|
Post by Emily & Sophie on Oct 17, 2018 11:01:51 GMT -7
Emily's Sophie - paralysis in only one paw?
Hi all, This is my first post - I used the search function and couldn't really find the answer to my question. I'm sort of distraught, too, so I apologize if it's been asked before.
My name is Emily and I have a 9.5 year old purebred Welsh Corgi (Sophie) who about a week ago (10/10) began showing signs of neck pain. She was very withdrawn, couldn't do steps, and kept her neck down. When I gently tried raising her head, she yelped for a few seconds and we immediately went to the vet.
He prescribed Carprofen, 1/2 tablet (75 ml) twice a day and also Hydromorphone .5 mg, 2x a day. She's been under strict crate rest for about five days now and I carry her outside.
[Moderator's note: please do not modify 30 lbs carprofen as of 10/10: for 7 days, then stop 10/18 to test for pain/neuro hydromorphone 0.5mgs 2x/day Gabapentin 100 mg 2x a day. stomach protector?...Pepcid AC??]
Well, two days later she suddenly began to have physical symptoms - her front left arm drags when she walks, causing her to be very uncoordinated and stumble. Her vet was surprised it was only affecting one side of her, but he said to wait a few days and if it didn't get better, to come in, so we did last night (10/16). Because of the new clinical symptoms, she had an x-ray done that was pretty inconclusive due to the structure of a dog's neck, but her vet was concerned about a lesion on her spine near the neck. I asked what exactly "lesion" meant as I understand it's a sort of general term and he basically said it could be a list of things from disc rupture to cancer and recommended a neurologist. He also gave her a prescription for Gabapentin, 100 mg, 2x a day.
We have an appointment on Friday with a neurologist, but I am terrified. My question as indicated in the title is, has anyone experienced IVDD in their pet where only one paw was affected? I see a description actually in these forums where a symptoms is "holding paw flamingo style" - I know this sounds silly but it's like I can't confirm if that's it or not. She doesn't yelp when I pick her up anymore and still turns to her side for belly rubs (in her crate which led to a very difficult task coaxing her out this morning LOL), but this morning when the meds wore off I could see her shivering so I am sure pain is still present.
A few positives: today was the first time she ate her food and drank on her own (had to hand feed her and hold the water up to her mouth), but I can't tell if it's just the new medicine blocking out the pain and giving her confidence. She also hasn't lost bladder control, but she did hold in her poop for about 4 days, which my vet says may be a side effect of the Hydromorphone, so we decreased the dose for a bit and this morning she pooped. I have never been more relieved to see dog poop IN MY LIFE!!!
Lastly, this hasn't been confirmed IVDD, but I'm guessing it's a possibility, and I'll know more on Friday.
Any advice, comments, etc would help this worry wart (me)!
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Oct 17, 2018 12:22:45 GMT -7
Emily, welcome to the Forum. What country do you live in? I would encourage you to take action to get the pain meds corrected by phone with your vet asap today. While the visit with a neuro on Friday would be because your vet is uncomfortable with his knowledge of IVDD and you need help getting meds adjusted so there is no pain at all dose to dose, let's hope you can get your vet to take action today and not have Sophie having pain surfacing until a Fri neuro appt. 1) Advocate for methocarbamol to be on board every 8 hrs. 2) Advocate for gabaentin to be given every 8 hrs. 3) Adovcate for an adjustment to hydromorphone OR switch to tramadol at every 8 hrs. 4) Ask a simple question as to whether Sophie has any health issues to keep her from Pepcid AC (famoditine) IF the answer is no health issues, go to the grocery store and buy it. Pepcid AC (famotidine) given at 5mgs dose 2x/day. "Doesn't need Pepcid AC, let's wait "are not answers to your question. Some facts about a neck disc episode: ---Pain meds for a disc episode likely will NOT control pain round the clock unless the vet prescribes them for promptly every 8 hours. We don't see hydromorphone precribed much here in the States, so I am not familiar with that narcotic, but just a brief Google it appears it also has a very short half life in dogs. --- A neck disc is more painful due to head usually has to move when any other part of the body moves. --- All three sources of pain should be addressed...assume there is pain when a disease IS a painful one!!! 1) gabapentin for nerve pain 3x/day, 2) methocarbamol for muscle contraction pain 3x/day 3) adjust hydromorphone or possibly choose another such as tramadol