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Post by Eddie & Dox on Dec 18, 2017 0:42:01 GMT -7
Nevada Doxie needs guidance
I am Eddie. My dog is a Dachshund, and he we call him Dox or Doxie (I know, very original). He is 21lbs. He is not a miniature, more of a tween-sized Dachshund. Before this episode, he was relatively healthy and athletic. We run our dogs 1/2 to 1 mile a day and allow them to hunt and dig for ground squirrels in the desert. They are all pretty fit. Dox was the pack powerhouse and had stamina to run for longer than any of the younger dogs. I accidentally ran over him several years ago, which broke two back legs and pelvis. He healed on strict crate rest, and came back very strong. However, this probably altered his gait, and could have contributed to disc deterioration. Drugs: Tramadol-- Was started on 11/30/17 @ 50 mg a.m. and 50 mg p.m. Vet reduced this to 25 mg in the a.m. and 25 mg in the p.m. due to issues with constipation. After constipation resolved with addition of pumpkin to diet, I upped the p.m. dose back to 50 mg to help with restlessness overnight and promote good sleep.The vet told me that it was safe to adjust the dose in this way. Prednisone-- started 11/30/17 @ 10mg in the a.m and 10 mg in the p.m., but on 12/7/12 vet reduced to 5 mg 2x daily Gabapentin-- started 12/7 @ 50 mg in the a.m. and 50 in the p.m. Bethacanechol -- started 12/15 @ 25 mg in the a.m. and p.m. Amoxicillin--100mg in the a.m. and in the p.m. for utiI will add the Pepcid. He is not currently showing any digestive issues (after the constipation was resolved), but I will start him on this tomorrow. [Moderator's note: please do not edit
21 lbs
Prednisone as of 11/30: 10 mg 2x/day for 7 days,
as of 12/7: 5mgs 2x/day for 11 days, then test-for-pain Prednisone taper
Tramadol 50 mg 2x/day
Gabapentin 25mgs am +50 mg pm
Bethanechol - 25 mg 2x/day
Amoxicillin 100 mg 2x/day]The vet said IVDD. Results were based on X-ray showing narrowing of the disc space in the lower middle of the back. The vet is a rural general DVM in a farming community. We live in rural Nevada. There is a current T.V. commercial on the Reno stations with the dog neurologist showing a Dachshund that had surgery to correct the discs. We are not going to do the surgery, and the commercial makes us feel guilty every day. I first took Dox to the vet on 11/30/17. I was very confident that after previous crate rest for pelvis, that we could also do this for his back. He was dragging his legs by the time we finally got to the vet. Prior to visiting the vet, I purchased a L'il Back Bracer. At that time, Doxie had some weakness in the back legs. Brace helped, and he improved function, but we didn't keep him crated. We let him have have a much-modified exercise regimen where he was allowed to dig, but not run or jump. Frankly, we had no experience with any dog having a seemingly spontaneous back injury...and my spouse and I were on different pages. Beating myself up about this daily! NO crying, nipping, shivering, but I did notice he starting barking in the middle of the night to go outside. I thought maybe he was angry at the coyotes, and needed to tell them off--which he did while he pee'd. This may have been the beginning of bladder issues? Then he relapsed and lost control of his legs entirely. That's when I took him to the vet. He eats great, with normal vigor. Doctor said he would be hungrier on the Prednisone. As mentioned, he was constipated after first vet visit, but that is sorted now and he has at least one b.m. a day. He does not poop his bed. He used to wag his tail to facilitate the go, but hasn't done that in a few days. He lost bladder control, we learned later, after the first vet visit. I was worried and began to express, but didn't do a good enough job. Bladder swelled and he got a uti, with blood in urine. So this third visit, the doctor prescribed Behacanechol to improve the bladder tone, put a catheter in, which seems to be working well. We got his swelling down, and after two days on Amoxicillin, I am not seeing blood when I drain him--that is the improvement tonight. Small victories... As far as deep sensation, the vet said that Dox had it, as of last visit. We check it every time. However, I pinch him, and I don't know if he does or not. I read lots of articles in the last few weeks, and I think his reaction is not exactly deep pain reaction. He doesn't look at me or his toe when I pinch. As of a few days ago, he seemed to be able to move his legs a little. Now I don't see that. But, he can manage a nice "sit" posture, and legs aren't splayed all over. I deep down think he can move them where he want just a tiny bit. If worse comes to worse, he would be a great candidate for a wheelchair. But the bladder may be the deal-breaker, as expressing 4 times a day for the rest of his life may not be tenable. Direction and words of support would be appreciated. -E  bbcode for images |
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Dec 18, 2017 7:52:12 GMT -7
