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Post by Terri's & Pippin on Aug 8, 2016 23:57:19 GMT -7
Hello. Again. December would have been four years since my Pippin had back surgery and achieved what I considered a full recovery. I had wonderful advice from this forum at that time--thank you again. He just turned nine and has been feeling great. We've moved from Michigan to Oregon and he is a little country dog now. I started a new job and just today, had him at the dog sitter's home for the first time. She is aware he had previous back surgery...he is not allowed on furniture and is only allowed very limited stairs...one step into house; one step out to back yard. We have ramps everywhere around our house, because there are a lot more steps up and down to porches, but I thought the very limited steps at the sitter's house would be ok. We picked him up after work and he was quite excited to see us...jumping around, etc. until he suddenly started yipping and acting like he was hurt. I know from his first episode four years ago that it can "happen" out of nowhere, so I am not blaming the sitter. He and our other mini doxie ride in a small crate when in the car. He cried most of the way home and immediately crawled into his bed when we got home. During the 2012 episode, he was dragging his hind legs and could no longer stand; but the surgery and subsequent crate rest restored his ability to stand, walk and run. His left leg has always been weaker since then, but he gets along pretty well...just a little crookedness to his gallop. He is currently able to walk, but it is obviously hurting him.
Pippin weighs about 14 pounds. I actually still have some of the meds from his first surgery (done by Dr. Isaacs in Ann Arbor), but of course they are old drugs. He is sleeping in his bed now, but I am too sick with worry to sleep. I have the crate ready and I'm off tomorrow, so he will get his first full day of crate rest (we still have the little wheeled carrier the crate sits on to bring him with us into every room where we are). I know how to lift him and limit his movement. He seems to have full bladder control. Unfortunately, I just started a new part-time job, with a commitment through October. I am in a new place (state) and don't have any good options for in-home dog care--I tried to find someone but have been unsuccessful. What is your opinion about transporting him to the dog sitter's twice a week (in the car crate he shares with my other doxie) and having him in his own small crate at the sitter's? I can show her how to lift and carry him outside for potty breaks. I am concerned about this twice a week travel for him, but it is my only option right now, short of quitting my new job, five days in. With very few friends here yet and zero family within a thousand miles, I am feeling completely overwhelmed--I remember well what little Pippin and I went through together the first time he was hurt. He was quite the trooper...it truly is amazing, how he communicated his needs to me--we had a little system worked out. He is adorable! Any thoughts or advice would be very appreciated.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Aug 9, 2016 4:17:22 GMT -7
I'm sorry to hear that Pippin is having another disc episode. My name is Marjorie - what's yours? It doesn't sound as though Pippin has been to a vet yet. Please don't start her on the old drugs without seeing a vet to verify that this is another disc episode. Also, the drugs used for conservative care can be different from those used post-op. Please don't give pain meds at least 8 hours before his exam so the vet can properly evaluate her and see where the pain is coming from. Pippin needs to have EMERGENT vet care with the immediate starting of an anti-inflammatory to start reducing the swelling that's pressing on the nerves of her spine (which causes pain and can cause the nerves to die resulting in nerve damage). She also needs immediate pain meds to mask the pain until the anti-inflammatory gets the painful swelling down. She also needs a stomach protector such a Pepcid AC to help with the excess acid caused by the anti-inflammatory. If you have given any meds, be sure to let the vet know. Without an anti-inflammatory to reduce the swelling that's pressing on the nerves, nerve damage could be the result, with loss of bladder/bowel control and/or paralysis. In order to help you more, could you please answer these questions? ☐ What breed is your dog? ☐ Let us know you are on the same page about crate rest as crate rest during conservative care is much stricter than post-op. The hallmark component of conservative treatment is the crate rest part. With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. That 6 weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form. Super tried and true tips for setting up the recovery suite: www.dodgerslist.com/literature/CrateRRP.htmSTRICT means: - no laps - no couches - no baths - no sleeping with you - no chiro therapy - no dragging or meandering at potty times. Carry to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog's back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on! www.dodgerslist.com/literature/slingwalk.jpg☐ Once the vet exam has been done, please list the exact names of meds currently given, their doses in mgs and times per day given? What was the start dose if on a steroid, date of taper? Please include the all-important stomach protector such as Pepcid AC. Phrase the question to your vet this particular way:" Is there a medical/health reason for my dog not take Pepcid?" If there is no reason, we follow vets who are proactive against not eating, vomit, diarrhea, bleeding ulcers by giving doxie weight dogs 5mg Pepcid (famotidine) 30 minutes before the anti-inflammatory. ☐ 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? It is unfortunate that you have to transport Pippin twice a week. Be sure to pad the inside of his crate well with blankets/towels to help keep her from being jostled around too much when turning corners or braking. You can refer the dog sitter to our forum and your thread where we'll be glad to help her with any concerns she may have. Here's our page where she can start to read up on IVDD, too, and for a refresher course for you should you need it: www.dodgerslist.com/healingindex.htmPlease let us know what the vet says today after the exam and what meds are prescribed, including name of med, exact dosage in mgs and frequency given. Healing prayers for Pippin. |
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Post by Terri's & Pippin on Aug 9, 2016 8:01:53 GMT -7
Hello Marjorie and thank you for the response. My name is Terri. I have no way of getting Pippin to the vet today or tomorrow...my husband took the car to get to work, which is more than an hour away and we are both working tomorrow (very long hours); however, I can get him there Thursday.
