By Wendy C. Brooks, DVM, DipABVP
Educational Director, VeterinaryPartner.com
Unfortunately, spinal damage leading to rear leg paralysis is not an uncommon problem in pets. The animal will be normal from the point of the spinal injury upward and paralyzed from the point of the injury downward. These animals are colloquially called downer animals and have special management needs. Rarely is rear paralysis temporary so long term management will require commitment. It is not for everyone and it is important to understand what you are getting into; though, for the right owner and patient, management of the downer can be rewarding and the human/animal bond can continue.
The downer animal is frequently also a victim of urinary and fecal incontinence and, of course, will have limited ability to groom. It is important that the animal be bathed frequently for the sake of your household as well as the animal's sense of cleanliness. This is obviously more practical for the smaller pet. Expect to have to bathe the animal every few days at least to prevent urine scald on the skin and odor issues.
TIP: If dry skin becomes a problem with frequent baths, a moisturizing rinse can be obtained from your vet.
TIP: Be sure to maintain good flea control. You will need a waterproof flea product.
TIP: Dry shampoo is available at some pet supply stores and may be helpful for spot cleaning.
Do not use zinc oxide-based cremes (commonly used for diaper rash) on pets. Zinc oxide is toxic if licked.
Baby wipes are especially handy in caring for the downer dog.
Underpads come in assorted sizes and have a padded side and a plastic waterproof side. They are manufactured as a human incontinence product but have many pet-related uses.
When it comes to protecting underlying carpeting or flooring upon which a downer dog is bedded, nothing beats an office chair / floor protector (or two, side by side, if need be). Towels, blankets, dog bed, food that may spill, etc. can all safely be placed on the protector.
Diapers, wraps and piddle pants for dogs are available at most pet supply stores.
Another important concern regards the pet outdoors. Urine or fecal odors or damaged skin will attract flies readily. The animal will not be able to shoo flies properly. It only takes an hour on a hot day for fly eggs to turn into tissue-eating maggots (a condition called myiasis). If the tissues are deeply invaded, death may result. Be sure your pet is not allowed to attract flies.
Bed Sores And Damaged Skin From Dragging
The paralyzed pet will probably have some ability to drag himself or change positions somewhat but be aware of sores developing on pressure points. Especially vulnerable areas include: elbows, ankles, and hips. If sores develop, see your veterinarian for care. Padding or bandages for these areas may be needed.
Support garments to prevent pressure sores on the elbows and joints of the legs can be purchased.
Similarly, the paralyzed pet may be very strong in the forelegs and move around with the rear quarters dragging. This can lead to scraped skin, especially if the pet does not have sensation to the rear limbs and cannot feel what would normally be quite painful. Again, be aware of the potential for this type of injury; special bandaging or padding may be needed.
A specific type of harness can be a great help in your ability to move or carry your dog around, letting you keep the front or hind quarters raised when your dog can’t.
An orthopedic bed is a crucial investment for the downer pet. These beds are designed to protect pressure points from bedsores. If your vet's office does not sell such a product, they are available through pet supply stores or on line.
TIP: When buying an orthopedic bed, be sure it is machine washable. Buy a second bed for use while one bed is in the laundry. It will not be helpful if only the cover of the bed is washable.
Bladder Care and Infection Prevention
The downer pet is often inefficient at keeping the bladder empty. This strongly predisposes the pet to bladder infections, which can go up to the kidney and cause big problems. Your pet may need periodic urine cultures to monitor for infection. Your veterinarian will give you a recommendation for your particular pet. Bladder infections are easily eradicated with a simple antibiotic prescription. Some people are able to tell when the pet has one by a change in the odor or coloration of the urine. If you notice any changes, notify your vet at once.
Animals with spinal lesions at the level of the waist or higher will have excessive bladder tone (the so-called upper motor neuron bladder). This means that the bladder will require manual expression by pressing or squeezing. Your vet’s staff will show you how to do this. Emptying the bladder should be done a minimum of three times daily. If the bladder is allowed to remain over-filled, it will stretch out and become flaccid. After a couple of weeks, the upper motor neuron bladder develops into an automatic bladder, which means that when it fills it will empty on its own. If the bladder has over-stretched in the first two weeks after the spinal injury it will not be able to empty itself when it develops the neurologic capability to empty later on.
Spinal injuries of the lower back produce lower motor neuron bladder, which simply leaks and never has enough tone to fill. It is important not to assume that an animal can empty its own bladder simply because there is urine in the bedding. The full bladder may simply be over-flowing. Regular emptying of the bladder is one of the best ways to prevent bladder infection.
Mobility carts are especially important for the paralyzed dog who is strong in the front legs. A dog with a strong upper body will be able to run and exercise in a cart, which is not only healthy but psychologically good as well. Carts are fitted according to your dog's measurements.
Muscles are more comfortable when kept flexible. As long as there are no dislocations or healing fractures, passive flexion and extension and light massage are very good for the paralyzed limbs. The joints of the leg are moved through the full range of natural motion and relaxed. This is repeated for about five to 10 minutes two to three times daily.
Towel walking is also helpful physical therapy in keeping muscles flexible and strong. Slip an appropriately sized towel under the belly and use it as a sling. The dog is lifted so as to walk relatively normally in the front with the towel as support in back. As an alternative to the towel, several gadgets are marketed. Keep in mind that a dog supported from the rear may be difficult to lead. A second person "steering” in front may be helpful.
Ask your veterinarian to show you how to do the exercises or give you a referral to a physical therapist.
Care of the downer dog requires commitment and dedication. If the dog is too big for one person to move, the effort is that much more. Still, for the right dog and human family, paralysis need not interrupt the bond.
Support On The Internet
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