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Post by Lilli & Mae on Dec 3, 2013 12:22:30 GMT -7
Paw waves from Germany... First of all I want to excuse myself for my mistakes or maybe wrong words... Mae is a 5 year old dappled Doxie - she has two Doxie sisters, a Border Collie sister and an English pointer brother and... we are new to the subject IVDD and we feel like we'd be living in a developing country  . We feel sad and helpless and like standing in front of a huge mountain called 'IVDD' All started last Wednesday (11/27) during a walk in the forest. Mae didn't want to walk when we left the car and showed signs of limping with her right front leg. She didn't want to sniff or run around like she usually loves to. I stopped, walked over to her and when picking her up I felt her shivering. Mae has epilepsy too since three and a half years and the first seizure happened when another dog ran into her leash! We still believe that caused the epilepsy but the vets say that would be impossible! A shock / trauma with the spine would not cause epilepsy. But back to Wednesday... We went back to the car - because we thought a seizure might could come. The other thought was - Mae maybe did eat something toxic? Maybe she ate some acorns (of course that's forbidden!). We felt bad and immediately called a big clinic near Frankfurt and went there to the emergency vet. The vet, a young woman did some tests, also neurologic tests but said she wouldn't find something. Maybe it would have been a very small seizure and it's gone. We went home and Mae slept the rest of the evening and night. Thursday 11/28 In the morning when Mae was carried outside in the yard, the same problem. She didn't come in (normally that only takes two or three minutes). We went outside and she was sitting behind the car and she had a strange look and didn't seem to find her way back inside the house. We called the clinic again and made an appointment with the neurologist. Now things went really bad!! That specialist - let's call him Dr. Snooty - made blood work (all great) and said that MUST be the epilepsy. We mentioned the limping and also that we think the pain would come from Mae's back. We mentioned that several times but Dr. Snooty didn't want to listen and seemed to be not interested. He said we should make an MRT of the brain and to be sure we agreed. The MRT of the brain (fortunately) was negative. So the vet sent us home again still saying that it would be epilepsy and there might be more seizures the next days due to the anesthesia. She had a seizure the same evening / night that could be stopped by her emergency meds. Friday, Saturday, Sunday 11/29 - 12/01 The following days have been really, really bad and pain increased over the weekend. None of us did sleep and Mae was so much in pain, she couldn't get up herself, putting her up, she immediately sank together and she even could not move her head on Sunday. The guess about the back got stronger and stronger and we were sure it MUST be the back. Same time we got mad and sad thinking about the snooty kind that neurologist treated us. Monday 12/02 We called the clinic in the morning and made another appointment with the boss of the clinic - also a specialist - neurologist and surgical orthopedic. At the clinic that doc was very friendly and nice and soft with Mae. He examined her very carefully and agreed with the guess of the back. So we did another MRT - this time of her back. And there we found that one disc that causes the pain. It squeezes about 1/3 or half of the nerve. The neurologist said the option would be surgery or conservative treatment. At this point we had no idea, so we asked what he would do if Mae would be his 'kid'. He said he'd try the conservative. He said - and that's a quote: 'Best think would be, the meds would work so well, Mae would run and jump around like a young puppy at Friday'. If Mae isn't feeling much better on Friday he would prefer a surgery. (Except for the limping the first days - gone now - Mae has no neurologic problems, she could walk if allowed, she can wagg her tail and no problem with pee or poo - both looking ok. Only the pain!). The meds he gave us: Gabapentin 75 mg - every 8 hours Rimadyl 20 mg - every 24 hours That's all! The Gabapentin is in capsules with 100mg, so the vet said we have to open the capsule and take 2/3 of the powder outside and give it on something yummy to Mae. Now here comes my first question: If the meds are supposed to be in a capsule, does it still work without that capsule? Because the powder will be in the mouth and not in the stomach?? The second question: Yesterday after the narcosis she was pain free. Today she has much pain again!! I read, pain should be totally