Monday, March 11, 2013

Happy 5th Birthday Godiva!!!

Yes, despite all the doom and gloom (and the cliffhanger) from The Surgery, Godiva turns 5 years old today, not too much worse for wear.

Some day I will write about the rehab. It took me four months to be able to get through The Surgery, the rehab may be even tougher to write. But to cut to the chase, she can walk, though a little sloppy, and she has her spunk back. We are still rehabbing her. She has her good days and her less good days, but overall we think she is getting better. Still no climbing, so we have to assist her getting into bed. She has no issues jumping down, despite our best efforts (and whining to get back up about 15 seconds later).

So, on her fifth birthday (already???) we are just happy to have our little girl back again.

Happy Birthday Diverdoo!!!

Sunday, March 10, 2013

The Surgery

In the dachshund world “the surgery” is shorthand for back surgery, the kind that many dachshunds need because of their long backs and their activity level. On October 22, Godiva had the surgery.

It started, so far as we can tell, a few weeks before when she would reluctantly climb the four steps to our bed. We thought she was just scared. In the living room, we have a three steps to the sofa. In that apparatus, the top of each stair lifts out so that you can store toys or whatnot inside. A good idea (that we don’t take advantage of, still have toys all over the place), but we have seen Godiva step on the front edge of a stair and have the stair fall out. So, she has been a little cautious with those steps for a while. We thought she was transferring those fears to the bedroom steps, which is just solid plastic, but steps nonetheless (she is a puppy, what does she know from physics?). By the way, the reason we have steps to the bed and the sofa, Couper’s non-surgical back problems from a few years ago.

So, we continued on, wondering why Godiva was having issues with the steps to the bed. But things got worse. She would go up two steps, cry, wait for help, and either get help or struggle up the rest. She then refused to go up the stairs at all. She would just sit and cry at the bottom until someone helped her up.

But, we began noticing a few other things as well. She was not jumping up on our other sofa that does not have stairs, the one she loves to climb onto the back cushion and nap. She also wouldn’t jump on the sofa with stairs, thereby avoiding the scary steps. It was like she wanted to get up there, but just wasn’t able to. 

I don’t think there were other signs. Not that we remember. Maybe she squealed once or twice when we picked her up? But she always did that. Did she limp at all? Not that I remember. In fact, I remember Couper limping on his front legs a couple of times in the last few months, but nothing with Godiva. The ironic thing is that she had just begun enjoying, and demanding, to play. She always like to play outside with the big balls (small basketballs or footballs). With the weather cooling off, we were able to do that more frequently. But, she also started liking to play inside with the small rubber balls that Couper normally plays with. And by playing, I mean she liked to play keep-away and tease people with the ball and run away. Eventually, she learned it was fun to give up the ball every once in awhile so it could be thrown and she could chase it. When we went into the living room to watch TV, she would lie on the floor with a ball and whine until I came down on the floor to play. And I gave in, because, that is what I do, and I figured it might help her shed a little weight.

As the days or weeks wore on, it became more obvious that something was going on with Godiva. One night she just could not get comfortable in bed. Since she usually sleeps by my side, her constant readjusting kept us both awake all night. Then there were the screams during her and Couper’s after dinner playing. Usually they chase each other around the living room after dinner and potties. Couper will inevitably try to mount her to prove he is top dog. The last couple of times they did this, she let out a huge scream. Finally, there was the screaming and crying she did before we left for work in the morning. At that point, we knew we had to do something.

I went to work that Wednesday knowing that we had a vet appointment for Saturday when both Godiva’s Mommy and I could be there with her. However, she was so bad that morning that I got an afternoon appointment and left work early. When I got home, Godiva was basically sitting on the ground shivering and unwilling to move. She could move, but not unless she absolutely had to. I got Couper pottied, got Godiva in a kennel and off to the vet we went.

We had been down this road before. When Couper was 4 (the same age Godiva is now), he started having back issues. He was x-rayed, diagnosed with a herniated disc (and one too many vertebra), given anti-inflamatories and pain pills and sent on his way. The second time he had problems, later in the year and in a new location, he got the same diagnosis, medicine, and a new order, six weeks bed rest, which, given his hyperactivity, we did the best we could with. But both times, he bounced back.

So, as Godiva and I waited for the vet, I was pretty sure of what was to come. Godiva got x-rayed. We saw possible issues, but nothing major. They do a test with the back paws where they fip the top of the paw under her and see if she corrects it. She did. That was a good sign. We got anti-inflamatories and pain pills. And we went home. Same as with Couper.

By Saturday, she was not really doing better, but she was not really worse. Compared to Wednesday, when she was a ball of pain, she was better. She would move, but was was a little clumsy with her walking. We reported as much to the vet when they called to check up on Saturday morning.

