Manny's Mom
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“A dog is the only thing on earth that loves you more than he loves himself.”
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Post by Manny's Mom on Jan 6, 2014 18:53:18 GMT -7
The Monday before Thanksgiving 2011 I adopted Manny from a local shelter. His start in life was in a puppy shelter where he spent the first 10 months in a cage and no one touched him. He was so sad and scared that you had to corner him to touch him but he quickly touch my heart and I made him part of my family. Because of his start in life he quickly became attached to me and developed a terrible case of separation anxiety. Always needing to be where ever I'm at. In the over 2 years I have had him we have only been apart twice when I traveled out of the country. He even flys with me every 4-6 weeks. This past friday in the early hours of the morning his and my life took a terrible turn. He didn't act himself before going to bed and by 2am he had lost movement of his hind legs. A trip to the Emergency Vet and a referral to the Neurologist confirmed that he suffered from IVDD. Because he had quickly lost deep pain sensation the surgeon didn't feel he had a great chance of benefiting from surgery. The rest of my friday was filled with tears and concerns for what quality of life could I give him or would he have. I truly want to do what is best for him and not afraid of what this means to my daily life so willing to try anything as long as it will give him the quality of life he so deserves. Manny will be 3yrs old in Feb and weights 14 pounds. He is currently on
14 pounds.
Pepcid 10mg
Tramadol 50mg
Gabapentin 100mg
Alprazolam 0.5mg
tapering dose of ▼Prednosone 5mg.
Because of his anxiety which was present before this I'm never sure what is pain and what is anxiety. He has bouts of shivering which come and go even with pain meds on board. He whimpers from time to time but sometimes I think it is wanting me, food or water, yet could be pain related. When he first went down he wanted only to sit up and getting him to lay was difficult. After we got all his meds going he appears most comfortable laying and is not comfortable sitting up nor even able to get himself to a seated position. This has made electing to do crate rest easy, since he doesn't move much and crates are a big negative for him. I have so many fears right now. Am I doing the right thing? Do I really know the difference between pain and anxiety? Will he grow weaker by the day so that even a wheelchair in the future will not be an option? So many questions and concerns but your site has given me hope I didn't have when I left the neurologist office on friday.
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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 6, 2014 19:10:28 GMT -7
Welcome to Dodgerslist. My name is Paula what is yours? What breed is Manny? What is the exact dose of the pred now being giving and how often do you give it? He was given a VERY short course of pred… apppears to be a 3 day course? And then a taper was called for. ON the taper if there is ANY hint of pain then all the swelling is not yet gone. The vet needs your feedback asap so that pred can go back up to the orginal dose for a bit longer. What was the originnal dose in mgs and frequency? Not finding a comfortable position to sit, reluctance to move, moving gingerly, yelping, not his normal perky self IS pain. -- Are you doing 100% STRICT crate rest 24/7 , carried to and from and only a very, very footsteps at potty time? 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 crate rest is to act as a cast of sorts to let the disc heal… only limited movement of STRICT crate rest allows that to happen…there are no meds to heal a disc. Immediate neuro improvement may or may not come during the 8 weeks of crate rest… as nerves may take more than 8 weeks to heal. -- Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy? -- Currently can he move the legs at all? or wag the tail specifically when you do some happy talk? The very, very lightest least aggressive range of motion and leg massage is necessary for paralyzed legs during conservative treatment. The information highlighted in PINK pertains to a dog who can't walk once off all pain meds and no more signs of pain.www.dodgerslist.com/literature/massagepassiveexercises.htm-- Do you find wet bedding or leaks on you when lifted up? -- Eating and drinking OK? -- Poops OK - normal color no dark or bright red blood? -- If there is pain or neuro diminishment, dogs can benefit greatly with acupuncture or laser light therapy. These therapies can be be started right away to help relieve pain and to also to kick start energy production in nerve cells to sprout. So if this therapy is in your budget, seek out a holistic vet. ahvma.org/Widgets/FindVet.html www.serenityvetacupuncture.com/index.php/faq_/ [one vet's overview/prices] Chiropractic is not recommended for IVDD dogs. First thing to know is that it IS in the cards for Manny to get back to enjoying life after recovering. Some dogs do have mulitple disc episodes. 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 This Disc Disease DVD is a wonderful way to help other family members understand and even others who might be around or taking care of Manny: www.dodgerslist.com/store/DVDorder.htmWe look forward to learning more about Manny with your answers. |
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Manny's Mom
New Member
“A dog is the only thing on earth that loves you more than he loves himself.”