every 8 hours --- Where the bad neck disc is, is usually the side of the body where more damage might occur to the spinal cord. So the disc is pressing on the spinal cord more to the left side. --- With any disc episode increased loss of neuro function is a clue to take immediate action not wait for additional loss of function! The quandry of NSAID vs. Steroid and when to deem it an emergency to switch to the more powerful class (steroids) without the usual 5-7 days washout! ANSWER: double stomach protection of both Pepcid AC (famtoidine) plus sucralfate. -- An X-ray would be taken to rule out other problems/diseases such as broken bone, bone tumor, disc infection or other potential causes of spinal cord damage. X-rays can show narrowed intervertebral disc spaces that are consistent with disc disease but not proof of a current disc episode nor where that disc is. With any procedure that requires anesthesia to get a quality picture, you will want to be assured your vet and all vet techs in attendance understand the risk. A dog's main defense against further disc damage is dependent upon control over the core trunk muscles and those in the neck – this defense is eliminated with anesthesia. --- 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 potato. 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. (teaspoon of pumpkin for every 10 pounds of body weight) QUESTIONS How much does Sophie weigh? For how many days is she to take carprofen? Are you doing the single most imporant care of 100% STRICT rest 24/7 only out for a very, very few footsteps at potty time. Are you doing these extra things to help with the neck disc: www.dodgerslist.com/literature/cervical.htm
|
|
|
Post by Emily & Sophie on Oct 17, 2018 13:06:25 GMT -7
Hi Paula, Thank you for your response. I am in the US. I will call now to see if we can decreased time between dosages and also get her on some pepcid AC. We did add the pumpkin yesterday which is why I believe she defecated today. She's 30#, a bit on the heavy side, but we are working on that.
Carprofen is for one week.
|
|
|
Post by Romy & Frankie on Oct 17, 2018 13:18:15 GMT -7
I am glad that the pumpkin worked for Sophie. It worked well for my Frankie during his disk episode.
It is very important that your vet works with you to find the combination of meds that will relieve her pain. Neck disks are very painful and pain will only slow the healing process.
During a disc episode it is not recommended to start a diet. Sophie's s body has a lot of repair to do, so continue her normal food rations during crate rest. You can watch her intake of calories such as avoiding treats outside of her normal meals. Treats if any should be low calorie like carrots, small cubes of apple, green beans or some frozen broth ice cubes to lick.
Let us know what the vet says about the pain meds. We will be wanting to hear.
|
|
|
Post by Emily & Sophie on Oct 17, 2018 13:59:22 GMT -7
Thank you! I am waiting to hear back But just for my own ease of mind, it's not uncommon for a disc issue to affect only one limb, correct? If it's on the lefthand side. I will discuss further with the neurologist, but my mind is racing!
|
|
|
Post by Romy & Frankie on Oct 17, 2018 14:31:26 GMT -7
It is quite common for one limb to be noticeably weaker than the other. That was what happened to my Frankie. The other side was affected, but not as much.
|
|
|
Post by Emily & Sophie on Oct 17, 2018 14:58:33 GMT -7
Thank you! I won't know anything until we go to the specialist, but this makes me feel better that it might not be all of the terminal things that are running through my mind.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Oct 17, 2018 16:59:35 GMT -7
Emily, thank you for the very important information that carprofen is for 7 days. That means it is supposed to be stopped and your job at home is to assess for pain or any new neuro diminishment.
Clearly since she is currently experiencing pain still not fully in control, it is not time to stop carprofen. It can take 7-30 days to resolve the swelling. So a vet simply must guess if a 7 or 14 day course of the anti-inflammatory. So tomorrow 1st thing, 10/18, you'll need to contact your vet for another course of carprofen.
Let us know all the details of how many days this new course of carprofen will be for and what are the adjustments/additions to the med list to get that pain fully in control round the clock.
|
|
|
Post by Merriem & Spike on Oct 18, 2018 20:20:16 GMT -7
Spikes left leg is not nearly a strong as his right. Thank you for posting. He is in a no progress mode right now.
|
|
|
Post by Emily & Sophie on Oct 25, 2018 21:14:46 GMT -7
Hi all,
here's an update:
We went to the neurologist last friday, 10/19. She upped her medicine because what her primary vet perscribed "wasn't even touching her".
