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Post by Julie & Perry on Dec 12, 2018 18:18:27 GMT -7
Hi Martin, I know that it must seem overwhelming right now.
Unfortunately you're having to patch together care for Delphine without much support from your vet or neurologist.
It's perfectly OK to put up Delphine's water two hours before bedtime.
Also, if you buy a couple of human incontinence pads your pup can't shred them. Found some online for pretty cheap. Washable, reusable.
I'm not a vet but I would recommend another round of Prednisone based on your reporting recent pain in Delphine.
Some doctors are reluctant to use Prednisone. It is a big gun, so to speak but I've seen it work very well.
It will get better! I promise. This part is hard, but hang on.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Dec 12, 2018 20:37:17 GMT -7
Martin, if I were you, I would call the ER Hospital. They're the ones who originally prescribed the Pred with the taper date of 12/14. Tell them of the recent pain and ask if they still feel a taper should be done on 12/14 or whether they feel another round of the anti-inflammatory dosage of Pred should be given, possibly for another 7 days. Also ask them what they want done with the pain meds on 12/14 - taper them also or stop them completely so a true test for pain/swelling can be made. Having pain meds on board during the taper of Pred would only mask any pain that you need to see in order to determine whether there is still swelling and still a need for the anti-inflammatory dosage of Pred. If they still want to do a taper on 12/14, ask what Plan B will be should Delphine's pain return at any time during the taper. Would you have their permission to return Delphine to the original anti-inflammatory dosage of the Pred and all other meds should pain return.
Pred not only causes increased thirst but it also causes increased hunger. Yet food is not provided all night long. She'll be fine without water during night hours, stopping it 2 hrs. before bed.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Dec 24, 2018 9:25:49 GMT -7
Martin, I sense your frustration. A month is a short amount of time, not long, when dealing with self repair of nerve function. The only thing you should not have any patience with is if there would be pain. Help us to get a better handle on your report of pain. 1) Is she still on Amoxicillin?2) When she tries to move too much what exactly do you observe? Yelps when moving? abruptly stops moving due to pain? Shivers/trembles? Reluctant to move again? Tight/tense stomach muscles? or ??? Being exact in describing what you observe helps us and it would help a vet to determine signs of pain too. 3) I can tell you with surety, that IF, if what you observe are signs of pain, then it is not time to be in the taper of pred. Not all neuros are experienced with conservative treatment. All depends on their experiences prior to their enrolling in a neurology program that focuses on surgery for the alleviation during a disc episode. So IF, if Delphine is still experiencing pain, you need to hire a different vet. Could be an IVDD knowledgable general DVM vet or it could be a different specialist from a different hospital. Just as we humans will seek a 2nd opinion when the current physician is not able to help and it shames no one, it is just what we must do for ourselves. The exact same for your dog. REMEMBER: 1) it can take in the range of 7-30 days up at the anti-inflammatory pred dose (no taper days can be counted as they are too low a dose to deal with inflammation) to get all painful swelling fully gone. 2) Delphine has only had the advantage of a 14-day course. The taper is the means to test to see if pain or increased neuro diminishment surfaces...MEANING another course of pred is still needed.
Pain meds are NOT at the max. IF, if there is really pain, then in addition to another course of pred, these areas of pain meds can be seriously discussed to achieve full pain control. ◼︎Tramadol at the max analgesic dose for a 15 lbs (6.8 kg) dog: 50 mgs every 8 hours ◼︎ For many dogs methocarbamol is superior to diazepam to relieve muscle spasm pain. ◼︎ When the max dose of pain meds has actually been used, and there is still pain it is very worthwhile discussing amantidine. Amantadine is something we are seeing neuros Rx as part of the pain med cocktail as it allows other analgesics to function more effectively. Please do read more at this vet's webpage so you understand amantidine: marvistavet.com/amantadine.pml
NEURO STATUS
While on crate rest there can be some muscle atrophy that can make the legs weak (kinda like when we are sick in bed and we get up for the bathroom and our legs are weak but we can still carefully walk. So help us understand what you mean by the front legs are weaker as to try and pin point muscle weakness or neuro dimenishment. -- Do you see any of these signs of neuro diminishment as being something new since the Dec 7th neuro report or since the test pred taper for neuro diminishment began on Dec 14? • Front paws knuckle under when standing on front legs? • She is not able to push up into a front leg stand? • She barely moves front legs such as to reposition in her recovery suite or can move front legs at all? EMOTIONAL PAIN I hear what you are saying. It is quite difficult as a care giver to maintain a clear and positive mind when sleep is continually disrupted and you are exhausted. Let us know if you can try these things to help you get the rest you must have to best care for Delphine. -- While diapers are generally not recommended, this is a clear case where the benefit of your sleep at night makes the use of diapers a good idea. Have you tried the baby diapers. Now a days the absorbant stuff in diapers does a good job of turning liquid into a gel and keeps the urine away from skin. You might smear a bit of a non-zinc barrier cream around her genital area to further prevent urine contact to the skin if needed (Bayer's A+D® Original Ointment, Aquaphor Baby or Aquaphor regular Healing Ointment). An option to keep the diaper in place overnight is a baby's onsie  I am proud of the dedication you are giving Delphine in her care. What I am sorry about is that you have not yet found the right vet, to work with you and be on the same page as you are about conservative treatment. It is like night and day when you have found and hired an IVDD knowledgable vet re: conservative treatment and one who is on the side of the steroid controversy to realize that steroids like pred can play a good role in a disc episode....they are out there. |
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Post by Julie & Perry on Dec 24, 2018 12:52:58 GMT -7
Martin, you are amazing at how hard your fighting for Delphine.
