doesn't sound like you need to make a decision right away, so keep trying and see if you can make it work.

[CarolC]

You did not address our concerns of the level of effort required to maintain his quality of life or how that might cause our family resentment.

I understand that he is our responsibility but we need to consider the well being of our human family unit to a higher degree.

We are also concerned with giving the children the distinct impression of supporting his handicaps only to find ourselves in the unfortunate position of making the choice in the near future and having to restart the entire process of saying goodbye and mourning our loss.

The children have not been in school all last week.

I am sure you understand the issues, I am really frightened of the level of commitment necessary to keep him comfortable and healthy, and the toll it will take on our family.

We both work and the children range in age from 23-15, all with full time school, College, and other work related commitments.

On average, Max is left at home alone for 7-8 hours a day.

I don't know if that is feasible now.

It would be a real disservice to Max and the family if he became such a burden as to turn our love for him into resentment.

To our minds, that is a much worse scenario to saying goodbye now with love.

I can kind of guess what might be a typical situation based on your description of your family. I can imagine in a typical family like yours, we are talking about a mom who is working and is already carrying a lot of responsibility for the million things it takes to keep a family going, from grocery shopping to cooking to laundry to taxiing kids around to disciplining to clothes shopping and perhaps living with some teenage drama and not as much me time or even sleep as you would like. You sound like someone who is very much a manager, you are looking at this from an objective perspective because either you are just a good organizer or have learned to be, in order to juggle working and raising a family. I don't know, but I could see myself in this situation and you may already be running on maximum, overly busy already and with little reserve or margin of extra energy or patience when added burdens occur because you are already operating at close to 100%. I don't know.

Your point about patience and resentment is totally valid. It is interesting to note that many of the regulars here are single. Many are caring for multiple disabled dogs or cats, but they (or we, I include myself in this) never have to feel resentment over other family members not helping because the responsibilty is all ours from the get-go. We had a moderator here who was literally in the sandwich generation, caring for no less than 4 elderly (80's and 90's) parents and a teenaged daughter, and then her dog became paralyzed. She did it, but I'm sure she would tell you at times it wasn't easy. She is a strong and good person. As you might be imagining (I think it is often true) even though he was the family dog, nearly all the care fell to her. Yes, everyone loved him but all the responsibility fell to her. I think you may be wondering if this is how it will go in your family. You have probably assessed the willingness to help of your other family members, or their ability, and how you will feel if you end up pretty much doing everything. And sometimes with groups of people, it becomes easier to do it all yourself rather than try to assign some of the work to another person, because then you have to follow up to see if they did it, etc. If that is the case, then it kind of comes down to you looking at the dog, trying to feel if you have it in yourself to save him and make it work even if everyone else goes about their own affairs (and even if you secretly think they are selfish or inconsiderate of you) because you love him or you feel it is right or you want to give your family the gift of still enjoying him, or whatever motivation you have. I would also like to add, when I had my first down dog I was in my 30's but when I got my first paralyzed dog I was nearing the end of menopause. If you are there, I don't need to go into detail. Personally, I had pre-existing back issues as well.

I wish I could be more help. I've done it alone with 2 down and 2 paralyzed dogs (and a paralyzed rabbit) and no one to help. What I would say is, you also sound like the kind of person who is going to analyze every aspect of his care and tweak it to maximum efficiency. You won't just get malewraps, you'll get the ones that fit him best, you'll get the most absorbent pads, you'll get the wheelchair that is simplest to use, you'll adjust his diet for excellent output and have him whipped into shape and things running as smoothly as possible. Organizational skills are probably the most important trait to have in this situation, along with love.

[Maxissonice]

Thanks Carol for your thoughts and observations.

Yes to everything you wrote.

At some point when Max stabilizes and the kids move on from their obsession over him, I will be left holding the proverbial bag. I think I can do it long term, I know I want to try.

There is something we need help with immediately which is his fear at night. He is so fearful every night to the point of not being able to lie still, constantly panting, and not sleeping.

We need him to sleep and we need to sleep.

We got stronger antianxiety meds from the vet but they are not helping.

We think he has been traumatized from.his two night stay at the hospital.

Thanks for the support.

[Bobbie]

Try putting a small fan on him at night. We don't know why, but it seems to help with nightime anxiety.

[CarolC]

Also, is he on any meds? Steroids are a help and I would want them for my dog, but they can do a number on the GI tract from diarrhea to gastric ulceration. They recommend giving the dog a stomach protectant such as Pepcid a/c when on steroids. If he's on steroids and not on a stomach protectant, I would ask the vet about that. Pepcid a/c is over the counter, you just need to know the dose.

Yes, you need your sleep! When my golden retriever went down I didn't know about putting a fan on him. I would check him over and tend to everything but he would still whine when I went to bed. I ended up moving to a bedroom on the other side of the central air unit and leaving the air conditioner fan running all night to mask the sound of his whining so I could sleep. The whining was only at first, he didn't continue it long term.

[Maxissonice]

OK, thanks, we'll try.

Also, isn't it true that paralyzed animals are very scared at night due to predatory vulnerability?

If so, how do you combat that?

[Maxissonice]

Yes a full litany of meds.

We have the pepcid ac 10mg, but his bowels movements are solid and I do not like to administer meds just for the #### of it.

Also, he is not in pain during the day at all.

I am really concerned with how traumatized he got from the hospital.

He is scared of the groomer too but not like this.

Thanks.