|
|
Post by brodysrents on Dec 21, 2013 13:52:38 GMT -7
Please Help! Our dog Brody is a Multi-Poo (Has some features of a Shih Tzu also) and is only 3 years old. He is about 9-10lbs. Brody has always been very active and is such a big part of our family. We have 4 children that all adore him as well. My husband and I were out of town this past weekend and the kids called and said he wasn't his normal self. Since my grandma was staying with the kids and her dog was at our house as well we thought he was just a little depressed and missed us. In the middle of the night on Monday Dec 16th he was in great pain. Our kids took him to the local vey first thing Tuesday am and did xrays and found out it was a herniated disc. He stayed at the vet until Thursday morning then we picked him up.
We are heart broken! He sill has no use of his back legs at all. We have been doing laser treatment and have also been doing water treatments at home. He also does not have any control over his bowels and has had diarrhea and it is also bloody. The vet said that is because of an enema he gave him because it looked like a lot of stool in his xrays as well. Since he is having lots of accidents he has had baths several times a day. We are using diapers, but since it is runny it is just not working as well as we hoped.
After reading some of the blogs and your comments it seems that we have been told to do to much too early with him..... Very upsetting. My husband was in the process of building a wheel chair because the vet said it was ok do to that....
This is the list of medications he is currently taking. 1.Prednizone 5mg (1 times a day) 2. Metro 250 mg 1/2 tablet (2 times a day) I think this is for the bleeding in his tummy- I believe it is like Pepcid? 3. Amoxicillin 1 CC's (2 times a day) 4. Just started this today bc of his tummy- 1/2 tsp Kaolin Pectin (twice a day)
We asked the vet about switching to Rimadyl.... thoughts? He gave us a prescription for Vetprofen25 mg 1/2 tablet 2 times a day. He said we could start tomorrow or Monday since he took prednisone. Sounds like we should wait 4-7 days before switching though? Should we switch? What about all the other medications?
We have also made an appt about 2 hours from here for an acupuncture animal place in Tulsa, but our appt isn't for a couple of weeks due to the holidays.
Please help us! Thank you so much! Leon, Charlene, Dakota, Morgan, Jaylee, Callie and Brody!!
Feel free to call us anytime.... 555-555-9399 or 555-555-1954
|
|
PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
|
Post by PaulaM on Dec 21, 2013 15:07:03 GMT -7
Welcome to Dodgerslist. My name is Paula what is yours, Leon or Charlene or ? Can you give us the exact name of the Metro med. You have a very dangerous situation that needs immediate attention. Get two stomach protectors on board. 1. Pepcid AC (famotidine) you get it at the grocery store. Do ask your vet in this very particular way if there is any reason he may not take Pepcid AC 5mg of Pepcid AC now and thereafter every 12 hours. 2. Sucralfate this is a Rx item. It has a timing to it, you will need to read how to use it in relation to food and Pepcid AC. I would NOT, I repeat NOT give Prednisone, do not start it. The GI tract is now in a dangerous situatiion switching these two classes of anti-inflammatories could lead to death at this point in time. Do NOT give any more baths. Snip his fur with scissors where and if needed. Wipe him up with a damp washcloth or baby wipes. A pot of cooled green tea is good to balance the urine and give a clean fragrance. This is a public forum where all members can benefit from learning and have an opportunity to share information. When phone calls are made we loose the history of the dog, members are out of the loop. So I hope you can stay with us here on the Forum. For your protection I removed your phone numbers from public view. I am quite worried, so please let me know asap that you have the two protectors on board asap. Then we can deal with the rest of getting things right for Brody. YOu may wish to set up an email alert so you know when someone has responded to Brody's thread  |
|
|
|
Post by brodysrents on Dec 21, 2013 15:34:10 GMT -7
