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Post by Melissa & Pepina on Mar 20, 2014 16:01:57 GMT -7
Pepina (8 1/2 year old doxie, red, short hair, no serious medical conditions previously)was diagnosed with IVDD in the neck after visit with ER doc last night. The doc recommended pain shot, sedation and xray to be rule out other things. She was uncomfortable before being taken for xray but nothing prepared me for what she looked like afterward. After everything she came back trembling and whining to high heaven. She is still whining today but not as badly and I am worried. I called last night after we got back and the ER vet said that reaction to the sedation is different for every dog. She had a horrible blank eye stare yesterday with that being better today at least. I am still very worried about her whining and would like some reassurance that this normal. Taking currently: Carprofen-every 12 hours 25 mg Tramodol - every 8-12 50 mg
Still going to the bathroom fine, but the whining and woobly legs over 12 hours after seeking medical care has me worried. I am trying not to over react. Working today on getting a crate area downstairs for her. Thank you for all comments and help so far. -One worried mommy
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,586
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Post by PaulaM on Mar 20, 2014 19:17:14 GMT -7
Welcome to Dodgerslist. My name is Paula what is yours? Can you fill us in on a bit more detail:--What is your dog's name and yours? -- Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, head held high or nose to the ground, tight hard tummy? Pain is not just torture but will hinder the whole healing process. Back ground reading to discuss pain meds with your vet....as you will see your vet has room to move to get things right for Pepina: www.dodgerslist.com/literature/healingpain.htm-- Make sure you do these extra things to help with a neck disc:http://www.dodgerslist.com/literature/cervical.htm -- How much does your dog weigh? What are the exact names of meds currently given, their doses in mg's and frequencies? Anti-inflammatories can increase GI tract damage. Phrase the question to your vet this particular way:" Is there a medical/health reason my dog may not take Pepcid?" If there is no reason, we follow vets who are proactive in stomach protection by giving doxies 5mg Pepcid (famotidine) 30 minutes before the anti-inflammatory and thereafter every 12 hours. We ask that all members read about each med their dog is on or may take as a safety measure. This directory very good for learning about each of your dog's meds: www.marvistavet.com/html/pharmacy_center.htm -- Eating and drinking OK? How are poops today- normal color and firmness, no dark or bright red blood? -- Currently can your dog till wobbly walk is that the front or rear legs? move the legs at all? or wag the tail when you do some happy talk? - -- If there is pain or neuro diminishment, dogs can benefit greatly with acupuncture or laser light therapy. These therapies can be be started right away to help relieve pain and to also to kick start energy production in nerve cells to sprout. So if this therapy is in your budget, seek out a holistic vet. ahvma.org/Widgets/FindVet.html www.serenityvetacupuncture.com/index.php/faq_/ [one vet's overview/prices] Chiropractic is not recommended for IVDD dogs. With 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. Are you ready? Here's the link www.dodgerslist.com/healingindex.htm Make sure your whole family can identify IVDD emergencies with this Fridge flyer: www.dodgerslist.com/literature/FridgeInfo81907.pdf and d/l this card to carry in your wallet for reference at vet visits here: www.dodgerslist.com/literature/MedCard.pdf
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Post by Melissa & Pepina on Mar 20, 2014 20:09:10 GMT -7
My name is Melissa, my little girl's name is Pepina. She weighs around 12 pounds and we have always been very cognizant of food and limiting stairs her entire life due to known issues with breed in back problems. She still seems not her self, she can pace if we let her but still wobbly legged in the back and trembles, but does wag tail and look much better than earlier in the day. She is eating/drinking gingerly and her stools have been normal, fingers crossed. My husband wants to wait to take her to vet after two weeks, but from the above symptoms should we take her in sooner? Have made a little cage, egg crate and blanket for her will access to water. She is a relatively healthy dog except for one issue which is sensitivity to all vaccines (had bad allergic reaction in her second year of boosters and rabies/antibiotics last year). This has made us relatively afraid to put her on too many meds in general. Thank you for all the helpful info on here we appreciate it.
