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Post by Dorthia & Puppy on Jul 12, 2019 10:37:54 GMT -7
Quality of life I’m having to make some huge decisions. We’ve been struggling with IVDD for the past 3yrs. Stella won’t crate rest, she just goes nuts, and yes we have tried drugging her. She is at an apex point. She is on the verge of loosing her ability to walk. If she can’t walk, and I can’t provide her with around the clock care, I honestly don’t know what to do with her. I’ve deeply considered euthanasia. She can’t even go outside to potty on her own. The diagnostics and surgery are ?ks and it is doubtful she’ll rest for 6wks. I can barley get 1wk, at a time. I work from 8am-9:30pm and don’t have enough money to hire an around the clock care giver. How do you manage paralyzed dogs and work ?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Jul 12, 2019 11:39:15 GMT -7
Dorthia, I can feel your anguished words of struggle. Let's see how we can best help Stella to live out many happy years ahead with you. We'll best be able to make specific comments to help by being up to speed on this current disc episode. Would you be able to give answers to the questions below: QUESTIONS currently any of these 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 + 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, advocate for any of the pain meds be given 3x/day (every 8 hours) for round the clock coverage, dose to dose 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. ❖2 How much does your Stella weigh? How old is she? …A Please list the exact names of meds currently given, their doses in mgs and times per day given. …B If on a steroid….what was the start date & dose? Date of steroid taper? If on a NSAID, for how many days has it been prescribed for? …C PEPCID AC: 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). Doxie weight dogs: 5mg Pepcid AC (famotidine) every 12 hours. NOTE: Pepcid AC (famotidine) for dogs is 0.44mg per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory. www.1800petmeds.com/Famotidine-prod11171.html❖3 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? ❖4 What was the current date you saw the vet to confirm this disc episode, meds and started following STRICT rest to allow the disc to heal? 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 ◼︎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. NEURO STATUS?? ❖5 Can your dog specifically sniff and squat and then release urine which is bladder control – OR- do you find wet bedding or leaks on you when lifted which are indication of an overflowing bladder and loss of bladder control? Overflowing bladders need to be expressed to avoid UTIs. Review video then get a hands-on-top-of-your-hands expressing lesson. www.dodgerslist.com/literature/Expressing.htmDOGs with BLADDER CONTROL: 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! ❖6 Currently can your dog wobbly walk? Or move the legs at all in any way? or wag the tail when you specifically do some happy talk? ❖7 What breed is Stella? ❖8 Did you specifically get a diagnosis of IVDD, aka: a disc problem, a disc herniation, a bulging disc, slipped disc? — Is the vet a general DVM or a specialist surgeon: ACVIM neurology or ACVS ortho? COMMENTS from you? Can you tell any of the specific challenges about cratiing. ---What are the names of the meds used to try and help calm her? ---What kinds of recovery suites have you tried: plastic airline crate, wire crate, ex-pen, Pack N Play, pet stroller. --- what is your city/state? Look forward to coming up with useful ideas for you and Stella with yours anwers.
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Post by Dorthia & Puppy on Jul 12, 2019 14:19:17 GMT -7
Dorthia, best if you can not key in your sentences is to dictate on your iPad. Images being transcribed to words by moderator so we can best understand things...
Give sucralfate 2x daily by syringe -pink half pill 2 hrs before other medications Give methocarbamol 50 mgs 2x daily - orange pill slices Give fomotidine 2x/dayly 30 mins before meals Give gabapentin oral solution 2x daily by syringe Starting wednesday [exact dates please!] Give Prednisone 5mgs 5mgs 2x/daily[Moderator's Note. Please do not edit 23 lbs Prednisone as of 7/8: 5mg 2x/day for 7 days, 7/14 test taper _pain _neuro methocarbamol 50? mgs 2x/day sucralfate 500mgs 2x/day gabapentin 250mgs/5mL (0.5mL) 2x/day famotidine 10 2x/day]
Stella is slow to rise and shift in the mornings, after she wakes up Stell weights 24-22 lbs. She is 11 years old Eadint, drinking urinating and deficating is normal My dog is wobbly walkingStella is a miniature schnauzerMonday - Jly 8 [refers to what?]Stella squats and sniffs to urinate.
