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Post by Peyton & Geoffrey on Mar 2, 2014 0:13:52 GMT -7
Hello!
Geoffrey is a 10-12 year old piebald Dachshund. He is particularly long with a slight curve to his back. He never carries an ounce of extra weight, and he has no tail. The x-rays show that there are two tail vertebrae tucked in his body. He has an odd tuft of hair at his back end as if the tail started to develop and failed. I've been told this qualifies as a spinal deformity. He came to us from Southern States Dachshund rescue (now called All American Dachshund Rescue) in 2006. He was considered special needs, because he is terrified of men and they believe he was badly abused.
His first occurrence of IVDD was circa 2007. He just refused to walk one day. It turned out that he could walk, had full deep pain sensation, and his reflexes were all in tact. He was diagnosed without x-ray. They just seemed to assume the source of his problem was IVDD. I was never sure he'd had an incident, because there was no wobble. We'd only had him about a year, but I have come to understand that he has a very low threshold for pain. He's very sensitive, too. If anything is bothering him, he won't get out of bed. He's used to having a doggie potty in his room during the day, so he opts to use that instead.
In December, he started wobbling suddenly. One of his legs was weak not both. We put him on 10 weeks of crate rest again. He was failing the reflex tests. He would turn his feet back over slowly. He was put on Rimadyl (with Pepcid), Tramadol, and Prednisone. He improved over night. Initially, he would sag when he lifted his leg to pee, and he would have to prop himself up on something. The x-rays showed even spacing between all vertebrae. No signs of calcification. The vet found tenderness at the high point in his back (he often curls into a ball to sleep and this is the point where the strain is placed). The interesting thing was that as he got better, his back straightened out better than I have ever seen it. It struck me as odd, though, that it would do that. After a few weeks, he stopped improving. The straight back was fascinating, but he couldn't pee properly. He could lift his leg fully but he would sag slightly (it was more like flexing) while peeing.
Before I go on, I should admit that we were lax about his crate rest because when he went down we had puppy whose spay had gone wrong and a month later, we suddenly had a very sick 15 y/o cat with a severe tooth abscess. We did keep Geoffrey contained, but we let him walk outside and let him get away with more than we should have.
On Thursday, I found Geoffrey all hunched up. He was worse than he initially was in December. I felt like I'd failed him. He tried to pee and couldn't lift the leg (he dropped down into a spread-legged position like a tripod). I had no idea what we were going to do, because he's not a good candidate for surgery (heart murmur), and I was so sad for him. He's a runner, a digger, and a jumper. He does yard patrol (that's how he stays so thin). He's not a dog who adjusts to strange things. I'm not sure he would ever accept a cart. I can't even get a sweater on him when it's cold. I still had some of his meds left (he had begun refusing to eat anything if he could smell the pills in them), so I started him back on the Pred and the Tramadol that night and kept him home.
I decided to put him on a more stringent 10 week crate rest and look into holistic options. He now has a very small space in the laundry room...enough room for his bed, his bowls, and a piddle pad so he can go when we're not home. This time, (thinking about how straight his back had been for awhile), I swapped his shorter bed for an ortho crate bed we'd just purchased and put his area in the back part of the laundry room where the bed would be against the wall (used blankets for bumpers). I was hoping if this would encourage him to stretch out and reduce the compression on the lower portion of the middle disc where the pain was identified.
The next morning, he was standing properly. We didn't allow him to leave his little zone in the laundry room until Friday night when I carried him outside to pee. I wanted to see if heavier restriction would make any difference.
The strange thing is this: When I took him outside tonight and he peed, he didn't flex his stance at all (I am not letting him walk around outside but the sling freaks him out, so I set him down and keep the leash tight). He lifted his leg tall and strong......better than he has since December (he looks like nothing ever happened). So, I decided to test his reflexes when I got back inside, and his reflexes are back to near normal?? He turns his feet back over with almost no delay. He does still have some tenderness, but not around the disc as it was in December. It's tender around his ribs on one side. It reminds me of when I've had my back adjusted (I have scoliosis).
I'd be really curious as to what thoughts or experiences people have with something like this. I'm so surprised by the return of his reflexes and his ability to raise his leg properly. I thought we'd started down the path to eventually needing bladder expressions and a cart. I don't know what to think now.
I can't say I'm happy to be back in the Dodger's List community, but I am feeling more optimistic than I was a few days ago.
