Intervertebral Disc Disease (IVDD)- Care of a Paralyzed Pet

There are some spinal conditions that result in paralysis, which is the inability to move the legs.  The most common cause of paralysis in dogs is intervertebral disk disease. Most dogs that suffer from disk disease can be cured with medical or surgical treatment, and so their paralysis is only temporary.  However, sometimes spinal cord damage is so severe that paralysis is permanent, even despite surgery.

The following contains advice for caring for a pet that is permanently paralyzed.

Confinement:

Dogs that cannot walk or move themselves must be confined to a clean, well-padded, area like a crate, playpen, or laundry room depending on their size.  They should have enough space to move around, but should not be able to drag their body.  If the patient is not moving around on their own, the body position should be rotated every 3-4 hours.

Cleanliness:

A paralyzed pet will have to rely on diligent owner care to help them stay clean.  They might urinate and defecate where laying, so the bedding must be kept clean and dry.  Urine and fecal material can cause serious skin irritation.  Bathe as needed with gentle, moisturizing/oatmeal based shampoo that won’t dry out the skin.  Other products like baby wipes and dry shampoos can be used.  Diapers can be used if necessary, but must be changed often.  The skin must be bathed and dried often as well.

Bed sores and ulcers can occur as a result of the pet laying down all of the time or dragging the legs when trying to move.  Hindlimb sores may occur over the top of the foot, on the legs, hips, near the tail, or on the tail. Forelimb sores generally occur on the elbows.  Orthopedic beds may help to prevent sores by providing more padding.  If using a harness or a sling to walk your pet outside, booties may help to prevent sores from developing on the toes.  If your pet starts developing sores, see a veterinarian right away.

Mobility:

A Walk-About harness or other support device allows support of the pet’s weight to allow him/her to walk with the front legs. Care must be taken to prevent sores from dragging the rear limbs or toes. Do not allow the feet or toes to drag on rough surfaces.

Rehabilitation Therapy:

Postoperative rehabilitation therapy is crucial for pets that might someday regain the ability to walk.  Consultation with a veterinary rehabilitation specialist is essential to learning more about therapy options and rehabilitation techniques.  Veterinary rehabilitation specialists can also provide underwater therapy, as well as information about use of a cart, or animal wheelchair, if necessary.

Rehabilitation therapy is important in order to keep joints healthy and muscles flexible. Massage the legs frequently. Gently move each limb through range of motion 10-15 reps 3-4 times a day to keep them from getting swollen or stiff.  Also, move one limb at a time in a circular motion, in a normal range of motion pattern as if the dog were walking. This can be done with the pet either standing or lying down. Make sure to rehab all limbs that are not moving normally.

Urination/Bladder Expression:

Pets who are unable to move their hind limbs are unable to urinate on their own. Sometimes, when a paralyzed pet is lifted, urine is passed – this is likely due to “overflow.”  The pressure on the abdomen with a full bladder may result in release of urine.  A bladder that overflows will still not empty completely, so owners of paralyzed pets must learn how to adequately assess bladder size and manually express the bladder at least four times daily.  The bladder will feel like a water balloon in the abdomen. If the bladder is very large it may be difficult to feel.  After expressing the bladder, wait a few more minutes and feel it again.  It may become easier to express.

Method of Bladder expression:

The bladder can be expressed with the pet either standing or lying on the side.  Place 1 hand on either side of the abdomen, just in front of the back legs.  With steady pressure and increasing firmness, begin pressing on the abdomen over the bladder, directing pressure toward the tail.  It may be easier to have both hands flattened and the fingers slightly spread apart while pressing so that the bladder is stabilized and squeezed by both.  Gently squeeze the hands together and press both hands toward the tail.

Once urine starts to flow, apply steady pressure until the bladder empties completely.

Do not be fooled into thinking your pet is urinating just because you find wet bedding. Many times this is due to overflow because the bladder has become too large.

The bladder will need to be expressed until your pet can voluntarily urinate, which generally happens once they can move the legs, but might not ever happen. If you are ever unsure, please contact a veterinarian for assistance.

If the pet is showing some ability to urinate, they should be taken outside and held upright in the grass to give them a chance to get the idea.  If there is no urination, or only a little is passed, the bladder must still be expressed 3-4 times daily.

Bladder expression may be one of the most frustrating parts of caring for a paralyzed pet.   A veterinarian or technician can help.

Paralyzed pets that are unable to voluntarily urinate are predisposed to urinary tract infections.  A veterinarian should perform a urine test and culture every 3 months.

Internet videos about bladder expression:

http://www.youtube.com/watch?v=CAaLdeJCIkw (veterinary technician)

http://www.scoutshouse.com/videos/video_bladder.html (veterinary rehabilitation specialist and technician)

http://www.youtube.com/watch?v=yoYWs6OEfJI (owner video)

Carts:

More information can be found through a certified canine rehabilitation specialist or online at these websites:

www.k9carts.com

www.dogwheelchairscenter.com

www.handicappedpets.com