When your in the trenches it can be exhausting and overwhelming!
I promise we've all been there.
Please push hard for complete pain control.
For some professionals their training and experience is surgery.
It takes a different person who understands crate rest.
As far as diapers, there are also doggie diapers available online and at stores.
I've used them at times and they can be a lifesaver.
If Delphine needs a diaper, mild sedative, and water put up 2 hours before bedtime, so you and she can sleep, go for it.
Once your rested everything will look better.
You can make it. Look how far you and Delphine have come.
Hang on, it will get better!
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Post by Barb & Oswald on Dec 24, 2018 21:43:55 GMT -7
I am by no means an expert on IVDD, just a doxie mom who knows that Dodgerslist saved me and my Oswald. June 9th 2018 Oswald went down, second bout with IVDD. First one was 2015, he was 8. This time he is 12. First signs for him was weak legs, wobbling walking and knuckling. Since we did this before I am IVDD savvy. Crate and call to our Vet for meds. Since Oswald is now 12, he didn't bounce back like he did before, in fact it took 16 weeks of back to back conservative crate rest. During the second 8 weeks Oswald lost function of his tail and hind legs. I was terrified but this forum steadily returned my sanity and confidence and helped me understand there is no set time for nerves to heal. I did have Oswald tested for deep pain sensation after he list his legs, the good news was he responded and almost bit our Vet, never thought I'd be happy about that. Very slowly Oswalds tail came back first, started with a protective response to our neighbor, but I knew that I needed to look for a happy tail wag, which came a bit later. Nothing was so beautiful then seeing his tail wag. Ever so slowly his left leg started to move, it did a kind of circle movement when outside, but only on pavement, I firmly believe in a sling supporting their backend along with harnesses and leash. The sling keeps them completely steady and keeps them from falling while doing their business. Low and behold, after a few weeks his right leg started doing the circular movement too. I totally thought I was seeing things but I wasn't. I also kept a day by day journal, including how he was doing, any improvement if any and the advice I was getting from this support forum. Wow, did this help me. Once his second 8 weeks were over, he still wasn't able to walk alone but he was weak and his muscles needed therapy. We got him a cart from Eddie's wheels which is only used after conservative rest is over, (therapy too), a cart is great therapy and gets them mobile. I worked twice daily on him, walking for 10 minutes, twice a day with a sling supporting his bottom and massage therapy which Dodgerslist has the most wonderful video showing step by step hiw to do it at home. We also did laser therapy twice a week. Oswalds legs were so skinny and so weak, but I'm here to tell you that muscle mass comes back very quickly. Within 2 months after his 16 weeks crate rest, Oswald could walk on his own. I was still very careful, he graduated from a crate to an xpen when I was taking a shower, but when I left the house, only a crate is safe enough. Up until 2 weeks ago, he slept in his xpen during the night. I bought him toe grips, as an extra precaution from slipping on our hardwood floors. I don't believe in my doxies sleeping with me, so all 3 are trained to sleep in their beds, just safer I think. Please, listen to these experts, but the most important thing is, NEVER EVER GIVE UP. Oswald is a true miracle and living proof.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 1, 2019 6:21:23 GMT -7
Martin, was the tail wagging as a result of Delphine hearing a happy voice or when given a treat or when someone she knew walked into the room?
