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Post by Judith & Charlie on Sept 15, 2018 23:59:27 GMT -7
Hello, my name is Judy and sadly, I've found my way to this forum because one of our miniature Dachshunds, Dexter(DOB 11/01/2012), has lost all use of his hind end. He cannot control his bladder and needs to be expressed regularly to prevent urine leakage. He's had maybe 3 prior episodes where he's "tweaked" his back (walking gingerly, asking for help on and off the bed instead of using the ramp, etc) but with rest, he'd always fully recovered. His last episode was probably sometime between last summer and early last winter. He used to be moderately+ overwheight but had since gotten down to a much healthier weight ( a little over 11 pounds) and I had hoped he wouldn't have any furher issues...
Dexter "tweaked"his back on 9/10, not sure exactly how but we have a busy household (5 dogs of our own and one we're currently fostering, 2 cats, and 2 young boys) so it could have been any number of ways. We were mindful of his back but after reading through all the information here I'm fairly wracked with guilt because we did EVERYTHING wrong. We didn't crate him and let him sleep in bed with us. On 9/12 I woke up to one of my worst nightmares come true....Dexter couldn't move his back legs or his tail, and I would soon discover he couldn't control hiis bodily functions. I crated him immediately.
My husband was already at work and we only have one car, the vet didn't have any appointments open until the following evening. He was eating and drinking normally, did not appear to be in any pain, and was moving his bowels and empting his bladder wih my help every few hours so we kept him crated until we could get him to the vet on the 13th. My husband took him to the appointment and the vet gave him a 5 day supply of Gabapentin (100mg every 8 hours) and Rimadyl (1/2 of a 25mg tab every 12 hours) and instructed my husband to have him seen by the emergency vet specialists to be evaluated for surgery the following day with strict crate confinement.
[Moderator's note: please do not modify
11 lbs
crated 9/14
Rimadyl as of 9/13: 12.5mgs 2x/day] for 5 days, then 9/18 stop to test for pain/neuro loss
gabapentin 100 mgs 3x/day]
We took him the following day, 9/14, and he was examined and deemed to be a candidate for surgery but because it was a friday evening, there were no vets available to do it so we came home with the intent to return Monday to see if he would still be a good candidate for surgery. Someone from a dachshund group I belong to told me I should check out the site and I've been reading pretty much non stop since. I'm no longer sure surgery is the answer but really need advice please. Since seeing the specialist Dexter started "stretching" his legs when i lift his hind end to express his bladder and has lifted his tail slightly a few times too...both of these are new.
Should I still just pursue surgery or should I try conservative and get my vet to prescribe the necessary meds? He is REALLY unhappy about being crated, I've given him .025 mg CBD oil, have chamomille scented toys with treats tucked inside but he gets very upset and whining/barking. Can I give benedryl or something? If so, how much? He weights just over 11 pounds. Thanks you in advance, please help me help my baby
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,589
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Post by PaulaM on Sept 16, 2018 7:36:50 GMT -7
Judith, welcome to Dodgerslist. Good to hear you are reading and trying to absorb as much as possible. Kudos to you on that front! If you haven't yet, do go over to our main webpage for access to our full treasure trove of IVDD info: www.dodgerslist.com/healingindex.htmWas the specialist you saw a neuro (ACVIM) or ortho (ACVS)?