Thank you so much for your reply. My name is Charlene and my husbands name is Leon. Ok I am freaking out even more now.... We thought we were doing the right thing  I am not for sure the name on the Metro medication it just says take 1/2 tablet of Metro 250mg # 5. I looked up and I think it might be Metronidazole.... We can go buy some Pepcid AC and will try to get a hold of the vet to see about getting the Sucralfate. We can only get that from the vet correct? He has been on Prednisone we were just thinking of switching to vetprofen 25mg (Is this the same as Rimadyl?) So should we stick with the prednisone or stop it? Ok on the baths. We will just use baby wipes. |
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
|
Post by PaulaM on Dec 21, 2013 15:49:51 GMT -7
If this is indeed Metronidazole www.marvistavet.com/html/metronidazole.html is an antibiotic. It does NOTHING to protect the GI tract. Brody has blood in his stools because of the Prednisone not the enema!!! OK DO NOT switch to Prednisone. Do NOT switch classes of anti-inflammatories, this is double GI tract jeopardy with out 4-7 days washout….. Brody is already showing he is in serious trouble now. Can you get with ER now… for the Sucralfate is only available via prescription at the vet's clinic, pharmacies also carry it.. The pepcid AC you may have in you house already. The ONLY active ingredient should be famotidine. 5mg Pepcid AC now and then every 12 hours. You will need to keep your vet in the loop as soon as you can again contact him. Do your reading on Pepcid AC as is necessary to do for all meds Brody takes, vetprofen, rimadyl, etc. www.marvistavet.com/html/pharmacy_center.htmlFirst priority is to get his stomach protected now. Prednisone is one drug you may not simply stop. If Brody needs to go off of it, it needs to be tapered under the direction of a vet.
|
|
|
|
Post by brodysrents on Dec 21, 2013 15:59:47 GMT -7
Just got off the phone with the vet. Actually talked to a different one than before at the same clinic. He is going to meet me at the clinic in about 30 mins to give us some Sucralfate. I will go pick up Pepcid AC also.
Should we take him off Prednisone? Not switch just take him off completely?
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
|
Post by PaulaM on Dec 21, 2013 16:04:55 GMT -7
with two protectors on baord, Brody maybe able to continue with predinisone. Let's see how the protectors do in getting runny and bloody stools resolved quickly. Do of course discuss and get a 2nd opinion from this vet. Feel him out if his is more IVDD knowledgable than the other vet. Sounds like you need a new vet more comfortable in treating a disc episode.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
|
Post by PaulaM on Dec 21, 2013 16:34:52 GMT -7
This is how is it determined how long an anti-inflammatory is needed. Often it takes being at the anti-inflammatory dose of prednisone (5mg 2x/day) ranging from 7 - 30 days before all the painful swelling is gone. When the vet guesses swelling might be gone there will be a call for a taper. The dose is lowered to less than the anti-flammatory dose your job at home would be to assess just how well reduction of swelling is going by observing for any hint of pain. To have a clear picture on a taper, pain meds are also stopped or backed off too. Rule of thumb is: pain = swelling = more time on Pred, pain meds and Pepcid AC is needed. If there is no pain on the taper then it goes to completion. Then no meds at all are needed. Disc healing will continue for the remainder of the 8 weeks. Nerves can continue to self heal…think in terms of months. With a bit more information, we'll be better able to support you and Brody: -- Has there been a recent taper (lowered dose) of Prednisone or did Brody come home on Pred 5mg 1x/day? -- Brody is not on any pain meds. Do you see any shivering, trembling, yelping, slow or reluctant to move or change positions. Is he his normal perky self? -- What meds and treatment was he given while at the vet for several days? Tell us more about his neuro functions: -- can he wag his tail if he sees you coming or hears a treat coming, in other words he is happy. -- Can he move his legs at all such as when he repositions himself in the recovery suite. -- What type of recovery suite do you use: wire crate, ex-pen, packNplay? Does he stay there 24/7 only out for potty times. -- Does he have bladder control? That means you set him on an old pee spot and he