Posts: 4
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Post by Manny's Mom on Jan 6, 2014 19:35:51 GMT -7
Manny is HavaPoo mix.
You are correct it is a short dose of Pred with just 3 days and today starts the tapering to every other day. I wasn't sure what is normal but will call the Vet tomorrow. As for the Pepcid giving it 30 min before the Prednisone as your website suggested. As for
Tramadol it is q8,
Grab is q day
Zanax is q6.
It was only after finding this forum that I learned that crate rest was an option to helping heal, we quickly adopted but that was just sunday and sad that I may have prevent healing sooner. I really feel the neurologist didn't give me what I needed, possibly because he heard from my husband I'm a nurse and assumed I knew more. But thats humans not dogs that can't talk to know what is wrong. The vet did refer me to a rehab specialist on friday and Manny did have a laser treatment and scheduled for another wednesday and friday this week. I do worry about the pain! We are trying to stay firm to the schedule with medications and not letting time lapse in coverage.
You asked about eating and his appetite has been good which he has always been a self feed kind of guy.
I keep pushing water and when he wants it drinks a lot but I supplement with a syringe when I give meds and he doesn't want to drink on his own.
As for bowels, they are normal stool and we are trying to learn how to stimulate it to avoid a bigger mess.
Finally his tummy is soft most of the time. It has been a 50/50 situation with the leakage, primarily when it does it is when we pick him up. Not sure how much of it is our continual learning of how to fully empty his bladder. I sure could use some better tips on how to hold him and express it without causing him pain or misaligning his spine.
I will take your advise and review the phase of healing.
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Post by Sherry Layman on Jan 6, 2014 19:54:51 GMT -7
What a wonderful gift you gave Manny rescuing him! I'm so sorry this is happening but as Paula said, Manny WILL have a wonderful life no matter what happens and there is always hope for recovery.
I agree with Paula that the course of Prednisone is short, do let us know what the vet says tomorrow when you talk to him about lengthening that original dose.
Here is a link to our page on expressing the bladder and bowels, there is both written instructions and a video. If reading/watching this information doesn't help you ask for a hands-on demonstration when you go to your laser appointment Wednesday. Have the vet or vet tech put their hands ON TOP of your hands and express him so you can feel just how it's done.
Generally dogs don't need water "pushed" and in fact the Prednisone is often a cause of increased water consumption. If he has access to water at all times he will drink what his body needs. There are bowls that attach to the crate to prevent spilling, pet stores and even Walmart sell them, and while on crate rest this is an optimal arrangement...he will have constant access but no risk of laying in wet bedding from a spill.
Do hang in there and keep us posted. I'm rooting for Manny!
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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 20:30:00 GMT -7
OK then, let's see if we have his med list correct now: 14 pounds. Pepcid 10mg: 5 mg, 2x/day Tramadol 50mg, 3 x/day Gabapentin 100mg, 1 x/day Alprazolam (Zanax) 0.5mg mg, 6 x/day ▼ Prednisone 5mg every other day starting 1/6 Good idea from Sherry about the water and food bowls being inside the recovery suite. Here's a homemade solution with deli containers and tie wraps. ![]() Gabapentin bioavailability is not dose proportional; i.e., as dose is increased, bioavailability decreases. Bioavailability of Gabapentin is approximately 60%, 47%, 34%, 33%, and 27% following 900, 1200, 2400, 3600, and 4800 mg/day given in 3 divided doses, respectively. www.drugs.com/pro/gabapentin.html</div>Divide the 100mg capsule powder into 3 equal parts by dumping into a creased pieced of paper and with a razor blade move the powder into 3 equal piles. The remainder of the powder piles I stored in one of those 7 day pill boxes with a lid for each compartment. |
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Post by Pauliana on Jan 6, 2014 21:21:26 GMT -7
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Manny's Mom
New Member
“A dog is the only thing on earth that loves you more than he loves himself.”
