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Post by Nicole Bailey on Dec 26, 2013 10:28:59 GMT -7
I have a mini dachshund named Oscar who is 5 1/2 years old. Last Wed. we noticed that when we would pick Oscar up, he would cry. A couple days after that he was not being himself. He was laying in the closet, not moving much when he is usually a very active dog. On Saturday we noticed that he was walking very stiff, but our vet was closed until Monday. We took him in Monday and we they did all the nerve tests where they bend his hind legs back and he was not flipping them over. They squeezed his paws, he did react, but he did not turn his head toward the pain. We were then told either we needed to get surgery or try meds. We decided to try meds first. He started crate rest and meds on Monday, Dec. 23rd. We only took him out to use the bathroom and that was the only time he was allowed to walk at all was to do his business. Yesterday morning I took him out and he walked around a tiny bit to do his thing. Yesterday afternoon, I took him out and all of a sudden he couldn't hold himself up on his hind legs. Of course we freaked and we were sent to an emergency clinic in another city. We were going to go ahead and go with the surgery, thinking it would be around $3500. Well, when we started talking to the Vets, they informed us it would be around $6000! That is just something my teachers salary can't manage. We were given a new set of meds. He is now on Diazepam, Bethanechol, and Tramadol. He still is currently not holding himself up on his hind legs, however if you position him right, he can stand and he is still able to urinate on his own. The only thing that worries us is that he has not pooped since yesterday morning.
My questions is, where do we go from here? He hasn't been diagnosed with IVDD, they have never really told us what is wrong with him. I feel like they are assuming. So should we expect that he will loose all feeling in his legs and not be able to hold his urine even though at this point he still is? We are obviously going o continue the meds we were given and continue crate rest. I was just wondering if anyone has experienced what we are going through as far as their pup not actually loosing feeling in their legs yet and still being able to control their bladdar. We are preparing ourselves for him to loose these things, but secretly hoping he will recover. Any suggestions, past experiences, and advice would be greatly appreciated.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
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Post by PaulaM on Dec 26, 2013 13:20:07 GMT -7
Welcome to Dodgerslist. My name is Paula what is yours? Meds used with a disc episode are an anti-infammatory to get painful swelling down over 7-30 days. Other meds are to relieve pain and protect the stomach from acids. Good place to get a feel for the meds used and why: www.dodgerslist.com/literature/healingpage.htmWhat the exact names of the meds given on Monday? Re: the new set of meds, what is the dose in mg's and how often do you give them. What date did you get them. Diazepam ?mg; ?x/day? Bethanechol ?mg; ?x/day? Tramadol ?mg; ?x/day? Is there a reason neither of the two classes of anti-inflammatories are being used --steroid nor non-steroid anti-inflammatory (NSAID)-- ? Tramadol as well as other meds can cause constipation. Also it may hurt to poop. Pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation. The amount of water in the diet makes all the difference. To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day. To firm up the stool add 1 teaspoon pumpkin to kibble and no extra water 1x a day. Note alternatives: really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potoato. First thing to know is that it IS in the cards for Oscar to get back to enjoying life after recovering. What can make a great deal of difference is your own self education. Knowledge is the best defense in fighting and winning with this disease. Reading others posts on the forum can be of comfort. But the meat of what you need to know is on our main web page. A very quick way to get up to speed on meds, how healing happens and when for each of the phases is the "Overview: the essentials" yellow button. Then work your way through the rest of the orange and blue buttons to complete your education. Here's the link www.dodgerslist.com/healingindex.htm The Disc Disease DVD is a wonderful way to help family members understand and even others who might be around or taking care of Oscar: www.dodgerslist.com/store/DVDorder.htm-- Are you seeing any signs of pain: trembling, not his normal perky interetested in all things going on around him? Yelps, slow to move or unwilling to change positions in the crate. -- 100% STRICT crate rest 24/7 is the length of time for the disc to heal. Just so we are on the same page that means only out to potty: 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 purpose of the recovery suite 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. You will want to understand the order of nerves functioning and what it means. Worsening is something the vet needs to know about asap as the anti-inflammatory may need adjusting. 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. Can Oscar move he legs at all? 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 is the last neuro function How to set up email alserts when someone replys on Oscar's thread:
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Post by Nicole Bailey on Dec 26, 2013 15:21:08 GMT -7
Nice to meet you Paula, my name is Nicole.
As far as the meds Oscar was put on, Monday he was originally put on
Methocarbamol- 1/4 tablet every 8 hours and Rimadyl 25mg 3/4 tablet, one in the morning and one at night.
