trouble recovering bladder function after spinal surgery

[carterbug]

Just over two weeks ago my dog began having problems. He refused to go up the stairs and was in a lot of pain. The next morning we took him in to the vet who diagnosed him with a herniated disc and gave him steroid injections, but later that day instead of getting better or staying the same his rear legs became paralyzed. We rushed him in to a specialist and he ended up having surgery on his back (hemilaminectomy). The surgery was two weeks ago tomorrow.

His legs are recovering function very well and he is now able to walk around again although he stumbles a lot and of course we are keeping him from walking too much so he doesn't injure himself. The big problem we are having is with his bladder function. Prior to the surgery he had no problems with his bladder at all. When we brought him home, the vet showed us how to express his bladder, but we had a lot of difficulty doing it even after taking him in to the emergency vet to have them show us again. He would thrash around, yelp, and bite at us when we tried to express him. The vet had said that when he recovered his hind leg movement he should recover his bladder function as well but that has not been the case. We had to bring him back in the vet to be catheterized for 72 hours in an effort to keep him empty long enough for his bladder muscles to recover.

At this point he still is unable to pee on his own. We are having a little more success expressing him now than we were before because he has a bit of function, so once he gets going you can see the stream pulsing with his bladder contractions. However, the entire time he has been also steadily dripping urine all day. Originally they had thought he was dripping because his bladder was too full since we couldn't express him, but now we are expressing him and he is still dripping. We're changing up his medications to try to resolve this and we have another appointment with the surgeon on Wednesday, but I guess I am just looking to see if anyone else has had this problem. We have him in male wrap diapers right now and are taking him outside regularly, but we're really struggling with trying to take care of him. When we go to express him he thrashes around, tries to sit down, yelps, howls, barks, growls, and snaps at our hands (he has already bitten my husband once while we were trying to do it). Once the urine actually starts coming out he calms down, but it's a real struggle to try to get anything out of him. Right now we cannot leave him alone at all, even in a pen, since he yelps and tries to chew out of the pen and we're afraid he will hurt himself more. We've been taking turns working from home for the past two weeks but we can't sustain this long term.

Does anyone have any advice? We are stuck in a waiting game waiting to see if he gets better and waiting until the vet can examine him again but emotionally we are at the end of our rope. The vets are saying that given his hind leg function there should be nothing wrong with his bladder at this point and they have no idea what's going on. He's also been having issues with food bloat but I think we are getting that back under control with a bland diet. I guess I am just looking for some emotional support.

[CarolC]

Just over two weeks ago my dog began having problems. He refused to go up the stairs and was in a lot of pain. The next morning we took him in to the vet who diagnosed him with a herniated disc and gave him steroid injections, but later that day instead of getting better or staying the same his rear legs became paralyzed. We rushed him in to a specialist and he ended up having surgery on his back (hemilaminectomy). The surgery was two weeks ago tomorrow.




Hi, I have some questions...

What kind of dog is he?

What age?

What weight?

Where on his back was the surgery, for example did they say T-something or L-something? Was it his neck, mid-back, lower back, tail area?

His legs are recovering function very well and he is now able to walk around again although he stumbles a lot and of course we are keeping him from walking too much so he doesn't injure himself. The big problem we are having is with his bladder function. Prior to the surgery he had no problems with his bladder at all. When we brought him home, the vet showed us how to express his bladder, but we had a lot of difficulty doing it even after taking him in to the emergency vet to have them show us again. He would thrash around, yelp, and bite at us when we tried to express him. The vet had said that when he recovered his hind leg movement he should recover his bladder function as well but that has not been the case. We had to bring him back in the vet to be catheterized for 72 hours in an effort to keep him empty long enough for his bladder muscles to recover.

