Physical Therapy is really helping!

Heidi has been to 3 physical therapy appointments so far, and the technicians have already noticed that she's starting to relax her muscles and use her back and hind legs more properly!  Her back is not as arched as it used to be. And, she's not as tight in the groin anymore and she's holding her hind legs more square on the ground rather than trying to use hind both legs together as one leg.  She has increased her walking intervals on the treadmill from 6 minutes to 8 minutes and she's really loving all the attention.

I can tell she's starting to feel SO much better.  It's remarkable how happy she is now. I don't think I realized how gradually her personality had been changing over time. She must have been having some back pain for several months and I never realized it.  Because now, she is much more perky and happy than she had been for a few months. Its just amazing that she's so happy given all she's been through.

A new breed - The Mexican Water Dog

Heidi had her first physical therapy appointment today with Dr. Burke at Paradise Animal Hospital. Dr. Burke was amazed at how well Heidi is doing only 15 days after surgery. I am constantly reminded of how blessed I am that Heidi’s recovery is going as well as it is.

Dr. Burke first did some exercises with Heidi that I can do at home with her. The focus of the exercises is to get muscles in Heidi’s back and groin to relax and to force her to begin shifting her weight to her back legs. Right now, she carries most of her weight on her front legs in order to compensate for the weakness in her back legs.

After doing some expercises, they then,dressed Heidi up in life jacket and headed for the pool.

After a little bit of warm up in the pool and applying warm towels her to back and groin, they lowered the treadmill into the water and attached Heidi to a lead so that she wouldn’t slide off the back of the treadmill once it started moving. Of course, there was a person in the water with her the whole time and she was perfectly safe on the treadmill.  From the look on her face below I can only assume she's saying "Mommy, PLEASE RESCUE ME!!!"

After they got her all hooked up, they started the treadmill and she started to walk. It was hard to get a clear picture because she was moving the whole time. But, what I like about the picture below is that you can see how hard she is concentrating!

And this last picture is my favorite. She’s a little more relaxed and chugging right along. She’s such a trooper! And a very special little girl  :)

Next week, we have another therapy appointment on Monday, her surgery follow up appointment with Dr. Jarboe on Tuesday, and another therapy appointment on Saturday.

Never ceases to me amaze me!

Heidi never ceases to amaze me. Just now, I saw her try to scratch her body with her right hind leg! She didn't quite make it though. Still a little stiff on the right side. Heidi's recovery seems to go for a little while at a certain pace. And then, she makes leaps and bounds of progress overnight. She did this to me again this week. I was just starting to worry that her pain level might be hard to manage because she just wasn't feeling like herself yet. But this week, she pretty much decided that staying in that crate during the day and through the night was for the birds! On Sunday she started whining at me when I'd put her in the crate at bed time. On Tuesday night she wore me down and I finally let her sleep in the bed with me. It was either let her out or laugh at her all night and never sleep. She stayed on the bed all night and never approached the steps to get down. She's afraid to go down them right now (which is a good thing!) even though they are tiny puppy steps and have only a 4 inch rise. I'm planning on replacing the steps with a ramp but for now she gets carried on and off the bed.

Since then, she's been very interested in playing and her personality is completely returned so I know she's feeling really good. This morning she did one of her trademark "Heidi" maneuvers to say "Good Morning". She puts her head down and underneath herself like she's getting ready to stand on her head. Then, she tucks her head right into the nape of my neck. All the while she's smiling and wagging her tail (very cute). This has been a morning ritual with her for the past 10 years. I have no idea why she loves to do it so much but and I was very happy to see her do it.

As far as walking goes, she's doing a bit better. She doesn't cross her hind legs anymore. She stumbles every once in a while, but for the most part she's pretty stable. And she very rarely lets her right hind toes knuckle over. I shot this video on Sunday. It's outside and she's wearing her cute pink horsey-style coat so its a little hard to see her legs at times. But if you watch it all the way through I think you'll get a good idea of how well she's able to walk. Of course, I'm very proud of her and very happy with her progress. She will go to physical therapy on Friday at the Paradise Animal Hospital. I'll be sure to bring my camera for that. I can't wait to see them put her in the pool!