Yesterday he was pput on the following: Diazepam 10mg 1/2 tablet every 8 hours Bethanechol Chloride Tabs 1/2 tablet every 8 hours Tramadol 50mg 1/2 tablet every 8 hours
He started these three meds last night.
He was originally not put on a steroid because we were possibly going to go to surgery, but since that estimate has now doubled, there is no way.
We are not seeing signs of pain. At times he will whine at us, but he has always been a dog with anxiety who gets anxious when we are leaving, thinking we are not going to come back. He has been on crate rest since Monday. We have put in a memory foam pet bed to still provide cushion, but also to provide comfort. For the most part is he is doing a good job and not getting too ansy.
Oscar can still move his legs,however he is not able to hold himself up on his back legs anymore without support. My concern now, is making sure he is going to the bathroom when and as much as he needs too. Shortly after I wrote the first post he did poop. He has been peeing too, but not always. He is still in control of it. He doesn't seem to like us to hold him up to urinate. I was holding him up and he sat down. As soon as I stoop up, he pushed himself to the grass and urinated, but only a little.
I have been doing a lot of reading lately, to get as much information as I can to help us go in the right direction. I appreciate any advice I can get!
Thanks, Nicole
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Dec 26, 2013 19:12:15 GMT -7
Just to be sure we have everything correct, Nicole, Oscar originally was prescribed the Methocarbamol and Rimadyl and then they added the Diazepam, Bethanechol Chloride and Tramadol so he's now taking all five medications, correct?
Pepcid AC should be given to protect your dog from the excess acid produced by the anti-inflammatory. The FDA and manufacturer pkg insert indicate gastrointestinal problems are side effects of using NSAIDs. The natural defenses of the stomach to shield against stomach acid is hindered when taking NSAIDs. Serious gastrointestinal toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms. Please get your vet's permission to give 5 mg of Pepcid AC (generic is famotidine) 30 minutes before the dose of the anti-inflammatory and thereafter every 12 hours. Phrase the question to your vet in this particular way: "Is there any medical reason my dog may not take Pepcid AC?" If your vet says your dog has no health issues such as liver, heart, etc to keep him from taking Pepcid AC, then do get it on board.
That's great that his pain is under control! That's the first goal accomplished.
Good job on making sure he's peeing enough and still has control of his bladder.
Things will get easier, Nicole. There's a lot of information to absorb but once you get a good handle on how to deal with IVDD, it all begins to make sense. We're here for you. Please keep us updated.
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Post by Nicole Bailey on Dec 26, 2013 20:36:36 GMT -7
He is no longer on the Methocarbamol or the Rimadyl. They replaced those with three new meds since he seemed to have gotten worse since starting those two meds. When taking him to urinate a little while ago, he was able to stand without my support, which he hadn't been able to do in the last two days. I did not let him try to walk, it was straight back to the crate. I will ask about the Pepcid when I call the vet tomorrow to schedule his follow up,
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Post by Pauliana on Dec 26, 2013 21:10:49 GMT -7
Hi Nicole, I am Pauliana, Welcome to Dodgerslist!
It's important that he be back on Rimadyl, the NSAID to get the swelling down. Or a Steroid if he has been off the Rimadyl for at least 4-7 days..Steroids are more powerful. NSAIDS are normally used if the dog is still walking.. This is what is happening with Oscar:
They didn't give Rimadyl enough time to work on the swelling which is causing loss of function due to nerve damage. Swelling also causes pain. Dogs tend to be stoic and many of them don't act like they are in pain until it becomes way too much to bear and they especially don't like to show it when they are at the Vet.
Diazapam is for anxiety and muscle spasms, Tramadol is for pain and Bethanechol is to help him urinate and can also help with acid reflux.. Nothing there to help the swelling go down..
Inflammation, swelling in the spinal cord. What to expect during the inflammation/swelling phase of a disc episode:
SWELLING of the spinal cord may take anywhere from 1-2 weeks with post-op swelling to over a month on a NSAID OR a steroid (Never both) to resolve the pain caused by inflammation during conservative treatment. Swelling is best resolved by using the big-gun medications rather than herbs. Glucocorticoid steroids are synthetic versions of the body’s naturally occurring hormone, cortisol. Steroids are basically the most powerful of anti-inflammatories. With IVDD, an anti-inflammatory dose is used rather than a higher immuno-suppressive dose used for other diseases. There are no safe medications. There are two safety factors with drugs. One is a vet who practices safe medicine with a blood test to verify the liver and kidneys are healthy prior to starting the medications. The other is an owner who is educated on what the side effects are and monitors their dog.
