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Post by Marcie & Bradley on Oct 5, 2014 16:46:14 GMT -7
Hi. I have 15.5 year old dashchund named Trixie. Relatively healthy all her life with the exception of one back issue years ago. Crate rested and has been fine since. I added things like ramps and never allowed her to come down stairs etc. Recently, she had gotten slow moving especially in the am. I assumed it was age. The other day she started walking funny, turning front left paw under and not realizing it. Trip to the vet and my worst fear---they assume it's a disc in her neck because of he lack of control of all 4 legs. It actually got worse afte the vet appt and a trip the same day to a neurologist. They recommended doing a MRI and then surgery. At her age, I just don't feel that it the best decision because of her age. So they have put her on crate rest,
11 lbs Tramadol 50 mg quartered, every 8 hours and prednisone 5 mg, halved twice a day.
She weighs about 11 lbs. She is eating fine, going potty outside with the help of slings to hold up her front and rear. Occasionally, she attempts to walk but doesn't have the ability to do it. 1st question-are the meds the right dose. From what I have read, they seem low 2nd question-have you know other dogs to recover from this with crate rest and the meds prescribed?
I should add that she is able to turn over into the crate and has so tried to get up and get to water or food bowl. Thank you for your response.
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Post by Pauliana on Oct 5, 2014 17:42:14 GMT -7
Welcome back to Dodgerslist, Machong! I hope I have your name right. You sure did the right thing by crating Trixie, you've been through this before so you know the drill. As you know Dodgerslist recommends 8 full weeks of 100% strict crate rest. It is the limited movement that helps the disc to heal. It is movement that will tear an early healing disc. So 8 full weeks of 100% STRICT crate rest 24/7 means: No laps, no couch, no sleeping in bed with you, no meandering, around during potty times. No baths, no chiro (aka VOM). In other words do everything you can to limit the vertebrae in the neck from moving and putting pressure on the bad disc. Can you answer a few more questions for us so we may better help you? What was the date you saw the vet? Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy? Yes you are quite right, Trixie is under medicated for both pain and swelling reduction. Neck disc episodes are very painful and the pain medications need to be aggressive in order for her to heal comfortably. We have seen higher doses of Tramadol in dogs her size.. My dog was 12 lbs and he was prescribed 25mg of Tramadol and others if the pain is severe go up to 50mg every 8 hours. Additions of Methocabamol to relax her muscles and Gabapentin is very helpful for nerve pain, all 3 are very helpful for cervical disc episodes.. Pain hinders healing and neck discs are hard to heal because the neck moves whenever the head moves so it's hard for it to get the rest it needs to heal.. But yes Trixie CAN heal and even at her age. We have had many seniors here.. Here are some special tips for neck disc episodes you will find helpful: www.dodgerslist.com/literature/cervical.htmI am not a vet but I do know that Prednisone is at the anti inflammatory dose given 5mg every 12 hours. 1/2 a tablet twice a day is not a high enough dosage to get her swelling down. It is imperative to get that swelling down so the nerve damage can be reversed.. The reason she can't move her legs is due to the disc or discs pressing on the spine in her neck.. It can take from 7-30 days to get the swelling down but she needs to be at the 5mg dose twice a day.. Does the Predisone bottle state the date of taper? Please include the all important stomach protector such as Pepcid AC. Phrase the question to your vet this particular way:" Is there a medical/health reason for my dog 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 Prednisone. Can your dog specifically sniff and squat and then release urine or do you find wet bedding or leaks on you when lifted up? Poops OK - normal firmness & color -no dark or bright red blood? With this disease self education is critical not just so you make sure the right things are being done for the best recovery but for your own emotions. The goal of our Forum is to support you, to teach you how to look up things at the original source point (a credible and authoritative resource), question everything and read so you become the most important part of your dog's health care team. www.dodgerslist.com/healingindex.htmAdd this comprehensive "must-have" $3 DVD on IVDD to your arsenal of educational resources. Friends, family and those who will be caring for your dog should also watch this DVD www.dodgerslist.com/store/DVDord.htm Tape this flyer to your fridge so the whole family knows what things are emergencies: www.dodgerslist.com/literature/FridgeInfo81907.pdf Healing thoughts and prayers..
