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Post by Victoria and Allison on Dec 26, 2014 6:32:01 GMT -7
Pauliana, thanks and sorry my post was not clearly written. Charlie is STILL on the tapering dose started 12/24. That is because we believe the main issue of pain and discomfort was likely gastric-related. Yesterday the vet increased the famotidine from 10 to 20 mil. He would not approve adding Sucralfate. His strong gait and happy tail occurred with no pain meds since 12/23! Thanks so much for being there!!!
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Marjorie
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Post by Marjorie on Dec 26, 2014 7:45:27 GMT -7
Great news on the progress that Charlie has made, Victoria! What a wonderful Christmas gift. Hopefully the double dose of Famotidine will help the GI distress. If it doesn't, then advocate strongly for Sucralfate. Sucralfate works in a different way to bandaid the damaged mucus lining and also promotes a healing environment. Sucralfate will require timing with other meds…so do your homework so you can discuss things with the vet: www.marvistavet.com/html/sucralfate.html
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Post by Victoria and Allison on Dec 26, 2014 10:43:49 GMT -7
I don't know why vets have been hesitant to prescribe Sucralfate! Tried to get this for a kidney cat this year and met with resistance and that was another vet. I totally agree that the benefit far outweighs any risk, especially since we don't know the real source or extent of the gastric problem. Thanks again!! By the way, sorry for the bold typing, it's not intentional and I don't have any idea how that happens.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Dec 26, 2014 12:32:15 GMT -7
Victoria, what a very nice Christmas present to see Charlie doing so well neurologically and emotionally!
Do read up on sucralfate so you know the points to bring up and can better advocate for it in the future. Sucralfate does prevent acid production like Pepcid AC. It works to band aid damaged areas of the GI tract mucous lining. We can't see the inside of the stomach, but when a dog is on anti-inflammatories and you are seeing loss of appetite, vomit, diareah, you gotta assume damage to the stomach lining IS happening.
Moderators do the bolding of words, it helps us to track important points as we review previous posts before replying.
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Post by Victoria and Allison on Dec 27, 2014 10:31:18 GMT -7
First, please know that Charlie is doing fantastic and I am cautiously ecstatic. My friend said Charlie is acting even more energetically than ever. He's still in his pen, only out for elimination. This site has been a blessing for us both! I don't know where to post about this: I found an amazing article about a controlled study in Europe where paralyzed dogs were able to walk again simply by transplanting cells from their own noses. The 11/2012 BBC news article includes a before/after of one of the doxies that regained the use of its back legs as a result of the trial. Here are excerpts and a video of a doxie before and after: "Jasper, a 10-year-old dachshund, is one of the dogs which took part in the trial. His owner May Hay told me: 'Before the treatment we used to have to wheel Jasper round on a trolley because his back legs were useless. Now he whizzes around the house and garden and is able to keep up with the other dogs. It's wonderful.' You can see Jasper's before/after results on a video at the link below. "The researchers say the transplanted cells regenerated nerve fibres across the damaged region of the spinal cord. This enabled the dogs to regain the use of their back legs and coordinate movement with their front limbs. The new nerve connections did not occur over the long distances required to connect the brain to the spinal cord. The MRC scientists say in humans this would be vital for spinal injury patients who had lost sexual function and bowel and bladder control." Here is the link to the video and this article: www.bbc.com/news/health-20365355
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,605
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Post by PaulaM on Dec 27, 2014 12:43:57 GMT -7
There are many kinds of studies from different angles, the hope is with enough of them, finally a good solution can be found, not just for people but also for our dogs.
