|
|
Post by Monique & Madison on Sept 7, 2015 13:17:57 GMT -7
My name is Monique here is the info on my fur baby:
1 Which breed? Dachshund 4 years old What is your dog's name? Madison
☆ 2 Did you specifically get a diagnosis of IVDD (pinched nerve, slipped disc, herniated disc, bulging disc)? Yes
-- Is the vet a general practice DVM or a specialist surgeon (ACVIM neurology or ACVS)? We saw both
☆ 3 date you saw the vet - 9/4
☆ 4 Currently pain? - meds are managing pain well.
☆ 5 How much does your dog weigh? 20 lbs.
☆ 6 On 9/4 Tramadol 50 mg 1 tablet every 8-12 hrs, Carprofen 25 mg 1 tablet every 12 hrs, Methocarbamol 500 mg 1/4 tablet every 8 hrs
9/5 to current
[20 lbs]
Tramadol 50 mg 1 tablet every 8-12 hrs
Methocarbamol 500 mg 1/4 tablet every 8 hrs
Famotidine 20 mg 1/4 tablet twice a day
Prednisone 5 mg twice a day for 5 days, once a day for 5 days and one every other day after
☆ 7. Now had no use if her hind legs but can wag her tail.
☆ 8 She has lost bladder control but I was taught how to express it for her and have not had any wet bedding.
☆ 9 Eating and drinking OK? Poops OK - normal color no dark or bright red blood? Hasn't popped in 24 hrs. Not eating or drinking well at all. I have to coax her to eat chicken and rice and have resorted to low sodium broth to try and get liquids down her.
|
|
|
|
Post by Ann Brittain on Sept 7, 2015 14:27:13 GMT -7
Hi Monique, Welcome to Dodgerslist. My name is Ann.
First thing to know is that it IS in the cards for your Madison to get back to enjoying life whether immediately walking or waiting on more nerve repair - IVDD is not a death sentence. Find out why that is true: www.dodgerslist.com/index/SDUNCANquality.htm
You say that the current pain meds are managing the pain well, but here is a list of the signs of pain. If Madison is showing any of these pain indicators, please contact your vet. Shivering, trembling, yelping when picked up or moved, reluctant to move much in crate such as shift positions or slow to move, tight tense tummy, can't find a comfortable position. Arched back. Holding leg flamingo style not wanting to bear weight, head held high or nose to the ground. Not their normal perky self. Remember dogs have a tendency to hid their pain so watch for any "unusual" behavior.
Pain should be fully in control in one hour when the dose in mg and the frequency is right for your dog and stay that way dose to dose. Pain not only hinders the healing process but is torture. This page has very good information as background to advocating for pain meds today via phone: www.dodgerslist.com/literature/healingpain.htm
Tail wagging is a good sign. Did the vet test Madison to determine if he has deep pain sensation? If so, what were his/her comments about the level of DPS or the lack of it?
Not eating much food today is a red flag sign of GI distress. Please speak to the vet today about adding Pepcid AC (generic famotidine). Phrase the question to your vet this particular way:" Is there a medical/health reason for Madison not to take Pepcid?" If there is no reason, we follow vets who are proactive against not eating, vomiting, diarrhea, bleeding ulcers by giving doxie weight dogs 5mg Pepcid (famotidine) 30 minutes before the anti-inflammatory.
It is imperative to keep Madison quiet 24/7 during the recovery period of 8 weeks for conservative treatment (crate rest and medical management). Conservatively treated dogs follow a plan of 8 weeks of quiet and rest to allow the disc to fully heal. Dogs on conservative treatment are limited only to a few minimal footsteps at potty time. Follow your veterinarian's instructions
Options for recovery suites
Wire crates are tolerated well by most dogs over the plastic airline crates. Wire crates can be purchased or modified so the top opens to lift the dog in and out of the crate. Playpens, ex-pens or with noted restrictions for pet strollers are other options. Size of the recovery suite should only be big enough to stand up, turn around and when lying down to fully stretch out legs. Pad out extra room with a rolled up blanket or towel www.dodgerslist.com/literature/cratesupplies.htm
We have a nice refresher summary of how conservative treatment works. Even if you have been through a disc episode with a previous dog, it is always good to make to hit all the important points again. Here is the link — look for the yellow button on our IVDD 101 page: www.dodgerslist.com/healingindex.htm
Look over our member tips and ideas to help make crate rest go smoother for the next 8 weeks. 8 weeks is how long it takes for the disc to heal. Check out the rose color box to the far top left for lots of good supply tips for your dog's recovery suite: www.dodgerslist.com/literature.htm
Keep us post as Madison recovers and be sure to post any questions or concerns. We will be thinking positive thoughts for you and your dog.
|
|
|
|
Post by Monique & Madison on Sept 7, 2015 15:32:42 GMT -7
She was grunting and arching her neck prior to pain meds but is now comfortable. Her stomach is nice and loose and she has been sleeping with out the muscle spasms that I could see before.