sniff and then chooses to release urine there. If instead you are finding urine leaks in bedding and he leaks on you when lifted, you will need a hands on top of your hands type of lesson to manally express the bladder. You can get more out of the lesson by first reviewing: www.dodgerslist.com/literature/Expressing.htm And this one for how to express for poop: www.dodgerslist.com/literature/Expressing.htm#poop-- Is surgery an option for your family? It is always good to know all of your options…this is a very good article for that: www.dodgerslist.com/literature/healingsurgery.htmI'm sorry you are discovering your vet may not know this particular disease. The good news is you can know just one disease. In fact this is what we owners need to do be a mini-expert on IVDD. This lets us assess and hire the right vet. It lets us be a participant in all decisions, allowing us to ask pertinent questions and importantly recognize red flag advise that could hurt our IVDD dogs. I hope between you and your husband, you can get a good head start on IVDD 101 during this episode and be prepared in living with an IVDD dog for the rest of his life: www.dodgerslist.com/literature.htmPlease do keep us updated on how the stomach protectors are working and what the new vet said this evening. -- |
|
|
|
Post by brodysrents on Dec 21, 2013 23:58:14 GMT -7
He has been on prednisone since Tuesday, we are starting to taper that off this week. Below are the vets recommendations. This vet seemed much more familiar with IVDD as the other vet seemed really "old school".
Medications and directions currently.
[9-10 lbs]
1. Sucralfate 1/2 tablet twice a day. He suggested to dissolve in water and give through a syringe. He also said once he takes it not to give him anything else for 30 mins. I guess this gives it time to coat the tummy..?
2. Pepcid AC 1/4 tablet 1 time per day
3. Prednizone - He wants us to taper off this is his instructions Tomorrow- None Monday - Full tablet Tuesday - None, but he wants us to start on the Rimadyl 25 mg 1/2 tablet twice a day. We asked about mixing the two and he said since one is a steroid and the other is not it is fine to mix while we are tapering off the Pred. He said if it were two steroids we would have to wait the 7 days flush period. Wednesday- 1/2 tab of Pred and Rimadyl 25 mg 1/2 tablet twice a day Thursday No Pred just Rimadyl 25 mg 1/2 tablet twice a day Friday 1/2 tablet of Pred (last dose) and Rimadyl 25 mg 1/2 tablet twice a day Going forward Rimadyl 25 mg 1/2 tablet twice a day only.
3. Amoxicillin 1 CC's (2 times a day)
4.1/2 tsp Kaolin Pectin (twice a day)
5. Metro 250 mg 1/2 tablet (2 times a day)
He normally just lies in his crate which is a medium size travel crate that he can turn around in if he needs to. There is no shivering or anything unless we have given him a wash down which we will no longer do.
He has not been his normal self.
He did for the first time today get excited when he saw a dog at the vet, which he hadn't done up to this point with the injury. He can move his tail like normal, but he has not wagged it like he used to. It's like he is depressed.
He has been able to use his back to pull around his hind end when he needs to move in his kennel, but sometimes he will sit up on his bottom and it looks like it could be hurting him but he does not ever appear to be in any pain. Is this OK for him to sit like that?
Bladder Control
He has just been using the bathroom, potty & pee in his diaper, he has no control over this, but today he has started jump up from lying down, and then you will hear him go to the bathroom. It's like he has become aware he needs to go, but has no control, so we plan on buying some pee pads and start standing him on them so retrain him. Do you think this is OK?
Surgery is/was not an option & we were told this evening that it has been too long to consider anyway.
While at the vet they gave him Amoxicillin 21 times @ 250mg, 8 Laser treatments, Prednisone 21 times @ 5mg. That was for Tuesday - Thursday.
We plan on no more water therapy or walking therapy for weeks now.
This evening the vet did say that we could have him stand & try to balance several times a day, is this OK? If so then this is when we would try to re-potty-train. The vet also said to do stretching movements with his legs to keep them lose. Good idea?