controlled. So we called the clinic again and they said - that would be normal that she's in pain. But the vet said he would send another med that would be with a little bit of cortisone. We should not give it immediately, just in case it wouldn't get better. Is that normal? Is it normal she doesn't want to move? We felt very lost in that 'special' clinic. The neurologist didn't mention crate rest with one word and telling him about the thought of laser therapy on the phone some minutes ago he was not euphoric. He said better make a surgery. Also mentioned we only feed fresh organic food - and the reaction was not good - they'd prefer dry dog food and don't think fresh food / barf would be good for dogs. - Just to give you a feeling about the education of this clinic. Bought a puppy pen for crate rest. I have to say - we are so glad there is Dodgerslist - and also the help of friends on fb. I have no idea if otherwise the nightmare would ever come to an end! THANK YOU for your help. (sorry for the long text) Tiggi |
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Dec 3, 2013 14:02:24 GMT -7
Tiggi we are very glad you have found us, you did a wonderful job in providing good information. With no neuro diminishment and pain only…Mae is a good candidate to recover under conservative treatment. 100% STRICT rest 24/7 for 8 weeks PLUS pain meds, stomach protector and anti-inflamamtory (rimadyl). As you have found out, it is us, the owners, that need to be really on our toes to know everything about our dog's disease. Not all vets have a great deal of experience to know every detail..but we can know just one disease. Our main treasure trove of self education is here: www.dodgerslist.com/literature.htm For right now you need to concentrate on this information to quickly get up to speed on the care Mae needs: Danger of cortisone with Rimadyl… read about the days of washout necessary: www.dodgerslist.com/literature/healingsweling.htmMae IS in pain now (doesn't want to move) Pain affects all the systems of the body in a negative way, it actually deters healing. And it is of course morally wrong to let a dog be in pain when there are meds to provide comfort. Advocate strongly for methocarbamol and Tramadol. You'll need to do some background reading: www.dodgerslist.com/literature/healingpain.htmYou do not need a specialist necessarily to work with you in caring for Mae. A general DVM vet can also prescribe medications. You need to find a vet who understands that aggressive pain control meds are necessary with a disc episode (most often it is these three meds at the same time… gabapentin, methocarbamol and tramadol) Gabapentin powder is very bitter. You'll need to carefully hide in the well of say a quarter-size banana ball. Don't get any gabapentin dust on the outside. One taste and Mae will be forever suspicious. Use three treats. 2 are plain, one has the med inside. 1st a plain treat with med ball in sight. Idea is for her to be greedy for #2. When #2 is in the mouth, also have #3 in eye sight so greedy Mae will hurry to eat #3 med ball. Find a weekly pill box with lid for each day. I open capsule and place in crease of sheet of paper. Use razor blade to divy up powder and slide into one pill box compartment, etc. The FDA and manufacturer pkg insert indicate gastrointestinal problems are side effects of using NSAIDs. The natural defenses of the stomach to shield against stomach acid is hindered when taking NSAIDs. Serious gastrointestinal toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms. Phrase the question to your vet this particular way:" Is there a medical/health reason Mae may not take Pepcid?" If there is no reason, we follow vets who are proactive in stomach protection by giving doxies 5mg Pepcid (famotidine) 30 minutes before the NSAID. Good directory to look up all of Mae's meds: www.marvistavet.com/html/pharmacy_center.htm this vet website also warns against use of cortisone with NSAIDs such as rimadyl without 4-7 days washout. Let us know you have Pepcid AC (famotidine) on board, what adjustments to pain meds have been made. We anxiously await your post. |
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Post by Lilli & Mae on Dec 3, 2013 14:35:05 GMT -7
Hello Paula,
I thank you so much for all your helpful information! I'll have to read and learn a lot. I'm glad I can stay at home with Mae 24 hours - so there's enough time to learn.
We have no Pepcid AC right now. I think I'll have to drive to the clinic to get it, already made a note - I already can imagine the face of the vet when asking for it. Oh dear... We've used Rimadyl a lot before, but not one vet EVER mentioned a protection of the stomach - just told us to only give it with some food.
