Tina's Diesel 2/22 Conservative

Hi Tina, you are at the scariest part of this with Diesel; just be strong for him. The moderators on this site are going to help you with some amazing information and the way to approach your vet - and/or help you find a vet that works best for your pup. I am still in the midst of this with my 5 year old dachsie, Emmie, but it gets better once you are equipped and feel like you know what you are doing and that it is what is best for your dog. I would have been lost without the support here, so welcome. Emmie and I will send healing thoughts to Diesel.

I am so thankful for this site. After educating myself today on this website I feel like unfortunately I was not really given accurate information about what the best course of action was for his care. I was told he needed to be on bed rest and that we would take it day by day. When I heard bed rest, my mind went to me being on bed rest. So my thought was to keep him in bed next to me at night, where I could feel him move if he needed anything, and then crated during the day, where he could rest. I am now worried that I have caused more damage. 

When I brought him home on Saturday afternoon he ate and was still wagging his tail. He isn't wagging his tail anymore and he has not eaten since Saturday and has been reluctant to drink water. I have been using a medicine syringe giving him a couple cc's worth of water when I get into his crate to change out his puppy pad and tonight he took a few drinks of water on his own. He is still refusing to eat. Up until today he seemed to be holding his pee until I took him outside, but since this morning he seems to no longer have control over his bladder and is peeing on the puppy pad that I have put under him in his crate. 

He currently only has the use of his front paws and is able to prop himself up almost into a sitting position. He does not appear to be in pain, in that he is not crying or yelping, but I have noticed that he is holding his head back away from his body, which I read on one of the pages on here was a possible sign he may be in pain. Tomorrow is day 4 of the patch so it sounds to me like it is time to get some more pain meds from the vet. As I mentioned in my post I spoke with the vet briefly today about my concerns and he said he would call back, but never did. 

As far as what he was given at the the vet. He was given a
.55 dose of Recuvyra  [Fentanyl transdermal solution] 4 day pain control and a 
2mg/ml injection of Dexamethasone. He is taking
half of a .75 mg dose of Dexamethasone once every 24 hours.

I do not have any Pepcid AC in the house, I will run out now to get some and inform my vet in the morning of that development. 

He has had only one very small runny stool this morning, it did not appear black or tarry or to contain any blood. But I will pay more attention to the next stool he passes. 

Finally, I have the name of a Vet in Corpus Christi, which is about an hour from where I live, that does both acupuncture and laser light therapy. I intended to call him today but am an Asst. Dist. Attorney and unfortunately, as luck would have it, our office is in trial this week and I was lucky that I was able to sneak home around lunch to check on my little guy and take some time on your website. I am hoping to have some time tomorrow to contact this specialist and arrange an appointment as soon as he thinks it is wise. 

Thank you for your advice thus far. And thank you to Vita & Emmie for your kind words. This site has really been a blessing to find. I was considering taking him for a second opinion because I did not feel like I was doing enough for him, but I feel so much better after reading some other threads and learning about how to build a good confinement space for him. I will continue to keep you all posted about his progress. Thank you again. 

After reading the link on Recuvyra I am somewhat relieved to know that lack of appetite is a known side effect. I ran out last night and got some Pepcid AC and gave him his first 5mg dose last night and will be giving him his second dosage when I run home for lunch. At that time I will take him outside to a pee spot to see if he will release urine on his own. I have fashioned a sling out of an old pillow case that I think will work as shown in the diagram regarding keeping his back aligned properly while on potty breaks.

This morning I was somewhat excited because he drank water on his own and gave a little tail wag when he saw one of my other dogs. But moments before I left for work he threw up and there was still undigested food from the last time he ate which was on Saturday. Needless to say I was very alarmed. I called the vet again and they agreed to see me today as soon as I am done here at the office. I also informed them that I had started him on 5mg of Pepcid.

Finally to answer your question about a pain pill that would require frequent dosing. My ability to leave work and run home varies depending on how busy the docket is on any particular day. Most days I can for sure leave and run home during the lunch hour and would also be able to leave every few hours if he were on a med that required a dose say every 2-3 hours, however, there are some days when I am in the courtroom most of the day and am lucky to see the light of day myself. So to be on the safe side I would need a pain med that has a longer range between dosing periods to account for those days/weeks when I can't get away. Not sure if there is a pill like this out there, but I am hoping to find some more answers today at the Vet especially now that I am armed with so much more info that I can be a part of the conversation on his treatment.

Thank you again for all of the feed back and I will once again give an update after his appt this evening.

Oh a few more things I forgot to add. No x-rays were taken and the vet did not perform any type of test to determine if he had feeling in his lower extremities. Should I be alarmed? Does Diesel need a more proper examination to determine exactly what is wrong or is it at all possible that the vet could tell from feeling his back and listening with stethoscope (which is all that was done). Also, I was given no instructions about tapering off his steroid meds. Doesn't he need to be tapered off so his little body knows it needs to start producing steroids again or is that something unique to humans taking steroids? Finally, I am reading other threads and seeing that the other dogs seem to be on much higher and more frequent doses of some sort of steroid. Is this something I should address with the vet today? Thanks once again.

Well I must say after visiting the vet last night I am more confused than ever. The Vet is not going to give another pain med because he said Dexamethasone is also used as a pain reliever. I told the vet I had begin giving him 5mg every 12 hours of Pepcid AC because of my concern for his stomach and asked if Diesel could be prescribed sucralfate to make sure we were protecting any damage to his GI Tract. The vet said he did not need either of those meds and instead prescribed a once a day pill for vomit and nausea. Unfortunately after taking the nausea meds, Diesel still did not want to eat anything.

