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Post by Rob & Oliver on Jul 19, 2017 4:21:23 GMT -7
Hi Linda and Paula and Admins. I'm a veteran of the IVDD wars, I just emailed Linda actually but wanted to ask for the Admins to chime in and offer thoughts.
I think Oliver has a new minor IVDD thing going on. I noticed this morning as he was super slow and not wanting to walk at all this am, which is symptom #1. I got him out and he pooped nicely so got that out of the way, yet his movements were particularly slow; and for Oliver that’s always his first symptom when his IVDD comes up, last incident was 2 years ago plus. When I got him upstairs, I did a back test, moving slowly down his spine towards his tail and he yelped which is another clear symptom as you know. He’s not shivering, no signs of pain, but I think he may have a minor issue at one of his mid back disks. He's just chilling right now on his cushy bed bit Im a very conscientious, proactive doggie-parent so wanted your thoughts. I'm thinking its okay if I just let him relax for a few days, I cancelled his dog walker today so he just stays in. Can I just keep him low key and inside a few days and see how he seems? OR Should I just call my doc and order the rymdyl, tramadol and Pepcid AC and keep him confined etc? I know this condition well enough to know its likely there but VERY minor, only needing the conservative approach.
There was one yelp about midway down his back. I don't want to test him again right now.
Your thoughts would be appreciated.
Thanks all. Hope to hear from Paula or someone soon. Thanks. Robert
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 19, 2017 4:41:15 GMT -7
Hi, Rob. Yes, it does sound like another disc episode that needs to be checked out ASAP by a vet and have meds started. You need to immediately crate Oliver, carry him in and out to potty with very few steps at potty time, to protect his spine from further damage until he's seen by a vet. A small tear in a disc can worsen to a larger tear or a rupture quickly if there is too much movement of the spine. So crate him immediately and have him seen by a vet ASAP to confirm that this is another disc episode. I wouldn't press on his spine anymore - have a qualified vet perform a neuro evaluation.
Even with a mild episode, 100% 24/7 crate rest for a full 8 weeks is necessary to heal the damaged disc.
Please let us know what the vet says. Prayers for Oliver.
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Post by Rob & Oliver on Jul 19, 2017 4:52:58 GMT -7
okay. will report back. Just made appt with my vet neurologist. luckily he is in today and had a 2pm availability so taking your advise. better to be safe than sorry, you[re right thanks
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Jul 19, 2017 9:57:42 GMT -7
Rob, keep us posted as your learn more from your neuro. As Marjorie points out at any suspicion of a disc episode, the single most important care is the crate rest part to protect the disc:
100% STRICT rest 24/7 for the full 8 weeks, only out for a very, very few footsteps at potty time.
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Post by Rob & Oliver on Jul 19, 2017 14:33:24 GMT -7
Hi Paula and Marjorie. Okay, so here it is. First off, I wanna give a plug for my man Dr. Boaz Levitin from Blue Pearl Vet Hospital in Manhattan. If you're in NYC and you need a veterinary neurologist/neurosurgeon, this is the guy.
Anyway, so my Oliver has the least severe form of IVDD; we agreed not to do an MRI as the treatment would wind up the same, and while having a more specific look at the disk issue would be nice but not necessary. So Oliver yelps mid back (somewhere in the "T" section), doc felt it was probably calcifying, may or not be a busted disk but again can't be sure without MRI. All neurology intact, perfect clinical examination.
Drugs are Tramadol, 50MG tabs, 1/4 pill 2-3 times a day. Personally I think that's a bit skimpy so Im gonna give him closer to a 1/3 to a 1/2 pill at a time. Rymadyl 25MG chewable tabs; 1/2 pill twice a day. I have Pepcid AC but Max Strength, which is 20MGs of Famotidine, so 'm giving Oliver 1/3 of a pill twice a day. What do you think of that dose. He's 15 pounds.