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Post by Marcie & Bradley on Oct 5, 2014 18:21:10 GMT -7
Thank you for your quick response. She saw the vet this past Friday, Oct. 3rd. There is no shaking or trembling. She ideally can't move. Since all 4 legs are impacted, the best she can do is turn over to lay on the opposite side. Her tummy is a little tense. I am to start the taper after 5 days. The vet didn't recommend Pepcid AC. She can sniff and semi-squat to pee. She is only pooping in the am. Which is extremely unusual as she almost always peed/pooper everytime she would go out before this.
Should I go back to my regular vet or call the ER vet that prescribed the meds. Trixie saw both on Friday. I went to the ER vet at my vets request to see a neurologist---either one should be able to take care of increasing the meds. Thanks again for the advice. She was walking much more prior to the vet visits- I think l the poking and pulling helped move things in the wrong direction.
She doesn't appear to be in pain. she whines when she wants something--water or to go out. Whining stops once we do those things. Should I be concerned she is pooping more often. I know from previous dog, that will come out when it should, if she isn't doing it on her own.
I must admit the two slings are hard to coordinate--any tips there?
Thank you, Marcie
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PaulaM
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Post by PaulaM on Oct 5, 2014 19:35:55 GMT -7
Marcie, I'm surprised that only one pain med and Rx'd very lightly is actually controlling pain (Tramadol 12.5 mgs 3x/day). Neck discs tend to be rather painful. So do continue to be alert for any hint of pain as the vet has much room to increase the pain meds and even add in the one that specifically addresses pain from muscle spasms. Tight tummy muscles are often a sign of pain, referred pain from the back. So I'd assume Trixie is in pain and advocate accordingly for more aggressive pain relief. The vet depends on your feedback and observations to know if further meds adjustments are needed. So Trixie can't really stand up to walk with all four legs? When she stands she knuckles the paws. But she can move them to attempt a squat at potty time and you see her move her legs to some degree in her crate as she turns, etc.? We follow the vets who are proactive in protecting the stomach....we see too many dogs develop problems when this is not done. Trixie doesn't need another problem on top of what she is dealing with. Pepcid AC is a generally safe over-the-counter suppressor of stomach acid production for healthy dogs. Dogs don't speak up at first signs of trouble like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach. We ask that all members read about each med their dog is on or may take as a safety measure..this is a good directory: www.marvistavet.com/html/pharmacy_center.htmDo not be dismayed if a 5-day course of pred at the lower end of the anti-inflammatory range is not enough. Often it does take anywhere from 7-30 days at the upper range of the anti-inflammatory dose to get all the swelling down. Swelling not only causes pain, but also pressure to the nerves. Nerves react to pressure by dying and we observe the result as loss of neuro functions. The effect of the dying is a release of chemicals causing a cascading effect of death for adjacent nerve cells. So getting swelling down sooner than later is a much better idea...time matters with dealing with the spinal cord. As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order. 1. Pain caused by the tearing disc & inflammation in the spinal cord 2. Wobbly walking, legs cross 3. Nails scuffing floor 4. Paws knuckle 5. Legs do not work (paralysis, dog is down) 6. Bladder control is lost 7. Tail wagging with joy is lost 8. Deep pain sensation, the last neuro function, a critical indicator for successful surgery. Surgery can still be successful in the window of 12/24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Age has nothing to do with safety of anesthesia. As long as the pet is healthy with a current blood panel and exam, the appropriate anesthetic agents are used, and the pet is carefully monitored during the anesthetic procedure, it is no more risky to anesthetize an older pet than a younger one. Are you carrying her to and from the potty place? I would use maybe a figure 8 sling with an Ace bandage or long winter scarf for under the chest. Or since she really is not able take any footsteps, you could place her on a known old pee spot to let her sniff, squat and pee. Holding her up with hands??
