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Archive for the ‘life after decompression’ Category

Holding pattern

We’ve been in a kind of holding pattern this week, waiting for Charlie’s next acupuncture appointment (our vet is away until Monday), and waiting to get our appointment dates for the PSOM study at Ohio State University. I’m more concerned about Charlie’s day to day comfort than about rehab right now. We’ve been giving him one dose of Tramadol nearly every day this week, which saddens me after how well he responded to his acupuncture treatment last weekend. Charlie is scheduled for acupuncture Tuesday evening.

As far as the PSOM study goes, I’m hoping that we will get an appointment for Charlie this month, but we may have to wait until January. If he is diagnosed with PSOM, perhaps that could be an answer to what is causing his head pain. Dr. C. is going to talk to the OSU neurologist about Charlie, as I told her he will need to be sedated to have his ears scoped.

Here at home, Charlie still prefers to sleep the day away, but he’s fairly active in the evenings, exploring around the house, playing with our dog toy collection, and chewing on bully sticks and dental rawhides. Our other three cavaliers have accepted him as one of their own and genuinely like to hang out with him. When I brought Charlie to Ohio I was worried that he wouldn’t like our winters very much, but he loves the snow. He has very good traction in the snow – I don’t have to carry him off the deck any more if there’s snow on the ground.

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Charlie turns two years old on Dec. 11, 2007. Happy birthday little boy!

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Charlie, napping at home after his acupuncture treatment:

Yesterday we took Charlie to see his vet. The vet practice at Northview is a large one; our chosen vet is a young doctor whose area of interest is neurology. She has training in acupuncture and Chinese herbs as well. She has been seeing our other three cavaliers as their regular vet since she joined the practice a few years ago.

She examined Charlie thoroughly, including a neurological exam, and she looked at his gait and hocks. He had a pain episode during his appointment, so now she understands what we’ve been trying to describe. She gave us a prescription of Tramadol for Charlie on his bad days.

She thinks it would be a good idea if we take Charlie to OSU for the PSOM study, since his one ear is so sensitive. The discomfort could be from Charlie’s SM, but we should explore and eliminate other possibilities as well. So I will be contacting Dr. Cole next week.

As for Charlie’s weak legs, she gave us the go ahead to schedule his first rehab appointment, which will include massage, range of motion, strengthening, and underwater treadmill exercise. In addition to this, we’ve decided on acupuncture treatments for Charlie, both for relieving pain and for stimulating neurological pathways that may be blocked.

Our vet was very kind and patient with us – we had a long discussion about Charlie’s medical issues – then she had an appointment with another patient, and she let us stay for an acupuncture treatment that went past closing time.

I had never seen acupuncture in real life, so it was fascinating to watch and be a part of. We sat on pads on the floor, and Charlie lay with his head and upper body on my lap and his hips / hind legs on the pad. Earlier, I had been holding him cuddled into his blanket while we waited for her to return from another patient, so he was already warm and sleepy. I stroked him and talked to him while she placed 20 very fine little needles; starting with one in the top of his head, several along both sides of his spine, and in his right leg. Some of the needles he felt a tiny bit, but the sensation was so slight that he didn’t bother to raise his head from my lap.

Then he fell asleep while the needles were in place for 20 minutes or so. He was so relaxed afterwards when I carried him out of the office that it felt just like holding a warm, sleeping baby.

Immediately following Charlie’s appointment, we had to pick up Chocolate from a grooming session at her breeder’s, a 30 minute drive. Chockie’s breeder had been wanting to meet Charlie, so we brought him inside, where he was very comfortable and content to have a good sniff around the room.

Charlie had a quiet, restful evening and night, plus he’s napping this morning after breakfast. We’ll be watching him closely to see how he responds to the acupuncture. His next appointment will be Dec. 17 or 18 in the evening.

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Rehab

This afternoon I called our vets’ office and spoke to their rehabilitation specialist. She is originally from the hospital where Charlie had his surgery, and has experience working with neurology patients. We have started to set up a plan for little Charlie.