Welcome to Dodgerslist, Eddie. First thing to know is that it IS in the cards for your dog to get back to enjoying life whether immediately walking during the short 8 weeks of conservative treatment it will take a disc to heal or waiting on more nerve repair - IVDD is not a death sentence. Find out why that is true: www.dodgerslist.com/index/SDUNCANquality.htm While the dosage of the Prednisone has been reduced, Dox is still on an anti-inflammatory dosage. How long does the vet want him to be on that dosage? Once the dosage goes below 5 mg 2x/day, which would be below the anti-inflammatory level, you will need to be on the lookout for any sign of pain. If he starts showing signs of pain, that means there is still swelling pressing on the nerves of the spine and therefore still a need for the anti-inflammatory dosage of the Prednisone. You would need to immediately alert the vet so Dox could be returned to the original dosage. Please know that nerves can heal with conservative care. He needs to be on the strict 100% 24/7 crate rest, only carried in and out to potty with very few steps at potty time, for a full 8 weeks. Nerves are slow to heal so don't expect too much too soon. It sometimes can take months for improvement. Why would expressing 4 times a day be untenable? Actually, once Dox is off of Prednisone, which causes increased thirst and urination, he would only need to be expressed 3 times a day, the same as he would have had to be let out to do his business before his paralysis. With the catheter in place, you'll be unable to tell whether bladder control has returned. Once the catheter is removed, you would occasionally need to do a sniff and pee test - carry him to a spot where he's peed before, support his hind end by holding him by the hips not under the belly, let him sniff and see if he can release urine on his own. If he can, then bladder control is returning. How long did the vet say he wanted the catheter to remain? Expressing does take some practice but it can be learned. Please don't use the L'il Back Bracer while Dox is on conservative care. During a disc episode these are the concerns: - Getting them on without causing any more pain or damage to the spine is on top of the list. Too much movement to get the brace on is not good for a dog that you are trying to limit movement of the back. - Additional muscle atrophy in the spine is another big concern as muscle strength is very important to maintaining spinal health. - Unnecessary discomfort, pain and anxiety caused by having to wear this device tight enough to limit movement… adequate limited movement is supplied with owner commitment to safe and effective 100% STRICT crate rest 24/7. - Braces would require monitoring for pressure (rub) sores. Also, if not properly fitted (not covering from thoracic down to tail) there is the potential to create a fulcrum. It is hard to immobilize the entire back and not end up creating a fulcrum that stresses out adjacent disks. - A brace would not be a preventative measure. Disc disease is the cause of prematurely aging discs…a disc problem happens at the point the disc has hardened too much. Any activity such as turning to lick a paw or putting on and off a brace could be the last straw for a disc that is no longer flexible. At this time there isn’t enough research on them for Dodgerslist to support their use with an IVDD dog. It would also be best if you didn't pinch his feet as if he can feel it, he would jerk his leg back and that would cause unnecessary movement of the spine and could cause a relapse. The less movement of the spine, the better. It can sometimes be difficult even for a vet to determine deep pain sensation and should only be determined by a Board-certified neurologist. Please confirm that you've started 5 mg of Pepcid AC 30 min. before the Prednisone and then every 12 hours thereafter for as long as Dox is on Prednisone. 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. 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.jpgIf there is great pain or severe neuro diminishment, acupuncture or laser light therapy can be started right away as an adjunct to pain meds and to kick start nerve cell energy production. Options: Acupuncture vet who does home visits to avoid back moving during transports. For transport to necessary visits, pad out the recovery suite extra space with a rolled up towel/blanket to prevent body shifts during braking or cornering. CAUTIONS: ----- Laser light therapy is contra-indicated with tumors which are detected via x-ray. ----- During conservative treatment, anytime out of the recovery suite is a dangerous time for the healing disc. Movement of the back can increase a disc tear and escape of disc material into the spinal cord . For an animal with very mild neuro deficits, the risk of transporting to therapy has to be carefully weighed against what benefit is to be gained. www.ahvma.org/find-a-holistic-veterinarian/ ----- Why Chiropractic is not recommended for IVDD dogs: www.dodgerslist.com/literature/chiropractic.htmWhile we are not vets we do have much to share with you - things we have learned from the neuros and other professionals who Dodgerslist consult with, our own personal experience with IVDD plus observing the many, many thousands of dogs who pass through this Forum and what their vets prescribe. We can help you to interpret what you observe and make sure you relay the important feedback to your vet quickly to get speedier help for your dog. You will see we point you to invaluable background info to read. The reason is that with this particular disease, knowledge IS most definitely the power to fight the IVDD enemy and win. Many vets know IVDD and some are new to it. You can play an instrumental role in working with the vet you have hired when you bring the best command of this disease to the table. www.dodgerslist.com/healingindex.htmHealing prayers for Dox. |
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Post by Eddie & Dox on Dec 18, 2017 13:38:52 GMT -7
So, this treatment has been in fits and starts...
