pam
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Post by pam on Apr 3, 2013 7:02:43 GMT -7
Hello! My name is Pam my dogs name is Nikko,he is an 11 year old pomeranian. We are on day 8 of crate rest. Nikko started by tilting his head to the side and pulling up his right front paw and screaming(worst sound ever!!!!) Rushed him to the Vet after about 20 mins the symptoms were gone. Tons of Xrays and hospitalized,meds started. The head and paw thing would come and go. Day 3 in hospital not much improved so sent to Ann Arbor for neuro consult,Nikko was perfectly fine for that whole visit! Neuro felt confident that was probably herniated disc and with meds and crate rest he would recover! So back to hospital with new meds by next day my vet thought he was worse wanted him to go back for MRI,I decided to wait the weekend and wanted stronger pain meds so he was started on an FLK drip for 3 days he still had what I am now calling "incidents" (head tilt and raised paw) off and on and very agitated on that drip so weaned him off on Easter Sunday and let me bring him home. On Monday neuro tweaked his meds and he is sleeping ALOT!! He is still have incidents of tilting head and drawing paw up but no yelping or crying,anything cann make him start doing it from turning around in the crate to sleeping to long to going potty! I know it has been only 8 days but I am super frustrated! I don't think surgery is an option for Nikko because of age and he also has a collapsing trachea and heart murmur! So already I am thinking am I gonna have to put my baby down because I am not seeing improvement  I am sorry if this is a little disjointed! He is eating and drinking fine! No tail wagging. Here are his meds Tramadol,methocarbamol ,pred,pepcid,gabapentin any adive would be appreciated!
Thanks
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Post by lmingras on Apr 3, 2013 10:17:32 GMT -7
Hi Pam. Sorry to hear about Nikko! Did you end up getting an MRI for him? My dog had a disc incident in his neck last year and when it happened he was screaming anytime he would move wrong. After a few days on some heavy meds we had an MRI for him and it was a slipped disc, but it was also a pinched nerve. Our neuro said that was probably what was extra painful for my dog which was causing the screaming in pain. When he would have the episodes he would bite whatever was around him (like he needed to clench on something because he was hurting so much). After a few days of being in the crate, he stopped screaming and eventually got better. Those first few days we put a divider in his crate so he couldn't even turn around...it seemed like every time he turned it would happen, and keeping his body straight may have helped with the nerve...not sure if Nikko is having the same issue but I thought I would share. Good luck!
Lisa
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pam
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Post by pam on Apr 3, 2013 10:30:33 GMT -7
Lisa,
At the time we went for neuro consult he felt we did not need it. Now my vet has said if we are not going to do the surgery then there is no point in doing the MRI,which I kind of understand because not sure if the MRI would change the treatment plan.
Pam
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Apr 3, 2013 10:37:04 GMT -7
Pam, welcome to Dodgerslist. What is the name of the Neuro hospital where you went for a consult? Can you give us the exact names of the meds along with the dose in mg and how often you are giving them? The key to being able to carry on with conservative treatment to let the disc heal is that pain must be fully under control dose to dose of the pain meds (Tramadol, mehtocarbamol and gabapentin). It sounds as though the disc is squeezing a nerve coming off of the spinal cord going to the front leg. Root signature pain and neck pain can be more challenge to get the pain in control as the head has to move when other parts of the body move. Your neuro will have the best education on pain control, so if you are seeing any signs of pain...do get back with him. 8 days is not time enough to let things heal.... stay positive, start your reading program...as being a reader is going to be Nikko's best protection... knowlege is power to fight this enemy and win! Start your readings here www.dodgerslist.com/literature/healingpage.htm and do make sure to read the Neck Disc Tips to ensure you are doing all the little extra things to help with a neck problem. Only take the word of the surgeon that surgery would/should be an option... 11 years old is not too old. Know all your financial options now. No or low interest credit for veterinary costs can be obtained from Care Credit. You find out online if you qualify: www.carecredit.com/faqs.html |
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PaulaM
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Post by PaulaM on Apr 3, 2013 10:52:05 GMT -7
Correct, Pam, an MRI would be used to help plan the surgical procedure as they need to know exactly which disc, etc. For conservative treatment knowing the exact disc location is not needed.
