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Post by Aimee & DixieBelle on Nov 12, 2013 12:25:22 GMT -7
Dixie Belle was the feature story in October's issue of Dodger's Digest. (see Dixie Belle-Bell of the Ball).
October 23 Dixie Belle had another episode. She cried in pain and trembled and since I recognized the signs I knew it might be another disc problem. I immediately started her on 100% strict crate rest 24/7 and watched her closely. Since she did not improve 100% and was still in pain I took her to the Vet School on October 31. This is where she had got her surgery back in May 2012. They ran a CT scan on her and discovered that she has another ruptured disc in her neck but it is not as bad as it was last time because I caught it early. They showed me the CT scan of her first disc too, which looked terrible and would have never gotten better without surgery. They said this one was very recent and that it was good that we caught it early. It also does not look near as bad as the first one did. They put her on Diazepam, Tramadol, Prednisolone, and Gabapentin. I researched all of the drugs and ask the doctor a lot of questions before I started administering them. Dixie Belle is also being treated by the best Neurologist in Starkville. He works closely with the vet school and also has his own practice. He did her first surgery and did a great job. When I took her in on the 31st I ran into him and requested that he take over her treatment closely, which he has gladly done. Since the disc was caught early they are hoping that it can be treated with meds and will not require surgery. We go back to the doctor, Neurologists, on Monday and they will re-evaluate her to see what needs to be done next. Please pray that the disc will heal and that it will not require surgery. I am prepared to pay for it if surgery is required because this dog means the world to me and I will do whatever it takes to help her.
She is eating and drinking okay and does both jobs regularly. He stool looks normal and I watch it closely for any changes. I make sure she does not run outside and it is a lot easier this time since I bought a house and she has a fenced in back yard. There are also no stairs to climb and she can just go from the kitchen outside. It is a lot easier on the both of us. Her pain is under control with the meds she is taking so that is good and is a lot better than last time.
I am so thankful that thanks to this group here that I was able to recognize the signs early and take care of her before things got worse. I am still always open to any help and advice this group can give me.
Aimee Foster (Dixie Belle's mom)
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Nov 12, 2013 17:02:48 GMT -7
I'm so sorry that Dixie Belle is having another problem, Aimee. From what you've written here, it does sound as though you caught it early and she's a good candidate for conservative care. Great job on getting her into the crate ASAP and to the vet for evaluation. Could you please let us know the exact dosage of all meds in mgs and the frequency? How much does Dixie Belle weigh? Please get your vet's permission to give 5 mg of Pepcid AC (generic is famotidine) 30 minutes before each dose of the anti-inflammatory and thereafter every 12 hours. Phrase the question to your vet in this particular way: "Is there any medical reason my dog may not take Pepcid AC?" If your vet says your dog has no health issues such as liver, heart, etc to keep her from taking Pepcid AC, then do get it on board. The crate rest for conservative care is a lot stricter than for post-surgery. She needs to be carried in and out to potty, only taking a few steps when she does potty. No laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no chiro (aka VOM). In other words do everything you can to limit the vertebrae in the back from moving and putting pressure on the bad disc. You may already be familiar with this webpage with tips that deal specifically with neck episodes but you might like to review it: www.dodgerslist.com/literature/cervical.htmAlso, you should read up on when to consider surgery so you are armed with that knowledge when you meet with the neurologist again: www.dodgerslist.com/literature/healingsurgery.htmMy prayers are with Dixie Belle. |
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Post by Aimee & DixieBelle on Nov 12, 2013 17:54:14 GMT -7
Hey Marjorie. Yes, I am so thankful we caught it early.
Here are her med dosages:
Tramadol 50 mg every 8 hours for 2 weeks
Diazepam 5 mg every 8 hours for 2 weeks
Gabapentin 50 mg every 8 hours for 2 weeks.
Prednisolene 5 mg every 24 hours. She was on this for 5 days.▼ The day after she stopped taking it she started having pain again so the doctor told me to start giving it to her again until I come back on ▼11/18, at which time we will start to taper it.
She weighs 12 pounds.
I will ask again about Pepcid AC. I already asked once but they said it was not necessary but I will ask again just in case.
The doctor knew about Dodgerslist and agreed it is a great place. They were impressed by how much I knew about IVDD and I gave this place all the credit.
Thanks for all of your advise, prayers, and concern.