I don't know how long Doxie will be on the Prednisone at current dosage. The catheter stays in until next visit, 12/26/17 to give the UTI time to heal and the bladder needs time to shrink to normal size, and Bethecanechol time to tone the bladder muscles. I've been told by the vet that the Bethecanechol needs weeks to do its job. At the same time, we will go over the meds and adjust, if needed.
[Moderator's note: please do not edit
21 lbs
Prednisone as of 11/30: 10 mg 2x/day for 7 days,
as of 12/7: 5mgs 2x/day for 11 days, then test-for-pain Prednisone taper
Tramadol 25 mg am + 50mg p.m.
Gabapentin 50 mg 2x/day
Bethanechol - 25 mg 2x/day
Amoxicillin 100 mg 2x/day
✚Pepcid AC ?mgs ?x/day]
I asked the vet if Doxie's bladder will go back to normal, and he said it might but might be permanently stretched and damaged. It [bladder] was distended for almost 2 weeks.
Yes on the crate rest. We start the ✚Pepcid tonight with evening dose.
Just to note:
Tramadol is administered at 25mg in the a.m and 50mg in the p.m.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Dec 18, 2017 15:20:31 GMT -7
Eddie, I would encourage you to get up to speed on the use of prednisone with a disc episode. This way you can paritcipate in discussion and ask pertinent questions. Here is the link on how anti-flammatory drugs are used during a disc episode: www.dodgerslist.com/literature/healingsweling.htmSince pred is used only until all painful spinal cord swelling is gone, most vets will take a guess with a 7 or 14 day course of pred. So far there has been a 7 days course and now a bit lower anti-inflammatory course of unknown duration. If the pred continues until the 12/26 appt, that will have been a total of 19 days days on pred with no testing to see if he even needs it that long. No one wants a dog on pred any bit longer that achieving the benefit of all painful spinal cord swelling gone. The ONLY way to get that proof is with a test-for-pain Prednisone taper. If perchance all painful swelling is gone now, then all that is left for Dox is all the potential adverse side effects! NOT GOOD AT ALL! Prednisone is a powerhouse hormone in getting spinal cord swelling down! But using it when it has no job to just exposes the body to serious side effects such as: -- change in mood, behavior -- decreased wound healing -- secondary problems of bacterial infection -- increased secretion of gastric acid, decreased mucus production - potential for bleeding ulcers Prednisone will not aid in healing nerve functions, will not aid in healing the disc. Prednisone has only one job. Somewhere in the range of 7-30 days comprised of perhaps several courses of pred, the swelling will be gone. To help you visualize the 4 phases of healing, expected time and what it takes for healing, this page is worthwhile to print out, put your notes in the margins as a guide the 8 weeks it takes to heal a disc: www.dodgerslist.com/literature/healingpage.htmQUESTIONS 1- What date did you start 100% STRICT rest 24/7 , only out for a very, very few footsteps at potty time? 2- Is all pain fully in control dose to dose of pain meds Gabapentin and Tramadol? You do not see any of these signs nearing the next dose or when he has to move to potty: ◻︎shivering-trembling ◻︎yelping when picked up or moved ◻︎slow to move ◻︎tight tense tummy ◻︎arched back, ears pinned back ◻︎ restless, can't find a comfortable position ◻︎slow or reluctant to move much in crate such as shift positions ◻︎ not eating well due too much overall pain ◻︎not their normal perky selves
3- For a 21 pound dog the Pepcid AC would be 10 mgs every 12 hours. Let us know. 4- Let us know if you were successful in advocating a test-for-pain Prednisone taper before Dec 26. Pain meds are stopped on the test taper so that you can clearly and quickly assess for pain. Let us know for how many days 5mgs 2x/day will continue then a test for pain pred taper. Pain= another course of pred + all pain meds back on board + Pepcid AC No Pain= go to conclusion with pred taper... finish out the 8 weeks of crate rest for the disc to heal. |
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Post by Eddie & Dox on Dec 18, 2017 17:21:02 GMT -7
Hi Paula,
Thanks so much for the reply. I have read the links you suggested. I will keep studying them until it sinks in.
