What can I expect after surgery?
Ninety eight percent of dogs with surgically managed disc disease (of grade 4 or less) will make a progressive improvement in terms of their ability to walk and urinate normally if this has been a problem before surgery. Some dogs will never regain their full pre injury status, however they will ultimately improve to the point of being able to lead an independent and active lifestyle with perhaps a subtle change in the way they use their legs.
When you first see your pet you will immediately be aware that their back has been completely shaved and that there is a 10 cm or so surgical scar in the middle of their back. The incision will heal over the coming week and the hair will regrow over the coming two months or so. They will most likely still be unable to walk or may do so in a very uncoordinated fashion. Every week to ten days however you will see a progressive return of function in their legs beginning with an ability to stand for progressively longer periods. Eventually (usually four weeks following surgery in grade 3b and 4 patients) your pet will take a step or two on their own. This will progress to awkward looking walking that will gradually become more and more controlled and refined. This occurs as the communication between brain and body becomes more fluent and complete. Your pet will still tire incredibly quickly however and even short periods of activity will sap your pet’s strength so that they look more wobbly on their legs. This phase will pass and your dog should redevelop his or her original level of stamina over the months following surgery.
How can I help my dog after surgery?
There are two main things that will help both yourself and your dog in the first two months following discharge. The first is to try to remain happy with your dog’s current status whilst encouraging improvement and the second is to be patient. This is not always easy as progress can seem relatively slow at the beginning and our only wish is for our dog to be normal again. This can lead to frustration and a feeling that your dog will never get better and this gives rise to obvious distress. If we feel like this our interaction with our dog will be flavoured by disappointment and what can be a unique opportunity to deepen our bond with our pet can turn into a tortuous process. In order to avoid this think about how long it takes a baby to learn to walk and how complicated walking is, think how long a baby spends in nappies and how complex the act of appropriate urination is. Your dog will not take that long and things only seem to be dragging because you are focussing so intently on your dog’s disability rather than their progressive improvement in ability. Remember to keep life normal, do not spend every minute with your dog looking for progress, do not become housebound; go out and meet friends and family as you would normally, in this way ‘the kettle will boil’.
Apart from staying optimistic, there are activities that will help your dog on the road to recovery. All activities should be kept reasonably short (5 minutes at most) in order to prevent fatigue from hiding your dog’s ability.
- Massage of the muscles of the limbs is useful before and after any activity as a warm up and cool down session.
- Taking your dog out to the garden frequently to allow them to urinate appropriately. You may need to use a towel to support your dog if they have no ability to walk. Allow them to sniff at their usual spots and so forth and use encouraging words. If your dog does not like to soil in the garden, then carry them if possible to a place that they usually go to.
- Try to make your dog stand by placing the feet in a normal position and gradually allow them to take their own body weight. Time how long they can stand.
- Following the stage above, place one foot in front of the other and encourage stepping.
- When your dog is beginning to walk, keep the sessions very short as tired legs make for reinforcement of negative habits.
- Swimming can be useful unless your dog is afraid of water. Even suspending them in a half full bath so that their feet are just touching the base of the bath can be useful especially if combined with massage.
- Reduce your dog’s food intake in order to minimise the risk of weight gain which will make progress slower.
Do not try to do all of these things at once, introduce them gradually as your dog gains function and ability. Later on you may begin postural correction exercises. This is when your dog has strength to stand for extended periods and entails gently and slowly pushing them over from one side whilst having a hand to the other side to prevent them from actually falling. This will improve your dog’s ability to correct themselves when they turn.
Remember we are here to help you throughout the period of recovery. Our nurses and physiotherapist will be able to help you with specific problems or difficulties with the exercises, you do not need to do this all on your own!
What will the process of recovery be like?
This depends upon the starting point of recovery, however if you look at the grade list of spinal injuries, recovery is in the reverse order. In other words a grade 5 patient will first regain pain sensation in the limbs. Following this there will be a gradual improvement in hindlimb strength and return of continence (occasional accidents may still happen even after your pet can stand but these will eventually cease). Standing will be achieved when placed in a standing position although they will not be able to voluntarily get into a standing position. The length of time that they can stand will extend and then a few steps will be taken. After this the progress is defined by gradual improvement in coordination and stamina. The time taken from injury to return of independent function may be up to 3 months although improvement will still continue six months after surgery. In this latter stage the rate of improvement is slower and the process is more subtle, but it will happen.
Summary
Discs age differently in different breeds. In breeds such as Dachshunds, Lhasa apso and so forth with foreshortened limbs relative to body, this process of degeneration occurs very quickly. Thereafter the disc struggles with its shock absorbing function. As a result, in some dogs the hardened centre of the disc may break through the top of the disc and impact on the spinal cord. This causes bruising and crushing of the spinal cord resulting in reduced spinal cord function of varying degrees. In most cases this injury is reversible and this is aided by decompressive surgery (removing the material from the spinal canal). The rate of recovery following surgery is reasonably variable, however most dogs are walking in a still incoordinated fashion within a month of surgery. You can assist in the recovery by helping with standing and early attempts at walking. You should keep activity sessions short, productive and enjoyable. Remember your dog is not made of crystal and you do not need to be fearful of handling and lifting.