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Post by squigglerdig on Jan 4, 2014 20:58:31 GMT -7
My dog cant walk and the vet doesnt seem to be interested in figuring out why
Things have happened so fast in the past few days I cant seem to find any good resources as to what has happened, and what our options are. 3 days ago i awoke to my 6 year old dachshund Squiggs in severe discomfort, shaking and twitching his back legs. He would only lay on his back and didn't want to eat or drink. It was after business hours so when i called my vet i got their on-call service, at which point the vet recommended I give him a low dose of aspirin and try to get him to drink some water, aside from keeping him still. Several hours later when we tried to go out he couldn't stand up or use his back legs so I called the vet again. He told me to meet him at the clinic immediately (this was 11:30 at night). When the vet got there (in his pajamas) he loaded Squiggs up with an injection of painkiller (he referred to it as "the good stuff") and gave me some Robaxin (skeletal-muscle relaxer) and Tramadol for pain. He squeezed Squiggs' toes and the little guy still had deep pain sensation in both feet, so feeling better we both went home and I put him to bed. I woke up the next morning around 5am to find Squiggs writhing in pain, arching his neck, whimpering and struggling to find a comfortable position. I did what i could to get some medication in him and he settled down a bit. At 7:30 i called the vets office (surely as they were turning on the lights) and they said if he wasn't out cold after what he got the night before that something was wrong and he needed to come back. When we got there the awesome vet that had met me in the middle of the night was off duty and i was informed wouldn't be back for several days. The vet he saw instead i didn't like very much. He was short-spoken and very "matter-of-fact" and parental in the ways he tried to explain things. He squeezed Squiggs' toes and there was no reaction. In those few hours the dog had lost deep pain sensation. Hg said it seemed as if the spine was compressed, but they didnt knowif it was a disc issue or what. They asked to keep him for several days to start a round of steroids in hopes to reduce some swelling. This morning the vet clinic called and said there hadn't been any change and he was no worse, but no better. He cant urinate without manually expressing the kidneys, and the other just happens on its own. They've been telling me i need to think about letting him go, which i have considered, but without knowing exactly what is causing this and if its something the little guy can move forward from.
I dont expect him to regain full use of his legs, but even still, cant a satisfying fulfilling happy quality of life be achieved even without his legs? Is our situation so hopeless that its time for him to go?
can someone PLEASE help my friend?
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Post by Pauliana on Jan 4, 2014 21:21:56 GMT -7
Welcome to Dodgerslist! My name is Pauliana, what is your name? Please let your dog know with your utmost confidence that things are going to be ok…because they will. With this disease self education is critical not just so you make sure the right things are being done for the best recovery but for your own emotions. The unknown is simply a scary place. Get ready to fight this disease now and in the future by knowing all things IVDD. There is no better place to start than on our main web page with "Overview: the essentials" and then read all you can as soon as possible. Here's the link www.dodgerslist.com/healingindex.htmPlease mark your Aspirin bottle not for pets. It is not at all recommended for a dog with disc disease and there are better anti inflammatories for dogs with this condition and he does need to be on one to get the swelling down in his spinal cord. www.dodgerslist.com/literature/healingsweling.htmREGAINING 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. Yes your dog can have a great quality of life. Please read this: www.dodgerslist.com/index/SDUNCANquality.htmIf your Vet doesn't want to help and suggests putting him to sleep, he is not a good Vet for your dog.. IVDD is not a death sentence, it can be treated and they can have a good life afterwards with great care from you.. Here is a link that tells you how to find a Vet experienced in treating IVDD and it also has a search engine to help you find a Vet in your area.. www.dodgerslist.com/literature/VetchkList.htm In order to help you more, could you please answer these questions? -- What was the date you saw the vet and started the all important 100% STRICT crate rest 24/7 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)? -- Is there still currently pain - shivering, shaking, crying when picked up or moved? -- What are the exact names of meds currently given, their doses in mgs and frequencies? Please include the all important stomach protector such as Pepcid AC. Please ask for Vet this way: "is there any medical reason why my dog can't take Pepcid AC?" If there is no reason, be sure to get him started on it right away.. For Doxies we give them half a 10 mg tablet or 5 Mg every 12 hours.. 30 minutes prior to their anti inflammatory. -- Can your dog move the legs at all or wag the tail due when you do some happy talk? -- Can your dog 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-- Eating and drinking OK? -- Poops OK - normal color and firmness no dark or bright red blood? 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. www.dodgerslist.com/literature/massagepassiveexercises.htm Laser light therapy, acupuncture and electroacupuncture which sends a microcurrent of electricity to and from acupuncture points (which are really big nerve bundles), can be very beneficial at helping to re-establish the nerve connections in the body. Any one of these therapies can be started right away if in your budget... they not only help relieve pain and inflammation but will kick start nerves to begin regeneration. Find a holistic vet here: ahvma.org/Widgets/FindVet.html www.serenityvetacupuncture.com/index.php/faq_/ [one vet's overview/prices] NOTE: Chiropractic is not recommended for IVDD dogs. Add this comprehensive "must-have" $3 DVD on IVDD to your arsenal of educational resources. Friends, family and those who will be caring for your dog should also watch this DVD; plus don't forget to order one DVD for your vet www.dodgerslist.com/store/DVDorder.htm Sending soothing thoughts and prayers your way.. All of us here have dogs with either current or past IVDD episodes.. so you aren't alone..