Yes, you can certainly try a sniff and pee test. Carry Delphine to a spot in the yard where she or another dog has peed before. Hold up her hind end but not under her belly. Let her sniff and see if she can release urine on her own. If she can, then bladder control is returning. You should still try to express her after she's gone on her own until you're sure she can empty her bladder completely.
Have you been able to speak to a vet to get another course of Prednisone since Delphine was showing pain during the last taper? When will the next taper be tried? Is her pain completely under control now?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Jan 1, 2019 7:06:48 GMT -7
Martin, so glad to hear it appears then what was thought to be signs of pain, where not. Of course the full proof of the prednisone test for pain taper will be complete when the pain meds are fully stopped.
What are the pain meds still on board and their current backed of dose/frequency?
leg/tail movement at pottytime are hard to tell about. BUT the getting a treat and then a tail wag is the proof of a conscious happy tail wag.
The next neuro function to return will be bladder control. So as Marjorie mentioned periodically take her out to smell an old pee spot and see if she can make a decisioin to release urine there.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Jan 1, 2019 7:59:05 GMT -7
Martin, nerves very typically come back in the same classic, textbook, predictable order. Only take the word of a specialist about DPS as it is hard for the often unpracticed eye of a general DVM vet to correctly identify the subtle signs.
So for us lay persons, if you see a true happy tail wag, then obviously the dog would have first had to have DPS come back.
1. Deep Pain Sensation (Only correctly identified by a specialist.)
2. yes? 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.
There are different charts, with different number (stages) systems vets use. Confusing. Just observe for a head level involvement with the bladder or a tail, a leg movement to figure out if reflex or actual brain directed movement.
For us humans to be able to distinguish between reflex and brain directed, we have to see some sort of head level involvement with the tail, with a limb or with release of urine so we know the movement was done with purposeful thinking.
--- Sniff (head level nose) then release of urine would be brain directed.
--- Hear (head level ear) you doing some happy talk and then tail wags is brain directed. Tail movement during potty time can often be a reflex
--- Itchy sensation at at neck and then tries to scratch would be purposeful movement. Tickling paws, etc can cause reflex leg movements.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Jan 1, 2019 11:39:11 GMT -7
Martin, make sure you do tail wag test totally exclusive of any time near potty time. Do your tests ONLY when you are providing a head level involvement (something she can hear, can see to focus on, can smell). Then observe for that tail to go side to side even if a weak happy wag, leg movement, bladder control.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Jan 2, 2019 10:50:55 GMT -7
So you specifically did some happy talk or showed her a yummy treat and that did not cause some tail movement side to side, even it weak, slight movemet? Specific details accompanying your comments are the most help in understanding what is meant by "did not see any wagging today."
Regarding going back to work next week, can you fill us in.
--- would your wife be able to join us on the Forum as she may have a different work hr schedule? Is she also going back to work next week?
--- How is she doing with her expressing skills?
--- If it is simply not doable to have a person come to express Delphine, would you be able to make arrangements to take her to a vet on the way to work where you could hire the vet tech there to express her and pick Delphine up and the end of the day? Or maybe something similar?
--- where are you in the pred taper, how many more days til she will have completed the final taper dose? As the taper dose gets lower, there should be less thrist, less drinking and less need to express as often .
--- Sorry, I don't recall, have you investigated the use of brand name good quality baby diapers as a last resort while you are at work? The new technoolgy of keeping liquds from the skin in those good quality diapers is pretty good. Plus a non-zinc containing cream for babies is extra precaution for urine scald. Testing this out before to see how Delphine reacts would be important before leaving her alone with a diaper on.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Jan 2, 2019 11:51:04 GMT -7
Good to hear pred is winding down on the final taper days! When will all pain meds be fully stopped (gabapentin and tramadol)?
I meant for you to take Daphine to a clinic on the way to work each day where you have hired a vet tech there to express midday. Then you would pick Daphine up at the end of your work day. There may be some boarding facilities where a person is trained how to express, ask for help in this matter, ask for about other options that might be available in your area.
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Post by Julie & Perry on Jan 25, 2019 23:35:37 GMT -7
Martin, there's nothing you could have done to prevent Delphine from being born with a genetic disease.
Even if you had known and taken every precaution it's still possible this would have happened.
Right now it sounds like you and your wife are grieving the old life you had with Delphine.
