Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
Posts: 105
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Post by Susi & Hans on Jan 31, 2015 15:30:09 GMT -7
Hi, My name is Susi and I have a 9 year old dachshund (20lbs) who went down with IVDD on Wednesday (1/28/15) morning. I had taken him out with my other dogs, and gave them breakfast. I bumped into him, and he yelped loudly and ran away. When I went to find him, I called him and he would not come. I went to him and he tried to stand, but it was difficult for him to raise up his hind end, but he was able to do so , but was wobbly and could not walk. I immediately called the vet who saw him 2 hours later. The vet (general DVM) stood him up and bent his back feet back, Hans did not return them to the normal position. While he was standing, he appeared to have some voluntary movement in his hind legs but could not walk. The vet did not take exrays, he told me that he probably had a herniated disc and needed to be in crate rest. He gave him an injection of Dexamethasone and something else ( I don't remember the name) I think it was a muscle relaxant. He told me to keep an eye on him and if he seemed to worse to call him otherwise call in a week to 10 days. He sent me home with
20 lbs Dex injection 1/28 and 1/30 Dexamethasone 1/28: .5 mg (1 tab 2x a day for 2 days, then 1 tab a day for 5 days, then stop) Dex 1/30 extended: more pills to give him, this time twice a day until gone. Tramadol 50 mg to be given 1/2 tab every 8-12 hours. He also told me to give him 1 10 mg of Pepcid 1x a day.
Hans was in a lot of pain Wednesday, panting, trembling, holding his head stiff and crying a lot. The next day Thursday 1/28/15, he seemed somewhat better, he ate and drank a lot if water. He did seem to still be having some pain. Yesterday, Friday 1/30/15, he was very quiet and lethargic, refused to eat and take meds (I had to force them into his mouth), so I took him to the vet again. The again did the same test of bending his feet back ack and trying to stand him up and Hans could not do either.; the vet said he had increased neurological deficits, so he did an exray. He showed me where a few of the vertebrae were somewhat close together and that he had some arthritic signs also. He also did a pinch test, and Hans did respond to that. So the vet gave him another injection of dexamethasone, and gave me more pills to give him, this time twice a day until gone. He did talk about sending him to get a myelogram (sp), and to possibly see a neurologist, both of which are extremely expensive, and I cannot afford (I am on disability). I asked if we could just keep him on crate rest for now and the vet agreed. He will see Hans again next Wed. I don't know how much pain he's in now because he is finally resting and sleeping where at first he would even lie down.
Anyway, I've gone on too long so to answer the rest of the questions, I'll try to be more brief. He cannot stand not walk. He does not wag his tail. He is peeing buckets wile in the crate I have him on pads), the vet said that he would be very thirsty and urinating a lot because of the medicine. He has only pooped 3 times since this happened. Once when I was attempting to use a sling to hold him up, then yesterday on the vets exam table, and just now on the crate. It's all normal, just not the usual amount. I've had two other dog with IVDD before, and they both recovered (they each had two episodes). Fully after 100% strict crate rest for 8 weeks. This time it seems so different though. The girls never peed in their crate and were able to poop outside with me holding them up in a sling. A sling is not working with Hans at all. I've given up trying to take him outside, I live upstairs and I was having a very difficult time carrying him up and down and he wasn't able to do anything. I was going to try outside on the balcony on a pad but to no avail. Poor guy is peeing so much that I'm having to change out the pad every hour it seems. I hate for him to have to sit in his urine. I hate seeing him so sick. II am so sad that I can't seem to help him any way. I have two other doxies as well, one who has a seizure disorder and the other has Cushings (she's not sick, she just has to pee every two hours or she pees inside) my apartment is starting to smell like urine. I am overwhelmed. I know that here I can probably get good advice and support. I'm sorry this is so long but thank you for reading it.
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PaulaM
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Post by PaulaM on Jan 31, 2015 15:50:21 GMT -7
Susie, welcome to Dodgerslist. In order to help you more, could you please answer these questions? ☐ Is the vet Hans saw a general DVM or a specialist (ACVIM neurology or ACVS ortho)? ☐ Are you currently doing the single most important care: 100% STRICT crate rest 24/7 only out to potty for this current disc episode? …. STRICT means 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)? ☐ Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy? Full pain relief is expected in 1 hour and stays that way dose to dose of pain meds. Your vet or an ER vet needs to know asap to add in pain meds if you are seeing pain. Dexamethasone is not a pain reliever. Over the course of 7-30 days it can get painful swelling down. ☐ How much does your dog weigh? Where you given any pills to take at home? Please list the exact names of meds currently given, their doses in mg’s and times per day given? This information should be on the bottle or on the veterinarians payment receipt. Please include the all important stomach protector such as Pepcid AC most especially because DEX is being used and it stays in the body for quite some length of time. 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 against not eating, vomit, diarrhea, bleeding ulcers by giving doxie weight dogs 5mg Pepcid (famotidine) 30 minutes before the anti-inflammatory. Please read up on Pepcid AC and if you believe he has no health issues of heart, liver, or kidney give the Pepcid AC and soonest as possible keep your vet in the loop on Monday. Know all about your pet's meds, reading IS very important: www.1800petmeds.com/Famotidine-prod11171.html ☐ Currently can your dog still wobbly walk? move the legs at all? or wag the tail when you specifically do some happy talk? ☐ Can your dog specifically sniff and squat and then release urine or do you find wet bedding or leaks on you when lifted up? ☐ Eating and drinking OK? Poops OK - normal firmness & color -no dark or bright red blood? ☐ If there is pain or neuro diminishment, dogs can benefit greatly with acupuncture or laser light therapy. These therapies can be be started right away to help relieve pain and to also to kick start energy production in nerve cells to sprout. So if this therapy is in your budget, seek out a holistic vet. ahvma.org/Widgets/FindVet.html Chiropractic is not recommended for IVDD dogs. Would at some point would surgery be a consideration for your family? Excluding an emergency of pain not being controlled or diminishment of nerve functions that require prompt vet help, we have excellent resources for many IVDD questions members have. While you are waiting for a reply, do check out our "All things IVDD" resources for getting the recovery suite setup to an overview of just how Conservative Treatment works: www.dodgerslist.com/literature.htm
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Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
Posts: 105
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Post by Susi & Hans on Jan 31, 2015 19:23:08 GMT -7
I answered all of these questions in my post. I guess I did too much explaining in between. Here they are once again:
1. My vet is a general practice DVM. 2. He is on 100% strict crate rest, beginning within 4 hours after he "went down". He has only been out to go to the vet or to potty. 3. He still has some pain, although it's not as severe as yesterday. He is reluctant to move or be moved, his tummy is tight, he yelps when I need to take him out of the crate. I really have not seen that he has had full pain relief after getting the Tramadol 4. The medications that he came home with are:
20 lbs Dexamethasone 0.5 mg every 12 hours BTW I know IT is not a pain reliever, but a steroid Tramadol 50 mgs 1/2 tab every 8-12 hours The vet did tell me to give him Pepcid AC 10 1x daily.
