Chad & Winston & Angus
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M-dox Angus 2/20 surgery................ M-dox Winston 3/14 surgery
Posts: 24
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Post by Chad & Winston & Angus on Mar 11, 2019 18:38:48 GMT -7
Winston Hi! My name is Chad and Winston is a 4 year old Daschund that weighs 21.7 lbs. We live in Dallas, Tx. I noticed right before bed on the night of 3/10 that he was not acting like himself. He was shivering and looking back at his back this morning. I started immediate strict crate rest. Took him to the vet today (3/11.)My vet gave him 5ml of dexamethasone, IV today (3/11) and Tramadol, 25 mg, 3 times per day. He was currently out of Gabapentin so none of that. I told him my desire to have an oral steroid. I will get some prednisone by Wednesday.
[Moderator's note: please do not edit
21.7 lbs
Dexamethasone IV 5ml on 3/11
Prednisone to start 3/13: ?mg ?x/day for ? days then taper to test for pain/neuro issues
Tramadol 25mg 3x/day
Pepcid AC 5mg 2x/day?]We don’t have a definite diagnosis but know it’s a disc issue. The vet is a general practice vet and will refer me to a neurologist if needed. Currently, Winston is able to walk fine, can urinate and is pooping. So, now, I have Angus who is three weeks post surgery and now Winston, who started conservative treatment today. I can’t believe I’m having another dog with IVDD issues. I feel like such a bad dog parent. I don’t know what I’m doing to cause this. I try to limit their jumping and no stairs if possible. I can’t stop beating myself up about this. Chad Oh, Ive also got him on Pepcid AC per dosing instructions from the board. |
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Post by Julie & Perry on Mar 11, 2019 20:00:31 GMT -7
Chad, you are a good pet parent. It's just a genetic disease they're born with.
I also have two dogs with IVDD.
We can take precautions; healthy weight, no jumping or stairs, and help reduce episodes.
But sometimes it will still happen.
Conservative crate rest is stricter than post surgery as the offending material is still there. Read up so you are completely up to speed. It's on the main website under IVDD 101, Conservative crate rest.
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Mar 12, 2019 6:56:30 GMT -7
So sorry to hear that Winston also has IVDD. He's lucky that he has an owner who knew exactly what to do when he showed signs of a disc problem - immediately crate and get to a vet! The anti-inflammatory, Prednisone, should be started ASAP today. Can the vet give you a prescription that you can take to a local pharmacy to have filled? All Winston has now is Tramadol to mask the pain but nothing to work on the swelling that's causing the pain. It's that swelling pressing on nerves of the spine that also can cause nerve damage so it's important to get an anti-inflammatory on board ASAP. Just to confirm, please let us know what dosage of Pepcid AC you're giving. It will help us work together with you and avoid offering ideas that could cause harm or lead the discussion in the wrong direction delaying help for your dog — please share a bit more detail with us: ❖1 Is there still currently pain? ☐shivering, trembling ☐yelping when picked up or moved ☐reluctant to move much in crate such as shift positions or slow to move ☐tight tense tummy ☐can’t find a comfortable position ☐Arched back ☐ Holding front or back leg flamingo style not wanting to bear weight ☐head held high or nose to the ground ☐Not their normal perky selves? Full pain relief is expected in 1 hour and stays that way dose to dose. If not in control your vet needs to know asap to adjust meds. ❖2 GI Tract problems? —Eating and drinking OK? No nausea/not eating, no vomit? —Poops OK? Normal firmness & color -no dark black or bright red blood indicating bleeding ulcers? No diarrhea? ❖3 As Julie said, the crate rest is much more strict with conservative care than post-op crate rest.The hallmark component of conservative treatment is the very STRICT crate rest part (no PT, little movement). With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. Those 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, the mattress and more! —> www.dodgerslist.com/literature/CrateRRP.htmSTRICT means: ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy whys: www.dodgerslist.com/literature/chiropractic.htm ◼︎no dragging or meandering at potty times. ◼︎no PT for conservative dogs during 8 weeks to heal disc ◼︎At home laser or acupuncture for severe neuro damage is best. 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. 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.jpg  Knowledge is the power to fight the IVDD enemy and win!! The very best thing you can do for YOU, the caregiver, and for your dog is to get up to speed on IVDD soonest possible. Begin absorbing the must-have overall sense of meds, care and how the treatment works. Your dog will be depending on your ability to learn - excellent video series here: www.dodgerslist.com/literature/theater.htm PRINT OUT this link and tape to your fridge: www.dodgerslist.com/literature/healingpage.htm use the printout as your roadmap to avoid dangerous detours in your dog’s care make notes/highlight to keep yourself on track follow all the links in the next days to become the IVDD savvy pet parent your dog needs. Use the “search box” to easily locate topics over at our Main www.Dodgerslist.com website: www.dodgerslist.com/index/searchBOX.jpgHealing prayers for Winston. |
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Chad & Winston & Angus
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M-dox Angus 2/20 surgery................ M-dox Winston 3/14 surgery
Posts: 24
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Post by Chad & Winston & Angus on Mar 12, 2019 17:09:52 GMT -7
Winston is on 5 mg of Pepcid AC 2x daily. The vet gave us some ✙prednisone today. I just picked it up but have a couple of questions for you experts. Winston weighs 21.7 pounds, the prescription states to give 40 mg for 3 days, then 20 mg for 10 days then 10 mg ever other day until finished.