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Post by squigglerdig on Jan 5, 2014 10:14:17 GMT -7
Hi Pauliana, my name is Sean, and thank you for your timely response. I will have a full outline of his medications and care since arrival when i pick him up tomorrow. I saw him yesterday and he appeared to be in a bit of pain, shaking and shivering. He could not move his hind legs, and he was sitting down, but i dont think his tail wags either. He didnt appear to want to eat anything, but would happpily drink water if i held the dish up for him. I will give a full update once i see the vet and pick him up tomorrow.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Jan 5, 2014 14:18:21 GMT -7
Sean, do know that it IS in the cards for Squiggs to be back enjoying family life again after this disc episode!! Your reading skills will make that happen and ensure he is protected and healing in the right environment. Have you started your readings on this very good overview page? www.dodgerslist.com/literature/healingpage.htmOutside of 100% STRICT crate rest 24/7 only out to express the bladder the next most important is to get pain fully under control. No shivering, no yelping, etc. Pain actually slows and deters healing. If you can communicate with the hospital today, Sunday, I would want to know: --- is the stomach being double protected with Pepcid AC and sucralfate due to no 4-7 day washout between aspirin and steroid -- Is the pain now fully under control dose to dose. Is staff there on the premises to monitor Squiggs 24/7 or is he alone at night? You will want a hands on top of your hands bladder expressing lesson. Call ahead at least an hour to remind them to let Squiggs drink maybe 1/4 cup water so you have something to practice on with the lesson. Reviewing this material first will allow you to get alot more out of the lesson for urine and for poop: www.dodgerslist.com/literature/Expressing.htmwww.dodgerslist.com/literature/Expressing.htm#poopKnow your neuro signs and let us know if surgery if needed would be an option for your family: www.dodgerslist.com/literature/healingsurgery.htmLook to the right for the rose color box…great info and tips on setting up Squigg's recovery suite he'll need for the next 8 weeks…ex-pen, wire crate, packNplay…. www.dodgerslist.com/literature.htm If this vet will not see his way to be on board in helping you to help Squiggs, then he is a hindrance with a negative put to sleep attitude. You will need to hire a vet who is comfortable in treating this disc episode and one where you feel comfortable in teaming up, discussing things..that is why you hire a vet. Good information in finding a new IVDD vet:http://www.dodgerslist.com/literature/VetchkList.htm Do keep us all posted on Squiggs
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Post by squigglerdig on Jan 6, 2014 1:33:14 GMT -7
My fear is that they think im coming in to put him to sleep in the morning and have halted or slowed care. Its sunday so they werent open, not even their on-call service. What do i do if i get there and he is just in terrible pain and the vet doesnt want to release him to me?
Is it likely the pain is impossible to eliminate?