Do let us know you are doing the single most important part of conservative treatment. 100% STRICT crate rest 24/7 only out to potty for a full 8 weeks …. 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.
Do let us know the name of the neuro consult in Ann Arbor. And also if Nikko does have pain under control now.
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pam
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Post by pam on Apr 3, 2013 18:15:54 GMT -7
Thank you Paula! After reading up on your site I guess today will be first day of 100% crate rest  I was getting him out and holding him when he was having an "incident",so now I will crawl in the crate as far as I can with him to comfort him lol
His meds are Gabapentin 2 mls every 8 hours
Prednisolone 5 mg 2x a day for 5 days etc
Tramadol 25 mg every 8 hours
Pepcid 5 mg 2 x a day
Methocarbomal 125 mg every 8 hours
Hycodan 1.25 mls as needed for his cough
We went to Dogwood and saw Dr.Galle(who I loved) He is the one who said he didn't think we needed the MRI because Nikko was perfectly fine the whole time we were with him! He felt confident from what we told him and what my vet told him and looking at Xrays that it is a herniated disc.
The trouble at this point with getting his pain under control is that my vet has said that Nikko is at the high end of the doses for his weight.
I have learned a lot of things from this site that I hadn't thought of! water bowl hooked on crate,how to pick my dog up!!! I am so thankful that Andrea from Dogwood told me about you guys
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Apr 3, 2013 18:40:44 GMT -7
Pam, we love Dr. Galle too! He and Dr. Isaacs answer questions at the Dodgerslist Neuro Corner. www.dodgerslist.com/neurocorner.htmWe did not get firm answer whether at this point, today are you seeing any of these signs of 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? If the answer is yes, I would contact Dr. Galle as he has a specialist's training and daily practice of using aggressive pain meds where as your general DVM may not. What does Nikko weigh? Also, let your vets know you are now being STRICT on crate rest and also have incorporated strategies to help Nikko not move his neck so much.
I hope to hear now that you are doing 100% crate rest and have added addition strategies to keep Nikko from having to move is neck/body, that he can be moving forward in healing.
Be prepared that a 5 day course of Pred at the anti-inflammatory rate may not be long enough to get all the swelling down. Has the taper already started...that could explain pain. Let us know what date the taper is scheduled for. On a taper you will want to be very particular to observe for pain. swelling = pain = more time on Pred is needed and your vet needs to know asap. In fact with the weekend approaching you want to have a plan B. What if there is pain on the taper at night or weekends when your vet is not open. Do you have enough Pred to go back to the anti-inflammatory dose on hand, enough pain meds, enough Pepcid AC? All things to discuss ahead of time with your vet in getting a plan B together.
Your Nikko has such a cute face.... give him a kiss and tell him things are going to get better because mom has been reading and she is better equipted to fight the IVDD enemy and win!!!
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pam
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Post by pam on Apr 3, 2013 18:56:48 GMT -7
It is moments like now that makes me think I can't do this!! Nikko just had another "incident" just a little yip,but his meds are not due until 1am,I calmed him down after about 10mins,but what else can I do?