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Post by Romy & Frankie on Jul 12, 2019 15:10:59 GMT -7
You have set up a very nice recovery suite for Stella. From the picture it looks a bit larger than optimal. The recovery suite should only have room for the dog to stand up, turn around and fully stretch out the legs when lying down. Pictures sometimes do not show things in true perspective but if her recovery suite is too large just pad it out with rolled up towels to make it smaller. The reason it needs to be so small is that it is immobility that heals the disc. We cannot put a cast on a dog's spine the way we would with a broken limb to keep it from moving so we use the crate instead. Crate rest is hard on our dogs and on us. Dogs don't understand why. We pet parents know that it is the absolute best way to help a dog on conservative treatment for IVDD to heal. If Stella is wobbly walking and has control of bladder and bowel she is an excellent candidate to heal with conservative treatment. Stella will not need round the clock care. She will need to be taken out to potty though. Dogs on pred will want to drink more and therefore pee more so she will need to potty more than usual. I see that you are using an ex-pen type of crate. These are excellent because they can be configured in different ways. You can configure it so that a pee pad can be right outside the resting area. Has she used a pee pad in the past? I needed my dog to use a pee pad during his IVDD episode. At first he wouldn't use it because he had been trained to go outside. I was able to get another dog's urine on a paper towel and put it on the pee pad then he used it. If Stella has not used a pee pad in the past that might help her do so. If you have that kind of setup where Stella need only move a very little bit to get to the pee pad is there a neighbor that could come in and do this? This short video shows a way to configure an ex-pen: We have information on ways to help a dog adjust to the crate here: www.dodgerslist.com/literature/EmergencyCrate%20Training.htmIf a dog is very anxious and other methods on the web page above don't help Stella keep calm in the crate there are prescription meds that can be used. I know you have tried these types of meds but some dogs will respond better to one particular anti-anxiety med and if you have not had success in the past there may be other meds that can be tried. It is so frightening when our dogs are diagnosed with IVDD but Dodgerslist has lots of information about the disease and the more you learn about it the less frightening it will be. Healing thoughts for Stella.
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Post by Dorthia & Puppy on Jul 15, 2019 15:09:21 GMT -7
Stella is up and walking, she keeps trying to run out of the back door during potty time, and jump around, and up on us, I will not let her of course.I have found a surgeon on this website off the list provided. We have an appointment on Aug, 19th. I’m very happy with Stella’s progress, however, my vet isn’t as impressed. He said we need to get her into surgery when we can. I’m ecstatic that my dog who c ouldn’t walk a few days ago is up and trying to run and jump again in just a few days. Stella is over her initial depression. Also Stella will stay with the vet for 2wks after surgery, to insure proper healing, the vet also added tramadol 50mg 2X times a day to her medications. Long term while we await surgery he wants her on ✙ tramadol 50mg 2x a day, Gabapentin .5ml 2x a day, and famotidine 10mg 2x a day 30 minutes before other medications. [Moderator's Note. Please do not edit 23 lbs Prednisone as of 7/8: 5mg 2x/day for 7 days, 7/14 test taper _pain _neuro methocarbamol 50? mgs 2x/day STOPPED? sucralfate 500mgs 2x/day gabapentin 250mgs/5mL (0.5mL) 2x/day ✙tramadol 50mgs 2x/day famotidine 10mgs 2x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Jul 15, 2019 18:46:06 GMT -7
Dorothia, two worrisome things your vet is promotiing! -- clearly when a dog is showing neuro improvement already in this short of time, then an IVDD knowledgeable vet would not be pressuring you for surgery—— conservative is working!! -- In general a board certified surgeon would not want to operate on a dog who is walking. They would continue to go with conservative treatment as it is less invasive, less risk than a surgery. Excellent page to learn about surgery vs. conservative—good stuff to have under your belt: www.dodgerslist.com/literature/healingsurgery.htmPart of owners getting very quickly up to speed on the disease their dog has, is to be able to identify things that just do not seem right. At home you are describing something that needs your help in fixing to protect Stella's fragile healing disc. -- Any time out of the recovery suite is a real danger to the disc of too much spine movement. Therefore anytime out of the suite, stella needs to have her harness and leash on. -- At potty time you will need to carry her to and from the potty place to avoid Stella taking any more than a very few footsteps during the act of pottying. Limited movement of the back at all times is the goal. Your firm commitment to the principals of STRICT rest will very likely have the disc being able to form good secure scar tissue by graduation date of Aug 26. And no need for a surgery. Laxity on crate rest which allows too many footsteps, a dog not in control with a leash harness any time out of the crate could spell disaster for the early healing disc. At minimum you might be back at square one with 8 weeks of crate rest, Stella back in pain and facing a very expensive and risky surgery. QUESTIONs to help us best understand things you may report by us being up to date on her med list.