Sunday, November 2, 2008
You think you can foresee the work involved when you think about caring for a paralyzed dog. And for the most part, you're probably right. But there are tons of little things, little problems you don't know enough to consider until you're actually experiencing them.
I knew it would be extra work to care for Popeye when I first made the decision to take him in. I figured it would involve diaper changes and lots of carrying him around, and I think that's about as far as I thought about it.
One thing it definitely has been is a challenge--not physically or emotionally (except for the first week) but creatively. I see something not working out or think it can work better and I want to fix or improve it. At least when it comes to caring for Popeye.
I want to state straight out that I'm not a crafty person--I don't know how to build things or sew or tinker with gadgets. Going to Home Depot is overwhelming because I don't even know what half those things are. So I'm sure a person who is handy would be able to come up with more elaborate and probably better solutions, but I think it says a lot about the will to make it work and the power of heart that somebody as lacking in practical skills as I am has had some successful ideas.
Our diapering system has changed dramatically. Popeye doesn't wear full diapers--we have his bowel movements under control enough to not need them. But he does wear belly bands. The key to keeping his belly band from falling off is still to tie it to his harness. But this is what I used to do:
A regular disposable baby diaper, with the flaps folded down. Poke 3 holes and insert elastic string in each hole.
Tie one string to the d-ring I attached to the front of his harness.
The other 2 strings would be tied together at the back to "close" the belly band. Then I looped a 4th string through those 2 strings to attach to the ring at the back of his harness.
This method worked quite well but it was a minor pain to have to poke holes and insert the strings every single time I had to change his diaper, which was 3-4 times a day, not to mention having to tie each of those strings every time. It also led to a lot of waste (those disposable diapers fill up the trash can very quickly), something the suppressed environmentalist in me wasn't too happy with.
I transitioned to cloth belly bands, mostly purchased from eBay, that required attaching a disposable adult incontinence pad like Depend. I cut the pads in the half, but the cost of these pads really added up and there was still a high degree of waste.
The belly bands that exist for dogs are very simple. Generally they consist of 1-2 layers of fabric and a velcro closing and always require a disposable pad.
I wanted a full cloth belly band so that there would be no added waste. Because Popeye wears a belly band virtually 24 hours a day, I wanted to make sure the fabric was breathable and comfortable. So I started researching cloth diapers for babies.
It wasn't long that I started thinking I was getting in over my head. There is a whole elaborate world of cloth diapers out there. To someone who had no clue, it was all very confusing. There are not only different types of diapering systems like the all-in-one, pocket, prefold, and cover but also a wide range of diaper fabrics, such as hemp, PUL, microfleece, wool, and bamboo. There could be an entire course in cloth diapers.
After weeks of reading and re-reading, I had an idea of what I wanted to make. So I bought the cheapest, most basic sewing machine I could find, a Brother for about $80 (I never in my life that I would ever own a sewing machine).
I also researched the type of closures I would use. I am not a fan of velcro because I always forget to close the velcro before I put it in the laundry and clothes always end up sticking to it and getting pulled or warped. I looked into o-rings, hooks, buttons, things I didn't even know the names for. I finally decided on snaps. Of course, I had no idea how to attach them so had to look into the various methods of that as well. I found the Snap Setter.
At first the thought of doing anything that required the use of a hammer sounded too complicated, but when I watched the video of how it worked, I figured even I could that.
My first several creations were basically throwaways. I was still learning about the design specifics and measurements as I went along, something I still haven't gotten completely down yet. But here's what I eventually came up with:
An outer layer of water resistent & breathable Windpro by Malden Mills, which keeps the moisture from seeping out and wetting Popeye's bed or the carpet or your hands. Top and bottom have elastic (I had to learn how to sew that too) and the ends close with snaps. Elastic strings with snap closures to attach to the harness are also sewed to the top.
An inner layer of microfleece by Malden Mills, which has wicking properties so that moisture is pulled away from the skin. I also sewed a pouch in the center to insert a soaker, which would be the primary method of absorbing the moisture.
There are 3 types of absorbant materials I've tried so far.
Hemp/cotton blend is said to be highly absorbable, breathable, and machine-washable. Hemp is also naturally anti-microbial and resistant to mold, mildew, rot and degradation by UV-light. Minor cons are that it is bulky and every once in a while has to be "stripped" by washing with a tiny amount of dishwashing liquid like Dawn in order to rejuvenate its absorbancy properties.
Zorb is one of the latest technologies in cloth diapering. Zorb contains fibers from bamboo/cotton/viscose and poly micro fiber and is purportedly non-allergenic, durable and easy to sanitize, plus it's very lightweight. Minor cons are I don't think it is breathable and it doesn't look like it will last as long as other fabrics.