Aimee
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Nov 12, 2013 19:56:35 GMT -7
Some doctors feel the Pepcid AC isn't necessary until a GI tract problem arises. But we at Dodgerslist follow the proactive doctors who protect the GI tract BEFORE a problem happens. Dixie Belle has enough going on without dealing with an emergency situation and serious gastrointestinal toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms. Tell the vet that you want to be proactive and prevent a problem from happening.
Please keep us updated.
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Post by Aimee & DixieBelle on Nov 13, 2013 6:53:59 GMT -7
I will go on and give her Pepcid AC just in case. I would rather be safe than sorry and I don't think they would oppose but I will let them know I am doing it anyway. The way I see it-she is my dog and I am in charge of her healthcare.
Thanks for all of your help and advice and I will keep you updated.
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Post by Aimee & DixieBelle on Nov 27, 2013 10:06:33 GMT -7
Dixie Belle continues to do well so far. I give her 5 mg of Pepcid AC 30 minutes before I give her each dose of Prednisolone. I give her canned Pumpkin as well. She is being tapered off of her meds and is doing great so far. She is off the Tramadol and I gave her last dose of Diazepam last night.
Her med schedule is now:
Gabapentin 50 mg every 8 hours until 12/18 when we go back to vet.
Prednisolone-started 0.25 mg every 24 hours on 11/20 and will go through 12/3
12/4-12/10 0.25 mg of Prednisolone every other day for 7 days. She will be off this completely after that.
I pray since she has not been experiencing any pain that when she gets off all of her meds she will continue to be pain free. I will continue of course with complete crate rest for another 6 weeks or longer. She stays in her crate most of the time and really likes it. I have made it dark and cozy for her.
Her doctors are very pleased with her progress and they think she could get better without surgery. Please pray she does well when she comes of the Pred.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Nov 27, 2013 10:37:54 GMT -7
Aimee, sounds very good so far on the taper. We've got our fingers crossed for a taper to completion without any signs of pain resurfacing. Graduation day of Dec 18 will soon be just around the corner!!!
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Post by Aimee & DixieBelle on Dec 5, 2013 9:43:30 GMT -7
Thanks Paula. She had a dose (0.25 mg) of Prednisolone on Tuesday 12/3 at 4:00 and will receive another one today. As of this morning at 7:20 (after 15 hours off of the Pred) she was still doing great and was pain free. Yay! Does this mean that the disc is healing and will not require surgery?
Am I correct in staying that inflammation is the body's attempt at self-protection; the aim being to remove harmful stimuli, including damaged cells, irritants, or pathogens - and begin the healing process. When something harmful or irritating affects a part of our body, there is a biological response to try to remove it, the signs and symptoms of inflammation, specifically acute inflammation, show that the body is trying to heal itself. Inflammation does not mean infection, even when an infection causes inflammation. Infection is caused by a bacterium, virus or fungus, while inflammation is the body's response to it. Inflammation aggravates the disc and causes painful signals in the nerve. That is why the disc can not heal as long as she is in pain because of the inflammation that is occurring. As long as the inflammation aggravates the disc then the disc can not heal. That is why the treat it with anti-inflammatory drugs like Prednisolone.
I am still trying to get a full understanding of IVDD. I will never run out of questions and I will never stop doing research. I have learned so much from this group and I am still continuing to learn.
Her last does of Pred is on Monday, 12/9. I pray she will continue to be pain free.
Thanks for all your support, thoughts and prayers. We still have a long road ahead and many more weeks of complete crate rest. She loves her crate and feels very safe and secure in it so it has not been a problem for her.