5. He cannot wobbly walk. He cannot stand on his hind legs or walk at all. He does not wag his tail at all. 6. He cannot specifically sniff then squat to urinate. He is urinating on his bedding, but he is not dribbling urine at all. He is not able to squat to defecate either, but when he does need to he kind of shuffles himself around in the crate until he poops. 7. He is eating and drinking normally.
Unfortunately acupuncture,and/or laser light therapy is not in my budget. Surgery is not an option financially as well, unless it comes to that, then I will need to raise the funds somehow. I'm hoping with all my heart that conservative treatment will be all that is needed, but will find the means to do whatever is necessary to help my dog.
I do hope this post has answered the required questions more thoroughly. I will do more reading and research here on Dodgers list while I wait for a response. Thanks you, Susi
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Post by Pauliana on Jan 31, 2015 20:47:34 GMT -7
Welcome to Dodgerslist, Susi! I saw that Hans could be given Tramadol at 8 to 12 hours. Are you giving it every 8 hours or every 12 hours? Tramadol is a very short acting drug and it doesn't work well unless it's given every 8 hours. Discuss with your Vet that Hans is still in pain and ask for an adjustment of his pain medication, Tramadol. His dose is light for a 20 pound dog. ( My 12 pound dog gets 1/2 tablet every 8 hours for his disc episodes) When pain is hard to control, it is helpful to add in Gabapentin, it helps Tramadol work better. If Hans is having the pain of muscle spasms, it could help to add Methocarbamol. The three together work wonders to manage the pain of IVDD so Hans could heal comfortably. Pain hinders healing, so it is very important to address that right away. www.dodgerslist.com/literature/healingpain.htmGreat your Vet knows the value of crate rest for healing a disc episode! He sounds like a wonderful and caring vet who will support you in caring for Hans during this episode. Just let him know that Hans needs more help to get pain free from dose to dose with no break through in pain. Any pain at all is too much pain. Also have your Vet or vet tech teach you how to express Hans bladder with a hands on your hands lesson. To get more out of the lesson please watch the videos and read our article on expressing: www.dodgerslist.com/literature/Expressing.htmA dog on Dex would have to pee every two to 3 hours. Most dogs that can't walk due to a herniated disc lose bladder control, so he can't pee on his own, what is happening is overflowing. Urine that sits in the bladder to the point of overflowing can cause a urinary tract infection as well as a loss of bladder tone.. Once you get the hang of expressing, the accidents will be a thing of the past as long as he is expressed until he is completely empty every 2-4 hours as long as he is on Dex. He can be expressed for poop as well so no more accidents on bedding. Here's how to set up recovery suite for easy clean up and to keep urine away from his skin: Mattress: Soft firm mattress of some sort: 2 inch 4 lb density memory foam mattress to relieve pressure points. NOTE: protect the foam mattress by inserting in a large trash bag and duct taping closed. Tuck in/cover with fleece. www.foambymail.com Check Walmart, etc. for human memory foam bed topper can be cut down and stacked for several recovery suite locations. Egg crate foam is another alternative __ Blankets and change of bedding: Fleece fabric as a bottom sheet wicks moisture away from skin (have 2-3 on hand) and dries quickly. Inexpensive fleece throw can be cut to sizes at Big Lots, Walgreens 2/$10. You can buy fleece yardage at JoAnn Fabric Store or the like. This is a no-sew project as fleece does not ravel. Layer in this manner: Trash bag enclosed mattress, pee pad*, fleece bottom sheet tucked in all around mattress. *Use human pee pads as they have no scent to encourage peeing. *OPTION to disposable pee pads are reusable waterproof absorbent bed pads: reasonably priced, washable and last a long time. www.allegromedical.com/ ; look for children's disposable bed mats at your grocery store. Cut down the twin size to make several crate size ones. Comforting thoughts and prayers.
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Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
Posts: 105
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Post by Susi & Hans on Jan 31, 2015 22:08:23 GMT -7
Thank you PaulinA, for thebinfo you gave on how to make a cratevrecovery suitebfor Hans. It looks likebi need to do some shopping to get his crate prepared. I may have to substitute somr e things, but ill do the best i i can
Please excuse my typing as i am using my tablet!
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Marjorie
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Post by Marjorie on Feb 1, 2015 6:11:35 GMT -7
Susi, when did the vet call for a taper of the Dexamethasone? Often, because Dexamethasone is very strong steroid, a vet will only use it for a few days before calling for a taper. A taper should not be started if a dog is in pain so if the taper is supposed to start in a day or two, please speak to your vet about continuing with the Dex for a little longer. Pain indicates that there is still swelling and more time of the anti-inflammatory dosage of the steroid is still needed.
We'll be awaiting word on what the vet says about adjusting Hans' pain meds and how your lesson on expressing goes today.
