ANNPE Diagnosis-Success Stories?

[CarolC]

That is great news! Woohoo!!!


Here is an article with extremely encouraging statistics for ANNPE. Kind of technical but worth it.

https://veterinaryrecord.bmj.com/content/181/11/293

I want to say something about licking/chewing. It's a phase some dogs go through during recovery from paralysis. As far as I know most dogs do fine, but there have been dogs reported here who got carried away with the licking/chewing to the point that they did real damage. They say that during recovery, dogs may feel a tingling or pins and needles sensation, sort of like a human does when you sleep on your arm funny and then it starts to wake up and it tingles. Dogs will lick and chew at the annoying sensation and for some reason some dogs don't stop even when they draw blood. You just want to keep an eye on him, and if you notice he's really licking/chewing, I would put a cone collar on him right away and get him to the vet. There are a couple of medications they have found to treat the problem (gabapentin, pregabalin) to prevent the dog from doing any damage. I did a post a while back with some examples of cases where dogs injured themselves. It doesn't mean your dog is going to do that at all, it's just good to be informed so you can keep a better eye on him. Here was the post.

viewtopic.php?p=112620#p112620

[kh12265]

I wish you the absolute best and hope to hear nothing but good news about your pups recovery!

Thank you for the reply and links! Much appreciated.

Quick update - 4 days after his injury, my dog has regained a little feeling in his legs, and have been moving them and his tail even when he has not been touched. As of today he has also shown a lot more awareness of his legs and will often abruptly start licking his legs as if he feels something, even while he was sleeping. He is getting started on physical therapy next Monday and the physical therapist has let me know these are all good signs for recovery. Will do everything possible to maximize his chances for a full recovery.

[Ufr321]

Thank you!

Quick question - I noticed that my dog sometimes stretches his hind legs when he wakes up, randomly, etc. every once in a while. Does anyone know if this can be considered a voluntary movement or a reflex?

[CarolC]

I am not a vet or a neurologist. In my experience, it was intentional. One way you might be able to tell better is, if it seems spastic like a mule kick, that might be a reflex or spasm. If he seems to know he's doing it or even have a look on his face like, "Oh, that feels good," then it was more likely on purpose. Again, I could be wrong. To me it looked conscious and intentional with my dog. Here is what I posted about my dog.

We are 14 weeks and 2 days post spinal fusion for a chihuahua. We are doing the following: bicycling legs, scarf walking twice a day, tub therapy, and also standing exercises. She still has some strength in her legs but cannot stand or walk. She raises her feet like she's riding a little Harley when I express her. She can stretch and point her toes, and can raise her tail up and also wag it sideways.

[Ufr321]

Hi all,

My dog had his 2 week checkup with his neurologist. Unfortunately, she said that he has not recovered deep pain and is pessimistic that he will be able to regain feeling. I asked her about his stretching of the hind legs that he does by himself (i.e. when waking up, randomly) and that I've even seen him do it at the same time he stretches his front two legs, and she said she has never seen that before and is very confused how that can be possible without deep pain. Now I just want to stare at my dog all day for the next time he stretches his hind legs lol. Very disappointed that he didn't pass the deep pain test, but am very curious if anyone has any thoughts on my dog's current status.

[critters]

In my experience most vets have very little clue about brain and/or spinal cord stuff with critters. As far as I'm concerned any movement is good movement in such a case, and I don't worry about deep pain, reflexes, the like, or no.

[CarolC]

Pip was paralyzed in his front and hind legs, and the hind legs came back first. On his front legs, his shoulders, elbows, and wrists work. I squeeze his front paws hard frequently, and get nothing. Zero. I don't think he even knows I'm doing it. Nevertheless he is walking. He often flips his paws, especially the left front, and walks on his knuckles, but he walks. Dogs figure out how to make use of what they've got. PT is king. It helps them make the most of recovery.

With my first paralyzed dog, they didn't find deep pain sensation in her toes until 149 days (almost 5 months) after her accident.

[ljpatton]

My girl was hurt with ANNPE last August 18. Her tail was down and she dragged her legs behind her. She was walking on hr own in 10 days. BUT it has taken over a year to get her gait back and know where her legs are. Trust your physical therapist they know how recovery works. I also will recommend laser therapy it helps the spinal cord heal itself by stimulating your dogs own stem cells. I also bought a Assisi Loop to use at home it does the same as laser and accupuncture- https://assisianimalhealth.com I got mine on Amazon and my insurance paid for it as my vet physical therapist wrote me a prescription.