[Moderator's note: please do not edit
21.7 lbs
Dexamethasone IV 5ml on 3/11
✙Prednisone 20mg tab as of 3/12 Immune suppressive dose: 20mg 2x/day for 3 days
as of 3/15 hi anti-inflammatory dose: 20 mgs 1x/day for 10 days
as of then 3/25 taper test for pain/neuro issues
Tramadol 25mg 3x/day
Pepcid AC 5mg 2x/day]
I looked up the dosage for a dog his size and what the vet prescribed seems like pretty high dosages.
Chad
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Mar 12, 2019 17:33:33 GMT -7
Chad, the usual we see is that the anti-inflammatory dose is used for a disc episode. The higher the dose of pred the more exposed to GI tract issues. I would address with the vet today your concern of a rather high dose of pred for 3 days. You've reported Winston has no to very little neuro issues. How many times a day are you to give the 40mg pred dose? How many times a day are you to give the 20mg pred dose? CAVEAT: Please do not self prescribe meds. That is the vet's job. Your job is to express concerns, report observations and advocate on behalf of Winston. Reference for the usual in dosing pred "Anti-inflammatory doses range from 0.1 to 0.3 mg per pound (0.2 to 0.5 mg/kg) up to twice daily." Dr. Dawn Ruben, DVM. www.petplace.com/article/drug-library/library/prescription/dexamethasoneWhat are the credentials of the vet. General DVM vet? or a specialist neuro (acvim) or ortho (acvs)? |
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Chad & Winston & Angus
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M-dox Angus 2/20 surgery................ M-dox Winston 3/14 surgery
Posts: 24
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Post by Chad & Winston & Angus on Mar 12, 2019 18:01:31 GMT -7
Paula,
2 tablets daily (40 mg) for 3 days, 1 tablet daily (20 mg) for 10 days then half a tablet (10 mg) every other day.
Chad
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Mar 12, 2019 18:19:56 GMT -7
How many mgs are in one pred tablet?
Clarify
Pred: how many tablets given at one dose session? given how many times a day for three days.
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Chad & Winston & Angus
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M-dox Angus 2/20 surgery................ M-dox Winston 3/14 surgery
Posts: 24
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Post by Chad & Winston & Angus on Mar 12, 2019 19:21:56 GMT -7
1 20 mg pill 2x daily for 3 days. 1 20 mg pill 1x daily for 10 days. 1 10 mg pill every other day until finished.
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Marjorie
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Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 13, 2019 5:36:55 GMT -7
That's a very long time to be on an immune suppressive dosage, Chad. Using the least amount of the anti-inflammatory dosage of prednisone and for the shortest time is the goal with a disc episode. Hence the reason for the vet to take a guess at usually the 7 or 14 days point to start a test-for-pain taper of prednisone (going below the anti-inflammatory dosage) as well as the stop of pain masking pain meds. If there's still pain, that would mean there's still swelling and still a need for the meds.
An anti-inflammatory dosage for a dog of Winston's weight would be 5 mg 2x/day. Winston is never below an anti-inflammatory dosage - or even down to an anti-inflammatory dosage - except for the days when no Pred is given to even try to test for pain with the stopping of pain meds.
Very occasionally we'll see a vet who believes in steroid blasting, giving extremely large amount of steroids, usually through IV, within 8 hours of the injury for dogs suffering with severe neuro loss (paralyzed legs, lost bladder control). And that is usually only done for a very short period of time. Most vets realize the dangers of this type of practice and we very, very seldom see it. And Winston has little to no neuro deficits to warrant such a high dosage of steroid, which will only more highly expose him to side effects and since this dosage suppresses the immune system, more open to getting an infection.
Please do speak to the vet today about this high dosage of Prednisone to determine his reasoning for it and advocate for the usual anti-inflammatory dosage of 5mg 2x/day for 7 days and then taper to test for pain/swelling.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Mar 13, 2019 10:21:24 GMT -7
Chad, please advise us.
--- Just to be clear one whole pred tab contains 20mgs?
--- You do not have any 10mgs tabs in the bottle?
