Help with fecal incontinence please!

[Neds mum]

Hello all

My 10 year old border terrier Ned recently had surgery for a herniated disc (the surgery was last Wednesday after he woke up paralysed on his hind legs Tuesday morning).

We've been told the damage to his spinal cord is quite severe but there's no way of knowing how things will turn out this early in the game. He is on crate rest for 4 weeks. He has no pain response in either of his back legs, he has a flaccid bladder so needs expressing which we do 3 or 4 times a day - all of which we can cope with quite easily. The stressful part is his fecal incontinence. He has no control of his bowel and there is no way of knowing when he needs to go. We picked him up from surgery on Saturday and since then he has not eaten a full meal (I hasten to add that he is not off his food but is a picky little so and so and has decided that he prefers the menu at the surgeons to his regular food and is now turning his nose up at his dinner!!) He has always been a bit irregular with pooping and mostly just used to let us know when he needed to go and we let him out.

His poop is also not hard. The surgeon said he did develop a bit of post operative diarrhoea and his stools haven't hardened up as yet. He's only been home 3 days and we've had to bathe him twice and put about a thousand loads of washing on. I'm having difficulty imagining how we can keep this up twice a day for the rest of his life? My first question is - are we supposed to be taking him outside in his sling and encouraging him to go number 2 outside or do we just have to clean him up every time he goes on himself? We have tried dog nappies but the poo just comes out the tail hole into his bedding and gets all over his rear end when he sits up!! I'm quite prepared for him to not walk on his back legs again but I'm really hoping he can regain control of his bowel. Is this possible? Will he have bowel control if he cannot feel his rear end? I've read the bowel management advice posted on here about making a dog poop on demand but does this only work for dogs who have feeling in their rear end?

Also , Ned has always been a foot biter! He has allergies which make him quite itchy and he was constantly chewing his paw pads. Its become a bad habit of his. The problem now is that as he cannot feel his back feet, he is literally trying to chew them off! This morning I found him with his feet on tatters and blood all over his face. He had pulled all the back claws in one of his feet clean off!! He now has to wear a buster collar to prevent him getting to his feet and I just feel so sorry for him at the moment. Is this a know thing with paralysed dogs chwwing their back legs?

I love the little man to bits so am quite determined we get through this and make the best of what we've got but am just struggling with motivation some days. Could do with some pep talks from anyone with any light at the end of the tunnel?? Am so thankful I have found this forum!!!!

[CarolC]

Replies in blue

Hello all

My 10 year old border terrier Ned recently had surgery for a herniated disc (the surgery was last Wednesday after he woke up paralysed on his hind legs Tuesday morning).

We've been told the damage to his spinal cord is quite severe but there's no way of knowing how things will turn out this early in the game. He is on crate rest for 4 weeks. He has no pain response in either of his back legs, he has a flaccid bladder so needs expressing which we do 3 or 4 times a day - all of which we can cope with quite easily. The stressful part is his fecal incontinence. He has no control of his bowel and there is no way of knowing when he needs to go. We picked him up from surgery on Saturday and since then he has not eaten a full meal (I hasten to add that he is not off his food but is a picky little so and so and has decided that he prefers the menu at the surgeons to his regular food and is now turning his nose up at his dinner!!) He has always been a bit irregular with pooping and mostly just used to let us know when he needed to go and we let him out.

His poop is also not hard. The surgeon said he did develop a bit of post operative diarrhoea and his stools haven't hardened up as yet. He's only been home 3 days and we've had to bathe him twice and put about a thousand loads of washing on. I'm having difficulty imagining how we can keep this up twice a day for the rest of his life? You won't! See below. My first question is - are we supposed to be taking him outside in his sling and encouraging him to go number 2 outside or do we just have to clean him up every time he goes on himself? We have tried dog nappies but the poo just comes out the tail hole into his bedding and gets all over his rear end when he sits up!! I'm quite prepared for him to not walk on his back legs again but I'm really hoping he can regain control of his bowel. Is this possible? Will he have bowel control if he cannot feel his rear end? I've read the bowel management advice posted on here about making a dog poop on demand but does this only work for dogs who have feeling in their rear end?