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Post by Victoria and Allison on Jan 5, 2015 9:40:15 GMT -7
Charlie is doing really well in every way: appears pain free, has gained back neurological control of his rear legs and his stomach symptoms and l oose stool have resolved. He is no longer depressed. He wants to run and play and roll over on some of his potty outings- of course he is then brought in. This is his 23rd day of crate confinement and if all continues well he will be off all meds January 20th. Can you see a photo I attached? 1) Do you think 6 weeks will be enough confinement if his symptoms remain in remission and because this is his first episode? Vet said 4 weeks would be OK but I trust your opinion. 2) I want to plan ahead for Charlie's 'release'. He will always have the rear weakness and my tile floors are a concern. I got them because tile is so easy to keep clean. Runners and rugs are great except they can be very difficult to keep clean, in place and my kitties would attack them. I read here about paw grips (glue on, etc.) and paw boots. Any feedback?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,605
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Post by PaulaM on Jan 5, 2015 11:07:43 GMT -7
Victoria, what an absolutely WONDERFUL report!!!! The only disease we know about is that of disc disease. So our comment is ALWAYs when a torn or damaged disc is invovled, that a full 8 weeks of crate rest is necessary so that the disc can heal, can form the necessary scar tissue. I would say, that the nail grips and paw boots may work much better for Charlie's larger paws than for our little doxies. The discussion about those products is here: dodgerslist.boards.net/thread/1564/footwear-harnesses-scooting-garmentsI still would investigate inexpensive rug runners for Charlie's normal pathsways with some of that waffle like grippers to keep them in place. They can be easily hosed down outdoors to dry. Have you seen what is available at the big box stores like Home Depot, Lowes' etc.?
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Post by Victoria and Allison on Jan 5, 2015 11:29:51 GMT -7
Will definitely check the runners/rugs out, too. Thanks, Paula. Can't tell you how grateful we are for all the help we've received here!
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Post by Victoria and Allison on Jan 10, 2015 19:55:28 GMT -7
Charlie continues to do very well except I notice that he is has been licking his left 'wrist' (distal radius). The skin and hair still look normal, though there is possibly minor swelling there. I know pain is one possible cause though he has been acting otherwise normally with no neurological signs.
I am wondering if you have seen licking as a coping mechanism for dogs confined for extended periods. The other concern comes from the side effects of prednisone which lowers the body's immune response, making a dog more vulnerable to infection or cancer. The wrist is the most common area for canine bone cancer which Idealt with in the past.
I will take him next week to see if the vet recommends an x-ray of his wrist. Charlie is on every-other day tapering and has 4 more pills to go. Thanks for your feedback.
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Marjorie
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Post by Marjorie on Jan 11, 2015 6:27:09 GMT -7
If there's swelling there it may be something besides neuropathic pain but I'll explain about that type of pain anyway so you can be watchful that the licking does not move to biting or chewing. Everyone has experienced numbness or pins and needles tingling in your legs when sitting in a bad position for too long a time. Your dog can be feeling abnormal nerve sensations that are mild pins and needles to quite painful burning, on-fire feeling that makes them bite to stop the pain. These are abnormal signals coming from nerves.
You would need to stay on top of observing for any more signs of chewing on body parts as this can lead to death. Immediately put a e-collar on or a lengthwise folded towel and secured closed with duct tape. Gabapentin can help this kind of nerve pain.
As for the tapering, is Charlie still on any pain meds or have they also been tapered or stopped? If he's still on pain meds, they can mask any sign of pain so a true test for pain can't be made. You need to have a true test for pain so you can determine whether there is still swelling. If there is still swelling/pain, then more time on all meds are needed. Please let us know if pain meds have been tapered/stopped and if they haven't, please speak to the vet about stopping them also so you can be assured that the anti-inflammatory can continue to be tapered.
Prayers that the wrist symptoms are nothing serious.
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Post by Victoria and Allison on Jan 12, 2015 11:19:07 GMT -7
Thanks, Marjorie! Charlie has been off all pain meds since December 24th. That marks the beginning of his tapering off period. Ever since then he's been getting famotadine 2x's a day and 20mg of prednisone every other day.
I did see him licking his other paw and a leg which makes it less likely to be a distal radius issue on one paw. The licking is several times a day but not incessantly. His skin and hair still look normal. I don't see any biting.
He did have softer light colored stools today, partially formed, with a trace of mucus. He had gastric issues a while back (prior posts). That is when the vet would not agree to Sulcrafate but did doubled his dose of famotadine from 10 to 20 mg.
Charlie only has 3 more pred pills to go and will be done on the 18th.
Do you think the licking could be coping because of the confinement? He's been confined for about one month.