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 6, 2014 6:02:44 GMT -7
If Squiggs is still in pain when you get there, insist on more pain meds. If they are already giving him the maximum dosage of Tramadol, they can also add Gabapentin, which works very well with Tramadol to control pain. There are options to control pain that haven't been tried yet. Squiggs needs a vet more knowledgeable about IVDD and is willing to try more aggressive pain meds. Be sure to find out exactly what meds Squiggs has been on since he's been at this vet - names, dosages, frequency. Have you had any luck in finding another vet in your area? If you let us know where you're located, we might be able to help you. Find another vet today who is knowledgeable about IVDD and arrange for an emergent consult with them today. Here is the link again to help you find a vet: www.dodgerslist.com/literature/VetchkList.htmAlso, our members have recommended vets here: dodgerslist.boards.net/board/10/guidelines-postingPlease update us when you have a chance. We'll be anxiously awaiting word from you. Having the right vet will make all the difference for Squiggs.
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Post by squigglerdig on Jan 6, 2014 12:05:20 GMT -7
Ok, so ive got the little guy back at home, in his crate resting. Hes on an orthopedic pet bed, with pee pads and fleece blankets. Here is what the vet sent me home with: Dexamethasone .50 Mg tablet - 1 tablet once daily for inflammation Carafate 1 Gm tablet - 1/2 tablet twice daily for bowel irritation Tussigon syrup - 3 cc every 8 hours So far i have only given him 1 1/2 CC of the tussigon. I have to work later tonight (from roughly 9pm-2am) so im tryng to match up the meds and his need to potty with my work schedule. As i work extremely close to home, i figure i can duck out at least once or twice in the evening to come check on him I have not yet expressed his bladder, and his bowels are just kinda doing their thing. My question at this point is, should i try to convert my front opening crate into a top opening crate, as to provide easier access for expressing and cleaning? He is shaking and trembling a good bit, but it seems to come and go. The vet said it appears as if he doesnt have a whole lot of feeling in his front paws, but every time he closes his eyes and i pick up one of his front feet, he opens his eyes so i think he can definitely still feel it. I Live in Winston-Salem, NC and have been treating Squiggs at Abri Veterinary Hospital. I just want to state for the record, Dr. Charles Bochalis is a saint among men. He didnt charge me for the meds i was sent home with, the emergency visit he made on new years day, or the round of xrays he had done, and the overnight hospitalization SHOULD HAVE been over $150/night, but instead he charged me $20/night. He is primarily a surgeon, so he doesnt do a lot of clinic hours, but when he saw me come in this morning he stopped what he was doing to see us, and he was hopeful and optimistic and very much wanted me to have and know everything i needed for Squiggs' recovery. I will keep you updated on our progress and any other questions. thank you all so much for being here. I dont know what i would have done without this as a resource.
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Post by squigglerdig on Jan 6, 2014 12:08:20 GMT -7
Also, here is the best record of his care to date i could lay my hands on.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 6, 2014 12:59:20 GMT -7
Sean, the first thing that needs to be addressed is Squiggs' pain. Shivering and trembling are signs of pain and his pain must be brought under control. I see that he was given Tramadol in the hospital, but they didn't send him home with any? Tussigon (Hydrocodone) is a narcotic but is used as a cough suppressant. I have never heard it used for disc pain. Here is the info on Tussigon: www.marvistavet.com/html/body_hydrocodone.htmlI see that you've only given him half of the dosage prescribed. Until you can get other pain meds for Squiggs, please be sure to give him the full 3 cc every 8 hours since he is in pain. You should call the hospital back, advise them of the signs of pain that you're still seeing and ask that Tramadol be prescribed. Or find a new vet ASAP who can see Squiggs today to manage his pain. Did they give you a hands on your hands demonstration of how to express? You'll need to express every 3-4 hours. If the bladder gets too full, it will overflow and will stretch out of shape. Also, the bladder will not empty completely on its own and any urine lying in the bladder for more than 6-8 hours can breed a urinary tract infection. Here is our information about expressing: www.dodgerslist.com/literature/Expressing.htm Let us know how you make out with expressing. I did a search for neurologists in your area and found the following list: www.acvim.org/PetOwners/FindaSpecialist.aspxThere is one vet there who is right in Winston Salem: Dr. Todd Skeen 1600 Hanes Mal Blvd Winston Salem, NC 336-896-0902 www.carolinavet.com/about-carolina-veterinary/animal-doctors/todd-skeen-neurology/Please immediately contact either Dr. Skeen or one of the other vets listed on the page link above and ask for an emergent consult. If you can't afford surgery, explain that to the new vet and tell them that you just want the specialist to examine Squiggs and monitor his medications. In the photo, the door to the crate was open. I think you may have done that just to take Squiggs' photo but if not, please be sure to keep the door closed. Dogs are known to do the unexpected and you don't want Squiggs trying to crawl out of the crate. As far as converting the crate to a top-opening crate, that would be fine if easier for you. Here's how to convert the crate: www.dodgerslist.com/literature/cratesupplies/cratetopconvert.pdfBut it would be best to take Squiggs out of the crate to express him, either outside or on a pee pad. Here is the proper way to lift and carry: We're here for you and Squiggs, Sean, if you have any questions or concerns at all. Please let us know how you make out getting an emergent consult with a vet more knowledgeable about IVDD. Prayers for Squiggs.