That's perfectly understandable. You've all been through a lot.
The good news is it will get better as you adjust to the changes.
I know one of the moderators here, Paula, had a dog who also couldn't walk because of IVDD.
He was very happy and had a great life.
Please know that you will eventually get to a new normal.
There are many ways to adapt that will help Delphine and you.
I'm sure Paula, and others here will have more experience.
However, I know there are things like drag bags to let dogs scoot around inside the house and dog wheels to give her indepence outside.
If expressing alone isn't keeping her dry there are doggie diapers that you can use.
So there are options.
I'm sorry this happened and I know it's hard.
You and your wife are doing everything you can for Delphine.
Hang on and it will get better.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 26, 2019 5:59:29 GMT -7
Martin, please don't give up hope of a good life for Delphine. Dogs don't see paralysis like humans do. They are much more accepting of it. They aren't handicapped - they're handi-capable! Here's a good article for you to read: www.dodgerslist.com/index/SDUNCANquality.htmAnd please don't be so hard on yourself. You've done your very best for Delphine and your love for her shows in every word you write. IVDD is a terrible disease but it's not your fault that Delphine was born with it. Many dogs have surprised their owners and vets and have shown improvement months after being told there would be none so please don't give up hope. Even though Delphine is still paralyzed, she'll quickly learn how to drag herself around. Delphine will need to gradually build up her strength and stamina. So take it slow. If she overdoes it, it would be difficult to tell whether pain is from sore muscles or a new disc problem. Here's our page on how to gradually reintroduce movement after crate rest: www.dodgerslist.com/literature/AfterCrateRest.htmHere's our page on how to care for an incontinent and downed dog: www.dodgerslist.com/literature/IncontinentDown.htmAs for the muscle tone, physical therapy should help with that. Here's our page on exercises that you can do at home - all of the exercises on these pages can be done: www.dodgerslist.com/literature/massagepassiveexercises.htmAcupuncture and laser light therapy are helpful treatments that can be very beneficial to assist with re-establishment of nerve connections in the body and usually can be started right away if within your budget. www.dodgerslist.com/literature/healingacupuncture.htmAlso water therapy can be performed after the stitches/sutures are removed. Some of these exercises can be done right in the bathtub. Please check with the surgeon before starting any of these. www.dodgerslist.com/literature/watertherapy.htmAs Julie mentioned, carts can give paralyzed dogs freedom of movement and can also be used in PT. You can give the PT a chance for a few months and then see where you are before investing in a cart. Once you're ready to look into a cart, here's our page on what features to look for: www.dodgerslist.com/links/cart.htmStay strong, Martin. Delphine is still the same little dog you've always loved and cherished. Keep a happy face and voice around her to keep her spirits up. And be grateful for every minute that you spend with her. Tell her each day that she's just fine because she is! She has everything that she needs most - a warm, safe home, good food and people who love her. She has a lot she will teach you in the days ahead. Dogs are so much more intuitive about their present situation than we are. I know my Jeremy has taught me so much about acceptance and living in the present moment and finding happiness there. Please continue to keep us updated. Blessings to you all. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,792
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Post by PaulaM on Jan 26, 2019 9:24:11 GMT -7
Martin, we would LOVE to see a video of your Delphine! —First upload your video to YouTube.com —At the top of your browser when viewing your uploaded video you will see a "share" button below your video window. — Pressing it will expand to reveal the URL (it starts with <http...> ) you can paste into a Forum post. —How-to details from YouTube for mobile devices and computers: support.google.com/youtube/answer/57407?hl=enCongratulations to you and your wife for seeing Delphine though all 8 weeks of crate rest. This gives assurance that the disc has healed and gives every chance possible for nerves to self repair to the degree possible. Now it the time you can have patience to see if nerve healing will happen still. In the meantime you will be helping Delphine get back to the new normal of family life and all the fun of living life! As mentioned in the links provided, a program of gradually re-introducing physical activity to strengthen her upper body AND you or a clinic doing PT and massage to maintain back leg muscles and joints will be in readiness for the day enough nerve healing has taken place to allow leg movement. Delphine does not think like a human, she doesn't have to worry about driving to work, to the grocery store for food...she has you guy to do that. So it will matter not to Delphine how she gets from point A to point B in her daily life. So be happy about Delphine's new journey to the new normal as you work together and learn! BUTT protection
Choose a garment to protect skin and fur from scooting about. Ollie’s Cape DIY with a commercial option: www.dodgerslist.com/literature/incontinentdown/Olliecape.pdf
Clark’s Bumpad: users.cyberport.net/%7Emilnerwm/bumpad1.html [for dogs who scoot like a frog] Tandy’s Butt Protect: www.dodgerslist.com/literature/aftercraterest/Buttprotect.htm Airy mesh panel www.handicappedpets.com/index.php/walkin-wheels-drag-bag.html [drag bag] Custom Heavy Duty or Outdoor drag bag for disabled, handicapped, paralyzed, or amputee pets: www.etsy.com/listing/192118583/outdoor-protective-scootie-overalls-for?ref=related-1 $50+
TEACH her how to slide! Here's my Clark being trained to slide down from his most favorite spot along side me in my recliner. If Delphine will be sitting by your side, then provide a ramp so she can slide down when she hears your wife in the kitchen or something else she needs to do. Use a few panels of an ex-pen to prevent her from going off the side of the ramp. Of course you can buy a ramp with a side too. Take the time to train her to be comfortable and how to go down the ramp. Discussion on ramps: dodgerslist.boards.net/thread/867/rampsDIY ramp training: www.dodgerslist.com/literature/ramptrain.htmTEACH her how to open the screen door to the deck
Purchase a magnetic screen curtain or make it yourself.