She's now on ▲Gabapentin - 200mg, 3x per day ✚Methocrabamol, 500 mg, 3x a day ✚Codeine - 15mg, 4x a day Rimadyl - 75mg, 1/2 tablet, 2x per day. She's also on omeprazole, 20mg, 2x per day.
[Moderator's note: please do not modify 30 lbs Rimadyl (carprofen) as of 10/10: then stop 10/18 to test for pain/neuro as of 10/19: 37.5 mg 2x/day for how many days? to stop for test for pain/neuro
hydromorphone 0.5mgs 2x/day STOPPED Gabapentin ▲200 mg ▲3x/day ✚Methocrabamol 500 mg 3x/day ✚Codeine - 15 mg 4x/day ✚Omeprazole 20 mg 2x/day]
We go back next Friday for a follow up and I just feel discouraged. She's on these meds round the clock but when I picked her up to go inside today, she started crying no matter what position I put her in.
I can't afford a $6,000 surgery, so I have to have faith it'll heal with strict crate rest, which is what we're doing. She's in the crate 24/7. I know shes only been on the upped medicine for 6 days, but this whole episode has been going on since 10/10 and I just feel physically and mentally exhausted.
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
|
Post by Marjorie on Oct 26, 2018 8:25:43 GMT -7
Emily, please don't wait until the follow up visit next Friday to speak to the vet about the pain that you observed today. Call them today and let them know so Sophie's pain meds can be adjusted. There should be no sign of pain from one dose to the next. Pain hinders healing so have no patience with it. Pain should be completely under control within one hour of giving a new course of pain meds so for any adjustments made today, if pain is not completely under control within an hour, then speak to the vet again. We usually see Tramadol given as a general pain med rather than Codeine. Do speak to the vet about adding Tramadol 3x/day rather than Codeine. "Codeine is not a recommended analgesic for dogs or cats. It is generally only available in combination with acetaminophen (Tylenol) which makes it completely unsuited to feline use. Its use in dogs is discouraged as most dogs lack the CYP2D6 enzyme primarily responsible for the conversion of codeine to morphine, its most active metabolite. That being said, there may be some analgesic value to codeine in dogs via the C6G metabolite." www.vasg.org/newer_options_for_chronic_pain_management.htmOn what date was the Rimadyl restarted? For how many days will that be given until it's stopped to test for pain/neuro loss? Since Sophie is still having pain, the anti-inflammatory needs to be continued for awhile longer. Neck injuries can be much more painful than back injuries and can take longer to heal. With a neck injuries, most vets will prescribe a steroid rather than a NSAID since a steroid is a more powerful anti-inflammatory. A switch to a steroid from a NSAID usually requires a 4-7 day washout period. However, such a switch can be made with the addition of TWO stomach protectors. We usually see Pepcid AC and Sucralfate prescribed with a switch is made without a washout period. Since Sophie is on Omeprazole, Sucralfate would need to be added. Do speak to the vet today about a switch to Prednisone instead of Rimadyl to get the painful swelling resolved quicker.Most vets understand the importance of strict crate rest with an IVDD episode and adjust meds via phone consults without the necessity of bringing the dog in for an exam. Please speak to the vet about that follow-up visit next Friday and advocate strongly for a phone status consult instead. If you must take Sophie into the vet, please be sure to secure the crate in the car and pad it well with blankets or rolled up towels to prevent her from being moved around too much in the car when you brake or turn corners. Good to know you're doing strict 24/7 crate rest. Was that started on 10/10? Sophie is rather heavy at 30 lbs. Are you able to carry her outside to do her business with as few steps as possible allowed, then carry her back to the crate? Or are you using pee pads outside of the crate. The less steps taken at potty time, the better. You can add caster wheels to a wire crate and wheel her down a ramp to the potty area. Let us know what you're doing at potty time to ensure that Sophie is only taking a very few steps to potty.Are you also doing the extra steps recommended by Paula to help the neck heal? Raise food/water dishes so Sophie doesn't have to bend her head, soften hard kibble, etc. Tips at this link: www.dodgerslist.com/literature/cervical.htmPlease let us know what the neurologist says after speaking to them today about Sophie's pain. Healing prayers for Sophie.
|
|