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Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
Posts: 105
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Post by Susi & Hans on Feb 1, 2015 15:46:43 GMT -7
On Wed 1/28, the vet put him on a tapered dose of Dex. When I took Hans in again on Friday, he upped the dose to 2 a day until gone. There are 20 tablets so I'm assuming ten days [Dex] He did not give any instructions on tapering down. I will bring Hans in again on Wed 2/3, for a recheck. I am going to ask for more pain medication because the Tramadol just isn't doing it. Hans seems to be in pain before eight hours are up. I'm also going to ask if they will teach me how to express his bladder, although he seems to be peeing every couple of hours now. He has been struggling to poop for two days, finally he was able to, and I think he felt some relief afterwards! I have a question, is panting a sign of pain or stress? When he is awake he pants all the time, but then again he always has been a dog who pants a lot....
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Feb 1, 2015 17:21:57 GMT -7
Susi, sounds like Hans does not have bladder control with all the urine leaks in bedding. Are you taking him outdoors every 2/3 hours to pee on his own? To confirm loss of bladder control does he leak (overflow) on you when lifted? That would show lack of ability to wait until in an appropriate spot to release urine. If bladder control has been lost and he has been overflowing all this time, he quite likely may already have a bladder infection. The standard test to know if there is bladder control is being able to sniff an old pee spot and then choosing to mark/release urine there. Let us know what you observe. Both Dex and tramadol can have the side effect of panting. And it can also be a sign of pain. If the panting is Tramadol/Dex related, you can try to place a small fan near the crate but not pointed at Hans to see if that will help. If pain, getting to the vet asap in the am will be necessary to see about more than 25mgs Tramadol, adding methocarbamol and maybe even gabapentin. Pain and expressing just can't wait til Wednesday.
-- At ER tonight or first thing in the AM you will need to get to your vet for a hands on top of your hands lesson on expressing if you believe he no longer has bladder control. You will get more out of the lesson by first reviewing the video and the tips: www.dodgerslist.com/literature/Expressing.htm You don't need a lesson to express for poop and it is not the health issue that bladder expressing is. You express for poop to keep abhorant-to-him accidents from happening in Hans' recovery suite: www.dodgerslist.com/literature/Expressing.htm#poop -- On Monday you wlll also want to verify if an infection has already started by a urinalysis. Lots of vets can do it while you wait or call you at home if antibiotics are needed. -- Since you are already giving Tramadol promptly every 8 hours, then it is clear Hans is being under medicated for pain with only a very light dose of 25mg Tramadol 3x/day. You will want a bit of background reading under your belt so you know why you are advocating for a muscle relaxer (methocarbamol) and possibly a 3rd pain med (gabapentin) Background reading: www.dodgerslist.com/literature/healingpain.htm You will want to advocate for increasing the mgs for Tramadol more in line with 20 lbs. Please let us know adjustments made to Hans' med list: 20 lbs Dex injection 1/28 and 1/30 Dexamethasone 1/28: 0.5 mg 2x/day for 2 days, Dex 1/30 extended: 0.5mg 2x/day for 10 days Tramadol 50 mg tablet: 25mg 3x/day Pepcid AC 10 mg 1x/day
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Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
Posts: 105
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Post by Susi & Hans on Feb 1, 2015 22:39:31 GMT -7
Hans doesn't leak at at all when I pick him up. I take him out on the balcony so he can pee on a pad that he's already peed on, but he doesn't pee. He wont stand up even if I am using a sling under his belly and hind end. I've even just tried holding him up myself, and he won't have it. I don't take him out to the grass because I live in an upstairs apartment, and he is heavy. It's been raing and cold also, so it's easier to take him to the balcony or just to put him on a tray that that has a pad on it. I still feel like he is holding his urine, I check him often to see if he's dry. He lets me know by whining that he needs to be changed. I will discuss this with the vet again though. I am going to call tomorrow to see if they can get him in and if not to get me more pain meds. I still need to read the info that you've recommended so I can advocate for myself and for Hans. I know that waiting until Wednesday is too long, I want him to be as comfortable possible. I haven't been able to get any foam for his crate yet, tomorrow a lady who runs a local dachshund rescue is ging to bring me some floor padding, but I don't think it's going to be thick enough. I'm going to see if I can get some on freecycle, and I'm going to also look at Goodwill, as I need to get more fleece throws for him. IBe not been able to get any of these things because I have no money until my SSDI check comes on the third. I'm am doing the very best that I can with what I have right now. He has a folded blanket padding the tray and a pee pad on top of that. He doesn't bunch them up until he's wet it, whiz is regularly every two to three hours. Please excuse me for rambling, I am so frazzled by all that is going on that I just think straight. My other two doxies have been neglected somewhat during this time, and my little girl who has Cushings is also peeing everywhere. I feel like I'm swimming in urine sometimes! My other little guy had a seizure tonight so I had to deal with that as well. I'm pretty much alone in taking care of all of this. Sometimes I just break down and cry because I'm so overwhelmed, other times Im holding it together. Now you can see why I say that I am frazzled. Anyway, I've rambled on enough for now. I'm not sure if I have explained my observations of what Hans is doing, I hope I have. Again, please forgive the length of this post!
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Marjorie
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Post by Marjorie on Feb 2, 2015 7:10:19 GMT -7
If Hans' isn't peeing when placed on a soiled pee pad (and he's used to going this way), then he hasn't passed the sniff and pee test, he doesn't have bladder control and needs to be expressed. Wetting in his crate as he's doing indicates that his bladder is overflowing with urine, which isn't good for the bladder. The bladder can be stretched out of shape and that can make it difficult for urine control to return. Also any urine lying in the bladder can lead to a urinary tract infection. You need to get a hands-on-your-hands demonstration on expressing this morning. Press upon your vet how urgent it is that you learn how to express Hans' bladder ASAP. While on the Dex, you'll need to express him every 2-3 hours. Here's our page again on expressing for your review before your demonstration: www.dodgerslist.com/literature/Expressing.htm
When you go in for your demonstration, I would also ask that Hans' urine be tested for a UTI. If you believe he's holding his urine, it may be that he has a UTI and it's painful to urinate. UTIs are common with IVDD dogs.
