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Post by Deb & Ruby on Sept 13, 2016 19:15:53 GMT -7
Hello! When I awoke on Labor Day morning my little Ruby (Miniature Dachshund 10.2 pounds) was curled in a ball and would not move. It was obvious there was something drastically wrong with her. I scooped her up and brought her to the Emergency Vet. They xrayed her and prescribed 1.5 (5mg) prednisolone for 4 days then 1 for 14 days and so on, tramadol hcl 50mg 1/4 tab every 8 hours and robaxin 500mg 1/4 tab every 8 hours. The ER vet said she was sure she had IVDD and 100% crate rest for 8 weeks except for potty breaks. Four days later [9/5] we followed up with our regular vet. Ruby seemed to be doing better. I asked if she needed to stay in her crate all the time and I was instructed to keep her calm but she did not need to be in crate all the time and could stop her pain med. Monday [9/12?] we were back at the vet as she seemed to relapse. Our vet increased her prednisolone back to the 1.5 tabs and back on the tramadol. Our vet refereed us to a neurosurgeon for today, Tuesday. The neurosurgeon after examining the xray and examining Ruby is recommending surgery. He diagnosed the damaged disk as being in her neck. He will preform a Myelogram test and operate this Thursday. Her meds are now
[10.2 lbs] prednisolone [5mg tabs as of 9/1: 7.5 mgs 1x/day for 4 days, then taper as of 9/5]: 1.5 tab 5mg tabs 1x a day 9/12? pain tramadol 1/2 tab of a 50 mg tab 3 x a day, robaxin 1/4 tab of a 500mg tab every 8 hours, gabapentin 50mg - .5ml every 8 hours.
With all meds she is resting somewhat comfortably. She can walk but when in these painful periods will not work. She may have been a little leaky with urine. The neurologist is confident that she is a good candidate before she is paralyzed. I am beyond nervous and scared as this has happened so fast. Any input???
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Sept 13, 2016 19:47:17 GMT -7
Hi and welcome to Dodgerslist. What's your name? A med list is far easier for us to follow. Please check it over. If it needs adjusting just copy/paste into your next post with the changes: 10.2 lbsprednisolone 5mg tabs as of 9/1: 7.5 mgs 1x/day for 4 days, then taper as of 9/12: 7.5mgs 1x a day for ? days, then taper9/12? paintramadol 1/2 tab of a 50 mg tab 3 x a day, robaxin 1/4 tab of a 500mg tab every 8 hours, gabapentin 50mg - .5ml every 8 hours. It appears two things may have been the cause of the pain. Not being under 100% crate rest and the disc retore and/or the test for pain tapering of Pred reveal there was still spinal cord swelling. When pain appears on a taper, it tells the vet another course of pred is needed. Prednisone is an unusual drug. It is actually a hormone! The body normally makes its own steroid hormone to run the body. When there is a disc episode, vets use a synthetic steroid hormone which is at a higher level to try and get all the swelling down soonest possible. Here is where there can be a lot of confusion as to how long the effective part of prednisone is being given, the level where inflammation is being worked on. The number of days before the taper are very important to know. The days on the taper serve a different purpose. One is to test for pain in order to know whether to resume the original higher level of pred. The other reason for a taper is to signal the body to again produce its own steroid hormone as the pred taper might go to conclusion and stop if there is no observable pain. I know you will want to be completely up to speed on how the prednisone taper works, how pain meds are handled during the taper, etc. So I'm suggesting this page for the in depth knowledge you will want to have under your belt: www.dodgerslist.com/literature/healingsweling.htmRead over this information on surgery so you have some background on why you are choosing surgery and things you might wish to discuss with the surgeon. www.dodgerslist.com/literature/healingsurgery.htmDr. Isaacs answered alot of questions we've had about surgery: "Surgery needs to be a decision an owner enters into recognizing the risk, but also recognizes the benefit. This way if something unforeseen occurs an owner can be comforted and at peace with the fact that surgery was the right decision and they did all they could for their dog." You will find it worthwhile to read the rest of his answers about surgery: www.dodgerslist.com/literature/surgery.htmUntil there is a surgery, the pain needs to be in control fully dose to dose and/or when having to move in the suite and at potty time.. Contact your vet asap in the AM and strongly advocate for an aggressive use of tramadol at 50mgs 3x/day. The usual in controlling pain is to Rx at the higher end of the mg range AND promptly every 8 hours. What is the name of the hospital for the surgery? These are the extras you can do at home to help with a neck disc: www.dodgerslist.com/literature/cervical.htm
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Post by Deb & Ruby on Sept 14, 2016 9:10:26 GMT -7
10.2 lbs prednisolone 5mg tabs as of 9/14: 7.5 mgs 1x/day tramadol 1/2 tab of a 50 mg tab: 25mgs 3 x a day, robaxin 1/4 tab of a 500mg tab every 8 hours, gabapentin 50mg - .5ml every 8 hours.