You paint a clear picture. It is too soon to know (as you said) whether he will regain bowel control. Since he is apparently feeling his feet (see further comments below) there is more hope he will regain bowel control. Even if he does not, it is quite manageable having a fecal incontinent dog as long as the stools are good quality. Most of your problem right now is the diarrhea, more than the incontinence. If he was incontinent with firm stools, it would be a whole different story. If it was my dog, I would do whatever is needed to get him firmed back up. That may simply mean insisting he eat his former diet, if it produced firm stools. It may mean waiting till he is off a medication that is causing the diarrhea. If he is off the medication, you may want to consider a probiotic (such as an acidophilus supplement, ask the vet) in case antibiotics he was given with surgery have affected his intestinal flora. Once you have his stools firmed back up, this will all be infinitely more manageable. I sympathize! Nobody likes having an incontinent dog with diarrhea, but it is not permanent, and diarrhea is uncommon once you get past the surgery. In the meantime, you are doing extra laundry, and diapers are likely to make a mess on him if he has diarrhea, which is no fun at all, but it is temporary. You could consider shaving his bottom to make cleanup easier. It will grow back.


Once the stools are better, you can try "poop on demand" as explained in this article. It is a way to stimulate him to eliminate at a time and place of your choosing.
viewtopic.php?f=5&t=18586

Also , Ned has always been a foot biter! He has allergies which make him quite itchy and he was constantly chewing his paw pads. Its become a bad habit of his. The problem now is that as he cannot feel his back feet, he is literally trying to chew them off! This morning I found him with his feet on tatters and blood all over his face. He had pulled all the back claws in one of his feet clean off!! He now has to wear a buster collar to prevent him getting to his feet and I just feel so sorry for him at the moment. Is this a know thing with paralysed dogs chwwing their back legs?

This is a problem that needs to be addressed immediately. Even though he chewed his feet for allergies, I would assume (to be on the safe side) that this is something different right now. Some dogs will chew their feet or other areas (such as the male area/p*nis) during recovery. They assume the dog is feeling a pins and needles sensation, like we feel when we sleep on our arm funny and then it starts to wake back up. Dogs will lick or chew it in an attempt to soothe it or make it stop, and for some reason they do not stop even when they draw blood, and this can lead to self mutiliation.

You can put a cone collar on him (is that what a buster collar is?), but it is not enough to be safe, because dogs can get out of the cone. You can rub bad tasting substances on the area, but they will ignore it. I am not a vet, but the best solution that has been found (that I am aware of) is to get the dog on medication to prevent the annoying sensations. A common one is gabapentin (it must be the veterinary formula because the human formula is not safe for dogs), another one is pregabalin. I would contact the vet immediately and explain what is going on and get meds immediately.

The chewing is a temporary phase some dogs go through during recovery. It is not uncommon, but it is possible for the dogs to do serious damage to themselves. Back before they had medication for it, I know of 2 dogs who chewed when the owner was asleep or out of the room and did so much damage that they were put to sleep. The good side of this problem is, it would seem to indicate there is feeling in the toes, if that is what is going on.

I love the little man to bits so am quite determined we get through this and make the best of what we've got but am just struggling with motivation some days. Could do with some pep talks from anyone with any light at the end of the tunnel?? Am so thankful I have found this forum!!!!

The main thing to know is that it is still very early, but it sounds like he has feeling in his feet, so that would be reason to be optimistic. The first days are the hardest, but it gets better. Even if he was paralyzed, he could live a happy life and you could have a clean house. I have had 5 incontinent dogs and my carpet is fine thanks to feeding a diet that produces quality stools that are firm, low odor, non-sticky, and easy to pick up. I haven't used carpet spray here since I don't know when. It's the cat hairballs that soil my carpet, not the incontinent dogs.

Here is a video I did a few years ago, showing how I was doing "poop on demand" with one of my dogs, and the real purpose of the video was to see the stool quality. The stools fall on a clean potty pad and do not leave a trace. The video is graphic, but look at the clean pad and imagine if this was your carpet or the dog's bed, and how you would not have to worry if your dog doodled in the house. Hope this helps!