Pippin is a male mini doxie, nine years old. I just took him out and he peed and pooped without any issues other than being a bit unsteady. I carried him outside and carried him back in, putting him in his little ambulance crate that was built for him after his surgery nearly four years ago. I am using the sling to support his hind end and limit his meandering. He ate his breakfast with his normal doxie vigor. I haven't given him any pain meds and won't until I can get him to the vet for evaluation.
Since he is still able to walk, etc., I am wondering if it's possible that he hasn't actually ruptured anything, but just hurt his back moving in the wrong way, and needs a couple of weeks of strict crate rest to recover, rather than a full 8 weeks. I hope this is the case! Our daughter is arriving for a visit in two weeks and Pippin hasn't seen her in two years. He is going to be overjoyed! 😄 But of course, if more time is needed, that is what we will do. I will post again once I have the opinion of the vet, any meds, etc. I sure wish I could take him back to Dr. Isaacs...I have no idea how knowledgeable our new vet is with ivdd. Thanks again, and for the healing prayers too.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Aug 9, 2016 9:14:49 GMT -7
Terri, the single most important care whenever there is a suspicion of a disc episode is the 100% STRICT crate rest 24/7 only out at potty times for 8 weeks. With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. That 6 weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form. Getting up to speed on disc disease will play a significant roll in your working with a new vet... not all know conservative treatment. Do make sure you see the yellow button info today, and follow the rest of the colored buttons in the next days
Getting to the vet soonest possible is to get the right diagnosis which then can follow with the correct treatment and meds. When there is unsteadlness or other neuro signs (nails scuff floor, wobby walk, legs cross, etc. that can indicate a real potential this might well be a disc episode. Nerve damage is caused by the bad disc pressuring the nerves in the cord. Nerves react by pain and as pressure continues/increases death. We observe nerve damage as weak legs, loss of paralyzed legs. So the treatment of starting one of the two classes of anti-inflammatory drugs is to get the swelling down. You would not want to start an anti-inflammatory yourself because you do not yet have a diagnosis and you may be tying the vets hands as to which class of anti-inflammatory he wants to use. The two classes may not be mixed nor switched without a 4-7 days washout Must read about anti-inflammatory drugs . Your own knowledge will help you better discuss meds and treatment with your new vet, understand how IVDD knowledgeable he is. Pain meds (such as Tramadol, methocarbamol) will leave the system in 8 hours and allow the vet to properly observe/diagnose Pippin. So if you are seeing pain, they might be used in in a pinch situation to give some comfort til you can see the vet. A NSAID or the steroid class are anti-inflammatory drugs and should not be given by you. You will want to monitor for nerve diminishment which requires getting ER vet help right away by a taxi. Hours matter in regard to seeing nerve death and getting the right anti-inflammatory on board. As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order. 1. Pain caused by the tearing disc & inflammation in the spinal cord 2. Wobbly walking, legs cross 3. Nails scuffing floor 4. Paws knuckle under 5. Legs do not work (paralysis, dog is down) 6. Bladder control is lost 7. Tail wagging with joy is lost 8. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. Surgery can still be successful in the window of 12-24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome.  Conservative crate rest is much more strict than for post-op crate rest. Keep up the good work of carrying to and from the potty place and limited footsteps to the minimal. Each time the back moves it pressures the suspected bad disc. Pippin is a good candidate at present if this is a disc episode to heal under conservative treatment with 8 weeks of rest to give the disc time to form scar tissue. Please keep us posted on how Pippin is doing regarding any signs of pain and neuro function. |
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Post by Terri's & Pippin on Aug 9, 2016 14:53:27 GMT -7
I was able to obtain meds for Pippin today and will take him to the vet for evaluation on Thursday. The vet prescribed
Methocarbamol (1/4 of 500mg tab every 12 hours) and
Rimadyl (1/2 25 mg every 12 hours)plus I'm giving
Pepcid 1/2 tablet a half hour before meds.