Wool is my most recent discovery. Wool can absorb up to 30% of its weight without feeling damp, is breathable, water repellent, and anti-bacterial. I hesitated using wool because it requires special washing using lanolin and can't be thrown in with the rest of the laundry. I'm not a housekeeping sort of person, so any fabric I can't throw in the machine and forget about is considered too much trouble to care for.
But then I found out that wool has a "magical" property as well. I don't pretend to understand the science behind it but apparently the lanolin reacts with urine and neutralizes it, so all you have to do is air dry it and it will still smell fresh and can be reused without washing. Google it--I'm not making that up! And people are doing that with the wool they use on their own human babies, so you know it's the real deal. Anything that you can wash less is a huge plus in my book. You only have to wash every few weeks with special detergent to replenish the lanolin. I haven't had a chance to incorporate wool on a large scale yet, but I did air dry a urine-soaked piece of wool and as touted, it felt and smelled as good as new.
I also changed Popeye's harness. Dr Burke, a vet chiropractor, had mentioned that another one of her clients had a soft mesh harness for her dog. So I tried a Puppia and Ipuppyone harness on Popeye and really liked it. The problem with attaching his belly band to his harness is that the weight of the band pulls down on the harness, causing particularly the neck strap to dig somewhat into his neck. A mesh harness distributes the weight a little more evenly against his chest and shoulders. It's not a perfect solution but better, especially since I tweaked it a bit.
We start with a regular soft harness.
I sew 3 d-rings to it, 1 on front and 2 at each side to loop the straps of his belly band through.
I also sew a few layers of scrap microfleece along the collar to provide more cushioning since the collar does inevitably press down against his neck with the weight of the belly band.
Just recently, I also lined the inside of the strap that touches his back with some microfleece as well to soften it against it skin.
End result. May not be the prettiest thing but it's functional.
So how exactly do I handle Popeye's incontinence? It's probably easier than you think, once you get used to it.
I had mentioned in a previous blog that we got a crib to serve as a changing station because the mattress was elevated so I didn't have to bend over as much.
I now rarely change Popeye's belly band in the crib, and instead have a new setup outside.
The fact that it is outside means that messes are easier to clean. I can express him, change him, bathe him, all in 1 place.
In case you missed it, the metal cage on which everything rests is a humane animal trap. I had purchased it when I was helping to search for a missing dog belonging to another rescue, and the dog was successfully trapped in it. It just happened to be just the right height for me and was only taking up space in the garage (thank god I don't have to use it often for the purpose for which it was intended). I think it works out better than a table would because water drains right through it.
The plastic bin is a regular storage bin that Popeye perfectly fits in sitting down. Accidents are rare nowadays but when they happen, washing his lower body in the plastic bin outside is an easy thing to do that only takes a couple of minutes and doesn't require bending down on my part as it would in a bathtub. Popeye is also less freaked out being bathed outside than he is in a bathtub. There are holes drilled in the bottom of the bin so that the water drains out as I am rinsing Popeye off.
So this is how I change Popeye's belly bands.
I don't really have to express Popeye's bladder because the way he sits and moves naturally puts pressure on it, so he generally expresses himself. However, every time I change him, I do give his bladder a squeeze and sometimes urine does come out.
I then wipe him with a sensitive formula baby wipe.
I always have a new diaper ready to go with some corn starch sprinkled on. Corn starch helps to absorb moisture.
I used to rub (Vitamin) A&D ointment on his underside to prevent diaper rash but he's never had diaper rash so I skip that step now.
Snap his belly band closed.
Loop the elastic ties through the d-rings and snap close.
What I do use the A&D ointment for is on the areas of Popeye's legs that have been scraped from his dragging. A&D oinment helps heal dry, chafed skin, and protects & soothes minor cuts & burns. Note: Only use ointment without zinc oxide, which is toxic to dogs. And Popeye loves the flavor of A&D for some reason. I think he'd lick the whole jar if he could.
It's mostly the joint areas that get scraped since those are the parts of his legs that rub against the floor the most.
Between his thighs too, though this area is already mostly healed.
I used to be pretty lax about making him wear the mermaid sacks, but now he wears them whenever he is outside and during most of the day inside the house. They also prevent him from licking off the A&D.
Double voila. The whole process takes less than 5 minutes and is performed 3-4 times a day.
My father just built this support stand to hold Popeye's lower body up, to which I wrapped some fleece around to serve as a cushion, so that both my hands would be free to change the belly bands, but it turned out to be more awkward to use it than not, so I don't. Just one example of the "failed" solutions (there were many of these during the early days).
So what about his bowel movements? Luckily the raw diet I have all the dogs on keeps Popeye's poop dry and firm, so that any occasional accidents are generally easy to clean up--just pick up and toss, maybe a quick wipe. I also try to add pure canned pumpkin to his diet regularly as a precaution because that also keeps the stool solid.