Ok Nikko weighs 9.7lbs I did call the office Monday that is when
they upped everything his pred was 5mg once a day! He is not tapering
yet I am supposed to call Andrea at Dr.Galle's office Friday with update
and we will re form a game plan. I have plenty of evrything and my Vet
is open 24/7! And yes he is having probably 5-6 incidents a day,tilting
head and pulling up right front paw no vocalization until just a minute
ago! And one of my other dogs just starting limping on his back leg lol
We can't catch a break
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Post by Pauliana on Apr 3, 2013 19:31:06 GMT -7
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pam
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Post by pam on Apr 3, 2013 19:52:16 GMT -7
Thank you! We have been doing laser therapy for a week now
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Apr 3, 2013 20:15:50 GMT -7
You will need to call Dr. Galle first thing in the am and not wait til Friday. Tell him all your observations of pain and when it happens in relation to the next dose of meds. Also mention that you are starting very strict rest and including all the tips on the cervical page you've been reading about since this morning when I gave you the link. Are you also soaking her kibble so she won't have to crunch and use her jaws, maybe even hand feed the softened food to her. Have no patience with pain, it takes prompt communication so you are working together as a team with the vet to get the pain meds right. For tonight you might try a rice sock to see if that might bring some comfort to Nikko. Fill a sock with 1-2 cups of dry rice or dried corn kernals. Knot the end. Microwave for 1-2 minutes. Test in crook of your arm for warm not hot temperature. Wrap in a towel so it's not too hot for the skin and place in crate. Let Nikko snuggle against when you are present to supervise in case your dog has a desire to munch on the warm rice. Note: human heating pads can get too hot burning skin. Snuggle Safe is a commercial product that will keep warm the whole night. tinyurl.com/4jk2cx7 [snuggle safe] We'll be waiting to hear back in the morning on what Dr. Galle says and prescribes. |
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pam
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Post by pam on Apr 3, 2013 20:44:35 GMT -7
I will! I am feeding him can food from the vet and I have a microwavable flaxseed bag that I have been using for him. He is conked out now  Again Thanks for all the info |
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pam
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Post by pam on Apr 4, 2013 8:28:27 GMT -7
I called Dr.Galle's office this morning,Nikko's meds cannot go any higher I really,really wanted to do conservative especially since his "incidents" of pain are only a few minutes long and do not seem severe(to me) but I am not the one having the pain and I cannot watch him go through anymore so we have decided to have the MRI on Monday with possible surgery depending on the results. Thank you for all the info
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Apr 4, 2013 8:53:09 GMT -7
I'm glad you did consult with Dr. Galle to know all your options. There are times when the pain just can not be brought under control and then it is a consideration to go ahead with surgery. My Lewis had the same issue... pain with her neck disc just could not be controlled with max pain meds. The next day after surgery she was walking and pain free. Please do keep us posted on your sweet Nikko.
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pam
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Post by pam on Apr 4, 2013 10:30:30 GMT -7
Thank you! May I ask how old your Lewis was at time of surgery? It is very frustrating because he will be completely fine and normal for hours and then one little move and he is in pain!!
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Apr 4, 2013 11:11:28 GMT -7
She was 9 years old at the time of the surgery. Most small dogs live mid to late teens.
You can relate to having slept wrong and wake up with a crick in your neck... move in the wrong position and it hurts. For Nikko, the disc is pushing on the nerves and the hope is with time it will shrink back enough and the swelling will go down in the spinal cord. The problem is during the healing time, Nikko needs to be able to do that in comfort. Pain will actually slow the entire healing process. Plus you can't care for her properly, take her to potty, etc without causing pain. I wanted conservative treatment to work too, but pain control was not working at max doses.
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pam
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Post by pam on Apr 5, 2013 22:04:22 GMT -7
My baby boy has been a different dog today!! I am almost afraid to say it for fear of jinxing him! For almost 24 hours he has been perky and no incidents of tilting head,lifting front leg or yips of pain!!! He was barking at me today which he has not done in 10 days! The only thing I did differently was to move his Gabapentin.Tramadol and muscle relaxer closer together. The only bad thing today was that after 10 days of pill pockets he has decided to not eat any of the 3 flavors! I tried a little pumpkin,nope lol So I gave him a small bit of cheese and he ate that
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Post by natureluva on Apr 6, 2013 8:10:56 GMT -7
Pam, I'm so happy to hear that Nikko's pain is under control! Continue with the STRICT crate rest so that his disc can fully heal. Remember, it is time and limited movement that heals the disc while the meds mask the symptoms and help control the inflammation on the spinal cord.
