FCE, no deep pain and hind legs paralysed - any success stories?

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.
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TClare
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FCE, no deep pain and hind legs paralysed - any success stories?

Post by TClare »

Hi All, we have a female 9 year old mini schnauzer called Nudge who suffered a suspected FCE 5 days ago. She is home with us for the next couple of weeks while we give her body time to heal and hopefully walk or atleast show some improvement. We are starting her with acupuncture and otherwise just doing stretching and seeing vet twice daily for manual expressing of the bladder. I have read so much about FCE in the last few days but couldn't find any real success stories for a dog that has no deep pain sensation with both hind legs affected. Does anyone know of any cases where the dog has gained pain sensitivity after 5 days and gone onto recover and lead a relatively normal life? Thanks in advance to anyone who takes the time to respond... really appreciated. Cheers Teree
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critters
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Re: FCE, no deep pain and hind legs paralysed - any success stories?

Post by critters »

:welcome: FCE is quite common on this board. I suggest searching or looking around the board for lots of hints. Know that it's possible to learn to express pee at home, although some vets don't believe it. Some people here have even learned to catheterize their puppers after a spinal cord injury!

Also know that some spinal cord and nerve injuries can lead to "funny feelings," like pins and needles, for instance, in the body as the nerves heal, and meds like gabapentin and Lyrica can help that. It's important to watch out for that because critters can cause damage biting at the part/s when they feel it.
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CarolC
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Re: FCE, no deep pain and hind legs paralysed - any success stories?

Post by CarolC »

TClare wrote: Thu Feb 25, 2021 12:02 am Does anyone know of any cases where the dog has gained pain sensitivity after 5 days and gone onto recover and lead a relatively normal life? Thanks in advance to anyone who takes the time to respond... really appreciated. Cheers Teree
:welcome:

There have been a lot of miniature schnauzers here with FCE, often in the neck affecting all 4 legs, so in that sense you are lucky.

The statistics are overwhelmingly in your favor for recovery.
https://veterinaryrecord.bmj.com/content/181/11/293 wrote: Two hundred and one dogs were included. Outcome data were obtained via medical records and telephone questionnaires. MRIs were blindly reviewed by three board-certified observers, obtaining substantial to almost perfect interobserver agreement on diagnoses (κ=0.635–0.828). Presumptive ANNPE and FCEM were diagnosed in 157 and 44 dogs , respectively. Ambulatory function was regained in 99 per cent of cases, with persistent motor deficits in 83.6 per cent and 92.5 per cent of dogs with presumptive ANNPE and FCEM, respectively. The presumptive diagnosis was not associated with motor function recovery, recovery times or urinary continence. Faecal incontinence was five times more likely in dogs with presumptive ANNPE (23 per cent) compared with presumptive FCEM (7.5 per cent).
The way I read these statistics, 99% of the dogs in the study regained the ability to walk. 92.5% of the FCE dogs had some residual symptoms in their walking, to where if you watched them walking and running you might be able to tell they had an injury once. But dogs don't care and they go on to lead normal lives. They just carry on enjoying life.

Deep pain sensation can return days, weeks, or months after an injury. When my dog was paralyzed from an accident, they did not find any deep pain sensation until 149 days after the injury (that's almost 5 months.) I would be surprised if it takes your dog anywhere near that long, but it is an example of how healing from spinal injury can be very slow, but it is still going on in the background even though the dog might look much the same, so we just have to give it time.

FCE dogs benefit from aggressive physical therapy. If you have professional PT available and can afford it, and can do it safely, that would be a good option. They may have hydrotherapy (a swimming pool or underwater treadmill) available, and they will do exercises with your dog and give you instructions of exercises to do at home. Hopefully you will start to see improvement. Improvement tends to be gradual, a little bit at a time by baby steps. If you don't see any change right away, just remember that healing from spinal cord injury can be slow, but healing and improvement continues for a long, long time (months and years).

If you can't get into professional PT, I would be doing some exercises at home. Bicycle the legs through the full range of motion a couple of times a day. Massage the legs and feet and toes as often as you can. Do it even if you think it isn't helping (because we can't see what is going on with the nerves). Stimulate the feet. Her body needs to remap the pathway from her brain to her toes, and the more you massage the feet the more you give it to work with. With her lying down, press up on the bottoms of her feet and see if she will push back (resistance exercise). Even if she cannot bear weight or doesn't have good balance, put her in a standing position with all 4 feet on the ground. It is good for her to just be in that position with her pads contacting the ground. Do not be surprised if she flips her paws under (it's called knuckling), this is normal and will probably go on for a while, just fix her feet for her. Since you are working with a small dog, hopefully you will be able to work with her several times a day. Keep doing the exercises even if you see no change, and just know that they are helping in the background where you can't see it.

I think you are going to want to learn to express her bladder. It is a lot of trouble to have to take her to the vet every day, and really they recommend emptying the bladder 3x a day (every 8 hours). The vet should show you how to do it.

Here are some videos with demos of expressing the bladder. (Scroll to the end of the article.)
viewtopic.php?f=5&t=16027

I would ask the vet if his staff says she is easy or difficult to express. Some dogs have loose urinary sphincters and will empty their bladder without too much squeezing. Other dogs have very tight urinary sphincters which makes it harder to empty the bladder. If the vet staff says it takes quite a bit of pressure, then ask him/her to put your dog on medication to make her easier to express.

