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Post by itgirl74 on Mar 28, 2013 18:59:12 GMT -7
I apologize in advance for this very long post.
My dog Brody - an almost 7-year-old Scottish Terrier - was diagnosed with IVDD on Monday 3/25. About 5 days earlier, I noticed he seemed to be having an issue in his left leg or foot. Unfortunately I misinterpreted this as pain in his left foot, where he had his toe amputated on Jan 16 to remove a tumor (turned out to be malignant melanoma - yes it has been an absolutely horrible year for this sweet dog). For the first few days, it didn't seem so bad. He didn't want to play, but he was walking around fine and even jumping on and off the furniture, albeit a little more slowly than usual. I noticed his back left foot slipping a little bit, particularly when standing to eat, but again I thought it was just the foot that hurt and maybe he was reluctant to put too much weight on it. On Sunday he declined rapidly and by the evening was clearly in pain - shivering, hunched back, yelping when turning around to lie in a different position. His back legs were wobbly and he was walking very slowly. I almost took him to the emergency vet but found a leftover pain pill from the surgery, and that allowed him to rest comfortably until I could get him to the vet on Monday morning.
The vet examined him and found very slow reflexes in his back left foot (it took him quite some time to right it after she turned it upside down) and tenderness in his spine. The vet thought it was IVDD but also recommended a spinal x-ray to make sure it wasn't the cancer metastasized to the bone. X-ray was clear for cancer in the spine (it showed metastasis to the lungs which he hand't had before, but that's a whole different issue) and confirmed the IVDD diagnosis.
The vet recommended 2-3 weeks of limited activity and prescribed Vetprofen (Carprofen) 25mg 2x/day and Tramadol 25mg 2x/day. When I brought him home, he tried to jump on the couch and yelped loudly, and I immediately put him in his crate so he wouldn't hurt himself again. For the next couple of days I only let him out to go outside for potty breaks and to eat. Last night I found this site and realized that I had to be much more strict about limiting his movements and that it's going to be a good deal longer than 2-3 weeks. It breaks my heart to have him in pain and confined for such a long time considering that I don't know how much longer he has to live. However, before this back issue you would not have known that he was a sick dog, and I have to believe that his cancer treatments are going to work and he will have some happy and pain free time left after 8 weeks of strict crate rest.
Today has been difficult day. We had a 4pm appointment with a holistic vet. Just as I was getting ready to leave, he threw up in his crate. I was kicking myself for not running immediately to the drug store to get Pepcid AC after reading last night how important it is to give while on anti-inflammatories. He rode in his crate to the vet and did not throw up again, though he was drooling. He seemed happy enough throughout the examination - definitely not his usual exuberant self (he loves new people and places), but walking slowly and kissing the vet and techs who were sitting on the floor. The vet did acupuncture, including some electrostimulation, and gave him a shot of Vitamin B12 for nerve health. He was still drooling a lot and by the end of it was panting and stopped taking the treats the vet offered. I took him outside for some air, and the vet tech came out to give him a Pepcid tablet. Just then he yelped loudly, crouched down whining, and when he tried to lie down, he rolled over like he couldn't hold himself up. The poor vet tech felt awful thinking maybe she did something to him even though she didn't touch his back. It looked to me like what happened is that his left leg gave out (it's been rather unstable), and he twisted his back when he fell. The doctor came outside, and we managed after a few minutes to get him to walk back in. By then he was drooling like crazy, so the vet took him in the back to give him subcutaneous fluids, an anti-nausea medicine, and a shot of Buprenex for pain and to calm him down. We were able to leave, but he drooled like crazy all the way home (his chest and front legs were soaked). I had to pull him out of his crate, but he was able to walk back in on his own, though his left leg is extremely wobbly. The vet sent him home with Pepcid (5mg 2x/day), Metoclopramide (anti-vomiting med to be given 1 hr before feeding), and Methocarbamol (125-250mg 2x/day as needed for muscle spasms). She wants us to get the digestive upset under control before giving him anything else and suggested holding off on the Vetprofen until Saturday morning. I can resume the Tramadol if he appears to be in pain.
Once he is back to normal, we will be adding a Chinese herb, San Ren Tang, and 2 homeopathic remedies, Discus Compositum and Traumeel, in addition to the anti-inflammatory and pain meds. He'll get acupuncture weekly for 4 weeks.
Mostly I just needed to get this story out, but if anyone has any ideas on how to get the nausea under control, I would greatly appreciate it. Also, if I hold off on giving him Vetprofen for ~36 hours, will he be in terrible pain, and will this inhibit the healing process? I am really scared of doing something wrong and making this worse.