They did not check her for deep pain.
She is already taking an antacid. I read on a few of your threads that you recommend a secondary Drug to protect her stomach because of the lack of washout prior to her switch prednisone. Our Vet is closed today but I will call them in the morning to see if they will let us pick that up.
She ate a bit of chicken an hour ago and also drank some water. No BM yet. Do I need to get some kind of fiber in her to keep her stools loose?
I am hoping that the prednisone kicks in and we can see a little progress. If she can just get her bladder control back I can handle rehab and even getting her on wheels. I just don't have a way to manage expressing her bladder every 4-6 hours long term.
|
|
|
|
Post by Ann Brittain on Sept 7, 2015 16:02:46 GMT -7
Hi, I'm glad Madison is comfortable. That is the first step to help her heal.
It is also good she's on antacid. Can you tell us what specifically she is taking?
As regards no BM, her digestive system may be out of sorts due to the meds and inactivity.
You could try giving her a teaspoon of plain pureed pumpkin. This magical fruit - its high fiber can firm up stools, help with diarrhea, and loosen the stool to help with constipation. The amount of water in the diet makes all the difference. Note alternatives: really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potato.
For dachsie size dogs:
---To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day. This would be the amount to give Madison with her meals.
---To firm up the stool add 1 teaspoon pumpkin to kibble and no extra water 1x a day. I gave my Chloe, who had pancreatis, pumpkin when she had diarrhea, and it really helped solve the issue. It also helped our Buster after he had back surgery and was having a constipation issue. Hope it works for Madison, too!
As Madison starts to heal, her functions will return in the reverse order of the damage.
1. Deep Pain Sensation (Only correctly identified by a specialist.) (Madison has not been tested for DPP, so a confirmation from a specialist would help determine the extent of her condition.)
2. Tail wagging with joy at seeing you, getting a treat or due to your happy talk. (you said she's wagging so one indication of function is positive)
3. Bladder and bowel control proved by passing the "sniff and pee" test.
Take your dog out to an old pee spot in the grass. Let her sniff and then observe for
release of urine.
4. Leg movement, and then ability to move up into a standing position, and then wobbly
walking. (Sounds like Buddy is here)
5. Being able to walk with more steadiness and properly placed paws. 6. Ability to walk unassisted and perhaps even run.
You're taking the right steps to be sure your dog has the best chance to recover. Keep up the good work!
|
|
|
|
Post by Monique & Madison on Sept 7, 2015 16:44:15 GMT -7
Famotidine 20 mg 1/4 tablet twice a day
I listed all her meds in my original post.
|
|
|
|
Post by Ann Brittain on Sept 7, 2015 17:10:37 GMT -7
Hi, sorry I missed that in your list. I'm glad Madison is taking the antacid it should help settle her stomach.
|
|
|
|
Post by Pauliana on Sept 7, 2015 19:47:45 GMT -7
Hi Monique! Welcome to Dodgerslist. Glad you are here with us! Glad to hear that Madison's pain is under control and you are doing well with expressing since she has had no wet bedding. Great job!! Since there was no washout between Carprofen and Prednisone, Glad you are already giving Pepcid AC but I would ask for an Rx of Sucralfate, also. When it is deemed an emergency there can be a switch from a NSAID to a steorid without a washout. This has to be done with great concern for the double jeopardy to the GI tract. Both NSAIDS and steroid can damage the stomach mucous lining to cause bleeding ulcers to life threatening perforated stomach lining. Please very strongly advocate for another GI tract protector, in addition to the Pepcid AC, be on board, with the addition of Prednisone. Sucralfate works in a different way to immediately bandaid any disruption to the stomach lining and it has healing components in it's "bandage" while Pepcid AC works to stop production of stomach acids. You will want to be in the know about the timing of sucralfate with food, and with Pepcid AC at this vet's web page: www.marvistavet.com/html/sucralfate.html Sucralfate has to be given on an empty stomach, give Pepcid AC 30 minutes after Sucralfate and give Prednisone and a meal 30 minutes after Pepcid AC. Let us know what your Vet has to say about adding Sucralfate..and thanks for keeping us posted on how Madison is getting along. Keep on trying to coax her to eat and drink. Healing thoughts and prayers. |
|
|
|
Post by Monique & Madison on Sept 8, 2015 7:23:10 GMT -7
Madison finally ate a good size dinner last night and drinking quite a bit too. We have been able to express her bladder without any problems, but she hasn't had a BM in two days. I have not tried the pumpkin yet. She has been pretty finicky about her food and I'm not sure she will eat it. This morning I couldn't even get her to eat her pills wrapped in liver wurst. Do you think I need to take her into the Vet? I already have a call into them for the second stomach med.