[Moderator's note: please do not modify 15 lbs Rimadyl 12.5 mgs 2x/day for 14 days, then test-for-pain stop Tramadol 25mgs 3x/day Pepcid AC (famotidine) 20 mg tab: ) 6.6mgs 2x/day]
And I was able to get the Tramadol down after the vet tech was useless at doing so. Me and a piece of cheese worked but the Tramadol is much more difficult as it has a much more bitter taste than the Rymadol.. My backup from two years ago is a dog pill dispenser I bought online two years ago during his last bout as then you just put it in the back of his throat and push the pill in with a plunger.
Ill be X-penning him (not crate) with his bed in it. He's an inactive dog and will just stay on his bed. Will carry him out with bag twice a day for short walk to try to do his business.
Did I miss anything? Let me tell you, after my day today, I need a pill. What would you prescribe for the daddy?
Thanks. Rob
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Post by Romy & Frankie on Jul 19, 2017 15:00:38 GMT -7
Dr Levitan performed my Frankie's surgery about three years ago. I liked him very much. Compared to what we usually see, the dosage of tramadol is very low at 12.5mg for a 15 lb dog. Tramadol does not last long in the body and in most cases will need to be given 3 times a day to be effective. Veterinary pharmacologist Bruce KuKanich, DVM, PhD, DACVCP: "Tramadol is rapidly eliminated from dogs after oral administration. Recent studies are suggestive the bioavailability of tramadol in dogs is lower than originally determined and the dose of tramadol needs to be increased with dosages from 5 - 10 mg/kg PO q 8-12 hours in dogs to maintain similar plasma drug concentrations as those in humans." New developments in opioids: old drugs and some future directions (Proceedings)" DVM360. Nov 01, 2009 By Butch KuKanich, DVM, PhD, DACVCP veterinarycalendar.dvm360.com/new-developments-opioids-old-drugs-and-some-future-directions-proceedingsIf he is still showing signs of pain at that dose, please speak to the vet about increasing it. For the Pepcid AC, the usual dose in dogs is 0.44mg per pound every 12 hours so what you are giving is about right. Tramadol is very, very bitter. Make sure you do not transfer any dust from your finger to the outside of the pill treat. One method that has had a lot of success is to prepare three treats, one will have the pill inside. Give the first plain treat with #2 pill treat in view. The idea is a greedy gulp to get the next. With #2 in the mouth have #3 plain treat in view.Most dogs like sweet banana. The pill will stick inside a little ball. If need be wrap with a thin piece of deli meat to make even more yummy.The small size marshmallows also make a good pill pocket as the stickiness keeps the pill from falling out. This video shows an alternative way to give a pill: I am not sure what kind of bag you will be carrying him in, but it is important to keep his back straight when lifting and carrying. This video is an example of a good way to do that.
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Post by Rob & Oliver on Jul 19, 2017 17:49:58 GMT -7
Yeah, I agree on the Tramadol. Im doubling the dose. Oliver has been very relaxed since we got home and I gave him a 1/2 pill.
The bag? I forget the brand but it's one of those super stable dog bags with the opening in the front and on top, and has a firm hard wood bottom to keep his body fully horizontal and on top of that is nice sheepskin of some sort.....
Will update in a day or two...
And thanks for the support
Oh, so how is your dog doing 3-years post-op from Boaz LEvitin?
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Post by Jean & Mimi on Jul 20, 2017 5:34:54 GMT -7
Rob, please do not increase the tramadol on your own. It is really important to continue to work with your vet regarding increase in medication. If you are still seeing pain, you may want to discuss adding Gabapentin with your vet. Gabapentin and Tramadol work very well together to control pain. Let us know what your vet says.
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Post by Rob & Oliver on Jul 20, 2017 7:23:42 GMT -7
Admins -- Ive already received his blessing to bump the meds. And sneaking it in the cheese it working fine....for now at least.