Glad to hear you're getting Nikko laser treatments! Acupuncture is also extremely helpful. In addition to stimulating the nerves and reducing inflammation and pain, it induces a state of well-being.
Keep up the great work with him! Best wishes, ~Lisa
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pam
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Post by pam on Apr 6, 2013 9:14:25 GMT -7
Thank You I will have to see if there are any acupuncturist in my area,never heard of any! still on crate rest!!!
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pam
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Post by pam on Apr 7, 2013 6:23:15 GMT -7
Looking for opinions,today is day 3 of Nikko being back to his old self! No pain incidents since late Thursday night. So my question is...we have an appt. tomorrow for the MRI and possible surgery,I am considering canceling it for now and continuing with meds and rest! Could the crate rest after 12 days finally started helping?
Also after 8 weeks of rest is it possible/probable that this keeps happening?
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Post by Linda Stowe on Apr 7, 2013 8:00:40 GMT -7
Hi Pam, It is certainly possible that the swelling has now gone down with the meds and crate rest and most likely that is what has happened. As to cancelling the appointment, it never hurts to have an exam by a specialist. My opinion, would be, unless he could give you a very good reason to have the surgery at this point, I would stay with the conservative treatment if you decide to go.
As to it happening again, yes it could and it could with surgery too. There are no guarantees with either. We have seen dogs with as many as three surgeries. Some dogs have only one episode and some have multiple. I've had four dogs with IVDD. Two were treated conservatively and never had another episode. Two had surgery and never had another.
There just aren't a lot of answers unfortunately.
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pam
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Post by pam on Apr 7, 2013 11:49:30 GMT -7
Thanks Linda! He is doing great!! Took his crate outside today as it is so nice,he loved it He even tried to play with my hand in the crate a little! He has been seen by Dr.Galle after this first started and he didn't recommend even the MRI but then he got worse so we scheduled again,but now I think he is on the road to recovery(I hope)
Good to know it could happen again,thank goodness he is not a jumper or climber or a runner!
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Deborah & Angel
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No current back issues... Living Life.. <3
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Post by Deborah & Angel on Apr 8, 2013 11:10:50 GMT -7
Praying for your FurBaby..Much love and many hugs.. |
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pam
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Post by pam on Apr 8, 2013 21:11:06 GMT -7
Any suggestions?? When I take Nikko out to potty I put him down and he will urinate right where I put him with no steps and if he is done he will just stand there until I pick him up,but if he needs to poo he has to go round in circles. Usually 3 times and I am worried this is to much walking. He is doing so good I don't want to have a setback
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Apr 9, 2013 7:31:29 GMT -7
A few small circles with a very few footsteps is likely ok, of course the fewest of footsteps is best. Try training him to poop on command. As you see him circiling give the command "go potty" or "go poop" When he does poop, lavishily praise him. Soon he may be able to shorten the time it takes to poop.
If he is just walking around and not pooping, pick him up and back to the recovery suite and try again in an hour.
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pam
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Post by pam on Apr 13, 2013 21:37:30 GMT -7
We are on day 19 of crate rest,Nikko is doing great! The vet decreased pred last week so far no issues with that. I worry about when they start decreasing the methocarbamol,gabapentin and tramadol,but I will cross that bridge when we get there. I 100% believe if I hadn't come here and learned how important crate rest is Nikko would not be doing as well as he is
I just bought some of the calming treats I have seen mentioned here,but I am wondering if they are safe to give with all the meds Nikko is on?
Also wondering,I see everyone here mentioning 8 weeks crate rest,but the Neuro doctor had told us 2-4 weeks initially.
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I am sorry if this is a little disjointed! He is eating and drinking fine! No tail wagging. Here are his meds Tramadol,methocarbamol ,pred,pepcid,gabapentin any adive would be appreciated!
I was getting him out and holding him when he was having an "incident",so now I will crawl in the crate as far as I can with him to comfort him lol
Again Thanks for all the info
