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Post by Nancy & Maisy on Mar 24, 2013 14:48:00 GMT -7
Faith is my beautiful blonde mini dachshund. She's 11 pounds. Her age is unknown because I found her in my office parking lot 6 years ago this month. We guess her to be 11-15. She turned up with shaking and head wobbling 16 days ago. X-rays show three thinning lumbar discs. I got no other info than that. Should I have more diagnostics done?
Faith can walk, has bowel and bladder control and is eating normally. She has been on crate rest, but I've been letting her sleep with me because she stays so still. I had a trip to Hawaii planned and with great guilt feelings and at the vet's urging found someone wonderful to care for her while I was gone, but she bathed her after an accident in her crate. When I came home on the 20th, I was told that she'd been allowed out of her crate quite a bit... to cuddle on the couch, etc. Oh, boy. Luckily, no new symptoms. But her strict crate rest really starts today. I will put her close to me to sleep and leave her in the crate from now on, I promise! I have been carrying her out to go potty. It worries me. Her lower back gets pressed on when I pick her up and carry her. I have tried picking her up under her chest and lower abdomen, but even this creates pain for her. Unless she has the Gabapentin right before I take her out, she's shaking with pain by the time we come back in. I only allow her to make 3-5 steps, potty, one step, then carry her in. Any hints? I hate to see her in pain!
She's very cooperative and calm in her crate. She started prefering to be in it a few days before her pain became noticeable.
Meds: Faithy has technically been in kidney failure for almost 2 years. I have worked very hard to keep it at bay and use the 5 Leaf herbal products and Azodyl. I have managed to keep her BUN at 42 and Creatinine below 2.5 all this time. She is also on chinese herbs and a very low dose of benazepril for high blood pressure (secondary to kidney failure). The only med prescribed for the IVDD is Gabapentin, for pain, with good results. I am so afraid that it will hasten kidney failure. I read it's excreted through the kidneys and isn't recommended for use in kidney patients long term. The vet does not want her on Pred or steroidal anything because of the kidney issues. Any suggestions? Also, does she need the Pepcid AC with the Gabapentin?
I've been aware of the site for a long time and frankly, hoped I'd never need it. Now that I do, thank god you're here!
PS I have Faith scheduled for accupunture and laser light this week.
Nancy |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Mar 24, 2013 16:48:41 GMT -7
Nancy, I'm sorry to hear Faith is having a disc episode. Since medications with kidney problems have to be weighed carefully, I am glad you are going to do the one thing you CAN do that is so very important.....100% STRICT crate rest 24/7 only out to potty for a full 8 weeks …. No laps, no couch, no sleeping in bed with you, no meandering around during potty times. No baths, no chiro (aka VOM). In other words do everything you can to limit the vertebrae in the back from moving and putting pressure on the bad disc. The crate is the only surface that is firm, supportive for the spine, not inclining, always horizontal and keeps a dog from darting off at a TV doorbell and safe from other pets and kids from bothering them. The rest of the details of doing crate rest to ensure the best recovery in this excellent document: www.dodgerslist.com/literature/CrateRRP.htm 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. Pepcid AC (famotidine) is used primarily when a steroid or a NSAID is on board. Her pain is not under control. Do get back with the vet to see if perhaps a combo of pain meds would mean less of each to still control pain. Since she can't have an anti-inflammatory it is a challenge to get the swelling down in the spinal cord with the body's own cortisol (a steroid hormone) Do discuss what options your vet has to safely get pain in control. You can care for her and she can't get on with the business of healing when there is pain to contend to. The pains meds to discuss with your vet is methocarbamol and tramadol with the gabapentin... or some combo. Mar vista vet page is the place to get educated on meds: www.marvistavet.com/html/pharmacy_center.htmlThe sooner you can get acupuncture and laser light therapy started the sooner it can help with pain. What does in mg and how often do you give Gabapentin? Might see if it is safe to give it a bit sooner, since pain is surfacing before the next dose. This is a good start in getting an over all picture of what you are dealing with, etc.http://www.dodgerslist.com/literature/healingpage.htm Please keep us posted... if the pain can be brought full in control, then Faith can heal in comfort. |
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Post by Nancy & Maisy on Mar 24, 2013 17:01:43 GMT -7
Thanks, Paula. I have been giving .5 ml of Gabapentin every 4 hours. I can give up to 2 ml/day. I just have to remember to take her out while it's in full effect and not towards the next dosage time. I think this might do the trick. We see the vet on Wed for accupuncture and laser. I'll talk more with her about it then.
What is the best way to pick her up?
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Post by Linda Stowe on Mar 25, 2013 11:21:24 GMT -7
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Post by Nancy & Maisy on Mar 26, 2013 22:49:26 GMT -7
Thank you. I have spoken with the vet and have switched her to Tramadol, which is metabolized by the liver instead of the kidneys. I found a medical article that warned against using Gabapentin for kidney patients. It referred to it's use as "a preventable cause of morbidity"! Faith is doing well on the Tramadol and her pain is under control. Tomorrow we start accupuncture and laser light.