But here's today and I'm super upset and concerned. The first and only med doses were given yesterday and the doc office at about 2:30PM. As it was already midday, I didn't give him a second round prior to sleep. When I woke he looked pretty out of it, probably in part from the new meds and in part from his condition; that's my opinion. I gave him has tramadol and Rymadyl and Pepcid with breakfast around 630AM, and after a while he started to perk up a bit but mostly has been laying by the front door on my wood floor looking really pathetic. I wanted to see his movement and he struggled considerably to get up, and walked about 6 feet towards me, very sluggishly, and his rear was clearly slightly dragging and his gait was slightly off. So scary. I['ve already called Dr Levitin to go over it with him -- waiting for call back -- but wanted your thoughts on my observations. Poor little guy....
Thanks. Rob
[Moderator's note: please do not modify 15 lbs Rimadyl 12.5 mgs 2x/day for how many days?, then test-for-pain stop Neuro diminishment 7/20 Tramadol 25mgs 3x/day Pepcid AC (famotidine) 20 mg tab: ) 6.6mgs 2x/day]
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Post by Jean & Mimi on Jul 20, 2017 7:44:10 GMT -7
Rob,
I am glad you had your vet's blessing on the meds - sorry if I misunderstood.
If I am reading this correctly, it seems like his neuro function has decreased, is that correct? Then I am very glad that you have already called your vet. It may mean that the Rimadyl is not strong enough as an anti-inflammatory and the he will need to be switched to a steroid. The washout period from an NSAID to an steroid is 7 days. However, your physician may not think it is a good idea to wait and may want to switch asap. If that is the case, please ensure that you have sucralfate onboard as an additional stomach protector and be sure to watch for any signs of gastrointestinal distress (vomiting, diarrhea, bloody stools).
Please let us know what your vet recommends. Are you observing any additional signs of pain?
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Post by Pauliana on Jul 20, 2017 8:18:20 GMT -7
Hi Robert! Oliver should have had his Tramadol dose at 10:30pm which was 8 hours after the dose he got at 2:30 at the Vet.. Tramadol should be given every 8 hours (3x/day).. To keep pain under control it has to be given on schedule! Once pain gets out of control it is harder to get back in control. Call the vet and let them know about the dragging.. Losing ability to stand and walk is considered an Emergency! He should be seen right away!
☐ Let us know you are on the same page about crate rest. 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. www.dodgerslist.com/literature/slingwalk.jpgAn 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! He shouldn't be laying on your wood floor. Struggling on the wood floor can cause his disc to tear further into a rupture! He doesn't have any traction on a bare wood floor. He should be in a comfortable and cozy crate or recovery ex pen set up like this: www.dodgerslist.com/literature/CrateRRP.htm
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Post by Rob & Oliver on Jul 20, 2017 9:45:39 GMT -7
I spoke with Dr. Levitin just now reporting what Ive reported here. He says its good that he's laying comfortably on his soft bed and just dozing in and out. He was fine with increasing the TRamadol to 25MGs 3d/day but doesn't want to increase the anti-inflammatory right now. He wants to let him rest and see how he's doing Monday, of course calling them if theres any negative change of any kind.
Good point about the wood flooring. I havre mostly carpet but he seems to go to the wood sometimes, but Im gonna tighten up controls today -- yesterday was day one after not having to deal with this for two years so I can already see I need to firm up my protocols and am doing so.
So, while I worry away, I hope he's going to start to heal.
I'm wondering if, for the first few days, if I should even avoid putting him in his carry bag and walk him downstairs for a short potty walk. Would it be best to just leave him be and when he has to go, he'll just go on the pads or floor? Believe me I could care less about my floors. Oliver's well being is my only concern.
