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Post by Traci & Minpee on Jul 30, 2019 14:51:15 GMT -7
[Original Subject New Here - 7yr old Dachshunf with Neck issue]
Hello
My name is Traci. I have a 7yr old male dachshund named Minpee. He was diagnosed with IVDD in may of 2017. The first time he went down he couldn't use back legs. We did crate rest and Meds ,he healed pretty quickly.
The second time was a year and a half later. Again no use of back legs. Never lost deep pain sensation. And never lost his bladder function. Again we did all the meds and crate rest. It took about 12 weeks for a full recovery.
Now here we are a few months later and it has happened again. We are currently trying to get weight off of him as his vet thinks is a lot of his problems. He is 24 pounds. He is on a special food now. Last week I took him out and he didn't want to move. I tried to help him up and he would fall over. His front feet were buckling. I took him in to vet the next morning 7/25. She confirmed after xrays that the problem was in his neck this time.
He is back to the crate rest. And taking prednisone, Tramadol , Gabapentin , and methocarbamol.
[Moderator's Note. Please do not edit
24 lbs
Hills mobility & Joint food started 7/27
Dex injection on 7/25 and 7/27 and 8/1
Prednisone begun on 7/26: 5mgs 2x/day for 4 days, 7/30 test taper for: _pain / _neuro
tramadol 25mgs 2x/day
gabapentin 100mgs 2x/day
methocarbamol 250mgs 2x/day
no GI tract protector Pepcid AC on board! ]
He is eating and drinking as always. He has had two acupuncture and cool laser therapy treatments. And will have another on Thursday. Still going potty on his own.
He doesn't seem to be in pain. He isn't yelping or anything. But he can't walk. He can for little bits at a time. But only when we take him out to go potty. But he falls over. He just seems depressed. However , I know he is on a lot of meds. I am freaking out about the front legs and the neck being affected. With the back legs I used a sling to hold up back end. I don't know how to support him this way .... I don't want to hurt him. I feel like this is the beginning of the end.... If he totally loses the front legs he wouldn't be able to have a cart. My anxiety is off the charts. I can't seem to get it together this time. I don't know how to calm myself down. Any tips or advice would be so helpful.
Thank you in advance.
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Post by Romy & Frankie on Jul 30, 2019 15:39:27 GMT -7
Welcome to Dodgerslist, Traci We are so glad you’ve joined us all. We’ve got valuable information we’ve gleaned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you! It is important to know that disc disease is not a death sentence! Struggling with quality of life questions for your dog? Re-think things: www.dodgerslist.com/index/SDUNCANquality.htmIt 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: A disc problem in the neck can be more painful and may take longer to resolve because a dog moves its head with almost all actions and whenher part of the body moves. That constant movement means that healing can take longer because the neck doesn't get the rest to allow the disc uniinterrupted healing. However, we have seen many dogs recover from neck disc issues with Conservative treatment so there is absolutely no reason to think this is the beginning of the end. There are carts for dogs with front leg paralysis. But at this point you have no reason to think it will come to that. We have some tips you can do at home to help Minpee: www.dodgerslist.com/literature/cervical.htmI know you do not think Minpee is in pain but just for your reference these are the signs of pain we look for: ☐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. Please list the exact names of meds currently given, their doses in mgs and times per day given. What was the start date & dose of the pred ? What is the date of the steroid taper? All anti-inflammatories, in your case pred, cause excess stomach acid which can cause stomach damage. Pepcid AC can be used to help prevent this. Ask the vet 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). canigivemydog.com/wp-content/uploads/2011/10/can-i-give-my-dog-pepcid-ac-300x300.jpg Doxie weight dogs: 5mg Pepcid AC (famotidine) every 12 hours. The usual dose of 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.htmlThe 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. 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 Minpee to and from the recovery suite to the potty place and then allow a very few limited footsteps. You can help support his front end when he goes to potty.. 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 If Minpoo is too big to carry it is still important that the amount of movement to the potty place be minimized. Try a pee pad right outside the crate. 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.jpg |
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Post by Traci & Minpee on Jul 30, 2019 17:55:17 GMT -7
Thank you for all this great information. I need to review all the attachments. And get you the does and mugs of his meds. One question I still am having the most problems with is with the front legs being the problem. The support figures shown look like they are still supporting the back end. How do I use a sling or scarf etc to support the front end without hurting him ? Do you place it under the front legs or closer to the belly?
