Donna's Beijo 7/3 conservative

Hi Donna, I'm Sabrina. Welcome to Dodgerslist! I'm so sorry for all that you and Beijo are going through, but I'm so glad that you've found us and are researching how to give Beijo the best care!

Here are a few links we like to give to all new members - you may have already seen them:
--- YES, Your Dog CAN Have a Great Quality of Life! - www.dodgerslist.com/index/SDUNCANquality.htm

--- "Overview: the essentials" www.dodgerslist.com/healingindex.htm

--- Add 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 www.dodgerslist.com/store/DVDorder.htm

--- Tape this flyer to your fridge so the whole family knows what things are emergencies: www.dodgerslist.com/literature/FridgeInfo81907.pdf

--- The very, very lightest least aggressive range of motion and leg massage is necessary for paralyzed legs during conservative treatment - but only once off of all meds and there is no more pain. The information highlighted in PINK pertains to a dog who can't walk.
www.dodgerslist.com/literature/massagepassiveexercises.htm

--- Great to hear you have access to laser and acupuncture! 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.

From reading your post, it sounds like you are well on your way to becoming a "mini-expert" in IVDD so that you can be a great advocate for Beijo! Here are a few things I noticed:

Pain: Some dogs are masters at hiding it! If you notice any signs such as - shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy, etc. those are indicators of pain. "Not his typical self" can be a sign of pain, too.

Tramadol has a very short half-life, and typically needs to be prescribed every 8hrs (3x/day) for full pain coverage. If you notice any signs, don't hesitate to call your vet to report them and ask that Beijo be prescribed Tramadol 3x/day.
www.dodgerslist.com/literature/healingpain.htm

Med timing: Did your vet instruct you on the timing of the PepcidAC and Sucralfate? If not, from what I've read Sucralfate is best used on an empty stomach and given 30 minutes before administering an antacid. "Sucralfate requires stomach acid in order to form its protective gel. If possible, it should be given 30 minutes prior to the administration of an antacid."
www.marvistavet.com/html/body_sucralfate.html

(If that is the schedule given by your vet, do call and verify that you can change the order to: Sucralfate - 30min - PepcidAC - 30min - Steroid.)

Also, could you tell us:

► What was the date you started the all important 100% strict crate rest 24/7 (only out to potty) for this current disc episode? (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))

► Is the vet growing out a culture from Beijo's urine to see if he's on the best antibiotic for his specific infection?

► Does the vet has a certain day planned for removing the catheter?

► What are the vet's reasons for the Prazosin and Diazepam? Was the Diazepam intended as an anti-anxiety? Do let your vet know that it seems to be acting as an "upper" instead of a "downer" (not uncommon in my understanding - often times different "sedatives" work differently on different dogs).

))Hugs!(( We are here to support you while you help Beijo through his episode! 

Donna we appreciate your sharing our IVDD materials with your vet. What a wonderful vet you have... open to learning more about this disease to better help the next patient.

To do a culture the urine would normally be taken out via needle in a very sterile way to make sure it is not contaminated with other bacteria. The urine would be sent to a lab where the bacteria would be grown over several days to identify the exact bacteria to the correct antibotic can be selected. A urinalyis is often run in the vet's clinic where the bacteria won't be identified just that there is a bacterial infection or not.

What observation are you interpreting as "being sad"? Is he not interested in what is going on in the room, not interested in getting a treat or .....?

Hi Donna,

Did they teach you how to put the catheter in?  If not, I would try expressing him to make sure his bladder is empty. The longer the urine sits in the bladder, increases the risk of worsening his UTI.  www.dodgerslist.com/literature/Expressing.htm

I would let the Vet know the catheter slipped out and about the blood..

He may be pouting because of being crated or just upset about what he is going through. Be very upbeat when you are around him, to cheer him up. They get anxious or depressed if they think their family is upset, which we all seem to be when our dog has an IVDD episode.. : ) 

Sending comforting thoughts across the miles...

The purpose of crate rest is to act as a cast of sorts to let the disc heal… only limited movement of STRICT crate rest allows that to happen…there are no meds to heal a disc. Immediate neuro improvement may or may not come during the 8 weeks of crate rest… as nerves may take more than 8 weeks to heal. Think in terms of months rather than days/weeks with nerve repair... I know it really takes patience on our part. So not seeing diminishment of nerve functions is good, Beijo is not going backwards!!

So sorry to hear about the blood in the catheter! I don't have any experience with catheters - as Beijo has previously been seen at the ER, will they discuss this over the phone with you to see there is something you can try at home first or if you should head straight to the ER?

Let us know what they say!
))Hugs!((

Thank you for your excellent quick response!! I gave him a good drink of water and the catheter is already running clearer. He's been drinking quite a bit so I dont think it's a hydration issue.  I think you are right - he may need a different antibiotic. I just gave him another dose of the Enrofloxacin antibiotic. He supposed to get it once per day, so today he got 2 doses. I will definitely get a urinalysis done ASAP. I am waiting for the Emergency hospital to call me back. Right now I'm in much less of a panic. It is possible there was some sediment that came through looking like blood in the catheter. No matter what,  If the blood is present again tomorrow we'll go to emerg. If not I'll do it Monday with our vet.

Thank you so very much !!! I trust this site more than any of the vets we've seen so far! 

Will do! Thank you, hugs!