All further thoughts welcome and appreciated, thanks gals of Dodgers. Rob
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Jul 20, 2017 10:24:30 GMT -7
Rob, anytime Oliver is out of his recovery suite it an opportunity for the vertebrae to be moving too much. Moving vertebrae from walking naturally push on cushiony discs. The problem is that one of Oliver's discs has degerarated and is no longer cushy and able to bounce back into shape. Instead pressure causes a bulge as tiny little cracks develop on the exterior of the disc. Too many tiny crack can move to tears of the disc. As the disc bulges out of shape or if it tears, there is only one place for it to go. It pushes up into the spinal cord canal. The nerves in the cord do not like pressure they can die! We see death of nerve cells as neuro diminishment.
The increased neuro diminishment you observed may well be do to lax crate rest allowing too much movement. So I'm so glad to hear you will now be able to give Oliver the single most important part of conservative treatment--- the 100% STRICT rest 24/7 only out for a very, very few footsteps at potty time. Attach his food and water bowls on the inside of the recovery suite. Make sure he has only enough room to easily turn around. When he lies down that he can fully stretch out his legs. Pad out any extra space with a rolled up blanket. If you can carry him to and from the potty place outdoors. At potty time think footsteps, not walks. With your 6 foot leash, his harness and sling, he may only take very, very few footsteps that 6' leash permits as you stand in one spot. Setting up an expen in the grass is a good alternative to keep Oliver's footsteps to a minimum with its physical and the visual limit. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep your dog's back aligned and butt from tipping over. A harness and 6 foot leash will 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! Now that you will need a sling, male dogs prefer a figure 8 at potty time over a long scar under the belly.
As you mention you could set up an alternate potty spot in indoors, adjacent to his suite. Using an ex-pen and where it is shown setting up a temporary mattress while attending to the main mattress, that spot could be the potty area. Keep a piece of urine soaked pee pad in a zip lock bag. Place on the pee pad to help give Oliver inspiration and to know it is OK to potty in the house. Let us know which potty method you are finding does the best job of limiting potty time footsteps.
You will want to monitor as you have been doing and report any worsening of pain or neuro function right away to Dr. Levitin. 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/toes scuffing floor 4. √Paws knuckle 5. √drags leg(s) 6. __ can't move back legs up into a stand position. 7.__ Legs do not work at all (paralysis, dog is down) 8. __ Bladder control is lost 9. __ Tail wagging with joy is lost 10. __ Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. Rob for how many days is the Rimadyl prescription? 12.5 mgs 2x/day for how many days?, then test-for-pain stop
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Post by Rob & Oliver on Jul 20, 2017 12:13:47 GMT -7
Okay. I bit the bullet. I'm definitely seeing decreased neuro functioning. Doesn't really wanna sit up, but will if I coax him -- just to check that he can. But even though the doc rated his condition as the least severe form of IVDD, clinically, to me it is starting off as looking like the worst case so far; so that said, I just bought a new crate and cushion bed for tomorrow delivery, etc...Cant play around with this. He keeps trying to come say hello to me in the bedroom -- he's in the living room, but every time I go over to him, he's sitting. It's very upsetting,,,,,
he gave me a 2 week prescription for both meds. We didn't set any date certain to stop
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Jul 20, 2017 12:27:44 GMT -7
Rob, do you have an ex-en in your house you can immediately put him in, if not can you go to a pet store to get an ex-pen or a crate now? Do what you can right now to ensure he is not able to escape from a restricted area, not able to move more than to turn around or when lying down to fuly stretch out the legs. Do what you can now to protect his spinal cord.
If he can no longer move his back legs up into a stand, call the vet asap. It may be time to leave the lessor anti-inflammatory class (RIMADYL) and move to the most powerful (STEROID) in an effort to prevent further nerve cell death. Hours matter, alert your vet if you have seen a worsening from this morning of dragging legs.
If he is not wanting (reluctant to move) to sit up with front legs (butt on the floor) he may now be in pain that tramadol alone can't mask. Usually there are three sources of pain, thus the reason three different pain meds are Rx'd. Alert your vet to pain so that he can adjust meds. Tramadol is the general analgesic, it can be moveed up in dose from the light 25mgs 3x/day Gabapentin works on nerve pain methocarbamol works on muscle contraction pain.