Well, hallelujah for the legs!!! Experience here has shown there is no set rule about what comes back first. In general, since he had bladder control going into surgery and he has hind leg function now, I would be very hopeful that he will get his bladder control back, but not necessarily at the same time or even right away. In some pets the bladder control comes back before mobility, in some pets they can walk before they have bladder control. There is no hard and fast rule. My dog's physical therapist says you have to give it at least 3 months to see if bladder control will return, and 6 months to be sure. Usually whatever you have at 6 months is pretty much what you are going to have, but there have been exceptions where there was improvement even after that. It's good that you are on top of things and got him emptied so his bladder would not stretch. It is possible (I don't know, it doesn't seem really likely, just thinking out loud) the catheter may have had a little affect on his sphincter, but I imagine that will improve with time and exercise. My grandmother had issues after being catheterized when she was in the hospital, but exercise helped.

Here are some tips on expressing, but it sounds like his reaction is the problem, not so much your technique.

http://www.handicappedpets.com/mediawiki/index.php?title=Express_a_dog_or_cat

At this point he still is unable to pee on his own. We are having a little more success expressing him now than we were before because he has a bit of function, so once he gets going you can see the stream pulsing with his bladder contractions. However, the entire time he has been also steadily dripping urine all day. Originally they had thought he was dripping because his bladder was too full since we couldn't express him, but now we are expressing him and he is still dripping.
If his disk problem was in his lower back or tail area, it can cause a loose sphincter so the dog leaks or drips continually, I have a dog like this who had an injury in the tail area.

We're changing up his medications to try to resolve this and we have another appointment with the surgeon on Wednesday, but I guess I am just looking to see if anyone else has had this problem.

What medications is he on? This could be part of the problem. There are medications to help the bladder contract, and medications to help the sphincter relax.

We have him in male wrap diapers right now and are taking him outside regularly, but we're really struggling with trying to take care of him.

Malewraps are such a great invention, I'm glad you have some. If you are having any issues with the wrap not fitting properly, coming off, not being absorbent enough, etc., please be sure to mention it. I think you are going to want to use them for a while till his control is reliable, so you want good ones that are working really well for him.

When we go to express him he thrashes around, tries to sit down, yelps, howls, barks, growls, and snaps at our hands (he has already bitten my husband once while we were trying to do it). Once the urine actually starts coming out he calms down, but it's a real struggle to try to get anything out of him. Right now we cannot leave him alone at all, even in a pen, since he yelps and tries to chew out of the pen and we're afraid he will hurt himself more. We've been taking turns working from home for the past two weeks but we can't sustain this long term.

Is he a terrier or a high strung dog? I really feel for people in this situation. My last nerve would be frayed in very short order. If necessary, I would not hesitate to ask the vet for something to calm him, you have to be able to work with him. I wouldn't do that for every dog, but if he's really wired and tense and snappy, I'd definitely consider it. You won't need it forever, just for a few weeks. I think this is the whole problem because you are doing everything right. You got him the surgery, it is successful, you are restricting his activity, you took him back to the vet when he wasn't urinating, you have malewraps for him. You are doing everything right. But he is too tense. I'm still curious about his medication. Dianne's dachshund was on prednisone and she said it made him very snappish and difficult to work with. The snapping and yelping and growling are not the norm in this situation...it doesn't make you feel any better but I'm just saying, everyone has trouble expressing and few dogs enjoy crate rest, but your dog is acting up quite a bit more than usual. I guess you need to figure out if 1) his pain control is adequate, maybe it is not 2) he is reacting to a medication like Dianne's dog did 3) he is just a drama queen...I don't think so. I do know that if I just had back surgery 2 weeks ago, I would be in a world of pain. There are excellent pain meds for dogs, if the one you have is not working, tell the vet. They can give him something stronger. You can put the medication you have now in the cupboard and use it later when he does not need the super strong kind. I do think you can be optimistic about the prospect of bladder control returning, I expect that is going to work out, but you have to survive till then!

My big dog whined and whined when he was on crate rest, and I had done everything I knew to make him feel calm and comfortable. In the end I had to use hearing protectors to kind of screen it out or I would have gone nuts. There was nothing more I could do for him, I had to do something for myself... Also, since there are 2 of you, I would make a conscious effort to let each one of you get out of the house and go do something relaxing, walk the mall, get a bite to eat, something you enjoy. You deserve it and it will help you return to caring for him feeling a little more refreshed and able to do your best.