I called the vet just now. He gave me the green light to reduce the Prednisone to 25mg 1x daily, starting today--12/18 until checkup on 12/26. He said I could split that dosage in two, if I want. I don't see benefit to splitting the dose. Is there a benefit? If dosing Prednisone once daily, would Pepcid 10mgs be required twice daily or just one time (before a.m. dose?).
[Moderator's note: please do not edit
21 lbs
Prednisone as of 11/30: 10 mg 2x/day for 7 days,
as of 12/7: 5mgs 2x/day for 11 days
as of 12/18: 5mgs 1x/day, a test for pain taper
Tramadol 25 mg am + 50mg p.m. STOPPED?
Gabapentin 50 mg 2x/day STOPPED?
Bethanechol - 25 mg 2x/day
Amoxicillin 100 mg 2x/day
✚Pepcid AC 10mgs 2x/day]
I started him on 11/30 in the crate. We carried him to potty, but probably allowed too many steps, dragging and sniffing forays. I have been strict for the last 3 days, using a blanket to hoist his back end and allowing no walking/dragging. I feel like my answer should honestly be 12/15 then because I allowed too much movement at potty time before that date.
He seemed pain free (back) since the first day, even before pain drugs. I took him to the vet on 11/30. The vet said incredulously, "You don't think he's in pain?" I said, "No". He shows none of the signs you mention in regards to his back. However, the episode with the swollen bladder was painful, I'm sure. He barked for us a lot during that time. Remember, he had a overfull bladder but was off his Tramadol because of constipation... But now that the bladder is draining, and blood has cleared from urine, he is in great spirits (but back on Tramadol). And since this Dachshund loves his food, Doxie never quit eating the whole time.
At of last visit, the Tramadol is listed in my notes "As needed". The vet took Dox off of it because of constipation, but allowed it for the bladder episode. I determined the 25 mg a.m. and 50 mg p.m. dosage. It is up to me to reduce the dosage if I think he can handle it. If we are to taper the Prednisone, it is wise to also reduce the Tramadol to test his tolerance, correct?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Dec 18, 2017 17:30:29 GMT -7
Eddie, check that pred dose. It should NOT be twenty-five (25) mgs! Does it have a decimal point such as 2.5 mgs?
How many mgs does a whole Pred tablet have? How many pieces are you supposed to cut it into?
Pepcid stays at 10 mgs 2x/day til totally tapered off of Pred.
With the taper of prednisone starting, the pain-masking pain meds should also be stopped. Otherwise how could you accurately assess for pain when pain meds mask pain?
We've got our fingers crossed that the pred taper and stop of pain meds will reveal no pain at all. If there should be pain, your vet should tell you to get back on the 5mgs pred 2x/day and back on pain meds. Is that the plan you two worked out just in case pain would surface at night, weekends when your vet is not open?
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Post by Eddie & Dox on Dec 18, 2017 18:31:43 GMT -7
Sorry for the shock. Yes, the Prednisone tabs are 10 mg. We've been giving half @ 5 mg ea. twice daily. So the vet said I can go down to 5 mg 1x daily or 2.5 mg twice daily. I don't know if there is benefit to quartering the tablets; surely more mess and hassle involved. It would be easier to give half a tab in the a.m.. The total daily dose will be 5mg until next visit after Christmas.
Since I have given 5mg this a.m., I will not give a prednisone dose tonight. Tomorrow a.m. I plan to give the 5 mg dose again and continue in this manner until next visit.
I will stop Tramadol. I will not dose with it tonight (12/18). I will watch for signs of pain and only give Tramadol if pain recurs. If that happens, I will go back up to Prednisone 5mg, 2x daily and Tramadol 25mg 2x daily. I do not have the green light to stop Gabapentin.
Thanks everyone for help and encouragement. Also, I'd like to thank that rabbit for showing up right at potty time tonight. My dog got so riled up barking at it, he had a huge B.M.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Dec 18, 2017 18:47:22 GMT -7
Eddie, thank you for clearing up the pred mgs. 5mgs once a day sounds good.
Do call the vet. Gabapentin will mask nerve pain so you will not be able to quickly and correctly assess for pain.
Hope, not but if there is pain and you do have to go back on tramadol, pumpkin can be Dox' friend so that he does not have to stop this pain med. Tramadol is known to cause constipation.
Plain pureed canned pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation. 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 plain canned pureed pumpkin 1x a day to kibble.
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Post by Julie & Perry on Dec 18, 2017 20:40:31 GMT -7
Haha! So funny about the rabbit! Keep your sense of humor. It really helps when dealing with IVDD.