-- What date did you begin crating Stella so her disc could heal? Did prednisone start on 7/10?-- For how many days is she to take prednisone 5mgs 2x/day?--Double check the methocarbamol bottle. a 50 mgs dose would be WAY, way undermedicated. Let us know what the corrected mgs are twice a day.-- How many mgs are in one whole sucralfate tablet?-- Check the gabapentin bottle. How many mgs of gabapentin are in one mL of liquid?-- Let us know you have sized down the space in her crate to only enough room to turn around in easily and when she lies down that she can fully stretch out her legs. Looks like using only four panels may be the right size space. You can always pad out any extra space with rolled up blankets. Click to enlarge illustration below:
Owner Education is key with IVDD Keep in mind the key word in the name of the disease is DISC. #1 Take a look so you can visualize just why the need to be strict about crate rest for the DISC is so important in preventing a surgery
#2 How/why meds are used while the DISC is healing. A good review of the many things your vet may have mentioned about his diagnosis, the Rx’d meds, crate rest, other stuff that you may not have fully processed during that short vet visit.
#3 The very best thing you can do for YOU, the caregiver, and for your dog is to read and learn as quickly as you are able. Calm your mind by being “in the know” how long each the 4 phases of healing is expected to take. What treatments for which phase? At what point would a surgery be considered? This is the page to bookmark and return to in the next days to have a full understanding of the now and the future of living many happy years ahead with your IVDD dog. Here is the link to bookmark: www.dodgerslist.com/healingindex.htm
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Post by Dorthia & Puppy on Jul 15, 2019 21:58:59 GMT -7
Hi Paula, - we crated Stella on the July, 3rd when her episode started. -Stella saw the vet on July, 8th - Stella started prednisone on July 10th- Stella then took prednisone 5mg 2x daily until the July 14th - she is now on prednisone 1x daily until July 19th the she goes down to 1x every 2 days until the 24th, the she is off prednisone completely. - the bottle sucralfate is 1gm so that should be 1000mg - the Gabapentin bottle read 250mg/5ml, my math comes out to 50mg/1ml ( I also posted a photo of my Math so you can see if it looks wrong) - we moved Stella into a large soft sided crate, she’s been more reasonable about resting, but she still starts to get crazy on occasion, I then let he out and make her lie down on her dog bed next to the crate. - the reason for the move is she tried to jump out of the panels and knocked the whole thing over, she tried to crawl up the side of the hard-sided crate (last episode), she can’t crawl up this crate and it’s flexible she she can’t climb up it or knock it over. - also when I try to carry Stella outside she gets super stiff and flips around in my arms ( she basically fights me) ,she doesn’t help me help her, she makes everything as difficult as possible.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Jul 16, 2019 5:09:28 GMT -7
Dorthia, the larger soft crate is fine as long as you fill in any extra space with rolled up towels/blankets. The area should only be large enough for Stella to stand up, turn around and lie down comfortably with legs extended. Any more room than that and she would have too much room to move around in. Please, please keep her in the crate except for potty time when she's safe. Please do not let her lie down outside of the crate. Dogs so often do the unexpected and dart off when a doorbell rings or something flies past the window. The crate is the safest place for her. Think of the crate as a cast for the spine. As Paula explained, since Stella is walking, she's a very good candidate for conservative care. But in order to avoid a worsening of her condition and surgery, the crate rest needs to be kept very, very strict. Having pain meds on board during the taper of the Prednisone is counterproductive. Stella was only on a four-day course of the anti-inflammatory dosage of Prednisone (5mg 2x/day) which is a very short course - we usually see 7-14 days prescribed. She may still have swelling pressing on the nerves of her spine and may still need the original dosage of the Prednisone but the only way for you to know that is to stop or at least taper the Gabapentin, Methocarbamol and