Still improving slowly

Sorry for not posting any updates in the last couple of days. It would be hard to beat the improvement I saw on Tuesday. This morning I woke up late and Heidi must have been sending telepathic messages telling me to get up. When I woke up she was standing in her crate staring at me with her tail wagging and a big smile on her face. She definitely enjoys her time out of the crate. I've been letting her wobble around my bedroom for a few minutes in the morning and wobble around the family room for a few minutes in the evenings. This morning I saw she was using her right hind leg a little more. She still holds it up off the ground a little bit, but she is using it more. Her toes don't knuckle over quite as often but they still knuckle over some. She will usually correct them with the next stride. And she's still wobbly, of course, and trying to get her coordination. But, she's doing really really well.

A definite improvement - see video!

Today was a really good day. I can definitely see improvement in Heidi's condition overall. She is brighter and more energetic. Her personality is returning. She is even MORE interested in moving around than she was yesterday. And, I have seen her use her right hind leg occasionally.  She is still wobbling and hobbling around, but I am thrilled with her progress. I put together a short video to show everyone how well she's doing today.   In order to shoot footage of her hind legs I had to toss a few cookies out on the floor so she would walk away from me.  But don't worry, I didn't over do it with her. What you see in the video was all she did. Afterwards, I put her back in the crate to rest. I think you'll be as pleasantly surprised as I was. Yay Heidi!!

Almost a full body shake!

I came home at lunch time today and woke Heidi up from her nap. She was a little groggy but very happy to see me. She was shaking a little bit after she woke up and I couldn't figure out why. It wasn't until later that I remembered I didn't give her the Diazepam this morning and that she must just be anxious (because she was nice and warm and couldn't be "shivering" from being cold, and, she didn't seem like she was in any discomfort). So, I visited for a little bit and gave her meds with a little bit of food, waited for her to pee and poop, and then went back to work. When I got home after work at 6:00, she was shaking again.  But after she ate her dinner she soon relaxed and went sound asleep in my arms while we sat on the couch and watched TV.  Later on, I sat down on the floor with her (the floor is carpeted) and let her move around a little bit on her own. She seemed happy to walk (I use that term loosely) over and check out her toys and have a little freedom. But she soon became tired so I put her back up on the couch (then I took the picture).  There's no real change in her use of her right hind leg. If I had to say anything was different today I would say that she is still just getting a little stronger. She gets up a little easier, she wags her tail a little easier, and she is more interested in moving around.  She's also been doing a couple of funny things. Sometimes she stands on her hands. Sometimes she even walks on her hands!  Its hilarious.  And, she's been trying deparately to do a full body shake. Usually it just goes down half way and then stops, but I think she got a full shake in today. If it wasn't a full shake, it was pretty darn close. Of course she usually falls down afterward, but today she caught herself and didn't fall all the way down. It was very cute.

Eating, Sleeping, Peeing, Pooping and Resting Comfortably!

There's not much to say this morning. There has been no significant change in how she was yesterday. She's sill eating, sleeping, peeing, pooping and resting comfortably. I took her out of the crate for a few hours and let her watch TV with me on the couch. But other than that, yesterday was uneventful.  She definitely can feel and use her right hind leg a little bit. She mostly uses it when she stands up. When she tries to walk, it looks like she drags it some of the time and holds it up off the ground some of the time.  On the left leg, sometimes when she's tired she will let her toes knuckle over and is just too tired to fix it. So she'll stand there for a few seconds and then lift her hind end up by balancing on her forarms and then straighten everything out.  

I stopped the Diazepam medication and did not give her any this morning. She is peeing really well, so I thought it would be ok to stop giving it.

I could tell she was sad this morning when I left for work. I had planned to stay home with her for a few days had she come home from the hospital on Monday. But since I had part of Saturday and all day Sunday with her, and was able to get her on a medication schedule that works if I go home at lunch time, I decided to go ahead and come into work.  I'll run home in a few hours and see how she's doing, and if she's still just resting comfortably then I'll probably give her her medications and come back to work for a few more hours.

The tail is wagging!

Heidi had a major milestone overnight last night. At around midnight she woke me up because she had to pee. So I took her into her room to pee and she peed. Afterwards she was so proud of herself that she stood there and wagged her tail!  This is the first time since surgery she's been able to wag her tail. Of course, I was cheering and clapping for her like I always do when she pees in her room (even after 10 years, she still enjoys the positive reinforcement that she peed in the right place!). So she wagged her tail and waited for her treat. What a good girl!  Then, a few minutes later she pooped too! Yay! She woke me up again at 4:00 am but didn't seem to have to pee.  And when I woke up this morning she was standing up wagging her tail again and looking at me from inside her crate as if to say "Glad you're awake Mommy, I'm HUNGRY!"  She's definitely feeling stronger today and able to stand up and support herself easier. Her legs get tangled when she tries to walk. But she definitely feels better and she is doing much better than I expected at this point.  We'll just have to wait and see what today brings.  Here she is right after she ate all her breakfast.