Thank you for your response. I had combed all your articles previously. I did find Dr Issacs article helpful. Your comment on the tramadol is a bit confusing to me. She is on 1/2 tab of a 50mg tab, which is 25mg 3 x a day. Are you saying she should be on 50mg 3 x a day? She is scheduled for surgery tomorrow. With her current level of medication she seems to be comfortable. I think it was adding the gabapentin and moving the tramadol from 1/4 tab to 1/2 tab. We believe it is in her best interest to have a full life and not risk paralysis etc. The surgeon is Michael Kimura, DVM, DACVIM-Neurology with Blue Pearl in Tampa Florida. He believes she is an excellent candidate for the surgery. I believe part of the issue is that her disc issue is neck versus back. He explained the back is more receptive to conservative treatment than the neck. He stated that she would have maybe a 20-30 percent of success in medically treating and she has probably 90% or better chance for success with surgery. As absolutely agonizing as it is, we will try to give her the best quality and most comfortable life possible by pursuing the surgery.
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PaulaM
Moderator. ![*](//storage.proboards.com/forum/images/stars/star_magenta.png) ![*](//storage.proboards.com/forum/images/stars/star_magenta.png)
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Sept 14, 2016 9:56:53 GMT -7
My name is Paula, what's yours? We are a friendly little group and just go by first names.
If the current dose and frequency of the pain meds have Ruby in comfort then they are correctly prescribed. I just wanted you to know a vet would have room to increase Tramadol IF, if Ruby were still showing signs of pain. So 25mgs of Tramadol 3x/day is doing a good job for Ruby to keep her in comfort til the surgery.
Please keep us posted on Thursday as you hear back about how the surgery went. We will be thinking of you both and sending positive thoughts for a good results!
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Post by Deb & Ruby on Sept 14, 2016 12:54:52 GMT -7
Paula,
Thank you! Needless to say I am a nervous wreck heading into this surgery, but the Neurologist and my vet are quite confident. Her surgery is tomorrow 9-14-16 and they say I can see her the next day. She should be discharged on Sunday 9-17. I am already thinking ahead to Rehab and Laser treatment for her. Some say total bed rest and some say that is old school and rehab should be introduced early. The Neurologist said 2 weeks strict bed rest. I have a call into the Rehab Dr now. Any recommendations?
Deb Powell aka Ruby's mom
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Post by Romy & Frankie on Sept 14, 2016 13:43:04 GMT -7
Surgery for our beloved dogs is a scary thing. I remember how scared I was when my Frankie went in for surgery. His surgery went well and took care of his pain immediately. What we most commonly see prescribed after surgery is 4 to 6 weeks of crate rest. Sometimes a surgeon has prescribed as much as 8 weeks if the surgery was complex. Usually laser therapy or acupuncture can be done during the post-op crate rest period. Dr. Isaacs, a nuerosugeon, has helped us to understand why the importance of crate rest after surgery with this answer: "Crate rest is important post-operatively to help prevent damage to the surgical site. If a dog gets too active bleeding can occur that leads to a hematoma (blood clot) compressing the spinal cord. Also, it takes 2-4 weeks for the rent/hole in the intervertebral disk to heal and seal over. So, if a dog gets too active post-operatively additional disk material can rupture and we are right back or worse than we were to to begin with." You may find his other post op answers good reading and of particular interest: www.dodgerslist.com/literature/surgery.htm. We will be anxious to hear news when you are updated by the surgeon. Sending the most positive of thoughts for a good surgical outcome and getting all the offending disc pieces removed.
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PaulaM
Moderator. ![*](//storage.proboards.com/forum/images/stars/star_magenta.png) ![*](//storage.proboards.com/forum/images/stars/star_magenta.png)
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Sept 14, 2016 15:29:04 GMT -7
Deb, the benefit of surgery is that PT can be started very soon after., sometimes the day after. PT is always supervised, slow and deliberate, under your full control to keep from darting off with a leash and harness and sling if needed. So on discharge day you will get all the particulars from your surgeon for how many weeks he wants for crate rest PLUS the kind of PT he directs. When there is no neuro diminishment, that PT might be just a slow and diliberate controlled walk to and from the potty place. Sunday will be upon you before you know it. Now is the time to jot things down that concern you. Here's a starter list of questions to which you can add some of yours so nothing goes without an answer during the excitement of picking up Ruby: www.dodgerslist.com/literature/dischargequestions.htm
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Post by Deb & Ruby on Sept 15, 2016 16:22:04 GMT -7
Surgeons update: Ruby's surgey was very successful. Her issue was between the 2nd and 3rd vertebra. In stead of a jelly like substance it was more toothpaste/cottage cheese ( as he described ) but he was able to get it all. The rest of her spine does have degenerative disc disease, 2 vertebra with tiny mineralized deposits. He said she had a small seizure post op, due to the milogram but that she is fine now and resting comfortably. He does not anticipate any more seizures. I will visit with her in the morning. Upon discharge he is prescribing 2 weeks of complete crate rest with only out to potty.breaks. As she had not yet developed and paralysis or dysfunction he does not anticipate the need for therapy. After 2 weeks he wants us to begin with a low chest harness, walking her for 3-5 minutes 1 -2 2 times a day and weekly increase up to 10-12 minutes 3-4 times a day.
