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Post by Tricia & Bogey on Aug 1, 2015 18:47:56 GMT -7
7/26 Bogey woke up a little stiff. He wasn't really interested in breakfast, although he always wants to eat. By noon he was limping, mid-afternoon his front paws kept sliding out from under him, and by morning his hind legs were weak and he was unable to stand. We went to our general vet first thing in the morning (7/27). They verified that he still had deep feeling in all 4 paws but referred us to the emergency vet where they could do an MRI or CT. He had an MRI the morning of 7/28 and they confirmed he had a herniated disc. They did ventral slot decompression surgery on 7/29 on C3-4 and removed a large amount of herniated disc material. He came home the afternoon of 7/30. He was prescribed
[16.5 lbs]Prednisone 7.5 mg tapering off over approx. 2 weeks, Tramadol 25 mg, diazapem 1.5mg, famotidine 7.5mg, and he was already on trilostane 30mg for his cushings disease. Bogey is 12 yo dachshund approx 16.5 lbs. Bogey is confined to a metal kennel at all times other than potty breaks. He can't seem to find his comfortable spot so he's been scooting in circles (he currently can't use his left front paw). I'm concerned that paw is knuckling under and he lays on top of it after scooting in circles (worried it may lose circulation), so I've been gently repositioning it when I see it ( good/bad idea?). He still can't walk/stand although his other 3 legs are visibly stronger, so I'm looking for advice on helping him potty. I can hold him in a standing/squatting position, but since none of his legs are strong enough yet to hold him up, I'm essentially just hovering him over the grass. He hasn't gone yet in that position, so I've ultimately been lying him down on his side in the grass and he usually goes within a few minutes. Does anyone have any better suggestions? Also, does anyone have additional advice for neck surgery beyond what I found at www.dodgerslist.com/literature/cervical.htm? It seems that most doxies with IVDD have issues lower down their back. Any advice is greatly appreciated! |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,570
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Post by PaulaM on Aug 1, 2015 19:10:22 GMT -7
Tricia, welcome to Dodgerslist. It sounds like Bogey is in some pain. You need to get a call in to the surgeon and let him know your observations. Can you complete the med list with time/per day each dose is given so we have a better picture. [16.5 lbs] Prednisone 7.5 mg? ?x/day; tapering on what date? Tramadol 25 mg, ?x/day diazapem 1.5mg, ?x/day famotidine 7.5mg ?x/day trilostane 30mg ?x/day I would try a figure eight sling at potty time to keep his back aligns and from tipping over. A harness and leash would control his speed from darting off.  What did the surgeon direct for the number of weeks of crate rest. Many for example say 6 weeks. What did the surgeon direct for PT. PT is where Bogey is walking with slow and deliberate footsteps vs. being allowed to meander around and do what he wants. Helping Bogey place his paw properly as you are doing is a very good idea. This page will give you a good idea about nerve regeneration to repair damage such as the knuckling you see: www.dodgerslist.com/literature/healingnerves.htmDid your vet give you any exercises for paws/legs that are still paralyzed. Let us know if any of these exercises are ones you do. Physical therapy can help maintain the muscles with lost nerve connection. Therapy keeps muscles in optimal condition while in wait to on regenerating nerves Post-op PT for the paralyzed IVDD dog: |
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Post by Tricia & Bogey on Aug 1, 2015 19:37:14 GMT -7
Thanks for the quick reply! And thanks for the figure 8 sling idea! I do have a leash and harness but am not currently using it as darting off is not a concern since Bogey can't currently stand/walk and his scooting is so slow I can easily stop him. But the harness is waiting by the front door for as soon as he's mobile. I have a call into the surgeon but won't hear back until Monday. When I asked about PT I was told not to do anything at this point (we'll have a 2 week followup and discuss then). They said 6-8 weeks of strict crate rest.
meds:
[16.5 lbs]
Prednisone 5mg tablets. 1.5 tablets 1x/day for 3 days, 1 tablet 1x/day for 3 days, 1/2 tablet 1x/day for 3 days, 1/2 tablet every other for remaining (I think that will end up being 3 more half tablets, so 6 more days)
Tramadol 50mg tablets. 1/2 tablet every 6-12 hours
diazapem 2mg tablets. 3/4 tablet every 8 hours
famotidine 10mg tablets. 3/4 tablet 1x/day
trilostane 30mg 1x/day
Also, I forgot to mention, Bogey has full control of his bodily functions [bladder/bowel] and is still wagging his tail like crazy when I walk in the room!