Here is info on laser etc. https://www.medvetforpets.com/using-las ... dogs-cats/

Here is Chante's story: https://www.youtube.com/watch?v=dI36HuptSb0

Hang in there!

[ljpatton]

Here is one more that talks about stem cells in regeneration.

https://www.veterinarypracticenews.com/ ... -changing/

[Ufr321]

Thank you all for the super helpful feedback and links.

Post 5-week update since my dog's injury:

I don't believe the neurologist's assessment that my dog is deep pain negative was correct. That week I checked my dog's deep pain at home via his tail after doing some online research, and he showed very clear signs that he felt something (i.e. trying to shift his entire body the very second his tail is pinched). I don't think the neurologist checked the tail and was a little dismissive when I asked her whether she had checked for more subtle reactions other than a head turning reaction with a pinch to the toes, such as pupil dilation, breathing changes, etc.

Anyways, since then, my dog has made significant progress and has been showing clear and continuously improving signs of voluntary movement every day. I have seen him use his hind legs for a few seconds to literally walk to his bed or to just move himself from A to B multiple times, he makes clear left/right hind leg walking movements in physical therapy, he semi-stood up for a few seconds with his hind legs, moves all 4 legs when he's dreaming, list goes on.

For anyone else who's dealing with ANNPE, I just want to say that the animal hospital and neurologist gave him a very poor prognosis for recovering feeling and ambulation (actually the neurologist had the gall to bring up euthanasia only a day after he was injured. Regardless of her intention, shows a serious lack of emotional intelligence IMO lol), and obviously they were wrong. They're not always correct in their assessments and it's worth it to do your own research and get many second opinions. My dog's still got a long way to go, but I'm just relieved that he is showing undeniable signs of voluntary movement. Hoping that he will also regain the ability to urinate on his own. If anyone has any advice on that, would appreciate it!

[CarolC]

Replies in blue

Thank you all for the super helpful feedback and links.

Post 5-week update since my dog's injury:

I don't believe the neurologist's assessment that my dog is deep pain negative was correct. That week I checked my dog's deep pain at home via his tail after doing some online research, and he showed very clear signs that he felt something (i.e. trying to shift his entire body the very second his tail is pinched). I don't think the neurologist checked the tail and was a little dismissive when I asked her whether she had checked for more subtle reactions other than a head turning reaction with a pinch to the toes, such as pupil dilation, breathing changes, etc.

In real life experience it seems that cursory exams and seemingly a seat-of-the-pants diagnosis are common. If it turns out to be wrong later, it's not surprising. I think I got a proper neuro exam when I took my dog to the board certified neurologist here, but all she did was put a descriptive name on the paralysis and didn't seem the least bit interested in finding the cause. Sometimes when I hear of vets that don't do much of an exam, I think it's because they aren't specialists, but in your case and in the case of my dog, it was a trained neurologist not using all that training to do the best job, so there's no excuse. We pay them for expertise.

Anyways, since then, my dog has made significant progress and has been showing clear and continuously improving signs of voluntary movement every day. I have seen him use his hind legs for a few seconds to literally walk to his bed or to just move himself from A to B multiple times, Woohoo!!!!! he makes clear left/right hind leg walking movements in physical therapy, he semi-stood up for a few seconds with his hind legs, moves all 4 legs when he's dreaming, list goes on.
Best news!!!

For anyone else who's dealing with ANNPE, I just want to say that the animal hospital and neurologist gave him a very poor prognosis for recovering feeling and ambulation (actually the neurologist had the gall to bring up euthanasia only a day after he was injured. Regardless of her intention, shows a serious lack of emotional intelligence IMO lol), and obviously they were wrong. They're not always correct in their assessments and it's worth it to do your own research and get many second opinions. My dog's still got a long way to go, but I'm just relieved that he is showing undeniable signs of voluntary movement. Hoping that he will also regain the ability to urinate on his own. If anyone has any advice on that, would appreciate it!

On the urination, my dog's physical therapist said you need to give it at least 3 months for bladder control to return, and 6 months to be sure. After that whatever you have is likely to be pretty much what you're going to have. But there are examples on this forum of dogs that regained bladder control later than 6 months, so that is only a guideline. I think I have links to examples of later return of bladder control if you want them, just ask and I'll check.

Are you using male wraps? (aka male doggie diaper or belly band) They are a wide belt that goes around the waist and holds an absorbent pad over the male area. You change the pad as needed. Usually it's a Poise pad or similar, and if it's a small dog you can cut the pad in half or even thirds, depending on how long the pad is. There are 2 kinds of wraps, the kind with elastic along the edge or the kind that lie flat. I like the ones that lie flat. Malewraps are wonderful!

