Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
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Post by Tracey & Duke on Jan 27, 2014 15:40:52 GMT -7
I had to email since I am in class all day. Here is the vet's reply to my email:
Continue Methocarbamol and Gabapentin for 10 days then stop the Gabapentin. Continue methocarbamol twice daily for 7 days , then decrease methocarbamol to 1 time daily for 1 week and discontinue. Continue ▼Prednisolone decreasing dosing schedule as the bottle indicates.
I'm not sure why she wants those meds continued for so long. She didn't say anything about Tramadol but probably because I said I had not given him any since Saturday night and he is doing ok without it. They also insist on seeing him tomorrow. I canceled last week's appt. because I didn't like the idea of moving him if it wasn't necessary. He is doing well, but I'm afraid that taking him out for an appt. to the vet in and out of the car will not be good for him.
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Marjorie
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Post by Marjorie on Jan 27, 2014 18:39:19 GMT -7
OK, so it looks like Duke will be on pain meds for another two weeks (with the last one being the Methocarbamol). What is the taper schedule for the Prednisone? When will the last dose of that be?
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Jan 27, 2014 20:33:41 GMT -7
He is currently on day 5 of Pred 1/2 twice a day. Tomorrow will begin week 3 of crate rest (we started Jan 14) and he will go down to 1/2 prednisone once a day for 5 days, then 1/2 every other day until gone. That is what the prescription label says but I don't know about that. I would still have 9 and a half pills left after the next 5 day taper. That would last through Feb 25!! I don't think she remembered that I had some left over from the last episode.
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Marjorie
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Post by Marjorie on Jan 28, 2014 6:48:25 GMT -7
You'll need to remind her of that, Tracey, so she's accurately aware of how long he'll be on the Pred with the taper she's prescribed. As for the taper of the Methocarbamol and Gabapentin, both should be stopped before the Prednisone or at least at the same time as the Prednisone so a true test for pain can be made. If the Prednisone is stopped before the Methocarbamol and Gabapentin, it would be difficult to tell if there is pain (swelling) and Duke shouldn't go off the Prednisone if there is still swelling. All things to be discussed with your vet.
Continued prayers for a pain-free taper.
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Jan 28, 2014 9:54:43 GMT -7
Thank you. It appears the Methacarbamol and Gabapentin will stop before the Prednisone as the Prednisone will continue through Feb 25 if I use all she gave me. Can you tell me exactly what is the reason that you guys recommend splitting the Gabapentin into 3 doses rather then giving in one per the vet's instructions?
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PaulaM
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Post by PaulaM on Jan 28, 2014 12:09:05 GMT -7
If there is pain to deal with, keeping the level of pain med more even in the body is a goal. All medications have half lives. As the hours tick away the amount of med in the body becomes less and less until it is no longer masking pain. "Gabapentin Elimination half-lives range between 2-3 h in rats, 3-4 h in dogs, and 5-6 h in man." www.ncbi.nlm.nih.gov/pubmed/3730018 Duke is now no longer on an effective anti-inflammatory dose of Pred. The true test of the taper is that pain meds are considerably backed off or stopped so there is an immediate feedback of any hint of pain so the dog would be able to get back up to the effective pred dose asap to finish working on inflammation. We observe that most vets do prescribe gabapentin 2-3x a day to give better coverage. In a previous post I shared my reading that unlike other pain meds giving a larger dose may not give more pain relief as one would expect, so possibly another reason why vets divide that 100mg capsule into 3 equal doses throughout the day. so if pain would not be fully covered one wants to discuss with the vet all avenues to get better pain relief. I agree that if there is not an emergency, the less transporting the better for Duke.
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Jan 30, 2014 18:27:12 GMT -7
Just returned from follow-up appt. Plan is: continue tapering Prednisone down to 1/2 every other day, until gone. Continue the Gabapentin and Methacarbamol for 2 more weeks. He also had his first laser treatment today!