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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 Aug 2, 2015 5:48:39 GMT -7
Is there any chance you could reach your regular vet or another vet at the hospital about the pain (not being able to get comfortable) that you're seeing so Bogey doesn't have to deal with pain until Monday? Every hour that he's uncomfortable is miserable for him so hopefully you'll be able to get an adjustment to the pain meds today.
Glad to hear that he still has bladder/bowel control and is giving you such a happy tail wag when you walk into the room. It's early days in his healing. It can take a couple of weeks for the swelling to resolve so you may not see any improvement until then. Keep up the good work!
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Post by Tricia & Bogey on Aug 2, 2015 7:13:46 GMT -7
I just put a call into the on-call doc and should hear back within an hour. I guess I hadn't thought they might up his meds. On the upside, Bogey slept straight through for 7 hours last night and has only struggled to get comfortable once in the 4 hours since we've been up. I noticed that he nudged his neck roll away so maybe that was bugging him.
Thanks for the encouraging words. I'm trying to do everything I can for him and am very thankful for all of the great info I've found on dodgerslist and people here on the forum. Although the pain, paralysis, and ultimately surgery came on so quick I didn't have a chance to review any of the literature, the whole time he was in the hospital I was able to scour the site and learn about a proper recovery suite, what to expect in recovery, etc.
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Post by Tricia & Bogey on Aug 2, 2015 8:52:20 GMT -7
the on call Dr. called back and increased his tramadol to 3/4 tablet (every 6-12 hrs.). I will still talk to the neurologist tomorrow about his comfort and a few other things. I noticed his famotodine will run out almost a week before the prednisone. I'm not sure if it's okay since the prednisone will be at a low dose by then, but I'll ask. Also the front left paw knuckling under and him laying on it still worries me. I can keep correcting it for now, but am worried about later in the week when I have to go to work and he'll be unsupervised for a few hours a time (in his crate but able to move and lay on his paw).
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Aug 2, 2015 9:17:44 GMT -7
Famotidine (Pepcid AC) can be bought over the counter, Tricia, and doesn't need a prescription. I just noticed that the vet prescribed 3/4 tablet 1x/day. We at Dodgerslist recommend giving 5 mg (1/2 of a 10 mg tablet) 30 min. before the anti-inflammatory and then every 12 hours thereafter (2x/day) for as long as the dog is on the anti-inflammatory, even during the taper, for the best protection. The famotidine should only stop when the anti-inflammatory stops. But of course since Bogey has Cushings Disease, that would all need to be approved by the vet/surgeon. Possibly you could discuss with the surgeon starting some massage and/or range of motion exercises to keep the joints limber and to help with circulation. Here are some exercises that you can check with the surgeon about as to when you could start doing them: www.dodgerslist.com/literature/massagepassiveexercises.htmGood job on getting the Tramadol increased. I hope that will keep Bogey nice and comfortable so he can relax in his crate. |
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Post by Tricia & Bogey on Aug 2, 2015 11:37:52 GMT -7
Thank you for all the famotidine info. I will definitely bring this up, along with the passive PT and massage. I don't want to wait 2 weeks if those are things that could help him now. After the increase in tramadol (and following a strained bowel movement), he's now been comfortably sleeping for about 2 hours. I read to add 1t. pumpkin to his food to help with constipation, so I'll start adding that at dinner. Thanks again for all the guidance!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,570
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Post by PaulaM on Aug 2, 2015 12:58:38 GMT -7
Tricia, the key to using the high fiber in pumpkin is the amount of water. Not sure where you read about pumpkin gave all the facts.
Pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation. The amount of water in the diet makes all the difference. NOTE: alternatives are really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potatoe.
--To loosen the stool, add equal parts water to each kibble meal and soak overnight. At mealtime add one teaspoon of plain canned pureed pumpkin 1x a day.
-- To firm up the stool add 1 teaspoon pumpkin 1x a day to kibble and no extra water.
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Post by Tricia & Bogey on Aug 2, 2015 14:51:56 GMT -7
Hmmm... that's good to know about pumpkin. Bogey has been drinking a lot of water since hes been home (and eating normally) but I know he wasn't interested in either at the hospital. Maybe that's just working its way through? I'll start offering him more water. He's always been very agreeable and will drink when told (unlike his brother). I'll also start soaking his food. I've done that in the past when he's not eating and he loves it. And if that doesn't do it, I'll pick up some pears. Thanks!
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Post by Tricia & Bogey on Aug 3, 2015 8:26:05 GMT -7
I spoke with the tech in neurology and ran my list of questions past her. She agreed that the famotodine can be given 30 min. before prednisone, so I'm making that change. She was going to check on the famotodine running out before prednisone, but didn't seem to have a problem with me picking up some more. She thought the Dr. might not feel it's unnecessary when we're tapered down to 1/2 pill every other day. She said they don't prescribe the pepcid 2x/day; just once.
I brought up the passive PT and/or massage and she said the Dr. doesn't want me doing any of that yet. That's frustrating to me if even gentle massage could help with blood flow in the meantime. I guess luckily our followup is only a week away now.
She confirmed it's okay to straightened his knuckled under left front paw after he's repositioned, but said it's not a circulation concern since he's not heavy. (I'll continue straightening it ).
I know I'm getting ahead of myself, but waiting and doing nothing is hard! I would like to begin researching options in the area for laser and acupuncture (location, Dr. qualifications, cost, etc.). Is there one method recommended more than the other? One better in neck injuries? I see they're both recommended, but am guessing cost is going to prohibit doing it all.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,570
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Post by PaulaM on Aug 3, 2015 8:59:52 GMT -7
If either acupuncture or laser won't break the budget these therapies can help stimulate nerves to regrow. With the good nerve functions he has (bladder control) that really bodes well for future nerve regeneration .... so don't feel negative if the therapies are not in your budget.
You can seek out a holistic vet who is trained in acupuncture or laser therapy
ahvma.org/Widgets/FindVet.html
Chiropractic is one therapy not recommended for IVDD dogs.
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Post by Tricia & Bogey on Aug 3, 2015 12:14:41 GMT -7
Thanks Paula that's good to hear. I want to do everything I can to help him get to the best possible outcome. They seem confident that 3 of his legs will come back to good (and he's already using them scooting to change position), but that front left paw is what I'm most worried about. Apparently doxies can't really function on 3 legs without assistance like other breeds can.
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Post by Tricia & Bogey on Aug 12, 2015 14:55:09 GMT -7
Our 2 week followup with the surgeon is finally here! Bogey has been standing on his front left leg but still can't walk on it ([front left leg] still knuckles under when he steps forward). His neck isn't bothering him anymore, and personality-wise he's back to normal. He's still on strict crate rest. I've started compiling a list of questions for our followup, but thought I'd see if anyone in the community can suggest any others. Here's what I've got so far:
-He's done with his meds; still has some tramadol. Should I wean off?
-can we start physical therapy yet? if so, what? stretching, massage, (ask for specific exercises, frequency)
-water therapy - can we do? when/how much? (get specific movements/exercises desired)
-acupuncture and/or laser - recommended? which, how often?
-will we see you (neurosurgeon) again? Should we get an appointment with the regular vet soon? What kind of followup Dr. visits should Bogey have?