We just met with a different vet a few hours ago and this is what he has us doing....
He also showed us the x-rays and there was no apparent injury or deterioration that was seen in the x-ray.
Thank you again for all your help! This is so helpful as we had no idea IVDD existed just a few days ago. We really appreciate all the support!!!
|
|
Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
|
Post by Marjorie on Dec 22, 2013 7:13:28 GMT -7
Dear Charlene, you need to find a new vet, one that is more knowledgeable treating IVDD, ASAP. These vets are giving you incorrect information. Please do not start the Rimadyl. Continue Brody on the Prednisone until you are able to get him evaluated by another vet. FDA andmanufacturer package inserts warn against use of a NSAID with a steroid or with another NSAID without a washout period of 4 to 7 days before starting the new medication. Vets that practice safe medicine require a 4- to 7-day washout period between the medications. Not only is the vet not using a wash-out period but he's prescribing both meds to be taken together. And this with a dog that is already showing signs of GI tract distress. This is terribly dangerous. Brody's stomach could perforate and he could have internal bleeding. Dogs can die from this. It's even iffy whether he should stay on the Prednisone since he has diarrhea. We're hoping that the Pepcid AC and Sucralfate will get that under control quickly so he can continue with the Prednisone, since it's important to keep the swelling in his back down. But to switch to Rimadyl is really very dangerous and to give them together is compounding the danger. Please read our page on IVDD meds: www.dodgerslist.com/literature/drugs.htm#intestinaldrugsBoard-certified neuros (ACVIM) and ortho (ACVS) surgical specialists can be found at University vet teaching hospitals. You can locate others in your area here: www.acvim.org [neuros] online.acvs.org/acvsssa/rflssareferral.query_page?P_VENDOR_TY=VETS [orthos] Dodgerlist Members' vet recommendations dodgerslist.boards.net/board/10/guidelines-postingNot being his normal, perky self indicates that he could have pain. Disc episodes are usually very painful. Dogs can be very good at hiding pain. You need a vet who will treat him correctly and assess his pain. As for his bladder control, have you tried a sniff and pee test? Take him to a spot where he's peed before, let him sniff and see if he can release urine on his own. Just support his hips while doing this and don't press on his belly so you can be sure if he's going on his own. If he cannot release urine on his own, you need a hands on your hands demonstration from a vet as to how to express his urine. If you do not express his urine, his bladder is being allowed to overflow, which can stretch out his bladder. Sometimes it's difficult for them to regain urine control once the bladder is stretched out of shape. Also, any urine lying in the bladder can lead to urinary tract infections. He should be expressed every 2-3 hours while on Predisone since that causes increased thirst and urination. Here are some tips on expressing: here: www.dodgerslist.com/literature/Expressing.htmYes, you can stand him on a pee pad if he will go on one. Or if he can't release urine, you can express him on a pee pad. Or you can carry him in and out to take him outside to do his business. Only allow him a few few steps to do his potty. It's OK for him to sit up in the crate. Please do not do any therapy, such as standing him to see if he can balance or stretching movements, at this time. He may still have swelling around the spine and needs to be kept as still as possible. The very, very lightest least aggressive range of motion and leg massage is necessary for paralyzed legs during conservative treatment once off all meds and there is no pain. The information highlighted in PINK pertains to a dog who can't walk but only after all meds are stopped and there is no pain. www.dodgerslist.com/literature/massagepassiveexercises.htmPlease let us know if you need any help in finding a more knowledgeable vet. If you let us know where you're located, we might be able to help you. |
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
|
Post by PaulaM on Dec 22, 2013 11:17:41 GMT -7
Your vet needs to be informed and corrected so he does not harm other animals in his practice.1. It is also unacceptable to concurrently administer steroidal and nonsteroidal anti-inflammtory drugs (NSAIDs) to disc disease patients, as this combination increases the chances of severe gastrointestinal complications. Curtis W. Dewey, DVM, ACVIM Neurology Cornell University.A Practical Guide to Canine and Feline Neurology 2nd ed Blackwell Publshing 2008 Chapt 10 "Myelopathies: disorders of the Spinal Cord"; By Curtis W. Dewey p331-332. 2. All NSAID package inserts carry this similar FDA required warning:
Rimadyl package insert sheet: "Concomitant use of Rimadyl with other anti-inflammatory drugs, such as other NSAIDs or corticosteroids, should be avoided because of the potential increase of adverse reactions, including gastrointestinal ulcerations and/or perforations." www.rimadyl.com/content/RIM016007.pdf
3.