Here is a picture of my senior dog, Merlin, wearing his malewrap. If your dog drags and you have any issues keeping the wrap in place, they make several styles for that. Just ask if you need links. You can also make your own wraps at home if you sew. Merlin was a large dog and I ended up sewing handles on his wrap to help me get him to his feet. It was easier than trying to keep him in an all day harness and trying to change the wrap with the harness on. Malewraps are your friend!

viewtopic.php?f=4&t=11277&p=65511#p65511

[Ufr321]

Yes, if you could send links, that would be great! And the wraps look handy, will look into that forsure. Thanks a lot!

[CarolC]

These are examples of bladder control returning after 6 months.

My shih tzu
Post by jaywilly36 » Tue Dec 04, 2012 3:38 pm
Just started peeing on his own after 7 or 8 months only got 1 uti the whole time although when he number twos i have to hold his legs up up cause he falls in it sometimes just be patent its a alot of work but there worth it i would die for my little baby boy praying for all of your little cuties

Re: Dogs: Pete
Post by Sheri » Tue Oct 25, 2005 10:47 am
Pete had no bladder or bowel control for 2 years. It has just been in the last few months that Pete gives me about 30 seconds of notice of going to have a bowel movement. Prior to that it just fell out without Pete being aware. His bladder is slowly gaining more control, he stands up and pees when you let him out but does not empty his bladder. We still express to keep ahead of the UTI. Pete still dribbles from time to time when he gets excited.

Re: Newbie ~ What recovery steps did you see?? (Disc issue)
Post by Syd's Mom » Fri Jun 16, 2017 8:16 am
Hello All,

I wanted to give you an update since it has been over 2 years since Syd's injury. We spent thousands of dollars on the surgery and therapy. Even though he never regained his ability to walk I am glad we gave him the chance. He is happy and doesn't even act like the paralysis slows him down one bit. We used to feel sorry for him dragging himself around. Now its the norm and he can move a mile a minute, which is a little scary . He has a cart from Eddie's Wheels Co. that has been a blessing and he loves to go on the trails near our home. He plays with our other dog as much as he used to. Recently we purchased a large area rug that covers the majority of the room he spends the most time in, covering the hardwood floors. This new ability for traction has stimulated him to stand and eat all on his own, which we have assisted him prior to. He takes several steps now without assistance and we are getting encouraged there may be more progress after all this time. I only wish we had bought this rug sooner We still express his bladder but he is also starting to urinate on his own. Nerve pathways grow back slowly.
Bottom line, yes we wish he could walk but we have worked around his special needs, it doesn't take that much time now that we have a routine. We are glad we gave him a chance and he is an important part of our family. Good luck to all of you!!!

Syd's Mom

Note: Rajah's Mom reported Rajah was getting some control back in April 2004, about 5 mos post-injury, so not sure at what point Rajah actually had it back. This post is at 7 months and is the first report where she flat out says Rajah has it back.

We were in the same boat
Post by Rajah's Mom » Mon Jun 28, 2004 6:00 pm

Rajah (100+ pound furbaby)fell and suffered a spinal cord injury on Thanksgiving Eve 2003. Before and After surgery, Rajah had NO deep pain sensation in her hind quarters. We REFUSED to let go, brought her home and began nursing care. By way of this board we found MANY MANY MANY (thank you bendy, critters, sandy, carol, etc) useful and helpful hints. We bought a cart (EDDIES IS WONDERFUL WONDERFUL WONDERFUL) and I stood outside the PT clinic everyday until they finally gave up and admitted Rajah. Rajah can now stand on her own for short periods of time, has bladder and bowel control and as recently as yesterday climbed the stairs. Love will make all the difference for your baby. They feel it. And if nothing else, the bond that forms is amazing. Don't give up, but when you get upset/down/angry with your situation (and you will) turn to your friends on this board. You will make it! Good luck and keep posting!

Male wraps are the best! I always recommend you have at least 2, one to wear and 1 to wash, or more if you can afford it. They will sometimes get damp around the edges. I'm not sure what size your dog is. If he's really big, there are tips for dogs that need extra absorbency, just ask. Merlin was in his wrap 24/7 for about 3 years. It would be easy to get diaper rash or redness that way, so it helps to use some kind of barrier cream or ointment. I used Original Desitin diaper cream. I loved it because it stays on so well you don't have to reapply it with every change. Just butter him up real good and you can usually go all day and into the next day before you need to put more on.