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Sabrina
Helpful Member 
My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Dec 5, 2013 18:45:26 GMT -7
Hi Aimee, I'm Sabrina. I am so glad to hear that Dixie Belle isn't in any pain! This page outlines signs that surgery could be a consideration: www.dodgerslist.com/literature/healingsurgery.htmWhen surgery is a consideration: -- If your dog can't walk OR with STRICT crate rest, neurological functions worsen and are lost (legs and bladder control) -- STRICT crate rest is employed and after several attempts to go off of the anti-inflammatory, the pain returns -- If 100% STRICT crate rest has been employed and pain medications have been adjusted (dose, frequency, and mix of pain relievers) yet the pain can’t be brought under control -- if a dog is experiencing similar signs of neck or back pain, or mild neurological deficits for the 3rd or 4th time, meaning it may be the same disc is involved. But as Dixie Belle doesn't fit into any of these categories now, it sounds like she's on the way to recovering from this disc episode with conservative treatment. Well done on continuing to give her the crate rest that she needs! I think your understanding of inflammation is correct (though I'm still learning about IVDD myself, and I'll let others who are more knowledgeable reply!) - although I have read about dogs who because of other health complications have not been able to be on anti-inflammatory drugs. Those dogs still need pain medications to completely control their pain, and they need longer for their bodies to recover because they don't have any help from an anti-inflammatory drug to speed up the resolution of the swelling/inflammation. But when there aren't other health complications, anti-inflammatory drugs are used to resolve the swelling/inflammation asap. This page has a great overview of the 4 stages of healing from a disc episode. I find myself reviewing it often! www.dodgerslist.com/literature/healingpage.htm (scroll down to see the 4 stages) Here's to a successful steroid taper for Dixie Belle! ))Hugs!(( - Sabrina |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Dec 6, 2013 12:10:46 GMT -7
Aimee, below is just a summary..for the entire concept of a disc problem and how things heal: www.dodgerslist.com/literature/healingpage.htm
A disc problem is all about the worry of the disc doing damage to the spinal cord. That is why it is so important to let the disc heal itself before serious damage to nerves is beyond repair. Discs---- movement aggravates or worsens a disc problem as weak early forming scar tissue can easily be disrupted with too much walking around. There are no meds to heal a disc just limited movement for 8 weeks. A damaged disc can start with a painful bulge or pushing against the spinal cord. Worsening would be a move to a severe rip sending pieces of disc material into the vetertebrae's narrow spinal cord canal area.
Nerves ----The spinal cord's nerves do not like be to pushed on or pressured. Inflammation and swelling aggravates nerves. Too much pressure, the nerves react by dying (loss of neuro functions). Swelling is a painful thing.
Pain --- The pain can with time, often of 1-2 weeks, be resolved with an anti-inflammatory. The dog should not suffer with pain in the meantime. Pain meds work very fast when they are correctly prescribed for the dog's needs…. in one hour pain relief can be achieved with the right dose in mg's, the right frequency and the right combo of pain medications.
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Post by Aimee & DixieBelle on Dec 6, 2013 13:54:36 GMT -7
Thanks for the additional information Sabrina and Paula. I fully understand, once again, why crate rest is SO VERY important. I wish I could keep her from jumping up and down at all. She does it when she is in her crate. Her crate is in the kitchen. I tried to move in the bedroom so she would be away from everything but she did not like that. Guess she was afraid she would miss something. The crate I was keeping her in limits her jumping but there is no place to put her water bowl. It is a Polka Dot Collapsible Dog Crate that I got from Amazon to carry her back in forth to the doctor. I put a piece of plywood in the bottom to make it sturdy.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Dec 6, 2013 17:57:24 GMT -7
If you now have Dixie Belle in a wire crate, Aimee, you can lower the height of the crate with a piece of cardboard. Punch holes in the corners and tie it down into the top of the crate with some string to create a lower ceiling. Hope that helps.
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Post by Aimee & DixieBelle on Dec 6, 2013 19:17:53 GMT -7
Thanks Marjorie. I will try that. My mom, who is with her most of the day while I am at work, says she does not jump much during the day. It is mainly when I get home but is okay when she gets settled. I don't want her jumping at all so even a little is too much for me so I am willing to try anything. She is still doing great and has been pain free so far so I am happy about that. She sure has not lost her appetite. I gave her a few bites of apple tonight because I heard that is good for dogs. I also read oatmeal and blueberries are good so I am going to give her that tomorrow. I am trying to get her weight down again because she put on some weight from the Pred. I am sure she will go down after she gets off of the Pred.
I also use a homedics sound machine that imitates the sound of the ocean or rain and that seems to keep her calm.
Aimee (Dixie Belle's mom)
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Post by Nancy & Polly on Dec 7, 2013 12:05:47 GMT -7
You know, I have one of those sound machines, but I never thought of using it to calm the dog. Brilliant!
I was a little concerned when you said she was loose in the back yard, and that she is in the crate MOST of the time. I've been through this twice, as well, and know how hard it is to be strict with the crate rest, but it's SO vital. I hope I just misunderstood.
