Hi there, newbie to a handicapped dog and newbie to this forum!
Steve (Chihuahua mix) had surgery last Thursday for herniated disc and is paralyzed and incontinent. I *think* expressing is going very well, however, he is ending up with a considerable amount of urine in the crate between expressions. I was led to believe that once he was expressed (assuming empty) there wouldn't be any urine unless there was overflow for the bladder being too full. I am now expressing about every 3 hours in hopes of catching the accident before it comes (it's not working). He is not on steroids, currently, so I'm thinking 3 hours between expressions seems excessive?! The surgeon told me every 8-9 hours (which seemed too long to wait). Steve is taking Tramadol for pain and Prazosin to make the expressing easier.
Just wondering if this a normal part of the process or if maybe I should take him off some of the medication or what? He's only been home one day and I'm already overwhelmed. Any insight is appreciated!!
Dog going between expressions?
Re: Dog going between expressions?
Stevesmom wrote:Hi there, newbie to a handicapped dog and newbie to this forum!
Steve (Chihuahua mix) had surgery last Thursday for herniated disc and is paralyzed and incontinent. I *think* expressing is going very well, however, he is ending up with a considerable amount of urine in the crate between expressions. I was led to believe that once he was expressed (assuming empty) there wouldn't be any urine unless there was overflow for the bladder being too full. He could also be leaking.I am now expressing about every 3 hours in hopes of catching the accident before it comes (it's not working).Hmm. What ain't in (thanks to expressing) shouldn't be leaking, so maybe he'd be leaking more otherwise. He is not on steroids, currently, so I'm thinking 3 hours between expressions seems excessive?! The surgeon told me every 8-9 hours (which seemed too long to wait). Steve is taking Tramadol for pain and Prazosin to make the expressing easier.None of my spinal cord injured boys have taken Prazosin, and I'm not quite sure whether it's intended to treat a spastic bladder or a hypotonic (floppy) one. If it does spastic ones, though, it may be that he needs a med to give a bit more tone to his bladder and maybe cut down on the leaking. My boys did PBZ (phenoxybenzamine) for spastic bladders and bethanechol for floppy ones.
Just wondering if this a normal part of the process or if maybe I should take him off some of the medication or what? He's only been home one day and I'm already overwhelmed. Any insight is appreciated!!
Re: Dog going between expressions?
My guess (?) would be you are like I was when I first started expressing, being very conscientious and thinking I was getting it all but I was not. Especially if his belly is tense from pain right now in spite of the Tramadol, you would have a hard time feeling whether you've got him empty. We are not born knowing what a dog's abdomen feels like with an empty bladder versus a full bladder. Also, if he is constipated, it makes it hard to feel the bladder. You develop a more sensitive touch in time but not necessarily the first week. Yes, I agree 3 hours is pretty often, 6 ought to be plenty, 8 is what is normally recommended because it is enough to prevent infection and prevent the bladder from becoming stretched. But I can see why you were trying 3 if he was leaking in between and you're assuming he is empty.
Where is the disk injury, is it lower back? There are 2 kinds of bladder incontinence, depending on where the injury is. An injury in the lower back/tail area tends to cause loose sphincters and you can have a dog that leaks or dribbles, in extreme cases they can leak 24/7 and are not able to be expressed because they are always empty. In other cases they may be able to go a few hours without leaking, but then they will leak between expresses, or he might not leak till you try to pick him up, then he empties. It does not require a lot of pressure to express a dog like this. When the injury is higher up, you have a dog with tight sphincters. That is the dog that takes more pressure to express, he does not leak, his bladder can fill until it is overly full, then it will overflow. I do not think this would happen in 3 hours though.
One idea is to do an express check, ie. take him to the vet, you express him to the best of your ability, and then have someone who is good at it express him afterward and see if they get any more. That is how I found out I wasn't getting my dog empty.
If the injury is mid or upper back or neck then I would not want to stop the Prazosin, but if it is lower back you could ask the vet because you may not need it and he may be leaking. Also, depending on where his incision is, you may be able to let him wear a malewrap. A malewrap is a belt that goes around the waist and holds an absorbent pad over the male area. They are also called male doggy diapers or belly bands, they are wonderful. I'm *guessing* it is lower back (?) so right now he does not need any kind of belly band going over his incision, it would need to wait.