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Feb 8, 2014 23:05:06 GMT -7
Update on Duke. Since his last appt., he has had 4 laser treatments. I thought at first, that things were going very well, but the last couple of days I have noticed his back leg trembling and this seems to coincide with the taper. He does not appear to be in pain, does not hold it up, was even scratching his ear with it the other day. But I have also noticed after he potties, he won't walk much at all. He will stand there and wait on me to pick him up where he was trying to walk around a bit a week ago. However, if the neighbor dog barks, he will try to run to the fence. On his taper, I had decided to go against the vet's recommendation of tapering his prednisone for such a long period of time since it was not an anti-inflammatory dose anyway. I know it has been a while, so I'll summarize his treatment so far:
Jan 14 - original pain noted and saw vet. Started 1/2 pred twice daily, 1/2 Tram. 3 times daily, 1/4 meth. three times daily. 1/2 pepcid before pred.
Jan 17 - had a severe pain episode upon moving too quickly in his crate, so vet increased meds to 1 whole pred. twice daily, 1 whole Tram. 3 times daily, added gabapentin (I broke into 3 doses as recommended here, 1/2 pepcid before pred.
Feb 23 - taper pred. to 1/2 twice and Tram. to 1/2 3 times daily, all other meds the same.
Feb 26, stopped Tram.
Feb 29 Began taper of pred to 1/2 once daily.
Feb 3 - continued taper of pred. to 1/2 every other day.
Feb 5 - stopped Gabapentin, tapered Meth to twice daily.
Feb 8 - gave what I had planned to be his last 1/2 pred. today.
I was supposed to stop Meth on Feb 12 and, according to vet's instructions to continue to taper Pred. that would have lasted at least another week or so. Just seems pointless to taper that long if the dose is not effective.
So tonight, after seeing the trembling leg at potty time, I panicked and gave him all of his meds at the higher dose again!!! Maybe I panicked too soon. I just don't know. I would like to add that at his last visit with her, I had a long talk with her about the prednisone and her thoughts about a longer course then 2 weeks and she was just against the idea. I asked her why and she said research shows it does not really do much after two weeks and if he continues to feel pain after the taper then it is time to see a specialist. I told her I'm not ready to see a specialist and I'm not doing a second surgery. I feel like we were doing good as long as we were on meds. And even now, I don't feel he is in any great deal of pain. He has not cried, he wags and moves about in his crate a great deal. I just see that trembling leg at potty time and worry. I wonder if it might just be weakness. She said she thought he appears to have lost some muscle tone in his hindquarters. Now I'm not sure what to do after giving him those higher doses of meds again. I won't see her again until Monday afternoon when he goes in for his laser treatment.
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Post by Pauliana on Feb 8, 2014 23:32:03 GMT -7
Hi Tracey,
It is natural that Duke would lose muscle tone during crate rest, but don't fret, it comes back pretty quickly after they gradually ease back into activity.
Some dogs need to be on Predisone at the anti inflammatory dose for two weeks and some for a month to get the swelling down. It is best to taper exactly the way the Vet prescribed.. It gives his body more time to begin to make it's own cortisol hormone.
Do keep watch for signs of pain that would suggest swelling is still present and if so it would be necessary to inform your Vet right away so Duke can return to the anti inflammatory dose until the next taper..as well as his pain medications.
Hopefully it won't come to that, it sounds like he's been doing well on the taper so far, other than the shaking leg.. which could be weakness or pain.. Put your detective skills to work to determine what you are seeing and discuss with your Vet..
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Feb 9, 2014 16:53:33 GMT -7
It's strange. When I come home from being out, he is standing in his crate jumping up and down wanting to be taken out. When I take him out, then he just stands there. He won't take any steps at all. I did call his vet today and she told me to put him back on 1/2 Tramadol and 1/4 Methacarbamol 3 times daily. We will see her tomorrow for his regular laser treatment. He has had 4 treatments and I really can't tell if they are helping or not.
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Marjorie
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Post by Marjorie on Feb 10, 2014 5:43:06 GMT -7
Tracey, if your vet feels Duke is in pain and that the pain meds need to be increased, then he would need to also be returned to the original anti-inflammatory dose of the Prednisone. The pain is caused by something pressing on the nerves of his spine. Either there is still disc material that hasn't been absorbed by the body yet or swelling and an anti-inflammatory is necessary. Pain meds just mask the pain - they don't take care of the source of the pain. As Paula mentioned, it can sometimes take a month or more for the swelling to resolve.
Is it very cold where you live? Do you think he may not want to move when he goes outside due to the cold? It sounds as though he's very active in the crate. Trembling legs can be due to weakness or nerve damage. My Jeremy had surgery two years ago and ever since then, if he stands a certain way, one of his hind legs trembles.
