Lori's Oscar Wiener 10/26 Conservative

Welcome to Dodgerslist, my name is Pauliana, what is your name?  Sorry to hear that Oscar is having a disc episode but I am glad you came here to share his story with us. Here you will get a chance to get up to speed on the disease he was born with, to not just care for him now but to live with this disease for the rest of his life. We hope he is one who only has one disc episode his entire life! So do start your reading journey here so you are a well informed owner who can talk and discuss everything with the vet: www.dodgerslist.com/healingindex.htm

In order to help you and Oscar can you let us know what medications he was sent home with, the dosages and frequencies given? Please include the all important stomach protector such as Pepcid AC. Ask your vet in this particular way "Is there any medical reason why Oscar can't take Pepcid AC?"   (Prevacid takes several days to start working and Pepcid AC works in 30 minutes which is important for Oscar while he is on Prednisone.) If there is no reason you can buy it over the counter. We give Doxie's and other small dogs, 5mg 30 minutes before Steroids to protect their stomachs, every 12 hours.

The focus with conservative treatment is 100% STRICT crate rest 24/7 only out at potty times for 8 weeks. No laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no chiro (aka VOM). In other words do everything you can to limit the vertebrae in the back from moving and putting pressure on the bad disc.

The crate is the only surface that is firm, supportive for the spine, not inclining, always horizontal and keeps a dog from darting off at a TV doorbell and safe from other pets and kids from bothering them. Here's how to set up the crate with their comfort and healing in mind. : www.dodgerslist.com/literature/CrateRRP.htm

The purpose of crate rest is to act as a cast of sorts to let the disc heal… only limited movement of STRICT crate rest allows that to happen…there are no meds to heal a disc. Immediate neuro improvement may or may not come during the 8 weeks of crate rest… as nerves may take more than 8 weeks to heal.

-- Can Oscar move the legs at all or wag the tail due when you do some happy talk?

-- Can he sniff and squat and then release urine or do you find wet bedding or leaks on you when lifted up? Helpful videos with tips on expressing both urine and poop: www.dodgerslist.com/literature/Expressing.htm

It's not a good idea to for an IVDD dog to have Chiropractic and the info below is from a Neurologist that advises us here on Dodgerslist. Chiropractic as well was VOM can cause further injury that your Oscar does not need.   Laser light therapy and Acupuncture are very effective therapies for IVDD and encourage the nerves to regenerate! Hope the info below helps!

From Dr. Andrew Isaacs, DVM Diplomate ACVIM (Neurology)

"Extreme caution needs to be exercised in considering chiropractic therapy for a dog.

In general, chiropractic therapy is contraindicated for a chondrodystrophic dog (Dachshund, Beagle, Basset Hound, Shih Tzu, Pekingese, Lhasa Apso, etc.) with clinical signs suggestive of degenerative intervertebral disk disease (IVDD).

There is a big difference between a chondrodystrophic dog and a human with a "bad disk". Poor understanding of the pathophysiology can lead to treatments appropriate for a human being applied to dogs with catastrophic results. Unfortunately, I have seen cases where chiropractic therapy has caused loss of deep pain sensation."

I know how scared and worried you are, my Tyler also has IVDD. I was in an emotional whirlwind when he was diagnosed.  I calmed down as I learned how to take care of him and I can tell you there is a light at the end of the tunnel and all of us here on Dodgerslist  will be there for you!

Hi Lori,

I was scared too when Tyler woke up on January 28th unable to move his hind legs.. I understand how scary and upsetting this is to put it mildly..
  
You should use a sling to steady her hind end - use either a long scarf or a towel. Take her to a spot where she has peed before, left her sniff and see if she can release urine on her own. If she can, then she has bladder control. If not, please contact your vet for an immediate demonstration of how to express. It's important to empty her bladder to prevent urinary tract infections and to prevent the bladder from overflowing, which can stretch the bladder out of shape. If she has bladder control, that may be why you've been unable to express her bladder and you should let her urinate on her own.    www.dodgerslist.com/literature/Expressing.htm

It is important to contact the Vet and insist on an adjustment of pain meds if Oscar is still in pain. He needs to be pain free from dose to dose for the sake of his healing.  Pain is detrimental to healing.  How often is the Tramadol given?  If it isn't every 8 hours it wouldn't be very effective.  www.dodgerslist.com/literature/healingpain.htm  We will be looking forward to hearing the dosages and frequencies of his medication so we can better advise you..