Keeping my fingers crossed that the rest of the 8 weeks go smoothly! Conservative treatment can and does work. Hang in there!
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Post by Aimee & DixieBelle on Dec 8, 2013 6:19:04 GMT -7
Oh no, I never ever leave Dixie Belle loose in the back yard and she stays in her crate all of the time. I can't find where I ever said that. I know how important strict 24/7 crate rest is because this is my second time to go through this. She jumps when she is in her cage. When she goes out side she is on a leash and walking is limited. I also use a harness. When my mom is home during the day Dixie Belle stays in the crate and mom only lets her out to go potty. Mom is very serious about her treatment and has helped me so much. She loves Dixie Belle and wants her to get well as much as I do.
Thanks for your concern and sorry about the misunderstanding.
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Post by Nancy & Polly on Dec 8, 2013 16:40:33 GMT -7
"She stays in her crate MOST of the time and really likes it."
I copied that from one of your posts. That and your saying that you didn't let her run in the yard, making me wonder if she was loose or not. Thanks for clarifying. I know I sound nosy, but there is so much information here to digest, that I worry people might miss a point or two. I know I did. Continued good luck to you!
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Post by Aimee & DixieBelle on Dec 9, 2013 6:58:48 GMT -7
Oh my, I can't believe I said that and I can see why you would get alarmed. I don't think anyone on this group is nosey. I love this group because everyone cares and treats Dixie Belle like they own her and that she is their dog. I appreciate that so much. Thank you for caring about her enough to point out my mistake and for showing your concern.
She still continues to do well and still has not been experiencing any pain so far. She takes her last does of Prednisolone today.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Dec 9, 2013 8:05:48 GMT -7
Aimee, I agree with you, this group IS the best. All the dogs on this Forum are part of the Dodgerslist family. Pollysmom and others read posts with a fine tooth comb looking for any clues that could better help a dog. We have to take what is written literally because we are not there to see for ourselves. So glad you clarified! So pleased to hear the taper is coming to conclusion today and still no signs of pain. Dec 18 will be graduation day! We would LOVE to see some photos of that day, how you are doing with a gradual introduction back into physical activity and how much fun is it to again cuddle with Dixie Belle. So get out that camera…here is the information on uploading those pictures to the Dodgerslist Gallery. dodgerslist.boards.net/thread/260/upload-photo-dogSome ideas plus a plan on that gradual build up of stamina after graduation day: www.dodgerslist.com/literature/AfterCrateRest.htm |
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Post by Aimee & DixieBelle on Dec 9, 2013 8:23:19 GMT -7
I am so glad that ya'll read the posts with a fine tooth cone. Another reason this group is great. Dixie Belle is alive today because of this group. I will never get offended by anything ya'll tell me because I KNOW you care about my baby.
Thanks for all the additional information. I always love posting pictures of my sweet Dixie Belle so it would love to do that on graduation day. It is so much fun to cuddle with her and I look forward to doing it again and I can tell she can't wait either.
She may not have to have surgery but do you think physical therapy will help her and if so what kind?
I feel so honored to be a member of the Dodgerslist family. That does not mean I am glad she has IVDD. It means I am glad that there is a place I can go to get help, learn everything I can about IVDD so I can help her and give her the best care. This place also gives me hope and encouragement and reminds me that there is life after IVDD and there is hope for an IVDD dog. Hugs to all of you!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Dec 9, 2013 8:55:04 GMT -7
Since Dixie CAN walk, likely the PT would be walking, gradually building up her stamina to eventual long walks at a fast pace of up to a mile. Walking, swimming are low impact and help to strengthen the core muscles which are important in support of the vertebrae.  |
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Post by Aimee & DixieBelle on Dec 9, 2013 9:00:48 GMT -7
Is this type of physical therapy something I can do on my own? Can I do some type of therapy with her in the bathtub? Would putting her in a warm bath help her? I wish I had a swimming pool but when summer gets here I could get a kiddie one that she can swim around in.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Dec 10, 2013 9:19:46 GMT -7
See how she is after the 8 weeks of crate rest as no type of PT or water therapy can be done until then. As Paula said, all she may need is to build up her muscles and stamina which walking will take care of. If you see that she needs anything further, water therapy can be very helpful. It would be a good idea to have one visit with a therapist to show you the correct way to do that type of therapy and then you can do the exercises in a bathtub or small pool. But only after the 8 weeks of crate rest are finished. Here's our info on water therapy: www.dodgerslist.com/literature/watertherapy.htmAs you can see from the following link, re-introduction to movement will be very gradual after the 8 weeks are done so you'll have plenty of time to assess how well she's doing. www.dodgerslist.com/literature/AfterCrateRest.htmI'm sure you're counting the days until Graduation Day! We're counting with you!  |
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Post by Aimee & DixieBelle on Dec 10, 2013 14:49:47 GMT -7
Thanks Marjorie. Yes, Dixie Belle and I are both counting the days too. I have become friends with her physical therapist and she is also one of my Facebook friends. She did physical therapy on Dixie Belle when she ruptured her 1st disc and she fell in love with Dixie Belle. Dixie Belle loves her too and gets so excited when she sees her. I know she will not mind helping with her physical therapy and giving me advice, should she need any PT. She loves Dixie Belle so much in fact that if anything ever happens to me she said has agreed to take Dixie Belle for me if I were to die or something. I know that sounds creepy but I want to make sure Dixie Belle is loved and taken care of should anything happen to me. I would not just leave her with anyone and it takes a special person to take care of her since she has IVDD.