The important thing to keep in mind about Desitin (or other white diaper creams) is they contain zinc oxide, and zinc is toxic to pets if they lick enough of it. My dog didn't lick, and he wore his wrap all the time, so there was no problem. My vet said that was what they used in their practice, too. If your dog seems to lick himself, you may want to try another type of ointment without zinc oxide. I tried plain Vaseline and also A & D (the formula without zinc oxide, think they have more than one variety now). They worked more or less, but the original Desitin was by far the best. If you have to keep reapplying ointment with every change, that means you're getting your hands greasy many times a day, including when you are in a hurry or on your lunch hour, and you're going through a million paper towels wiping off your hands, etc. It just increases the hassle factor. So if you can use Desitin, it's a lot more convenient.

There are also several links for DIY male wraps if you have a sewing machine. (Just ask! )

There are probably more examples of bladder control returning after 6 mos. If I come across any more I'll add them.

[linzkaetz]

CarolC, I first want to say that you are an angel and all of your information and replies on this and the other ANNPE posts got us through the incredibly hard first few weeks of our girl Lilly's recovery journey for an ANNPE that happened to her on 11/19/24. Lilly had a very severe ANNPE while running after her ball in the yard. She is a very active medium sized dog (supermutt but definitely some herding dog in her). She lost complete use of both of her legs immediately, though the vet confirmed she did have deep pain sensation in both feet. We were very lucky to have a great emergency pet hospital near us and they were able to do an MRI on the same day to rule out a ruptured disc but they said her ANNPE was very severe and they really weren't sure if she would be able to walk again and told us either way it would be a very long road ahead. They told us the first 90 days are super important to put in the work with her doing PT and other treatments to set her up for as much success as possible. 

We were devastated but tried to do as much research as we could (mostly getting answers from this amazing forum) and tried to be grateful that she was even alive. (Apparently in rare cases a dog's spine can "die" for lack of a better explanation after something like this—they said once you are two weeks out without regressing that's no longer a concern.) We had to keep her very still for the first two weeks but they had us doing some basic massage and PT to try and make sure she wasn't in too much pain and to help stretch out her muscles since she couldn't move her back half at all on her own.

We were told to limit her activity at home for 4 to 6 weeks so we mainly kept her in a large playpen. The main concern was they didn't want her dragging herself around the house because she could get hurt, plus they didn't want that to become her norm and for her to become unmotivated to walk again. They told us early positive signs were that she could support her weight on her back legs, attempting to walk, responding to being touched, and tail wags. The only negative signs to look out for were if she seemed to be getting worse (not counting an occasional off day) or if she seemed to be in any pain. They did also tell us that this is a freak accident and it is very unlikely something like this might happen to her again. As she did more PT and got stronger, her left leg would do a weird vibrating/bouncing motion (not a shake) but they said that was normal. I was being an overprotective dog mom and constantly tried to move her out of positions that looked uncomfortable but the vet said if she was hurting she would cry out or shift herself and that we could mostly let her do her own thing regarding sleeping positions.

I know this has been said in this forum already but the first few weeks are brutal, BUT you will get a system down and figure out the easiest and best way for you and your pupper to do things, you will make progress, even if it's slow, and it won't always feel hopeless. You will get so excited about the smallest wins. My husband and I were lucky to have each other to help out with all of the new demands on our time and energy. If you're helping your puppy recover solo if you can have a friend help you with doing their physical therapy or giving them a bath it makes a huge difference, but everything your furbaby needs can be done solo too.

At the two week point, we met with a vet physical therapist and got Lilly started with some acupuncture, laser therapy, and estim therapy. They also had us start doing real PT with her. Three times a day we would have her do sit-to-stands where we would support her and help her sit stand up, tickling her hamstrings as needed since that was some sort of reflex to help her muscles want to stand, and then have her sit down and we would repeat that three times. At first we were shocked that she was even able to attempt to do the exercises because she had barely moved at home, especially since we were trying to keep her still to heal. The vet told us she was concerned at Lilly's lack of concern about her back legs and we needed to really get her motivated to get back as much functionality as we could. We had asked about getting her a wheelchair so she could move about freely and to make it easier to take her out to potty but the vet discouraged that and said we needed Lilly to work at these things to stay motivated and not give up on using her legs (mainly, don't make things super easy for her).

Lilly had been put on gabapentin and trazodone, and trazodone makes her super hungry so she was very treat motivated and she started trying really hard to earn her treats during PT. (As an aside, they put her on steroids as well which can make the pee accidents happen a lot more frequently so if your baby is having a lot of accidents and was on IV fluids and/or steroids there is likely some light at the end of that tunnel.) She would slowly start doing things like moving her paws in her sleep, slapping her tail in her sleep, moving her paws when we tickled them, and other things like that that gave us hope. The vet said these were just reflexes but took it as a good sign that her body was able to move her feet and tail at all so we tried to keep being positive. Lilly slowly started to get a tiny bit stronger each day. Her right leg started coming back way faster than her left leg. 