Did the specialist say if there was still deep pain sensation (DPS)? A very good page on when surgery and how it compares with conservative: www.dodgerslist.com/literature/healingsurgery.htm For now the single most important care you can give is the 100% STRICT rest 24/7 for the full 8 weeks, only out of the recovery suite to be expressed. Pressure to the nerves of inflammation and a disc pushing on nerves is what causes nerve cell death. Conservative treatment aims to heal the disc with limited movement and meds to bring down inflamamtion. Surgery aims to remove the offending disc material pressing on the nerves. It is time that where the body self heals nerves with both conservative and after a surgery. LET US know you are doing STRICT 24/7 crate rest.STRICT means: ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy "whys": __ www.dodgerslist.com/literature/chiropractic.htm ◼︎no dragging when out to be expressed ◼︎no PT for conservative dogs during 8 weeks to heal disc ◼︎laser or acupuncture for severe neuro damage is best at home via a mobile vet. Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment. Does Dexter stay dry expressing session to session?Does Dexter show any signs of pain with being on only one pain med?◻︎ shivering-trembling ◻︎ yelping when picked up or moved ◻︎ slow to move ◻︎ tight tense tummy ◻︎ arched back, ears pinned back ◻︎ head held high or nose to the ground. ◻︎ restless, can't find a comfortable position ◻︎ slow or reluctant to move much in crate such as shift positions ◻︎ not their normal perky interested in life selves + pain from neck disc: ◻︎ looks up with just eyes and does not move head and neck easily. ◻︎ not eating due to painful chewing or in too much overall pain ◻︎ holds front or back leg flamingo style not wanting to bear weight
If the pain meds are not yet right, please contact your vet ASAP to report your observations so meds can be adjusted. Advocate for any of the pain meds be given 3x/day (every 8 hours) for round the clock coverage. — Methocarbamol works on the pain of muscle spasms. — Tramadol is the general pain reliever. — Gabapentin works on nerve pain. There should be no sign of pain from one dose of meds to the next. Have no patience with pain as it does hinder healing. Look for your dog to be acting their normal, perky self when pain is fully under control round the clock. For how many days is Rimadyl to be given? before it stops so that you can test if there is still painfulness/increased neuro deficit? To understand how an anti-inflammatory works with a disc episode, if you've not yet read this page... take a look: www.dodgerslist.com/literature/healingsweling.htmWhen any anti-inflammatory is on board Pepcid AC should also be on board to protect against the extra acids Rimadyl causes. Be proactive, please. Dogs don't speak up at first signs of trouble like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach. Ask if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health issues” answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine).  |
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Post by Judith & Charlie on Sept 16, 2018 9:34:11 GMT -7
Thank you so much for your response Paula! Dexter has been on STRICT crate rest since late 9/14 when I read the guidelines for it on Dodgerslist.com. Prior to that it was “modified” due to ignorance, plain and simple. He was given “lap time” and allowed to be out of his crate on a pee pad while supervised. ALL of that has stopped and he has been crated exclusively since.
I’m sorry, but I do not know whether or not the specialist is accredited, I’ve been having a hard time absorbing the basics right now but both our vet and the specialist DID say that he still has deep pain sensation, yes.
Strict crate rest since 9/14
Dexter has been staying dry between bladder expressions, yes.
He seems to be “fighting” /tightening up and resisting having his bladder expressed since he’s started stretching his back legs. He also now hasn’t had a bowel movement since yesterday (9/15). I had been helping him “potty” on pee pads so today (9/16) I tried taking him outside for toileting using a scarf sling but all he wanted to do was try to walk around and check everything out so I ended the attempt and returned him to his crate.
He is not showing any signs of pain
i will pick up pepsid as ASAP (later today) and start immediately.
I guess my my main concern at this point is his distress with being crated. I got almost no sleep because despite being on an elevated stand right next to our bed he whined almost constantly. He whines and barks non stop unless someone is sitting right next to his crate. Can I give him benedryl? The CBD oil seems to have zero effect on him. I am desperate
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,589
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Post by PaulaM on Sept 16, 2018 12:11:18 GMT -7
Judith, it is possible a degree of bladder control is returning. While leg stretching is not proof to a human if it is brain directed or a typical relfex activity. To proove there is brain directed leg movement you'd want to observe for a head level involvment with leg movement or other neuro functions: --- ear (head level) itches so he attempts to use back leg. --- smells (head level) an old pee spot in the grass and makes the decision to release urine there -- hears (head level) you doing some happy talk and he give a happy tail wag. Let us know what you observe when you peroidocally take him out for the "sniff and pee test" every other day or so. Make sure the sling is not pressing on the bladder as that would be confusing why urine came out — reflex action of an overflowing bladder or brain directed sniff and then a pee. You can re-view bladder expressing and also learn how to express for poop here: www.dodgerslist.com/literature/Expressing.htm Let us know how the poop expressing