Waiting and home preparations

Leaving our little Lady Penelope in the care of Dr. David Lidbetter for surgery was one of the hardest things I have ever had to do.  It was really hard watching her in so much pain, and knowing there was nothing I could do, but also knowing that leaving her there was the best thing... I felt a little part of me die a bit.  

Anyway, when I got home I posted on my facebook page what had happened to us, as well as texting family and friends to tell them the news.  I had called my BFF "J"  and my mum from the car to fill them in. 

Social media is a marvel isn't it?  Almost immediately, 2 fb friends who up till this point had pretty much been just "virtual" friends, messaged me with offers of assistance.  One we had met at our local lake about 18 months earlier with her little dachshund Miss Violet, and the other we had never met, but been fb buddies via a dachshund site.   Miss Violets mum I'm gonna call her "A" offered us an enclosure, and the other lady "S" who had little Ellie, sent through picts of how she had set up her enclosure for when Ellie had knee surgery (also with Dr. David) .  This was really helpful, and between that and the information on the Dodgers list about setting up a crate I had a good idea of what we needed to do.  

Dr. David rang us at about 6pm to say that Penny went in 1st for surgery,  had come through surgery really well, her disc at T12 had a very large rupture.  He said her disc "exploded" and that he did prefer it when the rupture was large- as opposed to an animal being down and in pain with just a small occlusion.  The nerve looked blue, which was not great, but not as bad as it being black, as it still shows some life, as opposed to being dead and black.  We were invited to go visit her in the morning if we wanted, and he said we could bring her some treats, but that we could not stay very long.  I worked it out that from the time of Penny going down to the time she had surgery was about 37hours.  Not ideal, as the best recovery is made if surgery is done within 24-48 hours. 

The next day, I of course went to see her.  She was so groggy and doped up, but so happy to see me.  I was pretty emotional, crying.  I sat with her for about 15 minutes and fed her roasted chicken breast.   It was a long way to go for a short visit, but I needed to see her, and know she was OK.  It also helped prepare me for the task ahead, and got me over the shock of seeing her with a huge shaved area of her back and stitches that looked like they were made with fishing line and unable to walk.  She looked so sad, poor thing with her eyes sort of glazed over.  I could tell it was time to leave though, as she was getting obviously tired, her eyes closing, and leaning on my hand.   On the way out, I asked for her after care sheet so I knew what sort of supplies I would need.  (good move on my part, there was a lot to do) 

I could pick her up and take her home tomorrow! 

On the way home I stopped at Spotlight and for 3 meters of polar fleece and Pet-barn for puppy pee pads. 

Lady Penelope the day after surgery to remove a ruptured disc

That night Kane and I went to collect the enclosure from "A" we brought Gidget along, so Violet and her could meet.  "A" offered to have Gidget over for play dates and to look after her while we were settling Penny in.  Keeping Gidget off Penny, occupied and happy was now a major concern, as Gidget had never been alone in her life till 2 nights ago, and was not adjusting to her new reality very well.  I knew I needed to keep her busy and active, so this offer was very well received.  

To set up the enclosure we 1st put down a tarp, then we took a foam pad which we had in the garage (I can't remember where we got it) and wrapped it up in plastic and taped it all closed.  The foam is a bit longer that the enclosure so it makes a bit of an edge for Penny to lean on, but not as wide as the enclosure, so we have room to put a water bowl on a firm surface.  On top of that we put a puppy pee pad, on top of that a larger piece of fleece wrapped around it, and on top of that a smaller piece.  I had cut up the polar fleece I bought at spotlight into various sizes.  1 meter into 4 pieces, and the other 2 meters into 4 pieces (1/2 meter each).  The idea being that the top smaller piece of polar fleece can be changed as often as required, and polar fleece wicks away moisture so she doesn't have to sit in urine.  The puppy pad absorbs it, so you have various levels for changing cleaning as needed.  Again, I want to direct you to the Dodgers list, as they describe it very well, and here is a pic of how we set it up. The weights in front to stop Penny from moving the enclosure when she is pushing on the bars trying to get out. 

I just needed to get some baby nappies and some wipes and a hot water bottle and we were set.  

Surgery!

Overnight, neither one of us had very much sleep.... 

