Bladder expression has been going well, so I have scaled back the Phenoxybenzamine (most expensive drug EVER) to half the dose. If it continues to go well, we will scale back further.
Category Archives: Bladder Expression/Urination
A couple days ago it suddenly became really difficult to express Alec’s bladder, even though I had been doing fine the last few days. I know it’s not my technique because I can feel the “balloon” now under my hands and everything was going pretty well…then suddenly nothing! After my local vet, Dr. Leavey, checked and also found him hard to express, the doctors at Animal Care Center prescribed Phenoxybenzamine, which is a drug that relaxes the urethral sphincter. This drug cost $144 for a one week supply!!!!! Unbelievable… just my luck that he was prescribed the most expensive drug ever. I asked one of the neurologists if he would have to be on it for the rest of his life and she said quite possibly, but the other neurologist said no, it’s very rare that a dog would have to be on it for a long duration and that the plan should be to wean him off it, if and when expressing starts to be easier again. Luckily I accidentally gave him only half the prescribed dose the first night and I found he was already easier to express the next day. I am keeping it at this dose and within a few days will scale back if he improves. I called Costco pharmacy, which is supposed to be the cheapest option, and they will only order this drug in bottles of 100 pills, which costs over $600 per bottle!! I really hope he does not have to be on this for the rest of his life. 😦
On a happier note, I walked in the room yesterday and Alec looked at me and wagged his tail! I got really excited. I don’t know if it means anything, but I will investigate. Either way, it sure was nice to see it wag again!! He does this thing where if I walk in the room he will just wag the tip of his tail. It’s really cute – I call it his “rattlesnake tail.” Well, that’s what he did. It was pretty cool.
This is the original email update I sent out to friends and family in February 2008:
On the morning of 2/8, Alec came home limping from the park; an hour later, he could no longer walk. At that point I realized he not sprained his leg as I had originally thought…something was wrong with his back. My local vet sent me immediately to a neurologist (I later learned that with these injuries, time is of the essence) and it turned out he had ruptured a disc, which required surgery to repair. The injury was severe and there was significant bruising and swelling along his spine. For a while we feared he might develop ascending myelomalacia, which is a terminal condition where the paralysis spreads up the spinal column eventually causing the muscles controlling the lungs to stop working. Thankfully this did not happen, but improbably, a few days later while he was still recuperating in the vet hospital, the same disc re-ruptured a second time and another emergency surgery had to be performed. Two weeks and thousands of dollars later, he was able to come home. But not to my home in San Francisco, because like practically every place in SF, it has stairs, which are not an option for him right now – maybe not ever. Although the surgery saved his life, the injury was so severe I knew there was a chance he would never walk again.
A month after the surgeries, Alec still has not regained sensation in his back legs and he likely will remain paralyzed for the rest of his life. The underlying cause of this rupture is Intervertebral Disc Disease (IVDD), which is more common in small dogs, especially dachsunds, but not unheard of in German shepherds. Unfortunately, everything is more difficult when this happens to a large dog. If they do recover it takes longer and obviously it is more difficult to care for them; they can’t be lifted up and carried everywhere like small dogs. I am trying really hard not to injure myself (especially my back) in the process of caring for him! Since I could not return home, we have temporarily moved into a vacant office on the ground floor at ALDF, which as most of you know is 45 miles north of SF, and have been crashing here for a little over 3 weeks, me on my air mattress, Ali on his bed, a small table for my laptop, and a lot of microwave dinners. This is where we work, eat, sleep and everything in between while he recovers from surgery. I have been looking for a new place since we cannot go back home to SF. There is a very slight chance he could eventually regain some motor function with physical therapy but, even with the best case scenario, this won’t happen anytime soon. Some paralyzed dogs develop what is called “reflex” or “spinal” walking even if they can’t feel their back legs, but one study I read said the average time for this ability to emerge was 9 months. I am doing physical therapy with him to encourage these and other local reflexes to develop and we are also in the process of ordering a cart, or doggie wheelchair, which will help with his therapy and of course, allow him to get around once again on walks. Apparently even bigger dogs can do really well in carts, and they have all-terrain type wheels that allow them to go on trails, the beach, and even the snow.
One of the biggest challenges has been dealing with Alec’s bladder, which I have to manually express several times a day. Bladder expression is not easy to learn to do correctly, especially with a big dog, but it is very important (if not emptied completely the risk of infection skyrockets). But we are managing. It is no exaggeration to say my life has completely turned upside down in the last month. There have been a lot of challenges with learning to take care of a 65 pound paraplegic dog, not to mention being temporarily homeless, but my friends and family have been wonderfully supportive and I am so lucky to work for a great organization like ALDF so that I even HAD the option of moving into my office. Not many workplaces would allow that! Most importantly as far as I am concerned, Ali is in good spirits and has been an amazingly good sport throughout this ordeal. I am very excited to eventually get him out and about in his new cart, which we will be ordering from Eddie’s Wheels: http://www.eddieswheels.com/. The first picture on the homepage is a German shepherd in a cart, in case you are wondering what he will look like with his wheels. 😉 Another friend is in the process of building a website for Ali and I will keep y’all posted. Some folks have expressed interest in donating to Ali’s fund and so the website will serve as a place where people can contribute to his ongoing medical care, rehabilitation, and especially his cart (they are expensive, of course, and I am maxed out with around $16,000 in debt right now just from the two weeks he was hospitalized! Oh, how I wish I were exaggerating). Please think good thoughts for us! I am still hoping for the best.