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Post by Nicole & Birdie on Jan 18, 2014 8:12:38 GMT -7
Hello, My 5 year old Corgi Birdie Salvi was diagnosed with IVDD two years ago when she experienced her first episode. She recovered after crate rest and was doing well until 12/23/13. Long story short she is back on crate rest. Her is her basic information: Name: Birdie Weight:19lbs Breed/Diagnosis: Corgi, was given IVDD diagnosis after first episode Strict crate rest: started 12/23. My husband is an issue with carrying her to go outside to potty. He's terrified to pick her up, and I've seen him letting her walk outside. I'm working on this with him, as her care is a team effort. Pain: this is our issue. She did great the first two weeks with her pain being managed after seeing the vet on 12/23. She was on Morphine, and Rimadyl after that visit. Then I started weaning her off the pain meds at two weeks into the crate rest, and she started hunching her back and crying out in pain again. We rushed her back to the vet and they changed her meds, and she's been doing great these last two weeks, until yesterday. I spoke to the vet on Wed and she wanted to start weaning her off the ▼pain meds again, so we did, and now we are back to the hunched back and some crying out in pain (although not as bad as last time). So she is back on the meds. Current Meds:
Minocycline 100mg 1 tab once daily (3pm)
Dexamethasone 1mg 1/2 tab once daily for 7 days then ▼1/2 tab every other day (we are currently on 1/2 tab every other day) (3pm)
Tramadol 50mg 1 tab every 8 hers (7am,3pm,11pm) Gabapentin 50mg suspension 1mL once daily (6pm)
Movement: Birdie can walk, wag tail, potty fine. Today because she is hurting she is hunching her back. Continence: no wet bedding, no leaks Intake: She eats and drinks fine Stool: she poops fine
No x-rays were taken, vet thinks the injury is in her neck. I saw the vet with our cat yesterday and asked to be referred to Purdue for a neurologist. Even though she's doing well compared to her last episode (she was paralyzed for a few hours) I'm concerned that every time we try to wean her down, her pain isn't managed. We live outside of Indianapolis, and there is a neurologist in Indy, but I'm more drawn to the university, and am willing to drive her to the university. She'll have been on crate rest for 4weeks on Monday. My main concern is that even after 4wks,she is still in pain and hunching her back when not on the meds. Has anyone had experience with this, it feels like such an extended time for her to be hurting. Thanks for everything, I've been lurking here since her first episode, but this time I'm just baffled, and terrified for my sweet girl. While she has made some progress it just doesn't feel like enough. |
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Jan 18, 2014 10:18:00 GMT -7
Welcome to Dodgerslist. I'm glad you decided to post so we can offer you support through this disc episode. My name's Marjorie- what's yours? Was a washout period of 4-7 days done between the switch from Rimadyl to Dexamethasone? If not, it's important to ask your vet to start Birdie on Sucralfate to protect her GI tract. Vets who practice safe medication use a 4-7 day washout period before switching from a NSAID to a steroid. Also, regardless of whether or not a washout period was done, Pepcid AC should be given to protect your dog from the excess acid produced by the Dexamethasone. Please get your vet's permission to give 5 mg of Pepcid AC (generic is famotidine) 30 minutes before the dose of the anti-inflammatory and thereafter every 12 hours. Phrase the question to your vet in this particular way: "Is there any medical reason my dog may not take Pepcid AC?" If your vet says your dog has no health issues such as liver, heart, etc to keep her from taking Pepcid AC, then do get it on board. With the gabapentin, double check to be sure that the liquid does not contain xylitol, which is toxic to dogs: See Gabapentin here: www.dodgerslist.com/literature/drugs.htm#NeurontinOn the bottle it will likely NOT state the sweetener used. If your regular pharmacy makes it, do question the pharmacist, not your vet..the vet may not be aware how gabapentin is being compounded. A veterinary compounding pharmacy will likely know they should not use xylitol….still I would double check. As to the signs of pain that Birdie is still exhibiting, there should be no signs of pain from one dose of the medication to the next. It appears a taper of the Dexamethasone is taking place at this time. A taper is to test for pain, which is now showing. A return to the original dose of the Dexamethasone is now necessary. Pain = swelling = more time on