Signs of 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. Holding leg flamingo style not wanting to bear weight, head held high or nose to the ground. Not their normal perky selves.
Initially he did start out with mild symptoms of pain only The crate, ex-pen is to prevent worsening signs to prevent damage to the cord.
keep us posted, please, Rob.
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Post by Rob & Oliver on Jul 20, 2017 12:46:19 GMT -7
He's in a closed off ex-pen now lying on his bed resting. I decided to get the crate as I feel this may be a more serious bout but Im speculating as neither of us can be sure without an MRI and I'm not putting him through any further long trips to a vet and general anesthesia right now. He does not seem to be in any pain to me, which means the TRamadol is working. He is standing up on his hind legs, a bit shaky and with a bit of an off gait, but he can get up and move.
I did notice he was arching his back in a way I've never seen before, just for a bit, not at the moment (again he's resting), so now that I've closed off his X-PEn completely for the first time -- moving past my denial I suppose -- I'm going to let the meds take their course and keep him still.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Jul 20, 2017 12:59:58 GMT -7
Rob, you are now on the right track to ensure that Oliver can heal his disc and not do any additional harm to his spinal cord. Most of us find that a 2nd recovery suite is useful. One can stay in the bedroom for night time so you both can sleep in the same room. So money is not wasted. Arching bac can be a sign of pain, so don't hesitate to alert your vet if you continue to see it.... as it is very easy for the vet to give you the OK for adjustment to tramadol or add other pain masking pain med. So then it looks like you have a prescription for a 14-day course of Rimadyl. The end of the course is to do a test for pain. No one knows how long it takes for spinal cord swelling to resolve. At the stop of Rimadyl you will assess for your vet about any hint of pain surfacing. Pain surfacing would mean another course. It can take anywhere from 7 to 30 days for Rimadyl to complete work on swelling. You can refresh your memory on how anti-inflammatory drugs work with a disc episode, helps when you are discussing things with a vet. www.dodgerslist.com/literature/healingsweling.htm
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Post by Rob & Oliver on Jul 20, 2017 13:05:34 GMT -7
Paula, since he's so feeble right now, perhaps for a day or two; what do I do about pee and poop? I feel really uncomfortable about taking him downstairs in his bag and having him try to walk. And not so sure the scarf will work as it will cover his pee pee. I have wee wee pads but my dachshund, like most, are pills, so if I take him out of the x-pen for a few, he won't just walk to the wee wee pads to relieve himself.
Whats the move?
Any admins, would appreciate some help on this. Thnx
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Post by Romy & Frankie on Jul 20, 2017 14:55:47 GMT -7
Sometimes if you can get a paper ttowel or something iwith Oliver's own urine scent and put it on the pee pad they will use it. Some people, including me, had to get the scent of another dog's urine before their dog would use pee pads. Another thing you could try is the figure 8 sling. I used this for my Frankie while he was recovering. It is good because it does not cover the penis. You can make one out of two leashes. Here is some info on how to do that. www.dodgerslist.com/literature/cratesupplies/Figure8.jpg
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Post by Rob & Oliver on Jul 20, 2017 15:06:47 GMT -7
I have wee wee pads out with his pee from yesterday on it. He won't go
The current problem is he's pretty immobile and won't walk on his own so I can't even get him to the wee wee pad. I watched the video and tried to do anbkadder expression but couldn't figure out where his bladder was so I'm gonna leave him for the night as is. I don't know what else to do. There is nothing else to do
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Post by Romy & Frankie on Jul 20, 2017 15:19:28 GMT -7
If he has bladder control he will most likely not allow you to express him anyway. You can carry him to the pee pad. Just make sure you are supporting his back. You can use the figure 8 sling to hold his back up while he is on the pad or support his back legs yourself.
My Frankie didn't like pee pads either. He had been trained not to go in the house. My son brought me a paper towel with his dog's urine on it enclosed in a plastic bag. I put this paper towel on the pee pad and it worked.