We got up pretty early to collect Penny from the vet clinic, where she had rested well, and was in as good shape as she could be if we decided on surgery that day.  The overnight visit was $275- for the medication, drip, and overnight stay.  They had put her into a dog crate for us to borrow, and off we drove to the surgeons in Parramatta... we thought it may take about 2 hours to get there, and our appointment was at 10:30.   I had texted a friend of mine who used to be a vet-nurse and asked her if she had ever heard of Dr. David Lidbetter, and she said she had, only good things, so that was nice news..... Both my husband (I will use the moniker "K" from now on) and I had taken the day off work, and I told my boss I may not be in the whole week.   It was Tuesday.  

On the drive down we got a list of questions together.  What would the surgery do for Penny? What are her chances of walking again?  Would she be in pain after the surgery?  What was the expected recovery time? What if any are the "hidden costs" of the surgery?  How were we going to pay for it?  Fortunately, Kane had been saving up for a projector, so we were only about $1000 short of the quote of $4500 our vet had given us, I thought I could get an advance from work, or maybe borrow it from someone....All our credit cards were pretty close to maxed out, but there may be a couple hundred available.   We talked about the reality of having a post-op doggie, and how distressing it was to see her in pain.  As hard as it was, we did discuss the possibility of needing to have her put down, and what would we do with the body?  I wanted to bring her home and put her in the garden.  Kane said we couldn't really decide what to do until we talked to the surgeon, and got more information on her condition. 

On arrival we are amazed at how nice the place is... super modern, clean, airy and yet welcoming.  We were a bit early, but didn't have long to wait.  We were ushered into the consultation room, where the walls are covered with diplomas from all over the world.  Australian Vet Surgeon, European, American, England- we got the feeling we were in good hands.  There were thank you cards on the desk, which was nice, some with pictures of dogs in them.

Dr. David Lidbetter walks in, and the 1st impression is that he is so young.  Tall, dark and handsome, with a nice genuine smile, and warm handshake.  We took Penny out of the crate and he had a look at her.  Our local vet had emailed him all her information up to and including what medication she had that morning, so he was all up to date on her current situation.  Once again, our local vet had done us a great service in looking after us and preparing us for this consultation. 

We started talking about what our options were, and how we proceed.  So, 1st off by looking at Penny and doing what they call a Deep Pain Test (where he pinched her toe pretty hard to see if there is a pain reaction -I winced just watching...) , he was 95% sure it was a disc rupture.  What they do is they sedate her and take a scan of her back to confirm the diagnosis and to get an exact locale.  Then, he goes in and removes most, but not all of the ruptured disc to relieve pressure on the spine and sews her up.  

He goes onto tell us, that 1 in 5 dachshunds will suffer from ruptured disc and 1 in 20 will have a second, third, fourth incident.  It usually occurs in animals between the ages of 3-8yrs.
What happens is the discs calcify over time and loose their elasticity and then they burst, putting pressure on the spinal cord and causing nerve damage.   

(there is a lot of information and diagrams that explain it much better than I do at 
http://www.dodgerslist.com/index.htm)

Dr. David  sees about 1 dachshund a week in his surgery.  He gave Penny a 50/50 chance of walking again, and told us we were looking at a 8-12 week recovery period where Penny would need to be kept in a small space, which could be a crate, a baby play pen or a part of the room blocked off.   She would be incontinent and that may, or may not improve when she regains function of her back legs.  So we would need puppy pee pads, polar fleece and face washers etc on hand.  Usually bladder control and leg control come back together.  There were some exercises  for us to do with her, and we would need to look out for bed-sores, and keep her clean and dry.  He said that due to the long weekend, our costs were lower than usual, as he had a few animals in for surgery, so he could keep the costs down a bit for us.  If she was un-able to go home with us on Thursday (due to complications ) the costs would go up substantially, as Friday was a public holiday and he would have to keep the surgery open with a vet nurse on duty just for her.  The quote was $4800 including a blood test.  After the surgery, and the pain of the surgery itself was finished, he said there was only a very slight chance that Penny would still be in pain.  He said he had only had 2 dogs that had chronic post-operative pain.  Pretty much we had 2 options- go ahead with surgery or have her put to sleep.  David gave us some time to discuss the options and left the room.  

Gosh, it was a bit difficult... we looked at Penny in so much pain, and looked at each other.  I was waiting for Kane to say something, and I think he was waiting for me.  Then he said :"I think we need to do everything we can to save her"  I burst into tears of course, and I agreed. We briefly discussed how hard it was going to be to keep Penny calm and secured for 8-12 weeks, but both of us agreed we could do it.   We second guessed our selves for a few minutes like "how are we going to scrape the money together" "is it worth it"  "is it the best thing for Penny"  "are we just being selfish, because we can't let her go?".  