Question: what is the best way to stabilize her spine while she undergoes these treatments?
Thank you for all the information!
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Post by Nancy & Maisy on Mar 26, 2013 22:50:05 GMT -7
Thank you, Linda! I'm now doing it correctly!
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Post by Nancy & Maisy on Mar 26, 2013 23:09:53 GMT -7
I'm lucky that Faith is so calm and cooperative. She does well in her airline style crate. She doesn't like to come out of it since her disc episode began. It's just large enough for her to sit up in and lay down and stretch out in. So, that all works well. I worry when she scratches or turns around or scrunches her self up in her crate. Do I need to be concerned? I can't think of a way to prevent her from moving and my thought is that they all do these things as long as they have the ability to. Any advice?
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Post by Nancy & Maisy on Mar 26, 2013 23:11:57 GMT -7
She has an egg crate mattress. Since the crate is plastic, would it be advisable to put something firmer under the eggcrate mattress, such as a piece of plywood, or is the floor under the crate providing the firmness she needs? Thank you for entertaining my questions!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Mar 27, 2013 13:28:20 GMT -7
Nancy, alot of dogs do better with a wire recovery suite (ex-pen, crate) because of better visibility. So this is good new to hear that Faith likes her plastic airline crate. Turningn around or curling up is not anything to be concerned with. In fact it shows you she is not in pain to be able to move and change positions. If she were to be rambunctious.... jumping against the side of the crate then that could not be permitted.
The egg crate mattress is to provide better cushion and to prevent pressure sores with having to rest for so many weeks. So I do not think you need to make the mattress firmer. Is the crate's floor corrugated or uneven... then, yes, I would provide a smooth flat surface underneath the egg crate foam.
What dose of Tramadol and frequency did your vet prescribe? Faith has a good mom, with your searching to know about all her meds.
Faith is so pretty... give her a big hug and tell her she is a model patient!
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Post by Nancy & Maisy on Mar 27, 2013 19:11:51 GMT -7
Paula, she is getting Tramadol 25 mg up to every 8 hours. I have been giving it every 9-10 hours and she seems to be pain free. No trembling or shaking. I'd wait longer, in case she doesn't need it this often, but don't want to chance the pain coming back.
By the way, I've read that Tramadol is addictive in people. Is is addictive in dogs as well?
Thanks, she enjoyed her hug. She is a pretty girl, isn't she? I looked for a long time after I found her before I identified her color. It's American Cream. I feel for her previous owners, but was so happy to have her find me! She had been on the streets for a month or so, the vet thought. We went through bouts of HGE for 4 years because of her diet while she was wandering out there. She turned up in my office parking lot 6 years ago when I was looking for a companion for my other older doxie girl. Lucky me!
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Post by Pauliana on Mar 27, 2013 20:36:43 GMT -7
Tyler was on Tramadol for about a week after his surgery and when the prescription ran out, he had no symptoms of addiction or withdrawal.
Faith is a lovely Dachsie!
Wishing you both the best..
Pauliana
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Post by Nancy & Maisy on Mar 27, 2013 22:24:23 GMT -7
Thanks, Pauliana. Is it typical for them to be on it for just a week? Maybe I should begin tapering Faith off of it?
So happy to hear that Tyler is doing well!
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Post by natureluva on Mar 28, 2013 5:54:27 GMT -7
Hi Nancy, my dog was on Tramadol for several weeks with no withdrawal symptoms when we stopped. When your vet tells you to either stop or taper the Tramadol, watch for signs of pain returning. Signs of pain are trembling/shivering, reluctance to move, a tight-feeling tummy (like a drum), lack of appetite, panting, head/nose held up or down, and yelping. If you see signs of pain, notify your vet so they can prescribe a longer course of Tramadol.
I agree with Paula, Faith may enjoy a wire crate more so she can see you and see what's going on around her. I had good luck with a playpen during crate rest.
Glad to hear you'll be getting Faith acupuncture and laser. They are so helpful! In addition to stimulating the nerves to heal and reducing pain and inflammation, acupuncture also has the bonus of inducing a state of well-being. Please let us know how she's doing. Best wishes, ~Lisa
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Post by Nancy & Maisy on Mar 29, 2013 14:10:09 GMT -7
Thanks, Lisa. That's very reassuring! I noticed over the last couple of days that she has been in no pain at all, even after her Tramadol has worn off. So I cut the dosage last night to 12.5 mg. She is doing well on it so far, but I'm watching closely. If I see any sign of pain I'll increase the dosage. She really seems to like her intermediate sized airline style crate. In fact, she's reluctant to come out of it and can't wait to get back in after pottying or having meds. She loves it, what can I say?  |
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Post by Pauliana on Mar 29, 2013 14:52:34 GMT -7
Hi Nancy!