the anti-inflammatory dose of the Dexamethasone. If they don't want to switch back to the original dosage of the Dexamethasone, which is a very strong steroid, they might want to switch to Prednisone. There is no washout period necessary for a switch from one steroid to another. The anti-inflammatory dose of Prednisone is 5 mg 2x/day. The steroid is to get the swelling down, which is pressing on the spine and causing pain. Cervical injuries are usually more painful than back episodes. It can take quite a bit of tweaking to get the medications right. Please contact your vet today to advise of Birdie's pain and have the meds adjusted. Methocarbamol can be added for muscle spasms that are often associated with neck problems. Why is Minocycline, an antibiotic, being prescribed? Yes, please impress upon your husband the importance of limiting Birdie's steps and movement of the spine as much as possible. Too much movement, the disc can re-tear and you're back to square one. It will not harm Birdie to pick her up, if she is picked up properly, keeping her spine straight. Here is a video that you can show your husband on how to lift and carry any dog with IVDD (even after the disc has healed and crate rest is finished): (video) I think it's an excellent idea for you to consult with the neurologist at Purdue. Birdie has mild symptoms and is an excellent candidate for conservative care. She just needs some help getting the proper medication prescribed. Please keep us updated. Healing prayers for Birdie. |
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Post by Nicole & Birdie on Jan 18, 2014 13:02:22 GMT -7
Hi Marjorie, I'm Nicole. Sorry I left my name out  ?
We did do a washout period of 4 days before the Dex was started. We have Pepcid and I can start her on it.
I'll check on the Gabapentin. I know when I compounded meds as a vet tech for our avian patients we used lactulose. But I will call and find out for sure what the apothecary used.
Vet closed early today, but I'm going to call my vet friend that I used to work for to see about taking the Dex back up.
Our vet here in Indiana, while not a specialist, has a strong interest in neurology cases. So after she saw Bird she took her lunch, went home and found some new veterinary journal articles discussing recent studies with the Minocycline addition. She called the neurologists at the Purdue to discuss the addition and get opinions. She felt that it could help, and asked to try it, and I agreed after a discussion and reading some of the articles myself. I know it's an odd addition for a cervical injury, but I decided to give it a try.
Thank you so much for the video! He's going to practice on our other two corgis before trying it with Birdie. He is just not as comfortable handling the dogs as I am from all my years of being a vet tech, and as soon as she screams or even acts like she will, he gives up.
Thank you for all the great advice Marjorie. I appreciate it so much, and its so comforting to have someone listen and understand my concerns. I'll keep you updated. |
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Post by Pauliana on Jan 18, 2014 20:36:27 GMT -7
Hi Nicole, It is wonderful your Vet is consulting with Purdue, they won't steer her wrong. I live about a half hour away from Purdue Univerisity (We used to live just over the bridge from it but moved) and when our dog Tyler lost the ability to move his back legs we called Purdue small animal clinic, his regular vet, and told them we were on the way with Tyler.. This was the end of January last year.. They took wonderful care of Tyler through his surgery and aftercare. You can read his story by clicking on the link in my signature line.. I am interesting in learning more about the Minocycline.. Here is a link to read with tips about a cervical disc episode. www.dodgerslist.com/literature/cervical.htmSending soothing thoughts and prayers for you, your husband and dear Birdie.. |
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Post by Nicole & Birdie on Jan 21, 2014 11:01:25 GMT -7
Success!!! My husband is carrying her outside after watching the video and getting some practice in with the other two dogs. He is much more confident. Birdie is feeling well these last few days. We are waiting to hear back from her general vet about the dose on the Dex since she was in pain when we tapered it off, and waiting to hear from Purdue after everything was faxed over yesterday.
Pauliana- I was so glad to read your story with Tyler and Purdue. The cost of surgery (if it is needed) has been a concern of mine for the last few days, so it is good to see that there were options and that you and Tyler recieved excellent care.