Thank you,
Heather
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Post by Pauliana on Mar 28, 2013 20:41:50 GMT -7
Welcome Heather! So sad to read that Brody is having such a rough time with cancer as well as IVDD. Did the Vet have any answers about the drooling? Is that something that has been happening for a while or did it start with with the IVDD episode? Vetprofen is an anti-inflammatory as you know, and as such does not relieve pain. What it does is decrease the inflammation and swelling and when the swelling goes down, the pain is relieved. Since his nausea needs to be addressed first with Pepcid AC and the anti nausea drug, it should be ok to do without the Vetprofen under these conditions for the 36 hours. Tramadol should be given every 8 hours for proper pain control, please discuss with your Vet. It's a short acting drug and disc episodes are extremely painful. Also when picking him up be sure to support his back..Here is a wonderful video that shows how to lift and carry: Please do crate him for the 8 weeks. Crating acts as a cast protecting the spine from further injury. It is far better to do this than have him get worse. You can get a wheeled cart to put the crate on so you can take it to whatever room you are in and to give him a change of scenery.. You can sit next to the crate to visit with him or even lay next to it like Neil did with our Tyler. He definitely doesn't have to be alone while in the crate..You can put it by a window so he can look outside.. There are many things that can be done to make it bearable.. We went through all this with our Tyler and we tried to do what we could to make him feel included in everything.. The best tool for healing short of when surgery is indicated is – Crate rest— 100% STRICT crate rest for 8 weeks. That means 24/7 in the crate except for potty breaks. No laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no Chiro, no VOM. The rest of the details of doing crate rest: www.dodgerslist.com/literature/cratesupplies.htmwww.dodgerslist.com/literature/CrateRRP.htmOne reason some vets may be reluctant to give a full prescription of time is knowing many owners will not follow through. Perhaps not fully understanding the reason for it, is why people tend not to do it. Observation of 1000’s of Dodger dogs over years, has shown a conservative approach to crate-rest time, results in fewer relapses. Dodgers prefers the safer, more conservative recommendations of Neuros and other vets using 6 or 8 weeks for crate rest. Vertebral column injury and surgery can disrupt the normal stabilizing structures of the spine such as muscles, bone, joint capsules, and the intervertebral disk. Excessive, unrestricted activity after surgery or certain injuries can lead to vertebral column destabilization and prolonged healing of the injury site. The intervetebral disk, in particular, is very slow to heal and healing may be incomplete; excessive vertebral column motion after disk surgery may therefore lead to recurrence of disk herniation. Additionally, animals that are weak or incoordinated may accidentally traumatize themselves, leading to orthopedic and soft tissue injuries. Welcome to Dodgerslist! Our hope is that you will take on the duties of self education to be able to understand the IVDD enemy and take an active roll in working with the vet, be an integral part of making decisions based on a sound understanding. As quickly as time permits, begin to devour each of the articles in our Disc Disease 101 area. Brody is going to be dependent on your abilities. www.dodgerslist.com/literature/healingpage.htmStart with the article entitled "HOWs and WHYs of Conservative Treatment" which will be your road map for the next 8 weeks of crate rest. www.dodgerslist.com/literature/conservative.htmAdd 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/store/DVDorder.htm
Praying for you and Brody.. Pauliana |
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Post by Pauliana on Mar 28, 2013 20:59:03 GMT -7
Also another consideration instead of pulling him out of the crate is to put him in a ex pen or what we call a recovery suite. It doesn't have a top on it and you can lift from above..The links above on my previous post on crate rest has a picture of how a recovery suite can be set up..Tyler still loves his and goes in it all by himself now for a nap.
Also some crates can be changed to top opening. It would be easier for you and better for Brody.