Saturday night she was much worse. She was a lot like she was on Wednesday and walking even more clumsy. We wondered if the pain meds were messing with her (Godiva’s Mommy thought the pain pills were numbing her, and I thought maybe she needed steroids for strength) and were sure she needed more time to recover, but got the sense that maybe something more was wrong.

On Sunday she was just as bad, if not worse. We left a message with the Vet to get us in as early as possible on Monday.

At 9am Monday I loaded Godiva into a kennel to go to the Vet, much as I had the previous Wednesday. This time I wasn’t sure what to expect, but I had my fears. We saw a different vet, our regular vet actually, who once again showed me the x-rays from the previous Wednesday, but this time said that we should get Godiva operated on, the quicker the better. The paw test that Godiva had passed last Wednesday was not passing this Monday. He set up an appointment for me that morning with the veterinary specialists at what is actually our emergency vet hospital and sent us on our way.

Before I left, I called Godiva’s Mommy from the lobby of the vet’s office. I got patched through to her classroom and tearfully explained that Godiva needed surgery as soon as possible. As I was talking I looked over to the nurse/receptionists at the desk. I felt bad that I was having this emotional moment in front of them. However, as I picked up Godiva’s kennel and headed out the door, a woman and her husband were coming in the door, dog in arms, frantically yelling that their dog could not walk. I realized that they must see this all the time and that working in a veterinary office is not fun.

Regular vet offices are bad enough. Emergency vet offices are worse. I at least have some good memories at the regular vet. Good check-ups. Picking up the puppies from vacation boarding. Seeing how much Godiva grew each puppy shot session. I have no good memories at the emergency vet. By definition we are there at an unnatural hour for an unnatural reason. Usually Sunday nights for tummy issues. So going into that building always brings back bad memories. It made bringing Godiva there for surgery even worse.

The first thing I noticed about the first doctor we saw was his age. I realize I am old, and there are plenty of professionals who are younger, if not much younger, than me, but this guy looked like he was 18. So, while he is doing the exam and providing me with what I am sure was critical information, all I could do was worry about his age:

“Is he just out of vet school? Has he attended vet school? High school?”
‘Has he ever done this surgery? Any surgery? Carved a turkey?’
“Why would I rather this guy replace my computer’s hard drive than cut into my puppy’s back?” 

Much to my relief, he told me that the vet doing the surgery would be available in a few minutes to look at Godiva and advise me further. I caught this somewhere between my thought process of, “Maybe this guy is some sort of Doogie Howser veterinary prodigy” and “If he looked like Marcus Welby, wouldn’t I worry about his hands trembling?”

The operating vet was of an acceptable age range, so I listened to his diagnosis. If I learned anything that morning, I learned that the disk in your back is “like a jelly donut”. I was told that three time by three different vets. They must teach that in Vet 101a. Anyhow, it was likely that one or more of Godiva’s jelly donuts got too much pressure and was oozing jelly. They would do some imaging, and if that was the case, they would have to operate. The vet explained that this is common with dachshunds and that they do 2-3 of these surgeries a week. He also said that the only way to prevent it is to “box them up and put them on a shelf.” With that, they scooped up my huddling, shaking puppy girl and whisked her away.

Unlike human hospitals, which have those dreadful waiting rooms with horrible TVs and outdated magazines, I was told to go home and they would call me. I found out that when you are waiting for medical results on loved ones, my home, with the nice TVs and the current magazines, is just as dreadful.

Of course, they never call within the timeframe that they say they are going to call. Which of course gets my mind racing, “Did they do anything?” “Did they find something worse?” “Did they just forget about her?” Eventually I called them:

Me: I am calling for a status on Godiva.
Them: OK. Hold on. What’s the name again?
Me: Godiva! I brought her in this morning with a back problem. They were going to do imaging and let me know if surgery was needed. Why do I even need to tell you this! Godiva! You know, the cute dachshund in pain!!! How can you ask me who?!? Why do you even have other patients?!?!?”

Of course it didn’t go like that, out loud. But, I would have to wait for a call back from the doctor. When that call back came, I got the news, Godiva had a ruptured disk and needed back surgery. It was scheduled for 4PM and usually takes an hour to an hour and a half.

More waiting. Godiva’s Mommy came home and we had a good cry. We watched every step Couper took and scolded him for almost any activity more strenuous than scratching his ear. At that moment, if we could have boxed him up and put him on a shelf, we would. Mostly though we worried about Godiva.

Another call to the vet. Another we will call you back.

Finally around 6, we got the call from the vet. It was the younger vet I met with earlier. Godiva was out of surgery, it went well, and she was fine. Relief. Her prognosis for recovery was “OK”.
Our relief turned to concern. That was hardly the optimism we were hoping for. He told us that since it is such traumatic surgery, it is difficult to tell this early how well she would recover. In my earlier meeting with him I had asked if after the surgery, “When we pick her up will she come bouncing through the door tail wagging?” I got laughed at. We had no idea at that moment, but would come to find out why he was guarded in his optimism.