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,539
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Post by PaulaM on Jul 30, 2019 18:38:43 GMT -7
Tracy, you can make your own front end sling. If his back legs are also a bit wobbly then, you would have a 2nd, a rear end sling of a long winter scarf, belt, etc. 1) DIY sweatshirt sling...can also be used for front legs. Cut out leg holes in a long strip of towel or old sweatshirt as shown here: www.lyonpuffpetsit.com/htmlslp/sling.html2) DIY figure-8 sling if the rear is wobbly: www.dodgerslist.com/literature/cratesupplies/Figure8.jpgWhat is the name of the special food he is on. When did he start that food? We look forward to having the complete info about his meds. The part in pink is the information we will need. Helps us to make more informed comments when needed. Medication list: 24 lbs
Prednisone began 7/25: ?mgs ?x/day for ? days, then a test taper for: _pain / _neuro
tramadol ? mgs ?x/day
gabapentin ? mgs ?x/day
methocarbamol ? mgs ?x/day
no GI tract protector Pepcid AC on board!! ]
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Post by Traci & Minpee on Jul 30, 2019 19:47:50 GMT -7
Methacarbenol 1/2 of 500 mg twice a day
gabapentin 1 100 mg 2 times a day
tramadol 1/2 of 50mg twice a day
Prednisone 1 5mg twice a day
He had a injection steroid instead of pills on 7/25 and and on the 27th.
He goes in for treatment on Thursday 8/1 and will determine if we keep up on the twice a day prednisone.
started new food Saturday 7/27
1/2 cup twice day
mobility and joint - by Hills
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,539
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Post by PaulaM on Jul 31, 2019 8:04:06 GMT -7
Traci, thank you for the addtional med list info! -- What is the name of the steroid injections on 7/25 and 7/27? -- the pred pills, did they start on 7/28? The purpose of prednisone is to get rid of all painful swelling/inflammation. Pred will not heal nerves, that is something the body can self heal over a period of time. The really important single most important care is the limited movement of the back/neck so that vertebrae movement is curtailed and not putting press on discs. The normal discs are there to cushion vertebrae movement. The bad disc just can't take pressure while it is trying to form scar tissue. The early healing disc's scar tissue is quite weak and prone to re-tear with too much movement. Even treatments like acupuncture or laser light therapy have to be very carefully weighed risk vs. benefit. And why we say if it is determined either are a must, then seek a mobile vet that comes to your house. ---- What treatment are you pursuing on 8/1?It is pretty typical that vets will make medication changes when the owner calls them with updates. Vets usually estimate when they want the Prednisone to start to taper (lessen the dosage) and at that time, they also stop the pain meds so a test for pain can be made by your observing for any hint of pain resurfacing. If there would still be pain at the time of the taper, then it wouldn't be time to taper the Prednisone as there is still swelling. Do seriously discuss risky transports vs contacting your vet with phone updates about pain so he knows if meds need to be adjusted. As you know, there may or may not be nerve function improvements in the short time of 8 weeks dedicated to healing the disc. Nerves can take months to heal. On 8/1, there will have been no beginnings of a pred taper, no stopping of pain meds, which mask pain, to have information to know if pred has done its job of resolving all swelling. The length of the pred course is all guess work. Most vets will take a guess with a 5-7 day course of pred and then with the taper they see if their guess was right or not. Discuss with your vet about protecting the disc from risky vehicle transports with phone updates instead. -- With 2 days of steroid injections + 4 days of pred pills (6 days total) it might well be that all swelling is gone. Nobody can know this UNTIL the pred taper starts along with the stop of backing off of pain masking meds. Your job at home is to monitor for pain or new neuro issues on the pred taper. Let us know which your vet prefers backing off of pain meds or full stop on the date that pred begins tapering (8/1???)--With any taper, it is always good to have worked out in advance a "PLAN B" should pain re-surface at night or on the weekend when your vet is not open. Could be an emergency RX script you could fill at local 24 hr pharmacy or some extra pills at home til the vet opens again. An ER visit is very expensive, a "Plan B" is free!
Pain = another course of prednisone + all pain meds, protectors back on board. No Pain = complete the pred taper...finish out the 8 weeks of crate rest for the disc to heal.What to MONITOR during the PRED TAPER
You are the eyes and ears for the vet to alert him during the taper.
SIGNS OF PAIN surfacing: ◻︎ 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
NEURO diminishment
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 & resulting in 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.
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Post by Traci & Minpee on Aug 1, 2019 10:22:33 GMT -7
Hello
The injection he gets is Dexamethasone. He got Pred pills on 26th.
He went in this morning for Acupuncture , and Laser therapy. Another [Dex?] injection.
Vet told me that he seems less painful than earlier this week.
He can stand for tiny little bits at a time. But then the right front leg buckles. She said that is where he is having the most problem. She is concerned about that. She started to say she's concerned about it coming back..... but next breath said it is still very soon. It has been a Week today on Crate rest.
She wants to keep on the same med schedule to be safe ..... as she is gone for two weeks after FRIDAY. I am a little panic'd. She wants him to come in next week for laser therapy next week. Her partner is familiar with Minpee and his issue. He checked him over today with her. So he is aware that I may be calling.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,539
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Post by PaulaM on Aug 1, 2019 10:36:50 GMT -7
Traci, your vet is putting Minpee's GI tract in great danger by the continued use of Dex injections and prednisone but no thought to getting Pepcid AC (famotidine) on board. If Minpee has no health issues, then what is the stumbling block to going to the grocery store to pick up Pepcid AC? Proactive vets don't wait til there is lip licking of nausea, not eating, vomit, diarrhea leading to serious bleeding ulcers, red or black blood in stool due to the extra stomach acids anti-inflammatory drugs cause. Pepcid AC (famotidine) blocks the production of acid. The usual dose of Pepcid AC (famotidine) with a disc episode is 0.44mg mg per pound every 12 hours. Pepcid AC has a very limited potential for side effects. 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).