Luckily my son had a dog, but some of my neighbors would have been more than willing to do this for Frankie.
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Post by Pauliana on Jul 20, 2017 15:23:09 GMT -7
Robert,
Can you carry him and put him on the pee pad? Or put it in next to him in his ex pen. If he can't go once he is on the pee pad, you need to take him to the Vet and get a hands on your hands expressing lesson, so you can feel the right pressure to apply and they can tell you exactly how to feel where the bladder is..
The Vet also needs to know if he has lost bladder control and can no longer walk.
Urine that sits in the bladder for too long can breed a urinary tract infection..Learning to express is important to keep his bladder healthy.
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Post by Rob & Oliver on Jul 20, 2017 15:56:38 GMT -7
What type of sling is preferrable to hold up his rear carriage, something that goes around his stomach or that lifts up his rear legs? Anyone have any brands they prefer?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Jul 20, 2017 16:27:55 GMT -7
Most male dogs will not like the scarf sling. This figure 8 sling does not touch the penis and is better accepted for potty time. Duct tape or Brand X stretchy self adhesive vet wrap from the grocery store, a old beach towel you don't mind tearing into strips or even an old sheet will do if you do not have two leashes to use. See picture below for how to do. Rob, if Oliver will take to peeing in the house this is how you do it. ~~ Take the 8 panel expen — use three of the panels to make a small potty place. Watch the video below to see how to do this.
~~ Place the pee pad inside the new small fenced area. ~~ Place a piece of old used urine stained pee pad on the pee pad as inspiration ~~ Place Oliver in the new potty place. Give him 3 mins. If he does nothing back to his adjacent ex-pen recovery suite. ~~ Try again in one hour. Likely once he has gone he will need to pee every 4-6 hours. How to recognize loss of bladder control ~~ He leaks urine on you when lifted ~~ You find urine in his main bedding ~~ Another neuro loss demands emergency ASAP alert to the vet. Then it IS time to advocate for a switch to a steroid. BOOKMARK OLIVER's threat to receive an email alert when someone has replied 1. Go to your Profile> Profile Edit > Notifications: checkmark BOOKMARKS 2. Go to the Conservative Board: checkmark your dog's thread, then use the ACTIONS button to select bookmark
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Post by Rob & Oliver on Jul 21, 2017 3:58:36 GMT -7
6:30AM -- Woke, he was already awake when I went to visit him in his closed pen. He's now onto me with hiding the TRamadol in cheese so I had to use the pill dispenser which he hates but I can get the pills in at least. fed him, holding up his hind area and he ate 2/3rd of his bowl, but he has not peed or pooped in two days now, I feel he has full control, he just doesn't know how to do his business now and all I'm doing is letting him lie on his cushion as your big suggestion is fulll rest.
This am, when I did open his X-pen, he did come out of it and stood up for a bit and walked a few steps and then fell back down, so his near is intact and he had a bit of energy, so I put him in his carry bag and walked outside with a pee soaked wee wee pad and a scarf to hold his backside horizontal so see if he would pee or more. NOTHING. The scarf thing I have is just a scarf.. Will buy one of those rear support sling things today. But I live alone and this is so emotionally exhausting on me, and I feel like 'I[m having a heart attack -- not literally -- but felt some chest pains with all this going on.
we are not in a good place...help...
I[m calling vet to give full report now
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Post by Julie & Perry on Jul 21, 2017 4:55:37 GMT -7
Rob, I understand as I too have gone through this alone. It is very stressful.
Good idea about going to the vet. Make sure Oliver is in a crate with rolled up blankets around the inside to protect him.
Have your vet try expressing Oliver. Definitely need to find out what's going on. Also, have the vet check on constipation as pain meds can do that.
If he's constipated a teaspoon of plain pureed canned pumpkin added to kibble once daily and equal parts water to kibble at both meals can help.