goes. VET CREDENTIALS All vets have DVM after their name. A specialist would have ACVIM or ACVS in addition. Their website, their business card would have their credential after their name. The reason we do not take the word of a DVM about deep pain sensation is too general DVMs do not the extra training, the practiced eye that a specialist has to accurately and correctly assess. The happy tail wag is something that no one can get wrong and will happen after the return of deep pain sensation (DPS). CALMERS Using any oral calmer in combination with a Pheromone diffuser seems to work best. It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives (ACE or trazodone). Of course always keep your vet in the loop on all things you give your dog. Place a DAP pheromone diffusor at floor level where the recovery suite is: --DOG Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/Use diffusor with one oral calmer from below:Oral calmers: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed www.virbacvet.com/products/detail/anxitane-l-theanine-chewable-tablets/behavioral-health 2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. www.vetriscience.com/composure-soft-dogs-MD-LD.php 3) Rescue Remedy is a liquid herb combo to help with relaxation www.bachrescueremedypet.com 4) Benedryl- Get the dosage from your vet. The wrong dose can have dangerous side effects, so your vet needs to prescribe the proper amount for your dog. Avoid with glaucoma, lung disease, heart disease, some forms of thyroid disease, prostate disease or high blood pressure. |
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Post by Judith & Charlie on Sept 17, 2018 22:58:46 GMT -7
I spoke with the vet today and Dexter's new med routine is as follows:
Rimadyl 12.5 mg every 12 hours
Gabapentin 1.5 ml every 8 hours
✚Methocarbamal 125 mg every 8 hours
✚Trazadone 25 mg every 8-24 hours as needed to control anxiety for 3 days then 50 mg as needed
✚Pepcid AC 5 mg every 12 hours
✚Adaptil spray as needed
[Moderator's note: please do not modify
11 lbs
crated 9/14
Rimadyl as of 9/13: 12.5mgs 2x/day for 5 days,
as of 9/18: 12.5mgs 2x/day for ? days then stop to test for pain/neuro loss
gabapentin 250mg/5mL: 50mgs (1.5mL) 3x/day
✚Methocarbamal 125 mg 3x/day
✚Pepcid AC 5 mg 2x/day
✚Trazadone 25 mg 1-3x/day as needed for 3 days then 50 mg as needed
✚Adaptil spray as needed]
She wants to see him Saturday morning for a 12 hour fasting blood work up. She said the Riamdyl can cause damage to certain organs when used for prolonged periods so she wants to get a baseline.
Dexter is resting comfortably and doing better with the bladder expressing-thanks so much for the link to bladder expressing! He's also moving his bowels on his own, I think I was just over paranoid...all the stress and lack of sleep does it to me.
The vet gave me printouts for each of his medications and a list of things to be watchful for (one med can cause gi bleeds to I need to monitor his poop, keep an eye to make sure he isnt too sedated and that his breathing is normal and even, etc)....
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Sept 18, 2018 5:01:28 GMT -7
Excellent, Judith. You have a vet who has a good understanding of what a dog going through an IVDD episode needs and how to treat safely. I'm very glad to hear that Dexter is resting comfortably. If you do see any sign of pain today, do let the vet know. Remember that Tramadol is a general pain med that can also be added to the mix.
When you get a chance, please check the bottle of Gabapentin and let us know how many mg are in each ml so we have a complete medication list to follow. Also did she say how many days she's prescribing the Rimadyl for before stopping to test for pain/swelling, though she may want to do the blood work before deciding on that.
Now that Dexter has all he needs to heal, you need to get some rest. You need to take care of yourself in order for you to take care of Dexter. You've done a great job in getting him what he needs. We're here for you and Dexter and will help you through this. Healing prayers for Dexter and a hug for you.
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Post by Judith & Charlie on Sept 18, 2018 12:16:42 GMT -7
Gabapentin suspension 250mg/5ml
The vet did not say when she wants to check again but I will definitely discuss that when we’re there Saturday for his blood work.
Thank you and God bless all of you who put in so much of yourselves to help us help our babies!
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Post by Judith & Charlie on Oct 3, 2018 16:15:39 GMT -7
Just wanted to post an update although there isn’t much to report...
We have discontinued the Rimadyl except on the rare occasion Dexter exhibits pain, usually a low growl when he knows he’s going to be picked up for toileting. The rest of his meds are the same.
Dexter continues to “stretch” his legs and has started moving his tail more, mostly when he’s having a bowel movement but occasionally other times too. Sometimes when we lightly tickle one of his back feet he willl pull away, sometimes not. I continue to express his bladder regularly and haven’t tried taking him outside because even out of his crate, he just wants to be on the move.
Keep doing what I’m doing?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,589
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Post by PaulaM on Oct 3, 2018 19:29:19 GMT -7
What date did you stop Rimadyl? The stop of Rimadyl is to test for pain. So having pain meds on board defeat the test....you do not know if Rimadyl MUST back on board to fully resolve swelling or not. No accurate test for pain means the spinal cord is being delayed help IF, IF, if there would still be swelling/inflammation. Pain= another course of anti-inflammatory + all pain meds back on board.
No Pain= no need of any meds...just finish out the 8 weeks of crate rest for the disc to heal.