Tramadol so you can determine if there is still pain/swelling. Pain means there's still swelling and still a need for the anti-inflammatory dosage of the Pred for a bit longer. Please speak to the vet ASAP about stopping or at least tapering the pain meds so a true test for pain/swelling can be made. It can take 7-30 days for the swelling to resolve. More on that here: dodgerslist.com/literature/healingsweling.htmIf Stella is moving too much when you carry her outside to potty, possibly you could teach her to pee on a pee pad placed right outside of her crate, using a harness so she doesn't take off. Lay down a pee pad WITH the addition of urine from another dog or from Stella on top. Always save a used piece of pee pad in a ziplock bag to use at potty time. Stella can learn it is ok with you to pee on the pee pad, be sure to use the command go potty and when she does give lavish praise. In the next post, I'll give you some tips on how to calm Stella during conservative care. If those don't help, the vet may need to prescribe a mild sedative to help her rest so she can heal. You mentioned she previously received drugs to help calm her that didn't work but not all sedatives work well with all dogs. The vet has other options he can try.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Jul 16, 2019 5:10:17 GMT -7
Try to keep a happy voice and face around Stella. Dogs are very sensitive and pick up on our feelings very easily. Tell him everything's OK and that he's getting better every day. And you believe it, too! To calm your dog in the crate, it would be a good idea to cover the top with a towel. That should mellow him/her. It also creates a den like feeling that dogs love. 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 such as Acepromazine, Trazodone, etc. Of course always keep your vet in the loop on all things you give your dog. Other product brands may be available in your area or on-line… just shop by the active ingredient(s) on the label and the quantity for best price. Place a DAP pheromone diffuser at floor level where the recovery suite is. Dogs: Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/us/Products/ADAPTIL-Calm-Home-Diffuser with dog pheromones Use a diffuser with one oral calmer from below: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed 2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. 3) Bach's Rescue Remedy is a liquid 5-herb combo to help with relaxation (Star of Bethlehem – Orithogalum umbellatum, Rock Rose – Helianthemum, Cherry Plum – Prunus cerasifera, Impatiens – Impatiens gladulifera, Clematis – Clematis vitalba) Be aware you might be inadvertently training for unwanted behavior. To dogs rewards are: food, looking at them, talking to them, eye contact, approaching the crate, petting. So anytime you see unwanted behavior ignore it, turn your back, leave the room if you have to. Preferable is to start teaching what you do want before there is too much practice in doing the unwanted behavior. Anytime your dog is sitting or lying down quietly, give a reward. Soon your dog will see they get rewards for four feet on the floor, quietly sitting, etc. Consider some of these ideas: -- Many members have found a pet stroller to solve the whining problem because the stroller can be wheeled from room to room as you go about your activities. Pet strollers, however, should only be used when you are directly supervising. More details on strollers: www.dodgerslist.com/literature/strollers.htm--Caster wheels can be added to a wire crate so the crate can be wheeled from one room to the next so your dog can stay with you. -- Put a garment you have been wearing and have not washed in the crate. -- Nan Arthur, CDBC, CPDT, KPACTP writes: "According to the book, Stress in Dogs, by Martina Scholz & Clarissa von Reinhardt, the most well-behaved dogs get 17 or more hours of rest and sleep per day. Teaching self-calming exercises can also help your dog to relax more. You can make something as simple as eye contact a very rewarding behavior that also acts as a way for your dog to “ask permission” when he wants something. When dogs have a focus and an understanding about how to behave to get what they want, they are much calmer overall. To do this, each time your dog looks at you, say, something like, “Yes!” or use a clicker to mark the second he looks at you, and then give your dog a high-value food reward. Wait for your dog to look up at you again, say, “Yes,” and reward again. Do this exercise 10 or so times and then say, “All done,” and put the treats away. Come back later and do it again until you can see that your dog is really starting to make automatic eye contact in hopes you will say, “Yes,” again and give him his reward. " [NOTE: treats should be subtracted from the normal daily kibble ration so as not to gain weight during crate rest.] wholedogtraining.com/images/stories/Are_all_dogs_trainable.pdf -- If your dog won’t get too excited seeing what’s happening outside, during the day try putting the crate on the coffee table or the dining room table so there will be a view out a window