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Post by Marie & Clementine on Oct 4, 2018 8:34:17 GMT -7
I would like to introduce myself, as this is my first post to this board. I’m the dog Mom to a Dachshund/Jack Russell Mix rescue dog (Clementine Belle). Clementine Belle is 3 y/o and had an emergency vet visit for severe back pain on September 18, 2018. She went down only a few hours after we arrived at vet and became incontinent. She stayed at the vet 5 days for pain control and observation. During those 5 days she was on Prednisone, Gabapentin, a Morphine medication and Tramadol. She began emptying her bladder on her own after a week and her back legs have remained paralyzed. Her diagnosis is Degenerative Disc Disease and the prognosis is that she may recover to the point of being unstable in her hind legs. It has been recommended that she have a wheel cart in the future. We have her on bed rest and giving her CBD oil, Glucosamine, Tramadol, Prednisone [taper] for two more days, and Gabapentin.
[Moderator's note: please do not modify
15 lbs
prednisone at vet as of 9/18: for 5 days
Prednisone as of 9/23 at home: ? mgs ?x/day for 6 days, BEFORE 9/28 test-for-pain tapering
tramadol ▼25 mgs 2x/day
gabapentin 50mgs 2x/day ]
Our hope is that she will regain use of her hind legs. If she doesn’t, I see a wheel cart in her future. Thank you for taking the time to read our story.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,544
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Post by PaulaM on Oct 4, 2018 9:03:50 GMT -7
dmarie, welcome to Dodgerslist forum. Do know it is still quite early in the nerve healing department to make decisions if nerves will or will not heal....still much time for hope. The time to assess if money is best spent on a wheelchair or underwater treadmill is at the end of the 8 weeks it takes the disc to heal. Could you clarify the meds so we have a full understanding. --- how much does she weigh?--- prednisone at home started on 9/23? For how many days was she on ?mgs ?x/day BEFORE there was a reduction (a taper) -- What is t he doses and frequency on both pain meds (tramadol, gabapentin) With the begin of pred taper were those pain meds backed off to allow you to get an accurate and quick assessment about pain? Rule of thumb pain = swelling = back up at anti-inflammatory dose, pain meds and Pepcid AC (to protect the stomach)Tell us about bladder control. Can she sniff an old pee spot outdoors and then make the decision to release urine there? OR are you seeing signs of loss of bladder control of finding leaking in bedding, leaking on you when lifted? Can she give you a happy tail wag if you specifically do some happy talk? Do you see her attempt to use back legs such as when repositioning her body in her recovery suite? Nerves heal typically in the reverse order of the damage to the spinal cord:
1. Deep Pain Sensation (Only correctly identified by a specialist.)
2. Tail wagging with joy at seeing you or getting a treat or meal.
3. Bladder and bowel control verified with the "sniff and pee" test.
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 place the feet.
6. Ability to walk unassisted and perhaps even run.
More info: www.dodgerslist.com/literature/healingnerves.htm Let us know you are on the same page about crate rest. The centerpiece of "DISC disease" treatment is the healing of the disc via limited movement of the back via a recovery suite. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong disc scar tissue to form. --- Super tried and true tips for setting up the recovery suite: www.dodgerslist.com/literature/CrateRRP.htm --- PLUS further guidance on conservative treatment on our "All Things IVDD page: www.dodgerslist.com/literature/healingpage.htm www.dodgerslist.com/healingindex.htmSTRICT means: - no laps - no couches - no baths - no sleeping with you - no chiro therapy - no dragging or meandering at potty times. If she does indeed have bladder control: Carry your dog to and from the recovery suite to the potty place and then allow a very, 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!  |
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Post by Marie & Clementine on Oct 4, 2018 9:47:34 GMT -7
Thank you for your response to my post. I appreciate all of your input.
Clementine is at 15# right now. Her Dachshund body is super long and measures two feet from tip of nose to tail bone. She has quite the slinky.
Gabapentin 50 mg twice a day.
Tramadol was 50 mg twice daily, decreased to 25 mg twice daily
Prednisone Tapered off at day 6
She can’t go outside to potty because she drags herself to see the dog’s at the fence lines. I take her from cage to pee pad during the day. Her diaper stays dry all day. She wakes up wet after sleeping all night though.
No tail wag. She is a bossy girl and barks/yelps at us when we engage her.💕
She stiffens back legs during potty...while in her sling. No use of hind legs in bed.
We are following all crate rules except baths when she poops herself.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,544
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Post by PaulaM on Oct 4, 2018 12:59:58 GMT -7
Marie, right? Baths are too dangerous for the healing disc. A safe approach for poop would be twofold --- express for poop about 30-60 mins before mother nature would push it out. Details, tips and a video here: www.dodgerslist.com/literature/Expressing.htm#poop--- if there would then be still some times she gets in her poop, try these safe tip which come from our supplies list here: www.dodgerslist.com/literature/cratesupplies.htm1) Use unscented baby wipes for quick clean up on your doxie. 2) Marjorie's tip: boil and cool decaf green tea to dampen a washcloth. It is mild with acidifying, antibacterial properties to neutralize urine/poop on skin and fur to avoid rashes from urine scald + leaves aclean earthy fragrance.   White vinegar in a spray bottle to disinfect and remove the urine ammonia smell from floors, etc. Best is to have two spray bottles, one filled with plain white vinegar the other filled with peroxide . A spritz of each on urine and poop disinfects and completely removes the odor... good on linens, floors and other hard surface. Pre test for color fastness on important fabrics. At Costco you can purchase 2 qts hydrogen peroxide for under $2.00. articles.mercola.com/sites/articles/archive/2001/07/21/vinegar.aspxIs her poop loose and that is the reason for the diaper? At night do you give last drink at say 8pm, last chance to pee at 10pm bedtime. She ought to be able to stay dry for the night. What date will all pain meds be stopped so that you have the ability to correctly assess for unresolved pain? |
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Post by Marie & Clementine on Oct 4, 2018 15:09:29 GMT -7
Yes, Marie.😊
Great tips, appreciate it.