Also, the link to the tips about cervical disc episodes was helpful. I intend to put her up on our dining room table tonight while she is out with us in her crate so that she doesn't have to look up at us. Again, thank you for everything.....I'll update you when I know more.
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Post by Nicole & Birdie on Jan 22, 2014 20:11:36 GMT -7
Birdie and I head up to Purdue bright and early tomorrow. She's doing well, and tomorrow will be 48 hours without the Dex on board, so we'll see how she feels. Hoping we can establish a good relationship with the neurologist.
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Post by Nicole & Birdie on Jan 25, 2014 16:54:14 GMT -7
The Purdue team was wonderful. They felt that Birdie was doing well, so they made some changes to her meds and want to see her back in two weeks. If at that time she is no better or is worse they'll do an MRI. But they felt she is not a surgical candidate at this time.
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Post by Pauliana on Jan 25, 2014 19:58:02 GMT -7
Hi Nicole,
Very happy to hear you and Birdie had a great experience at Purdue as we did with Tyler.
Please let us know what her medications changes are and the dosages and frequencies given..
Keeping you and Birdie in my prayers and thoughts!
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Post by Nicole & Birdie on Feb 6, 2014 12:49:57 GMT -7
Hi Pauliana- sorry for the late reply, I've been away from my computer for awhile. They had us do the Gabapentin three times a day at .5mls, and then the Tramadol 1/2 tab every 8 hours, and the Dex 1/2 tab every other day. We have had her off all medication as of last Thursday and she's been feeling great. I took her back to Purdue today for a rechek and while she is doing really well the neurologist found her to be painful in her neck still, so she is at Purdue waiting for an MRI tomorrow. I'm really worried about her, and hoping that we can get some good news. We had to euthanize our cat late Sunday night after a trip to the emergency vet and a poor prognosis after diagnostics, so we need some good news with Birdie.
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Sabrina
Helpful Member 
My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Feb 6, 2014 13:38:08 GMT -7
Hi Nicole, I'm so sorry to hear about your cat passing away and Birdie still having pain. Do let us know how Birdie is doing and the results/recommendations after her MRI.
))Hugs!((
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Post by Nicole & Birdie on Mar 4, 2014 17:51:45 GMT -7
Sorry I haven't been able to update. Birdie had a chest x-ray and blood work before her scheduled MRI, and the chest x-ray revealed a mass. They canceled the MRI and scheduled her for a CT instead to get a better look at the mass in her chest. The CT revealed a herniated disc in her neck and a mass where her esophagus meets her stomach. Her neurologist decided not to operate on the disc as she has full motor function, she was just painful when he really applied pressure to her neck. He instructed us to crate her for another 4 weeks. That four weeks is up on Thurs, and she goes back to Purdue for a follow up. I'm crossing my fingers that all goes well and she can be released from crate rest.
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Post by Pauliana on Mar 4, 2014 21:54:06 GMT -7
Hi Nicole,
Very sorry to hear about the mass and send Prayers Birdie's way.. I hope she is able to get off crate rest after her check up on Thursday.. Keeping all of you in my thoughts and prayers..
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 5, 2014 7:15:16 GMT -7
My thoughts and prayers are with you and Birdie, too. So sorry to hear of the mass.
Blessings to you both.
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Post by Nicole & Birdie on Mar 6, 2014 19:21:45 GMT -7
Thanks Pauliana and Marjorie. They felt that that tumor was benign but of course can't be certain without removing it or getting a biopsy, and they felt the risk are just too great, they advised us that if she starts showing signs (regurgitating food or having difficulties eating) then we can schedule to remove it, but that it will be a very complicated surgery. Birdie has been doing well the last four weeks except in the last week she's been crying out occasionally when we pick her up. I just hope and pray that she hasn't injured herself further down her back. She is not showing any signs except for the crying out from time to time when we pick her up. I miss my sweet girl.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 7, 2014 5:21:08 GMT -7
Please let us know what Purdue thinks of the pain she's having when you go back for the follow-up. We'll be thinking of and praying for the two of you. I'm so sorry your girl is having such a difficult time.
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