Let us know when pain meds will be either backed off or full stopped so you can accurately observe if there is any pain still. The full details on how Rimadyl, an anti-inflammatory works with a disc episode. Good reading to be able to ask the right questions and discuss treatment: www.dodgerslist.com/literature/healingsweling.htmIs the low growl perhaps anticipation of pain that used to happen. Can you figure out if Dexter really is in pain or just expecting that it might cause him pain when lifted? Observing two or more signs of pain can help you decide. SIGNS OF PAIN ◻︎ shivering-trembling ◻︎ yelping when picked up or moved ◻︎ slow to move ◻︎ tight tense tummy ◻︎ arched back, ears pinned back ◻︎ head held high or nose to the ground. ◻︎ restless, can't find a comfortable position ◻︎ slow or reluctant to move much in crate such as shift positions ◻︎ not their normal perky interested in life selves There is nothing to be learned from tickliing paws. It might cause a jerking movement, might be too much movement for a healing disc. So I would not tickle his paws from now on. You could set up a fenced area for potty. May use an ex-pen or some garden edging fence for about a 6 foot diameter potty place. That way he'll have the physical and the visual to let him know no sniff festing will be going on... just a sniff and pee test. How's expressing going. How often do you do it? Does he stay dry inbetween sessions? |
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Post by Judith & Charlie on Oct 10, 2018 23:25:54 GMT -7
Sorry ya taken me so long to respond, never enough hours in the day... I spoke with his vet again, at length this time. Because he completely went off food, even with the Pepcid ac, and with him not really showing/expressing pain (I believe you are correct, that the growl is in anticipation of being moved when he’s not “in the mood”), we have discontinued the Rimadyl.
We have stopped messing with his feet, thanks so much for letting us know that it could be detrimental to his recovery! Bladder expressing is going better and he is staying dry between expressions. His bowel movements are normal/regular too.
I can’t expr how much I appreciate you all helping us get through this. We couldn’t have done it without you! ♥️
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Oct 11, 2018 4:35:57 GMT -7
Have the pain meds been stopped, too, Judith? If not, then the pain meds would mask any sign of pain that you would need to see to determine whether an anti-inflammatory is still necessary. If Dexter still has pain/swelling, then he still needs Rimadyl. I understand that he completely went off his food but IF he still has swelling pressing on the nerves of the spine causing pain, then he could continue with Rimadyl with a second stomach protector added to the Pepcid AC. That second stomach protector is Sucralfate. Sucralfate works in a different way than Pepcid AC.
If pain meds - Gabapentin and/or Methocarbamol - are still on board, do speak to the vet ASAP about stopping or tapering off of those meds so you can do a proper test for pain/swelling. If signs of pain return upon the stopping or tapering off of pain meds, then speak to the vet about starting Rimadyl again with the addition of Sucralfate and Pepcid AC for double protection. If no pain returns with the stopping of the pain meds, then no meds would be needed any longer. But if pain meds are still on board, you have no proof that swelling has resolved.
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Post by Judith & Charlie on Oct 13, 2018 11:57:14 GMT -7
Thanks so much for the reply and again, sorry for the delayed response. Dexter has been off the Gabapentin and Rimadyl on 10/11 since I got your reply and spoke with the vet.
His vet is keeping him on the Methocarbamol and Trazadone for now because he gets almost hysterical being crated without them. We also use the Adaptil spray but he really, REALLY hates being crated. He had been stretching his legs and moving his tail when going to the bathroom and yesterday (10/12) he wagged his tail for the first time. Today 10/13 my husband saw him stand for a moment too. The vet said to keep up with the strict crate rest and keep her updated. She’ll see him to evaluate him in a few weeks.
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Post by Romy & Frankie on Oct 13, 2018 13:24:11 GMT -7
Was Dexter wagging his tail in response to some happy talk? If so this is wonderful. This, in addition to standing by himself, even for just a little while, is an indicator that DPS is present and there is a much higher chance that additional neuro function will return.
With Dexter still taking Methocarbamol we have no way of knowing if all the spinal cord swelling is gone. Pain is an indicator of spinal cord swelling and the Methocarbamol may mask that pain. If there was still swelling in the spinal cord additional Rimadyl would be needed to prevent any more spinal cord damage. At this point we don't know if additional Rimadyl is needed or not.
Many dogs hate being crated. If the trazadone is not working well, you can ask the vet about trying Acepromazine (ACE ) instead. Different dogs react differently to these sedatives.
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Post by Judith & Charlie on Oct 13, 2018 19:20:28 GMT -7
Thank you so much! I will definitely talk to her about those things on Monday.
Yes, he was wagging his tail in response to praise, he did it again earlier this evening and he’s definitely trying to stand more while I’m expressing his bladder.
