Jen & Oliver
New Member
Surgery Nov. 2013, awaiting MRI 7/10/14 for possible second surgery.
Posts: 1 
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Post by Jen & Oliver on Jul 1, 2014 21:44:13 GMT -7
Hello,
My name is Jen and my dachshund Oliver bolted past me and fell down a flight of 14 stairs in October 2013. Miraculously he bounced up and appeared alright. 5 weeks later, he woke up form a nap ataxic. I have worked as a veterinary assistant for a little over 5 years and am about 3/4 through vet tech school. I recognized the IVDD signs immediately and called one of the vets I work with at home, she had me run up the the clinic and get him a steroid shot, tramadol, and prednisone because of course this was happening after hours. Despite administering the steroid IM he continued to decline and started to lose conscious proprioception. (ability to right feet when feet are flipped.) I knew his best chance was immediate surgery. I was able to get him in for emergency surgery on Sunday morning by which point he could not stand, about 12 hours after first onset of symptoms. 8 weeks total of crate rest- lessening restrictions as time went on. He recovered beautifully, he was an absolute angel in his crate (we were so worried because we completely failed at crate training him!) He was on a tapering dose of pred, tramadol, and pepcid. He only needed help being expressed for 2 days, then was able to urinate and have a BM on his own with support standing after. He did 20 sessions of water treadmill therapy even though his surgeon did not think it was completely necessary. Upon recheck his surgeon felt he would make a 90-100% recovery. (He's always had a little swagger becasue he's exceptionally long- sometimes it's hard to remember if he always wiggled that much or if it's more now since his surgery.)
Anyways, we made changes, he's not allowed to go up or down any stairs, we bought a platform bed and are practically sleeping on the floor because he won't use a ramp so we wanted to minimize the distance he jumps. We try our best to assist him on or off the couch or discourage it all together. He gained his strength back and has been hiking, canoeing, swimming, running, etc. since his recovery with his surgeon's premission.
We've always kept him lean. He's about 14-15 pounds, body condition 2-3/5. He's more of a "tweenie." When he had his surgery the ER doctor commented that it was such a shame this happend to him becasue he was at the perfect body weight.
Now, on June 15th he was playing fetch, (one of his favorite activities- swear he's part lab, swimming is his other passion) zipping around the back yard. The tennis ball bounced and he jumped up to grab it, he basically went vertical and drove his little butt straight into the ground. He sprug up and kept on playing, but we stopped him shortly after just in case. His November surgery was a right sided herniation at T-11. They did disc fenestration from T-10 to L-4 in hopes of avoiding future problems. On he 18th of June I sarted to notice he was reluctant to run to me when called or make the small hop on to the bed. I brought him into work and the vets that I talked to felt he just had a muscle injury as CP's were good and he was walking well. We started Pred again (5 mg x 3 days, reducing strength in have every 3 days) and rest (not crate, but just low key for 5-7 days.) He seemed to be responding well and was allowed to go on short walks. Sunday June 29th was his first day without Pred. (first on an every other day schedule) He was noticiably corssing over with his back feet maybe 25 percent of the time, so we gave him 2.5 mg Pred. and within an hour he was walking better. Monday I called his surgeon and he is worried that he has a herniation starting in the L-5/L-6 area. He felt we could extend the Pred. and rest but it ultimately would not fix the problem. My husband Ben and I both agree we want him to have surgery ASAP if needed.
However, the surgeon who did his procedure was amazing. he is a DVM, ACVS. We feel most comfortable with him doing the MRI and surgery if needed. He did not have an availability till July 10th. There was an opening tomorrow with another surgeon who none of the vets I work with are familiar with and he is only a DVM, MS. My husband, myself, and my coworkers all thought it would be best fo him to see his original surgeon. One of the vets I work with even called to talk to him. In the end he said that since Oliver is walking well maintained on steroids that it coud wait till the 10th. So no we're just nervously waiting and I feel as though I'm over analyzing his every move. We set his crate back up tonight, but are only going to put him in it when we are not home. I'm also going to use cold laser therapy on him every couple of days until his appointment. Of course if he goes down in the back like he did in November we'll rush him into surgery immediately with whatever surgeon is available. I just can't handle the waiting and I can't help but feel like we're making a poor choice by waiting till the 10th.