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Marjorie
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Post by Marjorie on Jan 12, 2015 14:33:59 GMT -7
Keep a close eye on the licking that it doesn't progress to excessive licking or biting. It might be due to boredom but you want to be careful that he doesn't start to injure himself due to neuropathic pain as mentioned. You can check with your vet and tell him what you're seeing - Gabapentin is the med that's prescribed for neuropathic pain.
Keep a close eye, too, on the bowel movements. If it continues or gets any worse, you'll need to strongly advocate for Sucralfate. I know your vet is balking at that. Hopefully, with only a few days of the steroid left, the bowel movements will not worsen and Charlie can get off of all meds. But GI tract issues can worsen very quickly. I would let the vet know today exactly what you're seeing and see if he'll prescribe the Sucralfate.
Prayers for a completely pain-free taper off of all meds for Charlie!
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Post by Victoria and Allison on Jan 12, 2015 20:31:55 GMT -7
Thanks Marjorie! If anyone has tips for helping a dog cope with confinement I'm open. I'm wondering if taking Charlie for acupuncture would help him. Would only a few sessions help or does it have to be ongoing long term. Also would the travel spoil the confinement purpose?
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Jan 13, 2015 6:39:40 GMT -7
Here are some tips to help Charlie through crate rest, Victoria: www.dodgerslist.com/literature/EmergencyCrate%20Training.htmIf Charlie is excitable in his crate, acupuncture might help him to calm down. You have more of a challenge in transporting Charlie due to his size than those with smaller dogs. I have an extra crate in the car and I pad it well with blankets/towels around the insides to help prevent jostling around. And I buckle the seatbelt through the back of the wire crate to keep it secure. But I can carry Jeremy to the car and back. If it would involve Charlie walking to the car and then into the acupuncturist's office and back again, then you shouldn't consider it. You might want to look for an acupuncturist who would come to your home as some of them do that. Acupuncture helped my Jeremy calm down immediately but it would only last the rest of that day into the next day. I would look into some of the tips in the link above first. Sometimes just covering the top of the crate with a blanket, creating a den-like feeling, can help. How are Charlie's bowel movements today? The licking still the same, no worse?
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Post by Victoria and Allison on Jan 14, 2015 7:56:49 GMT -7
Thanks Marjorie! Charlie is not excitable in his pen, he looks kind of depressed. I think it's hard for him because of his history as an abused dog and likely he was chained or confined due to his condition when I took him off the street, head wounds, lack of teeth, cigarette burns, 20 lbs. underweight, etc.. The reason I wanted to do acupuncture was strictly for treatment of his back and nerves as an extra one-to-punch assurance he will keep improving. But yes, it would involve considerable movement getting to the car, getting up into the seat, walking to/from office and back, so I will wait. Thanks for confirming.
His licking is not very often, and is not worse. His bowel movement a bit more soft, better not worse. I will monitor every day. Sometimes I see him swallow 5-6 times in a row which I interpret as nausea or gastric. Overall still doing very well and very happy about that! Thanks soooo much. You all are just incredible.
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Jan 14, 2015 10:02:38 GMT -7
I would let the vet know today about the suspected nausea and again ask for Sucralfate. I know you only have a few more days of the steroid left but if there has been damage to the GI tract, Charlie needs something to heal that up. The vet should be made aware that his increase of the Pepcid AC may not have been enough. He may be acting depressed due to not feeling well. Is he eating OK? Does he like Kongs? You can freeze some of his food in a Kong and it can take some time for him to lick that out, which might keep him occupied and not bored for awhile. You can also freeze some bananas, apples or veggies in a Kong, though we don't like to recommend giving too many treats as you don't want him to gain weight while on crate rest. My Jeremy hated the crate too at first as he was abandoned and left in a pound for 6 months where he became cage aggressive from confinement. But he actually grew to love his crate after awhile - I think he saw it as a safe place to be. Kudos to you for adopting this boy and for all you're doing for him. He's a much beloved dog for sure!
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Post by Victoria and Allison on Jan 15, 2015 19:56:27 GMT -7
Great idea! Will try the Kong! I haven't seen any licking in the last couple days. He's eating WELL. Plate is clean! I think he's losing a bit of weight, which the vet recommended to ease his joints. I think it's because before being penned, he was eating food from other pets and now he can't We are almost done with the tapering off. His last prednisone is Sunday! Yea! Do you think there is any reason to continue famotadine? I think EVERYONE coming here are amazing caretakers because they care enough to do so!
