Dogs suffering from severe signs of rapidly progressive paralysis should be hospitalized until the progressive stage of the disease is stabilized. Usually, this takes at least 4 days, and it can take longer. During inpatient treatment, veterinary professionals will monitor the patient closely and provide intensive supportive care, particularly for dogs with respiratory distress. Mechanical ventilation may be used if the dog’s breathing is severely compromised or if it is otherwise necessary to provide oxygen support. Most affected animals retain their desire and ability to take in and swallow food and water, as long as they can get to it with their limited and worsening physical mobility. Fluids can be administered through an intravenous catheter if the dog is dehydrated from being unable to reach or drink water. Other inpatient therapies may include manual expression of the bowels and bladder (normally unnecessary) and administration of intravenous antibiotics if infection occurs (uncommon with this disease).
Once a dog is stabilized, owners usually can continue providing supportive care at home. As mentioned above, most affected dogs can eat and drink if they can reach their food and water bowls. They often must be hand fed and have their water bowls brought to them because of muscle weakness and paralysis. Their appetite and degree of thirst should be normal, and they should not need any particular dietary restrictions or changes in most cases.
At home, the dog will need to be turned frequently to prevent pressure sores and possible lung collapse (called “atelectasis”). It will need extremely good padding, such as an air mattress, waterbed, lounge chair pad, regular bed mattress, fleeces, sleeping bags, blankets, straw or other lofty and soft forms of bedding to lie on. The outer layers of bedding will need to be changed and laundered often, and the dog will need to be cleaned frequently, until muscle function returns to normal. This is critical to prevent or reverse muscle atrophy and to prevent urine scalding, which can be severe and lead to secondary infections. Affected animals normally will not require their owner’s assistance to urinate or defecate, but their limb paralysis will prevent them from moving voluntarily to an appropriate place to accomplish these bodily functions. They will have to eliminate wherever they are bedded down. In-home care can be difficult and impractical for many owners, and it may be too much for one person to manage alone. Professional pet sitters, friends, partners, spouses and other family members can be recruited to help to with the necessary tasks to ensure that the dog gets the care that it needs to recover successfully.
Physical therapy is critical to the dog’s recovery as well. The attending veterinarian is in the best position to discuss the types of therapeutic exercises that are best for a dog recovering from Coonhound paralysis. It seems to be more important that physical exercises be performed correctly than that they be performed frequently (but incorrectly). Generally, owners should encourage as much managed activity as possible, despite the fact that most dogs are temporarily paralyzed in all four legs (tetraplegic). Each of the legs should be passively stretched and flexed by hand – called “range of motion” or “ROM” exercises – in a manner described by a veterinarian or veterinary physical therapist. When the dog begins to recover limb function, its owner will need to help it stand, put its limbs in the right place, shift weight, retain balance, turn, walk, exercise and otherwise regain muscle strength, stamina and control. Therapeutic massage and swimming exercises have been found to be quite helpful to dogs recovering from this disease, as well.
Most dogs begin to improve after the first week of supportive care, but actual recovery can take months. Some dogs recover spontaneously. Some dogs never recover completely, but this too is uncommon. Normally, the prognosis for full recovery is good. Owners should know that their dogs’ chances of developing this disease do not decrease after they have had it once. In other words, affected dogs that have recovered fully are just as likely to get Coonhound paralysis again - especially if they are outdoor dogs repeatedly exposed to wild raccoons.