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Post by Pauliana on Mar 20, 2014 21:09:38 GMT -7
Welcome to Ddogerslist Melissa! Pepina not being herself and trembling are signs of pain..How often have you been giving her the Tramadol? I see the prescription calls for 8 to 12 hours.. I understand about her bad reactions to the vaccines and being afraid to give her too many medications. Hopefully there will be pain relief for her without any reactions. Something very important to discuss with her Vet. A disc problem in the neck can be more painful and may take longer to resolve because a dog moves its head with almost all actions and when any other part of the body moves. That constant movement means that healing can take longer because the neck doesn't get the rest to allow the disc uninterrupted healing. These are additional things you can do to help with a cervical disc problem during the 8 weeks of 100% STRICT crate rest 24/7 with conservative treatment: Make sure the medications are fully controlling pain from dose to dose with no break through in pain. Continued feedback to your vet is vitally important until the pain medications have been properly adjusted for your dog. There is no "one-size-fits-all" pain control. 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, holding leg up flamingo style...not wanting to bear weight on the leg. These are the typical pain medications used to treat IVDD: Tramadol as the general pain reliever. It has a short half life of 1.7 hours and may need to be prescribed at a minimum of every 8 hours. Methocarbamol treats muscle spasms stemming from aggravated muscles due to nerve trauma related to the spinal cord inflammation. Gabapentin may be added to the mix for hard to control pain. Veterinarians are finding this medication works very well in combination with Tramadol. Prescription of a NSAID (Carprofen,Rimadyl, Metacam, Deramaxx, etc.) should be accompanied by a stomach protector such as Pepcid AC (Famotidine) to avoid serious gastrointestinal damage. For some dogs Pepcid AC needs to be accompanied with yet another protector, Sucralfate, when there are signs of GI problems of diarrhea, vomit, bloody stools. An anti-inflammatory can take 1-2 weeks or longer to resolve all swelling that causes the pain. Raise food and water bowls to head height to avoid Pepina bending down to eat and drink. If you feed kibble, moisten each meal with equal parts water and kibble and allow to hydrate in the fridge overnight. Then warm slightly in microwave, just to take the chill off, before serving. This will eliminate pain from crunching kibble. No chew treats or kongs during recovery. Chewing on those makes the head and neck move a lot and can deter healing and cause more pain. Snuggle Safe is a commercial product that will keep warm the whole night. Wrap in a towel piece of fleece fabric as a soft place to rest the head or snuggle with. Snuggle Safe is available at pet shops or on-line. Raise the crate up on a table so there is no need for your dog to to raise the head to look at you or watch the world from the crate. Laser light therapy has proven to be very beneficial in resolving inflammation, pain and speeding up the healing process so if that is a financial option for your family, it is recommended.
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Post by Melissa & Pepina on Mar 22, 2014 13:54:14 GMT -7
Update on Pepina: We took her to the vet yesterday 3/21 and he moved her body around and she had no reaction to it like she did on Wednesday night 3/19. She is up and moving around and he felt she looked very good. He actually can not diagnose the trembling since she is not exhibiting any areas of pain at this time. He did give us the muscle relaxer methocarbamol to give her every 12 hours. Meds: 12 pounds methocarbamol every 12 hours Tramadol -between every 6-8 hours 50 mg Carprofen - every 12 hours 25mg Pepcid AC (taken 30 mins before Carprofen) 5 mg
He speculated that the sedative and pain injection may have been a very traumatic mix for her in particular. He said the opiate could cause a reaction such as wobbly legs (which we thought meant IVDD getting worse by minute), but also unsure if something happened during the xray. He also thinks that she is still anxious from everything that has gone on instead of being in excruciating pain. He suggests to do 4 weeks of crate rest and continue the meds above. We are also doing chicken/rice/peas/carrots food for her due to her hesitancy to eat her dry dog food (he checked her teeth in case that was he issue, all clear). Her bowel movements are good, urine is fine, she is really is just shaky when she comes in from having a bowel movement. This whole episode has been crazy and we would probably should not have done the xray in hindsight as the methods to keep her still made things worse. She is one sad and miserable pup when we come and get her for her food/meds/bathroom breaks. I am uncomfortable that we do not have definitive answers on this episode but waiting to see how the crate rest turns out to decide whether to go with MRI. Her eyes tell me "no more vets!"Thank you again for the support.
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Deborah & Angel
Helpful Member
No current back issues... Living Life.. <3
Posts: 294
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Post by Deborah & Angel on Mar 22, 2014 14:47:10 GMT -7
Hi Melissa, my name is Debbie, it's good to hear that Pepina is at last getting some relief from pain, I know how hard it is to see them miserable...You are doing a GREAT job... Stick to the crate rest even though she seems to be better, it take a long time for the spine to heal, and for the inflammation to go down.. Hugs and Prayers to your and your furbaby from me and my Furbaby Angel..