Call the after hours number at your Vet's clinic and speak the the answering service and have them get ahold of your Vet and ask for a pain medication adjustment.  If she is unable to help Oscar then contact the emergency Vet in your area.. Disc herniation is extremely painful and Oscar needs help now.  How to find a Vet experienced in IVDD:  www.dodgerslist.com/literature/VetchkList.htm

Regarding your Vet's comment on Pepcid AC: We haven't heard of any research being done that proves an antacid is not needed and everyday we see vets and specialists recommending Pepcid AC. We follow the vets who ARE proactive. Currently a big study involving several hospitals and NCU is underway. North Carolina U. recognizes the high incidence of GI irritation in dogs with disc problems. The reasons are that pain and change in routines are stresses. Just as humans can experience ulcers when under stress, dogs can also. NCU and 11+ hospitals working with NCU prescribe a GI protectant. Dogs presented to NCU with IVDD often develop GI upset whether they are given steroid medications or not.
www.cvm.ncsu.edu/vhc/tc/clinical_services/neuro/acute_disc.html

REGAINING NEUROLOGICAL FUNCTION has no time limit for nerves to heal. Nerve repair is individual as each injury is different and each dog’s ability to heal is different. If deep pain perception (DPP) is present, even in paralyzed legs, there is a chance your dog may be able to walk again. For those dogs who have lost DPP, do know nerve regeneration can take place and that function may return. Once deep pain perception is regained, your dog has a chance at a walking recovery. Thousands of dogs on Dodgerslist have regained functions in as little as 2 weeks, others 11 months, and still others 3 years later. IVDD is a disease of patience to allow the body to heal on its own terms. Acupuncture and Laser Therapy stimulate the cell’s metabolism that leads to the body’s natural repair abilities and can be started at any time.  www.dodgerslist.com/literature/healingacupuncture.htm

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 scuffing floor
4. Paws knuckle
5. Legs do not work (paralysis, dog is down)
6. Bladder control is lost
7. Tail wagging with joy is lost
8. Deep pain sensation, the last neuro function, a critical indicator for successful surgery.

After a dog is paralyzed, the existence of deep pain sensation is an indicator that surgery could STILL be successful. That window of time is 12-24 hours from losing deep pain sensation (DPS). Even after that window of time, surgery is often successful. The spinal cord is very fragile, the more hours after the window, the less chance of a complete recovery.

Unfortunately, general vets do not see enough cases of IVDD daily, to become really proficient in giving the neuro exam and correctly interpreting what they see. Therefore precious time can be lost in wrongly identifying deep pain sensation. Only take the word of a board certified neuro (ACVIM) or ortho (ACVS) about DPS.

Hang in there, Conservative treatment can still work and many Dodgerslist dogs and their people can't afford surgery and many do regain functions and walk again.. Others are perfectly happy on wheels.

"Dogs don’t know pity. They don’t know “can’t.” They don’t understand “may never.” They don’t give up. They don’t get discouraged. They epitomize “where there is a WILL, there is a WAY.” They will find a way! They don’t give up easily or quickly. They move forward in life in the best way they can. They don’t care if they can walk again. They care about your love most importantly. OK, food ranks right up near the top too! To them each new day brings the promise of another opportunity to get MORE - more food, more treats, and more love. "

Our challenge is clear: not to allow our perspective on quality of life to influence our decisions or cloud how we judge our dog’s quality of life living with IVDD.

I just wanted to inform you of the window of time for surgical intervention just in case.. We did opt for surgery for Tyler since we lived in an area where the costs are lower than some.. You can read his story in my signature line..

Sending hugs your way

If Oscar is still showings signs of pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy - please speak to your vet about adding Gabapentin to the pain med mix. Gabapentin works synergistically with Tramadol. Have no patience with pain - pain hinders healing. There should be no signs of pain from one dose of pain med to the next dose.

Also be sure to let the vet know that you are seeing a worsening of neuro functions.