|
|
|
|
Post by Romy & Frankie on Sept 8, 2015 7:53:44 GMT -7
Not eating can be a indicator of stomach problems so I hope that you will be able to speak to your vet quickly and get approval for the Sucralfate. Stomach problems can be very serious. Maybe put in another call in case your message got lost.
When Frankie was undergoing his crate rest, we learned about pumpkin for digestion on this site. I though Frankie would not take to it. To my surprise, he liked it and it did help keep him from being constipated. I liked it also because it was natural and he was already taking plenty of meds.
|
|
PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
|
Post by PaulaM on Sept 8, 2015 7:56:08 GMT -7
Monique, tramadol can cause constipation. So you might want to try 1 teaspoon of the pumpkin 1x/day. You can put it in broth to make it tastier if you believe she will balk at pumpkin in her kibble. 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. Glad you have a call in to request a sucralfate Rx from your vet. Not eating liverwurst pills can be a sign her GI tract has been affected by the no washout. Better to not take a chance. Read over so you know why you are advocating for sucralfate and the timing choices with food and Pepcid AC: www.marvistavet.com/html/sucralfate.html |
|
|
|
Post by Monique & Madison on Sept 8, 2015 12:33:46 GMT -7
I picked up the Sucralfate and have already given it to her. She ate this morning and took a teaspoon of pumpkin. No poop yet but it's only been an hour. She was able to stand on her back legs for a couple seconds at her last potty break. It is the first sign of improvement we have seen so we are very excited! She also started barking again today. Still hoping and praying she gets her bladder back. With my expressing her bladder every 4 hours, how will I know if she is ready to go on her own?
|
|
|
|
Post by Romy & Frankie on Sept 8, 2015 13:52:01 GMT -7
Good news about the Sucralfate. This link has info about sucrlfate including timing and interaction with other meds: www.marvistavet.com/html/sucralfate.html The "Sniff and Pee" test verifies if bladder function has returned: Let Madison sniff a previous pee spot in the grass. If she urinates right after, that it shows a message has been able to travel from the brain to the bladder! It will be necessary to manually check her after urination until you are satisfied she can empty her bladder fully. Bring her to a previous spot where you know that she or another dog has gone before. Do this a little before you would normally express her. When she can sniff and pee, it will be very clear. I remember my excitement when I saw Frankie do it for the first time. If she cannot do this now try again in a day or two. Another way to tell if bladder control may be returning is that you may find it more difficult to express her as sphincter control returns. If this happens try another sniff and pee test. |
|
Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
|
Post by Marjorie on Sept 8, 2015 14:13:20 GMT -7
I just wanted to chime in to the excellent advice given to you by Romy by adding that when giving pumpkin, the amount of water in the diet makes all the difference. To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day.
|
|
|
|
Post by Monique & Madison on Sept 11, 2015 9:52:49 GMT -7
So today Madison would not pee for us and then wet her bedding. When I took her outside she was panting heavily and I was concerned that she was in pain, but she just took pain meds two hours ago. Is this a step backward?
Thursday
Madison stood on her back legs for 20 seconds, and she went poop and pee on her own today. We are beyond thrilled!!
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
|
Post by PaulaM on Sept 11, 2015 10:48:24 GMT -7
Monique as I review Madison's med list is shows that prednisone is now in the taper. The test taper is to see if there is still painful swelling in the spinal cord. Your job during the taper is to report any hint of pain to the vet Rule of thumb pain = swelling = more time on anti-inflammatory, pain meds and Pepcid AC needed. 20 lbs Tramadol 50 mg 1 tablet every 8-12 hrs Methocarbamol 500 mg 1/4 tablet every 8 hrs Famotidine 20 mg 1/4 tablet twice a day Prednisone as of 9/5: 5 mg twice a day for 5 days, then taper At the start of the test taper, pain masking pain meds are also backed off or stopped to have a conclusive picture during the test by vets. So right now the waters are muddy as to pain, there is not a clear test. You will need to put on your detective hat to see if there is pain with the taper yet still on pain meds. Is there more than one confirming indication of pain? Pain after moving, nearing next dose of pain meds? Panting can be pain and it can be a side effect of both Tramadol and Prednisone. shivering, trembling, yelping when picked up or moved, reluctant to move much in crate such as shift positions or slow to move, tight tense tummy, can't find a comfortable position. Arched back. Holding front or back leg flamingo style not wanting to bear weight, head held high or nose to the ground. Not their normal perky selves. PANTING:
-- Try a fan near crate but not pointed at the dog to help circulate air some.