and a better perspective on what is going on in the house from on high. -- Play classical music or one of the wildlife TV shows. -- Fill a Kong with soft dog food and freeze. Put part of the dog's total daily dinner kibble in the Kong to lengthen time to consume dinner. Good low cal snacks are carrots, apples, or frozen green beans, licking a frozen low sodium broth ice cube. Good thick low salt/no fat chicken broth is full of cartilage-building proteins and amino acids. Freeze it up into cubes for easy access as you need it. Fun and keeps the body hydrated: place cubes in a bowl for licking. If a dog is jumping up at the sides of the crate, you can lower the ceiling of the crate. Cut a piece of cardboard the size of the top of the crate, punch holes in the corners and tie the cardboard down into the crate to the level of the top of the dog's head when standing. Or cover the top of the crate with a blanket or towel, bringing the blanket/towel down to the level of the dog's eyes so when he/she jumps up, he won't be able to see anything. That may discourage him/her from jumping up. www.dodgerslist.com/literature/EmergencyCrate%20Training.htm
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Post by Dorthia & Puppy on Jul 16, 2019 13:13:17 GMT -7
Ok, I ordered the Adaptil diffuser and a potty grass and I’m trying to teach Stella to use potty pads in the mean time. Also I have been taking her to potty like this 👇🏽 Is that ok ?
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Post by Romy & Frankie on Jul 16, 2019 13:20:25 GMT -7
Harness, leash and sling are exactly right. Just keep the number of steps she takes to a minimum.
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Post by Julie & Perry on Jul 16, 2019 18:41:52 GMT -7
Gotta say, Stella is adorable!!
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Post by Dorthia & Puppy on Jul 20, 2019 11:44:45 GMT -7
I wanted to update everyone, Stella seems to be improving a little everyday. On the 17th I took Stella to my mountain camper in Arizona, after she chewed through her soft sided crate. The excitement of our other home 🏡 was just too much, she wanted to be with our other animals. It is just Stella and I, and very quiet. She has since complied with create rest & she is using the potty on the grass mat inside the very small camper, with full carpeting. ( I let her out of her crate & let her walk to the mat, as it is only a few feet from the crate.) we have no other pets & we are in the mountains away from anyone else making this a very quiet place to rest. I put heavy shades and curtains in the windows so she can’t see outside and sounds are muffled. Stella has an appointment with neurologist/ surgeon/ specialist, who has been treating IVDD dogs almost exclusively for 20 +- years. She will make the finals decision about surgery. Stella will see her on the 19th of August. The vet is in El Cajun California so tips on safe transport will be appreciated.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Jul 20, 2019 11:52:22 GMT -7
Wow, what a scare about escaping the soft sided recovery suite!!! I'm glad to hear you have not reported any neuro or pain setback. Kudos to you for taking charge to get her into a quiet environment so that her disc may continue to heal. Your camper sounds perfect for you and for Stella. Dorthia, the reasons behind the two treatments for a disc episode are these The purpose of surgery is to take the pressure off of the spinal cord by removing the disc material causing the compression. Surgical decompression allows a normal blood supply to return to the compressed spinal cord and for neurologic recovery to begin. The surgery itself does not heal the nerves...the body self heals nerves over time. Surgery is generally reserved for those dogs who have severe neuro diminishment of paralyzed legs, loss of bladder control and deep pain sensation (DPS. Surgery can still be successful in the window of 12-24 hours after loss of DPS the last neuro function. Each hour after that decreases that chance and a surgeon would not want to take a surgical risk when the chance of benefit is smaller. The purpose of conservative treatment is two fold. Crate rest to allow the disc to heal and meds to take the pressure off of the spinal cord. Once the swelling gone confirmed by the pred taper of no surfacing pain nor regress in neuro issues. You continue to report that Stella's mild wobbly leg neuro issue is getting better. Her pain is under control. In general a neuro would not want to do a risk filled surgery when conservtive treatment is as you report is working well and getting the disc to heal by graduation day of Aug 28. Could you fill us in more on the "why" part of the Aug 19 neuro appt for a possibly surgery..sounds like it is for some issue we are not aware of? If you just want her seen by a neuro to make sure all is healed well under conservative treatment, then why not wait til she has graduated from crate rest on Aug 28? Then the disc will have had its 8 weeks to form good secure scar tissue and the transport would not be a potential risk to the disc as it would be on Aug 19. More about the use of conservative vs. a surgery with a disc episode: www.dodgerslist.com/literature/healingsurgery.htm