You're doing great. Just keep reading and learning.
It gets better. Hang in there.
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Post by Eddie & Dox on Dec 19, 2017 13:58:29 GMT -7
Dox slept fine over night without the Tramadol. I have copied the meds schedule, and updated. See bolded below:
21 lbs
Prednisone as of 11/30: 10 mg 2x/day for 7 days,
as of 12/7: 5mgs 2x/day for 11 days
as of 12/18: 5mgs 1x/day, a test for pain taper
Tramadol 25 mg am + 50mg p.m. stopped as of 12/18
Gabapentin 50 mg 2x/day Questions before stopping
Bethanechol - 25 mg 2x/day
Amoxicillin 100 mg 2x/day
✚Pepcid AC 10mgs 2x/day
I have a question about the Gabapentin, before I call the vet about stopping it. Dox has been on Gabapentin 50 mg 2x daily for 13 days. I have read that humans need to taper off this drug. Is this true for dogs too? I want to begin the pain test, but want to handle the Gabapentin withdrawel correctly.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Dec 19, 2017 14:08:59 GMT -7
It is always good to pass drugs questions by your vet. Gabapentin is also used used to control seizures. So an abrupt stop might not be a good idea in a seizure dog. Read up on gabapentin from the Mar Vista Vet website so you may best be able to understand and discuss this topic with your vet. www.marvistavet.com/gabapentin.pml |
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Post by Eddie & Dox on Dec 19, 2017 15:36:33 GMT -7
Thank you for the uplifting thoughts. Today was a surprise at potty time. Our cat Pipsi came over to say "Hi", and Dox greeted her with a wagging tail! He won't wag for me, but Pipsi elicited a happy response. I haven't seen his tail move in about 2 weeks.
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Post by Romy & Frankie on Dec 19, 2017 15:57:30 GMT -7
Tail wagging is very good news. If a dog can do a happy tail wag, he has DPS.
These are the typical stages of healing:
1. Deep Pain Sensation (Only correctly identified by a specialist.)
2. Tail wagging with joy at seeing you, getting a treat or due to your happy talk.<==Eddie
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 him 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.
5. Being able to walk with more steadiness and properly placed paws.
6. Ability to walk unassisted and perhaps even run.
The next step to look for would be the beginnings of bladder control. You can't really test for that while he is using a cath, but once it is out keep trying sniff and pee.
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Post by Eddie & Dox on Dec 22, 2017 16:31:22 GMT -7
Here is the new meds schedule
Dox--21 lbs
Prednisone as of 11/30: 10 mg 2x/day for 7 days,
as of 12/7: 5mgs 2x/day for 11 days
as of 12/18: 5mgs 1x/day, a test for pain taper
Tramadol 25 mg am + 50mg p.m. STOPPED as of 12/18
Gabapentin 50 mg 2x/day ,as of 12/19: 50 mg ▼1x day tapering off; no pain so far
Bethanechol - 25 mg 2x/day
Amoxicillin 100 mg 2x/day
Pepcid AC 10mgs 2x/day
No catheter
So Doxie decided today was "sniff and pee" day. He ripped off his belly wrap, and took out his catheter. He's been pretty good with bowel control, but as you remember, he overfilled with urine and had to be cathed to make expression easier while treating a uti.
I was beside myself when I saw his line out. I called the vet office and the tech said it's o.k., sounds like he got everything out. He must know it's time to pee on his own.
I took him outside to test. He did sniff. It did trigger pee... all over. But then he tried to get away, and got his feet under him and got his legs under him. The legs are definitely moving. I have another wrap on him with an outer wrap that velcros in place. So hopefully he won't get that off.
We'll know more at the appointment after Christmas. I think he's doing much better, but now the real work begins. It's like infant to toddler now, and keeping him under wraps for the rest of his crate confinement might be a challenge.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Dec 22, 2017 18:43:23 GMT -7
Eddie, gabapientin 50 mgs once a day might as well be no gabapentin it is such a little dose for a 21lbs dog. When gabapentin has been stopped then you will have proof that continuing the pred taper to conclusion will tell if all swelling is gone. No pain and no pain meds would show veryly likely all the painful inflammation has been taken care by prednsone and the final part of the taper is next.
That is wonderful news on seeing those legs move. His body is doing a good job of self repairing nerve connections!
As you point out for the remainder of the crate rest time, you want to insure there is not too much back movement. You want nothing to cause a relapse to the still early healing disc.