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Post by squigglerdig on Jan 6, 2014 13:34:02 GMT -7
He has been laying on his side, and been shaking and in and out of it and out of nowhere just started whimpering alot and "digging" with his front legs. I called the vet they said just give him the rest of that dose of Tussigon. I did, that was about an hour ago. The crate door is open because ive been laying right in front of him, talking to him, petting his head. Do i pick him up to express? This seems quite dangerous in his condition. When the vet demonstrated it to me, he was on his side.
...so many questions
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 6, 2014 13:46:25 GMT -7
Sure, if you're more comfortable with expressing him while he's lying on his side, that's absolutely fine, Sean. You'll just need to ease the wet pad out from under him and replace it with a dry one. Squiggs' pain should be completely under control by now since you gave him the pain med an hour ago. If it isn't and if he is still showing signs of pain, you'll need to let the vet know again. Once his pain is under control and you get the hang of expressing him, he can heal in comfort. It's obvious from your postings how very much you care for Squiggs. Please know that he can recover from this. Neck episodes can be much more painful than back problems and it can take awhile to get the pain meds just right. Usually, Tramadol, Gabapentin and Methocarbamol are used together to control pain with neck episodes. Since you're dealing with a cervical (neck) issue, here are some helpful tips, such as raising the food and water dishes so Squiggs doesn't have to bend his neck down to them, moistening hard kibble, etc. www.dodgerslist.com/literature/cervical.htmPlease let us know whether the last dose of pain med has gotten Squigg's pain under control.
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Post by Jean & Mimi on Jan 6, 2014 13:58:16 GMT -7
Sean, I am just another mom, but I wanted to say that Squiggs is just gorgeous and it is obvious how much you love him. My Mimi had a hard time with pain and the Gabapentin/Tramadol combo really helped her. If you can, please talk to your vet and ask about what the moderators are suggesting. Do not worry about calling to much or nagging, trust me, my vet probably hated me after a while. But it was in being a strong advocate that I got my sweet girl what she needed to be pain free and to heal.
(((HUGS))) to you and Squiggs, I hope he is pain free soon.
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Post by squigglerdig on Jan 6, 2014 15:22:07 GMT -7
I called the vet back, they looked at his file, had me come back and gave me Tramadol HCL 50 Mg - 1/4 tablet every 6-12 hrs as needed just struggled to get it down but he took it with some water
So now were doing
Tramadol 50 mg tablets - 1/4 tab every 6-12 hrs Dexamethasone .50 Mg tablets - 1 tab once daily Tussigon 3CC - every 8 hours Carafate 1 Gm tablets - 1/2 tab twice daily
He has had a full dose of tussigon by 2:30 ( 1 1/2 at 1:30. The rest at 2:30)
And a dose of tramadol at 5:15 pm
I was instructed i could give him the dexamethasone later tonight or in the morning if i prefer
The carafate i don't know much about. Its for bowel irritation, so would i be worse off giving it to him right before i go to work?
He looks like he has calmed down a bit. Still breathing heavy, still shivering. Ill let the meds take it from here.
Are there interactions i should look for?