Does anyone have any advice? We are stuck in a waiting game waiting to see if he gets better and waiting until the vet can examine him again but emotionally we are at the end of our rope. The vets are saying that given his hind leg function there should be nothing wrong with his bladder at this point and they have no idea what's going on. He's also been having issues with food bloat but I think we are getting that back under control with a bland diet.

I am not sure how that factors into the situation, but when my dog is bloaty she is hard to express and I do think she is uncomfortable. I wonder if that has anything to do with his snapping when you go to express him. Again, the snapping isn't real common, it happens but not that much, so I would be looking for what is causing him to react that way.

I guess I am just looking for some emotional support.

Well, I think you're going to make it. He is getting a tiny bit better every day. It does take a while for the pain from surgery to go down, for the swelling to go down, for the dog to recover from the stress. In some ways, "tincture of time" is the best medicine. Every day you get through is getting you closer to your goal. I think it's going to settle down. I do think you might want to really try to figure out why he is snapping and restless. I'd try additional pain control first and see if that helps. My dog was actually kind of loopy on her medication. She rested in her crate with her eyes half shut and a happy look on her face. I could really tell the last 45 minutes before her next dose, she would become restless and her expression would change.

I hope you will post what you find out, when you find the solution what was bothering him.

[carterbug]

Carol, thanks for your reply! It definitely made me feel better to see that you think we are doing the right things for him. We are feeling much more hopeful today because he managed to pee for the first time since we brought him home!!! I was at work at the time and my husband was home, and he said that Carter had jumped up to go out, and as soon as he got his diaper off outside he started peeing all over the place. It's still not 100% (he was basically walking around peeing the whole time, and is still dripping a little) but we are feeling much more hopeful.

Here are the answers to your questions:
- Carter is a mixed breed, we think german shepherd/doberman/something else as well
- He is between 6 and 7 years old. We adopted him in 2008 and were told he was 4 years old at the time.
- His weight was about 85lbs before the surgery (though he has lost a significant amount of weight during the process)
- I've misplaced the paper with the details of his surgery, but if I recall correctly it was T11-T12, T12-T13, T13-L1. The vets initially thought it might be a tumor because it presented very strangely on the CT and myelogram but thankfully the biopsy confirmed it was all ruptured disc with a lot of hemmorhaging.
- Because the vet thought it might be lymphoma, he was put on prednisone, which we are tapering off now (he gets a pill every other day). He is on tramadol for pain relief, an antibiotic to prevent infection which we just finished up, zantac to prevent upset stomach, gas-x as needed for his bloating, and bethanechol to help his bladder contract. He was also on phenoxybenzamine before as well but we discontinued that yesterday since the surgeon thought it might have been part of his dripping problem. We also reduced his tramadol from 3x/day to 2x/day starting yesterday since the surgeon said for some dogs they have a bad reaction to opiates and that might be interfering with his bladder as well.

[carterbug]

Just wanted to give you an update. We took Carter off of the tramadol and he is now not only able to pee and poo on his own, but his stomach issues have resolved as well! So in case anyone else out there is reading this and having the same issues, know that tramadol can interfere with muscle function of the internal organs.

Now at three weeks post-op Carter is not on any medications anymore, and he is able to get up and walk on his own (with us following to catch him if he starts to fall) and take care of all his bodily functions. He's far from 100% but he is making great progress. Yesterday he even tried to scratch his neck with his bad back leg -- didn't quite manage to do it -- he got the foot to his neck but couldn't manage the scratching motion so I did it for him. Thanks for your help and support!

[CarolC]

Woohoo!!!!!!!!!! That is the best! Thank goodness, I'm so glad it worked out. Will bookmark this. Thanks for updating!

[cpdadd]

Thank you for posting this information. I am going through this now with my dog and you are both keeping me hopeful