Advice for a young, fully incontinent dog because of an injury

We rescued a small dog off the street. Vets say she's about 1-2 years old. She had some kind of an injury to her tail or lower back, which caused her to lose feeling in her tail, and be fully incontinent, both fecal and urinary. We did X-rays and the incontinence is caused by nerve damage in her lower spine. She walks, runs, and behaves normally aside from the incontinence. The vets gave us LOTS of pills and vitamins, including B vitamins, Omega 3/6/9, Magnesium, Calcium, and a LOT more. Every vet we've talked to either says there's no chance of recovery or very low chances of recovery. We live in North Macedonia, so there aren't even any options available for spinal surgeries. It's difficult enough to find a decent vet for normal consultation and medical advice. Anyway. We've bought diapers, pads, and we've learned how to do bladder expressions so we can "empty out" the bladder so she doesn't dribble pee all the time. The urinary incontinence seems easier to manage, at least compared to the fecal incontinence. So is there any advice on what we can do in regards to fecal incontinence? Any medications or therapies you can recommend that would help in healing nerve damage and restoring anal sphincter muscle control? Sometimes her poops are hard and larger, which is easier, but sometimes her poops are soft and smaller, which makes cleanup harder. What could we do to control her poops and make them harder, larger, and maybe less frequent? Regarding Proin and urinary incontinence, I don't think it can help in our case, based on my (unprofessional) opinion - because her urinary incontinence is caused by nerve damage, not caused by hormonal issues/spaying. Any advice or tips are welcomed, as this is the first incontinent dog we're taking care of.

Hello - it sounds as though your dog may have a LMN lesion to the spinal cord S1-3.  Nerve damage involving the lower back can be difficult to diagnose from X-rays, but your vet will perhaps have the context of the history and neurological examination. It is a huge undertaking to look after such a patient long term and not the right choice for everybody.  I dont know you, but I think it's only fair to say to anyone that if you find that this is too much to cope with, no one would have any grounds to criticise you.  To find more about making the task easier by dietary means, I imagine that keeping a diary of stool consistency and diet might be useful in identifying causative foods for your dog - there would be a few days lag between the two.  Furthermore, ask your vet to contact neurological specialists for advice - it is not common to meet owners willing to support a doubly incontinent dog, but there will be people doing it and both the internet and vet specialist networks might prove crucial in linking you together.   I am sorry not to be more helpful than that at this stage.

Finally, it is important to take care of the skin should any feces or urine be coming into contact with it; this can be seriously damaging to the skin's surface and lead to infections, so protecting the skin - and in some cases shving the hair - is a good thing to speak to your vet about.   For me, the priorities would be to: 1) establish with the vet whether this is a long-term condition or something that may resolve; if long-term to consider the realities of the situation and be realistic and whether you can provide the level of care required to support your rescue dog through this condition, with a good quality of life.   2) To set up a routine, paying attention to cleaning, drying, skin-care, diet and so on that keeps your dog as cmfotmrtable as possibe.  This is difficult and some trial and error will be involved.  Consulting experienced specialists or those who have done it before may be especially helpful. Wishing you both all the best, wherever things go from here.  

Finally, it is important to take care of the skin should any feces or urine be coming into contact with it; this can be seriously damaging to the skin's surface and lead to infections, so protecting the skin - and in some cases shving the hair - is a good thing to speak to your vet about.   For me, the priorities would be to: 1) establish with the vet whether this is a long-term condition or something that may resolve; if long-term to consider the realities of the situation and be realistic and whether you can provide the level of care required to support your rescue dog through this condition, with a good quality of life.   2) To set up a routine, paying attention to cleaning, drying, skin-care, diet and so on that keeps your dog as cmfotmrtable as possibe.  This is difficult and some trial and error will be involved.  Consulting experienced specialists or those who have done it before may be especially helpful. Wishing you both all the best, wherever things go from here.  

Would these Xray photos provide any more context/info on the exact issue she has? Just so I know what the chances of recovery or surgery/therapy options are.    

Im sorry but this is not my patient or case and I have not been asked formally to get involved; on this site, we aim to get you working constructively with your own vet in a professional way.  I know nothing about the context under which it was taken.  As such i have not looked at this x-ray.