Looking at him right now, you won't suspect much is wrong with him. We can tell he's a little less coordinated, but for the most part he's walking well and will even trot along if we don't stop him. He doesn't seem to be in any pain so we're only giving
14-15 lbs
pred. 2.5 mg. and
pepcid currently. We have
tramadol on hand in case.
I am sorry this is so long, I just needed to get it out, since my random crying and my husband and my tension at the moment paired with his exercise restriction is taking a toll on the little man. He just looks sad/confused currently. I can't stand seeing this because he is so athletic normally.
Thanks for reading,
-Jen
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 2, 2014 6:57:29 GMT -7
Welcome to Dodgerslist, Jen. I'm sorry that you were given an incorrect diagnosis when Oliver first went down. A disc episode can present with only signs of pain with no signs of neuro deficit. At this point, since Oliver is walking well and only had some wobbly walking with feet crossing when off the steroid, he would be a good candidate for conservative care. That is true especially in light of the fact that he is only now on Prednisone and Pepcid AC with no pain meds and appears to be doing well. But he MUST be strictly confined to his crate as too much movement can cause the disc to tear more and cause more nerve damage. Please keep him strictly confined to his crate starting today to protect his spine.Carried in and out to potty. 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.htmPlease take a look at our page on when surgery should be a consideration: www.dodgerslist.com/literature/healingsurgery.htmWith conservative care (8 full weeks of strict 100% 24/7 crate rest with as little movement as possible, only being carried in and out to do potty with only a few steps to do potty), an anti-inflammatory to reduce the swelling, pain meds to deal with pain and Pepcid AC to protect the GI tract, it's the hope that the body will reabsorb the damaged disc. It can take 7-30 days for the swelling to resolve. At some point, a taper of the steroid and pain meds would be made to test for a return of pain. If there is still pain, then more time would be needed on the steroid. Pain = swelling = more time on all meds. If pain does not return once the pain meds and steroid are stopped, then swelling has resolved and no more meds are needed. The full 8 weeks of crate rest is the time it will take for the disc to heal and form scar tissue. I don't believe you are making a poor choice to wait until 7/10. He is actually doing conservative care at this point. It would be my suggestion to continue with the strict crate rest and Prednisone and Pepcid AC and then under the direction of your vet/neurologist, try a taper of the steroid to see if pain returns. If no pain, then meds can be stopped and Oliver can continue to heal the disc in comfort in his crate. Please let us know the exact dosage of the Prednisone and Pepcid AC and frequency given. Please try to stay positive. Dogs are very sensitive to our feelings. He sees that you're sad and he doesn't understand why. He thinks he's just fine. If you keep a happy face and voice when you're around him, he'll be happy, too. He can heal and the 8 weeks will fly by. My Jeremy had one surgery after having lost deep pain sensation and it took many months for him to walk again. He also had a second, milder disc episode with just wobbly walking and pain and recovered beautifully from it with conservative care. 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.htmI am moving your thread to the conservative section of our forum in the hopes that the conservative care that Oliver is now receiving will continue in a good direction and surgery will not be needed. If Oliver does in fact have surgery, we can always move it back. Healing prayers for Oliver. |
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Post by Cindi & Kytt on Jul 2, 2014 7:36:49 GMT -7
Hi Jen and Oliver!