He is resting comfortably in the crate. I will update on Thursday. ~Terri
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Aug 10, 2016 11:12:54 GMT -7
Terri, very good news that Pippin is no longer in pain! Pain should stay in control dose to dose of the Methocarbamol. If not, phone the vet to get adjustments. Often it will take 2-3 pain meds (tramadol, methocabamol, gabapentin). So it is good if one pain med is doing the trick for a full 12 hours. Most of the time the short acting pain meds require an Rx for every 8 hours.
Pepcid AC lasts for 12 hours. Are you giving it 2x/day. Giving Rimadyl with a meal as added protection?
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Post by Terri's & Pippin on Aug 12, 2016 8:51:34 GMT -7
Well, it was good news at the vet yesterday. She took an X-ray and we could not find any areas to indicate new problems with Pippin's discs (thinning areas, bulges, white areas of hardening, etc). She was able to locate where the pain is generated during her examination...this time in his lower back, vs previously mid-back/shoulder area. Before seeing my new vet, I called Dr. Isaacs office to have them email all the relevant information of the 2012 surgery and I kept the X-rays from that time so my new vet was able to compare images and understand exactly what took place in 2012. Dr. Isaacs office suggested 3-4weeks crate rest with careful evaluation of progress. Short leashed walks once off pain meds and if any back sliding on progress...back in the crate. The new vet said very similar except she felt two weeks might be sufficient as it appears mostly a muscle pain issue; however, I am going to be very conservative in approach. She also prescribed an additional medication...100mg Gebapentin twice daily, to really knock this out. Pippin is still a little wobbly but not in pain. He is relatively content in the crate. I will be home with him for a full week before I have to go back to work, so hopefully, a lot of healing is taking place before another car ride to the dog sitter's.
Your article about living in fear with an ivdd dog is very relevant to us. Pippin is usually great about taking the ramps we have built for him from our porches to the yard, but every now and then, he wants to lay in the sunshine on a step, which of course causes him to go up or down a couple of stairs. My husband freaks out and yells at him, and also when he is "pogo-ing" with happiness when someone he loves comes over. He can't help himself and he jumps around with excitement. My husband yells at him to stop jumping around. A hate the yelling and constant fear of Pippin getting hurt. As long as he isn't in pain, I'm prepared to help him live life fully, taking what precautions we can but letting him live a happy dog life. Thank you for all your encouragement.
Is there a way I can upload a picture of Pippin's wheeled crate? My son In law built a wheeled platform for his crate in 2012, and we are using it again to keep him near us in the house. I thought other folks might like to see it and get an idea for building their own....
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Aug 13, 2016 10:10:12 GMT -7
Terri, is the wobbliness what you normally see because his left leg never did recover 100% after the surgery. Or is the neuro diminishment or still wobbly something new since 8/9? When there is pain only, it is difficult to know if a disc problem or overdoing muscles. With nerve diminishment that kind of points to something is pressing on the spinal cord. X-rays can show narrowed intervertebral disc spaces that are usual with disc disease but not proof of a current disc episode. Rochester Veterinary Specialists explain best the whys of xrays: To display a JPG on the Forum first upload it to a webpage and then copy/paste the picture's address in your next post. We'd love to have a picture of the wheeled platform for our Gallery. LOGIN www.dodgerslist.com/gallery/ : username: Dachsie password: dodgerslist14 Or you can email (owner's name, email addy, dog's name + photo caption) to : photogallery@dodgerslist.com |
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Post by Terri's & Pippin on Aug 13, 2016 13:19:15 GMT -7
Thanks for the response. The wobbliness I see is similar to what he has always had since the first surgery, just slightly more pronounced at times. When the meds are in full effect, and early in the morning after resting all night, he seems totally fine (i.e. his normal crooked gate). His left hind leg is the one that has always been weaker and that is still the case now.