Please let us know today how the sniff and pee test goes and whether Oscar has bladder control. And also let us know if you're seeing any signs of pain and if so, what the vet says about adding Gabapentin.

I do understand the fear and stress that you're experiencing right now. My Jeremy has had two disc episodes and with the first one, his hind legs were completely paralyzed and he had no deep pain sensation. It's very frightening. But dogs can recover from this, even without surgery. It's the hope with conservative care that the spine with reabsorb the injured disc with meds and limited movement. Until the swelling is down and the injured disc is reabsorbed, there is still pressure on the spine and the risk of nerve damage. However, that nerve damage can reverse once the disc material is reabsorbed. The fact that you are seeing him worsen doesn't mean that he won't improve.

Prayers for healing for Oscar and peace of mind for you.

Thanks for the good wishes. He isn't worse today. Talked to the doc and changing his meds. Saturday we'll start acupuncture.

I take that back, he's having a hard time turning around in his crate and he's grumpy enough it's hard to help him without risking getting bit. He is dragging his back end now.

Good job on getting the meds changed and starting acupuncture, Lori. Acupuncture can be very helpful, not only to rejuvenate nerves, but to help pain and relieve inflammation so kudos to you for getting that on board. Please let us know what the new meds are, exact dosage in mgs and frequency so we can have the important information.

Grumpy is grumpy but if he's grumpy enough to bite you, that sounds more like pain. Once you start the new meds, please be on the sharp lookout for any signs of pain as there shouldn't be any, not from one dose to the next. The first goal is getting pain completely under control, and then Oscar can rest his back in peace and comfort and heal.

Please let us know how he does today on the new meds.

Lori, no surgeon heals nerves via surgery, no DVM heals nerves with medications. The way nerves heal is because the dog's body self heals….the nerve regenerate themselves…so sorry no one can take credit for treating and voila the dog walks.  Oscar has had lady luck on his side today, if you are not seeing any worsening signs… pain, neuro functions.

Chiro who really knew this disease would never take on a dog who has IVDD much less one that is in the middle of a disc episode. A dog who has IVDD has the potential for any one of the disc to be prematurely aging. The only way to tell is with an MRI. Did this chiro take a $1000 MRI to know exactly where and what was going on in the spinal cord and the disc?

We have seen way too many tragedies with chiro. So we follow the neuros who know that protecting the spinal cord takes precidence over any therapies that put the disc and the spinal cord at risk. Oscar has only you to advocate for him and protect him and say "no thank you" to those who offer dangerous treatments. Dr. Isaacs a boarded neurosurgeon confirms why chiro is not a good idea with a dog known or suspected to have disc disease much less one in the middle of trying to heal a damaged disc: www.dodgerslist.com/literature/chiro.htm

It will be important for the health of the bladder (to avoid bladder infection and to avoid ruining the tone of the bladder) to get a lesson on expressing first thing in the AM.  

Can he wag his tail if you do some  happy talk to him or if he sees a treat coming?

Glad you got the ex-pen, I found that worked the best for my dogs too in caring for their needs and easier on my back.

Not a moderator, just a mom Keeping them happy when they are confined...good question. Mimi had a rough time for a while so she really wasn't interested in much. However, since she has been feeling better, she still doesn't have a huge interest in her toys, but wants to feel included in the family and desperately wants affection all the time.

I have taken to sitting next to her ex-pen on the floor. This way I can open it a bit so I can reach my hand in to pet her. She doesn't try to escape this, but is happy that she is "with" us.

I have also given her a Kong once in a while. I put in some organic peanut butter (not a lot, maybe a teaspoon) and slather it inside the Kong. Then I freeze it. I give it to her then and she will spend a good 15 minutes getting the pb out. Others have suggested putting some of their kibble with some broth in there and freezing it.

Mostly though, I have found she has just taken to really resting in her crate. As long as she feels included, she is content.

Hope Oscar is having a good day.