On a side note, we're starting with a new vet on Monday who does acupuncture.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Mar 2, 2014 6:01:57 GMT -7
Welcome to Dodgerslist. I'm so sorry to hear of Geoffrey's difficulties. Is your name Delenn? The purpose of the anti-inflammatory (Prednisone) is to get the swelling caused by the damaged disc down. That swelling and damaged disc are pressing on nerves of the spine. It's quite possible that the Prednisone brought the swelling down quickly and you saw an improvement right away. Also, the Tramadol is masking any pain he may still have. However, 8 weeks of STRICT 100% 24/7 crate rest is necessary to heal the disc. It's not enough to put Geoffrey in a small area. He needs to be crated 24/7, only carried in and out to potty with a few steps at potty time. The crate should only be large enough for him to stand up, turn around and lie down with his feet extended. Think of the crate as a cast for the back. The crate will also prevent him from "escaping" from the area you now have him in as he begins to feel better. It's most likely that the disc did not heal properly since strict crate rest wasn't done in December so please commit to STRICT crate rest for a full 8 weeks starting TODAY. The only way that he will need more than 8 weeks of crate rest is if he needs Prednisone for an extended period of 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. www.dodgerslist.com/literature/CrateRRP.htmYou mentioned that you started him back on medication but didn't mention going to a vet. Has Geoffrey been examined for this new incident? I also see mention of the fact that you have used chiropractic treatment for your own back. Please beware of using chiropractic treatment for Geoffrey as that can be a very dangerous practice for IVDD dogs. www.dodgerslist.com/literature/chiropractic.htmWith this disease self education is critical not just so you make sure the right things are being done for the best recovery but for your own emotions. The unknown is simply a scary place. Get ready to fight this disease now and in the future by knowing all things IVDD. There is no better place to start than on our main web page with "Overview: the essentials" and then read all you can as soon as possible. Here's the link www.dodgerslist.com/healingindex.htmCan you give us a bit more in essential information about your dog: 1. Is there still currently pain? Signs of pain are holding the head in an unusual position, head held high or nose to the ground, shivering/trembling, not wanting to move much or moving gingerly, yelping, tight/tense stomach muscles, arched back, holding leg up flamingo style, not wanting to bear weight on the leg, just not their usual perky-interested-in-life self. 2. What are the exact names, dose in mgs and frequency of all meds? It's important that you be knowledgeable about each medication being given and all cautions concerning them. www.dodgerslist.com/literature/drugs.htmmarvistavet.com/html/pharmacy_center.html3. A stomach protector should be given to protect your dog from the excess acid produced by the anti-inflammatory. We usually recommend giving 5 mg of Pepcid AC (generic is famotidine) 30 minutes before each dose of the anti-inflammatory and thereafter every 12 hours. However, with Geoffrey's heart murmur, the vet may feel he shouldn't take Pepcid AC. Please check with the vet to see what stomach protector would be best for Geoffrey but do get one on board. It's best to protect against GI tract side effects before they occur. 4. Eating and drinking OK? 5. Poops OK - normal color, firmness, no dark or bright red blood? It sounds as though Geoffrey is a very good candidate for conservative care and it's a very good sign that he's already showing signs of improvement. Just stay committed to strict crate rest. We'll help you and Geoffrey through this incident. Healing prayers for Geoffrey. |
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Post by Peyton & Geoffrey on Mar 2, 2014 12:35:44 GMT -7
I've actually spent the last six years assuming this was coming and preparing for it, so I feel like I have a good grasp on what to do. I have also had seriously ill pets with chronic issues (I had a seizure dog for 13 years), and we just lost her in September. I really never expected him to go six years without another issue. I've already made my decisions about how to proceed. I had a plan based on everything I have read over the years. Granted, with the sick puppy and the sick cat, the plan fell by the wayside, but they're fine now. We're back on our game. I'm really just posting because I'm curious as to whether anyone has experienced better recovery like this.
1. I put him on the meds to try and improve his chances for success until we could get him into the vet, but our vet made me very angry on Friday (we have only been seeing her since September and have been increasingly unhappy). I didn't want to go into it in the post, so I had just opted to mention that we were starting with a new vet on Monday. Our existing vet agreed to put him back on medication, so I drove over after work only to find that she had changed her mind. She was going to leave him to suffer until I could bring him in. Had she called me at work, I would have picked him up on the way over. Her expectation seemed to be that I would bring him in on Saturday.....no thought as to whether we were in town, had plans, had to work, etc. I was livid. She was willing to give me pain pills, but as we know, the inflammation is what does the damage and stopping it as fast as possible is important (I had plenty of the pain pills). I put him on the pills until we could get him to the new vet. I think that getting those pills into him that night made a big difference.
2. I have to disagree with you on the crate vs. small area, though. I will explain why. I learned this the hard way back with his first occurrence. Some dachshunds are an unfortunate size for crates. Long dachshunds can end up with crates much taller than they should be. He is very long and very flexible (since he carries no extra weight). A crate that will allow him to lay down is tall enough to allow him to stand up on his hind legs (he twists to do it). It undermines the purpose of the crate rest. The small area just has to be designed properly. He has a little more space in his small area than in his crate but not much when you consider how long he is. It's enough to allow him to piddle during the day (he can take four steps. He doesn't jump or thrash in it like he does in the crate. He will happily ride in a crate in the car, but if he wants to be with the family, all bets are off. He stands up, rattles the bars, jumps around.....Keep in mind that he was a rescue with severe emotional issues and still has triggers. We also don't have the ability to come home during the day, so I sized the area to allow him just enough room to do his business. He doesn't feel compelled to try and get out or stand up. He stays in his bed unless he needs to do his business. In essence, he gets more rest this way.
