Paul's Sadie's 4/9 surgery UK Epilepsy

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Paul & Sadie
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Paul's Sadie's 4/9 surgery UK Epilepsy Apr 13, 2014 2:37:54 GMT -7

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Post by Paul & Sadie on Apr 13, 2014 2:37:54 GMT -7

Hi
My name is Paul and Sadie is my 4 1/2 year old Longhaired Miniature Dachshund. She weighs 7.3Kgs.

Sadie story started on 26th March with Sadie being unable to climb stairs and whining mildly when we picked her up. We took her to the vet (Beautmont Veterinary Clinic) immediately who examined her thoroughly and she was absolutely 100% fine with the vet. No discomfort anywhere. He did bloods just in case it might have been pancreatitis.
The next day she was in pain, unable to get comfortable at all, and yelping when moved. She had also started to lift her right leg.
Back to the vet and he admitted her for X-rays. She had had a vetergesic injection so was pain-free for the rest of the day. We were prescribed Tramadol 20mg every 8 hours and Rimedyl once a day.
We were to crate rest her until the X-rays were reviewed by a specialist Neurologist and an orthopedic specialist at the Veterinary Hospital (Willows Veterinary Referral Hospital.) Not sure how it works where you are, but in the UK you have general Veterinary surgeons locally, and then a couple of specialist referral centers normally in the bigger cities. Ours is about 1 hour drive away so not to bad!

We had a call the next day from one of the Neurologists at Willows who explained that the Xrays were not 100% conclusive but they suspected IVDD. This was a Friday and after discussing her symptoms and the fact that she had not lost use of the legs and still had deep pain sensation that we would wait for Monday to have an MRI. Strict crate rest.

Unfortunately the Tramadol was not controlling the pain over the weekend so we rang the neurologist and he contacted our Local Vet to get her some Gabapentin 75mg every 8 hrs. Stopped the tramadol.
This did help, but after 6-7 hrs she was starting to get sore again, she was definitely deteriorating quite quickly and the limp was getting worse and worse and she could hardly hold herself up when taking her for toilet break, but we managed until Monday.

Monday we met the neurologist who did a neuro exam, again Sadie perked up for this, no whining, no limping, trotting around like nothing wrong. Neuro exam was good but the right leg was not right and she gave the Neurologist some darting looks ( that only a Dachshund can

when she was examining her.

The Neurologist wanted a quick consult with the orthopedic specialist before the MRI just to rule out a Hip or ligament issue in the right leg.
MRI came back with conclusive IVDD and a herniated disc. It had herniated to the side and was not pushing on the Spinal cord but on a root nerve that was causing the pain and lifting of the leg on the right. It was also very low down the spinal cord.
We discussed the options in detail and I must admit the care that we have received was fantastic, better than we have every had for ourselves. They explained everything in great detail with MRI's and models of the spine etc
We opted to get surgery as she seemed to just be deteriorating even with crate rest. She had Thoracolumbar hemilamectomy (according to the notes) on 09/04/2014. They kept her in on the Thursday and we were able to collect her Friday.
Discharge was
Strict crate rest
Gabapentin 50mg every eight hrs
Rimedyl once a day.

Friday was amazing, she was like to old Sadie, full of joy , tail waging every time we entered the room, even if we only left for 2 minutes. She rested well in her Crate and toilet breaks were fine she walked happily on the right leg for the 20 odd steps that she took while deciding where to poop!
2 poops on Friday 2 pees and no pain.

Saturday .... not so good. Lots more pain, uncomfortable , occasional whine. Just can see she is not happy.
Called Willows and they contacted the neurologist who suggested 100 mg gabapentin every 8 hrs as that is what she was taking when she left on Friday.
Upped the dose for Saturday midday tablets and this definitely helped, She was comfortable but only for 6hrs and the last two hours you can see is sore. Pees were one hobble and then sit.
This morning after 7 hrs since last Gabapentin she is very unhappy holding leg up and constantly readjusting in the crate. Checked her wound and it looks fine, not unhappy with me touching it. Gave her the Gabapentin straight away (1 hr early) as I could not bare to see her uncomfortable, and she is now out like a light!

I had a look at the notes from the surgeon and on Friday she had 2 x 0.3mg per ml vetergesic injections (buprenorphine) and gabapentin 100mg (twice on friday).

Should I be concerned about the pain that she is experiencing and the fact that she is holding her leg up or will this be alleviated by better pain meds? I am not doubting the Vet at all as they have been fantastic and always on the end of the phone, in fact I am waiting for him to phone back now, and I am sure he will do everything to make her comfortable.

I suppose I am just concerned as not sure what to expect from her recovery, as she is slightly different from most of the cases on here, as she never lost use of her legs. Her limping and pain were her only symptoms and they seem to be the same before and after. She has had major surgery so I am sure she will be sore.

Also I have posted a picture of her crate.....is this to big? She moves around a lot but just when she is uncomfortable and trying to settle. She doesn't jump up or anything like that.

www.icloud.com/photostream/#A2G4TcsmGlHRDV

Thanks to everyone on here, I have found this resource so valuable and some of the stories so helpful and motivating.

Cheers
Paul

Last Edit: Apr 13, 2014 14:46:07 GMT -7 by PaulaM

Marjorie
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Member since 2011. Surgery & Conservative

Posts: 5,724

Paul's Sadie's 4/9 surgery UK Epilepsy Apr 13, 2014 5:00:47 GMT -7

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Post by Marjorie on Apr 13, 2014 5:00:47 GMT -7

Welcome to Dodgerslist, Paul. I'm so sorry to hear of Sadie's difficulties.