A tip that we've learned that might be helpful to you is cleaning Hans with cooled down green tea. Green tea neutralizes the acidity of urine, helps prevent urine scald and leaves a nice scent. Just make a pot of green tea, allow it to cool down and then gently wipe Hans' belly and legs with it. Use white vinegar in a spray bottle to kill the bacteria and the odor they cause on floors, linens, carpets, etc.
I'm not sure I understand what you mean when you say that Hans won't stand up even if you're using a sling. If you place a sling under him, you would lift up his hind end for him since he can't do it himself. You would lift his hind end until his spine is straight. What type of sling are you using? Some male dogs don't like a sling under the belly and the type with two circles that his legs slip into and actually holds his pelvis up might work better. Here's a Figure 8 sling that can be made from two leashes: www.dodgerslist.com/literature/cratesupplies/Figure8.jpg
Please let us know how the demonstration on expressing goes and what the vet says about pain med adjustments. You certainly do have a lot to deal with right now and I can see how overwhelming it all must be. We're here for you and Hans. Big hugs to you.
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Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
Posts: 105
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Post by Susi & Hans on Feb 2, 2015 8:09:42 GMT -7
I don't know if this good news or not. This morning Hans' crate was completely dry, so I decided to take him out to the grass to see if he would pee. As usual, having sling under his belly didn't wirk to keep him up. He wiggles around until he's sitting again. I don't know what I can do for this. )I'm sure that when I read your post I'll have an idea). anyway, I thought he had peed, so I brought him back upstairs. On our way up he proceeded to poop. I put him back in his his crate. A minute later, I noticed that it looked like he was using his abdominal muscle to push backwards. I thought he was pooping again, but when I went to him, he was sitting in a huge puddle of pee. I think if I'd have given him more time outside he probably would have peed out there. I know that you are the people with the knowledge and experience here, but I still this that he's got control of his bladder. He never ever peed in the house or a pad before, and he could hold it for a very long time. I think that when he pees in his crate, it's just because there's no where else to go and he can't hold it in any longer.
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PaulaM
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Post by PaulaM on Feb 2, 2015 11:21:15 GMT -7
Susi, if you know Hans should have to pee, then IF he has bladder control he will pee on his own. A full bladder is uncomfortable, and the desire to sniff and mark is instinct and something a dog will not ignore. It is a very real health concern to figure out if there is bladder control. Most dogs will whine, get agitated BEFORE they have to pee/poop. A dog that has bladder control will be able to hold it so you can get them outdoors. Dog not having bladder control, will have reflexes they have no control over releasing urine in inappropriate places. This release of urine is not peeing it is called overflowing. Reflexes do not release all urine and very quickly in a matter of a day or two a UTI will develop. There will be the need of an antibotic to kill the bacteria. Many males dogs DO NOT LIKE a sling that fits under the belly. The figure -8 sling is what most males prefer. A sling is needed only if Hans has bladder control. If Hans can no longer SNIFF and then PEE, you need to quickly get a hands on top of your hands lesson on expressing from the vet today. Let us know what pain meds have been adjusted so that Hans has no pain showing dose to dose of Tramadol. if you got a lesson on bladder expressing if the vet did a urinalysis to see if an infection has started.
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Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
Posts: 105
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Post by Susi & Hans on Feb 2, 2015 12:29:35 GMT -7
Hello again, I just called the vet, and the doctor who usually sees him is not in. They are going to speak to another one of the vets there to see about getting more pain meds or an increase in the Tramadol dosage. Now for the peeing issue. I had to go out for a while, and took Hans out before I left. This time he did pee, and it was not just a dribble, it was like he did before he went down. I just came home, and checked if he had peed while I was gone, he hadn't. I was getting just opening the door to the crate when he got really agitated like he really need to go, he pushed backward and peed before I could even get him out of the crate. I took him out side anyway and he did not pee any more. I just got a call back from the vet, and they said I can give him a half Tramadol every 6-8 hours now. Hopefully that will work from now until Wednesday. Thanks for your help. Susi
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Feb 2, 2015 12:40:25 GMT -7
While on Dex he may need to be let out every 2-3 hours to pee on his own if he indeed has bladder control. Are you taking him out every 2-3 hours?
We get a better picture of what you know, with specifics, like hours, dates, mgs, etc. So now you know we are a group who LOVE the detail! LOL.
So now with Hans getting 25mgs of tramadol every 6 hours (as you were giving it every 8 hours, right?) let us know how a prompt every 6 of 25mg Tramadol works to keep pain in control.
Good job on advocating and getting a phone change on the pain med!!!
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Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
Posts: 105
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Post by Susi & Hans on Feb 3, 2015 14:27:12 GMT -7
You all were right, Hans does not control of his bladder or his bowel. I guess I was just in denial, and the times that he peed outside just happened. I saw it this morning. He was dry this morning, so I took him outside to the grass and nothing happened. I even took him to different places where he used to pee, and still nothing. Then almost as soon as I put him in his crate, he peed. I don't remember if he went again a couple of hours after that. I needed to go out to run errands and when I came back he was soaked
So I took him out, washed him down the best I could, and remade his bed. When I went to put him in the crate I saw that he had pooped. It was all over him and the floor. I had to give him a quick bath to get him cleaned up.. I will definitely be learning how to express his bladder tomorrow and have him checked for a UTI.. Now I have a question for you... Would it be all right to use a belly band on him with a women's pad in it? There are times that I need to go out and and won't be home for several hours. I hate to think that if he pees, he'd have to sit in a puddle of urine. I know that having a wet pad in a belly band is practically the same thing, but it may be more comfortable for him. Speaking of going out, is it ok if I do? I have to get out of the house or else I'm going to go crazy! I'm already going through some pretty serious depression, and I need to avoid isolating myself. I need to be able to take care of my furkids. Anyway, I digress again, do that will be all for now. I will update you after the visit with the vet. Susi PS: thank you for your help, advice and support. I don't think I could be doing this it I hadn't come to dodgerslist. I appreciate it.
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PaulaM
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Post by PaulaM on Feb 3, 2015 15:00:48 GMT -7
A belly band is not something we normally recommend, But until you learn to express so there is not leaking, that might be helpful. And yes, there is no reason you should not go out. While on Dex the outings should not be too long because he needs to be expressed often. But once off of Dec expressing would go easily to every 4-6 hours.