--- You would cut the 20mg tablet in half, giving a 10mgs DOSE when it comes time to taper?
CORRECT MED LIST??
Dexamethasone IV 5mL on 3/11
Prednisone 20mg tab as of 3/12 Immune suppressive dose: 20mg 2x/day for 3 days
as of 3/15 hi anti-inflammatory dose: 20 mgs 1x/day for 10 days
as of 3/25 ever other day 10mg dose taper test for pain/neuro issues
Tramadol 25mg 3x/day
Pepcid AC 5mg 2x/day
Please heed Majorie's concerns. Let us know if your vet will go to a typical anti-inflammatory dose of prednisone as you have not reported major pain not controlled nor severe neuro loss.
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Chad & Winston & Angus
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M-dox Angus 2/20 surgery................ M-dox Winston 3/14 surgery
Posts: 24
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Post by Chad & Winston & Angus on Mar 13, 2019 18:37:33 GMT -7
Winston I spoke to the vet today. He changed the dosage of prednisone to 5 mg twice daily for 7 days. Then 5 mg 1x per day for 7 days, then 5 mg every other day to wean off. [Moderator's note: please do not edit 21.7 lbs Dexamethasone IV 5ml on 3/11 Prednisone 20mg tab as of 3/12 Immune suppressive dose: 20mg 2x/day for 1 day as of 3/13: 5mgs 2x/day for 7 days, the test taper for pain/neuro issues Tramadol 25mg 3x/day Pepcid AC 5mg 2x/day] One whole prednisone tablet is 20 mg. I’m quartering each 20 mg tablet to make a 5 mg dose. I came home today around 2 to take both boys out to potty. Inst was great, had full neuro function, we peed, pooped went right back in crate. I get home from work tonight and he’s lost all function in his hind end. I don’t know if he has bladder control or not yet. I don’t know what the heck to do. I can’t afford another surgery. I just spent $5,0000, three weeks ago. Someone please tell me what my options are. I guess I’ll try to go to the DVSC tomorrow and see what options I have without surgery. Chad |
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Mar 13, 2019 19:40:55 GMT -7
Chad, stay the course with conservative treatment (STRICT rest to heal the disc, meds to work on swelling and pain relief and stomach protection pills.) Conservative treatment is the best option for your family. Nerves can self heal with time. At 2 today, did Winston get in more activity than he had been at potty time? Was he with your other dog or by himself. Was controlled by a leash and harness and allowed just a very, very few footsteps? Be aware, it can take somewhere between 7 and 30 days while on the anti-inflammatory dose of pred to get all the swelling gone. A vet Rx's a course (today the course was 5mgs 2x/day for 7 days). At the end of the 7-day course, the taper begins as a means to test to see if any pain surfaces or if neuro diminshment happens. If issues surface then another pred course is Rx'd. If no issues, then the taper goes to conclusion. Would confirm the details about pred.What dose in mgs and how often given on 3/12? What dose in mgs did you give pred today? How many times today? Are you observing any pain currently? Bladder control is prooved by being able to sniff an old pee spot in the grass and make the decision to release urine. Loss of bladder control is if he leaks on you when lifted or you are finding urine leaks in his bedding. Information on expressing the bladder IF you need a lesson. You'd get more out of the lesson by viewing/reading first: www.dodgerslist.com/literature/Expressing.htmWhile on pred if he has bladder control you would take him out to pee every 3-4 hours Can Winston move his hind legs at all? Such as to reposition himself in the suite? Push up into a stand with the hind legs?As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order. 1. Pain caused by the tearing disc & inflammation in the spinal cord 2. Wobbly walking, legs cross 3. Nails/toes scuffing floor 4. Paws knuckle under 5. Weak/little leg movement, can't move up into a stand 6. Legs do not work at all (paralysis, dog is down) 7. Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors. 8. Tail wagging with joy is lost 9. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. If surgery is not an option (for whatever reason) then the best option is conservative therapy. |
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Chad & Winston & Angus
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M-dox Angus 2/20 surgery................ M-dox Winston 3/14 surgery
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Post by Chad & Winston & Angus on Mar 14, 2019 18:25:09 GMT -7
Winston had surgery today to fix a T-13 - L1 severe herniation. Surgery was done at Dallas Veterinary Surgical Center. Received the call about 2 pm that he was out of surgery and doing well. If you’re in the DFW area, I highly recommend DVSC. Dr. Radasch did both surgeries and the entire staff has been great.
Chad
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Mar 14, 2019 19:38:10 GMT -7
Chad, thank you very much for the update. So glad to hear Winston is doing well post op!
As you get further updates, we'd love to hear how Winston continues to do. And, of course, when he is expected to be discharged when that is known.