Where is the disk injury, is it lower back? There are 2 kinds of bladder incontinence, depending on where the injury is. An injury in the lower back/tail area tends to cause loose sphincters and you can have a dog that leaks or dribbles, in extreme cases they can leak 24/7 and are not able to be expressed because they are always empty. In other cases they may be able to go a few hours without leaking, but then they will leak between expresses, or he might not leak till you try to pick him up, then he empties. It does not require a lot of pressure to express a dog like this. When the injury is higher up, you have a dog with tight sphincters. That is the dog that takes more pressure to express, he does not leak, his bladder can fill until it is overly full, then it will overflow. I do not think this would happen in 3 hours though.
One idea is to do an express check, ie. take him to the vet, you express him to the best of your ability, and then have someone who is good at it express him afterward and see if they get any more. That is how I found out I wasn't getting my dog empty.
If the injury is mid or upper back or neck then I would not want to stop the Prazosin, but if it is lower back you could ask the vet because you may not need it and he may be leaking. Also, depending on where his incision is, you may be able to let him wear a malewrap. A malewrap is a belt that goes around the waist and holds an absorbent pad over the male area. They are also called male doggy diapers or belly bands, they are wonderful. I'm *guessing* it is lower back (?) so right now he does not need any kind of belly band going over his incision, it would need to wait.
Re: Dog going between expressions?
Thank you so much Carol and Critters for your replies!
The injury is lower back and the vet said he was somewhere between a spastic and floppy bladder (super.).
I did scale back the Prazosin last night to see if maybe that was making things too loose and I think he was better. And I also put a wrap on him (and by some miracle it didn't cover the incision - I was very worried about that) just so I could see how much was leaking out to get more of an idea of the amount I may or may not be missing when expressing. I think both things helped. He was wet this morning, but then later this morning he didn't actually leak until I went to get him out of his crate and I was able to express a decent amount out. So maybe there is hope. I'm hoping the lower dose of Prazosin will help today. If not, I definitely will take your suggestion to take him to the vet. I just want something to go right for the poor guy.
The injury is lower back and the vet said he was somewhere between a spastic and floppy bladder (super.).
I did scale back the Prazosin last night to see if maybe that was making things too loose and I think he was better. And I also put a wrap on him (and by some miracle it didn't cover the incision - I was very worried about that) just so I could see how much was leaking out to get more of an idea of the amount I may or may not be missing when expressing. I think both things helped. He was wet this morning, but then later this morning he didn't actually leak until I went to get him out of his crate and I was able to express a decent amount out. So maybe there is hope. I'm hoping the lower dose of Prazosin will help today. If not, I definitely will take your suggestion to take him to the vet. I just want something to go right for the poor guy.
Re: Dog going between expressions?
A med trial of a bit of the other meds might be worthwhile. I certainly wouldn't want to fill a boatload of it, but a script of just a few to try. Glad he's doing a little better, anyway! Honestly, it looks to me like your vet is pretty knowledgeable and is WILLING to work with handicappers, so that's a very good start. I've never met a vet who knew loads about handicappers unless they have/had one, so it's OK if this one doesn't know it all.Stevesmom wrote:Thank you so much Carol and Critters for your replies!
The injury is lower back and the vet said he was somewhere between a spastic and floppy bladder (super.).Well, now, THAT'S a new one!! LOL
I did scale back the Prazosin last night to see if maybe that was making things too loose and I think he was better. And I also put a wrap on him (and by some miracle it didn't cover the incision - I was very worried about that) just so I could see how much was leaking out to get more of an idea of the amount I may or may not be missing when expressing. I think both things helped. He was wet this morning, but then later this morning he didn't actually leak until I went to get him out of his crate and I was able to express a decent amount out. So maybe there is hope. I'm hoping the lower dose of Prazosin will help today. If not, I definitely will take your suggestion to take him to the vet. I just want something to go right for the poor guy.