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Post by Pauliana on Jan 15, 2015 21:27:15 GMT -7
Hi Victoria, I would say to continue the Famotidine through couple of days after the last Prednisone and then stop it. Very happy to see that Charlie is doing so well.
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Post by Victoria and Allison on Jan 21, 2015 16:54:07 GMT -7
I can't believe what just happened. Charlie was doing great. I was by myself and because I am not very mobile I let him out in the yard. He stayed out and was lying on the warm concrete and I thought that can't hurt him. Then he must have gone with the other dogs for about 5 minutes. I could not see them or what happened. I then called him in. He came back in and I put him in the pen. He was panting. I thought he was excited because this was the first time he interacted with the other dogs for 4 weeks. But I was wrong. He kept panting, then he got up and turned around and around, trying to get comfortable and he could not. Then he started a little short groan. He's still panting and getting up and turning. He must have hurt his back! I'm beside myself that I let him out after 4 weeks of perfect crate rest. I'm on my way to get refills of all his meds. I hope this awful experience can be useful to anyone else how a perfect recovery can go awry by thinking it was OK to let the dog out for "a few minutes".
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Post by Debbie Blackwelder on Jan 21, 2015 18:21:37 GMT -7
I'm so sorry this has happened to you but the crate is absolutely the safest place for your baby. Dogs can always do the unexpected - a doorbell could ring or they could hear something outside. They have to get used to the crate and accept it. Think of the crate as a cast for his spine. Too much movement and the disc can re-tear and you are back at square one again. It's just not worth the risk.
When your dog has been re injured it is advised to restart cage rest again. So you will be starting back at week one with the new medications. If Charlie were my dog I would take him to the vet tonight to be seen. Most likely he will probably need stronger pain medications to get him through the night after his romp.
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Post by Victoria and Allison on Jan 21, 2015 19:53:12 GMT -7
Thank you Debbie! I just picked up all his meds approved by the vet, back to square one. Vet says stay on tapered amount, i.e., prednisone 20mg one every other day, gabapentin 300mg1 every 8 hours and tramadol 50mg 3 tablets every 8-12 hours as needed. Famotadine 20 mg 2x's a day.
I can't get Charlie into car by myself (88lbs) but I have help in the morning. I'm on crutches. I'll see how he's acting. I wish I had this afternoon over! One thing that could have contributed; my housekeeper brought him back from outside day Monday and instead of leading him directly to the crate, she allowed him to step a few steps onto the tile and he slipped and fell down, his rear swinging to one side. I told her that I would let him in from now on.
Questions: How long do I have to wait to give medicines after the famotadine? Do I have to wait 30mins or more?
Thanks for being here to help!!
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Post by Pauliana on Jan 21, 2015 20:53:55 GMT -7
Hi Victoria! So sorry to hear about what happened with Charlie. Give Famotidine 30 minutes prior to the Prednisone and again 12 hours later. Give it even on the days you aren't giving Pred. Always give the Pred with food. Tramadol works better given every 8 hours on schedule, due to it being short acting. It doesn't really work well given as needed. Tramadol and Gabapentin can be given together. Hope once the medications kick in that Charlie can rest easy and get comfortable. Prayers for Charlie and comforting thoughts for you.
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Post by Victoria and Allison on Jan 21, 2015 22:40:30 GMT -7
Thanks so much Pauliana!
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
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Post by Marjorie on Jan 22, 2015 5:53:51 GMT -7
Victoria, I'm so sorry to hear that Charlie is back to square one and that crate rest needs to start over. All of the meds should also be back to square one. The signs of pain you saw indicate that there is swelling pressing on the nerves of the spine and therefore an anti-inflammatory dosage of the Prednisone is again needed to get that swelling down. It's the swelling pressing on the nerves that can cause the nerves to die resulting in nerve damage. Please speak to the vet today about starting Charlie back on the anti-inflammatory dosage with a taper to again begin in a week or so. The original dosage was 20 mg daily for 7 days.
