Post-Hemilaminectomy

Mindi was discharged yesterday and this is part of the summary report, from admission through discharge:

Thoracolumbar CT Scan: Severe spinal cord compression at L1-L2 and moderate compression at L4-L5. Both lesions extradural and arising from ventral and slightly right-sided. The compression is caused by mineralized material.

Surgery: A right hemilaminectomy of L1-L2 spinal segment was performed 3/27/09. Moderate amounts of mineralized disk material were removed in addition to large quantities of fibrous capsule protruding into the spinal canal.

Case Outcome: Mindi recovered uneventfully in ICU where she received IV pain medications and fluids. A urinary catheter was placed to prevent overfilling of her bladder. On 3/29/09, Mindi was moved to the general wards where she continued to receive oral pain medications (Tramadol and Rimadyl) and urine production was monitored. Rehabilitation exercises were started to help promote joint health and maintain muscle memory. Over the next week, Mindi's neurologic function slowly improved although motor function in the rear legs was not detected. The urinary catheter was removed on 4/04/09 after she was noted to be urinating around the catheter. Oral medications were discontinued as well as she was no longer assessed to be uncomfortable. Mindi was noted to urinate voluntarily outside in the grass later that day and on 4/5/09 slight movement of the right hind limb was detected when her front end was supported. - We expect Mindi's neurologic function will continue to improve over the next weeks to months although we cannot predict how much function will return. It will be imperative to her recovery to continue with rehabilitation exercises at home and to promote significant weight loss with an appropriate diet.

So that's the story. The recommendation for her diet is Science Diet Canine R/D - 283 kCal/day to reach and then sustain a weight of 15-17 pounds. She is currently 23 pounds.

She got home about 4:30 and was still panting and excited. She settled down and eventually urinated in the grass. We got her a kennel, and she seems comfortable in it. Molli appears detached and is terrified of the kennel and, also, Mindi. She smelled her initially but has not bothered since.

We were told to hold Mindi's back side up by putting a towel under her. It is very awkward and a strain on our own backs. I had also bought a harness called 'Bottoms Up' that is for the purpose of holding up the back end. Didn't have much luck with it yesterday but will try again today. I also ordered a 'Belly Sling' today on eBay. Hopefully, she will walk again but no signs so far.

Three to four times a day, we have to do passive range of motion exercises on Mindi's hind legs, as well as weight bearing, and stand-to-sit.

Changing Mindi to this low-cal diet was not something we thought would happen easily. But, to our amazment, she gobbled it up! Even better is that Molli also ate it! So, that is the diet from now on.

Mindi made a poo this morning and she ate most of her food. However, when Mindi had not urinated for 24 hours, I was concerned. She went to see the regular vet at 5 p.m. and she was too tense for her bladder to be felt. An X-ray was done and her bladder was not distended. She did have pain and her temperature was elevated. They put her back on her pain meds. She came home and slept on my bed; I massaged her and did passive range of motion on her paralyzed hind legs. At 9:15, we were going to put her in her kennel for the night. We brought her to the kitchen for water, which she drank, then she ate all of her dog food. We took her outside and held her up with the towel -- and finally, she urinated. She was probably in pain all day and she became very tense. The meds decreased the pain and let her relax.