I also asked my vet clinic if they would refer little dude to the neurologist here in town, when i called them they said they cant even really talk to me until my vet refers me.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 6, 2014 15:32:57 GMT -7
Good job on advocating on Squiggs' behalf, Sean! I'm glad Tramadol has been prescribed. I see from the hospital record that Squiggs weighs 10.9 lbs. They have him on a very light dose of Tramadol so I would recommend giving it every 6 hours. Tramadol has a short half life and works best when given consistently and not just as needed. So give it to him every 6 hours. Please let us know if that dosage does the job of controlling pain. There should be no sign of pain from one dose of the Tramadol to the next dose and pain should be under control within one hour of giving it to him. Please keep us updated on this. How are you doing with the expressing? Is that going OK? Carafate (also known as Sucralfate) should be given on an empty stomach, one hour before food and Dexamethasone so the gel coating action can begin. Pepcid AC should be given 30 minutes after the Carafate. Both of these work to protect the GI tract from side effects of the Dexamethasone. www.marvistavet.com/html/sucralfate.htmlGI tract problems that you would need to watch out for are diarrhea, vomiting, bloody stools, not eating. I hope these meds will get Squiggs' pain under control so he can have a pain-free peaceful night. The poor boy needs some rest. I'm sure you could do with some rest, too, but I know you're on your way to work tonight. Take care and keep us updated. You've done a great job with Squiggs today. Also, Tramadol is very bitter. You should try to hide it in something Squiggs likes, like peanut butter or cheese.
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Lola & Hurley
Helpful Member
2 paralyses, 3 surgeries, 2 conservative treatments. Now walking :)
Posts: 135
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Post by Lola & Hurley on Jan 6, 2014 15:52:16 GMT -7
Sean, I've been following your thread.. Your Squiggs is so sweet! If you have a PetCo or PetSmart nearby, go and get Greenies Pill Pockets!! You can hide the Tramadol inside and at least my dog loves them... He thinks the Hickory Smoke is the best thing ever. No arguing over getting pills down anymore! Take care and hope you all feel better soon! Lola
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Post by squigglerdig on Jan 6, 2014 15:57:37 GMT -7
We expressed around 4:30. It was a bit light, though i waited 30 seconds and tried again he seemed empty. He didnt like it very much. I think putting my hand under his belly moved his back in an uncomfortable way. The vet said not to give him pepcid. As the carafate should do him well.
So it looks like im going to let him settle out, give him some carafate then feed him an hour from then. The dexamethasome will follow soon, and ill come home around 11:15 to give he more tramadol. Something like that?
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 6, 2014 17:30:22 GMT -7
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Post by squigglerdig on Jan 6, 2014 17:40:02 GMT -7
The pain SEEMS to be a bit subdued. Hes definitely calmer, but still a bit of shaking/grunting. Should i go ahead and hit him with the dexamethasone while i have a little bit of time to observe him? Do i need to worry about the dex and tramadol interacting with eachother negatively?
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 6, 2014 17:50:54 GMT -7
No, you don't need to worry about the dex and tramadol interacting negatively. However, there are still signs of pain, which means that the pain meds are still not right. Is there someone you can contact at the vet's ofice to ask about increasing the Tramadol dosage this evening? As I mentioned, it is a light dose. I do hope you'll be able to get in to see the neurologist tomorrow. Meanwhile, though, Squiggs still needs help with his pain.
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Post by squigglerdig on Jan 6, 2014 17:52:50 GMT -7
Well they said he hadnt taken any of the dexamethasone today
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 6, 2014 17:55:58 GMT -7
Dexamethasone is a steroid, not a pain med. It acts to reduce the swelling in the spine, which will also help with the pain. However, it can take time to get the swelling down, possibly a week or two, even a month. Right now he needs the proper pain meds.
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Post by squigglerdig on Jan 6, 2014 17:58:34 GMT -7
Ive got the time, but does he? And he didnt seem to want to eat. Ive been taking the syringe approach, but he just spits out what i try to give him
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 6, 2014 18:06:18 GMT -7
He may not be eating due to the pain he's in. I know my Jeremy doesn't eat when he's in pain. I'm not sure what you mean by you have the time but does he? It can take some time for the swelling to go down and as long as there is swelling, there is pain. That's why the need for pain meds until the swelling goes down. At some point, the vet will call for a taper of the Dex to test for pain, possibly in a week or so. If there is no pain, then the swelling is gone and all meds can be stopped. If there is still pain, then there is a need for more time on meds.
