jexas
New Member
Posts: 5 
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Post by jexas on Jan 2, 2014 19:20:40 GMT -7
Name: Zeke
Weight: 11 pounds
Breed: Maltipoo
Diagnosis: regular vet and surgical vet both think it's IVDD (based on x-ray and symptoms)
Zeke was seen on Christmas eve at the local vet clinic because he was whimpering in pain and trembling with a very tight abdomen and he didn't want to move. On 12/24 the vet prescribed medications, recommended 2 weeks crate rest and gave Zeke a referral to a surgical vet. Zeke was seen 12/30 by the surgical vet who also recommended crate rest but said Zeke should go for 3-4 walks a day for 10 minutes. Surgical vet also said Zeke could sleep on the bed as long as he didn't jump off the bed.
Current pain level - Zeke doesn't seem to be in pain. In fact, when he is let out of the crate for food or potty breaks, he runs around and jumps on us as if nothing is wrong.
History - In July (7/5/13) Zeke had the same symptoms (trembling, whimpering in pain, and tight abdomen) and was seen at the local vet clinic and all I was told was that he was constipated. Zeke was prescribed Rimadyl and Docusate Sodium (stool softener). I was not told about disc issues and Zeke seemed to return to his normal self, except that over the next few months he seems to have aged
Meds are:
11 pounds
Rimadyl Chew 12.5 mg, twice daily
Tramadol HCL 12.5 mg, twice daily
Zeke can walk, wag his tail, run etc.
Zeke doesn't have any incontinence issues.
Zeke is eating and drinking, was constipated at first and took stool softeners until that resolved. His poops are on his regular schedule and normal.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Jan 2, 2014 19:42:03 GMT -7
Jill, we are so happy you have joined us on the Forum. Being as Zeke is on a pain med and one to help get painful swelling down, that would make him feel so good! The problem is his body is like a roasting chicken. It may look all nice an brown on the outside, but take it out of the over before being fully cooked and you'll have pink juices flowing! Zeke is not fully cooked yet. Inside his body his disc is trying to form good secure scar tissue. Zeke has been on exceptionally lucky boy to have dodged the bullet with all this movement to not have had a relapse with pain, more vet bills for you and a lot of guilt you did not yet know about IVDD. It takes disc 8 weeks to heal because they have basically no blood supply. You may know from a friend or so that with a broken arm it needs to be in a cast for 6 weeks so the bone can knit back together. Bones have a good supply of nutrious blood. So if this is indeed a disc episode which it very much does sound like. the hallmark component of conservative treatment is the 100% STRICT crate rest 24/7 for a full 8 weeks. Only out of the recovery suite at potty time and then carried to and from plus only a very, very few footsteps allowed to take care of business. No laps, no couch, no sleeping in bed with you, no meandering 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. The rest of the details of doing crate rest to ensure the best recovery in this excellent document: www.dodgerslist.com/literature/CrateRRP.htm This video will help you to visual what happens with a disc problem, how it can worsen to the point of causing severe spinal cord injury. This page has the critical information you'll need to protect and help Zeke..it should be priority reading. Let us know that you have asked your vet in this particular way: Does Zeke has any health issues to keep him from using Pepcid AC? Here at Dodgerlist we have seen way too many serious GI tract problems…so we follow the vets who are proactive with GI tract protect by giving 5mg of Pepcid AC 30 mins before Rimadyl and thereafter every 12 hours. |
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jexas
New Member
Posts: 5
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Post by jexas on Jan 2, 2014 21:48:54 GMT -7
Thank you, Paula for the quick response. I will call the vet clinic tomorrow about starting the Pepcid AC. Will they sell me a doggy version of Pepcid AC or do I buy it over the counter? I'll post a follow-up on that.
Crating is challenging but I'm committed to it for his recovery. Zeke has been objecting to crate confinement by barking, jumping against the crate, etc. The article on emergency crate training is excellent and it will help me turn things around so that I'm training him to stay in the crate rather than him training me to let him out of the crate.
Zeke definitely dodged a bullet. On Christmas eve, I mistakenly thought it was strictly a constipation issue, so I took him for a walk several times to get his bowels stimulated. Poor little guy would walk a few steps and sit down. I'm still working on forgiving myself for that.
Thanks again and I'm sending prayers for all the dogs and their families on the forum.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 3, 2014 5:33:20 GMT -7
Please do forgive yourself, Jill. We all have moments that we wish we could go back and do differently if we had only known better. All that we can do is take the knowledge that we now have and use it for the best.
Pepcid AC can be purchased over the counter and comes in 10 mg. The kind that humans take. Just break it in two and give 5 mg 30 min before the Rimadyl and every 12 hours thereafter.
Also, I noticed that you mentioned Zeke coming out of his crate for his food. All food should be given inside the crate. No need to come out for that. Only carried in and out to potty and to the vet and the rest of the time inside the crate.
Please keep us updated. Healing prayers for Zeke.
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Post by Sherry Layman on Jan 3, 2014 9:32:05 GMT -7
Many people have mistaken IVDD signs for other issues. You make the best decisions you can in every moment in life with the information you have in that moment. Now you have information and as Marjorie said you take it and use it in the future.
If Zeke is continuing to jump at the sides of the crate you want to consider a calming aid while you are training him to behave. The barking is something you can learn to tolerate and is not harmful to him but the jumping at the sides of the crate can cause further injury to the disc. Pet stores sell a variety of calming aids, some take a couple days for full effect so ask someone to recommend one to you. Many are in the form of flavored treats and most dogs will gobble them up. Other options are Benadryl which you can purchase over-the-counter but you need to get the dose from your vet. Or ask your vet to prescribe something to help him relax.