That's what I said - I live in a developing country when it comes to animal health.
Also no adjustments to pain meds have been made...
That's why we really feel helpless - we don't trust the vets at all anymore. At the phone today, the vet said when mentioning the pain - we wants to do surgery. We said no and he really was angry.
If we go to another vet and ask for meds - they won't give them to us without examining Mae themselves. They will want to do all the tests again and I don't want anybody to touch or move Mae if not necessary. So that will be really a problem...
Right now she's a little better. She starts to shiver as soon as I leave her, so I stay by her side all the time. I'm sure she's afraid someone could hurt her again as soon as I'm not there...
We talked just minutes ago and agreed we will do the things exactly as you describe them and not listen to our vet. 'Cause we trust you and your experience and so many friends say - dodgerslist is the best in IVDD...
Again - thank you so much for helping us - thank you so much for your great work!
Tiggi
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Marjorie
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Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Dec 3, 2013 15:21:53 GMT -7
It's really important that Mae's pain be completely under control. You can request (demand!) the MRI results from the original neuro and take them to be reviewed by another specialist. Yes, it will most likely mean that Mae will need to be examined again but it's very important that her pain be under control. Can you speak again to the second vet at the clinic who said he thought you should try conservative treatment? Tell him you don't want the cortisone yet due to the necessity of a wash-out period from taking the Rimadyl. Cortisone is a steroid and not a pain med, though it can help pain because it brings the swelling in the spine down. Speak to him about adding Tramadol and Methocarbamol. Or find a vet who will work with you to control Mae's pain.
I'm glad you're getting the Pepcid AC as that's important, too.
Please keep us updated and let us know what is done about controlling Mae's pain.
All the best to you.
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StevieLuv
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Conservative Treatment 3x. It really does work!
Posts: 1,335
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Post by StevieLuv on Dec 3, 2013 19:59:51 GMT -7
Hi Tiggi, my name is Maureen. I am so sorry that your sweet Mae is having such a hard time. I have to chime in here and agree with Marjorie - find another Vet that will help you manage Mae's IVDD,and demand a copy of all of the test results that you have paid for! Be aware that while Tramadol is an excellent pain medication,it can also increase seizure activity in epileptic dogs. My Stevie has epilepsy too, and Tramadol did cause her to have seizures. What medication does Mae take for her epilepsy?
Keep us posted on Mae's condition. Keeping you both in thought and prayer
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Post by Lilli & Mae on Dec 4, 2013 4:24:40 GMT -7
Good Morning...
thank you Marjorie and Maureen for helping me and giving me all these information!
We'll get the MRT on a disc from the clinic. The MRT of the head and blood work they gave us with the paying. Maybe they forgot the other one of her back. Or maybe we just forgot them due to the emotional stress (headless chicken).
As soon as 'Daddy' is back from work I'll drive to the clinic to get it. We are thinking of talking to the neurologist of our hometown. He's a very good friend of a good friend of us. That's why we have been there some time ago - to find out more about Mae's epilepsy. But ... I can say we don't like him much - that's the reason he's not involved right now. But of course we can give it another try, go there together with our friend (and without Mae) but with all the results and ask for help - or at least for is opinion.
Thank you so much for the information on the meds. It's so hard to decide weather to take Rimadyl or cortisone :/. Maybe we should give it another try with Rimadyl... Mae is better today, she is sleeping a lot and seems pain free as long as she's not moving. But picking her up to take her outside causes much pain and she starts to shiver again. Not sure if that is kind of "normal"?
Thank you too for the information belonging the meds and her epilepsy!! The vet said the Gabapentin would be very good with epilepsy and control that too. She's not needing any meds at the moment - that's what three neurologists said. She's only having one or two seizures per year...
Thank you for your help!!