Please contact the vet or if they aren't open, whoever may be covering for them to let them know that Squiggs is still in pain so the pain meds can be adjusted. There should be no sign of pain one hour after pain meds are given.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 6, 2014 18:17:49 GMT -7
Also, I was just thinking about the Pepcid AC and recall that the reason we had recommended both the Pepcid AC and the Carafate (Sucralfate) both be used to double protect Squiggs tummy was because there was no wash-out period between the use of the aspirin (NSAID) and the Dex (steroid). 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. So it's important to also include 5 mgs of Pepcid AC 30 mins. before the Dex. Squiggs has enough going on without dealing with a GI tract problem, too.
I know you and Squiggs have been dealing with a lot these past few days and I know we've been throwing a lot of information at you. Hang in there. Once Squigg's pain is under control, things will get a lot easier.
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Post by squigglerdig on Jan 6, 2014 18:29:37 GMT -7
He seems comfortable. I was able to get in touch with the on-call vet, and it was the same nay-saying guy i didn't like when we saw him last week. He used phrases like " your dog has an ailment that cant be cured" among other things. He said its not exactly a bad thing that he hasn't had the dexamethasone yet, and he doesn't know what dr. Bochalis was trying to achieve with it, since its mainly for preserving spinal cord function? He said it would be ok if squiggs has an increase of the tramadol but for a dog his size, a half a tablet would technically be an overdose. I just plan on coming back around 11:00 and giving him his next scheduled dose.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 6, 2014 18:40:42 GMT -7
You can give Squiggs the Dex without food. The reason it should be given with food is that also gives protection against the acid the Dex produces. But it can be given without food.
I'm sorry you keep running into this vet who is so negative about IVDD dogs living quality lives. Many, many dogs prove him wrong!
I hope that Squiggs remains comfortable through the night. And hopefully tomorrow he'll have an IVDD knowledge vet taking over his care.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Jan 6, 2014 19:59:04 GMT -7
Sean, you are doing a good job advocating for what Squiggs needs. The "nay sayer" vet is simply telling you he is not comfortable in treating a disc episode, he lack experience in this area. Hopefully you will not need to interact with him again to get what is needed for Squiggs.
Marjorie has shared with you what we have seen 1000's of vet who do know IVDD and what they prescribe that works to get pain under control.
These are the things you do need to continue to advocate for strongly with another vet: 1. Pain control is not there yet. Vets who do know how to treat a disc episode know that it takes aggressive use of pain meds and often a combo of them. Information to help you discuss and asses meds. You should get from the vet the range of dose and frequency you may give so that on the weekend or night you know all your options. Neck discs are among the most painful thus needing aggressive pain relief.
"Dogs- Tramadol dosing in dogs varies, with suggested doses ranging from 2 to 5 mg/kg q8–12h. The highest dose for maximum analgesic effect in dogs is 10 mg/kg q8h." Source: Tramadol. Plumb DC. In Plumb DC (ed): Plumb’s Veterinary Drug Handbook, 7th ed—Ames: Wiley-Blackwell, 2011, pp 1002-1004.
Robaxin is for the muscle spasms so often associated with a neck disc. Can you get this back on board? Gabapentin is being found by vets to help with difficult to control pain. Works well with Tramadol and can be used with Robaxin
2. Two stomach protectors…sucralfate PLUS Pepcid AC. Pepcid AC you get from the grocery store no RX needed. Your vet does however need to be kept in the loop. Pepcid AC works differently thab Carafate. It reduces acid production and Carafate bandaids any damaged areas of the GI tract. Advocate STRONGLY for both as there was no washout.
Do ask specifically how Tussigon, helps with pain for a disc episode or if it has another intended effect. I've been here since 2006 and 1000's of dogs have have never seen a vet prescribe this med for pain. Let us know what you find out.
10.9 lbs Tramadol 50 mg tablets - 1/4 tab every 6-12 hrs. What did the vet say the increase could be? Dexamethasone .50 Mg tablets - 1 tab once daily Tussigon 3CC - every 8 hours Carafate 1 Gm tablets - 1/2 tab twice daily
Once you have pain fully controlled, then it will be like night and day. You can express without hurting him. He can eat, feel comfortable and not have pain hindering this whole healing process. We must have patience with disc healing, nerve healing. But we NEVER have any patience with pain. If the meds are properly prescribed in ONE hour pain will be in control and thereafter dose to dose of the pain medications.