Tyler had surgery, and healed very rapidly and that was why he was only on them for a week.. In conservative treatment they usually have to be on medication longer until there are no signs of pain present. Tapering the Tramadol, if you see no signs of pain during the taper, that is a great sign.. I am glad you are being so watchful. If you do see signs of pain put her back on her regular dose again. You can always try the taper again later. Make sure her Vet is aware of what is happening. Keep in mind dogs are stoic. They will hide pain,and won't show it until it is totally unbearable. Watch for signals..shivering, refusal to move, tight tummy and yelping.. You can also see it in their eyes. Be the great detective when it comes to your Faith.
Pauliana
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Post by Nancy & Maisy on Apr 6, 2013 19:20:08 GMT -7
Thanks, Pauliana! Faith has appeared to be feeling good. I discontinued the Tramadol a couple of days ago. I haven't seen any signs of pain, but after reading your post just now I have a question. Could the fact that she still prefers to be created mean she's in pain? She comes out readily for potty breaks, having a good stretch, but is happy to go right back in immediately after.
No shivering, shaking, yelping, eye looks good, good appetite. She has started barking for treats and attention when she's bored.
Another question: is an older dog on strict crate rest at risk for pneumonia? Her heart is doing well these days, but she has a history of heart murmur. I have treated it for 2 years with the Five Leaf program with really good success. No more murmur! But I worry about the effects of this extended period of relative inactivity.
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Post by Pauliana on Apr 6, 2013 20:05:32 GMT -7
Nancy,
Sounds like Faith feels comfy in her crate.. Some dogs like their own personal space and she may just need lots of rest after her disc episode. It's great she likes her crate, so many struggle with their dogs not liking to be crated during the 8 week crate rest recovery.
Have you mentioned your worry about Pneumonia to your vet?
Pauliana
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Post by Nancy & Maisy on Apr 7, 2013 21:02:57 GMT -7
Thanks, Pauliana. She is comfy in there, but she also answered my question about pain by turning up shivering and shaking a couple of hours ago, so back on the Tramadol she went. She's feeling better now. I will ask my vet about the pneumonia risk.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Apr 8, 2013 11:59:50 GMT -7
I'm sorry to hear not all of the swelling was gone. Often it can take 2 or more weeks when on an anti-inflammatory. Faith is dealing with the inflammation at her body's normal level of steroid cortisol hormones...so it may take longer.
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Post by Nancy & Maisy on Apr 8, 2013 21:39:19 GMT -7
Thanks, Paula. I'm sorry too. She really seemed to be feeling better, but now it's obvious her left hind still really hurts her as well as her lower back. She had a pretty good day today on Tramadol and I'm happy she's more comfortable.
Nancy
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Post by Nancy & Maisy on Apr 13, 2013 15:13:48 GMT -7
Faith had acupuncture yesterday. She did well. It really relaxed her! The vet was pleased. She seemed to rest better afterwards, sleeping most of the afternoon. We had to do a blood draw to check her kidney values. She struggled some and it worried me, but she seems to be doing okay regardless. The real point of my post is that I asked the vet about the risk of Pneumonia in older dogs on strict crate rest. I was so reassured! She said there is no risk. Pneumonia develops in dogs that are laying on one side for a prolonged period and not moving much, as in sedated or seriously ill dog. Ah, one less worry.
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Post by Nancy & Maisy on Apr 13, 2013 15:23:24 GMT -7
I also wanted to note that I found and ordered a supplement for disc health. I found it online. It's a Vetri Science product called VetriDisc. It's in capsule form and I'm putting it in Faith's food. It struck a cord with me because she can't be on NSAIDS or steroids due to her kidney issues. This product helps amp up the body's own cortisol levels, as well as supplying needed nutrients for disc health and healing. I was very happy to find it!
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Post by Nancy & Maisy on Apr 16, 2013 0:58:17 GMT -7
Good news and bad news? The good news: Vet called today. Faith's blood work shows that her kidney values are the best they have been since I started treating her for kidney failure almost TWO YEARS ago! I couldn't be happier. The Gabapentin she was on for 3 weeks didn't undo any of our kidney progress.
Bad news? I am up late tonight perusing the board. I have had a nagging question in the back of my mind that I've overlooked due to the learning curve involved in IVDD. For at least two months prior to Faith's accute disc event, I noticed a slight head wobble every once in a while... like maybe every 5 or 6 days. She would come look at me in the kitchen and her head would wobble slightly, just for a second. I had no idea why and wondered if I was imagining it. Not noticing any other symptoms I made a mental note to tell the vet next time I took her in. She goes in pretty regularly for kidney and blood pressure monitoring. I mentioned it to the ER vet who x-rayed her back and she noted it in her dictation, but didn't say anything to me about it. Could Faith have neck disc issues as well as the lumbar area? Her neck wasn't imaged. In my reading here, it sounds as tho' the treatment is the same, strict crate rest 24/7 with an emphasis on keeping her food and water at head level. Any ideas?