When Dr. David came back, we said that yes, we would go ahead with the surgery.  So we took Penny into the back of the surgery and settled her into her pen. (although there was nothing "settled" about her, the pain medication was wearing off and she had started star gazing again, during the time we were in consultation.)  We got to walk by the operating theatre, and it looked really good..... glistening instruments all laid out in packets, video monitors, trolleys etc Kane and I looked at each other and went "wow"  I thought it was better appointed than human operating theatres....   

Dr. David said he would call us when Penny was out of surgery.  

We went and paid a $1000 deposit, and left our little pup there.... fingers crossed she would come out ok. .....

On the way home we discussed what we would need, and how nice Dr. David was...he answered all our questions, quite fully, and we were not made to feel rushed or dumb for asking them, and how impressed we were with all his diplomas.  We left feeling that Penny had a good chance of recovery and that she was seriously in the best hands possible. 

Penny Goes Down

So, I had never been very protective of Penny, letting her run, jump, swim, go up and down stairs etc- as I was operating under the impression that if we kept her fit, and her weight down that would prevent any back problems.  Well, turns out I was wrong (and right).  Turns out disc degeneration in dachys is very common, and hereditary.  There are so many articles written on this, and I could never repeat it and get it right, so here are some links to the information:

https://www.facebook.com/groups/dachshundivddsupportaustralia/

http://www.dodgerslist.com/index.htm

These two sites have been an invaluable source of information and support, and with out them I really don't think we would have managed.  

Even if I had protected her from jumping, running, going up stairs it may or may not have happened.  Basically I have come to understand IVDD as a sort of time bomb... it could happen, or not.  By protecting her I may have reduced the severity (or not) delayed the incident (or not) prevented her need for surgery (or not).  The disks calcify and get hard, they may or may not rupture.  Keeping her fit, and her weight down was a no brainer- and in retrospect her quality of life and love in being active was part of her nature and I could have never taken even a moment of that away from her.  Now of course, we are putting in ramps to furniture and out the doggie door... any little bit we can do to reduce stress on those discs!  And we have Gidget to worry about now too....

On Easter Sunday (it would be a public holiday) we noticed in the morning that Penny tried to jump up on the bed and missed.  We didn't really give this a second thought, as she did not appear to be in any pain, and just carried on running around with Gidget.  This was about 12pm-ish.  We carried on with our day, Penny went over to visit the neighbours and play with their grandkids as she did on the weekend, and we were doing some gardening.  She came back from the neighbours, and her and Gidget settled down in the sun to watch us work.  I picked her up once and she did make a little yelp of pain, at which point I set her down and carefully checked her for tender spots.  I did not find anything, and she did not yelp, cringe, cry or show any other signs of distress.  As I picked her up with my gardening gloves, I though I must have squeezed her too hard... Again, I was not too concerned as she really did seem fine.  She  ate her dinner as usual- wolfing it down.  Still no sign of anything being amiss.  

At about 7:30 or so Kane said to me to check out Penny as she was walking crooked.  We both immediately thought she had eaten/drunk something (as once before she had accidentally drunk some alcohol and had the same legless gait- we rushed her to the vet of course- but that is a different story.... FYI all alcohol is toxic to dogs in case you didn't know) as it was a public holiday and after hours, we decided to keep any eye on her.  An hour later she was down.  We tucked her into bed and kept her warm, she didn't seem too distressed or in pain at that time.  

We took her to the vet 1st thing in the morning (still public holiday) as her condition had worsened over night.  She was in obvious pain and distress.  Our Vet immediately knew it was some sort of a back issue, and wanted to take some xrays and do a full neurological exam as well as give her some IV pain medication, so we left Penny there and came home a bit stunned.  It happened to be my husbands birthday that day.... some birthday.  I was doing internet research, and had made my own conclusions that it was probably IVDD- I just kept reading all these stories of people who had rehabilitated their dogs over 1 to 2 years, and the tears just would not stop.  