Vets who understand IVDD, know vet visits could potentially cause too much movement during the transport to get to the clinic.. So it is pretty typical to give a phone report to update, adjust meds. In Dox' case sounds like after Christmas all you will have to tell on the phone report is WONDERFUL news of nerves self repairing to bring back leg function and bladder control. IF gabapentin has been stopped you would also be able to give pretty positive proof report if all swelling is gone or not. If there is no pain, the vet will be able to tell you on the phone how to go to conclusion of the pred taper, which ends in an every other day dose and what the mgs would be.
When bladder control returns it is a good idea to continue to do a quick express check after he does his sniff and pee to verity he is fully voiding the bladder til you are satisfied he does it every time.
Got our fingers crossed on Dec 26, there will be no pain and Dox can go to the final leg of the Pred taper. Do keep us posted over the weekend.
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Post by Eddie & Dox on Dec 23, 2017 15:41:55 GMT -7
Dox went to bed last night without a belly wrap. He got me up twice to take him to urinate. He sniffed and pee'd both times. This a.m. we went out and he had a good controlled b.m., and then pee'd on his own. It comes out in jets, not a stream, and it's like he's learning to urinate all over again. His bed is dry, so it appears he is not leaking as he was before.
I am watching for bladder swelling like last time. I have tried to express to see if there is any extra left in him, but he is giving me nothing. I've laid him on his side like the vet showed me, but as he did for the vet, Dox tenses too much on his side, and he struggles to get up from that position--I know that's no good for his disc.
My best bet is to attempt expressing while I have him "standing" at the pee area. But I just can't get more out of him. I take him out whenever he barks, which is every few hours, and he produces every time. A few days ago, I could syringe his catheter while he sat on a mat near his cage, and he would also produce a b.m. there. He was desperate to evacuate anywhere but in his bed. Now he only wants to do his business outside. I am very happy with the bladder control coming back on board, and I am willing to take him out WHENEVER at this point, just to make sure he is clearing his bladder. He is drinking well, and eagerly eating.
I am going to keep the vet appt. after Christmas, as I would like a urine test to see if we cleared out the UTI on this first course of antibiotics, and I want to make sure the bladder is working correctly, palpating normally, looks o.k. on x-rays if necessary. I think after that, if the only issue is healing the disc, we can communicate via phone.
Thanks so much for advice and healing wishes. -Eddie
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Post by Romy & Frankie on Dec 23, 2017 16:04:31 GMT -7
If Dox is staying dry and sniffing and peeing when outside, it really sounds like his bladder control has returned. So you might not be able to get any more out when doing the express check. Seriously good news.
When my Frankie was regaining bladder control it came in jets also.
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Post by Eddie & Dox on Dec 27, 2017 22:04:25 GMT -7
Dox's vet appt. on Boxing Day showed improvement. He has bladder and bowel control. He has deep pain, some tail wagging. Vet o.k.'d removal of pain killers and finish the Pred taper. We finished the Amoxicillin on Christmas Day. Bethanechol stays on board for undetermined amount of weeks. Vet was noticeably excited and optimistic for Dox, who seems to be rebounding a little more every day.
Here is Dox's
current med arrangement:
Dox--21 lbs
Prednisone as of 11/30: 10 mg 2x/day for 7 days,
as of 12/7: 5mgs 2x/day for 11 days
as of 12/18: 5mgs 1x/day, a test for pain taper
as of 12/26: 5mgs every other day taper (Tue 26th, Thur 28th, Sat 30th) then stop.
Tramadol 25 mg am + 50mg p.m. STOPPED as of 12/18
Gabapentin 50 mg 2x/day ,as of 12/19: 50 mg ▼1x day tapering off; no pain so far as of 12/26: Stopped
Bethanechol - 25 mg 2x/day
Amoxicillin 100 mg 2x/day Stopped 12/25
Pepcid AC 10mgs 2x/day
No catheter
[Moderator's note: please do not modify
21 lbs
Prednisone as of 11/30: 10 mg 2x/day for 7 days,
as of 12/7: 5mgs 2x/day for 11 days, then 12/18 test for pain
Bethanechol - 25 mg 2x/day
Pepcid AC 10mgs 2x/day]
I noticed tonight that Dox can pull himself to stand. He knuckles on both back feet, and sways, but he's up. Should I discourage this, and make him stay down, either sitting or lying in his bed? He's got about 6 weeks of crate rest to go.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Dec 28, 2017 7:25:16 GMT -7
Eddie, good job in advocating for pain meds to be stopped during the test-for-pain Prednisone taper. And good news so far about no pain surfacing. At the conclusion of Pred on Sat 12/30, got our fingers crossed for full proof of all inflammation will be gone. Let us know.
