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Post by Dawn & Arnie on Feb 19, 2017 12:25:21 GMT -7
Hi. I am posting for the first time here regarding Arnold, my 7 yr old neutered dachshund. Just before and around Christmas he had two bouts of acute vomiting/diarrhea, one requiring iv fluids and anti-vomiting meds. it was diagnosed as suspected pancreatitis although his PLI test was above normal but not high enough to be totally conclusive. Since then I have been observing him almost obsessively for GI related signs because I felt that there was something more going on with him than pancreatitis. Last Tuesday evening he had an episode of acute onset pain which I thought was abdominal pain. He had no vomiting or diarrhea and his appetite remained normal. His symptoms resolved within 24 hours without a visit to a veterinarian. Friday night the same thing happened only his pain seemed worse. He preferred to lie in a sternal position and was unable to sleep. Saturday morning he seemed somewhat improved but not normal and I noticed he was favoring one of his front legs. Back pain did not once occur to me because I was so focused on GI issues that I think I developed tunnel vision. Anyway, I did take him to the emergency clinic yesterday morning. he was examined and a complete blood profile was done as well as a CPL snap test for pancreatitis. His bloodwork was all normal except for a mild ALT elevation which he has had for over a year. Snap test was negative for pancreatitis. He was prescribed tramadol for pain and was told to follow up with my vet if he responded in order to do a pain work-up. She asked if he had any back issues and I said no he never has before. After leaving the vet yesterday it became more and more apparent that he was having neck pain. I noticed he did seem to be walking gingerly with his head down and his one ear pinna seems itchy or sensitive in some way. He wanted to shake his head and would start to but then would stop as if it was hurting.
I started him on the tramadol yesterday every 8 hours and he has been comfortable, able to sleep, not whimpering, able to walk normally, no longer favoring front leg, urinating and defacating normally. This is my dilemma:
I feel that the vet should have considered IVDD as the number one rule out given his breed and the fact that he showed evidence of front limb lameness, even though it was mild and intermittent. He is responding to Tramadol and I have instituted strict rest even though I have not had a diagnosis of IVDD. I had intended to follow up with his regular vet on Tuesday (Monday is a holiday here in Canada). I am wondering if he should also be on an NSAID if he does have a mild case of cervical IVDD. This is where I need advise: Is tramadol enough if he is not showing any progression of symptoms? Will it have a negative impact on his outcome if he doesn't start on an anti-inflammatory until Tuesday or should I take him to emergency again to try to get the diagnosis sooner? Am I overreacting?
Thanks for any input.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Feb 19, 2017 13:08:56 GMT -7
Dawn, welcome to Dodgerslist. When there is any hint of suspicion of a disc invovled, then the most prudent thing is to crate until you have a diagnosis that says this is not a disc problem. Crating keeps the vertebrae from pushing on a weak disc and progressing so that the bad disc doing severe damage to the spinal cord. How much does Arnold weigh? How many mgs for each dose of tramadol and how often do you given it (every 8 hrs or every 12 hrs)
When the symptoms are mild it can be a challenge to diagnose as many other problems can have similar symptoms. The symptoms you discripbe of pain only are in line with a neck disc problem (favoring front leg/holding it flamingo like, head down, not wanting to shake head.) With a disc episode crating is to protect the disc from further damage. Pain meds are to provide comfort from pain until an anti-inflammatory drug can resolve all spinal cord inflammation over the course of somewhere in the range of 7-30 days. Your option could be to wait til Tuesday for a 2nd opinion from your vet IF, IF there is no worsening of neuro functions that REQUIRES getting an anti-inflammatory drug on board asap to prevent further diminishment of nerve function. You will certainly want to have a lot of information under your belt in order to understand a vet, their treatment and to ask pertinent questions and know when it is time for vet help with meds. With a neck disc many vets will Rx an anti-inflammatory from the most powerful class, the steroids...such as prednisone. As neck discs can be more painful and harder to heal as the head moves when most all other parts of the body move. With a neck disc often it will take 3 pain meds each addressing a different source of pain. It is good then that tramadol alone is providing full comfort from pain dose to dose. Education links:
1. When surgery? When to continue conservative treatment?The diminishing neuro signs to monitor for and very quickly get vet help of an anti-inflammatory drug. Hours matter when nerves start to die as evidenced with paw knuckling under, legs crossing, etc. www.dodgerslist.com/literature/healingsurgery.htm2. Which class of anti-inflammatory? stomach protection? The answers are here: www.dodgerslist.com/literature/healingswelingANSWERS.htm
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Vita & Emmie
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Currently graduated for the 3rd time; walking and running!
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Post by Vita & Emmie on Feb 22, 2017 10:43:04 GMT -7
Hi Dawn! Just checking on how Arnold is doing? Did you get in to the vet after Family Day?
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