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Post by Marcie & Bradley on Oct 5, 2014 21:03:15 GMT -7
Hi Paula, Correct, she cannot stand on all 4. She is most weak in front left and left rear. She attempts to move them when going potty. Squatty is what I allow with rear sling and she can hunch some when going #2. Yes, she moves [legs] them to some level in order to turnover in the crate. I wonder why the vet was so conservative in their prescription and not more aggressive. Surgery is not an option. And I explained that to them. Thanks for the suggestions on the hind sling.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Oct 6, 2014 8:35:33 GMT -7
Marcie good then, that she can actually still move all her legs..there is potential for her body to self repair nerves at some point to bring back leg function again. Here are some other options for slinging her front that may be helpful to you and your back at potty time. Perhaps some cutout holes for front legs would keep the front sling better in place as you are trying to handle two slings at once?
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Post by Marcie & Bradley on Oct 6, 2014 17:58:33 GMT -7
Thanks for the extra tips. I called the vet and they said the Prednisone they rx'd was the highest dosage for her. They did also add Gabapentin 50 mg every 8-12 hours and Pepcid AC. No change in Trixie today. I am surprised the vet was more aggressive with Prednisone. Should I consult another vet? Going to try the shopping bag idea now.
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Post by Marcie & Bradley on Oct 6, 2014 18:42:03 GMT -7
Cloth grocery bag worked great. How do you post a picture?
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Post by Pauliana on Oct 6, 2014 22:42:22 GMT -7
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Post by Marcie & Bradley on Oct 7, 2014 5:34:12 GMT -7
Thanks for the info on uploading the photo.
I have called my regular vet and talk to a vet tech about the dosage of prednisone. The vet tech says that increasing Trixie's prednisone rx could lead to liver issues. Is that what you find as a reason to not increase it--her age and liver damage potential? I am waiting for the vet to call me. Basically, I want to be aggressive with her treatment as surgery is not an option. I feel I would be remiss to not be aggressive given her age and the potential outcome...be aggressive and help her situation vs. not be and her condition not improve at all. If her condition doesn't improve, I am not going to allow her to go long term in her crate with no use of all 4 legs.-----I don't think that is a good quality of life.
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Post by Jean & Mimi on Oct 7, 2014 6:19:06 GMT -7
Hi Marcie, I agree with Pauliana, your vet is not treating Trixie aggressively enough. I know that find a new vet or a different vet to work with is a challenge. In my practice, there are three vets....I will only work with two of them (unless there is a dire emergency). The two vets I work with get IVDD, they understand that sometimes you need to be more aggressive and were willing to work with me. The other vet refused to have my Mimi on steroids for more than 5 days and she actually needed them at a stronger dose for a month. Please consider looking for another vet. Yes, long term, steroids can cause harm to a dog, but you are not looking for long term - just enough so that she can start to heal. Good luck
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Oct 7, 2014 9:10:07 GMT -7
Marcie, when anti-inflammatory drugs need to be used, vets who practice safe medicine call for a blood test to check the health of the body and organs such as the liver. Did Trixie get a blood panel done? Some vets are just not comfortable in using steroids and not comfortable in treating IVDD. We have no problem going for a 2nd opinion with our own health issues when things don't seem right...so there is no shame to go for a second vet opinion. Your self education about IVDD is going to play an instrumental role in being able to recognize when you have found a vet comfortable in treating a disc epsisode and it will make a world of difference to have that kind of support.
How often are you actually giving the Gabapentin at its most aggressive range 50 mg 3x/day? How often are you giving Pepcid AC — 5mg 2x/day?
Are you now see none of these signs of pain dose to dose of the pain meds: shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy, head held high or nose to the ground, not wanting to put weight on paw such as holding leg flamingo style?