[Neds mum]

Hi Carol. Many thanks for the response - I really appreciate it. Ned is already on gabapentin and has been since the surgery so not sure the chewing is related to any feeling. He never used to let me touch his feet but now let's me rub antiseptic into them so as much as it pains me, I don't think he can feel anything there. I spoke to our vet today and he seemed to think it was more to do with his allergies he already suffered from I'm afraid. I will definitely keep an eye on him and the collar is unfortunately going to stay on for the time being.

I've just been researching foods for sensitive stomachs so I can try to firm him up a bit. What do you feed yours? I purchased some probiotic supplements for him and hopefully this will help. We've had him on just chicken tonight so hopefully that will help. We have also shaved his butt, tail and back legs to help keep him clean. He is not the height of fashion at the moment but it will certainly help!! Thanks for the video - sounds weird to say but would be so much easier if his poop was the consistency of your pup! Hopefully we'll get there.

Just having a bit of a 'downer' moment tonight where you can't see a decent future. I know it will pass soon but I appreciate the support so much!

[coxmaria3]

It seems incredibly hopeless at first. The very reason I ended up on this wonderful board. Best advice and a place to vent and receive encouragement. Welcome! Tink and I send prayers and love, Colonel too.

Once you get formed poop, the poop on demand is fabulous and so easy.

[CarolC]

Hi Neds mum,

Very long reply...

To answer the easy question, 4 of my incontinent dogs (including the one in the video) have been on Science Diet w/d dry kibble. I tried the w/d canned food and did not get the same results. I can definitely recommend the dry. But other people here have had good results with their dogs with other foods, too. You just want something that agrees well with your dog's system. The w/d is low fat and has fiber.

If you feel strongly about a natural diet, then another option could be raw diet. I adopted a dog this year that was on Stella and Chewy's frozen raw chicken patties, so I kept him on it. His stools are smaller than Science Diet and crumble a little more, but they are not bad and do not stain his blanket. They are a little like crumbly cookie dough. No laundry nightmares and if they hit the living room rug I pick them up with kleenex and you never know it happened.

Again I'm not a vet. This is a sticky situation where you have a dog who has chewed his feet for allergies for a long time, and now all of a sudden he is at it again only worse. I can see why it might seem likely that is what is going on, and I can see why the vet would think so and you might think so, and maybe you are right. However I am very-very glad you are keeping him in the collar, and I want to try to say a little more about the chewing that is sometimes seen in dogs recovering from spinal/nerve injury. The reason I am going on about this, when it may not even apply to your dog and may seem unnecessary, or may seem like I'm not listening to you about his history of allergies, is because the stakes are so high. So please forgive me.

I do not have enough medical knowledge to know, but it may be that the kind of sensations that occur with the tingling feeling are a different kind of feeling from the kind of sensations he feels when you stroke the outside of his foot. I'm thinking of when I've slept on my arm, and basically the outside of my arm, the skin part, felt pretty numb, while the inside was going crazy with pins and needles. Do you know what I mean? That isn't scientific, it's just my experience.

I do not know the dosage of gabapentin when used for nerve pain, versus when used for other reasons. It is possible the dose he is being given after surgery is not as high as a dose that would be given for nerve pain, but I don't know. The vet would hopefully know. If he is on a low dose of gabapentin, and the vet says there is a higher safe dose of gabapentin for his weight, it would be interesting to try that (following vet instructions) and see if the chewing stops. Here is an article that describes the wide range of dosage of gabapentin for dogs.

Dosage of Gabapentin for Dogs

The dosage varies for each dog. It may range from 5-30 mg per kilogram of weight every 8-12 hours and depends on the use of gabapentin, your dog’s circumstances (other illnesses, causes of the neuropathic pain, reaction to the medicine), and their weight.

We had someone here with a dog chewing his feet, and gabapentin did not work. That was when pregabalin (Lyrica) was mentioned by someone who was using it for her dog. Here I am quoting the beginning of that discussion.

Our dog Benny is two years out from his surgery for IVDD/slipped disc. Although he had been doing fairly well, a few months ago he began chewing his left rear paw. He was not responding to gabapentin so we had been using a little booty and/or collar when needed. He had never gone after his right rear paw until yesterday. He chewed it up in the exact same place as he does to the left - the second digit paw pad. Since it was the exact same location as the other paw and he has never done it before, I am fairly certain this is a nerve issue and not allergies or some other irritation. Does anyone have any experience with this behavior so far out from surgery? Any other recommendations since the gabapentin hasn't been effective?