Tiggi
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Dec 4, 2013 9:21:30 GMT -7
Tiggi, Mae is not pain free at all…her pain meds are not YET right. There should be no pain (shivering/trembling) after being moved or picked up, no pain nearing the next dose of meds. Mae needs a vet on board who understands that no pain can be allowed during a disc episode. It takes any anti-inflammatory (NSAID or steroid) 1-2 weeks to get all the painful swelling down. During that time it is the pain meds that provide comfort.
You need a vet who knows her epilepsy and can prescribe the right combo of pain meds for the current disc problem. Painful muscle spasms often go with a disc episode…that is the reason methocarbamol is used for that type of pain. So discuss all the options of what pain meds can be used with epilepsy.
The problem with switching from the NSAID Rimadyl to cortisone (a steroid) is that 4-7 days of washout is required. During the time Mae would have nothing to deal with swelling. When there are no neuro deficits only swelling in the spinal cord, then many vets will use a NSAID.
Do you now have Pepcid AC (famotidine) on board as the stomach protector?
Please clarify the list of meds Mae is on and how much she weighs:
Gabapentin 75 mg - every 8 hours
Rimadyl 20 mg - every 24 hours
Pepcid AC now on board?
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Post by Lilli & Mae on Dec 4, 2013 13:02:13 GMT -7
Hello Paula, thank you for your help!! Been to another vet today but that 's been even worse. He would give me any meds - but I have to tell him what - because his education really is beyond acceptable  . If I just knew what. But I feel overstrained with that. The only good thing - I got something for her stomach but wanted to ask you first if that's ok? he product is called 'Pantoprazol-Actavis ( pantoprazole) 20mg. It's for human and the vet said she should take one to each Rimadyl. But one would be also the dosing for an adult human?? I have to talk to that other neurologist here in Wiesbaden. We don't like him much and probably he will be 'annoyed off' when hearing we did not go to him but preferred that clinic that is farer away. But I have to give it a try. It's 9:00 in the evening/night right now - so we'll have to wait until tomorrow morning. Oh no to forget... Mae weights 7 kilos [15.7 lbs] - I did not find a page that could show me that weight in pounds ... so sorry... Still giving the same meds ( Rimadyl and Gabapentin)... thank you for reading... Tiggi |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Dec 4, 2013 19:23:52 GMT -7
pantoprazole is a stomach protector, you would have to get the proper dose from a vet as we are not familiar with it. This research discusses gastric protection in dogs: www.ncbi.nlm.nih.gov/pubmed/15822586Here in the USA, famotidine is over the counter…no prescription required. I do not know if it is the same in Germany. It is reported these brand names contain famotidine: Famonerton, Famobeta, Fadul. You would have to verify that ONLY one active ingredient…no other is in any of those products. The dose for Mae's weight for Pepcid AC (famotidine) is 5mg 2x a day. This page is a good one to print out and take with you to discuss getting pain under control for Mae look for the light blue section on "Medications" www.dodgerslist.com/literature/cervical.htm How is she tonight…still very painful? |
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Post by Lilli & Mae on Dec 5, 2013 11:26:23 GMT -7
Good evening Paula, and again many thanks for your help! It seems / or feels like the big amount I felt standing in front is getting smaller. Mae had a good day today. I'm not sure if the meds are working right now or if it's her pen that she's not allowed to leave, but she seems to have not one moment in pain today. She want's to take part in family life gain and is following us with her eyes. She even could bark at the postman  and she did things like cleaning/licking her paws, yawning and stretching - all things she's doing, when being comfortable. Also she doesn't look so 'frozen' anymore. That's good for all of us, because we are really worn out. I sleep next to Mae's pen on the sofa and make sure she's not unwatched for one second. I'll try to visit a therapy center (first without Mae) - to inform myself on laser therapy and get a feeling for the people there. I hope we are on a good way... We talked a lot about dodgerslist at home and we wonder how many dogs got surgery just because the owners didn't have the chance to read here... Thank you! Tiggi PS: Sorry for the bad word (you changed) and thank you for writing Mae's weight down there... |
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Dec 5, 2013 18:58:27 GMT -7
Hi Tiggi! I'm Sabrina. I am so glad to hear that Mae isn't showing any signs of pain today! That is great news! Keep watching her in case she starts to show signs of pain, though, because it's common for pain meds to have to be adjusted. From what you wrote, it sounds like Mae's licking of her paws is simply her normal grooming behavior. But do keep an eye on that, and if she starts to obsessively lick or chew on any part of her, put an e-collar around her neck (or a rolled up towel taped together like a huge collar) and get vet help. Here is a page for you to print out so that you know if Mae is showing any signs of needing emergency help: www.dodgerslist.com/literature/FridgeInfo81907.pdfHave you been able to find PepcidAC? Keep us posted about how you and Mae are doing! She is so lucky to have such a caring person as you taking care of her! ))Hugs!(( - Sabrina |
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Post by Lilli & Mae on Dec 7, 2013 16:44:32 GMT -7
Hi Sabrina,
thank you for your thoughts and for reminding me of things and all that... We feel all much better in the meanwhile.