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Post by Pauliana on Sept 15, 2016 17:13:43 GMT -7
Hi Deb,
Thanks for the after surgery update. Glad Ruby is recovering. Sorry to hear that she had a seizure after the Myelogram.. glad the Vet doesn't expect any more. I am sure you are anxious to go see her. Please let us know how your visit with her goes tomorrow..
Healing thoughts and prayers for Ruby.. and comforting thoughts for you!
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Post by Deb & Ruby on Sept 16, 2016 18:19:24 GMT -7
Pauliana,
Hello! Thanks for the thoughts and prayers. No more seizure incidents for Ruby. I visited with Ruby today. Tough visit. She seemed to be in pain and shaking when they brought her out to me. They bring her to an examination room for the visit. I asked when her pain meds were due. They told me not for another hour and they are strict on the time :-( After some time with her she seemed to calm a bit and snuggle in. I think it was good to visit with her and give her some love and support. She seemed very sad when they took her back. She probably thought she was going home. I called in to check a few hours later and they told me they did give her some extra pain med to settle her and she was resting comfortably. Going back to visit tomorrow. She comes home Sunday...can't wait.
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Post by Pauliana on Sept 16, 2016 21:50:08 GMT -7
Hi Deb, Glad you got to see Ruby. Sorry to hear she was in pain, very hard for you to see! ![:(](//storage.proboards.com/forum/images/smiley/sad.png) It's a good thing they gave her more pain medication. If the dose is right, she should be pain from from dose to dose. Before she comes home they will put her on oral pain medications and send them home with her. More info on pain meds used for IVDD. dodgerslist.com/literature/healingpain.htmHopefully Ruby will be feeling better tomorrow. It takes 2 weeks for the surgical swelling to go down and at that point you will begin to see the direction her healing will take. I'm sure you are looking forward to having her back home! Thanks for keeping us updated.. We'll be thinking of you and Ruby!
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Post by Deb & Ruby on Sept 19, 2016 7:46:27 GMT -7
Pauliana,
Hello! Ruby is thrilled to be home. Her furry buddies were also thrilled to see her, particularly my sons doxie. I know they were stressing as to her whereabouts. Her meds are keeping her comfortable and she wants to do more than she can or should. She is walking well. I bought a small outdoor play yard for her to potty in, as no harness for now. I did find a wonderful harness for Dachshunds though and ordered one for when she is cleared to begin walks. buddy-belts.com Thank you for taking the time to talk to me through this. It is very much appreciated!!
Deb
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Post by Deb & Ruby on Oct 7, 2016 14:34:02 GMT -7
Well it has been 3 weeks since Ruby's surgery and my biggest issue now is keeping her calm. Her meds were all stopped after 2 weeks. She is too energetic and does not want to keep calm. She digs and hops around in her kennel. In her play yard she will jump up on the sides. I am trying to ignore her and reward her for being quite but I am afraid when she starts the digging and jumping that she will cause harm to her healing. I emailed the vet today to ask what he thought I should do. Any suggestions?
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Post by Pauliana on Oct 7, 2016 21:46:12 GMT -7
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Post by Deb & Ruby on Oct 8, 2016 7:42:16 GMT -7
Pauliana,
I had read the Emergency Crate article. She is good in the crate for quite a bit of time and then she just goes bonkers. But the crate is not really my issue as she has been crate trained for years.
My issue is that when she comes out to do her walks and potty trips she is wired and jumps on my legs and hops around etc. I am trying to get her to stop jumping on my legs by teaching her that she only gets attention and maybe a treat if she sits. Of course this takes time and I do not want her to injure herself. It is a little over 3 weeks now and she is supposed to be doing her walks and getting more exercise, but calm exercise.
Thanks for the calming instructions. I did put an email into the surgeons assistant with no response so I will ask Ruby's regular vet about what you suggest and make sure it's ok.
Thank again! Deb
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PaulaM
Moderator. ![*](//storage.proboards.com/forum/images/stars/star_magenta.png) ![*](//storage.proboards.com/forum/images/stars/star_magenta.png)
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Oct 8, 2016 7:57:09 GMT -7
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Post by Deb & Ruby on Oct 10, 2016 6:57:22 GMT -7
Thanks Paula!
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