NC State Dog Olympics

Today NC State Vet School held it's dog olympics and had their first paralympics for dogs.  Carl of course was the largest dog there and couldn't really participate as his cart was bigger than the obstacles.  Next year apparently there will be a "big dog" class and already the gauntlet has been thrown down.  I have been told that there is a female in a cart who will "whoop Carl's ass" ... I don't think so!

 


Here is video from today - yes, Carl is in it ....

Standing More ...

Carl's response to rehab has been variable.  Some days he does well, others it is as we are back at day one.  Today I finally got to see how much progress we have made.

Carl remains paralyzed and has no motor or deep pain, but his strength has increased to the point where he can stand and stay upright for almost a minute.  Not a great feat for some, but it really helps when expressing his bladder and putting on his diaper.

Carl's 3rd Birthday

Happy Birthday Carl!

Carl's favorite thing in the world is a tennis ball, so for his birthday I got him an extra large tennis ball.  Carl had a great time playing fetch in the yard ..... 

Making Progress

There have been days when I wondered if rehab was worth it. Today I got the answer ... definitely yes.  I left Carl for only a couple of minutes and came back to find him on the sofa.  When I first adopted Carl he couldn't lift his front feet without falling over.  Now his core strength is such that he can lift his whole body!

Out of the Trial

The past month has been somewhat of a roller coaster. carl did well in the initial stages of the trial but had side effects from the drug used in the latter part. The researchers tried reducing the dose of medication, but even at very low levels carl showed side effects requiring medical intervention. Yesterday we called it a day, withdrawing him from the trial. I had high hopes for the trial as Carl's bladder function was much improved and there were some changes in his hindlimb function.

Carl is thus back to his old routine - daily rehab with weekly sessions in the underwater treadmill. I still hold out hope that somewhere down the line we'll find some way to help Carl, but am happy with how things are now.

Carl not concentrating in the UWTM (6/25/10)

Good days and bad ....

Last week was a great week with movement in both hindlimbs, wanting to stand all the time. Today things are not so good - Carl is his usual crazy self, but there has been no movement of his legs and his tail is hanging. The neurologist told me she expects dogs to fluctuate over time, but it doesn't make the less positive times any easier to handle. Tomorrow is Carl's week 4 trial evaluation, I'll be interested to hear how he does....

From last week is Carl's first "real" session in the UWTM (having a blast and behaving quite badly at times). No movement in his hindlimbs at this point. The plan from here on is to go in the tank and move his legs for him.

Trial and Conduction testing

Today was the end of the second week on the drug trial and Carl was in to be tested. I see definite changes, but these could simply be natural variation.

Also today Carl was tested to see if there was any conduction of impulses beyond his spinal lesion. There was nothing, but that was no surprise to the neurologists given the severity of his spinal cord injury. Given that Carl can wag his tail, there is some conduction, just nothing that registered in his legs.

The trial continues and we will see what happens over the coming months.

Spring is Here

Finally the snow and rain is gone and the trees are once again green (pity about the grass though).  Having tried all sorts of things from kids trousers to insulation leg protectors I finally concluded that the only way Carl could be outside was in a cart.  Thankfully I have two - his k9 cart he uses for playing in the yard, his Doggon cart for longer walks.

Trial Starts

After flunking out of the initial stages of the paralysis trial, Carl started to improve, most visibly being able to wag his tail.



The neurologists decided it was worth re-enrolling Carl in the trial, so today we began the medication. Life is a bit more complicated as Carl need the meds three times a day, but if he improved further it will be well worth it!

At Home Rehab and Off Roading

Finally got in the tape measure, NMES unit and additional pads. Started at home rehab last night with core strengthening (side sit ups and reaches), proprioception (rubbing feet on rough surfaces to try to elicit kicking, gently pulling toes to stimulate withdrawal reflex) and strength/balance exercises (gently bouncing on hindlimbs while standing). Finished with EMS to gluteals, quadriceps and hamstrings. Carl did well tolerating an hour long session.

Today went out for an off road spin for the first time in Bonnie's modified cart.  A few more adjustments are needed but it definitely is a better fit and Carl appeared more stable, easily navigating tree roots and steps.