Second thing that threw me off was that I told the vet about this wonderful site I had found and explained all the things I had done to make an appropriate confinement area for Diesel over the next 8 weeks and he told me it was bad to keep him in the confinement space all the time. That Diesel needed to be limited to a somewhat enclosed area but not confined to complete bed rest. That I should work out his hind legs that are paralyzed and also massage them at least once a day. He equated me keeping Diesel confined to what would happen if a person after an injury just stopped moving. He said the unused muscle would atrophy and they would be worse off after. He also told me I needed to give Diesel a bath when needed because he was having accidents and just to put a non-slip pad in the bathtub. And finally he said bringing him up on the bed with me where he feels safe at night was a perfectly okay thing, as long as I am sure he wouldn't try to jump off.

At this point I am unsure of what the best thing to do for Diesel is and am seriously considering taking him to another vet in town to get a second opinion. My apprehension with that is the cost seeing that I have spent hundreds of dollars since Saturday with my last two visits to his normal vet. Not to mention all of the items I purchased to make his confinement space safe. Are there different theories on a dogs best course for recovery? Or does my vet just not have experience in dealing with this type of injury? The other thing that seemed a little off was that he once again brought up surgery as an option and from what I have read surgery sounded like it was only really a viable option for the first 24 hours or so. Wondering what your thoughts are about finding another vet in town for a second opinion?

Finally, Diesel still will not eat. He drank water this morning and then threw it up. He did have a bowel movement and it was not black or bloody but it did seem a bit tarry. Not sure what to do now. Please help.

Tina,

It seems your vet is not at all comfortable with treating IVDD. From personal experience, I can tell you that Dexamethosone alone is not a pain reliever. My Mimi was on Dexamethosone, Tramadol and Gabapentin to reduce her swelling and control her pain. You need to find another vet who will work with you to treat Diesel conservatively.

I understand that cost is a factor, I really do. But after your initial appointment (with a good vet who understands IVDD), aside from the cost of medicine, you shouldn't have very many additional vet costs unless you see regression. I did most of my consultations with my vet over the phone and only brought her in during the two regressions with tapers and when we were halfway through successful treatment just as a follow up to determine the next taper. Also, many vets are willing to work with you to help minimize your costs. Here is a link that shows you where to get medications at reduced costs:
www.dodgerslist.com/literature/healingpain.htm

Our vet is three vet practice.  The vet Mimi first saw at the practice put her on dexamethosone and tramadol from the get go and instructed a minimum of 6 weeks of crate rest (of course I found Dodgerslist and did the recommended 8 + 2 because of her taper).  She then saw an inexperienced vet at the practice (1 year of practice experience) after the unsuccessful taper who put her back on the dexamethosone but was wanting her off the steroid asap.  The 3rd vet we saw (after another unsuccessful taper) was willing to work with us, keep Mimi on the steriod for longer and helped us through her recovery.  So even within a practice one vet could be much more knowledgeable of this disease than another.  One thing to note, all three of the vets were firm on a minimum of 6 weeks of crate rest. 

So please, start calling around for another vet.  GO through the phonebook if you need to, calling before you visit, to ensure that the vet is comfortable treating IVDD, so you don't spend money you don't have to.

Please let us know how things go.   

Over my lunch break I left my number with another vet here in town and asked the front desk staff if she could please call me when she had a minute. Thankfully she did, and I explained what was going on and asked if she was familiar in her practice with IVDD. She said she was and would personally be taking a different approach to treating Diesel. The earliest she can see him is Friday morning. Until then I I will continue with the Pepcid AC every 12 hours and as soon as I get home I will update with the name of the anti vomiting pill.

Hi Tina, I'm hoping we haven't had an update because you are busy camping at the vet's door step like Paula recommended . Update us when you can - I'm worried about Diesel.

Tina, that is encouraging that he is eating something. It may be the Pepcid AC is helping. I still would lobby for sucralfate on Friday. He still has loose stool showing GI problem. Just as with people stress can cause ulcers. Diesel is under stress with change in routine, dealing with pain and he has the added GI problems anti-inflammatory meds bring.

I would also be wanting to know exactly what the different approach is.... full pain management. OR that she is in the camp not to use steroids, but rather NSAIDs? Know your anti-inflammatories, that switching classes requires a 4-7 day washout with nothing to deal with all the swelling. Background information on anti-inflammtories: www.dodgerslist.com/literature/healingsweling.htm

Hot dogs are pretty heavy with fat which can cause diarrhea, which could contribute to a muddy picture with loose stools. Boil up a hamburger patty in a cup of water or so. Cool and remove the disc of fat. Some of the meat broth on his wet food and a teaspoon of the meat may just be the incentive he needs to eat a bit more.

You have a tough work schedule, so kudos to you for getting an appointment and all the time consuming things I know you are doing to care for Diesel. Good job! We'll be waiting to hear what the new vet prescribes. You are so much better educated now to be able to participate in discussion about his treatment, ask the right questions and advocate for Diesel's needs.

Just wanted to point out that any change of diet needs to wait until after conservative care. Dogs going through an IVDD episode have a lot of repair jobs to do so their normal food and rations need to be given. Plus, changing the diet can sometimes cause GI symptoms such as diarrhea or vomiting and it would be difficult to know whether the symptoms are from the change in food or from side effects of medication.