Posts: 4
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Post by Manny's Mom on Jan 7, 2014 17:45:42 GMT -7
That me first say I appreciate the support because this is such an emotional roller coaster with not knowing what each day will bring and trying to assure my self I'm doing to right thing for Manny and not keeping things going for myself.
Today hasn't felt like a good day! Manny appetite has really diminished and I have sent my husband off to the emergency vet for the soft critical care dog food that I can push with a syringe. He seem to becoming more flacid with his body each day making it difficult to support when emptying his bladder.
I appreciate the suggestion of the food and water attached to the crate but tried and he won't lift his head to even attempt. He spends all his time on his side with us repositioning him to avoid pressure sores. He will lift and move his head around but a more in frustration or to drink when we put the water under his nose.
On a better note I think his pain is under control, though when the neurologist office called today I asked about extending the predisone dose for a longer period as well as if he would benefit from a muscle relaxer to which he agreed to both.
So here is his new med list:
Prednisone 5mg twice daily for 5 days then a taper dose
Pepcid 10mg twice daily
Methocarbamol 500 mg 1/4 ta every 8 hours (not 100% sure if he needs this so haven't given yet)
Tramadol 50mg every 8hrs
Gabapentin 100mg every day
Zanx 0.5mg every 6hrs (I think I'm going to back off a bit on this because he appears less anxious and to lethargic)
Paula are you suggesting that I divide up the Gabapentin capsule into three doses since he isn't absorbing the full dose having been on for 4 days?
Sherry I didn't find the link on emptying his bladder if you could repost.
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Post by Sherry Layman on Jan 7, 2014 19:15:52 GMT -7
Yes, do divide the Gabapentin into three doses and give one of the divided doses every 8 hours instead of once daily. This medication is absorbed more effectively in several smaller doses rather than one larger dose.
I think Manny is over sedated. The Methocarbamol has sedating effects plus he is on the Xanax. The Methocarbamol is vital for his comfort right now so I'd skip the next dose of Xanax completely. When he starts to be alert you could give half the current dose IF you decide he needs it. Possibly the Methocarbamol is keeping him calm enough he doesn't need both at the same time.
My first thought when you mentioned his reluctance to eat is stomach concerns as this can be an issue when on the Prednisone. However, seeing his meds I'd say it's hard to tell and it could just be that he's too sedated. Be sure you are vigilant about the Pepcid 30 minutes prior to the Prednisone and also give the prednisone with some food. Entice him with anything you can think of to get something in his stomach at the time of the Prednisone. Be very careful force feeding him food or fluids. If he's really this sedated and would vomit he probably isn't alert enough and could inhale it back into his lungs. More important than feeding him at this point is to get him awake. The body can survive for quite some time without food so the priority is making sure he's not in pain but also not so sedated he cannot eat on his own.
If you can catch your husband while he's still at the vet you could ask him to get some Sucralfate from them just in case it is related to the Prednisone. Sucralfate would be in addition to the Pepcid. The Pepcid reduces acid production while the Sucralfate actually binds to the ulcertive spots in the stomach protecting them from the acid.
Please keep us posted.