Thanks for the support.

- Sam

This link gives the reply, about using pregabalin when gabapentin didn't work.

viewtopic.php?p=96671#p96671

Part of the reason I am going on about this is, your description of Ned chewing his nails off sounded SO much like what happened to Tiffany's German Shepherd, Eros. He chewed off some toes and they thought they were going to have to amputate, but fortunately they didn't. Here are 2 quotes from her description.

Help Needed: Urgent!!!!!

Post by Tiffany » Sat Feb 18, 2006 10:06 am
My dog Eros has a brachial plexus injury in his front leg he has no feeling in his paw. Last night while everyone was sleeping he chewed off his toe.

Re: Help Needed: Urgent!!!!!

Post by Tiffany » Sat Feb 18, 2006 7:34 pm
Unfortunately his paw is worse then I thought his first toe bone is completely exposed his second and third toe bones are partially exposed

You see that happened to Eros while they were asleep.

This following one is a dog who got around the cone collar.

Paralysis/neuritis in mixed breed--?s

Post by Nicole82 » Tue Jun 17, 2008 11:44 am
Our main problem started about a month ago. I knew from vet warning and from research online that they can start chewing on their limbs during recovery and had been watching closely for any signs. He'd shown no inclination of it until I can home from a meeting about a month ago and discovered that his RR foot was mangled. I took him in to the vet and vet gave me an antibiotic cream to put on it and had me changing bandages once a day along with giving an oral antibiotic and putting an e-collar on him. It took about 3 weeks and the area was almost completely healed--just a small scab on either side of his foot. It was to the point where the vet had us leave the wrap off so it could get air but he was still wearing the e-collar.

Last Tuesday my husband and I came in from working outside to discover a huge amount of blood on the floor. He had gotten around the e-collar and nearly chewed his foot off. He chewed through both collateral ligaments so his foot is very unstable now and on the inside of his paw it's nearly down to the bone. Back to the vet we went, of course.

Here is one more. The dog lost both hind legs to chewing back before we knew about medication.

Story: My Little "Broke Dog" Lindsey

Post by Margaret Ward » Thu Jun 30, 2005 6:41 pm
I have a nine year old female dachshund, who only has her two front legs. Her spinal cord severed about 3 years ago and after a few months she her self decided to take her legs off. Her legs dangled behind her as she moved around. We bought her a cart and she would not use it. One day I came home and found what she had done to one of her limbs. The vet immediately put an e-collar on her and we watched her for several weeks. She did not bother the limb for awhile but then began to chew on it again. Our vet felt it best to removed the limb at the hip. She went for severl months before starting on the other limb. Once this began we removed this limb as well as her tail.

This is a really sad one. In this case the owner fed the dog dinner and left the room, and the dog injured herself so badly in that short time that she had to put her down. I know you have enough to worry about, like we all do when our dog has spinal surgery, so I'm sorry to be going on about something serious. I just think if it was me, I'd want to really have the full picture to take into account and weigh, while I make decisions about my dog. Here is the link, it is short.

Missing my Kira

Post by AprilDB » Wed Dec 03, 2008 4:12 pm
For the past week I've been doctoring her back feet which she had started chewing on. Her foot was almost healed and when I left her alone today for a few minutes to eat, and when I came back into the room, she had chewed off so much she just couldn't be saved. I feel sick and guilty that I left her to eat and not sat there to watch her like I always do.

I promise, I did take into account the history of allergies, and that may be what's bothering him now. But I want to be sure, for your sake and your dog's sake, to convey how this is one of those "better safe than sorry" situations. If your dog never chewed off his nails before, it seems strange he would do it now. And if allergies caused him to chew before, but you are told, or it appears, that he has no sensation, then it might follow that he is not feeling any itchiness from allergies, so why is he chewing? Just a nervous habit? I don't know, I guess it's possible. It could also be a combination of both, a little nerve pain/tingling and a long established habit of nibbling his feet. But since it's hard to know for sure, and we do know that cone collars do not always work, I think all possibilities are worth considering.

A back-up plan for the chewing is leg protection. I'd personally go with medication, but people have made leg protectors to make it harder for the dog to reach the parts he wants to chew. I suppose a determined dog might chew the protectors, but it is one more idea. Here is a post about that.