I have found that expressing the bowels is easier to do if Popeye is in a crouched position because that generates the most pressure against his bowels. I found this video showing one way to express bowels and it's the method I tend to use now, except I think I apply more pressure than the video shows.
I tried doing it over a toilet like in the video but Popeye gets freaked out in the bathroom, plus he tenses up when he is being carried. Sometimes I try to express his bowels while he is sitting in his stroller. I use the angle created by the side bar and the front platform of the stroller.
I place a small towel there to provide a cushion.
And then I have Popeye park his bum there.
I don't actually use this method very often anymore. If Popeye is laying down in the house, I find it easier to just express him where he is laying. It's a much smaller production that way than the above method. He has learned "down" and this makes expressing him even easier. I sewed zippers into his mermaid sacks so I don't have to take the sack off to do it.
When he races and jumps around is when he applies the most pressure against his bowels and that's when he's most likely to have an accident. Sometimes I partially unzip his mermaid sack so that his rear is sticking out but the rest of his legs are covered, like the above picture shows, and let him bounce around on the lawn outside so that the stools fall out on their own.
Manually expressing the bowels is not a perfect act, so even if you do it on a schedule, you'll still get a random stool here and there. I don't think I'm very good at it anyway. That's why I find it more effective just to check him periodically throughout the day as he's laying around. To check him, I just squeeze the skin on either side of his anus. If I don't feel anything, then I don't do anything.
If I do feel something, I just place a napkin under him and do the rub/squeeze thing shown in the video. The stool comes out on the napkin and I just toss in the trash outside. I don't actually think this is considered expressing the bowels, but rather just squeezing out the stool that's already passed through the bowels and is sitting in the rectum, already waiting to come out. It literally takes less than a minute to do it this way so I don't have a problem with doing it this way.
So far I've mostly discussed how I handle Popeye's incontinence. And I would say that is probably the biggest job as far as caring for him. The secondary part of caring for him is dealing with his inability to walk on all 4 legs. This part, surprisingly, doesn't require much work at all, especially with the mermaid sacks.
The one he is wearing in the above pictures is a basic one made from a bed sheet. I added a long zipper and a few straps on top to attach to his harness. This seems sufficient for around the house. The more elaborate ones are used for outings to the dog park and such. These are still a work-in-progress, but I've found it easier to just start off with a pair of men's sport pants:
I sew cushioning around the bum area which has to go completely around because as Popeye moves around, the sack invariably twists around his body so what started off being the back side ends up at the side or front. The cushion provides a little protection for his rear, which lacks muscle and fat. I then line the outside with some type of waterproof nylon so that it's easier for him to slide around and he's also protected from any wetness outside. One of the problems I see with this sack is that it's heavier so I don't think it's as comfortable for Popeye, though he never acts like it's bothering him.
The one thing Popeye can't really do, even with the mermaid sacks, is go on walks outside, unless his rear is being supported with some type of sling or he's being wheeled, because of the concrete. When he gets his cart, even this won't be a problem anymore.
Although Popeye only uses 2 legs, he's really completely mobile and I never have to carry him from one place to another anymore. At most I lift him only to put him in his crib when we are out for long periods, to change him, get him on the bed, or to get him in and out of the stroller. Even then, on a typical day, I only lift him about 3-5 times.
We consciously try to create a setup in our home that minimizes the need to carry Popeye. Our backyard has a concrete patio from the back door to the lawn, so we used to have to carry or stroller him to the lawn. But I just put a trail of rugs down so that he can now travel the distance himself.
We used to put Popeye in a crate every night because we crate-train every dog. But that required lifting him inside the crate. So I instead created a sleeping area that was low enough for him to get onto by himself.
And I use a small baby gate propped between the wall and the bed frame if I feel the need to "crate" him at night (which I seldom do anymore).
It's obvious I've learned a lot already about the ways to take care of Popeye, and I'm sure there is much more I will discover. This is one of the reasons I wanted to foster Popeye, because I wanted to learn more about caring for a paralyzed and incontinent dog. Now is a far cry from the first week, when I was devoting half my day to looking after Popeye. Today, I don't think I even spend 1 hour combined in handling the day-to-day things.
I'm not sure what other people will think when they read all this. Maybe to some, it's a lot of work. But to me, especially now, it's no different than having a particularly energetic dog that you have to take on long walks multiple times a day, or a dog with constant allergies or behavioral problems, one that's not housetrained, or even one that just sheds a ton and requires daily brushing. It's no different than having a puppy! Maybe it requires a little extra effort on the owner's part to handle an issue that most other owners don't have to go through. But if you have a dog in the first place, you are in some way already devoting extra time and energy to caring for that dog. The form that takes will just be different with each dog.