Today - again - has been a day without pain at all. It's getting hard to keep her quiet and she's now crying the whole day for us to let her out of the pain. But we don't even if it's hard. But our family life now is absolutely around that pen.
She's very bored in the meanwhile.
We have an appointment in an animal rehab center. The first talk on the phone was very long and we felt very good after it. The woman agrees with our thought that Mae's neck problem probably is from a trauma, when a strange dog ran into her leash - this also caused her first seizure. I tryed to find a vet for the last three years, went from specialist to specialist but they didn't listen. They said a spine problem wouldn't cause epileptic seizures and didn't want to follow this thought. We've also been to several neurologists - they all said it's "just" epilepsy - we would have to accept this. But we never did.
This woman is the first one that also thinks Mae's epilepsy is not an epilepsy but a spine problem in her neck. And she agreed, that vets here don't listen.
The woman sounds very nice and smart and we have that appointment for the next Wednesday. She says she will find out if it feels ok for Mae, or if it might be to early yet. She said, we shouldn't start as long as there's a swell - that wouldn't be so good. That's how I understood her.
Oh - and I gave her the address of this site, because I told her of our hard experiences with the different neurologists and that this site "safed" us. She was very interested.
I have that stomach protection and give it some time before the Rimadyl now.
Her licking of her paws is just normal grooming behavior. She does that when feeling comfortable. At the moment she acts totally normal. Thank you for your tips! And the great fridge-info too!
Good to know the pain meds might have to be adjusted. At this point I'd have another question: How long are you giving the meds?
Thank you so much for your help - not only for Mae - but for our whole family ♥
Tiggi
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Dec 7, 2013 19:50:51 GMT -7
Tiggi, I'm glad to hear that Mae's pain now seems to be under control. That's very good news indeed.
What type of rehab are they planning on doing at the rehab center? The only type of rehab Mae could have during crate rest is acupuncture or laser light therapy. There should be no physical therapy or water therapy being done until the full 8 weeks of crate rest is over and chiropractic treatment should never be done on an IVDD dog. What Mae's spine needs in order to heal is limited movement and meds to get the swelling down and to control any pain, which treatment she is already getting. As long as Mae's pain is under control, you're doing exactly what she needs right now. If they're planning on doing acupuncture or laser light therapy, that can be very helpful in regenerating nerves and can be done during crate rest.
Good job on getting the stomach protection for Mae.
As far as how long Mae would be on the meds, a vet will decide at some point to test for pain (swelling) and will stop the Rimadyl and either stop or taper the Gabapentin. Your job at that point would be to closely observe for any signs of pain. If you see signs of pain return, that would mean there is still swelling on the spine and more time is needed on the meds. If there is no pain during a taper, then all meds can be stopped. A taper should only be done under the direction of a vet. You'll need to speak to one of the vets you've consulted with to see when they think a taper should be done. You've just gotten her pain under control so it probably wouldn't be right away, but since the meds have side effects, you don't want Mae to be on them any longer than she needs to be.