Heidi came home today!

I visited Heidi this afternoon and she looked much better. They had taken the catheter out and she was much more comfortable.  I sat with her on the floor for a while and she tried to motor around a little bit. Then she peed on the blanket all by herself (Yay!) Dr. Bush said the initial outcome is positive but the prognosis is still guarded. Heidi does seem to have some control over the movement of her right hind leg and he recommended that I follow up with some physical therapy to give her the best chance of regaining as much function as possible.  She was doing so well that she was allowed to come home today! Which was much sooner than I expected. I expected she wouldn't come home until Monday. But, I think she gets a little anxious in the hospital, and since she's eating well and peeing on her own, it made sense to let her come home where she's comfortable. Of course I was thrilled!

Here's Heidi in her laundry basket all ready for the ride home. She did OK on the ride home. She stirred and wimpered a little bit. I figured she may have had to pee or poop and was worried about doing it on the blanket. When I got home I found out I was right! She had peed on the blanket (Yay! another pee!).

At home, I set Heidi's crate up on a table next to the bed so she could sleep closer to me at night. Of course, Chloe (the orange cat), had to check out the accomodations and make sure they were up to her standards!

Here's Heidi at about 4:00 pm today resting comfortably and happy to be home. 

First Visit after Surgery

I visited with Heidi for about an hour yesterday. She looked pretty scared and nervous at first, but she relaxed some by the end of the visit. I think she will be happier and more comfortable when they take the urine catheter out. I'm not sure when they will do that, but I hope it is soon.

I don't want to get my hopes up too high yet, but Heidi actually put her weight on her right hind leg yesterday all by herself while I was with her. I was so excited about it that I quickly took a picture. She was eager to stand up, but her left hind leg was a little tangled in the tubes from the catheter and so she supported herself with her right hind leg instead.

This picture was taken close to the end of our visit. You can see she is little more relaxed. I brought her favorite bunny toy so she could cuddle with it.

And here's a closer look at the surgery site.  Poor thing, the incision is almost as big as she is!

All in all I was happy with our visit. She's still a little "out of it" but she responded well to my voice and she even gave me some kisses before I left.  Right now I'm waiting for the doctor to call and tell me how her neurologic exam went this morning and then I'll probably head out there to visit her again.

Here we go again .....

Unfortunately, little Heidi had to have another spinal surgery, so I thought I’d start up this blog again to keep my friends and family up to date on her what’s happening.

I’ll first give you the update I just got from the Dr. this morning, then I’ll tell you the story of how we got here.

9:45 am January 1, 2010.

Dr. Devon Hague, the neurology resident who was involved with Heidi’s case on Monday night (and who got stuck working on the holiday today) just called to give me an update on how Heidi did through the night. Heidi had just come out of anesthesia last night when I left her and she was still a little confused and wimpering a bit. It’s normal for dogs to wimper when coming out of anesthesia, so they are used to it. But Mom sure wasn’t. It was really hard to see her like that. But, Dr. Hague said she ate dinner around 11:00 and that was good. Typically, a dog won’t eat if they are in pain. So they took it as a sign she was comfortable. She also said that Heidi was a little anxious during the night so they gave her some anti-anxiety medication and that helped her sleep. (It’s too bad they can’t dispense that medication to the parents too!). She is also on IV Fentanyl for the pain. This morning Dr. Hague said Heidi look good. She’s bright and alert and looks comfortable. The neurologic exam showed she was about the same as before surgery. Which can be a good sign. Sometimes they can be worse right after surgery due to swelling that can occur. But Heidi seemed about the same. She can stand on her own. She still has good function in her left hind leg, and still a deficit in her right hind leg. But, she commented that Heidi has good tone in her right leg (not exactly sure what that means, if she’s referring to muscle tone, then it may mean that she should have the muscle strength to use the leg if the signals from the brain can actually get there) we just have to wait and see how she progresses over the next few days. The earliest they would expect to see any improvement in her right leg would be tomorrow or Sunday. I am going to head out there today to visit with her and bring her her favorite stuffed rabbit toy.