-- Try a frozen broth ice cube to lick on.
Dr. Isaacs discusses this issue: www.dodgerslist.com/neurocorner2/panting.htm
|
|
|
|
Post by Monique & Madison on Sept 11, 2015 14:43:31 GMT -7
Today is her first day down to one ▼Prednisone per day. She did take a large pee outside on her own just now. She also pulled herself up to a standing position. She did still have her paws knuckled under and they slipped out behind her, but it was encouraging. I think the panting was just from the heat. There haven't been any other signs of pain and her panting slowed after 20 min in the air conditioning.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
|
Post by PaulaM on Sept 11, 2015 16:34:11 GMT -7
Good news on pulling herself up into a standing position...she's following the classic textbook order of nerve healing Ann presented to you in her Sep 7 post!!
We've got our fingers crossed that the test taper will prove all the swelling is gone. Have you discussed having clearer picture on a taper by backing off or stopping the pain meds as well. Do you have a plan B you and your vet came up with as the weekend approaches. If there would be pain to avoid an ER visit with extra pills, an Rx in hand you could fill if needed?
|
|
|
|
Post by Monique & Madison on Sept 12, 2015 13:52:28 GMT -7
Only a day and a half into our taper and I can tell she is not taking it well. She is less active and less willing to try and move at all when I take her out to pee. She is also grunting when I pick her up. I already called her vet and they are going to take her back up to the▲ prednisone twice a day for 5 more days. Keeping all other meds the same for now.
[20 lbs
Tramadol 50 mg 3x/day
Methocarbamol 125mgs 3x/day
Famotidine 5mg 2x/day
Prednisone as of 9/5: 5 mg 2x/day for 5 days, then taper; as of 9/11: 5mg 2x/day for 5 days]
|
|
|
|
Post by Romy & Frankie on Sept 12, 2015 14:17:09 GMT -7
Hi Monique
Don't be discouraged that the taper showed that the swelling was still present. Typically it can take 7-30 days for pred to get all swelling resolved. The vet may try the taper again after the 5 days are up
|
|
|
|
Post by Monique & Madison on Sept 13, 2015 9:59:22 GMT -7
We went back to the prednisone 2x yesterday but she still seems off today. She ate well, but was still grunting quite a bit when I picked her up to go potty. She hasn't gone pee all morning and I can't express her anymore. When I try for too long she starts to grunt and wants to lay down. She is resting well in her crate. Do I let her sleep, or keep trying to get her to go potty?
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
|
Post by PaulaM on Sept 13, 2015 10:23:43 GMT -7
Monique now that Prednisone is back at 5mgs 2x/day, the pain meds (Tramadol 50 mg 3x/day, Methocarbamol 125mgs 3x/day) should be controlling pain.
I would first let her sniff and pee. If nothing, then try expressing for a 1-2 mins. IF nothing back to the crate try again in 1-2 hours when you think she should have to pee on her own (sniff and pee) if not try expressing.
Are you seeing two or more confirming signs of pain: not wanting to pee because she is in pain, shivering, trembling, yelping when picked up or moved, reluctant to move much in crate such as shift positions or slow to move, tight tense tummy, can't find a comfortable position. Arched back. Not their normal perky selves. And are you giving pain meds promptly every 8 hours?
Watch for leaking on you when lifted and urine leaks, which indicates loss of bladder control.
Let us know what you observe on the next potty break.
|
|
|
|
Post by Monique & Madison on Sept 13, 2015 23:35:40 GMT -7
Madison is back to her old self. She peed on her own today even squatted on her own after I got her standing. She also pooped a lot! So I know the pumpkin worked. She was much more active today. When out on a potty break she was crawling with her back legs today rather than dragging them. It was a delight to see but I didn't let her do much in fear of her setting herself back. So glad we pushed to get her back on the full prednisone for more time. She is getting much more whiny in her crate tonight. Not sure what started that. She is right next to me.
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Sept 14, 2015 4:53:54 GMT -7
So good to hear that Madison's bladder control is returning. Until you see that she is completely emptying her bladder on her own, it would be best to try to express after she has gone on her own to be sure the bladder is completely empty until control is completely back. Good sign of nerve healing.
You should be using a sling to support her hind end and not allow her to crawl or drag her legs. She can then move around using her front legs as you support her hind legs with the slinlg, but only a very few footsteps should be allowed during potty time. A sling can be made out of an ace bandage, a long scarf.