Let us know how pain is being managed now that you are giving Tramadol every 6 hours.
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Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
Posts: 105
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Post by Susi & Hans on Feb 5, 2015 11:08:33 GMT -7
I am very frustrated I went to the vet yesterday and Hans hasn't had much change, so he is going to taper him off of the dex. He also will not give me any more pain meds, he told me that it doesn't appear that he is in much pain. I told him that i don't think that he has control of his bladder and bowel, if he would teach me to express his bladder. He thinks that Hans does have some control, because he is not dribbling when I pick him up, and that his bedding is not constantly wet. He did not take a urinalysis to check for a UTI. He didn't think that he has one. He did try to express him himself, but was unable to, because Hans tensed up so much and he wasn't able to feel his bladder. So that was a bust. This morning he was dry when I got up, so I took outside to see if he would pee. When I took him out, I discovered that he had pooped in his crate. When I took him back up, I sat gim on a pee pad mat, and I went to prepare the tub to clean him up. When I went to get him, he had scooched himself up and had peed all over the carpet. Yet the vet says that he has at least some bladder control. He still has deep pain sensation, so that is good, I guess. The vet wants me to start swimming therapy with him the weekend, and soon after, to try "walking" him a bit holding him up with harness. This vet is doing things so much faster than the vet I had before who treated my girls. I thought that he needed more time to rest and heal before I start any therapy. He does agree that it is going to take a lot of time for him to heal, maybe longer that the normal 8 weeks. He said that there is the possibility of him not being able to walk again, that we just have to wait. I don't know what to do. I can't afford to go to another vet, I can't afford to go get acupuncture done. So I am going to do what my gut tells me to do, and keep him still in the crate, and do what I can to keep him clean and comfortable. On a good not, other that not being able to walk, he is back to his bright eyed happy self. He is eating well, and of course drinking well. I know that once the Dex is stopped, he won't be drinking and peeing as much as hes is.
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Post by Debbie Blackwelder on Feb 5, 2015 12:02:21 GMT -7
Susi, there is not a whole lot I can add to what the other Moderators have already told you, but I can express to you the need to find a vet fast who is comfortable in treating IVDD. Hans went down on 1-28, so it has only been 8 days, it is way to early to determine if Hans will walk again or not. Nerves sometimes take a long long time to heal, so be patient. If Hans is still in "ANY" pain at all then it is to much pain. Signs of pain are: 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 normal perky self. Your vet being reluctant to prescribe any further pain meds is just simply wrong. I also see that Hans is on Dex, did you know that Dex is the most powerful of the steroid anti inflammatories and sometimes it takes from 7 to 30 days to get swelling down in the spinal cord with any anti inflammatory. It depends on the dog and the severity of the swelling. If Hans is is any pain at all then it is never proper to start a taper. Click on this link to read more about this and the medications that heal swelling: www.dodgerslist.com/literature/healingsweling.htmWhether or not Hans has bladder control is not taking care of your problem. The sniff and pee test has been described to you and you have tried it. Is it possible that you are not giving Hans long enough to sniff and pee and check out the right spot to empty his bladder? Some dogs can be quite picky when picking a spot to go. And have you tried the other slings that Paula suggested you try? Sometimes that makes a difference as Paula stated in her comment. My Rooter did not want anything touch his belly so I created him a sling similar to the two leashes turned backward and slipped over each leg. It is so important for Hans to be expressed regular if he is not going outside voluntary on his on, and it is important for you to take him to a vet that will test for a UTI and teach you how to express Hans properly. Until then watch the video on our expressing page and try to teach yourself how to express him. www.dodgerslist.com/literature/Expressing.htmI know money is tight for you right now so call around and find a vet who is experienced in dealing with IVDD so you can get the treatment you need for Hans right now and then stick with that vet. Some vets will even let you do a payment plan. I am so sorry you are having such a difficult time but read this and look into the links I am going to provide you: Board-certified neuros (ACVIM) and ortho (ACVS) surgical specialists can be found at University vet teaching hospitals. You can locate others in your area here: www.acvim.org [neuros] online.acvs.org/acvsssa/rflssareferral.query_page?P_VENDOR_TY=VETS [orthos] Dodgerlist Members' vet recommendations - dodgerslist.boards.net/board/10/guidelines-posting Have you looked into applying for Care Credit so you have more options of going to another vet? No or low interest credit for veterinary costs can be obtained from Care Credit. You find out online if you qualify: www.carecredit.com/faqs.htmlOther links www.dodgerslist.com/links/financial.htm I hope this helps you and remember we have all had dogs with IVDD and we know and understand how you feel right now. Hang in there, eight weeks will pass in no time and remember you have to be Hans voice and the leader of his team, he is depending on you right now to read and learn all you can about IVDD and his needs.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,606
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Post by PaulaM on Feb 5, 2015 12:29:08 GMT -7
Susi, I want to chime in and add to the important points Debbie made. First do not ever give up. Accupuncture is not critical. Dollars are best spent on the essentials to help Hans. Below are priorities for today.
20 lbs Dex injection 1/28 and 1/30 Dexamethasone 1/28: 0.5 mg 2x/day for 2 days, Dex 1/30 extended: 0.5mg 2x/day for 10 days til 2/8?? Tramadol 50 mg tablet: 25mg 3x/day Pepcid AC 10 mg 1x/day
TODAY: -- It is prudent to do a taper to see if there is pain. Are you seeing any hint of pain now before the taper, then it would not be time to taper. You would then need to find a vet to support Hans with pain relief and continuation of his steroid this week before you run out of Dex. Let us know exactly if you are seeing any signs of pain today between doses of Tramadol (shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy, not his normal cheerful self).
-- You have dex at the 2x/day dose til Feb 8, correct? OR is the taper to start sooner, please give the date of the Dex taper. What will be the taper in mgs and how often?
-- Hans has to be protected when you are maintaining his recovery suite. Harness and leash him to heavy furniture leg so that he can't scoot around. The single most important care is the 100% STRICT crate rest 24/7 only out at potty times for 8 weeks, absolutely no swimming, no baths, no scooting around is how the disc heals.