"Corticosteroids and NSAID should not be administered concurrently" Merck Veterinary Manual Online. www.merckvetmanual.com4.
The FDA on NSAIDs a must read by IVDD dog owners:www.fda.gov/AnimalVeterinary/ResourcesforYou/AnimalHealthLiteracy/ucm196295.htm
|
|
|
|
Post by brodysrents on Dec 22, 2013 12:05:59 GMT -7
Gosh there is so much to learn and is really overwhelming.
We are located in Pea Ridge, AR. We can make an appt with another vet tomorrow.
How long are IVDD dogs usually on Prednizone? If we did the wash out period would you advise to switching him to Rimadyl or continue with Prednizone?
His diarrhea seems to be getting better and did not have any blood in his stool this morning.
We will go get some pee pads and hopefully that will work. He is going pee on his own because he has diapers on an we have cleaned up a lot of pee.
He really does not seem to be in pain, but if they are good at hiding it we might not know for sure. How can you tell if he is in pain? I hate to give him pain medication if he doesn't need it...
Thank you!!!
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Dec 22, 2013 12:38:40 GMT -7
Yes, it all can be a bit overwhelming at the beginning but eventually it will all start to make more sense as you become more familiar with the disease. I did a search for an ACVIM accredited neurologist in your area and surprisingly, only one came up for the whole state. I think he's about 3 hours away from you, though, so it may not be feasible. Larry Nafe Hillcrest Animal Hospital 2900 Kavanagh Blvd. Little Rock, AR 501-663-1284 I've labeled your thread with an alert that you're looking for a vet recommendation. Hopefully, one of our members may be able to recommend someone in your area. Here's our page on finding a new vet: www.dodgerslist.com/literature/VetchkList.htmSometimes it takes a week or two to get the swelling down and sometimes it can take a month. Until then, they need an anti-inflammatory to address the swelling. Prednisone is a medication that can't be stopped suddenly. It would have to be tapered off and then the wash-out period and then the switch to Rimadyl. Meanwhile, during the wash-out period, Brody would be without an anti-inflammatory and not have anything to deal with the swelling. I'm very glad to hear that his diarrhea is improving. Hopefully, that will resolve quickly. Signs of pain are shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy, arched back, just not usual, perky self. You had mentioned that he wasn't himself. And I see from your first post that he had been in great pain but I don't see that anything was ever prescribed for his pain. The Prednisone will help with the pain in that it helps reduce the swelling which is causing the pain but it's not a pain med. Pain hinders healing so that's why we always want to be sure there is no pain. A neurologist can usually tell if there's pain upon his neuro exam. I agree that he shouldn't be on pain meds if he doesn't need them. I just don't feel very comfortable that these vets have accurately assessed his pain. Does he sleep curled up and comfortable like always? Does he stiffen when you pick him up? |
|
|
|
Post by brodysrents on Dec 22, 2013 13:30:32 GMT -7
So would you recommend to stay on the Pred? The only reason we were going to switch to Rim is that we heard that others have had good results using the Rim over Pred. Do you recommend we just stay on the Pred? We are good with that.