Rehabilitation Trial

My NMES unit arrived so today we went to the local rehab center to set it up and also to try Carl in the underwater treadmill.  The first item of business was to make some adjustments to Carl's new cart ... what had looked ok in the house during initial alterations turned out to be very off balance, tipping Carl backwards if he lifted his head up.  A quick alteration of the level of the front harness was thankfully all that was needed.

The e-stim went well - we got Carl's quads, hamstrings, gluteals and biceps contracting well.  The underwater treadmill not what we had hoped for.  After surgery in 2009, Carl had some motor function.  The neurologists at NC State had said he no longer had motor, but I still hoped that he may do something in the tank.  Carl had a great time in the water, talking and splashing around, but there was clearly no movement in his hindlimbs.

Adjusting Carts is Not A One Person Job

After throwing my back out last week I finally felt good enough to try adjusting Bonnie's "FCE Cart" to fit Carl.  Getting Carl into the cart was a challenge as he didn't need to front extension, but I needed to see if the cart would even be an option ... General consensus - the cart should work, if I can alter it, hold Carl still, and take photos at the same time .. LOL!!  

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Tonight I changed the cart back to the original setup.  I got Carl in easily but the set up is still very wrong.  I think the front harness needs to be higher on his shoulder, the cart may need to be longer (his back is very curved, which is exactly what we don't want), and potentially a bit higher (his legs seem very flexed). 

Photos have been sent to Doggon Wheels and hopefully we'll hear something in the next day or so.

It's Official, Carl Flunked Out of the Trial ....

Dr Olby told me today that Carl has shown no change during the start of the trial so has withdrawn him :-(  She can script out the drug that may have caused him to wag his tail a bit and has suggested that I try it for a couple of months to see if there are any changes in the longer term.  If we do, then she can re-enroll him in the trial.

Now ... I have Carl home and I am seeing some significant differences.  Carl is "standing" a lot more, and it seems to me more than just weight shifting, or at least is different to what I have seen before.  I am also seeing a lot of twitching/trembling in his hindlimbs, also something "new".  This could all be a result of his 4 day stay at the vet school, but I don't know that it isn't something more ....

Carl is really pleased to be home, currently sleeping at my feet - sleep being something he did not get much of at the vet school!

Disappointing Day

I had such high hopes for the drug trial, but today I was told that the researchers had seen no movement/improvement at all.  There is one drug left to try, but it doesn't look like Carl is responding which will mean he will not be in the rest of the trial...

I am slightly concerned as all other dogs in the trial have responded.  I wonder if it is because Carl had a tumor and not a disk injury?  What if it is because there is still something actively happening in Carl's spine that we just are not aware of because he is already paralyzed?

Recheck radiographs have been scheduled for May to check for ongoing changes.

Preparing for Carl's Big Day

Tomorrow Carl goes to NC State to participate in the 4-AP and T-BOC trial. I hope that we will see an improvement in Carl's neurological status including bladder control.

In preparation for Carl's big day, tonight he got a bath. Being down and not able to urinate himself we have a lot of problems with bad aiming when I express him and reflexive urinating (all over his legs and chest)when he gets excited. Cleaning with baby wipes just doesn't do the trick which is a shame because it is not easy getting a large, paralyzed dog into a jacuzzi bath!

Rehabilitation Evaluation

Yesterday Carl went for his Rehab evaluation. It went much as expected. Carl has good forelimb musculature, but very atrophied gluteal, quadriceps and hamstring muscles. The initial plan is to work on his core strength and try to build up his hindlimb muscles. I have some exercises to try at home and will be buying a NMES unit to help get his muscles firing. We're also going to put him in an underwater treadmill to see if he will move his legs.

Will Carl ever walk again ... the general consensus is no. The aim of rehab is to give Carl the best chance possible, and who knows, we may well see a miracle .... My initial goal is to help Carl stand for longer periods making it easier to get him in and out of his cart, keep him clean and minimise trauma to his feet.

Neurology Appointment

This week has seen Carl's evaluation with the neurology team at NC State vet school. The findings were not unexpected, but also not what I was hoping for.

Carl is now totally paralyzed from his L3 vertebra down. There is no way to tell if this occurred immediately after surgery or if he did improve for a while then start to deteriorate again.