Your vet should be very excited as we are to hear about all the nerve healing taking place! The 8 weeks of crate rest is devoted to letting the disc heal. Slow growing nerves may or may not bring back nerve functions in the short time it takes a disc to heal.
When feasible, put the paws back to a normal position. That helps to teach the body what is correct. It is OK if he moves up into a stand in his recovery suite.
Mark your calendar for graduation day on Jan 25th in 4 more weeks.
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Post by Eddie & Dox on Jan 11, 2018 0:13:10 GMT -7
Update on Dox...
We went to the vet yesterday. Doxie is down from 21lbs to 19lbs. Of course he has lost most of his muscle mass in his back legs and along his stomach. So he has this tiny little waist, butt, and skinny noodle-legs. I told the vet we feed the other dogs only in the a.m., but I insist on feeding Doxie twice daily because his healing needs nourishment, any Bubbe can tell you that.
Yes, vet agreed that feeding 2x is fine. He dropped the Bethacanechol from 2x daily to 1x daily. We're going to wean off over the next 10 days, and see if Dox can maintain his bladder function without it. We take him out several times a day, and he controls both potty and b.m., but at night I put a belly wrap on him because he pees in bed (only overnight) without it. With it, he does not pee at all. The wrap is never wet. And this dog used to hate the wrap and tried to tear it off. Now if I don't put it on him, he will bark at me until I do. It must give some comfort.
[Moderator's note: please do not modify
19 lbs
Prednisone as of 11/30: 10 mg 2x/day for 7 days
as of 12/7: 5mgs 2x/day for 11 days, then 12/18 test for pain taper
Bethanechol 25 mg 1x/day
Pepcid AC 10mgs 2x/day]
The vet was enthusiastic about giving a Glucosamine supplement every day. Dox slowly wagged his tail while the vet checked placement of the back feet and watched the dog pull himself to a wobbly stand. Dox has stronger function in his left leg than right. I told the vet that I had already purchased a dog flotation jacket (steal of a deal on Amazon for around $5 as an add-on item) and as soon as crate rest is up, we'll start aqua-therapy in the bathtub. He told me to do range-of-motion excercises too, after crate rest is over.
If anyone has experience excercising an IVDD dog in the tub, I'd like to know what is effective and what is not. Also,if you can suggest timeframes, like 10 min to start, and how gradually or quickly to work up to longer sessions. How many days a week should I be doing this? Also, ides on the range of motion excercises would be appreciated. Also, does anyone have experience with the back-leg braces that hold the foot in normal (not knuckled) position. I think this might be preferable to a drag bag. Yes, the gait will be stiff-legged, but I'd like to see proper paw placement and muscles getting a workout. Thoughts?
I informed the vet that I have added a nighttime calming dog treat, Therabis Calm and Quiet, a whole plant cannabidoid. With the treat and belly wrap, he is not getting us up at night anymore. And I have to say, it's nice to finally get 7-8 hours of continuous sleep. I give it to the other dogs, too, and they all rest better. Usually if the coyotes howl, all 4 of my Dachshunds will howl along, Jamboree-style, at 2 a.m.. I mention this only because some people have been asking if CBD's are good at helping with IVDD treatment. I would not advocate hemp oils, CBD's, calming aids, etc. as a SOLE cure-all for this issue. Only with the meds and crate rest protocol preached on this board did my dog have this chance to come back. LISTEN TO THE MODS HERE!