-- It really, really sounds like Hans does not have bladder control. This would be a reason to see a new vet today and get a lesson on expressing. For the lesson Hans needs 1-2 hours before the lesson a 1/8-1/4 cup of water to drink so there is something to practice on. In 1-2 hours there will be enough urine produced to practice on. Call in chips, IOUs, from family and friends if need be. The concern with a bladder infection is that it will move up to the kidneys and become life threatening. It has been days of no expressing and very likely Hans already has bacteria in the bladder breeding.
-- Let us know your city/state.
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Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
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Post by Susi & Hans on Feb 5, 2015 21:29:30 GMT -7
Ok, let me see if I can answer everything. The Dex taper began yesterday, he had 0.5 mg in the morning, and this morning. Then two more days of one a day. After that, one tab every other day for a total of 5 tabs. I can still give him 25 mgs of Tramadol every 8-12 hours, but he wants me to only use it if he's in pain or at night. As long as he's on the Dex, im giving him the Pepcid. He doesn't seem to be in pain, but it's hard to tell. He doesn't cringe or cry when I touch his back, but he's a little reluctant when I go to take him out, but he's never liked being picked up he tenses up and gets nervous. He doesn't cry or yelp when I pick him up. His tummy is tight but that's how it is always. He is back to his normal happy self for the most part. I know that he does not have bladder control nor of his bowels. I've tried several times outside in the grass in different places and I've held up his bottom. I have not tried to make the figure eight sling yet. When he is out of the crate I put him on a tray that has a pee pad on it, and he scooch around, mostly so he can face me. Otherwise he's not moving about the floor at all. Today I had to give him another bath because while I was changing his bedding, he pooped again, and his back end was covered in it. I dried him off well, and put him back in; and no sooner had I done that, he peed again. This time I rolled him over on his back to wash him down and was shocked to see how red and irritated his belly and legs are. He also had a small blister formed on the skin of his belly, which burst when I tried gently pat it dry. I have no one that I can ask for financial help from. The only family I have here are two of my children and they are not "able" to help. I use my daughters Care Credit card, and make the payments on it, but she has asked me to not used it any more so she can close out the account. I applied for my own Care Credit card and was given a $500 limit. That is halfway gone because of bloodwork and meds that Nueman needs (he has a seizure disorder). My other doxie takes meds also. Hans had always been my healthy dachshund. I am on disability and I occasionally make a small amount of money selling greeting cards that I make. I've had doxies with IVDD before and they both were on crate rest for 8 weeks for both episodes they had. The vet they saw was at the same clinic I go to now, but is no longer there. She had a totally different method of working with IVDD dogs, one being that they were to be resting not "swimming" a week after they went down. I know that all of you have gone through this with your own dogs, and you understand what I am going through. The only support I've got is from Dodgerslist and the Dachshund Lovers group on Facebook.
I forgot to tell you that I live in Glendale AZ. My vet is Mile McconMcVpnauhhry.
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Post by Pauliana on Feb 5, 2015 22:23:26 GMT -7
Hi Susi, Check the belly and back legs daily for abrasions. Treat with EMT Gel or Neosporin and a self-adherent wrap such as Coban or VetWrap. Keep skin clean of urine and feces. Baby wipes or baby body wash is easy on the skin. Marjorie's tip: boil and cool green tea to dampen a washcloth, neutralizes urine on skin and fur to avoid rashes from urine scald. If the condition does not improve within 3 days, seems worse or oozes pus, go to your vet as oral antibiotics and perhaps a skin culture might be needed. This is the link to EMT gel lambertkay.com/health/emt-wound-careIs there a local rescue that would be willing to help you with vet care for Hans?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,606
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Post by PaulaM on Feb 6, 2015 11:41:43 GMT -7
Susi, do not waste the Tramadol. 25mg 3x a day is almost like not giving anything for a 20 lbs dog. Stop the tramadol and observe for pain during the taper. If you see pain then call the vet to advocate staying on the steroid a bit longer. Advocate for giving more than 25mgs tramadol 3x/day. Pain usually will show by several signs. Seeing more than one sign of pain is helpful to verify there is really pain. So let us know which if any of these signs of pain. shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move in the cate, tight tense tummy. Avoid baths where you put Hans in the bath tub or sink, that is way too dangerous. Use Pauliana's idea of patting his fur and skin with green-tea soaked washcloth or baby wipes if you have them on hand. Boil the washcloth to sterilize for next cleaning session. Do you have in your medicine cabinet any kind of anti-biotic ointment such as Pauliana mentions: neosporin, bacitracin, tripple antibiotic ointment? Watch for redness, inflammation, pus with that popped blister which would need vet help. Great idea to contact a dachshund rescue in your town to see about getting a hands on lesson to express the bladder. Are you expressing for poop...that is very easy to do just watch the video. Expressing the bladder needs someone to show you how much pressure to apply. Here is the poop expressing video and the tips to know approximately when to try to express poop: www.dodgerslist.com/literature/Expressing.htm#poop
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Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
Posts: 105
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Post by Susi & Hans on Feb 6, 2015 20:57:56 GMT -7
Gonna try to keep this short tonight. I am using baby wipes right now to clean him up and I'm going to get some green tea and antibiotic ointment tomorrow. He doesn't seem to be bothered by this, but I'm sure he's uncomfortable. Where the bluster popped last night there's just a red spit, but it's not weeping. He has one other little bump on his tummy, but it doesn't look like the blister did last night. I noticed something else that I've never seen before on the joints (elbows/knees?) on the back legs. He has a bunch of little bumps there. They aren't blisters though. Another think to ask the vet. Speaking of which I'm going to start calling around and also call the rescues to see if they can help me find a vet, maybe teach me how to express his bladder. About expressing his bowel, I noticed that he does a funny little wiggle of his butt right before he poops; you can see that he's really trying to push it out. Both times that I've seen him do this have been when he's just peed and he's sitting on the pee pad, so I've gently lifted up his rump so he can push it out. I also noticed that his tail sticks straight out when he's going poop. Now I just need to figure out when he needs to go! That's about all for now. I wrote much longer than I wanted to, but I'm sure that you've all figured out I'm a tally person. Is cornstarch baby powder okay to use on him after I've dried him completely after washing him?