I appreciate any suggestions anyone might have! Thanks,
Tricia
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Post by Pauliana on Aug 12, 2015 19:46:09 GMT -7
Hi Tricia,
Tramadol is normally backed off or stopped during the Prednisone taper so a true test for swelling can be made. If pain is being masked by taking Tramadol. the test for swelling didn't actually happen. If Bogey had shown signs of pain that would have meant the swelling was still present and more time on Prednisone at the twice a day anti inflammatory dose would have been needed.
It would be a good idea to stop the Tramadol with your Vets permission. If you do see signs of pain after stopping Tramadol call the Vet and let them know. They would likely put him back on Prednisone for another course and back on the Tramadol as well. Trying another test taper usually a week later. It can take from 7 to 30 days on the twice a day dose to get the swelling down. It is common for dogs to have to taper more than once. I noticed he was only on the higher Prednisone dose for 3 days, that isn't normally enough time.. Tapering doses aren't anti inflammatory.
Let us know how Bogey's follow up appointment goes.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,570
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Post by PaulaM on Aug 13, 2015 9:08:39 GMT -7
Tricia two weeks after surgery, often all the pain from the surgical procedure is gone. Some vets do wean off tramadol and other just stop it. So you will need to discuss with your vet. Physical therapy post op often is done days after surgery. Discuss which of these exercises and massage are appropriate for Bogey. Appropriate physical therapy can help maintain the muscles with lost nerve connection. Therapy keeps muscles in optimal condition while in wait to receive regenerating axon terminals and keeps joints from freezing up.. If there is underwater treadmill in your area that would also be an excellent therapy. You can even incorporate some of the ideas in at home water therapy: www.dodgerslist.com/literature/watertherapy.htmLaser therapy and even acupuncture can be started at any time to help kick start nerves to regenerate for that front leg. Read more including how effective U of FLA is finding laser therapy to be for their post op dogs. www.dodgerslist.com/literature/healingacupuncture.htm |
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Post by Tricia & Bogey on Aug 13, 2015 19:25:23 GMT -7
Followup went well! They were pleased to see him moving about, so we are now suppose to go on short leash walks daily. As soon as he gets tired or resists I am to carry him home, but to let him go longer distances if he wants. Since he is still knuckling under on the left front paw, she suggested I put a sock on it if it starts to get scuffed. I had started lowering the dosage of the tramadol a week ago, from 3/4 pill to 1/2 and from every 6 hours to 8 to 12. When we went in he hadn't had one in 24 hours, so they felt if he hasn't been in pain, we can stop those (so I have and he seems fine). Unfortunately the response to my questions about pt (incl. specifically massage and stretching) as well as water therapy was that we can't do any of that until 6 weeks. That's not sitting well with me  I asked about laser and/or acupuncture and was told those are fine but he doesn't seem to need either (although I have the ok if I want to). We will have a followup phonecall in 2 weeks where if all is well we will increase his activity (per the dr.), then an in person in 4 weeks which will be the 6 week mark. Sigh - glad we got a positive checkup, but I still feel like I could/should be doing more for him in the meantime. |
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Post by Romy & Frankie on Aug 14, 2015 4:51:22 GMT -7
I am glad to here that Bogey is doing so well. Sometime after Frankie's surgery, when he became able to stand and then walk, he could not position his feet correctly. We knew we needed something to protect his feet from being scraped. The product we used was PAWZ Dog Boots. They are made of rubber and just pulled on. This link has a discussion on footwear: dodgerslist.boards.net/thread/1564/footwear-harnesses-scooting-garments |
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Post by Tricia & Bogey on Aug 14, 2015 18:24:24 GMT -7
thank you for the links! Those sound great not only to protect his foot with the knuckling under, but also to help grip. I ordered some pawz today, and lucky me petco had them on sale and free shipping!