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Post by Dorthia & Puppy on Jul 20, 2019 21:47:28 GMT -7
Maybe there are things I don’t know and don’t understand, about IVDD and Stella’s condition. I’m pretty much just following my vets instructions. He said she needs to see a specialist who knows more and can better evaluate Stella and give a better idea on how to move forward. The 19th of August was literally the only appointment I could get. The vet is booked solid with IVDD surgeries and exams. You literally can’t get in as a new patient for 2-3wks, so you must book in advance. Maybe I can film Stella walking a few feet ? Then upload it to show you. Would that help ? She doesn’t sleep with her feet all stretched-out along her sides anymore, like she used to. She sleeps with her feet tucked under her like a normal dog again. When my vet examined her last she would leave her left foot tucked over with toes pointing back and not straighten her foot when she walked and when he (vet) made her foot that way. Now she keeps her toes straight when she walks. When I flipped her toes under a couple of days ago, she flipped them right back into the proper position, no problem. She is getting up, walking, and sitting much better. I think she has made great strides in her improvement, considering that she could hardly standup on her own when this started.
I would say these following things apply to Stella
• if a dog is experiencing similar signs of neck or back pain, or mild neurological deficits for the 3rd or 4th time, meaning it may be the same disc is involved.
1. Pain caused by the tearing disc & inflammation in the spinal cord
2. Wobbly walking, legs cross - no leg crossing
3. Nails scuffing floor- we are now here
4. Paws knuckle - we were here
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Post by Julie & Perry on Jul 20, 2019 23:52:28 GMT -7
It sounds like Stella is doing very well with crate rest.
Could you call and ask your vet exactly why they feel Stella needs to see a specialist.
Then you can decide if it's needed.
Typically, a dog is seen by a specialist if they're having trouble with continuing pain that can't be managed or if they aren't doing well with crate rest and may need surgery.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Jul 21, 2019 5:24:45 GMT -7
Since Stella is showing such wonderful signs of improvement while being treated conservatively, that is the treatment that should continue. Your vet is acknowledging that a specialist would know more than he does about IVDD. However, Stella is obviously doing very well and therefore taking her to a specialist at this point would just involve risk of too much movement of the spine when a specialist visit is not necessary.
Some dogs have only one disc episode their whole lives while other dogs may have several. It doesn't always mean that it's the same disc. Any disc at any time can degenerate to the point where it ruptures or tears, causing pain and/or neuro deficits. Surgery will not prevent a disc from degenerating in the future.
If the neuro is not taking new patients on an emergency basis, then that is not a neuro that you want to deal with anyway. Should Stella have a more severe disc episode in the future, she would need to be seen immediately, not in 2-3 weeks time. Should deep pain sensation be lost in the future, the sooner surgery is done, preferably within 12-24 hours, the better the outcome. It would be a good idea to find a specialist who would be able to see Stella on an emergency basis, just to have their information available, should Stella ever have another disc problem or should she worsen during this current disc episode.
There no need to video Stella walking. You gave a very good description of her improvements.
What I do think you need to do at this point in time is to speak to your present vet about stopping or at least tapering the Gabapentin. The Prednisone is now being tapered. This is the time to keep a careful watch for any sign of pain returning. Pain means there is still swelling pressing on the nerves of the spine and therefore still a need for the original dosage of Prednisone. The Gabapentin would mask any sign of pain that you need to see. Pain = swelling = more time on the original dosages of all meds for a bit longer.
Please let us know what the vet says about stopping or tapering the Gabapentin after speaking to him. And keep up the good work with Stella. You're doing a great job with her and it shows!
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Post by Dorthia & Puppy on Jul 23, 2019 17:02:55 GMT -7
Quick Stella update : she continues to rest and improve. I was able to move Stella’s appointment to Aug 26th, hopefully we will be close enough to grad date that she will be alright. Thank you everyone for your support and guidance. It is wonderful to have you all to turn to during these tough times. We’ll keep updating as things move along.