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Post by Marcie & Bradley on Oct 7, 2014 10:44:04 GMT -7
The vet is rx'ing something with a "C" -corbin. I will know when I pick it up. Trixie didn't have blood work done. Basically my regular vet sent me to an ER vet---at the ER vet they spoke of MRI and surgery which is not an option--so the regular ER vet (not neurologist) rx'ed the 1st drugs mentioned. I am giving the Gabapentin 50 mg 3x/day--just about every 8 hours. Pepcid AC 5 mg 2x/day.
No shivering, no trembling, she has yelped at pick up but honestly it is hard to get out of crate---so probably more me being bad at getting her out, she really can't move meaning she has no ability to really use any of her 4 legs. Her tummy is slightly tense, much less than Saturday. I would say very little. she hold hers head about even where it should be--not low to ground, but will lower it to sniff at times, not high. I do notice she likes to lay with it higher --but she has done that for years (was that the 1st signs I missed?)
I am using the "cut grocery bag" to walk her---meaning hold her up just so paws can touch the ground. She will try and move the right side paws. You can see that she has less ability on left side paws. She rolls the left paws (both front and rear)
She can turn herself over in the crate, she can "wiggle" to the water bowl that I place as close to her as I can (within an inch or so). She will eat. She can shake her head--ears.
She lays on her sides - I can not get her to lay flat on her tummy--afraid I will hurt something and she appears to like laying on her sides more
Peeing, as usual, first thing when out on grass--she can squat about 3/4 of the usual distance. She poops on her own--not as often as usual but is going twice a day. She will pee every time I take her out--that is usual. I am taking out every few hours or so, or when she whines.
She hates the crate, I leave the door open when I am home near her(trust me, this dog isn't going anywhere, she isn't even trying) I shut it yesterday when I left for a walk with my other dog and I came back and could hear her screaming outside--barking like crazy because the door was shut. Nonetheless, barking from the same spot.
I appreciate all of the responses back. This is quite an experience. Beyond your help with meds and such---the grocery store bag was a big help--trying to hold to slings even at 10 or so lbs. is hard and watch for peeing and watch for feet---if anyone else is dealing for no legs--I highly recommend the bag idea--cheap and it works.
I will update later when I get the new med
Finally talked to the vet--she wouldn't prescribed a higher dose of prednisone. She was ok not tapering at 5 days and waiting until 7. The other drug she was going to rx was mathacarbol (sp) but isn't now that she knows she is on Gabapentin and Tramadol.
Not sure what else to do now that I have talked to vets--both the ER vet and my regular vet.
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Post by Debbie Blackwelder on Oct 7, 2014 13:20:38 GMT -7
Marcie, Good Afternoon, you are quite in a situation. If Trixie is still in pain then her med's need to be properly adjusted as Pauliana wrote in her last post, along with her Prednisone for swelling reduction:
If you can't get results from your ER vet or regular vet, can you go to another clinic who deals with IVDD and is more comfortable in treating Trixie? I am worried about her and she needs the best possible care she can get right now to fight this disease. My babies are around the 10 to 15 pound range and they were prescribed anywhere from 25 mg to 50 mg every 8 hours of Tramadol. As Pauliana has said, we are not vets, but we are individuals who have been through what you are going through and we have this wonderful Dodgerlist data base to work from.