Don't use his relaxed state as a time-out for you though. Keep being diligent about the crate training. Reward him when he's good by talking to him or scratching him through the crate. But if he acts up at all just absolutely ignore him.
Hang in there.
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jexas
New Member
Posts: 5
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Post by jexas on Jan 3, 2014 10:36:50 GMT -7
Called the vet clinic about the Pepcid. Staff was off-putting but I persisted until she asked the vet on duty who relayed a message back through the staff that it was okay to give Pepcid to Zeke. Staff said the vet usually doesn't prescribe Pepcid unless there are "issues." Not exactly the proactive approach...
Zeke is 11 pounds so I'll go with 5mg 30 minutes before Rimadyl and every 12 hours thereafter, unless I hear differently.
Btw, I'm using mozzarella cheese to hide the pills. If that's a problem or anyone has other suggestions, I'm all ears. Zeke gobbles it down and his poop is still on schedule and normal.
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Post by Sherry Layman on Jan 3, 2014 10:51:00 GMT -7
Agreed, not exactly proactive but we see it often. So much of vet medicine is based off human medicine and with humans we sense the stomach pain and seek a treatment quickly. The problem is a dog will instinctively hide pain and they obviously cannot verbalize issues so being proactive and treating preventatively is sometimes necessary.
You have to be the ultimate decision maker but I once left a vet I dearly loved because I tried to get my dog in when he was down and the girl that answered the phone informed me that due to the weather (it was snowing) the vets had all left early and she refused to call the on-call vet for me. I repeatedly explained that this was an emergency, we'd been through this before and I knew and I told her but she refused. I called another vet clinic that was also closing but they waited for me and saw me right away. The staff at the office is as important as the vet. I'm not advocating that you leave your vet over this issue. But concern is valid after that exchange. If you love your vet mention this issue in a calm and non-judgmental way but do express your concern. Even the person who answers the phone at the front desk is vital because they are your gateway to the vet.
The 5mg dose every 12 hours is correct.
I don't see the harm in the cheese as long as it's tiny bits, just enough to conceal the pill. If he's the type of dog that requires a lot of treat with his pill I'd use something lighter. I use mini marshmellows whenever I have to medicate my dogs. Just poke the pill into the center and it's sticky enough it won't fall out but small enough most dogs will gobble it up without searching for a pill. If he's the type that will find the pill anyway give him two, first the one with the pill but be sure he sees the second one and he'll just swallow that first one in his rush to get the next. You could even use this trick to reduce the amount of cheese if he's getting a lot, just make the bits tiny.
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jexas
New Member
Posts: 5
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Post by jexas on Jan 5, 2014 6:15:18 GMT -7
Started pepcid AC on 1/3. At 6 a.m. on 1/4, Zeke vomited a small amount of bile. He ate, drank and pooed normally, so I continued all prescribed meds and the pepcid AC.
He woke up vomiting today at 4 a.m. (significant amount) and vomited again at 7 a.m. (moments ago).
Zeke does not seem to be in distress other than an upset stomach. He settles back down to rest after I change his bedding.
I think I'll hold off on offering any foods and medications for a few hours. Any recommendations?
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 5, 2014 7:42:37 GMT -7
Vomiting is a red flag for GI tract problems caused as a side effect of the Rimadyl. These GI tract problems can worsen quickly. Please contact your vet ASAP and if you can't reach your vet today, please contact a local ER vet. Zeke needs to immediately start taking Sucralfate along with the Pepcid AC. Sucralfate works in a different way than Pepcid to band aid the damaged mucus lining and also promotes a healing environment. Sucralfate will require timing with other meds…so do your homework so you can discuss things with the vet: www.marvistavet.com/html/sucralfate.htmlThe Pepcid AC wouldn't have caused vomiting. Most likely, the GI tract problem already was brewing when the Pepcid AC was started. Hopefully, the Sucralfate will work quickly to get this problem under control. Please keep us updated on this. |
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jexas
New Member
Posts: 5
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Post by jexas on Jan 6, 2014 19:21:28 GMT -7
Zeke saw the local vet today and it went well. The vet was totally on board with giving Zeke Pepcid AC and Sucralfate. Because of the vomiting, I skipped Zeke's pain meds yesterday and today and Zeke doesn't appear to be in any discomfort. The doctor examined him and agreed. However, if Zeke starts showing painful symptoms, the doctor told me to restart the rimadyl and tramadol along with Pepcid AC and Sucralfate.
It's going well, and now that Zeke isn't so drugged up, he looks better. I will keep a close eye on him and restart the pain/anti-inflammatory meds if warranted.
The doctor said I could dissolve the sucralfate in a small amount of water and administer it with a syringe. Anybody have any luck with that? I'm afraid I'd hurt Zeke trying to wrestle the syringe into his mouth.
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Post by Sherry Layman on Jan 6, 2014 19:40:57 GMT -7
Sucralfate is usually dissolved in liquid or at least crush rather than swallowed whole. The coverage is more effective in liquid form but I know what you mean about wrestling with him. If you crush it well and put it in something he can eat that has some liquid to it you should get good results. Would he take applesauce? Crush the pill, mix it in the applesauce.
They do always look like they've improved 1000 percent when they get off the meds and don't look so pathetically doped up. I'm so glad he's not showing any signs of pain off the meds.
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