I explained our situation, how unpredictable he is, and she came up with a great idea for how she can work with him in short sessions a few times a day twice a week, and he will be given his 1:00pm Gabapentin pill while he is there. I will drop him off at the facility in the morning, and he’ll rest in a crate in the ICU (where at least one nurse will be keeping an eye on him at all times.) Then he will get a little bit of physical therapy (rehab) 2-3 times per day, depending on how he feels. Either my sister or I will pick him up when he’s finished for the day. We will be shown some exercises we can do with Charlie at home as well.

I will ease him into it slowly, because he tends to growl at people he doesn’t know or trust, which is why he was sent home from the hospital so quickly after his decompression surgery. But Charlie bonds very quickly with his main caregivers, so I expect him to get used to them after he is there a few times.

I have scheduled an appointment with Charlie’s regular vet this coming Saturday morning for an exam, to have his hocks looked at, and to basically get approval to begin rehab. Our little boy is going to begin the next step of his recovery!

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I’ve mentioned a few times that Charlie is a bit quirky and came to us with a full set of behavior problems. When a dog has been as extremely ill as Charlie, training is at the bottom of the list of priorities. But now that he’s adjusting to life after surgery, we’re starting to focus on his behavior.

Charlie has finally grasped the meaning of the word ‘No’ last night, which is a HUGE step for him! Now if he starts barking during our dinner time, he will stop when he hears the word ‘no’. He usually starts up again several times, but at least he does stop each time he hears the ‘n’ word.

Then, this morning he actually let me know he had to go potty. He stood by the kitchen door, waiting for me to take him outside. This was after he had been loose in the house for 45 minutes.

I’m so pleased that we finally have a foundation to build on. I was worried that the little guy was incapable of any form of self control, but he has had two breakthroughs in the past 24 hours. Way to go, Charlie!

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Adjusting

Charlie is in his second week of adjusting to normal life. Dr. A. had indicated at Charlie’s last appointment that he needs to progressively get back to a normal life over a two week period. Usually when cavaliers have decompression surgery, they need to be confined for several weeks, but not Charlie. I’m thinking it’s because Charlie is handicapped, so he cannot overdo in the same way that a healthier cavalier could. He can’t jump on/off furniture or climb a flight of stairs, etc. Additionally, his muscles are weak and underdeveloped, so activity such as walking around is good for him, and we just let him do as little or as much as he wishes. Everything he does is at his own speed with no pressure from us.

Dr. A. had told us that the compression on Charlie’s brain and upper spine was by far the worst he had ever seen, and that Charlie is not at all a typical case of SM – he’s in a “class of his own”. Charlie’s skull malformation is such that it is not round, but more long and narrow in shape. Part of his decompression surgery also involved his upper spine.

Charlie isn’t house trained yet, so we’ve been managing him like a puppy. I don’t know if it will be possible for him to be house trained to the degree that our other three cavs are. Immediately after weeing outside, we let him have the run of the kitchen, living room and foyer for 90 minutes. I also let him follow me into the bedroom, bathroom and laundry room, but he is monitored closely. We’ve found 2 hours is too long for him to be loose – he had an accident on the kitchen rug. He’s still on Prednisone this week, and we’re hoping it will be easier for him after it is stopped. He doesn’t ‘get it’ that he needs to let us know when he has to go out, though; he seems to just wee without thinking. We were told about this problem before we adopted him, so we put a piece of vinyl flooring over the laminate floor where his pen and crate are, making it worry-free and easy to clean.

I’m planning to schedule Charlie a vet appointment for next Saturday to discuss physical therapy and how his progress will be measured, etc. Also, we need to explain about Charlie and how he can only do things when he feels well. It makes him a bit unreliable and people need to understand that about him. For example, some mornings he can go out and wee at 6:00am, but other mornings he cannot go out until 8:30am if he isn’t feeling up to it. That will make it difficult to make it to physical therapy appointments; I hope they are understanding!

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Our happy boy

This evening we gave Charlie a pedicure so he wouldn’t slip on our smooth floors. He was very well behaved having his nails and the fur between his foot pads trimmed. Here he is on the left – smiling! He enjoyed hanging out with Geordie, India and Chocolate watching Colin cook. Then he went to bed at 9:00pm and is now totally zonked out.

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