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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 7, 2014 19:21:16 GMT -7
Gabapentin has a short half life in dogs of 2-4 hours. PLUS as I read the bioavailiablity is not dose proportional. We see most vets prescribing it 3 time a day. So I would highly recommending discussing Gabapentin dosing with your vet. We here are NOT vets, we just read alot, observe 1000's of vets across the country and how they treat a disc episode. Rather than pushing food, you need to get to the root of why he is not eating. For most dogs Pepcid AC does protect the GI tract by reducing stomach acids. Some dogs just need more protection. So I would HIGHLY recommend advocating for a 2nd stomach protector to be on board tonight: sucralfate it is an Rx item and requires timing with food, with Pepcid AC and other meds. Those dosing details here: www.marvistavet.com/html/sucralfate.htmlI hesitate to share and do so only to educate not to scare you. You are the very best observer because you are there with Manny. There is a disease that can follow on the heels of any spinal cord injury..one by car accident, by a gun shot wound or by a disc pushing on the cord. The cause of Myelomalacia or how it progresses is still unknown and not too common. Myelomalacia can be easily confirmed by your DVM with the following and quick action taken to prevent a bad ending: * about 3-4 days into recovery, they become painful. Within the first week, they are in a LOT of pain. * development of excruciating pain (more than just pain from the original disc herniation) • even the strongest pain meds do not help * acute disc extrusion with no deep pain sensation * loss of anal tone, the anus hangs open, (anal flaccidity) and areflexia (below normal or no reflexes) * loss of cutaneous trunci reflex at a level more cranial to a previous evaluation over a period of hours to days with or w/o surgery * development of fever (normal rectal temperature is 100.5 to 102.5 degrees Fahrenheit) * sudden twitching or jerking of the neck and/or head * loss of voice, horse bark * can't hold body up, can't hold head up * increased respiration/ labored breathing • hyper-esthesia (over-reaction to any touch sensation on body) www.dodgerslist.com/literature/Myelomalacia.pdfI do like hearing you are not observing any signs of pain that is a positive. Hoping to hear it IS the Zanax that had him so lethargic as to be unable to get into a sitting position and now today you report can't hold his head up to drink out of a bowl. My ER vet helped Lewis to the other side in the wee hours of the morning some summers ago, so I know how fast this disease can progress and the need for good observations and quick action. How is the expressing going, now staying dry? What about expressing for poop? Our treasure trove of all things ivdd is worth bookmarking: www.dodgerslist.com/literature.htm and specifically express is here: www.dodgerslist.com/literature/Expressing.htm
I hope to read in the morning stopping the Zanax shows a positive change for Manny. Hugs to you, I know you are doing a good job caring for Manny. it is hard when they don't feel well..we want to make things better in an instant but Disc Disease does take time and patience.
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Manny's Mom
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“A dog is the only thing on earth that loves you more than he loves himself.”
Posts: 4
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Post by Manny's Mom on Jan 7, 2014 19:28:53 GMT -7
My husband was already back from the Vet so not an option to ask about Sucralfate.
As for the muscle relaxer I haven't started so he hasn't received any doses yet. The neurologist just gave me them this afternoon before I got home and saw how lethargic he was. I also held off earlier today on the Zanax as he didn't appear anxious. My biggest concern is if he over sedated or is he worsening. I'm not sure the half life of all these drugs in a dog. He is drinking lots of water tonight and I did use a syringe to get some food in him before his evening dose of Prednisone. Also not sure if I should give the Tramadol tonight but will see how he is before I go to sleep.
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Post by Sherry Layman on Jan 7, 2014 19:34:51 GMT -7
Tramadol is not sedating and you want to keep his pain under control. Don't skip the Tramadol.
If the Xanax is a new drug for him not something he takes daily it could really be hitting him. I'd hold off on it for now. If he starts to wake up and gets anxious you can give him a smaller dose.
If he's drinking on his own this is a good sign and makes me even less suspicious that it's his stomach and causes me to lean more toward sedation. Don't force any more food and just be sure he has some access to water so he can drink when he wants/needs. Do monitor to be sure that he is taking water so you can report to the vet if needed.
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