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Post by Eileen&Maria Rose on Dec 10, 2013 17:52:53 GMT -7
Dixie Belle is in my thoughts and prayers. She is a pretty girl!
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Post by Aimee & DixieBelle on Dec 11, 2013 9:56:32 GMT -7
Thanks Eileen. Your baby is pretty too and I will keep her in my thoughts and prayers as well.
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Post by Aimee & DixieBelle on Dec 16, 2013 13:56:30 GMT -7
Even though Dixie Belle graduates on the 18th I still don't want her running lose in my house for a very long time so I want to use a stroller. I know what steps to take to prevent her from jumping. I bought a stroller from Amazon for her a year ago but after I received it I discovered it velcros and does not zip so Dixie Belle is able to get out of it. I don't use it for her because of that. I want one that zips and has plenty of room. Also, it has one wheel in the front verses two. Does that matter? I found some really good ones that have 2 wheels on the front. Please advise.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Dec 16, 2013 19:52:25 GMT -7
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Post by Aimee & DixieBelle on Dec 19, 2013 7:14:33 GMT -7
Thanks for the info Paula.
Dixie Belle graduated yesterday. YAY!
They said she was bright, alert and responsive and showed no signs of pain. They said she did not require surgery at this time. She is going to stay on the Gabapentin for another 2 weeks. She takes it 2 times a day for a week and then 1 time a day the next week.
Lifestyle changes include no jumping on/off furniture, no excessive rough play with housemates, no walking around the house without being monitored, and wearing a harness when going for a walk.
Last time Dixie Belle ruptured disc C4-C5. She had surgery.
This time:
On 11/1/13, a CT scan was performed and revealed a foraminal disc extrusion at the level of C7-T1. Dixie Belle has been conservatively managed and is doing well.
Even though she has graduated I am still going to continue with strict crate rest for another 2 weeks to give the disc more time to heal.
I will post some pictures of her as soon as I get a memory card for my camera.
Thanks everyone for all your encouragement, thoughts, and prayers.
Aimee (Dixie Belle's mom)
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Dec 19, 2013 7:33:47 GMT -7
I'm so very glad to hear that you're going to continue with the crate rest for another two weeks, Aimee, mainly because Dixie Belle is still on a pain med. As long as she's on a pain med, which is masking signs of pain, it's impossible to tell if there is still swelling on the spine. So movement still has to be severely limited. Also, Dixie Belle might try to do more than she should since she doesn't feel any pain.
Did they say why they felt she needed to remain on the Gabapentin? Usually, that is tapered when the anti-inflammatory is tapered and stopped when the anti-inflammatory is stopped. That's a true test for pain. If there is no swelling, then no meds would be needed and she would be able to gradually be re-introduced to movement again.
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Post by Aimee & DixieBelle on Dec 19, 2013 7:48:44 GMT -7
Thanks for all of help Marjorie.
They were trying to taper her off all the meds one at a time. They took her off of the Tram first, then the Pred taper, and now the Gab taper. I think they wanted to taper each one of them at a time. She was taking the Gab 3 times a day so they want her to take it 2 times a day for a week and then 1 time a day for a week in order to taper her off of it verses stopping it abruptly. That is the only reason she has to continue with the Gab.
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