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Post by Allie & Andy on Jul 2, 2014 19:47:17 GMT -7
What a wonderful site first of all- thank you!!! Our foster doggy Andy (well he is pretty much ours now- lol) is about 7 years old and while we were out of town over the weekend (Saturday to be exact), my dog sitter noticed he was hurt and not coming out from under the bed. When we got home on Sunday night, he was still able to walk, but clearly had spinal issues and was walking sideways. By Monday afternoon, he was essentially paralyzed and had no bowel/bladder control. Tuesday I took him to the vet and we took xrays. Xrays showed calcifications). Our vet could not elicit a deep pain response by squeezing in between his paws at the time (however, Andy is a very calm and shy and was very bewildered). She appeared to get some withdrawal a bit later. Anyway, he had already missed the 24 hr window of opportunity of course. He started
prednisone,
tram, and
Robaxin (famotadine too). Doc said that if there wasn't much change the next day (today), then he probably would need to see a surgeon. We have a small rescue and clearly cannot afford surgery for this. Of course we have had many rescue friends and dog lovers tell us that their dog regained function after crate rest but I am not sure what their particular diagnoses were. I have tried unsuccessfully to express his bladder manually, but had to catheterize him instead.
Just wondering if anyone has in fact had success with crate rest IF they have lost bladder control, deep pain response, etc.. Of course it is nearly impossible to determine for sure if he has a rupture on an xray from what I am reading, but Doc did not see any obvious ruptures, infection, etc.
We have an appt next week to begin acupuncture and we are also considering Adequan injections (our Lab had spinal issues as well (primarily fusing of the spine, etc.) and responded very well to both so we figured it may be worth a try with Andy.
I am also looking for suggestions regarding how often to cath if I can't manually express him properly. Thanks in advance! We do not want Andy to suffer in any way, but do not want to "give up" if there is in fact hope with conservative treatment. Andy is not the type of doggy who would be happy in a wheelchair. I am not exactly sure how to obtain an URL for photos or I would post his xray photo, etc.
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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 20:38:52 GMT -7
Welcome to Dodgerslist. My name is Paula what is yours? For your privacy your email was deleted. Can you fill us in on a bit more detail, so we know best how to comment. --What breed is your dog? -- Are you doing the all important 8 weeks of 100% STRICT crate rest 24/7 only out to potty this way: …. 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)? The rest of the details are here: www.dodgerslist.com/literature/CrateRRP.htm-- Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy? -- How much does your dog weigh? Would you give us a list of exact med names currently given, their doses in mg's and frequencies? So very glad to hear Andy is on Pepcid AC! Is it noted when prednisone is due to start tapering? 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 wobbly walk? move the legs at all? or wag the tail when you do some happy talk? Keep in mind the very, very lightest least aggressive range of motion and leg massage will be necessary for paralyzed legs during conservative treatment once off all pain meds and no more signs of pain The information highlighted in PINK pertains to a dog who can't walk . www.dodgerslist.com/literature/massagepassiveexercises.htm-- Do you find wet bedding or leaks on you when lifted up? Cathing would be a last resort. Most people can learn to express quite well. It is a practice thing. So review this video and the tips on both expressing for urine and for poop and don't hesitate to go back and express right there in the clinic where the vet tech can check your work www.dodgerslist.com/literature/Expressing.htm-- 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. Never give up, stay focused, stay postitive and stay strong! You and Andy will get through this bump in the road of life. |
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Post by Allie & Andy on Jul 2, 2014 21:03:51 GMT -7
Oh gosh...I edited it with some of the info, but apparently it didn't save. My name is Allie (sorry). THank you for responding so quickly! Andy is a dachshund/beagle mix best guess and weighs 27 pounds (needs to lose a few more). Yes he is crated with padding, etc. He does have some pain when picked up certain ways (working on that)...hard to tell with Andy, he has always been vocal at times and is always slow (he is very stoic and that is why my vet had a hard time determining if he had any response to her squeezing in between his toes...he tends to freeze and look away with newer people anyway). Oh yes, we definitely taper steroids, etc. (been in rescue for over 7 years and have had numerous doggies sadly on steroids, etc.). These are the meds for now:
27 lbs
Robaxin 500 mg 1 tab every 8 hrs
Prednisone 5 mg 1/2 tab every 12 hrs
Tram 50 mg 1/2 tab every 8 hrs
Famotidine 20 mg 1/2 tab every 12 hrs
As far as bowels...totally normal tonight (a bit soft yesterday once and normal the other time). Eating and drinking great (he loves food/treats- lol).
Urine: he does have some leaking when picked up. My vet cath'd him yesterday at vet because she expressed quite a bit from him, but still had a full bladder upon xray. I have attempted numerous times, but cannot get enough out manually and I can tell he needs it so I made the decision to cath tonight too. Not my first choice, but until I can get back to the vet to have her show me on Andy again, I don't want him to sit with a full bladder all day and increase chances of a UTI. I am trying to find a vet tech near me to help express his bladder, but most are a good 30-45 min from me and I just can't make it there with work as often as needed. I am determined though....