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Chad & Winston & Angus
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M-dox Angus 2/20 surgery................ M-dox Winston 3/14 surgery
Posts: 24
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Post by Chad & Winston & Angus on Mar 20, 2019 14:43:50 GMT -7
Well, today is day six post surgery for Winston. He's still at DVSC. The recovery is not coming along near as fast as it did with Angus. He still can't move his back legs but he's getting close to moving the right leg. He CAN wag his tail which he couldn't do when I took him in for surgery. The vet had me come to the clinic today to see if I could get him to walk for me. They weren't sure if he just wasn't being a stubborn Dachsund or not. Today was the first time I've seen him that he was actually very excited to see me. We went out to the grass and walked some with the sling. They really can't do much for him past this point so he's going to be coming home on Saturday. I work 12 hour days so I can't get him Thursday or Friday. I'm so ready to have the little stinker back home.
Chad
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Post by Romy & Frankie on Mar 20, 2019 15:09:31 GMT -7
Good news that Winston can now wag his tail. That bodes well for more recovery. Recovering the ability to walk can take weeks or even months as in my Frankie's case. There is no timetable for nerves to heal. It is great that Winston is coming home soon. With the excitement of Winston's discharge day, make sure no question goes without answer. Here's a starter list of questions to which you can add some of your concerns: www.dodgerslist.com/literature/dischargequestions.htm Here is some good reading that can answer some post op questions or give you an idea of what you want to know more about: www.dodgerslist.com/literature/surgery.htmThe Physical Therapy that my Frankie did after his surgery was walking on an underwater treadmill. This can often be started as soon as the staples/stitches are taken out. You can ask your surgeon about it. Frankie did very well with this therapy. I do not think he would have recovered nearly as quickly without it. Here is a video that shows how it looks: We have info on other water therapies you can do at home once the surgeon has cleared it: www.dodgerslist.com/literature/watertherapyLet us know what the surgeon recommends for post-surgical crate rest and Physical Therapy. |
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Chad & Winston & Angus
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M-dox Angus 2/20 surgery................ M-dox Winston 3/14 surgery
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Post by Chad & Winston & Angus on Mar 25, 2019 19:17:12 GMT -7
Just an Update on Winston. He actually came home on Thursday, March 21st..we had one more day of Gabapentin 100mg, 2x per day. Those were given on Friday, March 22nd. He was also sent home on Carprofen, 1/4 tablet (75 mg full tablet) 2x a day. That’s 18.75 mg of Carprofen, 2x daily until we finish. We have several days of that left. He’s also on 5mg of Pepcid AC 2x daily as long as he’s taking the Carprofen.
Neuro wise, he’s now able to move most all of his back legs. Only his paws haven’t regained those reflexes. It’s coming along slowly but surely. We have to go to a PT consultation next week. However, Dr. Yaz gave use some exercises to work on at home.
Chad
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Marjorie
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Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 26, 2019 5:07:37 GMT -7
So glad to hear that Winston is now home and doing well, Chad. Excellent news. Is he able to wobbly walk at all now? Any sign of pain at all now that Gabapentin has been stopped? How many weeks did your surgeon direct for post-op rest? We usually see 4-6 weeks of post-op crate rest recommended, only out of the crate to do supervised PT and then back in the crate to rest and heal. What did your surgeon direct for at home PT? Here's our page on post-op exercises that you might want to take a look at and run any that you may not be doing past the surgeon. 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.htmPlease continue to keep us updated. Healing prayers for Winston. |
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Chad & Winston & Angus
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M-dox Angus 2/20 surgery................ M-dox Winston 3/14 surgery
Posts: 24
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Post by Chad & Winston & Angus on Mar 26, 2019 9:52:01 GMT -7
Winston Marjorie, I don't know if I call what he's doing wobbly walking. He's getting to where he can move quite a bit with the help of the sling. So I don't think we're at the wobbly walking stage yet. I haven't seen any signs of pain since we've stopped the Gabapentin but I'm continually assessing him. Dr. Yaz recommended 6-8 weeks of crate rest post-op. As far as at home PT exercises, he recommended massage, range of motion exercises and sit to stand exercises. I'll see what other things they introduce when we go to our PT Consultation. Chad |
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Mar 26, 2019 10:11:04 GMT -7
Chad, sounds as though things are going pretty good— no pain and off all meds. Able to move his back legs when supported by a sling means there is plenty of potential for more nerves to self heal.
If underwater treadmill is available and fits the budget, that is one therapy that will help the body relearn the art of walking while strengthening muscles as Romy mentioned in a previous post.
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Post by Roxie & Rowdy on Apr 20, 2019 20:17:10 GMT -7
Chad, so sorry to hear about your other dog. Glad he is doing better. Prayers for all of you.
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