About an hour later the vet rang and said it was worse than he had thought, and said we better come back up to the clinic.  We drove there in silence- both of us expecting the worst.  He told us he thought it was a ruptured disc, and that it was impacting on her spine causing pain, and ultimately nerve damage.  He drew us little diagrams and everything.  He then went onto say he had called a friend of his, who was a surgeon (turned out to be Dr. David Lidbetter)  and told him of Pennys condition.  If it was a disc as they expected, then an X-ray was not going to be conclusive, she needed a scan, which he could not do at the clinic.  Then he went onto say that he had booked us the 1st appointment in the morning with Dr. David, Tuesday at 10:30, and depending on what we decided, that she could go into surgery same day.  Our vet  told us the cost would be around $4500, a quote Dr.David had given him on the phone.  Then he said if we didn't want to wait, we could take her to the Sydney Vet Hospital where they most likely would not have a surgeon on duty being a public holiday, and if they called one in to do surgery on Penny that day it was going to cost a lot lot more, upwards to $8G.  We decided to go see Dr. David in the morning, and so our vet then started Penny on pain management that would not conflict with the possibility of her going into surgery the next day.

I just want to say here, that our vets quick analysis of Pennys condition and his contacting Dr. David, getting advise, getting us a quote and booking us in, was a seriously good call on his part.  It saved us a lot of un-necessary testing and waiting days for appointments etc, as well as making sure Penny was not given any drugs that would delay surgery.  As I have learned, every hour the spine is impacted more damage to the nerves occurs.  We just had super bad luck with it being a public holiday.  He will have our eternal thanks for his good judgement, we were so lucky. 

We took Penny home to try to settle her and get her some rest.  Crazily, my mum met us at the vets, to see how we were doing.  It meant so much to me, as she is not a pet lover.  Animal lover yes, but not a pet lover, she really actually hates dogs and cats.   Anyway I just mention it because it was really amazing she came up there to support us.  

At about 5, the vet rang us to ask us how Penny was doing, and I was so glad he did, because she was still in obvious pain and distress- it was awful to see... She was doing what they call "stargazing" looking up, and sometimes arching her back nearly in a U shape with her front legs stiff out front and un-bending.  She would arch back, then sort of sigh, or exhale and then do it again.  I had given her all the tablets I could, and she was not settling down at all, there was no relief for her.  So we brought her back up to the vets and he suggested he put her on IV meds and see if that helped.  So we left her there with him.  One of the hardest things to do, to leave her there in pain and confused, with her eyes glazed over.  He rang us about 8pm and said she was finally resting, and was on a heated pad as well, and for us to come and collect her 1st thing in the morning.  

Introduction

Ok, so it's been 4 weeks since our little Penny went down with a ruptured disk and had surgery to remove it, it's taken me this long to have enough space to write it down and share my experiences.  The reason for this blog is to share with others what it is like on a day to day basis to look after a dog post IVD surgery.  There is a lot of information on-line and many support groups of which I will get into in a bit, but no one can really tell you about the emotional toll it takes from you, and how to manage it (or not). 

I'll give you a bit of a background and then I'll fill you in on how we are progressing.

Lady Penelope (Penny to her friends) is a 6 yr old female, smooth, tan mini dachshund.  The day we brought her home was probably the happiest day of my life, I loved her immediately. She is the 1st dog we ever owned. My husband Kane wanted a home cinema, and I wanted a puppy and so a bargain was reached.  Penny changed our lives.  She went everywhere with us.  Her 1st outing was on the ZigZag railway when she was about 4 months old- we went on a picnic with some friends and their dogs, and Penny spent the day trying to keep up with them.  

She has *no idea* she is a small dog, and we never held her back or protected her too much from anything.  I took to her the usual puppy pre-school and then our local dog training club where she thrived- she loved the socialisation and learning new tricks.  Being extremely food motivated, she was quite easy to train.  Penny made friends wherever we went- every child, teenager and adult young or old always had to come and pat the sausage dog, and tell us about the dachshunds they knew and loved in their lives.    We took her to festivals, walked in parades, dressed her up, took her to off lead parks, our local lake - where she loved to swim, and chase her ball.  I think Penny is the only dachshund who actually played ball- she loved it!  

Last November we also got our little Gidget GoLightly.  Gidget came to us from friends who had a litter of dachshunds, and as Lady Penelope was getting "middle aged" I thought the time was right to get her a puppy.  Gidget fit right in!  They bonded immediately, and Gidget just loves Penny and follows her around, well, like a puppy! 

So, you get the picture that Penny is a pretty well rounded, fun loving, obliging, active (and a bit spoiled) doggie.  She came to work with me for 4 years about 3 times a week, and of course she was in charge of the place.  When we talk about separation anxiety- it was me getting anxious to leave her at home.... she was as perfectly content to stay home and sit in the sun, as she was to come to work with me.