As far as movement...very little if any at this time. Knuckling of both feet and cannot hold himself up when propped. Will check again tomorrow though- was worried about the bladder thing tonight so I didn't test much.
We do have an appt for acupuncture next week so hopefully that will help (can't get in until Thur though) like we did with our Lab. I am just praying by some miracle that he regains some function.
From everything I read, it seems Andy has missed the opportunity for surgery anyway based upon his deteriorating function and the timeline since we were out of town. I am still curious if anyone's dog has had such loss of control and still recovered with conservative treatment.
Please bear with me if there is a delay in responses...off to bed for now and likely cannot check it again until tomorrow night. THank you soooo much!
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Post by Pauliana on Jul 2, 2014 22:13:32 GMT -7
Hi Allie,
It looks like Andy is on a tapering dose of the Prednisone. When did the taper begin and what were the tapering instructions on the Prescription?
How to lift and carry Andy:
If he has pain with lifting it means his pain medications need to be adjusted and it also means his Prednisone should go back to the anti inflammatory dose that he should have begun with. It's 5mg twice a day for Doxie's.. His dose may have been higher since he is a larger dog. Pain means the swelling is still present and he needs more time on Prednisone to get the swelling down. Some dogs need from 7 to 30 days on the anti inflammatory dose.. Once the taper starts it is no longer working as an anti inflammatory. Discuss with your Vet about this and about an adjustment to the pain medications so Andy can be pain free from dose to dose. Pain deters healing.
Welcome to Dodgerslist... Sending feel better wishes to Andy.
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Post by Allie & Andy on Jul 4, 2014 6:48:03 GMT -7
Hi Paulina-That is Andy's original dose of Pred from my vet. He doesn't seem to be in pain, but I am not getting much (if any) of a deep pain response still. We are hoping this changes soon  |
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Jul 4, 2014 7:07:50 GMT -7
Allie, as Pauliana mentioned, the anti-inflammatory dose that we're seeing vets prescribe for dogs of Andy's weight is 5 mg 2x/day. It may even be higher for Andy since is on the larger size. Vets use a higher level of oral steroids to work more effectively in getting painful swelling down. Rxing a tentative lower end dose of Pred (2.5mg 2x a day) rather than being aggressive with the upper end of the dosing for inflammation (5mg 2x a day) means Andy is being given a dose of prednisone that may be similar to what the body makes on its own so the job is not getting done.
Swelling of the damaged disc presses on the nerves of the spine, causing pain and nerve damage. Once that swelling goes down and the pressure on the nerves is relieved, you may see neuro improvements. Please speak to your vet ASAP to discuss giving Andy an anti-inflammatory dose sufficient for his weight to get that swelling down.
If he's having pain when picked up certain ways, that definitely needs to be brought under control today. Andy is on a low dose of Tramadol, which can be brought up. Be sure to keep giving it consistently every 8 hours and speak to the vet about adjusting his pain meds. Also Gabapentin works well with Tramadol and can be added, too.
Please be sure to get a hands on your hands lesson on expressing ASAP so you can empty his bladder. While on Prednisone, he'll have increase thirst and urination and should be expressed every 2-3 hours. If you see leakage, then his bladder is overflowing and that's not good. It can stretch out the bladder and can lead to a UTI. Expressing can take a bit of practice but it's very important for the health of the bladder.
Loss of deep pain sensation can be difficult to determine, even for a specialist. Refrain from pinching his toes or feet as you won't be able to tell if it's reflex or not. And yes, DPS and nerve function can return with conservative care.
There is no timetable anyone can give you when to expect nerve repair to happen. In fact, there is no time limit for nerves to heal...it can take weeks, months or even a year or longer. However, it is known that neurological function usually returns in the reverse order of the damage. The first big sign you want to look for is that wonderful tail wag!
1. Deep Pain Sensation (Only correctly identified by a specialist.)
2. Tail wagging with joy at seeing you, getting a treat or due to your happy talk.
3. Bladder and bowel control proved by passing the "sniff and pee" test.
Take your dog out to an old pee spot in the grass. Let him sniff and then observe for release of urine.
4. Leg movement, and then ability to move up into a standing position, and then wobbly walking.
5. Being able to walk with more steadiness and properly placed paws.
6. Ability to walk unassisted and perhaps even run.
Please let us know what the vet says after speaking to him about Andy's meds and how you make out expressing.
Healing prayers for Andy.
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Post by Allie & Andy on Jul 4, 2014 8:01:51 GMT -7
Thank you both for your responses. I am not sure why the pred dose is so low, but I will ask her about increasing it for sure right away. I agree with you both that it should be more aggressive (I honestly had no idea on the correct dose amount because most of ours are bigger dogs). I spoke to Doc yesterday about expressing his bladder because I can only get a little each time. She had a hard time as well with him...not sure if due to his size, etc. but we are catheterizing him at this time because we both felt it was necessary. We just went through a similar thing with my Lab (she crossed the Bridge June 11th), so pain control is definitely important to us (she was on Gabapentin as well). I am giving everything exactly on time, but will certainly increased the dosages if needed. Thank you all so much! Will keep you posted!
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