Please let us know what the vet says after seeing him today.
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Feb 14, 2014 19:20:45 GMT -7
Update: Duke is really baffling me. At times, he stands and his leg trembles. He is reluctant to do much else after he potties. Looks at me like "take me in now please". But once in the house, back into his crate, he is moving about and acting fine. I live in South Mississippi, so not too cold, however we have been having our share of winter storms recently. It has been very wet and the ground is cold and wet which he does not like. So the fact that he seems fine inside but only shivers outside leads me to believe he is just not comfortable outside. He has never liked cold or rainy weather and wet grass which is all we've had lately. I continued the Tramadol and Methacarbamol as the vet suggested for an additional week, but will plan to discontinue this weekend and see how it goes. We are entering week 5 crate rest and will be strict through 8 weeks to give him the best chance. I am now confident that things are going in the right direction and we can avoid another surgery. I appreciate so much all of you guys support and advice. This forum is a blessing to come to when you are worried, stressed and exhausted. THANKS SO MUCH!
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Post by Pauliana on Feb 14, 2014 21:09:46 GMT -7
Hi Tracey!
Duke likely doesn't like the wet weather and is just not happy it isn't the way he would like..Also a dog going through IVDD feels vulnerable/afraid outside. He knows he isn't 100% yet and couldn't defend himself should he need to.. Since he acts fine in the house, it sounds like he is going in a good direction as you said. Keep watch after discontinuing the Tramadol and Methocarbamol for signs of pain and contact the Vet if need be.
Fingers crossed!
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Feb 16, 2014 1:42:14 GMT -7
Thanks. Has anyone ever used Platinum Performance CJ? I have ordered it and would like to give it a try. I started cooking crockpot meals for my dogs a few months ago when Duke seemed to be having some allergy related skin issues and now I worry they may not be getting enough minerals. I do still give them some Duck and Potato formula in the mornings, but their main meal is a crockpot stew of chicken, chicken livers, brown rice and lots of veggies. Just wondering if anyone has thought of or used this formula for their doxies.
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PaulaM
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Post by PaulaM on Feb 16, 2014 12:55:15 GMT -7
Tracey, cooking for your dog is definitely doable. As you mentioned it is the education part that is very important with home cooking. Providing a balanced meal includes balance of minerals and vitamins in food. The crock pot home cooked food is deficient. Adding home cooking in excess of 10% (i.e. if 1/3 cup kibble then a max of max 1.5 to 2 teaspoons home cooked) is throwing the balance off of the commercial food. A no win situation. Do pass your ideas by your vet, of course, when changing to home cooking. Here is just one example so you will see that you do need to get yourself educated before tackling home cooking: When one part of the body needs a mineral not available in the blood supply it must raid stored sources…not a good health situation! The ratio of calcium to phosphorus is important to maintain muscle tone, bone strength such as the vertebrae. Calcium is an essential mineral which triggers heart beats and pumping blood. Monica Segal, certified in Animal Health Care through the University of Guelph with studies in animal nutrition, physiology, has an email group. The group specializes in proper nutrition in a diversity of diets whether commercial, home-cooked or raw. Support for healthy dogs and those with disorders such as liver, skin, heart, etc. pets.groups.yahoo.com/group/K9Kitchen/Good information regarding food and nutrition and home cooking: www.dogaware.com/articles/wdjhomemade3.html#rules So until you have a handle on how to create balance in home cooked foods, I would just feed a good quality commercial food. I would not be fooled by dog food brands which claim joint supplements ingredients. Likely the small portion you feed would not contain enough of this supplement to be of any benefit. Add 2 teaspoons of people food to the commercial if you like. One small tinned sardine packed in water is an excellent choice a couple of times a week. The beauty of sardines is they contain both Vitamin E and Omegas in the right proportion in mother nature's sardine package plus a lot more beneficial nutrients. www.3fatchicks.com/the-nutrition-of-sardines/
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Feb 20, 2014 15:23:28 GMT -7
Ok. That all sounds interesting to read, and I definitely will. Just to let you know, it isn't just some recipe or thought I conjured up. I follow Dog Dish Diet, bought the books and cook his recipes. He is a Vet in CA. www.dogdishdiet.com/I do worry still though about supplementation, which is why I wanted to try this product. Thanks for your reply. I know I have to do more research to be sure I'm doing this the right way. My dogs do get Ultramix Grain-free Duck and potato for one of their meals.