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Post by Tricia & Bogey on Aug 20, 2015 6:11:58 GMT -7
3 weeks in and Bogey's recovery is going well. He's walking! I thought the vet was nuts when she gave the okay for short leash walks since he was still knuckling under, so I started with walks on the grass. I also got some Pawz rubber booties that he wears in the house on the tile and wood floors for grip. Those things have helped a lot! Now he's hardly knuckling at all, so we've moved outdoor walks to cement. I can still hear his nails scrape a little, and he starts to stumble after a little while so I pick him up and we go inside, but he's going a little further and getting stronger with every walk. He's still on crate rest for the most part, but I do let him out for 4 or 5 small walks a day. He still doesn't seem to care that he's in a kennel the rest of the time, which I'm thankful for. He's been off all meds (except the trilostane for his Cushings) for a week now. We're supposed to have a phonecall with the Dr. next week, and I'm hoping she gives the okay to start therapy.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,570
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Post by PaulaM on Aug 20, 2015 9:07:15 GMT -7
Tricia, wonderful report. Your Bogey is on a roll with nerve healing!! Which one is Bogey?
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Post by Tricia & Bogey on Aug 20, 2015 14:43:49 GMT -7
Thanks, Paula! He's making progress a lot more quickly than I was expecting. I don't think he'd be doing nearly this good if not for all of advice on care, recovery crate setup, meds, harnesses, boots, ramps, and everything else I found here on the forum and on dodgerslist. I am so grateful.
Bogey is the short haired black and tan on the left, and Jax is the longhaired red on the right. The picture's a couple years old - they're both a lot grayer now (Bogey's 12, Jax is 13)
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,570
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Post by PaulaM on Aug 20, 2015 18:42:44 GMT -7
Tricia, it warms our hearts to know we have helped in some way to make the post op care go smoother. Would you consider paying forward to help a new member making decisions? We have a directory where you can share surgical costs: dodgerslist.boards.net/board/10/guidelines-posting State: Hospital: Address: Cost: Date of surgery: What was included in cost (MRI?, days stay, ER? PT? meds for home, sling, etc.) Comments: Then we invite you to hop on to our educational bandwagon team. Education about disc disease is our number one mission! We wish we did not have to hear of another dog that was put to sleep because of disc disease nor one denied the correct principles of crate rest to help them heal. We would like it when members to pay forward for the help they have received with their dog by helping us educate!
We depend on all members hand carrying our literature to their vets. When in conversation at the grocery store line or wherever they meet breeds most prone to IVDD (Dachshunds, Beagles, Poodles, Spaniels, Shih Tzus, Pekingese, and Chihuahuas) to give out our little cards. Hey if anyone reading this has not yet ordered literature..... don't wait a minute more, ask Linda to send you a starter packet: www.dodgerslist.com/literature/litorder.htm
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Post by Tricia & Bogey on Aug 22, 2015 6:25:31 GMT -7
done and done! sorry it took a couple days - I can't seem to figure out how to get alerted when there's new posts to my threads.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,570
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Post by PaulaM on Aug 22, 2015 8:02:20 GMT -7
Tricia, thank you for adding to our Vet Directory! Bookmarking a thread is very handy as when anyone posts to that thread you would receive an email alert. 1. Go to your Profile> Profile Edit > Notifications: checkmark BOOKMARKS 2. Checkmark your dog's thread in the Board's listings, then use the ACTIONS button to select bookmark  |
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Post by Tricia & Bogey on Aug 22, 2015 13:24:48 GMT -7
Thank you!! I had gone through all the profile settings but hadn't clicked edit profile to get the different options.