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Feb 7, 2015 6:11:52 GMT -7
The green tea will neutralize the acidity in the urine so it won't burn the skin. Also it leaves a nice fresh scent. So I don't think any type of powder would be necessary. I've read that cornstarch powder can be used on dogs but that you shouldn't use a lot as it puffs into the air and can irritate the nasal passages and lungs. I would just gently wipe belly and legs with green tea and pat dry.
Let us know how you do today with finding a rescue to help you learn how to express. Expressing him properly is the best way to protect both his bladder and his skin. Please also let us know if you're seeing any signs of pain during this taper of the Dex. Your vet will need to know ASAP if you're seeing pain return as that would mean the swelling has not yet resolved and more time on all meds is needed.
Blessings to you and Hans.
Blessings to you both.
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Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
Posts: 105
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Post by Susi & Hans on Feb 7, 2015 22:20:52 GMT -7
I am so furious right now. This was hans first day off the Dex and he's been crying all day. I don't know if it's his belly that's hurting him or what. I went to the vet and they gave me nystatin to put on his tummy. Even his feet are bothering him, he keeps licking at one. I got the green tea but I haven't made it yet. How many tea bags should I boil? I will use that tomorrow. I was using the powder to help dry him more after I patted him down. I was not puffing it on him, but turning away and putting it in my hand to then rub it on. Of course the vets office said to not use it, as it will cause more irritation. None of the rescues were willing to help teach me how to express his bladder. I'm afraid to try it even after watching Paula's video on YouTube. If the vet would have taught me way back on the 30th, maybe he wouldn't be so miserable. I've gotten good reviews of a vet that I will call on Monday and see how soon they can get him in. What kinds of questions should I ask them to know if they are experienced with treating dogs with IVDD? I wish I had the courage to go in to the vet who's been seeing him and tell him off, and tell them that I'm going to take him to another vet, but I dont . I don't even have the guts to ask for his records and exrays.. Hopefully they will. If not I will have to go ask for them myself, like it or not.
I just gave him 3/4 of a tab of Tramadol, hoping that it will ease his pain on his belly. It's the first he's had all day. One more thing that had me worried was that he only peed twice today, once in the morning and once just about a half hour ago. I feel so frustrated that I can't help him feel better. I've got a friend on the dachshund Lovers facebook page starting a youcaring account for me so I can try to raise the funds to help with his expenses and possibly with the meds that my other dogs take. Thank you the blessings I desperately need them now.
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Post by Rachel & Murray on Feb 8, 2015 3:11:46 GMT -7
Not sure how it works in the US but I'm in the uk and had to walk into the emergency bets and ask for my murrays medical history they were a bit funny but soon shut up when I told them I had a legal right to obtain them might be worth checking x
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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 Feb 8, 2015 6:16:23 GMT -7
Susi, the Dex works on stopping the inflammation. With the Dex now stopped, a return of pain indicates that the swelling has not yet resolved and more time on an anti-inflammatory is needed. If Hans is crying from pain, it could be the pain from the swelling once again pressing on the nerves of the spine rather than from his belly. Are there any other signs of pain besides the crying - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, nose held to the ground, head held up high, tight hard tummy, arched back? If there is pain, Hans must be returned to the anti-inflammatory dosage of the Dex ASAP. Does the vet have an emergency number where you can reach him today or is there an ER hospital available for you to contact? It's also imperative for you to learn how to express Hans' bladder. He may very well have a urinary tract infection and that's why he's only gone twice today since it's painful to urinate. It may be the UTI that is causing his crying, too. Do you have an emergency hospital within driving distance from you? Hans really needs to seen today by a more knowledgeable IVDD vet. Keep an eye on the licking to see if this turns to obsessive licking or biting. Hans could be feeling abnormal nerve sensations that are mild pins and needles but which could progress to painful burning, on-fire feeling that makes them bite to stop the pain. These are abnormal signals… neuropathic pain. Dogs have tragically chewed off body parts to stop the pain. An e-collar on or in a pinch a lengthwise folded towel, secured closed with duct tape can keep them from reaching their legs till you get vet help. Gabapentin helps with this kind of pain. www.dodgerslist.com/literature/neuropathy.pdfWith the green tea, make a pot of tea as you normally would - one teabag to a cup of water. Let it cool down, then dampen a wash cloth or sponge and wipe down. Here are questions to ask a new vet: www.dodgerslist.com/literature/VetchkList.htmYou need to be a strong advocate for Hans. Hans can't call the vet or make inquiries about a new vet on his own. You need to be his voice. Try not to be intimated by vets. YOU hire THEM and they are working for YOU. Hans is depending on you to get him the treatment that he needs. You have the right to Hans' medical records. Whether you get the records right away or not, Hans needs emergency treatment ASAP. My prayers are with you as you seek help for Hans today.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Feb 8, 2015 7:32:59 GMT -7
Susi, I did some searching for ER hospitals in the Glendale, AZ area. We've had problems before finding Board-certified neurologists in AZ so I had no luck there. But I did find an Emergency Clinic in Phoenix, which I believe you're about 9 miles from - Emergency Animal Clinic - 602-995-3757 - eac-az.com/?pmc=badge . Possibly, they could work out a payment schedule with you. Also there's a Veterinary Neurological Center in Phoenix. They have a doctor on call today who will return messages. 602-437-1488. I hope this helps.