--- Spring cafe curtain rod to wedge at top of open sliding door.
--- Length of screening fabric for repairing screen doors. Hand or machine sew a hem at top and bottom of lenth. Top is for the rod. Bottom hem is to accomodate a length of chain as weight to keep the curtain hanging down.
--- buy a remant of vinyl floor as a threashold over sliding door tracks
--- buy a soft indoor-outdoor rug that is scootable and covers the roughness of decking.
Video shows the screen curtain and a scootable deck covering in action Provide a means for ear flapping aerobic fun!
Do investigate a wheelchair so Delphine can enjoy the freedom of running. It takes about 2 weeks for one to be custom crafted to Delphine's measurements. Just about the right timing as you will be 2 weeks into that gradual building up of muscle tone in those front legs. A chair where the legs can be in the down position, could be a PT device when she starts to have some leg movement.
Please do stay intouch! We'd love to see a video and hear how things are going as you move to the new normal! |
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Post by Linda Stowe on Jan 26, 2019 11:22:41 GMT -7
Martin, this is a poem that was written by a member for Dodgerslist several years ago.
Because I'm "just a dog" you see,
I don't sigh and say "why me"
I just face it - go on living
and play the hand that I've been given
I need you more now, that is true
For there are things I just can't do
The ball you throw I cannot catch
I can't even lift my leg to scratch
Its embarrassing a little
that I may need your help to piddle
But if our roles were in reverse
I'd be proud to be your nurse
But hey I love you more than ever
Me give up well yeah like never
I don't regret what cannot be
With you my friend, I'll just be me
I'm still me within my soul
Where it counts I still am whole
My back is bent and I'm quite lame
but in my heart I'm still the same
~by Julie Smith for Dodgerslist~
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 28, 2019 18:17:26 GMT -7
Thanks for sharing the report, Martin. The vet who signed the report is a DVM. Deep pain sensation can sometimes be very difficult to determine and I wouldn't take the word of any vet as to deep pain sensation except for a Board-certified neurologist. Never give up hope.  |
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jun 16, 2019 6:27:23 GMT -7
Congratulations to you and your wife on the birth of your daughter, Martin! Adorable photo. What brand wheelchair did you buy for Delphine? In the photo, it looks as though the harness in front hangs very low. You might want to take a photo of Delphine in the cart and send it to the manufacturer so see if they can suggest any adjustments that could be made. Here's a page with tips on how to train a dog to use a wheelchair that might be helpful: eddieswheels.com/n/27/Training-a-dog-to-use-a-wheelchairYou can also use a sling or rear end harness to help Delphine walk. She might enjoy walks again that way. My Jeremy is having more problems walking now that he's older and he walks part of the way and then I use a sling to help him walk the rest of the way. www.walkaboutharnesses.com/Most male dogs seem to prefer a figure-8 sling. Here's one you can make from an old sweatshirt www.lyonpuffpetsit.com/htmlslp/sling.htmlKristen's figure 8 sling made from two leashes www.dodgerslist.com/literature/cratesupplies/Figure8.jpgAre you doing any type of physical therapy with Delphine, Martin? |
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