It will be OK. It gets easier. Try to make sure you're getting enough sleep and eating well. Oliver needs you to stay healthy.
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Post by Jean & Mimi on Jul 21, 2017 5:00:43 GMT -7
Rob, I wanted to chime in with Julie. This is a very stressful thing to go through, especially in the beginning as you are trying to figure out the right path. Take a deep breath and know that you will both get through this. Try going out and doing something relaxing today - maybe relaxing at a coffee house, strolling through a bookstore or just sitting outside enjoying the warm weather. Once Ollie has his meds, he will be just fine for a few hours while you take care of you!
Hang in there - we are here to support you.
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Post by Rob & Oliver on Jul 21, 2017 5:56:39 GMT -7
Thanks. So, I'm at Blue Pearl, saw ER doc, which I don't usually like (only neuros) but they see IVDD every day here. Anyway, they're going to do complete pee and poop expression, putting him on IV fluids to get him well hydrated, gonna give him fentynl steady so he has no pain. Given the problems I have with Tramadol they're gonna change his pain meds up and great some delicious compound of gabapentob. Etc. and the neuro, dr Levitin, they're calling him to come in just for Oliver. They used the dreaded word of surgery but I feel we've not given a med regiment a proper chance with strict crate rest (crate coming tomorrow), so I'm going to advocate against it. They said he still feels his nerves etc so he's not at the bottom of the neuro declination scale. And we agreed to let them keep him overnight so he'll have found the clock care and fluids and pain meds etc during what is clearly an acute phase.
[Moderator's note: please do not modify 15 lbs true crate rest started Thurs 7/20 Rimadyl 12.5 mgs 2x/day for 14 days, then test-for-pain stop
Tramadol 25mgs 3x/day Pepcid AC (famotidine) 20 mg tab: ) 6.6mgs 2x/day IV fentanyl 7/21 Gabapentin ?mg/mL: ? mgs ?x/day ]
As for me, I'm a wreck. Sitting alone in hospital waiting area. I'm oissedni forgot to bring him some of his toys.
I just paid $1300, and that's just for starters. Welcome to NY
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Jul 21, 2017 6:37:44 GMT -7
Rob, I'm so sorry you and Oliver are having to go through all this stress. Do they believe he had lost bladder control? IF the answer is yes, will they consider moving to the most powerful of the two classes of anti-inflammatories--- the steroid class? I do believe there is good hope that conservative treatment can work. It is hard to commit to conservative until one has a good understanding of the disease that you now are aware of. Being able to fully commit to the 100% STRICT rest 24/7 , only out of the recovery suite for a very, very few footsteps at potty time can give the disc its needed opportunity to heal and the anti-inflammatory med can get that painful spinal cord swelling resolved. Nerves can and do self repair with time as well. The focus with conservative treatment is all about the protection and healing of the disc. Nerve repair may or may not come back in the short time of 8 weeks it takes a disc to heal. I agree with Jean and Julie, take care of yourself as Oliver will be depending on your clear thinking and positive attitude to know you are on it giving him the gift of rest. He looks up to you to know that all is right in his world. There is really no better review on each part of conservative treatment including the 4 phases of healing than at the link below. You will find a quick overall summary + links to give you the in-depth knowledge : www.dodgerslist.com/literature/healingpage.htmIf you hear back from Blue Pearl later today, we'd loved to be updated too.
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Post by Rob & Oliver on Jul 21, 2017 6:49:13 GMT -7
Waiting for neuro to come in. Doc said "he's going to be okay", but I think it's open how the neuro will feel about the surgical option. He has not lost feeling anywhere, so his mergers remain alive and well, just hobbled a bit, but definitely worse. I feel strongly that I want to give conservative treatment rh full chance before considering an invasive surgery. I mean, when I woke this am, after his first full day of meds (yesterday) he was alert, responsive, didn't see signs of pain etc Anyway, we'll see.
That's a very nice concise article on the healing stages.
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