1) If pain is present, get the Tramadol upped 2) If pain is present, add the Methocabamol in addition to the Gabapentin 3) Get the Prednisone upped
Read all you possibly can about the medications so if you have to call your regular or ER vet then you will be knowledgeable and can advocate for Trixie, you have to be her voice. Follow this shortcut for more info:
www.dodgerslist.com/drugs.htm
Good Luck and Best Wishes, Debbie
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Oct 7, 2014 14:23:51 GMT -7
Marcie with Trixie I think either an ex-pen or a top opening crate would really help you lift her with greater ease. How to convert to top opening crate: www.dodgerslist.com/literature/cratesupplies/cratetopconvert.pdfEx-pen has great flexibility and makes accessibility to lift much easier. You know Trixie best, so you you will have to be observant if Trixie is not her normal perky interested in life self along with other confirming signs of pain. If you think she is in pain, it would be time to hire a different, new vet. What is your city/state? Have you seen our vet recommendation directory in case you need to hire: dodgerslist.boards.net/board/10/guidelines-posting
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Post by Marcie & Bradley on Oct 7, 2014 16:40:41 GMT -7
Thank you for the crate tip! I did look at the link and it refers me to the place I went, --carolinas vet specialists, although I only saw the ER vet on duty who said the neurologist was also there. I didn't meet the neurologist. I am in Charlotte NC. I generally don't think she is in pain. Even at times when she whines, I think it is out of boredom. For example, tonight she whined, and flipped her food bowl over in her water bowl. Then I picked it up and she ate it. Also tonight she started to try and wobbly walk. Again, more with the right side legs then the left. I let her do this with my aid for about 5 or so feet figuring best to not strain her.
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Post by Debbie Blackwelder on Oct 8, 2014 6:09:50 GMT -7
Good Morning, Marcie! You know your baby better than anyone else so go with your gut instinct. Some babies just get tired of boredom and do things to get attention, like flipping the food bowl. I have one who is that way, he is always the center of attention. I wouldn't advise letting her wobbly walk for any distance at all, I see you are using a sling, make sure you have it on her to assist her anytime she is out of the crate. Keep in the back of your mind that it is the 100% strict cage rest that heals the disk, no movement at all! Trying to walk, other than potty time, could reinjure the healing disk and set her progress back further.
Tips for entertainment during crate rest are:
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Post by Marcie & Bradley on Oct 8, 2014 13:56:11 GMT -7
Thanks for the tips. No improvements today but not any worse. I am still hopeful but I begin her taper of the prednisone on Saturday. I am hoping the inflammation has gone down. I don't sense that she is in pain--we got through the night last night with no whining, which I take as no pain and she didn't need to go out.
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Post by Marcie & Bradley on Oct 9, 2014 10:21:41 GMT -7
No improvements to report. I do have a question. I have been reading other posts and I am wondering, is it a bad sign that Trixie isn't even trying to get out of her crate; meaning is the damage such that she just plain can't and knows it. What should I expect, if anything, once I start to taper the prednisone? The instructions from Dr don't say to stop the tramadol or gabapentin.
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Post by Cindy & Eddie on Oct 9, 2014 11:04:54 GMT -7
Hi my name is Cindy & Eddie My dog was on prednisone for a couple of weeks. We are at week 8 now and is still taking tramadol and gabapentin. 50 mg twice a day. The vet i first went to was not at all aggressive with medication. And said his only option was surgery,which I could not do.I switched to another vet who is just wonderful. At one point with the first vet I thought we were going to have him put to sleep. He is almost back to his normal self. Still on crate rest but does walk out to go potty down ramps to enclosed area. If it were not for this website and all the information everyone shares I don't know what I would have done. The more knowledge you have when you go to the vet (if there a good one) the more helpful they seem to be. Keep Faith this does work!
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Post by Marcie & Bradley on Oct 9, 2014 15:37:31 GMT -7
Hi Cindy,
What meds was your dog first on, weight and how much had the dog lost in terms of control.
What would be the reason a vet would RX prednisone longer than 5-7 days before taper?