Her poop is normal. The diaper at night is to keep her bed dry. She has access to water 24/7 because she just started drinking on her own. We were using a syringe post injury.
Clementine sees the vet next week to assess her and talk about a medicine/treatment plan moving forward.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Oct 5, 2018 4:16:48 GMT -7
Usually vets who appreciate the importance of limited movement of the spine during a disc episode will assess via phone consults rather than risky transport to the vet. Too much movement of the spine during transport or during an exam at a vet's office could cause more tearing of the damaged disc and more damage to the spine. Please speak to the vet about doing a phone consult rather than an office visit.
At this point, Clementine Belle is on a Prednisone taper which serves two purposes. The adrenal glands have to be signaled to again make their own steroid. Also a taper is an opportunity to test for pain/neuro loss. Pain = swelling = more time on all meds. However, with pain meds still on board, that makes it difficult for you to determine whether there's still pain/swelling or not. If there is still swelling pressing on the nerves of the spine, it's very important to get the Prednisone back up to the anti-inflammatory dosage ASAP. Anything less than the anti-inflammatory dosage will not be effective in getting the swelling down. It's that swelling pressing on the nerves of the spine that causes nerve damage. Please speak to the vet ASAP today about either tapering off of the pain meds or stopping the pain meds altogether to test for pain. Should you see any sign of pain then you'll know there is still swelling and Clementine can be immediately returned to the original dosage of the Prednisone for awhile longer. It can take 7-30 days for that swelling to resolve.
Do you currently see any sign of pain? Signs of pain to be aware of are
◻︎ restless, pacing, can’t find a comfortable position
◻︎reluctant to move much in crate such as shift positions
◻︎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.
◻︎looks up with just eyes and does not move head and neck easily.
◻︎ not eating due to pain of moving jaw with a neck disc or pain of back disc
◻︎ holds front or back leg flamingo style not wanting to bear weight
◻︎not their normal perky selves
Am I correct that strict crate rest started when Clementine stayed at the vet's office on 9/18?
Healing prayers for Clementine.
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Post by Marie & Clementine on Oct 5, 2018 6:14:56 GMT -7
I put in a request for our vet to call me. I will ask her about a phone consult and medication. She had mentioned considering Rimadyl five days after Clementine stops Prednisone [??]. But, we still need to have that conversation.
We see no signs of her being in pain. It has been a challenge keeping her still because she just wants to go. She has been on crate rest since her ER visit to the vet.
We expect to have a plan soon for moving forward.
Thanks for your input.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,544
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Post by PaulaM on Oct 5, 2018 9:04:25 GMT -7
A switch to Rimadyl with a 5 day washout as a stand alone statement makes no sense in treating a disc episode. Do ask ALOT of why questions/thinking behind treatment, etc. if this would be the future treatment!
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Post by Marie & Clementine on Oct 5, 2018 11:16:42 GMT -7
Will do.👍
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Post by Marie & Clementine on Oct 12, 2018 17:28:56 GMT -7
Will do.👍
Update:
I have consulted with my vet. Moving forward we have five more weeks of keeping Clementine rested in her cage. She was just weaned off of all medication before being put back on Tramadol and Gabapentin twice daily.
[Moderator's note: please do not modify
15 lbs
prednisone at vet as of 9/18: for 5 days
Prednisone as of 9/23 at home: ? mgs ?x/day for 6 days, then 9/28 taper to test for √PAIN for _NEURO
tramadol 25?mgs 2x/day
gabapentin 50?mgs 2x/day ]
Without the Gabapentin, Clementine was chewing at her legs/feet. Our vet told us that she was experiencing nerve pain. Without the Tramadol, she was displaying signs of being in pain. During the time that she was off all medication, she stopped drinking water once again. Putting her back on medication’s has resolved that. She still has not wagged her tail. I feel like we are moving in the right direction and I only hope for more progress the closer we get to the 8 week mark.
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Post by Pauliana on Oct 12, 2018 21:38:01 GMT -7
Hi Marie!
Pain means there is still swelling pressing on the nerves of the spine. Clementine should go back on the twice a day dosage of the Prednisone until the next taper. It can take from 7-30 days to get the swelling down with some dogs.. Many dogs have to taper more than once.. It is not unusual. If she had no pain at all while off the pain meds, that would have meant the swelling was gone.. More work for Prednisone to do, call your Vet right away to discuss returning her to the anti inflammatory dose of the Prednisone.. Glad the Tramadol and Gabapentin are back on board to mask the pain..
What is the current dose in mgs for Tramadol and for Gabapentin given 2x/day?
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Post by Marie & Clementine on Oct 14, 2018 17:17:21 GMT -7
I will talk to our vet tomorrow morning when I am there with my other dog. Thanks.
Gabapentin is 50 mg
Tramadol is 25 mg
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