We really started to see her improvement happening faster when she was able to do the water treadmill at PT at 4 weeks after the initial accident. She needed a lot of assistance but we think having her be able to do a walking motion in the water was super helpful for her muscle strength, muscle memory, and to put an end to the knuckling. We also think the estim has been a huge help. (It basically exercises her leg muscles for her while she lays there and looks cute.) We were slowly given more exercises to do with her as she got stronger and her balance got better. She does side steps, steps over little bars, takes backward steps, goes around cones, steps up onto and off of a step, etc.
For a timeline (which I was desperate for but of course all dogs will heal differently): Her right foot stopped regularly knuckling around 3 weeks and her left foot finally caught up around 6 weeks and all knuckling stopped by 13 weeks. She started to be able to stand and stay standing (ugly and leaning on her stronger right leg) at about 5 weeks. Her tail started wagging at 6 weeks, but only when she's really excited and it's still that way. She also started to cross her legs less and sometimes correct the crossing around 6 weeks. She stopped falling down while doing a body shake around 7 weeks. She could do a clumsy walk on her own at around 10 weeks. With lots of physical therapy and estim we have gotten her strong enough at 14 weeks to take short walks with a sock on to protect her left foot which still occasionally drags. She is even hopping up onto the couch (mostly with success) and can easily jump off of it now, do a weird little hop and then balance herself out. She is also able to run and gallop around the yard quite well sometimes but it's definitely wonky. She still only has proprioception (basically the signals from her brain to her legs/feet) in her right leg but her left leg is doing really well on muscle memory alone. They said it is unlikely it will come back but there is always a chance, even years later, that it might "come back online."

I do want to mention that she had a ton of accidents in the first few weeks after it happened but after about a month I think her peeing was totally under control (we still occasionally have to press on her bladder to make sure she is going regularly) and she can now do a very low squat and pee by herself. Needing to poo seems to make her legs a little bit weaker so we still give her support for that (via her harness) and she has learned to do a little walking poo situation which works about half the time for her. She does still have accidents in the house when she gets super excited and is bouncing around.

Lilly hates car rides so the car stress started to outweigh driving her to the rehab place for her PT so we now have someone coming to our home to work with her occasionally. The new PT person pointed out that we should also be massaging and stretching Lilly's front legs since they are bearing so much more weight and strain than they used to (especially when she really couldn't use her back legs at all). We hadn't thought about that so this was a great tip and we can tell Lilly loves the massage on her front legs. We had been doing it on her back legs only for months.
Some things that helped us a lot: If you can afford it, I would recommend the help em up harness. I was resistant to it due to the cost but it instantly made bathroom breaks, home PT, and helping to support her so much easier. We had been using a makeshift harness from the vet that was not great. I would also buy an estim machine for the home as well. It's not too expensive and we think it helped Lilly out a ton. We also liked these socks for her: https://www.amazon.com/dp/B088FJXSVG?re ... title&th=1. I sewed them on the sides so they would fit her skinnier paws but the grip is good on them and the velcro band helps them stay on. The hard booties did not work for us. We also bought a ton of runners and put them down everywhere so that she would have traction throughout the house. Lastly, we kept pee pads, dog poo bags, and baby wipes in different areas of the house so that we always had them nearby if she had an accident.

I took a lot of videos of us training her and her progress and they are all in a google photo album so if you would like to have access to that feel free to send me a private message.

I also want to mention that while the vet, and especially the workers who actually did the PT with Lilly, were super helpful and a huge reason why our girl can walk today, they were very cautious about getting our hopes up and didn't always celebrate the wins as hard as we did. And there were days that we took her in when she was having an off day and they couldn't see the progress she had been making. I wanted to mention that so you don't lose hope if you're seeing good signs at home but not getting a ton of positive confirmation back.

We are so proud of her progress. We truly thought it would be a year or more for her to even come close to what she's able to do now. And we truly weren't sure she would ever be able to get around without assistance of some sort. I wanted to share our story to give others hope, especially those with furbabies that have severe ANNPE and whose abilities don't come back within the first few weeks or months. There is always hope!

[CarolC]

linzkaetz!

Lilly is a lucky dog to have a family that puts so much into helping her. She may still have some surprises for you. Congratulations on her recovery and your 3-month anniversary tomorrow!