If you are having any issues with Number Two, here is an article that may help with that.
viewtopic.php?f=5&t=18586
TClare
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Re: FCE, no deep pain and hind legs paralysed - any success stories?

Post by TClare »

Thank you so much for all the information you provided. It was always the intent we would express her bladder but she is very resistant and both the emergency team and now the vets have said we can't be taught she is so tough, they have never even done in front of us. Stubborn little thing! But understand why she might not be wanting to release, about the only thing she can still control. We've started acupuncture today and she is booked into hydrotherapy too. Thank you so much for sharing the positive statistics. We are giving it everything we've got, but at same time want her to have a life worth living. She is an extremely social and active personality that loves other dogs and humans.., until she finds a ball or stick! Have been told by specialists that we need to see some type of improvement within the next 2 weeks otherwise we won't. In fact, so many of the vets we've seen in the past week have already labeled her as a likely euthanasia case. Again, so appreciative of your response. It helps to keep a positive mindset. xxx
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CarolC
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Re: FCE, no deep pain and hind legs paralysed - any success stories?

Post by CarolC »

Hi TClare,

It sounds like your vet is being rather negative. There are vets that can be perfectly good for all kinds of problems in pets, but they just aren't good about paralysis. It is possible your vet has taken good care of your dog for years, and you really like him, but some vets just are not good about treating disabilities.

It can take longer than 2 weeks for recovery, and dogs need time. Your dog will heal on her own schedule and not the vet's. I would tell the vet that I plan to care for this dog whatever happens, and if he doesn't want to support me in that, I would find a vet who will, not one who is quick to give up.

If she has no deep pain sensation in her legs, then she mostly likely does not have the abilty to resist expressing. It is not something she is doing on purpose (a control issue) that is making her hard to express. This is very important.

Rear paralysis can cause 2 different kinds of incontinence. It depends on where the FCE (or other spinal injury) is on the spine.

The urinary sphincter is the muscle that holds the pee in. If the location of the FCE is down in the lower back or tail area, it causes the dog to have loose urinary sphincters and dribble and leak. It is easy to express the bladder of these dogs because the urinary sphincter is giving little resistance, it is kind of relaxed.

If the location of the FCE is in the mid-back or chest area, it causes the opposite effect. The urinary sphincter is tight. The bladder has a lot of tone. You can squeeze quite a bit and still have trouble getting urine out. It sounds like this is the case with your dog, based on what the vet is telling you.

There is a name for this. They call the injury in the lower back with loose sphincters a lower motor neuron injury. They call the injury higher up that causes tight sphincters an upper motor neuron injury.

My dog suffered a spinal fracture mid-back. When my dog was injured, she had a very tight sphincter and was very hard to express for the first 6 months. Sometimes it would take me over 20 minutes to do it. Nobody told me at the time, but there is medication for this! (For example, phenoxybenzamine, and it's not expensive.) If your dog is hard to express, you should not have to struggle expressing. I'm not saying you can't express a tight upper motor neuron bladder without medication, I did it, but it would have been so much easier with medication.

They should give your dog medication to relax the sphincter, show you how to express, and let you do it at home. You should not have to keep paying the vet to do it, and running over there twice a day, none of us can do that for very long. You'll go broke and you'll get tired of running back and forth. It's so much easier at home. And when you are the one who is expressing her bladder, then you can give her all the time she needs to heal. If they don't have the medication on hand, they can call it in to a pharmacy for you. Maybe that is the problem. You can pick it up at the drive-thru.

If it was my dog, I would discuss this with the vet. Maybe he does not have a lot of experience with paralyzed dogs. Maybe he is one of those vets who thinks being disabled is not a good life for a dog. Maybe he thinks the owner will not take good care of a paralyzed dog so it isn't fair to the dog. I'm not sure his reasoning. Most FCE dogs recover, but even if your dog remained paralyzed she could have a great life and you would care for her at home. I totally understand if she is hard to express, been there, done that. I just endured it, but only because I did not know about medication.

The statistics on recovery from FCE are so good. Do you by chance have another vet you sometimes go to, that you could switch your dog to? I am worried your dog is not going to have the chance she deserves if the vet is quick to give up.
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critters
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Re: FCE, no deep pain and hind legs paralysed - any success stories?

Post by critters »

I'm with Carol! NOT every vet is willing to deal with handicappers. My boys have had both spastic (tight) bladders and leaky, floppy ones (different boys), and we found that meds helped a lot, especially with spasticity.
Rescuedogmom
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Re: FCE, no deep pain and hind legs paralysed - any success stories?

Post by Rescuedogmom »

Hi Teree!

I wanted to let you know that I had the exact same situation happen to us and our dog 2 years and 3 months later is still alive and doing well! I know exactly what you're going through right now and we experienced the same types of response with our vet. Our dog has never regained her ability to pee but I express her 4-5 times a day and have her on a schedule which you will learn in time. One tip is our dog hated being put on her side to be expressed and fought us on it, so I learned to express her standing up and she prefers that. We too tried acupuncture and hydrotherapy and while it helped her spirits she never regained her ability to walk on her own. However we improvised and got her a wheelchair and a rear support harness (which is what we use daily). She regained deep pain at 3 months but very diminished sensation and it had no affect on her being able to walk again in our situation. So YES you can do this and our dog Stella is a success story! You are going to learn so much and if I can help in any way please ask!
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