If I have already talked to you most of what I’m going to describe below will be a repeat of what I’ve already told you. But I’m going to tell the whole story again anyway because it’s a little bit therapeutic for me.


12:30 am Monday, December 28, 2009

I just arrived home from the airport late Sunday night early Monday morning. (I spent a wonderful Christmas vacation with my family in Alabama.) When I walked in the door I expected to hear Heidi scratching with excitement at the baby gate upstairs (she’s confined to the top floor when I’m not home) but she was quiet instead. When I got up the stairs I saw she was wagging her tail but she was standing still shaking and her little ears were back trying to tell me something was wrong. When she finally did move around a little bit I could see she was wobbly on her hind legs – mostly the right hind. Well, my first reaction was OMG! because I’ve seen this before back when she had the herniated disk in 2008.

~12:00 pm Monday, December 28, 2009

So, I called Heidi’s Neurologist and Neurosurgeon who did the surgery last time, Dr. Larry Gainsburg in Catonsville, to try to get an appointment for Heidi. Dr. Gainsburg was on vacation. So they referred me to Dr. Steven Steinberg in Gaithersburg. But, Dr. Steinberg was also on vacation. So they referred me to Dr. William Bush of Bush Veterinary Neurology Services in Leesburg, Virginia. Then I called Dr. Gainsburg’s office back to let them know that Dr. Steinberg was on vacation, and they also referred us to Dr. Bush’s office. So, off to Leesburg we went. Dr. Bush wasn’t in that day so we saw Dr. Joli Jarboe and Dr. Devon Hague instead. Dr. Jarboe was very impressive. She was very methodical and thorough. And I really felt comfortable with her. I could tell right away that she loves animals just like I do. However, Heidi’s neurologic exam turned out to be inconclusive. There were a couple of reasons for that. First, during the day, Heidi had improved a little bit and wasn’t showing as much wobbliness in her back legs during the exam as she was the night before. And, Heidi is already a little weak on her right hind leg due to the knee surgery she had when she was 2 years old. The knee surgery she had on both hind legs to stabilize her luxating patellas (slippery kneecaps) didn’t hold up on the right side. As a result, it was hard to tell if she was having lg pain or a neurologic/spinal issue. The next step would be to do an MRI. Well, since Heidi looked like she was improving, and since the cost of the MRI at Dr. Bush’s office was about $600 more than if I were to have it done with Dr. Gainsburg, I decided to forgoe the MRI that night and try to see Dr. Gainsburg as soon as he got back from vacation on January 4. So, the Drs prescribed some medication for pain, told me to keep her confined to a crate and to watch her closely for any signs of getting worse.


Tuesday, December 29, 2009

The next day, Heidi was about the same, or maybe a little better, than she was the night before. Not perfect, but definitely better than she had been late Sunday night. When Dr. Bush’s office called to check on how Heidi was doing, I reported that she was doing ok and that I would call again if anything changed for the worse.

8:30 am Wednesday, December 30, 2009

This morning Heidi was worse. She didn’t want to walk and she didn’t want to put her right hind leg down on the floor. But I still couldn’t tell if the problem was in her leg or in her back. So I called Dr. Bush’s office and they told me to check in with Heidi’s regular vet Dr. David Tayman at Columbia Animal Hospital and see if he can determine whether she is having a leg problem or a neurologic problem before making the trip all the way back out to Leesburg. So I called Dr. Tayman’s office and got an appointment for 11:50. By the time of the appointment Heidi had gotten much worse. And when we arrived I was already in tears. As soon as Dr. Tayman took one look at her he knew it was a neurologic problem and that I should head back to Leesburg as quickly as I can to see if they could do anything to help her. Of course we were both thinking she had another herniated disk. And I was afraid to put her through another surgery. So I asked Dr. Tayman “Would I be a bad Mom if I put her through another surgery” and he said “Oh no, you wouldn’t be a bad Mom, it’s just a matter of whether surgery is indicated and whether or not anything can be done at all”. So, he got on the phone with Dr. Bush (Dr. Jarboe was off today) and talked to him about Heidi and let him know we were heading back to Leesburg. Then, he gave me a big hug and off we went. And he made me promise to call him when I knew something.

So, we get to the office in Leesburg and met Dr. Bush. Dr. Bush was equally as impressive. He is an expert surgeon. He was very friendly and introduced himself as “Bill”. He has a way about him that makes you feel like you and your pet are his most important case of the day. And he talks to you in terms you can easily understand. Even though I was holding back tears, I was starting to feel thankful that Heidi was in good hands and reassured that if anyone could help her, Dr. Bush and Dr. Jarboe could.

