Max's Progress Report

It's Monday night and Max has been home since Thurs night (4 days).  Home care is not for the faint of heart, but we are managing on getting a better schedule together. Max is being very patient with me, and has put up with me squirting food all over him, me, the walls, the ceiling, through the screens on the windows.. (definitely not something I recommend!).  We've mastered expressing his bladder, which I wish I had known about with previous animals!  And he's making some progress!

FEEDINGS:
So.. when Max first came home he was getting fed every 4 hours. His diet is supposed to be Purina EN (gastro-inestinal) which is ok.. not my preferred brand my any stretch of the imagination... but given the situation, I was following doctors orders. HOWEVER.... EN contains rice... rice does not fit through a feeding tube syringe.. even after going through the blender AND the food processor and having water and pumpkin added to it!  This has made the whole feeding tube experience INCREDIBLY frustrating.  Since Max has never eaten Purina in his life (we have only done home cooked raw and organic, or The Honest Kitchen or other organic, grain free, whole food brands) I talked with our holistic vets today and switched him over to WURUVA, grain free Steak Frites. It also has a higher water content and it's been tough to keep him as hydrated as he needs.. so I popped it in the blender with some water and additional pumpkin today and voila!  It slid right through the feeding tube! No issues! No safety pin required to fish out rice particles!  I also can more easily add his chinese herbs.  He's back on his Stasis of the Mansion of the Mind, and the Wei Chi Booster.  He's still taking 1 yunnan baiyao capsule / day to help clear up the bleed in his brain and keep any other bleeds from happening.  I've also added milk thistle and astragalus back to his diet too and just mix the powders from the capsules into his food. In addition I also have added colostrum to help boost his immune system and maybe help rebuild some damaged stuff. ... and I've also added a little polyMVA to see if that helps, but not too much. Don't need his fur to fall out again!  The Vit B complex in it should help though!

THE PROGRESS:
Progress has been very slow. We've had some good days and some flat days but I was told to expect that. Each day he seems to do something new though.  He's still in a coma technically, but he is definitely aware of what's going on around him.  I mentioned that when he was in the hospital he'd do a lot of sighing when the techs when to coupage him or do range of motion exercises or give him meds.. he's still doing that, but he's also doing it when the other dogs get all excited and bark around him (nobody touching him or near him). We know he can hear. Here's what he's done so far:

1. Still stretching all 4 legs and occassionally his neck
2. Slid his head about an inch to the side to readjust (hasn't lifted head yet)
3. Gets really agitated when he has to urinate (once he urinates he's ok and calms down)
4. He has moved his left front paw twice when he's been agitated and needed to urinate - just the paw up and down
5. He also moved his left front paw up and down twice in a row when Buttercup and I sat down with him
6. He is showing resistance when he's doing range of motion exercises and will push back
7. He has slid his left front leg twice to reposition it - just a couple of inches
8. He just stretched and flexed his right front paw (which he is laying on)
9. While his position was being adjusted the other day, he kicked out his left leg to try and push and stop being rotated, definitely purposeful
10. He has flicked the tip of his tail a number of times
11. He licks his nose if you put something on it and can put his tongue right back in his mouth where it belongs.. his tongue is getting much stronger and movements are much more purposeful
12. He can open and close his lower jaw without any issues now. He yawns, stretches his jaw, opens and closes his mouth sometimes just to do it, will open his mouth to try and lift up his head when he's in a sternal position
13. He's grunted a few times but not sure why (could be a reflex or just testing his body)
14. Tonight he barked or growled at me - or some kind of combination
15. Today he pooped for the first time and was pushing hard to poop

EXPRESSING BLADDERS:
Who ever came up with this is GENIUS!! Not only is it a good thing for a dog who won't urinate on their own - which Max WILL do if left to his own devices - I just love the fact that I can help him express his bladder and not worry about accidents!  I received a hand out on how to do it, but there's a video I found of a paralyzed dog having his bladder expressed which was REALLY HELPFUL!

If only Max was a little smaller, and I could hold him over the toilet!  I actually just slide him to the edge of his bed, put a pee pad under him so that his urine goes down hill on the pad and it's an easy clean up!


RECOMMENDED EQUIPMENT:
Our house is a single story which makes life a lot easier to move Max around the house. (I've lived in a 4 story house with a golden retriever who couldn't walk and we all ended up moving to the main floor so she wasn't alone!)

1. Diaper Genie
2. Box of pee Pads - the cheapest place to get them I've found is http://www.valuepetsupplies.com/puppy-pads.html
3. A boogie board (to put under the dog bed to help keep his body in line, also helpful to carry him without having him slide off his bed, you can pick him up and put him on your bed, or put him on the floor, and can put the head end of the board on a pillow to raise his head while feeding (head needs to be higher than stomach with the feeding tube)
4. Gauze - to help keep feeding tube ring from digging into his tummy after it's first put in
5. Neosporin - for feeding tube port until it's totally healed
6. Small kids 100% cotton T-shirts or tank tops (wash before you put them on) They should be tight - and are good to cover the body and the port to help keep it clean. You may need to cut the arm pits and neck to make sure it doesn't cut off circulation to your dog's arms or legs
7. A waggon (gardener's wagon, or red wagon) You can lift the whole boogie board with the dog bed on it and put it in/on the wagon and wheel your dog easily from one side of the house to another
8. towels - always have a few extra handy just in case. They are good for proping up the body when you put them sternal, or propping up the head
9. Extra big feeding tube syringes.. It didn't take me long to completely KILL one of the ones I was given!
10. Roll of papertowls
11. Sanitary wipes (women's or baby's will work to clean up accidents - we haven't used these much at all!)

One thing that is HIGHLY .. did I say HIGHLY?!!!  HIGHLY recommended!
If you have a veterinary tech who you can pay as a dog sitter for a day.. take some time off.  It helps to re-energize you, put a new perspective on things, and let's you step back a bit.  Today I had to go to personal appointments I had made a couple of months ago and if I canceled the appointments it would take a couple more months to make them again. Our amazing friend Amanda who is a surgical vet tech came over to feed, rotate, coupage, give Max his meds and check on him did an amazing job! and gave me the piece of mind I needed to be able to run up to my appointments!  (YES I was a total mess.. but the good news is that my blood pressure was actually normal! I still find that hard to believe!)

I'm sure there's more that I can write but sleep deprivation is setting in... I'm about to give Max his 11pm feeding and then we're off to bed for the next 6-7 hours and then we'll wake up and feed again!!!