Lori, I'm glad you are on it to get a lesson on expressing.  It really does not sound like Oscar has bladder control.  Dog's abhor being near waste and that is why he moves away as he may be able to feel pressure and know urine is gonna come out  or that poop is about to exit uncontrollably.  Bladder control means he would have  the ability for his brain to send a message to the bladder to not release urine until the right place has been found. Often that is by sniffing and the deeming the right place to pee. So have you seen him sniff and then release? Overflowing is what Oscar is doing.  When the bladder is filled to the stretching point, reflexes allow urine to be released anywhere anytime… the dog is not in control reflexes are.  Poop will will also come out anywhere anytime via reflexes when there is no bowel control. Expressing the bladder is a serious health issue to keep bladder infection (UTI) away and to protect the tone of the bladder.   UTIs can happen in days when the bladder is not being properly expressed.  I would highly recommend a urinalysis as Oscar may already have a high level of bacterial breeding in his bladder.  The results of the urinalysis will prove if an anti-biotic is needed.

Can he wag his tail if you do some happy talk or if he sees a treat coming?

Regarding keeping him happy, do know most dogs need some 16-18 hours of sleep per day, people sleep 8-9 hours day. What are they doing in the crate? Laying around and sleeping! Don't give into the temptation to start a treat routine to combat non-existent boredom. Adding as entertainment contributes to weight gain which isn't a good thing. Do watch toys that might encourage too much neck/back movement…each dog is different so you'll have to see how your Oscar does. Also what you CAN do is soak his kibble in broth and freeze each of his normal kibble portion into a Kong so he has a job... working for his food

Just as a note…. not interested in toys could mean he is still a bit painful..reluctant to move that bone chewing takes.  Let us know what you think… is this also accompanied by any sign of pain nearing the next dose of pain meds (tramadol/mehthocarbamol)  If you do see any reluctance to move, shivers, yelps, tight tense tummy muscles then speak with your vet about adding in gabapentin to the mix above to provide full pain managment

We now have a new issue. Oscar has had dominance aggression issues for some time but this is different. When he wants to move one way and I interfere, he bites and holds on! Yesterday I was reaching to help him out of the crate. Today I was going to reach (again under his chest) to stop him from "walking" when we were out going potty.

He bit Blake Friday when he was going to pick him up off his daughter's lap. That time Oscar was starting to slide off her lap and we chalked it up to him being uncomfortable.

No warning. No growling, just bite and hold.

Like most dogs, a minute later he's fine and there's no indication of how dangerous he can be.

Ideas?

I'm afraid to leave her to care for him and yet that's our only alternative most weekdays.
She won't know what to do if he bites and without a warning growl, I don't even know what to say to her to prevent her from getting hurt.

Thanks, Lori

He has been on strict crate rest and that's why I was trying to stop the attempt to walk (I was supporting his hips)! As to the lap, it was the fiancee trying to get the dog off his daughter's lap as that was how he had taken the dog to the vet. We do not have a vehicle that will handle a crate. The dog alone on the car seat isn't secure. When I take him to the vet, I have a suitcase rigged between the seat and the dash, and a little nest made of a quilt so he can't go anywhere or fall off the seat. But Blake didn't know that. All he knew was he had to keep the dog secure.

You are mighty quick to judgement without understanding that he saw no other safe way to transport the dog. I asked the vet about that yesterday and he suggested a laundry basket and also a wedge to ensure it doesn't slide off. So that is what he'll be doing this week. I'm thrilled that he can take the dog to the vet when I can't get time off of work. So your harshness is unjustified.

As to my choice to use a chiropractor, I'm seeing two different vets, both experienced with IVDD. Technically 4 vets since the chiropractor is also a veterinarian AND I've seen a third vet in that office and he's one of the most respected veterinarians in Austin. The vet doing the acupuncture does not work with or for the other three so he has no economic interest in promoting their work except that he respects their track record. All support the use of chiropractic and what I can say is that he immediately got back his bladder control and there's a marked improvement in his leg strength. Given the steady deterioration he experienced early in the week, I'm duly impressed.

I can also speak to personal experience. Two and a half years ago, my own back (I have degenerative disc disease) had gotten so bad I couldn't reliably walk. The back surgeon said it was time. I tried one more chiropractor, one that practiced a unique version. Guess what, he gave me my life back. Back surgery for humans has a 53% success rate and two months out of work. Turns out that wasn't my only option. So I am a believer in chiropractic services provided the doctor is well versed and knowledgeable and not just out to make a buck.