We all anxiously await hearing Squiggs' pain is finally controlled.
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Post by Jean & Mimi on Jan 7, 2014 7:03:53 GMT -7
Thinking about you and Squiggs. Hope he is doing better...you have been working so hard to help him. During this initial phase it is challenging to get things squared away, but once he is pain free and resting, this will all become routine.
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Post by Sherry Layman on Jan 7, 2014 7:40:35 GMT -7
Sean, you've had some great advice so far. I know this is such an overwhelming time and all of this is hard to process. I'd like to suggest that you re-read the posts from Pauliana, Marjorie and Paula. It's great information but so often when we are under stress it's really easy to miss things.
The Tussigon is a narcotic. One of the side effects of any narcotic is sleepiness and a euphoric effect. However, in recent years of human medicine we have come to realize that though a medication is the strongest in our arsenal it may not be the best for a patients particular condition, this translates to animal medicine as well. In this situation the pain is a result of a damaged disc putting pressure on the nerves that supply Squiggs' legs. Though this can be one of the most severe types of pain, narcotics do not really have much of an impact as they aren't targeting the cause. Getting the Dexamethasone on board and reducing the swelling will have the most impact. In the mean time drugs that work on nerve pain are far more effective than narcotics. Squiggs is sleeping because of the narcotic but likely still has pain even in his drunken, euphoric sleep.
The Tramadol is a great drug for this condition and we see it used often. However, usually more than one drug is needed in the beginning.
Methocarbamol is a muscle relaxant and is also commonly prescribed, it is safe to use with the Tramadol and Dexamethasone. Muscle spasms are common with disc/nerve problems and they can be terribly painful. Some of the symptoms you've describe are indicative of muscle spasms so please ask your vet for this medication and start it ASAP.
Gabapentin is also another drug that is widely used in IVDD episodes and targets that nerve discomfort. This is also safe to use with any of the medications discussed so far. Please also ask for this medication to be added to Squiggs list and also start it ASAP.
Squiggs is very uncomfortable so ask for the max doses appropriate for his size to start with, you can always back off once pain is fully controlled.
Don't try to force feed him right now. His body is telling him not to eat because the digestive system doesn't function effectively when there is such pain or when a patient is on narcotics. Offer food to him but if he refuses don't force it. Staying hydrated is important though. Make sure he has access to water at all times. If he's reluctant to drink you can try low salt broth, sometimes this is more enticing. If he were to go for a day without drinking you would want the vet to know and he should receive some IV fluids. Once the pain is under control Squiggs' appetite should return.
At this time you have a vet that isn't entirely comfortable with treating IVDD. It is vital that you read and educate yourself so you can be Squiggs' voice to the vet and be knowledgeable about what is appropriate and what is not. I know it's a lot to take in but I know you can do it, your love for Squiggs will give you the courage and strength. Paula and Marjorie both gave you the link to helping you find a new vet in your area that we know has comfort and knowledge regarding IVDD. Don't be afraid to switch, Squiggs life may depend on it.
If this is a cervical disc as opposed to one lower in his back it does indeed take more time and more aggressive medicating to get the pain under control. I've dealt with both in my dogs and the difference is dramatic. The neck is moving all the time which just keeps that disc aggravated. We cannot stop the dog from moving all together, that is not realistic. But appropriately medicating is realistic.
Hang in there and please do let us know how things are going. Thinking of you and Squiggs.
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Post by squigglerdig on Jan 7, 2014 17:33:34 GMT -7
My sweet boy finished his battle early this morning. I went home from work to check on him around 11pm lastnight and he seemed uncomfortable,but after I got a tramadol in him he slowed his breathing and his gums yellowed.
I rushed him to the emergency vet doing chest comoressions on him the whole time. When we got there he had a heartbeat but wouldn't breathe on his own.
As the doctor was explaining our options he slipped away calmly into the unknown.
Thank you all so much for your kind words and advice. Squiggs is in a better place, without any pain. I miss my best friend.
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