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Feb 24, 2014 14:43:51 GMT -7
I am baffled. This is beginning of week 7 for Duke. Some days he is perky and moving around a bit in his crate, shows no trembling, tail tucking or pain on potty outings. Other days he is trembling and tail tucking. He gets no free time outside of the crate, except in his stroller sitting right beside me while I work and going to the vet 3 times a week for laser therapy. At first, I thought the cold, or the rain was causing the trembling. On my last call to the vet, she suggested continuing the Methacarbamol and Tramadol 3 times a day. We did that for a while and he seemed great. He has now been off all meds completely for over a week and shown no signs of pain at all. I discontinued his dogsitter coming to the house to take him out to potty because I can no longer afford the $65 a week. Today was his first day to wait for me to get home. I leave at 6:30a.m. and return at 3:15 p.m. I thought surely he would have to go very badly, but when I took him out, he just stood there trembling with tail tucked. I brought him back in and took him out again 10 min later, same thing. Moved him to a different spot in the yard, still nothing. I brought him in gave him a chew bone, and took him out again and he finally did pee. He took a few steps. I understand this root signature pain is different and may take more time. I am concerned that he is still shivering and tail tucking but not every time. I don't know what to make of it. Other times he is bouncy and happy. He will be seeing the vet tomorrow for his last laser treatment and I intend to talk about this. Last time I asked about longer periods of prednisone, she stated that if he still had pain it was time to see a specialist and get an MRI. I'm not doing surgery so that is a waste of time and money. I have read many things on here about long term steroid use and cannot seem to get a good explanation in one paragraph that I can quote to her (if he needs more time). Can someone please write me a detailed paragraph concerning the possible needs for longer time on steroids so that I will have something to refer to when I see her. I'm not sure if this is what he needs. Maybe I do need to bring him over to the specialist in the next state and just let them evaluate him. But with the way this is up and down, I just don't really know what is going on. According to my calendar, he has only 2 more weeks of crate rest. Can miracles happen in 2 weeks and he will be ready to come off crate rest? I'm concerned that he won't.
thanks!
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PaulaM
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Post by PaulaM on Feb 24, 2014 20:01:15 GMT -7
The reason for the crate rest part of conservative treatment is to give time for the disc to scar and heal properly. So as long as there has not been a new tear and a need for another 8 weeks to allow that to heal, then in two weeks crate rest may well need to be over. As for why the intermittent pain of trembling and tail tucking could be several things. Such as not all of the disc pressing on the spinal cord has been reabsorbed enough to allow the nerves to no longer be aggrevated. If Duke were to move in just the right way, the disc could cause pain. Scar tissue also develops on the nerves where they were damaged and that could also cause pain. www.dodgerslist.com/neurocorner2/Randompain.htmwww.dodgerslist.com/neurocorner2/scartissue.htmThere is really not a way to know exactly what is going on. So if there is not another disc episode, a plan needs to be made to give comfort to Duke so he can enjoy life without dealing with pain. You might discuss with your local vet or a specialist vet about a pain reliever med to maintain a good quality of life you can use when one of these pain spells occurs. There are risks with steroids but if it comes down to a "lowest effective dose of steroid" that would be better than a poor quality of life dealing with pain. Non-steroid anti-inflammatories, NSAIDs, can also have the same risk as steroids. The safety in anti-inflammatory meds are owners knowing signs to monitor for. Vets who practice safe medicine by taking periodic blood tests to monitor the health of organs. Has a painful urinary tract infection been ruled out with a recent urinalysis?
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Feb 25, 2014 14:22:54 GMT -7
Thanks for your reply. A urinalysis has not been done. But he has never lost bladder control and usually goes with no sign of trouble. I will ask about that today.