HEALTH ISSUES: “Mar Vista Vet reports: Pepcid AC has a very limited potential for side effects, the reason of release to over-the-counter status. The dose of famotidine may require reduction in patients with liver or kidney disease as these diseases tend to prolong drug activities. There have been some reports of exacerbating heart rhythm problems in patients who already have heart rhythm problems so it may be prudent to choose another means of stomach acid control in heart patients.” marvistavet.com/famotidine.pml NERVE REPAIR Nerves self repair. Dex nor prednisone will bring back nerve functions. That is something the body does on its own...just like the body can self repair a broken arm. Dex is a very, very powerful and well known in the medical community for causing GI tract damage. It is not clear why given Dex injections intially why when pred was brought on board, it would then be the ONLY STEROID on board. That is how vets who are IVDD knowlegeable might use Dex...just to start but then go to pred for at home pills. PAIN Minpee is in pain because their is still inflammation pred is working on and the pain meds are being under medicated for a 24lbs/10.89kg dog. Adovcate for use of a more aggressive pain med approach: -- Each pain med to be Rx for every 8 hrs to provide round the clock dose to dose comfort -- Tramadol at the max analgesic dose everyt 8 hrs. Look for a dose nearing 100mgs 3x/day WARNING: Contact your vet, report your dog’s symptoms, and discuss adjusting the dose. The correct amount to administer can depend on several factors including your dog’s breed and medical history that your vet knows and owners can overlook. -- gabapentin 100 mgs 3x/day -- a methocarbamol dose that that can be increased to 3x/day frequency. Please let us know you were successful in advocating over the phone (avoiding risky to disc vehicle transports) and what the new med details are. Same principal with acupuncture/laser treatments, a mobile vet who comes to your home is far safer for the still delicate early healing disc trying to form secure scar tissue. |
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Post by Traci & Minpee on Aug 1, 2019 21:23:44 GMT -7
Sorry, I forgot to include the Pepcid. I talk to her about the ✙Pepcid and she gave me the green light on it.
She has also told me I can use the meds 3x a day, if needed. We have been doing twice a day and he is t showing signs of being painful.
[Moderator's Note. Please do not edit
24 lbs
Hills mobility & Joint food started 7/27
Dex injection on 7/25 and 7/27 and 8/1
Prednisone begun on 7/26: 5mgs 2x/day for 4 days, 7/30 test taper for: _pain / _neuro
tramadol 25mgs 2x/day
gabapentin 100mgs 2x/day
methocarbamol 250mgs 2x/day
✙Pepcid ? mgs ?x/day ]
I’ve been looking to see if we have mobile vets around here that do acupuncture but haven’t found anything yet. There aren’t to many vets here that do acupuncture. But I am still looking into to see what I can find out.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,539
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Post by PaulaM on Aug 2, 2019 7:36:48 GMT -7
Traci, you reported your vet said at last appt Minpee appeared less painful (while still taking pain meds). Less painful IS pain. Would you be able clarify this contradiction?
confusing CONTRADICTIONS
-- if on pred taper that started 7/30 to find out if there is actually any remaining painful swelling, then the pain meds would be stopped or backed off. Pain masking pain meds on board blindfold you in your observations about pain.
-- if Minpee is actually showing signs of pain as per the vet, then it would not be time to do a pred taper that started on 7/30. Instead vet would adjust pain meds and Rx another pred course (5mgs 2x/day). Most vets will take a guess of a 5-7 day course or even a 14 day course of pred and then try the test for pain prednisone taper with stop or backing off all pain meds to verify.
What is the dose of Pepcid AC in mgs you give and are you giving that twice a day?
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Post by Traci & Minpee on Aug 3, 2019 8:46:08 GMT -7
The Pepcid is a 10 mg pill - 1/2 a pill twice a day.
We have talked and agree that he isn’t currently showing signs of pain.
When he started acupuncture he was very painful. And now he isn’t. She changed the Pred from twice a day to once a day Pred [tapering dose].
She didn’t want to change the pain meds at this time. Since she is going to be gone for a couple weeks. She didn’t want to change much.
We did decide on if he
Would start to show signs of pain to change meds to 3x a day if needed. And go back to 2x a day on the Pred. This is plan B if things change.
There is another doctor there that is familiar with his case if I need to take him in.
So far he doesn’t show signs of pain.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,539
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Post by PaulaM on Aug 3, 2019 9:40:44 GMT -7
OK, then Minpee is to stay on pain masking pain meds while pred 5mgs 1x/day continues in a taper mode for two weeks. Taper doses do not work on swelling/inflammation if there would be any.
OK got it. So if perchance there is actually inflammation still, no one will know. No one will be upping pred to the anti-inflammatory dose to get back to work on resolving all inflammation until the vet gets back in two weeks.
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