Pauliana
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 28, 2013 21:27:23 GMT -7
Heather, welcome to Dodgerlist, we are glad you found us. I'm so sorry to hear of the health struggles Brody is dealing with and now a disc problem on top of it all. Pauliana, has given you good information to help speed up your knowledge and ability to help Brody. I'd just like to get clarification on what you have written and comment. What was the exact name of the leftover pain pill you gave on Sunday? How much does Brody weigh? With a disc episode pain meds are not used on an as needed basis. Give the meds as prescribed regularly to keep pain at bay. Once pain arises it is harder to get back under control. Also pain hinders the healing process so it should be in control 1 hr from getting his prescriptions in him and there after dose to dose. Let us and your vet know if you are seeing any hint or suggestion of pain Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy, holding leg flamingo style not wanting to bear weight? Often it takes being on an anti-inflamamtory for 1-2 weeks or even for some dogs more like a month before all the swelling is gone. When it is assumed the swelling in the spinal cord might be gone, the vet will call for a stop of Vetprofen and that is the time to assess just how well reduction of swelling is going by observing for pain. Pain = swelling = more time on the non-steroid anti-inflamatory, Vetprofen is needed. Tramadol can cause temporary side effects of panting. You can try placing a fan near his recovery suite but not pointed at him to just lightly circulate air. Also be aware that Tramadol is extremely bitter, so hide the pill well.. if he gets a taste he will be very suspicious the next time. Has Brody had a recent blood panel done to know his organs are healthy to use a NSAID? Reaction to the NSAID is due to the stomach not being protected at all. Metoclopramide does nothing to protect the stomach lining. Sometimes even Pepcid AC is not enough protection as its job is to reduce acids, then sucralfate is added as its job is to bandage the damaged areas of the stomach. I would discuss getting sucralfate on board tomorrow, Friday and hopefully you can then start Vetprofen on Friday, too. I always learn about each of my dogs meds at this vet's webpage. We encourage you to also read too. www.marvistavet.com/html/pharmacy_center.htmlWhat does "getting normal" mean before giving Chinese herbs? Very experienced holistic vets will be hesitant to prescribe Chinese herbs when the power house IVDD conventional medications are already in use. The reason is interactions with the other medications that could make your dog sick or worse. Chinese meds are made up of many herbs in one formula/bottle.... you will have to be a good researcher and look each one up. My policy is to know all the meds/supplements my dog is on. I act like the nurse in a hospital would....double checker for the doctor's prescriptions.... a safety factor. There is a great tip from Michelle in our supplies list on making a crate into a top opening one (5th paragraph down) www.dodgerslist.com/literature/cratesupplies.htmLet us know what the vet says tomorrow morning about an Rx for sucralfate and getting back on Vetrophen to start getting inflammation down.  |
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Post by itgirl74 on Mar 29, 2013 11:57:01 GMT -7
Thank you Pauliana and Paula. I appreciate all of the advice. I am absolutely committed to 8 weeks of 100% strict crate rest 24/7. I was afraid to pick him up, so the video was invaluable. I made my teenage daughters watch it as well since they take care of him when I'm not home. I'm going out tomorrow to shop for a new wire crate or pen. I love the idea of putting the crate on wheels so that I can easily move him from room to room. For now I figured out how to take the top off of his plastic crate, so I do that to lift him out more easily.
I am fully ready to learn everything I can and be Brody's advocate. I've done it his whole life - formulating his food myself, insisting on titer tests to prove immunity instead of getting unnecessary vaccinations, etc. When I learned he had a tumor, I learned so much about cancer that several vets asked me if I had worked in medicine. I've read almost the entire Dodgerslist site so far and will read the rest this weekend.
Brody was much better this morning. I gave him Tramadol at 3am because he was restless. He slept the rest of the night and was much more alert this morning. He ate a couple of treats but wasn't too excited about them, so I will hold off offering a bland meal until I'm home this evening.
Now to answer your questions:
The vet figured the drooling was from nausea, but she was unsure what caused it. She was worried it was a reaction to the acupuncture or electrostimulation, even though she'd never seen that happen before. When we spoke today she mentioned she might not use electrostimulation next time. As far as I can tell, the drooling started in the car on the way to the vet and stopped soon after we got home. My own theory is that, because he was already nauseous before he got in the car (he threw up right before we left), he might have had motion sickness in 40 minutes each way of city traffic. He's never had motion sickness before - in fact, the car is normally his favorite place in the world - but perhaps the car exacerbated the nauseousness he already had.
It was acetaminophen with codeine. He had just one pill on Sunday night.
He is 28 pounds.
Except for the incident outside the vet's office, the only evidence I have seen of pain is a reluctance to move, and he's not that way all the time. I left a message for his primary vet asking if I could give the Tramadol 3x/day (every 8 hours) and add Sucralfate to heal his stomach. I should hear back soon and will let you know what she says.
He had blood work done in January before surgery, and everything was normal. The holistic vet asked if I wanted a full workup done yesterday, and I agreed to it. She called me with partial results today, and his ALT (liver enzyme) number is elevated - 150 (100 is the high end of normal). She suggested giving him milk thistle to protect the liver, so I'm going to pick that up tomorrow morning. I've read really good things about it. The vet is still waiting for his pancreatic levels, which may not come in until Monday. Everything else was normal.
"Normal" means his digestive issues are under control, his pain is managed, and he's stable on the current meds. The plan is to add the herbs and homeopathics one at a time, 2-3 days apart, to see how he reacts. I didn't mention it before, but he'll also be taking Vitamin A every other day to fight the cancer, and next week we'll discuss starting him on Artemisinin (Qinghaosu / wormwood), which is a powerful anti-cancer neutraceutical. We simply cannot wait for the back to heal to deal with the cancer. Melanoma is too aggressive, and it seems that our first course of action (the melanoma vaccine) may not have been enough. I will most definitely read up on all of the herbs and supplements that he is taking.