He does not seem to be in any pain, does not stiffen up unless we are trying to get him to lie down. He just started to bark a little, we open up the top of his crate and he moves over for us to pet him. We feel he is starting to feel better mentally by doing this.
If we feel he is in pain, do you recommend a pain med?
He sleeps like normal, he used to sometimes sleep on his back, but he can't do that now, but over all he seems to seep well.
Thank you all so much. This is overwhelming and a lot to adjust to, knowing there is a community we can reach out to, really helps!!!!!!!!!! Thank you so much!!!
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Dec 22, 2013 17:28:03 GMT -7
Yes, keep him on the Pred until you find a reputable vet who can then eventually help you taper him off of it. Prednisone is a very good anti-inflammatory. Rimadyl is a NSAID and NSAIDs are usually given when there are mild symptoms.
And yes, if you see signs of pain, pain meds should be prescribed by your vet. Tramadol is a general pain med that is usually prescribed. Methocarbamol addresses the pain from muscle spasms so often associated with a disc episode. Gabapentin is something that vets are finding works synergistically with Tramadol and is a good addition with hard to control pain.
I just noticed that you said you were going to go to an acupuncturist in Tulsa, OK. I found an vet there if you can get to him. He's an orthopedic surgery specialist. I couldn't find a neurologist in your area.
Paul WM Dean, DVM, DACVS
Veterinary Surgical Referral Center
7222 E 41st St
Tulsa, OK 74145-4504
Phone: (918) 610-3569
Email: pdean@swbell.net
Please let us know how you make out tomorrow finding a new vet and getting an emergent consult.
|
|
|
|
Post by brodysrents on Dec 23, 2013 22:54:56 GMT -7
Thank you, I think we will just keep him on the Pred.
We haven't found a new vet yet.
He does seem to be improving mentally. He has barked more and sets up in his crate and or barks when the doorbell has rang.
We are trying to work on retraining on going to the potty. He seems to know when he is going, so we are trying to figure out how to accomplish this and if he even knows he is going. We've thought about getting a bigger crate, just enough where he can sleep & rest and enough to have a small potty spot, but not sure if this would be a good idea. What are your thoughts? He has no more diarrhea, but still goes in the diaper.
He did potty for us tonight on a pee pad, that is when I saw some worms, so I will address this with our current vet in the AM since this is where we are still getting laser.
We will give Paul a call tomorrow also & get some insights from them and maybe an appointment when we are in Tulsa! Thanks so much for this information!!
We have more reading to do, so we will be in touch tomorrow!!
Thank you all!!!
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Dec 24, 2013 7:04:04 GMT -7
I'm so glad to hear that the diarrhea stopped, Charlene - that's very good news!
The recovery suite needs to be only large enough for Brody to stand up, turn around and lie down with his legs stretched out comfortably - approximately as wide as the dog's length and 1.5 times the length of the dog's body. If you get a larger crate with room for a pee pad, Brody will have too much room to move around and you want to prevent as much movement in the spine as possible. It's best to lift him out of the crate and carry him to a pee spot, whether it be outside or on a pee pad.
He may have some bladder control or bladder control may be returning so he can sometimes tell when he has to go. If you're putting him on the pee pad often enough - every 3-4 hours while on Prednisone since that causes increased thirst and urination - and you still find wet bedding or wet diaper - then the urine you're seeing is due to overflowing of the bladder and is not bladder control. You would then need to learn how to express his bladder so his bladder does not stretch out of shape and to prevent a UTI. We don't recommend the use of diapers as they tend to cause skin problems since the urine lies against the skin and results in urine scald or burn. If he has bladder control, he just needs to be brought out of the crate to go potty often enough that he doesn't have accidents in the crate. If he doesn't have bladder control, then his bladder needs to be expressed often enough that he doesn't have accidents in his crate.
Please let us know how the telephone call to Dr. Dean goes today. Hopefully, he'll be able to set up a consult for you ASAP so Brody can get the correct treatment that he needs.
|
|
