One Story Every Day

Owners should not feel guilty. Disc injuries are never really anyone’s fault but rather a function of how the animal is built.
Dr. Dunning

It all started

At the beginning of october 2011 our dog Fluffy had one of the worst experience in his little life: a disk herniation. I’m writing this article because the resources online are very scarce and it’s very hard to find information about this kind of surgery and recovery. Fluffy is a 4 years old shitzu.

We heard that little dogs are predisposed to back problems but we (me and my wife) never imagined it can get so worse. This can be one of the hardest things a dog owner can go through.

These are the severity levels a herniation can have:

• Grade 1: spinal pain without neurologic manifestations

• Grade 2: a slight or partial paralysis but able to walk

• Grade 3: a slight or partial paralysis but unable to walk

• Grade 4: paralysis with deep pain sensation

• Grade 5: paralysis with loss of deep pain

From my observations Fluffy had a grade 4 herniation.

It all started one day when we sow him having problems standing up. We first though it might be and indigestion but then it got worst and worst. I took him outside for a little bit cause he loves that and he was able to move a bit but it was very hard for him. Then when the night came it got ever worse. He was starting to make noises that were definitely from the pain. Usually I let him one-two days before I take him to the vet, but it was clear this was not something that will go away. After one slip-less night from both of us, we got to the vet in the morning. He was still able to move a bit an urinate but he was not standing on his back legs at all.

The vet took a look and was pretty clear that Fluffy can’t feel anything from the middle of the back down. He had no reaction in his legs when he was pinched by them so this looked very bad. The diagnostic was clear: disk herniation.

Regarding the reason for this, for me it was very clear: he jumped from a chair or bad. The doctor confirmed after the operation that it was causes by a short shock and it wasn’t something developed in time. He based this on the fact that dogs that make the herniation in time can have a very high compression of the spine (>50%) but they are still able to walk. From a short shock the herniation is instant and the dog gets paralyzed in a very short period of time.

The first alternative proposed by the doctor was elongation. The doctor decided to try this step for several reasons: it had a chance, the surgery recovery is very difficult and the surgery price is very high. I searched a lot for this online but I couldn’t find any real information. From my understanding they take the dog, give him some sedative and try to stretch him in 2 direction: 1 person pulls from the front legs and the other from the back legs. Regarding this undocumented procedure there is a good rate of success if the case is not very complicated. For me it was clear it wasn’t going to work but the doctor insisted this is the right way to go. In my opinion this can only work if we are not talking about a physical deformation. If the herniation is very small and then the biggest problem is the inflation. Using noninflammatory and rest this can go back to normal with no other complication after 1-2 weeks. The case was clear because the dog was paralyzed. I must admit there was a small improvement ( Fluffy had deep pain sensation ) after one week but I think the sensation was there all the time and the initial shock was to big for him to feel something right after. After one week of anti inflammatory and physical procedure the next step was obvious: Fluffy needed it the surgery.

In order to do a surgery a RMN scan is need it. This is very expensive and usually only humans can have one. Depending on the country such a device might be available for dogs also. A normal radiography is of no use in such cases, and the only other way is a contrast radiography. From my understanding both a RMN and a contrast should be made before an operation.

The operation took a couple of hours and it all went well. The doctors took some photos and they were happy with the result. Regarding the operation I believe they also exaggerated a bit. The herniation was on two disks. In order to get to them and remove it they decided to actually cut the bone, the upper section of the spine. I think It was harder to get to them from one side but in the end this is debatable. The operation was done and I only had the facts not the decisions. In place of the bone they put some fat over to protected the spine. They assured me that if he recovers he will have no physical problems because of the top bone being removed.

Regarding the recovery the Dr. said it could take up to 3 months to walk again. From my reading I understood it can take to 9 months so it really depends on the severity.

The costs for the operation and treatment was around 800 dollars. This might seems cheap for some because in the USA I think it’s around 5000. For my country this is an important amount that not very people would pay for a dog.

After two weeks

The first small victory was when Fluffy managed ( with support ) to stay on this feet a bit ( 2 weeks after the operation ). When he ate or when his out we can make him stand on his feet. He can’t move them but he can stand on them. We took Fluffy to the vet and they did it again; they removed the stitches. For a few days he was ok. The wound was clearly not healed but the skin was holding on. After a few days when I got home again, the skin had break of. His muscles and body fluids wee clearly visible. I rushed Fluffy back and they stitched him again. I was clearly a mistake from their part to remove them so quickly.

The biggest problem from the start was the fact that Fluffy was paralyzed and lost bladder control. He couldn’t urinate himself. We had to go every single day to get the urine out with a catheter. The first week we tried to push his bladder with the hands and fingers. This seemed easy when the vet was doing it but It was clear after a few days this is not a solution for us. Fluffy was in pain the palpation we made, and this wasn’t enought to clear his bladder.