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Post by Lilli & Mae on Dec 8, 2013 2:12:06 GMT -7
Thank you so much Marjorie,
the vet said - she should take the meds for about 3 weeks. And then decide again.
Our appointment for the rehab center is only for a first talk and for finding out if Mae accepts laser therapy. We planned to do water therapy there as well (after the 8 week crate rest), but unfortunately they don't have a water treadmill, only a pool and that nice lady said swimming would not be good for Mae's neck. So we have to find another possibility for this after the 8 weeks.
Wishing everybody a wonderful 2. Advent....
Tiggi
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Post by Lilli & Mae on Jan 2, 2014 16:03:50 GMT -7
We now have half of the crate rest time behind us - 4 more weeks to go and now some new questions are coming up and I hope to find help here... Mae is doing very good! She acts like nothing ever happened! Ok - she's getting more and more bored and we are all trying to do our best to entertain her. We also had to carry out some modifications to change her pen into 'Alcatraz'  . She even learned how to open the zipper from the inside - but at the same time she's a good girl and does not try to chew the pen! Ok... the questions... or worries... 1. After some calls with the vet, he thinks w e should change the dose of the gabapentin down. She's having it every 8 hours - 75 mg. Now the doc says we should change it into 50 mg every 12 hours. I know the gabapentin covers only 8 hours. Isn't that a risk? Wouldn't it be better to give the lower dose every 8 hours? And - is it ok to slow the pain meds down at all? The doc says - we don't change the dose for rimadyl (1 x a day) and talk again at the end of January. Is it ok to give rimadyl the full 8 weeks long? How do you usually handle the management of the pain meds? We are so doubtful with giving the meds and how and how long... We have found a very nice physiotherapist - and we have a good feeling with her. She gave us a soft laser equipment for at home and so after having learned how to use it correctly, we had 10 laser treatments at home. She said after 10 treatments we should have a break. She said we should train Mae's muscles. And she told us, walking in sand (only a few sand at the beginning and more sand later on) would be perfect. So we decided to fill up our roofed trailer with sand, because a sand-box for children would be too small. We also will put a floor heating system (like the ones you use for bath rooms - waterproof) under the sand - so the sand will always be dry and warm and Mae won't get cold. She said we should start right now with the training 5 minutes - 2 times a day. But I think we should wait until the 8 weeks crate rest is over - shouldn't we?? She also said - working with a balance board would be great. So here's the same question: Isn't it too early right now?? Next question: How will we end crate rest? Just open the pen and let her be 'free' again? Or should we start with limited / controlled time walking in the house? What about starting walks again? Sorry for the many questions... :/ I hope you maybe can help me with all this.... Thank you so much ... and... HAPPY NEW YEAR to all of you ♥ Tiger Lilli |
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Jan 2, 2014 18:12:26 GMT -7
You are absolutely right - no muscle training should be done until all 8 weeks of crate rest are completed. Even then, it's a gradual re-introduction into movement. Here is our information about that, but again, this is only after the 8 full weeks of crate rest is completed: www.dodgerslist.com/literature/AfterCrateRest.htmIt takes a full 8 weeks for the disc to heal and limited movement is essential until the disc is fully healed. All NSAIDs have side effects and you don't want Mae to be on Rimadyl any longer than she has to be. At some point, vets will instruct that Rimadyl be stopped and pain meds be tapered or stopped to test for pain. If no pain, then all meds can be stopped as the swelling is gone. It can take 2-4 weeks for the swelling to go down. At this time, a test for pain should be made. You should speak to your vet about doing a test for pain at this time by stopping the Rimadyl and stopping or tapering the Gabapentin. Please let us know what the vet says after speaking to him. |
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. We feel sad and helpless and like standing in front of a huge mountain called 'IVDD'
. If I just knew what. But I feel overstrained with that.
and she did things like cleaning/licking her paws, yawning and stretching - all things she's doing, when being comfortable. Also she doesn't look so 'frozen' anymore.
. She even learned how to open the zipper from the inside - but at the same time she's a good girl and does not try to chew the pen!