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Post by Tricia & Bogey on Aug 25, 2015 17:36:04 GMT -7
Today we had our 4 week phone consult with neurology. They were very happy to hear how much better Bogey's doing (our walks have continued to get longer, he's not knuckling under anymore, his nails scrape a little, he limps, and he occasionally stumbles). He was given the okay to be out of his crate as long as he's not jumping or climbing stairs, even while I'm at work. I did replace the dog stairs (to get on the couch) with a ramp, but although he's been watching his brother use it, he only tried for the first time today and seemed a little unsure. I think I will keep him in the crate just when I'm at work for the next few days until I'm sure he's mastered the ramp and isn't trying to exit the couch another way when I'm not here. I'm so excited to let him roam free in the house. Although he was so cooperative in the cage, I know he'll be happier out!
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Aug 26, 2015 4:55:31 GMT -7
So glad to hear how well Bogey is doing, Tricia! Just a few words of caution. While the surgeon who actually did the surgery knows best what damage there was, we usually do see surgeons recommend 6 weeks of crate rest following surgery, only out for potty and PT (PT would include the walking that you're doing). I would be very careful of what you let Bogey do over the next few weeks. Until a dog is fully trained to use a ramp, they should only be used while supervised to be sure that the dog doesn't use the ramp to go up but jump off the couch to get down. The best place for an IVDD dog is on the floor and we have tips on how to make the floor cozy and comfortable for them. We also recommend that a dog with IVDD always be crated when left home alone. Here are some tips on making your home back friendly and how to make a comfortable area on the floor: www.dodgerslist.com/literature/protectback.htmHere is our page on how to gradually reintroduce a dog to activity following crate rest and includes a list of never again activities: www.dodgerslist.com/literature/AfterCrateRest.htmSince IVDD is a lifelong disease, unfortunately our little buddies will have some restrictions for the rest of their lives. But they soon adjust to their "new normal". Please continue to keep us updated on his progress. |
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Post by Tricia & Bogey on Aug 26, 2015 8:24:49 GMT -7
I was nervous about that myself so I put him in the crate when I left for work this morning. Thanks for the links. I had thought of some of these but there's a lot of really detailed good pointers that I will implement when I get home. I have a couch in front of the living room window that both dogs spend all of their time on when I'm away (so they can see out and protect the house from squirrels and mailmen and such). That's always been their livelihood when I'm away, so I do I want to get him to the point that he can use that ramp. I started yesterday and he's not resistant, so that's good. I'll only put the ramp out when supervised, though, until I'm sure he's got it. The never again activities list is a good reminder as well. Bogey loves to shake his toys, so we may have to get rid of some of the more shake-able ones (he doesn't seem to do that with balls). Thanks again for all o the great advice!
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Post by Tricia & Bogey on Sept 10, 2015 8:17:17 GMT -7
Our 6 week followup finally came! The Dr. felt Bogey was doing good, and left it up me as to whether to pursue physical therapy. I will. I had already made phonecalls a few weeks ago to see what clinics offered what services, and spoke to the Dr/therapist where possible. We have an appointment next week at my first choice where both the Dr. that does acupuncture and the certified rehab practitioner will be present at the consult to help determine what treatment might be most beneficial for Bogey. In the meantime, I've removed all of the toys that he really likes to shake, and have him comfortably using the ramp to the couch and the small ramps outside. He still sometimes tries to jump off the ramp part of the way down, so I've got obstructions there to stop him. I remove the obstructions and work with him when I'm home, but can put them back to be comfortable he's safe when I'm not here. He walks kind of angled due to his left front paw damage, which is why I think he tries to angle off the ramp. Hopefully PT will help that; if not, I'll just build permanent walls on the side of the ramp. Our walks are getting longer, and Bogey tries to run a lot more now (to keep up with his brother). There's no knuckling, but the left front paw does still scuff a little when he steps, so the 2nd nail is ground down (not to the point of blood or injury or anything). His range of motion is just less in that paw. Now that we've been given the okay for PT, I'm starting to work through some of the videos shared above. If this is the best his paw ever gets, I'm ecstatic he got this far and can have a great quality of life as is. I'm hopeful for more improvement with PT, but content as is  |
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I asked about laser and/or acupuncture and was told those are fine but he doesn't seem to need either (although I have the ok if I want to).