Please contact the surgeon ASAP to let them know of Sadie's pain. Tramadol works well along with Gabapentin and can be added. Also Methocarbamol works on the pain of muscle spasms and can be added. Her pain should be completely under control from one dose of meds to the next.

Please also speak to the vet about adding a stomach protector to protect against the side effects of the Rimadyl. Pepcid AC (famotidine) is only available via prescription in the UK so you would need to ask for one from the vet. Ranitidine, a different acid reducer, is available over the counter at the chemist there in the UK until you can get the newer better famotidine. Doses:
www.petplace.com/drug-library/ranitidine-hcl-zantac/page1.aspx and
www.1800petmeds.com/Ranitidine-prod11204.html

Do you find wet bedding or leaks on you when lifted up?

Eating and drinking OK?

Poops OK - normal color no dark or bright red blood?

The recovery suite should only be large enough for Sadie to stand up, turn around and lie down with legs extended comfortably. You can fill in any extra space in the crate with folded towels or blankets. How long did they prescribe crate rest for?

It can take 2-4 weeks for the swelling to go down following surgery so you may not see much improvement in the limp until then. But the pain does need to be brought under control today so Sadie can heal in comfort. Here's more information on nerve root pain that might be helpful: www.dodgerslist.com/neurocorner2/rootsignature.htm

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. Here's the link www.dodgerslist.com/healingindex.htm

Please let us know what the surgeon says after speaking with them.

Healing prayers for a speedy and full recovery for Sadie.

Last Edit: Apr 13, 2014 5:07:36 GMT -7 by Marjorie

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Paul & Sadie
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Paul's Sadie's 4/9 surgery UK Epilepsy Apr 13, 2014 5:34:39 GMT -7

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Post by Paul & Sadie on Apr 13, 2014 5:34:39 GMT -7

Hi Marjorie

Thank you for your reply.

I actually have ranitidine at home for myself.I will chat to the vet tomorrow about dosage for Sadie.
Spoke with the neurologist earlier and he is happy for us to bring the gabapentin forward a bit if she starts to get uncomfortable. He didn't want to up the dosage to 150g. He too was concerned about her comfort but less concerned about the limp as he felt 2 weeks before any improvement. If the pain is not controlled tonight we are going to pop back to the hospital for a check tomorrow, and he will add further pain relief. Not sure if in UK they are not that keen on tramadol? Talked about amytriptaline.

Do you find wet bedding or leaks on you when lifted up? NO

Eating and drinking OK? Yes bit stubborn about drinking but OK

Poops OK - normal color no dark or bright red blood? Hasn't pooped today, but yesterday fine no blood.

Crate rest was described as strict crate rest with only poop and wee breaks for 4 weeks, At 4 weeks she has a followup with the neurologist in which we will discuss PT and ongoing care. ( he did say to expect crating for 6 weeks at the minimum, so between my wife and I are arranging time off work to watch her.)

You are absolutely 100% correct about self education and being aware of the healing process more for our peace of mind rather than Sadie's. It difficult to see you pet unwell especially when it have never happened before. She has always been 100% healthy.

Since her last dose of gabapentin she has been fine and still resting well in her crate. Next dosage due in 30mins so think we are going to be OK.......

Thank you so much for your advise.
Will keep you updated
Paul

Hi

I forgot to mention that Sadie has Idiopathic epilepsy. She has diazapam but never had to use it as seizures are infrequent and very mild.

Is ranatadine or tramadol contraindicated?

Cheers

Paul

Last Edit: Apr 13, 2014 14:47:17 GMT -7 by PaulaM

Marjorie
Moderator~

Member since 2011. Surgery & Conservative

Posts: 5,724

Paul's Sadie's 4/9 surgery UK Epilepsy Apr 13, 2014 14:45:46 GMT -7

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Post by Marjorie on Apr 13, 2014 14:45:46 GMT -7

A change in drinking habits is a red flag sign for GI tract distress from Rimadyl so be very sure to speak to the vet ASAP about adding a stomach protector. You would need to speak to the vet about what would be best to prescribe for her and about any contraindications with other medication.

So how often do they say you can give her the Gabapentin? Is her pain completely under control now? Pain should be under control from one dose of pain meds to the next and not allowed to surface at all. Please be sure to educate yourself about any medication prescribed for Sadie. Here is some info on Amitriptyline. It's an anti-depressant and is sometimes given for neuropathic pain.
www.vetinfo.com/side-effects-amitriptyline-elavil-dogs.html#b

6 weeks of crate rest is usually what we see prescribed following surgery.

Self-education is not only for your peace of mind but you're the captain of Sadie's health team and need to be an "expert" in this disease so you'll know if any vet ever gives you incorrect advice. You also need to know how to live with IVDD and the restrictions that Sadie will have in the future (no jumping, no stairs, etc.). The link given above is a good place to start.
www.dodgerslist.com/healingindex.htm

Please keep us updated, Paul.

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Disclaimer:
This information is presented for educational purposes and as a resource for the IVD dog community. The coordinators are not veterinarians or health care professionals. Nothing herein should be interpreted as medical advice and all should contact their pet care professionals for advice. The coordinators are not responsible for the substance and content contained herein and do not advocate any particular product, item or position contained herein.

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Paul's Sadie's 4/9 surgery UK Epilepsy

Post by Paul & Sadie on Apr 13, 2014 2:37:54 GMT -7

Post by Marjorie on Apr 13, 2014 5:00:47 GMT -7

Post by Paul & Sadie on Apr 13, 2014 5:34:39 GMT -7

Post by Marjorie on Apr 13, 2014 14:45:46 GMT -7