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PaulaM
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Post by PaulaM on Oct 9, 2014 18:16:19 GMT -7
Marcie the signs of pain are not feeling like their normal perky interested-in-life selves, shivering, not wanting to move much, head held in unnatural position such as high or nose towards the ground, yelps. You know Trixie best, but to me not wanting to move to get out of the crate can well be a sign that is is too painful to move much. So if you believe she is in pain, do let the vet know your observations so the pain meds can be adjusted. If there is still pain, then a taper on Saturday may not be in the cards. The use of steroids such as prednisone vary in length of use dog to dog. Your vet will call for a taper when he believes all the spinal cord swelling is gone. It is the taper that tests that theory. Pain meds are normally stopped at the time of the taper to give a clear picture and not delay getting right back on the original d ose of Pred is there would be any hint of pain. So your job on the taper is to be observant for signs of pain. Since the taper is happening on the weekend when you vet will not be open, what is the Plan B you and your vet have come up with should there be pain (do you have enough meds on hand til Monday, what dose should you use, etc. These pages will give you a basic understanding of each type of meds used with IVDD so you are comfortable in your knowledge, able to discuss things with your vet and monitor the situation: Pain meds: www.dodgerslist.com/literature/healingpain.htmAnti-inflammatory drugs: www.dodgerslist.com/literature/healingsweling.htmKeep in mind that the meds are just to deal with swelling and pain. It is the 100% STRICT crate rest 24/7 only out at potty times for 8 weeks. At potty times keep the footsteps to the very, very fewest... all in an effort to prevent the early healing weak disc from tear further.
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Post by Cindy & Eddie on Oct 9, 2014 19:22:36 GMT -7
Marcie, The first vet we went to only was giving him 12.5 mgs every 8 hours (very low dose )and methocarbamal 1/4 tablet of 500mg. His symptoms were yelping, in severe pain, arched back and head held low and severe neck spasms. After seeing the new vet he upped his tramadol to 50mgs every 8-12 hours plus added gabapentin and pepcid. He did not loose function in his legs. He was on prednisone for about 3 weeks because of the sever pain. The first vet did not do blood work, but the second has done it twice. His first blood work his liver and pancreas were highly elevated, after about 3 weeks we had bloodwork done and everything was back to normal but one thing was slightly elevated. He is also on Denamarin for his liver. Finding a good vet that will work with you is important.
Marcie, Sorry Eddie weighs 20 pounds.
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Post by Marcie & Bradley on Oct 11, 2014 10:16:22 GMT -7
Trixie began the taper of the Prednisone. Also cutting back on the pain meds. She showed more "life" today. Some friends stopped over and she barked and wagged her tail for them. She also showed some interest in a toy. I let her squeak it a few times. She actually seemed happy for the first time in over a week. No change in ability to walk or use of legs. Hopeful, but discouraged that no progress has been seen at all. I am beginning to wonder about her quality of life. My other dog marked her crate---not sure what he was trying to say about all this.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Oct 11, 2014 12:25:40 GMT -7
Marcie, so glad to hear how nicely Trixie is coming off of Pred and pain meds....she has a zest for life that girl with her barking and wagging...now that's a happy dog. Trixie is into her 8th day of her journey of healing, showing already she can move her legs and can turn herself in her crate, bladder control and happy wagging!!! I'd say, stay tuned for more healing to happen. Nerves just to take time to heal... probably the part of the body that is slowest to heal. Having patience is not easy, but a definate must with IVDD. I think you will get a good perspective on things by reading Travis' story www.dodgerslist.com/monthstory/TravisVilardi.htm
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Post by Marcie & Bradley on Oct 11, 2014 15:33:30 GMT -7
Trixie has been panting a lot today. More than I would have thoughts since she is getting less of the prednisone. Is the panting a sign of pain? I am giving less of the pain meds. Just Tramadol, not any of the gabapentin
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StevieLuv
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Conservative Treatment 3x. It really does work!
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Post by StevieLuv on Oct 11, 2014 17:02:30 GMT -7
Hi my name is Maureen. Yes panting can be a sign of pain, are you seeing any others, like reluctance to move, shaking, trembling or tight tummy? Does the panting go away of you increase her pain meds back to where they were?? Usually pain=swelling=more time needed on prednisone or anti-inflammatory. It is not unusual to have to delay the taper to ensure that all of the swelling is gone. Let your Vet know about the signs you are seeing and find out about upping her medications again. Hang in there- you have been doing a great job
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Post by Marcie & Bradley on Oct 11, 2014 17:05:41 GMT -7
No other signs other than the panting. I am going to give a dose of the gabapentin and see if she calms. I went ahead and gave her a second dose of prednisone. So technically she wouldn't start taper. I have enough to get me through until Monday.