Later we got a call from the operating vet. He was a little more optimistic. They fixed the disks that were ruptured and fenestrated the ones that hadn’t to prevent this from happening again. He told us that we could come visit her the next day and come home the day after that. He also mentioned that recovery is still a long road and went over some of the steps in the process.

Godiva’s mommy had student conferences that Tuesday, and since the emergency vet is on the way home from my work, we agreed that I should go visit. I wasn’t excited about going alone, but certainly wanted her to be visited. Neither of us had any idea what to expect.

I got to the emergency vet around 4:45 Tuesday. They brought me into an empty examining room and went to get Godiva. She did not come bouncing through the door tail wagging. She was carried in by a nurse swaddled in a blanket and shaking. They gently placed her on the examining table, which is more or less like a small 1970’s kitchen counter. When the blanket was unwrapped I could see the damage. Her back was shaved from the base of her neck to the base of her hiney. Her back was swollen and humped. And right down the middle was a seven inch scar held together by stitches. She looked like an oversized football.

She sat on the table shivering and crying. She tried moving around a little with her front paws, but wasn’t too successful. Considering she was sitting on a counter, that wasn’t the worst thing. So I bent down, hugged her, talked to her, and tried to steady her. She just kept shaking and crying. For thirty minutes this went on. I really wanted someone to come look at her to see if she was alright. No one came. Finally I quickly poked my head out the door, they had not bothered to close it, and asked for help. When the nurse came back in, she explained that this was to be expected. She just had major surgery don’t you know. She also mentioned that she hadn’t eaten and it was dinner time. Maybe I would be able to help her eat. Sounded worth a shot. She came back with a bowl of shredded chicken, which under normal circumstances, Godiva would devour. Not this day. She would have none of it. I tried for another half hour. Finally I caught hold of the nurses again. I had to get home and take care of Couper. They took the bowl away and fifteen minutes later came to take Godiva. A more depressing hour and a half I am not sure I have had. On the positive side, bending over to hold her on that table provided me with sympathy back pain.

Based on that visit, I was certain that we would not be picking her up the next day. She was a shivering huddled mass that certainly required more medical attention. Early on Wednesday morning, I got a phone call from the vet, “Godiva is ready for release. When do you want to pick her up?”

So Godiva’s Mommy and I decided to meet at the vet at 4:45 on each of our ways home from work. It was the same routine and the same puppy as the day before. This time, it was Godiva’s Mommy’s turn to be shocked. 

For the check-out procedure, a couple of veterinary techs showed us the rehabilitation exercises that they told us were the key to her recovery. Let’s break that sentence down. Godiva was checking out after being at the vet for almost 48 hours after surgery. We, people with no experience in animal physical therapy, were then responsible for Godiva’s recovery. We were being taught by people barely more experienced than us. So, the bottom line, we give them $4500 for surgery AND we are responsible for her recovery. Not comforting. Add to that, we are looking at a hunched over shivering crying shell of a puppy. It wasn’t like we were working with what she was even three days before. So, we got the instructions. Make sure she can pee on her own. Clean her up so she doesn’t get saddle sores (or the equivalent). Physical therapy three times a day by lifting her by the tail bone and moving her back legs up and down and in a bicycle motion. Finally, having her “walk” by rolling up a towel, putting it under her tummy, and letting her front legs drag the rest of her body forward. Those were our tasks for the next three weeks until her followup exam. Gotta say, we were more than a little scared. That she screamed almost every time we touched her made it worse. But, what can you do? We were just happy to have our little girl back. We were hopeful she was in there somewhere. 

We were in for the most exhausting three weeks of our lives.

Next: The Rehab

PS: What happened and what could we have done differently?

When Couper hurt his back and we got meds and orders for rest, we did not have Godiva yet. Though we laugh at the notion of Couper resting, we did kennel him when we were gone and took it easy playing with him during his recovery. For one reason or another, it worked out.

When Godiva got hurt, we figured it would work out the same. However, we did not kennel the two of them when we were gone; we let them free in the kitchen. They also had each other to play with, and Couper sometimes is not exactly gentle.

If I could go back in time, I would tell slightly younger me to kennel Godiva after she got hurt. Especially, I wish we had kenneled her (and Couper) the Friday after her first vet visit when the yard guys come. Couper and Godiva do not like the yard guys. In fact they try to attack the yard guys through the glass doors in the kitchen. Although she did not show signs of being worse until Saturday afternoon, I am sure jumping around on Friday did not help. Every day, I wish I had that day back.