I just wanted to offer my support. I have had three dachshunds battle IVDD over the past 13 years. Hunter and Oscar both lost neuro function and were in intense pain with their episodes, and both were treated with emergency surgery. Hunter, had two episodes, the second not quite as horrific, but still treated with surgery due to his severe pain. Hunter came through both surgeries with flying colors and walked with little evidence of his IVDD until he passed at the age of 15 1/2. Oscar's surgery was not "successful" and he was a wheelie pup for the rest of his life. Let me assure you, being in a cart did not slow him down, and he too lived a long, happy life.
My current pup, Keeghan, was diagnosed with IVDD on 6/24. I knew immediately when he was hesitant to come out of his crate that morning, and whined when I picked him up what we were dealing with.
All my experience had been with surgical intervention; however, Keeghan has lost no neuro function, and his pain is controlled with his proscribed medication. We are doing cold laser and 8 weeks of STRICT crate rest. I was very anxious initially since I had no experience with conservative treatment, but Keeghan is doing beautifully!!! We have made arrangements with our surgeon to get Keeghan surgery if necessary, but so far, he is right on track with conservative treatment.
I just wanted to offer my experience and send good thoughts and healing prayers to you and Oliver.
Cindi and Keeghan
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,579
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Post by PaulaM on Jul 2, 2014 8:59:35 GMT -7
Jen, you have related some very good news that Oliver is doing well. Most surgeons would not rush to operate on a dog that is ambulatory. Surgery is a risk vs. benefit thing as Dr. Isaacs discusses in the link Marjorie gave you : "There is a balance between the risk associated with surgery versus the benefit gained if all goes well. With any surgery there is the potential risk that the patient may be permanently worse after the procedure. The risk is greater with intervertebral disk disease that is severe, at multiple sites, and chronic compared with mild, single site, acute." www.dodgerslist.com/literature/healingsurgery.htmAs damage to the spinal cord increases, there is a predictable stepwise deterioration of functions . When nerve healing begins, often it follows the reverse order. 1. Pain caused by the tearing disc & inflammation in the spinal cord 2. Wobbly walking, legs cross <-- Oliver is here?3. Nails scuffing floor 4. Paws knuckle 5. Legs do not work (paralysis, dog is down) 6. Bladder control is lost 7. Tail wagging with joy is lost 8. Deep pain sensation, the last neuro function, a critical indicator for successful surgery. Surgery can still be successful in the window of 12/24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance. Precious hours can be lost with a vet that gets DPS wrong. So if surgery is an option for your family get to a neuro or ortho asap. www.veterinarypracticenews.com/vet-practice-news-columns/surgical-insights/making-sense-of-the-neuro-exam.aspx[Making Sense of the Neuro Exam] Oliver is likely to be a good candidate to heal with conservative treatment. Just as most people can heal with rest the same is with dogs. Only thing is dogs don't follow doctor's orders and we must provide the rest environment for them to heal in. The big IF on conservative working for Oliver is if you do your homework and have a good understanding of this disease. The way the disc heals is by limited movement. The Rxing of anti-inflammatories & pain meds but not Rxing 100% STRICT crate rest 24/7 only out for a very, very few footsteps at potty time was a very dangerous combination. Oliver is truly very lucky his early healing disc did not have a severe disc tear causing severe damage to his spinal cord.
Can you tell us the current Pred dose, is it 2.5 mgs, how many times a day are you giving it?
Often it takes being at the anti-inflammatory dose of prednisone (5mg 2x/day) for 7-30 days before all the swelling is gone. When the vet guesses swelling in the spinal cord might be gone there will be a taper. The dose is lowered to less than the anti-flammatory dose your job at home would be to assess just how well reduction of swelling is going by observing for any hint of pain. To have a clear picture on a taper, pain meds are also stopped or backed off too.
Rule of thumb is: pain = swelling = more time on Pred, pain meds and Pepcid AC is needed.
If there is no pain on the taper then it goes to completion. Then no meds at all are needed. Disc healing will continue for the remainder of the 8 weeks. Nerves can continue to self heal…think in terms of months.
Never give up, stay focused, stay postitive and stay strong! You and Oliver will get through this bump in the road of life. |
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