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 23, 2014 5:08:52 GMT -7
Dear Melissa, Pepina is trying very hard to tell you and her vet that she is in pain! Going out to do her business would not cause her anxiety - it would cause her pain from movement and that is what is causing her trembling. I do hope that the addition of Methocarbamol will help the pain from muscle spasms, which is very common with neck injuries. Please let us know what the exact dosage of the Methocarbamol is. Be sure to give the Tramadol every 8 hours as it works best when given consistently every 8 hours instead of 12. Your vet can also prescribe Gabapentin, which works well with Tramadol. Pepina's pain should be completely under control within one hour of giving meds and there should be no sign of pain from one dose of meds to the next. If that is not the case and the trembling has not stopped, please contact the vet today to have Gabapentin added. Also, when was Pepina given her last Tramadol before going to the vet? That may well have been masking pain to an extent during the examination. 4 weeks of crate rest is not enough to heal a damaged disc. 8 full weeks of 100% 24/7 strict crate rest is necessary to heal the disc and to allow scar tissue to form. Neck injuries can be much more painful than back injuries and can take longer to resolve. The reason Pepina will not eat her hard kibble is that it's painful for her to do so because of the injury to her neck (yet another sign of pain!). It's not a good idea at all to change her diet while on conservative care for two reasons - (1) she needs her regular nutrition as her body has a lot of healing to do and (2) change of diet can cause GI tract problems that would make it difficult to tell whether it was from the change of diet or from side effects of the meds. Not all vets are experienced enough or have seen enough cases of IVDD to properly treat them. Board-certified neuros (ACVIM) and ortho (ACVS) surgical specialists can be found at University vet teaching hospitals. You can locate others in your area here: www.acvim.org [neuros] online.acvs.org/acvsssa/rflssareferral.query_page?P_VENDOR_TY=VETS [orthos] Dodgerlist Members' vet recommendations - dodgerslist.boards.net/board/10/guidelines-postingPlease let us know whether Pepina's pain is completely under control now that Methocarbamol has been added. We are concerned about her and will anxiously await word. Healing prayers for Pepina.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,586
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Post by PaulaM on Mar 23, 2014 9:29:39 GMT -7
Melissa, pain is the one phase of healing that we can have no patience with. Working with your vet means updating at ANY hint of pain to get an adjustment on the drugs (shivering, trembling, yelping when picked up or moved, ginger or reluctant to move, much or slow to move, tight tense tummy, yelps). There should be no pain after moving or nearing the next dose of pain meds. Not eating can be due pain with crunchy kibble, perhaps Carprofen distress as Marjorie explained. It is important to rule out the not eating kibble. A 2nd stomach protector may need to be on board if Carprofen distress. It can be painful with a neck disc to crunch. This tip plus other extra things you can do to help with a neck disc are here: www.dodgerslist.com/literature/cervical.htmA chicken/rice mixture should only be used for a few days to get over stomach issues not long term as the nutrition is woefully inadequate. Try transitioning her slowly over the course of the next several days back to kibble so as to avoid a confusing situation of stomach upset. Try soaking an equal amt of kibble as liquid overnight in the fridge for each meal. Warm before feeding. Adding chicken to the soaked kibble is fine...just keep it to no more than 10-15% to maintain the balance of minerals and vitamins a dog needs especially now with all the repair jobs the body is working on. 10 to 15% isn’t very much. For example, if you feed a dog 1/3 of a cup = 5 tablespoons = 15 teaspons, then you should only supplement with a max 1.5 to 2 teaspoons of homemade on top.
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Post by Melissa & Pepina on Apr 6, 2014 5:30:59 GMT -7
Good morning, I just want to thank everyone who has given us some great advice and kind words. Update on Pepina. Her symptoms have all cleared up since I last emailed, I was out of town last week and this past week have been catching up so kudos to my husband for playing nursemaid to Pepina. She is actually very hyper and full of energy and is giving us the "why am I still here" looks when we put her back in the pen, I see how sticking to this can be hard. We have another two weeks of the crate and will take her back to the vet around April 17th. I am still confident that we can stick with our general vet for now during the conservative treatment. She has finished all of her meds except the muscle relaxer. She is not showing signs of pain at this point, but we will continue to watch her. I guess I am curious will we need to avoid couches for the rest of her life after this episode has resolved entirely?
Thank you, Melissa and Pepina
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,586
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Post by PaulaM on Apr 6, 2014 10:29:24 GMT -7
Melissa, why is Pepina still on the muscle relaxer? When will she go off of it to give full proof all the pain is really gone... evidence there is no more swelling of the spinal cord? Very glad to hear then that there is no pain and no more wobbly legs. Now all that remains is letting the disc fully heal for the remainder of the 8 weeks. After graduation day, you will want to encourage activities that would place less/no stress on discs. You'll want to consider several avenues to achieve that goal. Furniture blockers, ramps to outdoors and couches, reinforce training to increase reliability of using ramps, and wrapping your mind around living a quality life with Pepina. These are the articles in particular you will find that needed information. Our All Things IVDD website is one to bookmark as it is "the" treasure trove of disc disease knowledge. All Things IVDD: www.dodgerslist.com/literature.htm#afterrest "After Crate Rest Easing Back into Physical Activity" "Back Friendly Home Ideas and Tips to Protect the Back "Ramp Training" Wrapping your mind around "Living with the Fear of IVDD" is right here on the Forum: dodgerslist.boards.net/thread/410/living-fear-ivddHow about joining our Dodgerslist Educational Team? We depend on our members sharing what they have learned not just with new dog owners, but their vet too. We have free business sized cards to hand out where you see breeds prone to IVDD and a beautiful written brochure vets find helpful in explaining all about the critical part of conservative treatment...crate rest to another client. Ask Linda to send you a packet of hands here: www.dodgerslist.com/literature/litorder.htm I also highly recommend adding this comprehensive "must-have" $3 DVD on IVDD to your arsenal of educational resources. Friends, family and those who will be caring for your dog should also watch this DVD; plus don't forget to order one DVD for your vet www.dodgerslist.com/literature/litorder.htm
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