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Post by Judith & Charlie on Oct 15, 2018 8:30:39 GMT -7
Dexter has become more resistant to having his bladder expressed again (I can do it effectively but it takes much longer due to him tightening his abdomen-he is staying dry between expressions) so I tried taking him outside yesterday(10/14) for the first time in probably a month. I used a scarf as a sling and for the first time ever Dexter not only straightened his legs but he actually moved them in a “walking” motion. He had a bowel movement but then just wanted to “walk” all over so I brought him back in. Just a few moments ago I brought him out again and today he pooped and peed! He still wants to go all over which makes me extremely nervous considering the fact that he’s just now making some progress after almost 5 weeks of nothing. He wants to go out for toileting but I’m terrified that no matter how careful I am, it’s going to lead to a set back. Please advise
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Mary & Mila
Helpful Member 
FEMALE— DACHSHUND
Posts: 218
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Post by Mary & Mila on Oct 15, 2018 11:07:41 GMT -7
hi Judy, Sounds like Dexter is on his way back!! Yesterday he was wagging his tale and today pooping and peeing without help. All great signs. Return of Neuro Function - the signs to watch for:
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. 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 stand, 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. Now is the time to stick to the crate rest more than ever.
Don't be nervous about taking him out to do his business. Just limit his steps as best you can. You could use a pen - like in the photo, to limit his ability to move too much and stop sniff fests!  After Crate Rest
When he has graduated crate rest you can then concentrate on a gradual return to his normal routine. www.dodgerslist.com/literature/AfterCrateRest.htmkind regards Mary |
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Post by Judith & Charlie on Oct 26, 2018 12:12:38 GMT -7
We cant believe how far he’s come! Still on strict crate rest, will be following up with he vet soon. Thanks so much for all the help and support. We were doing everything wrong and I was on the verge of a nervous breakdown until I found you all ♥️
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,589
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Post by PaulaM on Oct 26, 2018 19:55:39 GMT -7
Judith, he is really doing well with those legs!!!
I would recommend to always have a harness on him. The harness and leash is what ensures you have a way to control speed. The rear leg sling is just as back up should his butt start to tip over...keeping the back aligned is important.
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Post by Judith & Charlie on Nov 7, 2018 20:19:42 GMT -7
Thanks! Will do! ♥️ When can we let him sleep in bed with us again? I’d ask the vet but I feel like the experience here far outweighs our vet’s and I don’t want to risk doing the wrong thing. Dexter continues to slowly improve and is still on strict crate rest with outings to go to the bathroom. He can bear his weight for a few seconds and is doing better with using his back legs (stepping). He has been standing more when it’s time to take him out of his crate too. My biggest fear at this point is a setback due to ignorance. Graduation date on November 9, 2018
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Post by Pauliana on Nov 7, 2018 22:11:38 GMT -7
Hi Judith, Sounds like Dexter is doing so well. His crate rest graduation is November 9th.. I hope you have read the after crate rest article so you know how to handle GRADUALLY easing him back into activity.. Mary posted the article for at the end of her post to you 3 or 4 before this post.. Not a good idea to let him over do it by letting him have full access to the house all at once.. He's been resting for 8 weeks, slow and easy and please crate him when he is not being supervised.. www.dodgerslist.com/literature/AfterCrateRest.htmI would avoid putting him on your bed or on any furniture unless you have a way to prevent him from jumping or falling off which would injure him again.. IVDD is a lifetime disease and we always have to be one step ahead of them to keep them safe.. Ramps to furniture are a good idea once he has been trained to use them reliably.. I will attach a link to our article on having a back friendly home that has lots of wonderful ideas and tips.. dodgerslist.com/literature/protectback.htm |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,589
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Post by PaulaM on Nov 8, 2018 10:02:44 GMT -7
Judith, you will want Dexter off of all pain-masking pain meds before the start of gradual introduction back to physical exercise on Friday, Nov 9 as concrete proof positive there is no more painful swelling going on.
Is he now off of methocarbamol?
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Post by Judith & Charlie on Sept 16, 2019 18:46:54 GMT -7
Wow, that can’t believe it’s been a year since our journey with IVDD began. I’m sorry I stopped answering and just disappeared Paula but all of your advice was gratefully followed. Thanks so much to the website and this forum for EVERYTHING. Dexter walks, runs, plays, wags his tail, and goes to the bathroom by himself all because of the information and dedication here. I wouldn’t consider him back to “normal”, he has a bit of a wobble to his walk now but he’s happy and healthy and mobile on all 4s!
Side note: After Dexter’s recovery we had the confidence to take care of a “down” dog and adopted Balloo, a standard Dachshund, who was surrendered to rescue after losing the use of his back legs.
We just cannot express the magnitude of our gratitude for all the information and support
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