Once agin, thank you for all of the advice. I've read your responses to others as well, and it's clear that the moderators on this site care very deeply about all of the dogs whose owners post here. I will keep you posted.
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Post by itgirl74 on Mar 29, 2013 20:23:14 GMT -7
Just a quick update. The vet agreed that Brody can be given Tramadol every 8 hours to manage his pain better, and prescribed Sucralfate. He'll start that tomorrow morning and will go back on Vetprofen tomorrow as well.
Brody is feeling much better tonight. He doesn't seem to be in any pain and, in fact, wanted to get out of his crate and walk around. Don't worry, I didn't let him. He ate a full meal and so far has kept it down. This weekend will be the real test, when he's back on Vetprofen with the stomach protectors. We won't start anything new - except the milk thistle to protect his liver - until Monday at the absolute earliest.
I have a question about the Methocarbamol. Since this was prescribed "as needed" for muscle spasms, how will I know when to give it? I looked this up on the site that Paula recommended, and the side effects are salivating and vomiting. I don't want to do anything else that would upset Brody's stomach if it's not necessary.
Thanks again for your concern and advice!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 29, 2013 21:47:02 GMT -7
Good job Heather on advocating for better coverage with Tramadol and getting sucralfate on board. Do you have his pill schedule worked out with the requirements of sucralfate now?
If his pain can be controlled alone with Tramadol at every 8 hours, then maybe he does not need methocarbamol. Methocarb deals with the pain stemming from muscle spasms associated with a disc episode. If he still has pain, I would not wait til you see pain before dosing with methocarbamol or any of his other pain meds. With a disc problem it is far better to be on a regular schedule to keep pain at bay.
Let us know how he's feeling in the morning...hopefully still pain free!
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Post by itgirl74 on Apr 5, 2013 16:13:40 GMT -7
Brody's problem was not IVDD. It was almost certainly metastases to the brain. After a day where he was more lethargic than usual and showed signs of pain when taken to his 2nd acupuncture appointment, he had a horrible seizure last night. I rushed him to the ER vet, where he had a 2nd, violent seizure. Early this morning I moved him to a different location where his oncologist could see him. He had a 3rd seizure after the move.
The only way to confirm cancer in his brain would have been to do an MRI, but first the doctor did chest x-rays to see how far the cancer had spread in his lungs. They were full of nodules. There was almost no doubt the cancer was in his brain, and even if it wasn't, there was little that could be done. The only options were to keep him on continuous anti-seizure meds or to euthanize. I knew that keeping him alive would be only for my own benefit. I went to see him, and though he was happy for 10 minutes or so – he devoured the cheeseburger I brought him for his last meal, gave me dozens of kisses – he barely had control of his legs, and he soon whimpered in pain, tensed up, and started breathing heavily. I hated to see him like that, but it made it easy to see I had made the right decision. He passed peacefully, with my daughter and I petting him until the very end.
Thank you again for all of your advice and support. Though it could not help Brody, I am now much more prepared to deal with IVDD if it happens in my other dog, a basset hound.
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Post by Nancy & Polly on Apr 5, 2013 16:30:33 GMT -7
My heart breaks for you. We made that same horribly difficult decision 6 months ago. You did everything you could have done to help him, and he knew he was loved. Bless your heart, and his. (((hugs)))
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Apr 5, 2013 17:16:17 GMT -7
Heather, my heart breaks with yours in finding out about severity of the cancer. You certainly gave the kindest but most difficult of parting gift to your sweet Brody. He passed to the next world feeling the warmth of your loving arms and how much you cared for him.
Brody now lives where love resides eternally -- In the hearts of all who knew him. He did not leave you, just his body did.
((Warmest of hugs)) with my sincere condolences.
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Post by Pauliana on Apr 5, 2013 18:40:57 GMT -7
Heather,
Brody had such a loving family and you gave him the kindest of passings to rainbow bridge. You did everything you could for him and he knew that.. May your find comfort in your precious memories of Brody..
Lots of hugs headed your way and all my sympathies.
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derobe16
New Member
Bobo was not a graduate. He passed away.
Posts: 26 
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Post by derobe16 on Jul 20, 2013 11:10:43 GMT -7
I am really sorry for the loss of your boy. It is horrible but you did everything for him. A friend of mine said the other day, that his dog has been his best friend for many years and now he has to be his best friend by not letting him suffer. I never really looked at it that way and it still isn't easy for me 13 weeks after I had to have my boy but to sleep. You loved him, and he loved you.
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Post by lolalulu on Jul 20, 2013 12:30:05 GMT -7
So sorry to hear that Brody lost the battle, but he's playing at the Rainbow Bridge now until you meet up with him there.
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