The crate rest during conservative care does need to be very strict. With a small dog, we carry them outside to do potty and let them only take a very few steps at potty time. How many steps is Charlie taking when he goes outside to do his business? Do you have the crate right near the door to go outside? Are there any steps leading outside? He should be let right outside the door on a leash, allowed to pee right outside the door and back in. Movement of the spine deters healing of the damaged disc. I know you have more of a challenge with a large dog, especially now that you're on crutches but the less steps taken, the better.
I hope Charlie is resting comfortably now.
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Post by Victoria and Allison on Jan 22, 2015 8:27:25 GMT -7
Charlie just went out with my housekeeper. He wagged his happy tail. He can walk. No knuckling under today but I saw his back left paw knuckle under once last night in his pen. When he was walking back he faltered, like a trip, so his back legs showed weakness. Another sign is that the rear legs are spread farther apart. He's acting happy and hungry. I'm so grateful that it is not worse. I will be calling the vet today.
Thank you Marjorie and all for your support and help.
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Jan 22, 2015 8:32:52 GMT -7
So glad to hear that Charlie is hungry and happy! Please let us know what the vet says after speaking to them.
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Post by Victoria and Allison on Jan 22, 2015 8:39:51 GMT -7
The moderators think what I'm about to say will help others and my fondest wish is to keep other dogs from the awful pain of nerve damage. I sent a private message to Marjorie because I was ashamed of what happened yesterday. Here is that message:
"Thank you Marjorie. What happened is much worse than I thought. I looked up the tape on my security cameras, which were recently installed. I let him out and then a client called. So Charlie was out several minutes unattended - just what you have advised against. He went around the side and the video shows my other 80 pound 2-year old dog jump on his back, twice within several minutes, trying to hump him. Yes, right on his back. I cried as I watched the tape. The camera has a blind spot so more could have happened. Then Charlie came back to the door exhausted and I let him in, not knowing what had happened until now.
I know how awful this sounds. I have been kept him safe since 12/3. My only excuse is that my doctors have told me to stay off my feet altogether and pain convinces me to do so, rendering me chair bound and I'm really bad on crutches. I would go to the moon for Charlie. I'd do anything to take this back if I could.
This could be THE cause of Charlie's condition if my other dog has been doing this unbeknownst to me! I will never let my other dog near him again! I have two adjoining rooms with a see-through wall and lockable doggy door, so the separation is doable without limiting their lifestyles.
I'm pretty sure you will tell me to have him x-rayed again."
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Post by Debbie Blackwelder on Jan 22, 2015 10:33:08 GMT -7
Victoria, I am so proud you chose to share this with the group so that others can learn and be aware of dangers in their own home. I'm sorry I'm not that familiar with Cauda Equina Syndrome but I can tell you that having an x-ray on an IVDD dog is not that useful. Diagnosis of a disc problem can be suspicioned or suggested with standard X-rays but not proved. X-rays are used to rule out other disease that can mimic IVDD (vertebral fracture, tumor, bone infection, etc.) A standard X-ray can only show hard tissue and not soft tissue. X-rays show the bones of the vertebrae and not the soft tissue joints between them (the discs) nor the spinal cord running inside the vertebrae. Calcifications on an X-ray may not be the site of a current disc problem. Some dogs have calcifications but never have a disc episode. MRI, myelogram, and CT’s can prove the exact location of the injury and are used by surgeons in planning surgery.
Victoria I just wanted to say that I know how you feel having a sick puppy and not being able to get around. When my Rooter had his first surgery I was in a rehab facility recovering from double knee replacements and my son and husband had to take care of him all by their selves with many phone calls to me. I felt so helpless and worried. Hang in there, this will pass and life will go back to normal.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,605
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Post by PaulaM on Jan 22, 2015 11:17:49 GMT -7
Victoria, your own physical issues do make caring for Charlie a challenge. Sharing what happened at potty time can very well help to educate others. So thank you for a most excellent reminder Potty times are dangerous times as the dog is out of the safety of the recovery suite.
There should never be any other dogs around at potty times as things just WILL happen in a blink of an eye. Very glad to hear you already have a solution that can keep the dogs separated! When we learn more we can always do better. The reason for an xray would only be if there was thought of broken bone/fracture which an xray could contribute to giving the right treatment. Good news you have reported no pain, Charlie may just have luckily dodged the bullet! Let us know what the vet says.
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