Dr. Bush walked through the results of the MRI and CT Mylogram with me on the computer. He showed me all the different vertebra and pointed out where the problem was. It looked like Heidi had developed scar tissue and a cyst at the old surgery site. He said this is very rare and he’s only seen it happen once before. But he felt certain that surgery to remove the cyst was the only thing that would help Heidi. He also said that it would be a very complex surgery so he wanted to wait and do it tomorrow so that he could have overnight to think about it and devise a plan. He also suggested that we ask Dr. Jarboe to come in tomorrow to do the surgery because he felt she is a better surgeon than he is and that Heidi definitely needs every bit of Dr. Jarboe’s surgical skills.

So, we made all the plans for surgery tomorrow, I emptied my bank account, and then I left Heidi there for the night and went home.

Thursday, December 31, 2009

Today, this wonderful human being and talented surgeon named Dr. Jarboe came into the office on her day off to do Heidi’s surgery. She had already been in contact with Dr. Bush over night and she knew what kind of challenge she was facing today. They let me visit with Heidi for a few minutes and talk with Dr. Jarboe for a few minutes before surgery. I really enjoyed our conversation. She also made me feel at ease but was very straight forward with me about the risks of the surgery. Heidi is a tiny little dog, she was going to go back in to a previous surgery site and do more surgery. So there was a risk of doing further injury simply by doing the surgery, and there was no way to know what the final outcome will be. And Dr. Jarboe wanted to make sure I understood what I was getting myself into. But I also sensed she respected me for wanting to do everything I can to help Heidi and she reassured me she would do everything she could. Dr. Jarboe loves her pets as much as I love mine and it was very comforting to know that. And I also knew that Dr. Bush was going to be there and Heidi would have the benefit of their combined experience and skill. I knew Heidi was in good hands.

The surgery took about 2 hours. Dr. Bush came out and asked if they could do another MRI so they have a baseline post-surgical MRI. He said its best to do it now because if she has any problems in the future they will have wished they had done an MRI right after surgery. The MRI took about an hour. Then I was able to sit down with Dr. Jarboe and Dr. Bush to talk about the surgery. Dr. Bush’s first comment was “it could have gone better, but it also could have gone worse”. It turns out, what he thought was a cyst wasn’t actually a cyst at all. It was a gelatinous material that appeared to be an area of dead spinal cord tissue. It was right at the old surgery site. They are not sure why the area of tissue died. Tissue can die if there is chronic compression on the area, But Heidi’s previous surgery should have removed the pressure that was there before on that area of the cord. Dr. Bush used the word “dumbfounded” to describe what they were feeling when they dissected down into where they thought they would find a cyst and instead found this gelatinous material. So we sat there and talked for a while and they showed me the before and after MRIs and you can definitely see that Heidi’s spinal cord has a lot more room to relax and decompress now. It looks like the surgery itself was a complete success. They got all the dead tissue out, and they even got out a little bit of disk material from the two adjacent vertebra because they were a little bit herniated already. So, that might actually prevent further herniation of those disks in the future. The only question now is how much damage was done to the cord and how much can the spinal cord heal itself. And that is something we won’t know right away. They say if we see some improvement by Saturday or Sunday then the chances are good that she could regain up to 90% of function in her right hind leg. But, if we don’t, then we really don’t know how much she’ll regain, and she may never regain function at all.

So, I am trying to prepare myself for that possibility. And I’m trying to convince myself that as long as she can pee, poop and eat, I’ll be happy. If she walks funny, or if she can’t walk at all, that will be perfectly OK! I can always get her a little doggie wheel chair cart if I have to.

Moving right along

I am very happy to report that Heidi has been doing much much better yesterday and today. She is standing up and moving around more easily and she wags her tail the whole time she's doing it. I'd love to say she's walking around, but a better description would be that she's moving very wobbly on all four legs. She looks like she's had way too many Margaritas for her size. I actually stopped giving her the tramodol for pain yesterday afternoon and she's been fine and moving around well ever since. As I write this, she's down here in the basement with me motoring around on the carpet. She can walk pretty far now (maybe 10 feet) without falling down! I think she's happy to be out of her crate and have a little freedom. And I'm very very proud of her for doing so well. We will go back to the doctor tomorrow and probably get the staples taken out.