•Here's one you can make from an old sweatshirt www.lyonpuffpetsit.com/htmlslp/sling.html
•Kristen's figure 8 sling made from two leashes: www.dodgerslist.com/literature/cratesupplies/Figure8.jpg
Here are some tips to help calm her in the crate: www.dodgerslist.com/literature/EmergencyCrate%20Training.htm
Keep up the good work! 
|
|
|
|
Post by Monique & Madison on Sept 15, 2015 12:45:28 GMT -7
The vet has cut Madison's ▼pain meds in half and she seems to be doing really well. Her appetite has been restored. She is peeing on her own. No wet crate issues. She is standing and squatting to potty after I set her back legs. She has tried to lift up from a sitting position to standing on her own but loses balance in her rear. I bought a sling to support her back at bathroom breaks. She is doing quite a bit of tail wagging and her back legs twitch a bit when I have her in the sling but no real progress on steps. It has only been a week and a half but I've already noticed some muscle loss in her hind legs. Is there any therapy that I should be doing on them?
|
|
|
|
Post by Romy & Frankie on Sept 15, 2015 13:25:22 GMT -7
Good news that Madison is able to wag her tail and eating well. Madison is still on pain meds. When she is off all meds and still has no pain you can begin a very, very light least aggressive range of motion (ROM) and massage for Madison's paralyzed back legs as described in the information highlighted in PINK: www.dodgerslist.com/literature/massagepassiveexercises.htmCan you give us the updated med list below: 20 lbs Tramadol 50 mg 1 tablet every 8 hrs Methocarbamol 500 mg 1/4 tablet every 8 hrs Famotidine 20 mg 1/4 tablet twice a day Prednisone as of 9/5: 5 mg twice a day for 5 days, then taper |
|
|
|
Post by Monique & Madison on Sept 15, 2015 16:48:47 GMT -7
20 lbs
Tramadol 50 mg 1/2 tablet every 8 hrs
Methocarbamol 500 mg 1/4 tablet every 8 hrs
Sucralfate 1 gm 1/4 tablet every 8 hrs
Famotidine 20 mg 1/4 tablet twice a day
Prednisone [as of 9/5: 5 mg twice a day for 5 days]; as of 9/6 to 9/16 [for 11 days] at 5 mg twice a day, then taper to one per day for 5 days.
|
|
|
|
Post by Monique & Madison on Sept 16, 2015 16:06:46 GMT -7
I was watching Madison dream today and she was twitching and making noises like usual when she is really out. I noticed that her tail and one of her back legs was moving quite a bit but the other (right side) still isn't moving much at all. Is it normal to get the nerves back in one side before the other?
Also I read on another downed doxie site that they swear by a topical DMSO. Do you know what that is and if it's worth trying?
|
|
|
|
Post by John & Marley on Sept 16, 2015 17:46:42 GMT -7
I was watching Madison dream today and she was twitching and making noises like usual when she is really out. I noticed that her tail and one of her back legs was moving quite a bit but the other (right side) still isn't moving much at all. Is it normal to get the nerves back in one side before the other? Also I read on another downed doxie site that they swear by a topical DMSO. Do you know what that is and if it's worth trying? One of my dogs had his 2nd back surgery, his recovery took over 12 weeks before even having movement in his back legs and when he started walking his right side was more like a swing he didn't lift it, it kinda dangled. with a strict rehab program I developed for him his muscles came back and he was running a yr later like nothing happened.
You mentioned the DMSO topical, what were you told about it and what was it supposed to do ?
|
|
|
|
Post by Monique & Madison on Sept 18, 2015 14:05:25 GMT -7
That's great to hear John. I'm praying that Madison has the same success. We are two weeks in to her crate time. She has already regained her bladder control and can stand and even squat to pee. She does not seem to be in any pain but does grunt a bit when carried out to potty. This is her second day into the prednisone taper and I'm not noticing too much of a difference. She is still in great spirits and does lots of tail wagging when I talk to her. I'd like to look into laser therapy. How do you know that the places that offer it are properly trained? What is the average cost? Is it worth it? What about transporting her? Isn't more movement dangerous?
|
|
|
|
Post by Romy & Frankie on Sept 18, 2015 14:24:07 GMT -7
Hi Monique
When Frankie had his laser treatments his vet did them so we had confidence in her.
If you need to transport your dog by car during crate rest, pad out the crate with rolled up towels or blanket so that your dog will not shift in the crate as you turn a corner or brake.
To make sure the crate doesn't tip over wedge pillows between dash and the crate.
|
|