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Susi & Hans
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Mom of three grown human kids and three senior doxie furbabies that are the light of my life
Posts: 105
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Post by Susi & Hans on Feb 9, 2015 11:46:54 GMT -7
First of all, I have something I need to say. I know that you are all giving me advice on what to do in Hans best interest, but I must say that I am just overwhelmed with all the things that you are saying that I MUST do right away for him. I have said in the past that I am receiving disability benefits and am on an extremely limited income. It is not as easy to do the things that you are telling me to do. I could not take him to the ER animal hospital, I am familiar with them, and they do NOT accept payment plans. Right now the Care Credit that I have is almost maxxed out, and I do not have the cash to pay the remaining part of the bill. I have no family or friends to asist me in any of this, I am doing the very best that I can. I have called the dachshund rescues, and one only knows of a vet that is across the valley from me. The other is in the process of looking for a vet herself. None of them are willing or able to teach me how to express Hans bladder. Secondly, if there is anyone that knows my dog and his behaviors it is me. When I said that he was crying all day, i now know that it is because he is unhappy. As soon as I open the crate and pay attention to him, he calms down. He is eating and drinking very well and is alert.So what I am trying to say is that it is not as easy for me to do what is being told for me to do. It is easier said than done. I do appreciate all of the help and advice, but please, please, please take these things into consideration. I am super overwhelmed and stressed and because of my disibilty (mental health diagnoses), if I cannot get things under control and my emotions more stable, I could very well end up in the hospital myself.I cannot and will not allow that to happen. All of my dogs need me, especially Hans, and I refuse to give up up an ony of them. I am doing the very best that I can with what I have and can feasibly do.I also have Hans best interests in mind.
Now for an update on Hans. The rash is much better, where the blister was is healing nicely. the redmess is gone. I honestly cannot say that he is or is not feeling any pain, now that I am tapering him off of the Dex. He does seem to be a bit more reluctant to have me take me out of the crate, and he did yelp one time when I reached back behind his hips to get him in my arms, He is stiffer moving, and trembling some so more that likely he is not feeling some pain. Yesterday when I picked him up to put him back in his crate, I swear that he lifted his left leg to get it on my arm so it would not be hanging, He did it again this morning., I don't know if the movement was voluntary or not. He still has deep pain sensation in his back feet. I have not given him any Tramadol in two days, and other that what I have described to you, he seems to be okay.
I have called two new vets this morning, and I have found one that looks promising. They have treated dogs with IVDD, and according to to their website do believe in pain management when it is needed. I have made an appointment with them for this afternoon. I have printed out the questions that you suggested that I ask, so I am prepared that way. I am hoping that they are as good as they seem.
I called another, but immediately saw that I would not take him there, the receptionist did not even know what IVDD was and had to ask the vet what it is, and if her treats it. His response was it depended how severe it was, if it wasn't too bad.
So, Today I will take him to this other vet and pray that he has experience working with dogs with IVDD, that he believes in conservative treatment for a full 8 weeks before he tries and therapy (if it is possible). I will see what his views are on pain management, and if her agrees on giving him all the meds that he needs to manage his pain when he has it. I will definitely have hin teach me how to express Hans bladder, so I can do it on my own. I am also going to have him a a urinalysis to check to see if he has a UTI.Please send positive vibes that this vet will be good.
What I do know is that I do not want to go back the vet who has been seeing him.
Today will be a consult first to see if he will work out the best for Hans care. Then I will get hans records from the other vet to transfer them over.
I hope that my rant did not offend anyone. I just needed to say what I am feeling. I understand that you are trying to help, but I just can do what I am able to. I do hope that you understand.
Susi
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,606
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Post by PaulaM on Feb 9, 2015 13:08:15 GMT -7
Susi, thanks for sharing some good news with us.... rash better/blister healing just fine, leg lifting to stay on your arm and finding a new vet for this afternoon's appointment. You are doing a good job in caring for Hans!!! Kudos to you for doing everything in your power to get things right for him. You did not offend at all to tell your feelings and circumstances of why. Please forgive us sometimes in our exuberance to get things right, time to read back through posts after a long day at the keyboard to re-familiarize ourselves about each dog, we can miss some points. Do know we have each dog's best interests at heart. I know that by now you have firmly planted in your mind how conservative treatment goes. (quick review here if you need it: www.dodgerslist.com/literature/healingpage.htm I'm quite sure you will not likely be swayed by anyone to start active PT before the end of 8 weeks! Besure to share with the new vet, your financial limits. That will make a difference in how he approaches ideas for treatment. He will know that you are committed to conservative treatment. Points to bring up are --- Pain still exists as of today. Dex is tapering and no tramadol and you are observing: yelp, trembling, reluctant to move. --- Discuss using a steroid known not to be so damaging to the GI tract as Dex is...discuss prednisone. --- Bring all med bottles if you will not have Hans' records at the time of the visit today --- Remind the new vet that Hans has been on Dex 0.5mg 2x/day for a total of 12 days now > Dex injection 1/28 and 1/30 > Dexamethasone 1/28: 0.5 mg 2x/day for 2 days, Dex 1/30 extended: 0.5mg 2x/day for 10 days til 2/8?? -- Discuss that there has been pain the entire time on Dex. More aggressive use of Tramadol such as 50mgs 3x/day should be discussed as at 25mgs 3x/day there was still pain. -- Make sure Hans has had a drink of water say 1/8-1/4 cup liquid 1-2 hours before the vet appt so you have something to practice on with the expressing lesson. Discuss the need to come back to the clinic if necessary to express there and have the vet tech check your work. My vet does not charge for this. Ask what the usual is with this new vet. -- It is best if the vet collects the urine at the visit for the urinalysis, that way it will be fresh and he may be able to collect it in the more uncontaminated way right before running tests in his office. Tell him Hans has been overflowing (can't pee on his own) since Jan 28 or so. Review ahead of time the $4 per each 30 tablet Rx programs at Walmart, Target, local grocery stores. Then you will be able to discuss with the vet if he can help you by giving you written Rx to take to one of those pharmacies. He will be doing a big favor that he is not getting paid for. So be sure to appropriately thank the vet on behalf of Hans' care. Call your local pharmacy ahead of time to verify they do have the meds on the program currently so you are not blind sided...things change. Pharmacies with generic $4 program: genericmedlist.com/www.dodgerslist.com/literature/IVDDcourse/medications_used.htmlGot our fingers crossed this new vet will be much more comfortable in treating a disc episode and managing pain.
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