Our next vet visit is in February after crate rest is behind us, and when swimming in the tub commences.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 11, 2018 13:53:57 GMT -7
When my Jeremy was first learning to walk again after being paralyzed, I tried a no-knuckling shoes and didn't like them at all. Since they didn't allow his foot to bend, it made it impossible for him to get to his feet in them and when I helped him to his feet, he just dragged his legs. Plus, by holding the foot in one place, that doesn't help the foot and leg muscles get stronger. When crate rest ends on 1/25, Dox will need to be very gradually reintroduced to movement again to help gradually build up his muscles and stamina. Any rehab should wait for a few weeks after the end of crate rest. Dox will need to take things slowly after graduating from crate rest. Too much movement too soon can cause muscle soreness and it would be difficult to determine whether any pain is from sore muscles or another disc episode. Here's our page on after crate rest, but of course this all has to wait until 1/25. As you can see, it's a very slow reintroduction to movement. www.dodgerslist.com/literature/AfterCrateRest.htmHere's our page on hydrotherapy once his muscles are gradually built up again after crate rest: www.dodgerslist.com/literature/watertherapy.htmAgain, once his muscles are gradually built up following graduation from crate rest, you might want to look into hydrotherapy on an underwater treadmill, if one is available near you and affordable. Many members have found that to be very helpful. I found these exercises to be very helpful in getting my Jeremy to walk again, again, not to be started until after graduation from crate rest and gradual reintroduction to movement. www.dodgerslist.com/literature/massagepassiveexercises.htmIt's great that you're looking into what will be done after crate rest but don't rush things. What you can do now is to start making your home back friendly with these tips: www.dodgerslist.com/literature/protectback.htm |
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Post by Eddie & Dox on Jan 26, 2018 13:28:11 GMT -7
Graduation time...Doxie is now off all meds. His bladder is working normally again, and his bed is dry overnight without a belly-wrap. He can stand, scoot, and wobbly/criss-cross walk. I'm still carrying him out to potty, but while we're there, I'm letting him linger and putter around for about 10 min. He is slowly getting control of his back paws, and correcting them himself when he knuckles. He is happy to interact with the other pups again, and will enjoy resuming their daily Jeep rides. It was hard to see our way out of this during the holidays, when we had to deal with bladder infection, catheter, belly-wrapping, paralysis, constant dog-bed laundering. Things did get better, and I'm thankful for a positive attitude from my vet and the experienced mods here on the board. 
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Post by Romy & Frankie on Jan 26, 2018 15:45:26 GMT -7
Congratulations on Dox's graduation day! He has come a long way. What helped my Frankie the most in regaining his ability to walk was aqua therapy so it may be a good idea to continue that in the tub or a rehab place that offers it. We invite you to hop on to our educational bandwagon team in any way that makes you happy. Education about disc disease is our number one mission! We wish we did not have to hear of another dog that was put to sleep because of disc disease nor one denied the correct principles of crate rest to help them heal. --- You've been there, and are doing it....if you see another member on the Forum needing support or information share what you know to be true or point them to one of our many IVDD articles. The "search box" on each page makes quick work to find the right helpful link: www.dodgerslist.com/-- "Share" our FB/twitter/ posts to widen the reach of IVDD knowledge www.facebook.com/Dodgerslist twitter.com/DodgersList -- Hand carry our literature. When in conversation at the grocery store line or wherever you meet breeds most prone to IVDD (Dachshunds, Beagles, Poodles, Spaniels, Shih Tzus, Pekingese, and Chihuahuas) to give out our little cards. Ask Linda to send you our free packet: www.dodgerslist.com/literature/litorder.htm-- We have a store where you might find something you absolutely need! Our earnings go to paying for our webpage and literature to hand out. www.dodgerslist.com/store.htm-- Don't forget to add a photo to the gallery and 1-2 sentences. Give inspiration to others just starting a scary IVDD journey. Directions to u/l here: dodgerslist.boards.net/thread/2262/put-dodgerslist-photo-gallery-calendar |
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Post by Eddie & Dox on Feb 19, 2018 1:18:07 GMT -7
Update on Dox...
The fella is walking and even running (sort of). His back end is a bit loosey-goosey, and he looks like a runaway caboose sometimes, but he is on his feet (sometimes moving quickly) and obviously regaining his glutes and leg muscles. He is our hero.
Dox has rejoined the team on daily Jeep expeditions and is leading the burrowing for ground squirrels in the great Nevada desert. My husband likes to take the dogs to a sandy sagebrush area where, if Doxie needs to drag or scoot, he can ambulate without scratching himself on rocks.
While I don't always carry him out to his favorite potty place, I do oftentimes carry him to the edge of our back steps and put him on the ground. From there he determines where he wants to go, and returns to the steps to be carried back inside. Two days ago, he attempted to climb the steps, and I was yelling "Whoa! whoa!" His determination is inspiring, however.
Doxie's vet was overjoyed to see him stiff-walking around the exam room, wagging his tail, and barking happily. I jokingly told this young country vet that he is now the resident expert on IVDD. He said that he has had owners who return 3 weeks into conservative therapy and are very "cranky", wanting to know when the dog will be better. I am reminded that he told me the first week in that Dox would "look like this" (paralyzed) for weeks before he would improve. He said it could be 6 or 8 weeks of "looking just like this". But the whole time he was upbeat, and we reveled in any improvement Dox could make: overcoming bladder infection, regaining bladder control, pulling out his own catheter, wagging tail, standing without knuckling, etc. He remarked that I had done a great job and Dox was lucky to have an owner who didn't give up.
He added, "Oh, he's going to get a lot stronger, I can tell!"
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