After the surgery I read somewhere that it’s a good solution to use the catheter even home. Of course the risk in doing this was an urinary infection. The decision was made: we will use the catheter to help him and stop daily doctor visits just for this. The biggest problem was we couldn’t find an urinary tube for him. The doctor had only one, we checked over 20 pharmacies and no urinary catheters were available ( a really small one is necessary) to insert it right inside the urinary channel. The doctor gave us his only catheter but I had to give it back so every two days I had to go to him, take the catheter, use it and give it back. I finally found a solution: I found online that for dogs you could use feeding tubes. With this information I manage to find in pharmacies two small tubes. They were really short ( 20 cm ) but they were thin enought. The problem again was the very small length. We manage to get one in but the rate of urination was very small. The final solution was to connect two different tubes ( one of them was a bit bigger). The first one got in perfectly and the second one assured the right size for the urine to came out ( physics and gravitation). The problem with this was a yellow/green secretion that started to cover his urinary exit. It was probably a body reaction to this abusive technique. To give you more details we use Betadine to keep the catheter clean and disinfected and used on the tip of the tube some lube to slide in.

After three weeks

The next day after this small victory I took Fluffy out and he urinated by himself. I guess the little guy just said: I had enought, I will do it my self. What a happy moment that was.

As part of recovery there are several important things the owner must do. The physical exercises must be done 3-4 / day for 10-20 minutes. For the first two weeks we were massaging his back legs and muscles; to make his muscle work we put him on one side and make his legs move like he was pedaling a bicycle. Making him stand was not really an option.

To transport Fluffy we bought a small cage and he little guy loves it. He knows he will go out when we use it so he gets very happy. He stays in it for 3-4 hours with no problem.

But the next problem appeared: the seroma. When you remove a part of the body from surgery there is a good change the fluids like blood will build up. This looks like a lump. Usually is harmless but the risk of an infection exists. I took Fluffy to get his last stitches removed and I showed the Dr. the seroma. I don’t think he used the same name for it but he said it’s ok: if it doesn’t hurt and he has a good appetite we only have to wait. The body will reabsorbe it in time. We used Betadine twice a day and applied it on the skin. The doctor said the skill will absorb it and help ( I couldn’t find an online references regarding this ). The thing nobody told us was that seroma usually appears because the dog is active. The doctor always told us to make him stand, walk and so on but now I’m starting to think this is not good to soon.

After one month

4 weeks post op we notice a small improvement. The seroma looked a bit better and it’s seems to be retrieving. I’m also contemplating on buying a
wheel cart ( link ) but I hope the recovery will go faster for the moment.

After five weeks

My little shitzu has showed a lot of progress in the last days. The seroma has retreated almost 90% after we used Betadine twice a day to keep the skin clean and infection free. First he started jumping with his fronts legs like a little bunny, then one night while I was doing his physical training laid on one side he felt his leg and started scratching his year like before; it was a real strong move of his legs and very controlled. The next day, while he ate he managed to get up on his back legs. He is still shaky so after 30 seconds I had to support him until he finished. It’s very conforming to see the likes to stay on all four legs and it feels natural to him even if it’s hard. Other progress I sow was the fact that he tries to get on his back feet from time to time when he is moving, but he looses his balance quick and starts pedalling fast with his front legs.

We go outside twice a day so he can urinate and I keep him from the back legs to have a stand position. He likes it and I feel small movement in his back limbs. I think he can make 1-2 steps on his own for now. He sleeps for most of the day but the appetite is good and he looks better. He looks a bit to much at the couch and if he could he would jump on it. A very bad habit we will have to break.

One Month And A Half After

In the last week Fluffy had a good appetite, tried and succeed several times to stand while eating and also started to stand on his back legs while walking. He can’t really control his legs for a normal walk but the instinct is there. I started to do more exercises with him to speed up the recovery.

Updates coming soon….

What we learned from this experience

• never let you dog jump on beds, tables, sofas or chairs. Don’t let the dog climb stairs ( this can cause the herniation in time). A dog has to stay on the ground and you must enforce that no matter the costs.
• Betadine seems the magic solution to disinfection. Instead of it I think some people recommend oxygenated water.
• don’t remove the stitches after 2 weeks from the operation
• don’t let the dog have to much room to walk because he can make a seroma from the activity

Experience Log

• 2011-10-04 first signs of problem
• 2011-10-11 back surgery
• 2011-10-26 can stand on his back legs with support
• 2011-11-03 starts urinating himself
• 2011-11-07 seroma appears
• 2011-11-12 first signs of seroma retrieving
• 2011-11-18 seroma has retrieved almost 90%, first real signs of using his legs
• 2011-11-27 trying to walk in the last days on he’s own, standing while eating from time to time

Online resources

• Seroma after surgery
• Tinker recovery after surgery ( the site got hacked I think, use google cache )
• Disc Herniation of the Mid Back
• Home care after surgery
• DogWheelchairs and Other Pets

Tags: Experience Log, RMN