Radiographs show that his L3 vertebra is very abnormal. This is puzzling to the neurologists, radiologists and oncologists. The lesion in the vertebra is very aggressive but is confined to just the one vertebra. If it were cancerous it should have spread (although it may be a low grade plasma cell tumor which would grow very slowly), and if it were osteomyelitis then it shouldn't have resolved without Carl receiving antibiotics ....

On physical exam it was determined that Carl as no conscious movement nor deep pain in his hindlimbs. Reported movements and ability to urinate were likely simple reflexes and urinary overflow from a full bladder. Carl also has a skin infection and is a bit painful at his affected vertebra.

The plan .... I now express Carl's bladder three times a day which has made a huge difference (no more dribbling), have him on antibiotics for his skin, and Gabapentin for his discomfort. The most exciting part is that Carl will be enrolled in a clinical trial at NC State. It is for dogs with long term paralysis and involves giving two experimental drugs to see their effect on bladder and hindlimb function. For more information visit:

Let it Snow

It doesn't often snow in NC so the 5 inches we awoke to this morning was a treat for the dogs.  All the dogs loved being outside, but the laundry they generated was amazing.




Carl continues to do well, but is peeing all over the house .... His skin of his caudal abdomen has lesions on it - looks like pyoderma or a reaction to something. I've gone to using the loose male wrap that catches some, but not all of his urine but allows more airflow than a diaper. A friend sent me a link to a different type of diaper called tinkle trousers and I'm thinking of giving them a go until we can figure out why he's having problems.

Neuro exam is Monday, weather permitting....

Day Two

I adopt special needs dogs and thought I was prepared for a paralyzed dog .... I was wrong.

Things I have learned today:

1) Pee. Carl really has a large bladder.  I lost count of the number of times he peed on my arms this morning.  By this afternoon I had bought a diaper - life is much better.

2) Skin damage.  Carl had some abrasions on his legs where he drags them, that were made worse just on the carpet.  He has a cart for outside, but what about inside?  A bit of lateral thinking and some leg protection materialised in the form of foam pipe insulation and velcro.  It keeps Carl's legs a bit too straight, but has really done the trick both inside and outside (when he really needs to go to the bathroom and there isn't time to get him in his cart).  I have muddy, scraped up insulation but dry, protected legs.

3) Carts.  I've had a dog in a cart before, but she could use her legs and stand for short periods making getting her in and out of a cart relatively easy.  It is so much harder when you have limp back legs with a front end jumping about, just wanting to go.

Carl is a real live wire.  I thought a walk might wear him out - what was I thinking.  Two miles later he is running and I am struggling to keep up.  I was thinking of teaming him up with one of my older Labs for walks but they'd never manage the pace.

Carl

On December 15th 2009 I received an e-mail from a friend about a paralyzed black labrador in need of a new home. My house was full, so initially I did nothing ... but somehow I couldn't get Carl out of my mind. I finally e-mailed his owner, hinting that if there was no one else that I would be happy to help him.

There was no one else ....

Fast forward to January 24th. Through the efforts of some amazing people, Carl arrived at Raleigh Durham airport, three days after leaving Utah, courtesy of PilotsnPaws. So what is so special about Carl? Here is his story:

Carl is a two year old Lab who lived in the mountains of Utah. He loved to go hiking or snowshoeing and play fetch. About a year ago things started to change, Carl favoring a leg. What was initially thought to be something like hip dysplasia turned out to be a spinal tumor. Carl had a surgical biopsy which found he didn't have cancer. Unfortunately after the surgery Carl was paralyzed.

Initially Carl had no control of his bladder or bowels, couldn't feel his legs nor wag his tail. As he healed Carl regained control of his bladder and bowels, started to wag his tail and could feel his feet.

Carl was treated by a pranic healer and went to rehabilitation, working out in an underwater treadmill. The costs of rehabilitation eventually became too much and Carl's family had to travel out of town often. It was with much sadness that they decided to try to find a new home for Carl. Carl has come to North Carolina to be evaluated again by a neurologist and get further rehabilitation. We don't know if Carl will ever walk again. My hope is that he will walk and that he will then be reunited with his family.