Just as some people choose to give their human babies every shot, and many of us are far more selective having done research and made an informed choice not to, I have made a very informed choice to try chiropractic for my dog. I took your warnings seriously, did additional research and decided to trust the practitioners I trust to care for my pets.

There is no sign he is in pain and his meds are still as they are though the taper down on the prednisone begins tomorrow. I was told that taper off is important. In fact, very important as:
a. it loses its value over time, and
b . far more importantly, it will shut down the adrenal glands if used too long.

So he's going to taper down over the next two weeks. The rest of the meds will stay as is for now.

I asked about a behavioral issue. He attacked when not even touched and without warning. He has had aggression issues in the past but there was always warning. Not so this time!

If this is a support forum, perhaps you should be supportive and not judgmental.

You expect me to take your layman's word over that 4 different, experienced and credentialed veterinarians.

I tried the pee pads just outside the crate. That would be so much easier for me too. He isn't buying it.

Update on Oscar,

The combination of Chiropractic and Acupuncture has been wonderful. I see immediate changes after each treatment. His mood has improved as well. We got our first tail wag on Wednesday. Yesterday, after his chiro visit, he actually stood up from a sit and walked. All the vets who have been working with him are amazed at how fast it is all coming back.

His Prednesone was tapered down on Monday to 10mg per day. Robaxin is being spread out to twice a day. I switched his Tramadol to a double dose twice a day (on advice of the vet) and that seemed to better manage his pain. Next week, I'll start tapering that down to see how he does. There will be no vet visits until Thursday. In addition to being tapped out, I lost my job yesterday so treatment may be scaled back to bare minimums needed to get him fully healed.

Biggest issue these days is that even though we have a crate for him in the family room and an expen in the bedroom, he get's pretty antsy alone which is how it's been much of the day. He dug his way out of the expen yesterday (maneuvered to lift it up and his body underneath. That worries me as I'm sure that isn't good for him.

Now I'll be home more but can't just stay in whatever room he's in as there's much to do. At least I can hear him if he's trying to do that again. He has not shown much interest in toys the last few months. I think that's left over behavior because my other doxie, who is now living with my daughter was a total toy thief and really kept them away from Oscar and Floppy.

The only thing that will keep him occupied are bones and chews and I don't want him to have either all the time.

Ideas for keeping him chill while on crate rest?

Thanks. The vet suggested doubling the Tramadol because he also attributed his biting as a sign of pain. The Prednisone started at 5mg twice a day but after a couple of days it was clear to me it wasn't enough so the vet doubled that to 10 mg twice a day with a taper to once a day starting day 8. The Tramadol was doubled at day 6.

The vet said to taper the Prednisone because it begins to lose effectiveness so there's not much to gain by keeping the dose high. That came from two different vets. I taped him to 10 mg once a day last Monday but left the Tramadol high. Oscar is clearly not in pain.

Little bugger escaped his crate yesterday while we were at the grocery store. He then proceeded to the bedroom where he ravished a garbage can and pooped on the carpet. Then he went out to the living room, tinkled and was soon caught by my step-daughter who was coming home. That much movement doesn't indicate he's in pain to me.

Now the crate is carabinered shut and he's only in the pen with supervision and at night while sleeping (next to my bed so I could hear him if he tried to escape).

I will begin tapering down the Tramadol tomorrow to test for pain. Primary vet visit is scheduled for Thursday.

I think we're well over the hump. The challenge will be to keep him calmly crated for the upcoming weeks so he can fully heal.

Thanks. Me too. I think I'm going to start by going back to 50 mg 3x a day and take it from there based on how he seems to feel.

The vet insisted the Pepcid was of no value and he seems to be doing well. I do give him a teaspoon of pumpkin a day and he's been predictably regular (though I suppose he was an hour early when he pooped on my carpet yesterday)

Tomorrow I'm supposed to go to every other day on the Prednisone but I think I'd rather try a half tablet a day first, rather than skipping a day. Especially if he needs it as an anti-inflammatory.

Do you think that's a better idea?

Since I'm all spent out, there isn't any acupuncture scheduled for this week. Plus I lost my job Friday so waiting a week to see how he does without it makes economic sense too. If the vet thinks the chiro and acupuncture should run a bit longer, I'll do it as I can't see coming this far and not taking him all the way to well.

Thanks, Lori