Re: Story: My Little "Broke Dog" Lindsey

Post by Tracy Smith » Thu Jun 30, 2005 8:45 pm
She recently began to chew on her back legs which dont work. So far we have only lost a toe, but even tho she doesnt chew on her feet when we are around, she will dive in the minute we leave her alone. I improvised with a trip to home depot and made up two "Braces" made of electrical conduit which I slip over her back legs and tape them to her legs. I got the pipes that are angled at 45* and they fit perfectly.

I hope you are right and it is just allergies. Whatever it is, It's good you had a collar on hand to help protect him.

[CarolC]

P.S. I was just thinking about how it is the holiday season when you might normally be baking and wrapping presents and doing last minute shopping, but on top of that you have a dog on crate rest. So you are doing extra laundry, giving baths, and doctoring toes, trying to get everything done. It reminded me of Ilsa, who was also on crate rest one Christmas. Thought you might enjoy this picture.

click to enlarge

[Neds mum]

Wow thanks for all the above! I have discussed this with the surgeon on the phone today. He said his biting could be pins and needles, or it could be habit or it could be stress induced. Hard to tell but the important thing is to stop him doing it. I am going to speak to our local vet next week about possibly prescribing something (surgeon suggested diazepam) to break the anxious biting habit if it persists but until then I am watching him like a hawk and he is wearing his collar which is firmly sealed! We're lucky that I am working from home at the moment so am with him constantly.

My main concern is his diarrhoea. The surgeon said its possibly a reaction to his metacam and to stop giving it him and switch to paracetamol. My husband knocked up an excellent contraption so I can rest ned on it having his back legs dangle so I can clean his bottom easily and keep him still while I change his bed when I'm on my own. Necessity really is the mother of invention!!

I just think this is all very stressful for him and that's why he has diarrhoea and is biting his paws. He was used to being a stubborn little terrier who always did what he wanted and always got his own way and now he's confined to a crate for most of the time and can't even move around to get properly comfy. Will be much better in a few weeks when he can scoot about more.

[Neds mum]

And Ilsa looks very festive I've attached a photo of Ned in his christmas jumper a week before all this palava!!

[Neds mum]

It seems incredibly hopeless at first. The very reason I ended up on this wonderful board. Best advice and a place to vent and receive encouragement. Welcome! Tink and I send prayers and love, Colonel too.

Once you get formed poop, the poop on demand is fabulous and so easy.

Thanks

Find myself willing for a firm poo more than willing him to walk again at the moment!!!!

[coxmaria3]

I came to this board because I was like you feeling extremely hopeless. My Tink had IVDD surgery Oct 21 for a ruptured disc. Lots and lots of bruising around his spinal cord. When we brought him home, on Wednesday of the next week, he couldn't bare any weight at all on his hind legs without me holding him. And him being the diva he was, wouldn't eat much at all. I ended up mixing his regular dry kibble with the expensive meatball like dog food in the cold dog food section at Walmart. Even then he wouldn't finish all of it. At first, I put it in a small cat food pan, one side water and one side food, in his make shift kennel (I used a collapsible dog play pen, really near him so he could have access as he wanted it. He always seemed to finish it up. Eventually, we transitioned back to him eating in his normal spot. I would hold his back legs up for just a bit and then let him sit down to eat.

About a week and a half after surgery, he still could not bare any weight on his back legs without being supported. When I let go, his back end would fall to the ground and I thought to myself, "oh my gosh, my poor baby will never walk again." I felt hopeless and sick. Then I found this board. It really helps to vent and just share your emotions.

From what I am reading, every case is different. Here we are two months after surgery, Tink is almost back to normal. He still has some problems holding his poop, when it's coming, it's coming. But if I'm on a regular schedule of taking him out, he goes outside just fine. Unless it's cold or wet, then he locks it down and refuses to poop outside. But that was what he would do before the surgery. He continues to gain more control over those functions. I think CarolC told me usually what they have in terms of bodily function control after 3 months is usually what they are going to have in her experience. Can't remember if that's exactly right because as long as I see improvement, I'm not measuring time.