I also realized that while I know she has 3 thinning discs in the lower lumbar region, I don't even know which vertebrae are involved. But, again, that doesn't affect treatment. I'm just wondering; would a more thorough work up would benefit us in any way?
I've been thinking of moving her to a more open style crate. I have a large one with better visibility. My hesitation comes when I remember that one of her favorite things to do is to sit up like a meer cat and clap her hands when she gets excited. She's feeling pretty good and I'm afraid she'll sit up, stacking her spine if she had more head room. Maybe I'll leave her in the airline crate. She's not complaining about it at all. It's easy to move and so she's with me all the time when I'm home. It does have its advantages.
I have a ramp now. I'm trying to teach my 1 yo mini doxie to use it. He prefers his tried and true method of getting on and off the furniture which is of course to jump. Any tips on helping him choose the ramp?
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Post by Sally & Vinnie on Apr 16, 2013 6:11:05 GMT -7
Try leading him up and down with a small treat & lavish praising. That worked well with the youngest of my three. Not so much with my middle fur child, hitch, who had a mild disc episode three weeks ago and is now on strict crate rest!
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Post by Nancy & Maisy on Apr 16, 2013 12:07:16 GMT -7
Thanks, Sally. That's what I'm doing. We'll just keep at it. I hope Hitch heals well, Sally! |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
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Post by PaulaM on Apr 16, 2013 14:09:41 GMT -7
Nancy, that is good news Faith is tolerating these meds. A disc episode in the neck is very painful and you would see signs like holding her head in an awkward position, nose to the ground, head held high. She might even hold up a front leg and not want to bear weight on it. Here is more on neck discs and the extra things you would do to help: www.dodgerslist.com/literature/cervical.htmHow nice to not have a complaining patient... Faith IS a good girl! Give her a kiss from us all. |
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Post by Nancy & Maisy on Apr 16, 2013 20:55:05 GMT -7
Thanks, Paula! I just don't understand the significance of the head wobble. It seems it would be a neurological symptom. But, it sounds like she doesn't have an injury in the neck. I'm thankful for that. Thanks again, for answering my questions.
Nancy
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Post by Sherry Layman on Apr 17, 2013 11:27:33 GMT -7
Regarding the head wobble I would just caution you that it's so easy for us to begin to micro analyze our dogs once we know they have disc disease. It's never bad to keep it in the back of our minds but say you knew the head wobble was related...what would you do? We have never advised people to crate for such a symptom and still wouldn't. And this type of symptom could be related to so many other things. Think of humans with Parkinsons, they often get the tremor of the head. I'm NOT saying your dog has Parkinsons, I'm saying it's too vague a symptom to definitely determine that it's related to a disc. It's hard indeed but we have to relax a bit about our dogs every move and not try to anticipate or over analyze or we'll crate them forever. I've had a dog with a cervical disc injury and believe you me if your dog ever has one you will know it!!!
When training a dog to use a ramp the suggestion of treats and praise was perfect. But in addition it is important that you keep an eagle eye on the dog and when they even make a hint of an attempt to jump up or down and not use that ramp you must intervene. Give a quick, sharp "no" then in a happy tone give a command such as "use your ramp" and show them what you want them to do and praise them like crazy when they do it. If you catch them jumping put them back at the starting point (up or down) tell them no jumping and command them to use the ramp. It's an active process and requires vigilance on your part but they are capable of learning if you keep at it. I have one that's resistant as well and even though he knows "right from wrong" we periodically have refreshers...spending a few minutes going up and down using treats and praise when necessary. Dachshunds are stubborn, you must be more so.
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Post by Nancy & Maisy on Apr 18, 2013 21:55:18 GMT -7
Thanks, Sherry. Great advice. I appreciate it.
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Post by Nancy & Maisy on Apr 21, 2013 15:38:24 GMT -7
Question: How will I know when it's time to taper Faith's pain meds (Tramadol)? She will have had 3 weeks crate rest tomorrow. Do I start tapering and watch carefully? Is this the only way to tell?
This is such a great and very needed site. I'm happy I knew about it before she had her disc injury. After reading here today, I bought a stroller. It's the same size as her airline crate, but more open and on wheels. It will make life nicer for both of us. I read that no stroller "walks" until she's off her pain meds. What about car rides in her crate. I mean, she has to go to the vet, etc. I hope the bumpy roads haven't delayed her healing. Nothing to be done about that, though.
My one year old Mowgli (mini dox) is using his ramp more and more. He likes it!
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