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Mar 2, 2014 12:59:05 GMT -7
Appt. went well. No UTI. She checked him out completely, poked prodded, and pulled and he show no pain at all. She just said there may be some lingering nerve sensitivity. She noticed he seems to hold his leg out wide when standing and there is still a slight spasm occasionally when he walks. But I noticed this spasm and brought it to her attention months before the disc issue surfaced. She checked him over back then and did x-rays, but found nothing wrong other then a few calcified disk spaces which she mentioned back then may give him trouble. Tuesday begins week 8 and then a transition to living out of the crate again. Any suggestions for a smooth transition would be appreciated. Once out, I'll plan on letting him stay in my kitchen while I'm at work, no doggie door access until I'm sure. My kitchen is very small, galley style, and most will be blocked off. Just so he doesn't have to stay in the crate all day.
thanks
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Mar 2, 2014 14:12:39 GMT -7
Sounds like you have a good plan post 8 week crate rest. for when you are not at home so that he won't harm himself, but still have room to move about in your kitchen. After crate rest it is important to institute a plan of slowly, incrementally re-introducing physical activity. You may find it helpful to bookmark our core readings page. The last column on the right has good articles for handling physcial activity after crate rest plus how to make your home back friendly and train a dog to use ramps. www.dodgerslist.com/literature.htm#afterrestKeep us updated on this last week of crate rest. We all have our fingers crossed for it to go well to conclusion!
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Mar 3, 2014 17:50:36 GMT -7
I sure will! Thanks for everything!
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Mar 10, 2014 14:12:25 GMT -7
We made it!!!! Today is the last day of Duke's 8 weeks of 24/7 strict crate rest. It seems like it's been forever. I cannot wait to take him out for a few steps around tomorrow. He now hardly appears to ever had an issue at all. To all the doxie parents who are currently going through this, my thoughts are with you. I want you to know that crate rest works. This was our third episode, with a prior surgery, and we have stuck by the crate rest each time. So if you are having any doubts at all, please stick with it. Ask for and take all the advice here that you can get. At times, it what keeps you strong. Thanks again to all who responded with advice, encouragement, and support.
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Marjorie
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Post by Marjorie on Mar 10, 2014 17:41:42 GMT -7
Congratulations!! So happy that Duke is doing so well!! Thanks, too, for the encouraging words to other members that conservative care does work - Duke is proof of that! I'm sure you know the drill by now but here's our page on how to slowly build up Duke's stamina and muscles: www.dodgerslist.com/literature/AfterCrateRest.htmI truly hope and pray that Duke never has another episode - he certainly has already had his share. All the best to you both.
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Post by Jean & Mimi on Mar 11, 2014 13:20:22 GMT -7
Congratulations Tracey and Duke! I am so happy for you guys. I bet you are just thrilled to snuggle with your sweetie. Fingers crossed that he never has another episode again...you have served your time in your crate cutie
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Tracey & Duke
New Member
Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Mar 11, 2014 18:29:01 GMT -7
Thank you all! Yes it has been so nice to hold him on my lap again and snuggle with him today. He will continue to rest in his crate for most of the day, at bedtime, and when I am gone to work. When he is out for short periods, he is just happy to stay by me. I have blocked off a small portion of the yard so he can roam a little more on potty breaks, but not ready to give him full roam of the yard just yet. I feel so lucky and blessed to have found this wonderful resource and hate to think of where we would be without it. Thanks again...and we too hope never to have to go through this again. UPDATED 4/5/2020:12/14/2004 - 3/31/2020 due to tumor Duke lived 15 years and 3 and a half months with me but I needed more time
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Post by Judy & Vesper on Apr 5, 2020 23:15:35 GMT -7
I am truly sorry for your loss, we never have enough time. May he rest in peace and run free.
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Marjorie
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Post by Marjorie on Apr 6, 2020 4:35:47 GMT -7
I'm so saddened to hear of your loss, Tracey. I well remember Duke and the wonderful care that you gave him. He was a lucky dog to have had your love and such a good home. Blessings to you as you grieve.
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Post by Romy & Frankie on Apr 6, 2020 9:21:49 GMT -7
I am very sorry to hear of your loss of sweet Duke. There truly is never enough time. Please accept my condolences.
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Tracey & Duke
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Duke's 15 year doxie companion Daisy has now passed. (May 7, 2005 - May 6, 2020) Kidney failure
Posts: 44
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Post by Tracey & Duke on Apr 10, 2020 18:33:59 GMT -7
Thank you all for your kind words. Duke was very loved and he will be missed dearly.
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