Donna,
The medication my Oscar was given to help make expressing easier was phenoxybenzamine. I agree with Ms. Pauliana, expressing is preferable to a catheter. None of my dogs were ever sent home with a catheter. I actually drove an hour each way up to Texas A&M for a week to learn how to properly express Oscar before he was released. Hang in there!! You have gotten some excellent information from the others.
Hugs,
Cindi and Keeghan

Hi Donna, I just read up on your roller coaster (not the fun kind) with Beijo. First off, he is such a cutie - and how can you tell when he is sad because he is just that kind of soulful looking weenie! I'm glad you found Dodgerslist when you did and didn't have to do the scary weekend alone. My Emmie has been in acupuncture (electro) for months and months and at one time they recommended laser could "compliment". I don't know if it would conflict on the same day. I know that Emmie gets Vitamin B shots right after the acupuncture and that made a HUGE difference for her. Please be patient and know that the 8 weeks of crate rest are where the magic happens. During Em's paralysis episode she couldn't move her back legs or tail and was incontinent in every way. I had to express pees and poops. Even when she was released from her crate rest, she still couldn't walk. It came slowly after. So please be patient. There may be no hopeful signs until the very end! One thing I would like you to talk to your vet about is Gabapentin for pain instead of Tramadol. Gabapentin is amazing for nerve pain (which is what Beijo has). Tramadol has recently been proven to be more of a sedative (sleeping vs. pain relief). Just ask, no harm in that.

HI Donna!

Here is my thought on laser and acupuncture on the same day. All dogs are different. Each case of IVDD is different. Some dogs, like my Keeghan, have benefited greatly from laser, others from acupuncture, and still others both. How will you know which treatment is best for your Beijo, if you are doing both treatments on the same day? Do you see what I mean? Try one...watch for the improvement. If you know that treatment works, continue it then add the second and watch for improvement. Not a vet, not an expert, just a pupper mom who has had three dogs battle IVDD. Hang in there!!!
Cindi and Keeghan

The whole point of conservative care is to limit movement of the spine as much as possible during the 8 weeks that it takes for the damaged disc to heal and form scar tissue. Too much movement and the disc can re-tear, causing pain and the possibility of more nerve damage occurring. Yes, muscles atrophy during crate rest, but the muscle tone returns quickly once movement is gradually re-introduced after the 8 weeks. Right now, the muscle tone is not of concern. The concern is to protect the spine from further damage until it heals.

Please don't pinch his toes as that may cause him to jerk his legs, which can tear the disc. Please also don't do any standing exercises until conservative care is finished. We do recommend massage and passive exercises (but not pinching of toes!) for paralyzed dogs during conservative care but only after all medication is finished and there is no sign of pain or swelling.  Beijo is still on medication that will mask any pain that he may have upon movement.  At this point, there is no proof that the swelling has resolved and his movement must be limited as much as possible.

Please let us know how you make out expressing him.  I hope that goes well.  And please also let us know what herbal supplements have been prescribed.  Herbs can also have side effects and contraindications with other medications so you should make yourself familiar with each medication/herb given to Beijo.

Please keep us updated as the taper of his medication begins.  Please also keep a close eye out for any signs of pain due to his standing and massage today.

Here's our video on how the disc damages the spinal cord:

Some vets seem to think that atrophy is something to be avoided at all costs. But risking more spine damage is way too high a cost! My Jeremy's hind legs were very weak after his crate rest but I was really surprised at how quickly his strength came back - in a matter of about three weeks. Whereas, spinal damage from too much movement can be permanent.

Once Beijo is off of all meds and has no pain so you know that the swelling is gone, then the passive exercises and massage highlighted here in pink (massage and exercises #1-4) can be done:
www.dodgerslist.com/literature/massagepassiveexercises.htm
However, these should NOT be done while Beijo is on any meds that would mask pain/swelling and only should be started once all meds have stopped and there are no signs of pain at all.

Hi Donna, that catheter thing is a difficulty. Just from human experience, when you use a catheter the body kind of "forgets" how to pee normally. I know that when I have surgery and have one in; the first pees after they take it out take SO much concentration and that is with all my muscles and nerves working. I have to run water and sit and picture peeing and oh my goodness it is so hard! So if Beijo is getting used to having his bladder emptied for him, it will be hard to move to expressing him. I think it is a transition well worth it though. Do you have a vet or vet tech that can teach you proper expressing methods in person? I used Paula's posted dodgerslist video to teach me and eventually I got better at it. It is kind of tricky. It also sounds like you are getting some very aggressive advice from your vet and just a word of caution; the moderators here have dealt with thousands of cases where your local vet probably hasn't. I'm glad you've opted not to aggravate the disc while it is healing. It really needs to just rest and do nothing for the full 8-10 weeks. That is what will help Beijo. Are you having any problems with Beijo being stinky from lying in or around pee? The moderators here taught me about Green Tea sponge baths for the bum and it sure helped!

Hi Donna, YAY!!! I know, we celebrate such weird things. I too had to watch a million of the videos (most were all showing male dogs!)Funny as it sounds (Paula will just die reading this), I NEVER found Emmie's bladder. In all the months of expressing, I never once felt it. No balloon. I could express all the pee and do a good job, but never felt that little bladder. The vet said it was small when he had to aspirate for a urinalysis. Now for the poop - are you expressing that? It really relieved Em to not have it "fall out" in her crate.