With mild symptoms of pain and no neurological deficits, some vets will choose a NSAID. NSAIDs also are potent drugs calling for owners to be self-educated about the side effects and a vet who checks the health of the kidneys and liver before prescribing.
When using either a steroid or NSAID, an acid reducer such as Pepcid AC is necessary. Dodgerslist follows those vets who are proactive in protecting the stomach, choosing not to wait until a bleeding ulcer or life-threatening stomach perforation happens. NOTE: FDA and manufacturer 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.
The tapering off of a steroid is a health necessity that also allows a peek into the status of swelling. If pain returns, your vet needs to know and likely more time on the steroid would be prescribed. No signs of pain means the steroid has done the job. NSAIDs do not require tapering off, but require the same observations of pain returning and contacting the vet promptly to extend use. There really is no way to know how long it can take to resolve swelling.
Conservative treatment works.. Oscar is so lucky he has a Mom that is willing to learn all about IVDD to better care for him.. We are here for you!
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Post by Eileen&Maria Rose on Dec 27, 2013 9:07:34 GMT -7
Hi Nicole, The first time Maria 'went down' her function got worse before she got better. Completely paralyzed from the waist down. She could eliminate on her own which was a big bonus!
Body function at the time of injury IS NOT to the way life will remain from that point forward.
She made a complete 100% recovery. This second episode was minor in comparison, but the crate rest is ROCK SOLID the best thing I could do for optimal recovery.
8 weeks seems like a eternity at first. Then it becomes 'the new normal' for the middle weeks. Then it becomes a 'countdown'. 6 days and counting.....and after those first few crate free snuggles..... it all becomes a little blip in the screen!
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Post by Nicole Bailey on Dec 27, 2013 16:45:28 GMT -7
Thanks for the information so far. I did talk with Oscar's vet today about the emergency vet taking him off of Rimadyl. She told me to go ahead and put him back on it [Rimadyl]. So we will continue crate rest. I'm still just trying to figure out when to get him to the bathroom before he goes in his crate. Sometimes I time it just right and sometimes I don't! He is still able to go on his own. Still not walking, but can stand when he is put into that position to urinate.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Dec 27, 2013 17:03:34 GMT -7
Great job on advocating for Oscar, Nicole, and getting the anti-inflammatory back on board! Excellent news.
Please update his list of current meds for us:
Diazepam 10mg 1/2 tablet every 8 hours Bethanechol Chloride Tabs 1/2 tablet every 8 hours Tramadol 50mg 1/2 tablet every 8 hours Rimadyl ??mg ??frequency Pepcid AC 5 mgs every 12 hours - hopefully that's on board, too, as it's very important to protect Oscar's GI tract from the Rimadyl.
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Post by Nicole Bailey on Dec 29, 2013 10:06:07 GMT -7
His Rimadyl prescription is 25mg, he takes 3/4 tab in morning and 1/2 tab at night.
Does anyone have any suggestions as far as managing water and bathroom breaks at night. During the day Oscar is pretty quiet and has no issues in the kennel, but once it's night time it's a different story. He begins whining every 30 min or so. He obviously doesn't need to go to the bathroom all of those times. He is in our bedroom with us and he is close to my husband. My husband has always babied him, they are buddies. The last couple nights he was out of town for work and Oscar only whined a little when he needed to go outside. My husband was back last night and Oscar was a whining mess. I almost feel like it's attention from him. Any suggestions on how to go about this? I'm off for the next week, I'm trying really hard to get a schedule in place before I go back to work.
Thanks! Nicole
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
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Post by PaulaM on Dec 29, 2013 15:57:36 GMT -7
You might try a calmer to help Oscar relax at night. 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. Of course always keep your vet in the loop on all things you give your dog. Place a DAP pheromone diffuser at floor level where the recovery suite is. Some brands to consider: --Comfort Zone (DAP) wall plug-in diffuser 48ml www.petcomfortzone.com/dogs.html --Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/ Use a diffuser with one oral calmer from below: Oral calmers: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed www.virbacvet.com/products/detail/anxitane-l-theanine-chewable-tablets/behavioral-health 2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. www.vetriscience.com/composure-soft-dogs-MD-LD.php 3) Rescue Remedy is a liquid herb combo to help with relaxation www.bachrescueremedypet.com 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 Be aware you your your husband 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. Is the crate on a bedside sturdy table so Oscar can see you and you or your hubby can touch him through the wires? Other ideas that may help with emergency crate training: www.dodgerslist.com/literature/EmergencyCrate%20Training.htm
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