Some things that helped me:
1 - this board
2 - a really good, washable belly band from Etsy with a poise pad. We had to work so when I was unable to be home to take him out, he went in the belly band and couldn't slip it off. https://www.etsy.com/listing/709443421/ ... _purchases
3 - we made him a wheel chair that our vet suggested as we worked PT with him and it was a place I could put him if I was trying to clean up:
https://www.handicappedpets.com/lanies- ... heelchair/. Mine looked similar and I can share. Carolc told me it doesn't have to be beautiful, it just has to work. He didn't even use it for very long.
4 - poop on demand. I always took him out to poop unless he just went in his bed. I shaved his bottom myself and just gave up on the diapers. Like you, it would come out the hole, get stuck every where in his fur, etc. I would rather do laundry and a light clean up with wet, flushable wipes than a whole bath.
5 - this board

I'm so sorry this happened. It's super stressful, especially around the holidays. I will continue to pray for you guys.

[Neds mum]

Aww thank you I appreciate it.
I read the story (and very much enjoyed the pictures) of the adventures of Tink on your thread. Unlike Tink, Ned is not able to stand at all, his legs just drag behind him like loose socks He can't feel them at all but we are not even 1 week post op yet so I know it's a long haul. He stays in his crate most of the day except when doing his physio and massage (3x daily) or when expressing him or when cleaning him. Luckily I'm able to work from home at the minute so I put his crate in my office so we're near each other all day and then we put his crate in the living room in the evenings and sit next to him stroking him watching TV. Unfortunately because of the cone situation we've now found his crate is too small to allow him to turn around comfortably so we've bought him a child's play pen today to give him more room but keep him confined. Also a crate is a bugger to get a feisty terrier who can't move his back legs and who is wearing a massive cone in and out of!!!

This board has already helped so much with understanding everything that's going on. When we initially took him to our vet she did say euthanasia was an option we should consider! I was heartbroken but fortunately the surgeon we took him to didn't mention that at all. She said there would be a few outcomes:
A) he'll walk again
B) he'll learn to spinal walk
C) he'll be paraplegic

In all 3 scenarios she said he could still live a happy life.

[Neds mum]

Here's Ned in his new play pen!

[coxmaria3]

Sweet, sweet baby! Prayers for improvement and formed, ready to clean up poop.

[CarolC]

That's a great picture of him looking very handsome in his jumper.

Diazepam did a lot for my Dolly when she had to do crate rest for her neck. She's a little high strung and just could not relax without it. It was a godsend. Stress can contribute to diarrhea. Enough stress can even cause pancreatitis. The information on metacam does mention loose stools as a common side effect, so I hope that will be your solution!

Are there any potential side effects?

Dogs: The most common side effect of meloxicam in dogs is gastrointestinal upset, including vomiting, soft stools, and lack of appetite.

If by any chance your husband would allow you to post a picture of his potty stand he constructed, it might help someone else someday. There is also a section of this board called DIY Forum where it could be posted if you want to and have time.

This was the 3 months and 6 months explanation my dog's physical therapist gave me on recovery from incontinence:

I know my dog's physical therapist deals with a lot of back problems in dogs, especially long-backed dogs like dachshunds. She says with any back problem affecting the bladder, you need to give it 3 months to let the bladder function get back to normal, and 6 months to be absolutely certain. People who don't deal with back problems/nerve damage often have no idea of the time frame you need to be thinking in. I have heard the therapist on the phone to an owner more than once explaining that it takes time.

But that being said, I have learned in subsequent years that this is only a general guideline. There have been dogs on this board who began to recover bladder control well after 6 months. If you want links, let me know, I think I have some bookmarked.

Ned's playpen is super cute! I love playpens for making cleaning up easy and lifting easy. Right now Pip has a playpen (Pip is a chihuahua recovering from being quadriplegic) and he uses the net sides like one of those trampoline enclosures to bounce off of!

[critters]

Have you tried increasing the gabapentin in case it's paresthesia breaking through? My boy took a big dose, and for twice as long as anybody would've guessed.

I couldn't agree more with poop on demand, especially once the poop is more solid. Have you tried raising his fiber, whether in his food or added into it? It sounds counterintuitive, but fiber absorbs and transports water, even when it's extra water (diarrhea).

I also absolutely agree about shaving his butt; it's ever so much easier to keep them clean!!