I'll go into more about the meds and such when we have had the appointment with the new vet. Right now, we're just managing him until we can get him on the full regimen.
My name is Peyton. I thought I'd signed my post. Oops.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,597
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Post by PaulaM on Mar 2, 2014 15:00:00 GMT -7
Peyton, if nerves are just irritated and not yet damaged (killed) then yes, of course, you may see in a matter of hours that prednisone has brought the swelling in the spinal cord down just enough to bring back neuro functions. Once nerves have been damaged so that nerve functions have been lost such as parlayzed legs, loss of bladder control, then it can take take months or longer for nerve ending to regenerate enough to make connection again. With a heart murmur Pepcid AC may not be a good choice.... please discuss with your vet, perhaps another protector such as sucralfate would be a safe choice. Let us know what your vet prescribes as the necessary GI tract protector anytime an anti-inflamamtory is in use. I see you have a situation with working and the likelyhood that Geoffrey will need to potty every 3-4 hours while taking prednisone. Because the only way the disc heals is with limited movement, here at Dodgerlist we make every effort possible to ensure the dog is on 100% STRICT crate rest 24/7 during the 8 weeks and that at potty time the dog is carried to and from the potty place and then just a very, very few footsteps are allowed. Let's see if there are any options at all for your circumstances to make the strict rest happen. We have heard stories time and again...that dogs do the unexpected and get into touble with that healing disc. Let us know if any of these ideas could be incorporated: -- Use the right size crate that allows only room enough to stand up, turn around and when lying down to fully stretch out those legs. Tamara's idea to lower a crate's ceiling or the option 2 underneath may help Geoffrey: www.dodgerslist.com/literature/cratesupplies.htm-- Is there family or a friend that could stop in on Geoffrey to carry him to and from the potty place?Laundry rooms can be isolating to a dog who will be on crate rest for 8 weeks. So that would be another reason to use a crate or an expen that can be positioned in the middle of family activity.Reasons to not start an anti-inflammtory before a vet visit: -- A prior blood test should be done to verify health of organs -- There are other diseases (tumor, fractures, bone infection, etc,) which can mimic a disc episode. The vet seeing a dog in without meds is important to getting a good diagnosis. Tramadol is a short acting pain med that would be out of the system in 8 hours or so before a vet visit. But prednisone and NSAIDs stay for days. By now you are likely aware of the dangerous practice of using NSAIDs with prednisone w/o a 4-7 day washout. So until you get a diagnosis this is a disc episode, it is very prudent to do the crate rest as means of keeping the disc from further tears and the potential for severe nerve damage. We look forward to what the new vet thinks and prescribes. |
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Post by Peyton & Geoffrey on Mar 2, 2014 21:32:47 GMT -7
Thank you. The reality is that he is a special needs dog (regardless of the IVDD). The vets said we should not expect him to heal emotionally from what he had been through, and that he might always be full of issues. Our mobile vet (who we see for vaccinations) still can't believe the changes in him. o one thought he's come this far, but he still has his issues and triggers....especially strangers in the house when we're not there. That is why I have the plan in place that I am using. I did spend six years working it out..adjusting it as I saw ways in which it wouldn't work. Talking to our mobile vet about crate vs. other options for containment. It's well thought out. It takes into account everything that is recommended plus his special needs. It's vet approved (she has no office to deal with, so she spends a lot of time studying up on the latest information....very useful).
I didn't know about the height adjusters, but I'd still be very concerned about any thrashing if he decided he wanted out or if he panicked and felt he had to get out. His current situation keeps him calm. He doesn't jump. He doesn't panic. He doesn't try to get out. He stays in his bed. He barks if he needs to go potty. Remember, he's in the double digits...he may be as old as 13 or 14. We don't really know. He is perfectly content to sit in his bed and get up only if he absolutely has to. Of course, if I were to let him off leash in the yard, he'd go into "patrol mode", but in the house, he's a potato.
Sadly, despite years of trying, it's not an option to have someone come to the house. We can't board him. We can't even leave him with people he knows very well. Thankfully, he is used to this routine, and he is used to being contained much of the day (with more space than he has now, but the change is causing minimal stress). Of course, his age helps.
As for the meds, he doesn't appear to be having any pain at this point, so I will likely just take the pain meds and let him guide me as to whether he needs them.
More to come..
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