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Post by Dorthia & Puppy on Aug 2, 2019 15:37:00 GMT -7
Hi everyone, Stella is doing really good right now except for we have sort of hit a wall in her progress where she’s not improving at the same rate that she was, if she is improving at all. She has recently stopped accepting her medication I cannot make her take it anymore, she absolutely fights me and I don’t want her to get hurt. We are going to call the vet and find out what he thinks and go from there I just want to see what you guys thought. Stella doesn’t seem to be in any pain, though she hasn’t had her medication for about 3 days.
[Moderator's Note. Please do not edit 23 lbs Prednisone as of 7/8: 5mg 2x/day for 7 days, 7/14 test taper _pain _neuro]
She still seems to be comfortable and is still walking and doing good. I just haven’t seen a lot of progress, but besides that she hasn’t regressed she’s not doing worse she’s just not doing better and again she doesn’t seem to be in any pain. So just want to see what everyone thinks. I’m a little bit concerned that she won’t take a medication and about the fact that she’s not continuing to prove like she was. I have also tried the 3 treat method to no avail.
Her medications are :
Gabapentin: 250mg/5ml at .5 ml dose daily tramadol: 50mg
Both meds are given 2X daily.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 2, 2019 16:26:39 GMT -7
Dorthia, the test for pain taper of pred started on 7/14. To be taking pain meds during the test taper is counter productive as Marjorie explained in her post to you on July 21. You have not able to correctly assess about existing pain until Stella put the brakes on.
Thank goodness Stella put an end to taking any pain meds. Now you have the correct answer....she is on no pain meds at all and you are not seeing any pain. Prednisone completed it's mission with the 7 day course and all painful inflammation is now gone! THANK YOU Stella!!
Now all that is left is to complete the remainder of the 8 weeks to give that disc time to form secure scar tissue. There are no meds that heal the disc
Nerve healing is not expected to take place in the short time of 8 weeks it takes the disc to heal. So no worries there. Think in terms of months rather than weeks nerves to self repair. As the nerves grow, we do not see anything on the outside til there is a connection. So it's pretty common to see a plateau (nothing seeming to happen) and then some nerve connection and improved neuro function. There are no meds that heal nerves.
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Post by Dorthia & Puppy on Aug 4, 2019 11:59:08 GMT -7
We have horrible news, there was a thunderstorm last night. I wasn't home in time before it hit, and I think Stella hurt herself inside the crate, because all of the rolled up blankets were everywhere, before I got home. Stella's wobbly walking is a little worse, but her toe placement remains good, and she still flips them up, when I fold them under. I called her vet and he prescribed her another round of prednisone. 5mg 2x daily [conflict!] of the prednisone. I'm so heartbroken,she was doing so well. She does appears to be in pain now, but not a lot of pain.
Her medications now are :
Gabapentin: 250mg/5ml at 1ml dose 2x daily dose tramadol: 50mg 2x daily dose Prednisone: 5mg 1x daily dose [conflict!]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 4, 2019 12:07:31 GMT -7
All is not lost, so stay strong, you and Stella will get through this. Sucralfate? Famotidine 10mgs 2x/day on board? there should be no pain. Since there is then clearly the pain meds are not yet right. ---Call back and advocate for an every 8 hrs dose. Pian meds have a short half life and will not stay high enough in the body round the clock dose to dose unless RX'd for every 8 hrs (3x/day) -- May even need to add back in the methocarbamol. -- Prednisone For how many days 5mgs TWO times a day?5mgs ONCE a day is not up at the anti-inflammatory level, but a tapering dose. Tapering doses are likely to not be strong enough to work on the painful inflammation. Let us know what meds changes your vet makes. And what specifically you are observing that indicates to you pain.
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 ◻︎ 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 ◻︎ not their normal perky selves
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Post by Dorthia & Puppy on Aug 5, 2019 14:33:30 GMT -7
Sorry, I meant that is the medication she will be on. I live 2-3 hrs away from civilization, so the vet had to email me her prescriptions, and I’m in town now trying to get them filled. We also added alparazolam 1mg which she will take, whenever I leave the house. It’s a sedative to keep Stella calm. Stella looked a bit better this morning ; She was walking better & wasn’t acting like she is in any pain. The only trembling I’ve seen is in her right rear leg, it’s seems to be the worst one and does tremble from time to time. Today she seems to be back to her happy self. Thanks for getting touch with me so quickly, I panicked when I found Stella like that.