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Post by Marcie & Bradley on Oct 13, 2014 7:07:24 GMT -7
I have an appt. This afternoon with Trixie's regular vet. I tried to start taper yesterday as well and cut blac on pain meds. I think she is still in pain so ended up giving her the second prednisone pill last night with dinner and back to original schedule of pain meds--both Tramadol and gabapentin. The signs I am using is whining even after running through potty breaks and needing water. Her whines could just be boredom but after about 30 minutes and I think pain meds start to work, she calms down. I have not given prednisone this am with bfast but did give pain meds on original schedule. At times she is perky yet at other times she seems conpletely "over" the crate. No improvement on ability to walk or even try to. I can still leave crate door open knowing she isn't even remotely going to try and get out. Really beginning to wonder if she can regain control of her legs. She whines loudly when she wants to flip over but is able to do it on her own. No expectations of what the vet will say. Assuming they will prescribe more predispose and pain meds. Originally they said she should shows signs of improvement in a few days, it's now been 11 days since that appt. and no reall improvement. I know my vet is going to bring up worst case scenario, I am not ready to do that. I am hopeful trixie will get better since she hasn't gotten worse. As I am typing this she flipped twice, no whining. Will update later after vet appt.
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PaulaM
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Post by PaulaM on Oct 13, 2014 8:39:18 GMT -7
Marcie, the purpose of medications is to bring down painful swelling (prednisone) and to give comfort (Gabapenin, and Tramadol) while that happens over a period of anywhere from 7-30+ days. The key as to whether meds should be given is an accurate assessment of pain. If there is pain, it is due to swelling in the spinal cord. Whines for boredom, wanting attention to flip over- go potty, etc are not pain signs. So you will need to observe for actual signs of pain that you can report to the vet so he will know if extension of meds is necessary. Signs of pain with a disc episode often are more than one at a time which is helpful to distinguish between pain vs. wanting attention. Shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy, holding head low or high, not their normal perky interested food, what is going around them...life. The vet needs to see Trixie in a non-medicated state. Pain meds mask pain. Both tramadol and gabapentin have short half lives and might be out of the system if you do not give any more this morning. Realistic expectations for improvement in 11 days require an understanding of healing for each of the four phases pointed out in the essentials of "conservative treatment" page. You may want to re-review them: www.dodgerslist.com/literature/healingpage.htm--- Pain should be in control in one hour of giving pain meds and stay that way dose to dose. That kind of "improvement" is expected right away. --- Inflammation There will be pain until all of the swelling has been resolved by the anti-inflammatory. That kind of "improvement" is individual to each dog and takes about 7-30+ days to get swelling down. --- Disc repair takes about 8 weeks for the body to form good secure scar tissue. Trixie is a little over one week's improvement into this process --- Nerve repair is not expected during the 8 weeks of rest as the focus is on getting the disc to heal. Nerve repair may or may not come during that length of time. Normally nerves are very slow to heal and we think in terms of months not days and weeks. Some dogs have taken more like 6-11+ months to have nerves repair enough to return neuro functions. There is no time table anyone can give you, but it is known the typical order that neuro function return in — the reverse order of the damage to the spinal cord:
1. Deep Pain Sensation (Only correctly identified by a specialist.) 2. Tail wagging with joy at seeing you or getting a treat or meal. 3. Bladder and bowel control verified with the "sniff and pee" test. 4. Leg Movement<-- Trixie, and then ability to move up into a standing position, and then wobbly walking. 5. Being able to walk with more steadiness and properly place the feet. 6. Ability to walk unassisted and perhaps even run. ---
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