If I understand correctly, you are suggesting it is possible the X-ray did not detect possible nerve and/or disc damage. Without doing the anesthesia and further imaging, we don't know for sure, is how I understand your comments. Where I live now, I don't believe there is a vet specialist like Dr. Isaacs with more advanced equipment. I would probably have to drive him to Portland, which is 4 hours away. My plan for now is to see how he does on crate rest. I will try to wean him off meds in a couple of weeks to see if he is still in pain; if he still has pain, then it is back to the crate and the meds, if not, slowly introduce him to short walks. I would also prohibit play time with our other doxie, and if there was any running or jumping, back into the crate. Basically, I would want to keep him very calm and inactive for a few more weeks, even if he isn't in pain and is out of the crate. Thoughts? The vet thought two to four weeks in the crate would probably be all he needs. Your comments make me think I should keep him in the crate, no matter what, for the longer time. Of course, there is continual second guessing on my part and concern that I will do something wrong! I don't want to keep him in the crate longer than necessary, but I don't want let him out too soon!! 😳
I will email pictures to you as I don't have a website other than my Facebook page. Thanks ~Terri and Pippin
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Post by Romy & Frankie on Aug 13, 2016 13:56:30 GMT -7
If his wobbliness is becoming more pronounced and he has pain it does seem to me like a disk issue. Your understanding about x-rays is correct. They cannot be used to determine for sure if the dog is suffering from a disk issue. The diagnosis is usually made by the symptoms and breed of the dog. Until you get a specific diagnoses from a vet saying otherwise then you can only treat it as a suspected disc episode. If you plan to treat Pippin with strict crate rest, additional imaging will not be needed. The immobility that is enforced by STRICT crate rest will help heal all the disks. It is not necessary to determine exactly which one is causing the issue. STRICT means: - no laps - no couches - no baths - no sleeping with you - no chiro therapy - no dragging or meandering at potty times. Carry Pippin to and from the crate recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog's back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on! www.dodgerslist.com/literature/slingwalk.jpgThis is why we recommend 8 weeks of crate rest. With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. That 6 weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form. We have seen more dogs heal on this Support Forum without a relapse to the early forming disc scar tissue when there has been 8 weeks of crate rest for the conservatively treated dog. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Aug 16, 2016 19:58:31 GMT -7
Terri, how is Pippin today? Pippin's picture is now at the Gallery, thank you for sharing: www.dodgerslist.com/gallery/index.phpGallery LOGIN: www.dodgerslist.com/gallery/ username: Dachsie password: dodgerslist14  I am attaching a picture of Pippin in his crate-mobile. When he had his first IVDD episode in 2012, my son-in-law constructed a wheeled platform for his crate so we could easily move him around the house with us. It has been wonderful! We removed the wire top of the crate and fastened foam padding to the edges with plastic garbage bag type "ties" so we don't scratch up our arms when reaching in. Also, Pippin doesn't like to be picked up from the crate, so I fashioned a little carpeted ramp for him to exit the crate for potty time. When he goes back in the crate, he uses the little ramp, then I move it aside. The crate can be lifted off the platform when we no longer need to move him around like this. The wheels swivel in all directions, making it easy to maneuver around furniture. They are heavy duty rubber, which also makes it easy to go from bare floors to rugs. The red crosses on the sides are just red duct tape. All we need is a little horn to beep as we are coming through! 😀. I thought perhaps other parents might like to see this and construct their own version, if they are handy. |
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Post by Terri's & Pippin on Aug 31, 2016 10:38:25 GMT -7
Hi! Sorry I haven't responded sooner. We've had houseguests and more coming for the next couple of weeks. I feel like it hasn't been the best for Pippin, because he gets excited inside his crate when people come in and out. But, friends and family made these travel plans to visit us months ago, so there isn't much I can do about it. Everyone is aware of Pippin's situation and being very respectful of it. There is just a lot of activity in our house which isn't as conducive to calm resting. One thing I have noticed is that while Pippin has always had issues with excited peeing, it seems to happen more frequently, even when it is just me around and not our guests. I was having to constantly move him around to wash bedding. I tried a belly band, which helps if he hasn't wiggled out of it, but he is a squirm master. I am now resorting to poochie pants, which are sold on Etsy by same name. These can't be wiggled out of, but are a little more tricky to get on him. I have two of them and keep them on him with a disposable pad. To potty, I unsnap the back end and fold it up, rather than taking the entire thing off.  Pippin is not on any pain meds at this point. His back left leg is still weaker than when after the surgery in 2012. Labor Day will be four weeks in the crate. This actually may be as good as it gets, but I will keep him in the crate for another month and hope for additional improvement. I know we are doing the right thing. He knows it too. He goes right into the crate without any protesting after his potty breaks. |
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Post by Romy & Frankie on Aug 31, 2016 13:49:58 GMT -7
It may be that Pippin's back legs remain weaker than after his surgery but he may continue to improve. Nerve healing is slow and no one can know how much healing will take place. You are definitely doing the right thing by keeping him in the crate.
How often is he being taken out to potty? Maybe taking him more often would help with the peeing.
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Post by Terri's & Pippin on Aug 31, 2016 15:57:50 GMT -7
Hi. I am taking him out every 3-4 hours. He has always been able to hold his pee for much longer than that, but since being confined to a crate, he gets excited when you come up to him to help him out or pet him/say hello. 😐
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
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Post by PaulaM on Sept 1, 2016 7:57:21 GMT -7
Terri, thanks for the review on the PoochiePants. While in general we do not recommend diapers, etc. because dogs do not like to be near body waste. There are, however, times when first learning to express or exicitement pee that this type of garment is helpful as a temporary measure. Sounds like you are taking him out to potty often enough and changing the pad to keep urine scald from happening. Maybe upon graduation, you will be able to see Pippin change his behavior re: excitement pee.
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