So this will be Stella meds starting with 1 dose of each tonight. Then starting onto her regular doses tomorrow August 6th Gabapentin: 250mg/5ml at 1ml dose 2x daily dose tramadol: 50mg 2x daily dose Prednisone: 5mg 1x daily dose alparazolam 1mg 1x daily
[Moderator's Note. Please do not edit 23 lbs Prednisone as of 7/8: 5mg 2x/day for 7 days, 7/14 test taper _pain _neuro as of 8/5: taper dose of 5mgs 1x/day due to storm, worse wobbly walk gabapentin 250mgs/5mL: 50mgs(1mL) 2x/day tramadol 50mgs 2x/day alparazolam 1mg 1x/day famotidine 10mgs 2x/day ]
I also called my vet and asked him why he only wants to give Stella prednisone 5mg 1x a day, he never really gave me a straight answer and just told me if she isn’t feeling better in 48hr of her first dose to call him back, and we may start her on prednisone 5mg 2x a day.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 5, 2019 17:47:45 GMT -7
Glad she is feeling good and walking better now.
Do you have stomach protection back on board? which famotidine and or sucralfate?
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Post by Dorthia & Puppy on Aug 5, 2019 18:36:46 GMT -7
Yes famotidine 2x 10mg
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Post by Romy & Frankie on Aug 6, 2019 13:28:43 GMT -7
Good news that Stella is back to her happy self.
I am glad that you are giving Stella the Pepcid AC. Our IVDD dogs have enough to deal with without stomach problems.
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Post by Danielle & Otto on Aug 7, 2019 23:20:54 GMT -7
Hey Dorthia, who is the neuro in El Cajon?
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Post by Dorthia & Puppy on Aug 8, 2019 0:24:42 GMT -7
We have had a horrible day. The pharmacy that filled Stella’s prescription gave her the wrong medication. Stella got very sick. The only good thing is the vet who saved her, prescribed us the right medications. ▲ prednisolone 5mg 2x daily, this vet said that 5mg once daily was not enough. Stella, to spite all of the excitement of the day, seems to feel much better, now that she is on the appropriate medications. We are only on prednisolone & Pepcid right now, we are waiting for the rest Stella’s blood work to put her back on all of her other medications. To spite all of this, Stella is still walking and doing ok. The vet also assessed Stella & said she seems neurologically good to spite the wobbly walking, I’m unsure what that means. Prednisolone 5mg 2x times a day Pepcid 10mg 2x time a day [Moderator's Note. Please do not edit 23 lbs Prednisone as of 7/8: 5mg 2x/day for 7 days, 7/14 test taper _pain _neuro as of 8/5: taper dose of 5mgs 1x/day due to storm, worse wobbly walk prednisolone as of ?: 5mgs ▲2x/day for ? days then test taper _pain _ neuro 8/3 thunderstorm- worse walking famotidine 10mgs 2x/day ]We will gradually reintroduce all medications as time passes. [Editor note: You can locate board certified Veterinary surgeons (ACVS) and neuro surgeons (ACVIM) here: find.vetspecialists.com Dr. Nancy Hampel, a general DVM veterinarian: ]
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Post by Julie & Perry on Aug 8, 2019 3:32:45 GMT -7
Oh no, I'm so sorry that happened. Poor Stella!
I would take the comment " neurologically OK" as Stella being stable, the wobbly walking is from nerve damage and should heal in time.
Sending healing thoughts and prayers to you both.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 8, 2019 8:14:02 GMT -7
Dorthia, so sorry to hear about that wrongly filled Rx for Stella. What was the name of the wrong medication?
Prednisolone is very similar to prednisone. Prednisone must be processed by the body to become the active form prednisolone. Rxing prednisolone saves the the body, the liver, from that processing step.
What date did Stella begin taking the anti-inflammatory level of prednisolone 5mgs 2x/day? For how many days will she be on that dose before the taper begins?
With all pain meds having been stopped, do you observe any signs of pain?
Glad to hear no backward steps in neuro diminishment. Wobbly leg function will with time very likely self repair.
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