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Post by Sarah & Chewie on Jul 13, 2014 11:15:11 GMT -7
Hi everyone, my name is Sarah and I found your site/forum yesterday after my French Bulldog, Chewie was diagnosed with a ruptured disc. Hopefully, I'll answer all questions to the best of my ability. 
The night of 7-10-14 Chewie had slept in my sons bed instead of being crated at bedtime, when I walked in the room the morning of 7-11-14 Chewie had peed and pooped. Not something hes ever done, but outside of that he was acting his normal self and no more accidents. Later that night he Chewie wanted up on the couch but wouldnt get up himself (normally he just jumps up and every now and again he will whimper until you lift him up and put him up) so I assumed thats what he was doing and put him up except he wasnt acting like himself, just blah acting. At bedtime going into the crate it looked like he had slight trouble lifting one leg over the lip of the crate, he settled in for the night and was fine... so I thought.
The morning of 7-12-14 I let him out of the crate (kept in my sons room) and he came out walking like his normal self then wobbly and peed in my sons room. As I went out to get the cleaning supplies, he had also peed and pooped in the living room and also in my daughters room twice. At this point he was walking ok, but I knew something was wrong. It never dawned on me to crate him after this so I just had him lay on the floor beside me and immediately called the vet.
By the time he was in the car, he wasnt able to use his back legs, he was trembling and panting terribly and this continued at the vets office until they gave him a shot of Buprenorphine and Dexamethasone. The medications werent given until the vet had done all sorts of tests, like reflexes, deep pain, etc and was given just prior to Chewie getting x-rays.
The vet said he had two issues in his spine, one was up by his neck but was healed and fine apparently. The other midway in down his spine was a ruptured disc that had calcified and it is the problem, she said it more than likely happened a couple years ago, but he never acted any differently hes always been very healthy and not any visits to the vet except for routine visits and a allergic reaction to tear stain wipes.
Anyway, we were told our options were to treat conservatively with strict crate confinement and a cocktail of meds or back surgery and that we have a 48 hr window. So, now I'm just trying to educate myself and figure out what would be best. Chewie is our baby, I'm just not sure what the best option is for him.
Chewie's Stats:
-French Bulldog
-3 years old
-weighs 25.2 lbs
-wasnt technically diagnosed with IVDD, stated he had a ruptured disc that had healed a couple years back and calcified
-is able to feel pain in back legs/feet (at vets office)
-strict 24/7 crate confinement except to potty on puppy pads
-not eating (except when hes given people food for his medicine), drinking some water
-didnt potty at all yesterday except for the early morning accidents (pee & poop), but no accidents in the crate
-took him to potty this morning (7-13-14) and was able to pee on his own with proper support, still no poop
-no signs of pain but tenses up when picking him up to potty
-hes never wagged his tail, hes a frenchie, they shake their whole butt! but hes not able to do that, he cant wobbly walk.
-he supports himself with his front legs, no use of the back legs at all, he is trying to move around slightly in the crate.
-no leaks or accidents in the crate
Meds:
25.2 lbs
Prednisone 10mg: give 1/2 tablet by mouth every 12 hrs for 7 days currently then it tapers down.
Methocarbamol 500mg: Give 1/2 tablet by mouth every 8 hrs for 14 days.
Gabapentin 50mg: Give 1 tablet by mouth every 12 hrs for 14 days,
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,611
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Post by PaulaM on Jul 13, 2014 12:54:46 GMT -7
Sarah, welcome to Dodgerslist. First point a couple of points to address right away. With Dex and pred and the not eating, it really sounds like beginning of steroid damage. Cortisteroids (Prednisone, Prednisolone, Dexamethasone, etc.) are involved with stimulating gastric acid secretion causing GI upset to the more threatening bleeding ulcers or holes in the stomach or intestine. Phrase the question to your vet in this particular way: "is there any medical reason my dog may not take Pepcid AC?" If there is no reason, we follow vets who are proactive in protecting the stomach giving 30 mins before the steroid and there after every 12 hours. 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 www.petplace.com/drug-library/famotidine-pepcid/page1.aspx If you can't get ahold of your vet, it may well be a good idea to start Pepcid AC and keep your vet in the loop IF you feel he does not have any of the health issued mentioned in these links He sounds like he is still in pain if he is tensing as you go to lift him. Typically tramadol as a general pain reliever given at minimum of 3x a day is used. Advocate for Tramadol. Also it appears your vet has room to move up in dose for methocarbamol as well as Gabapentin to make sure Chewie does not suffer with any pain at all. Read over this information on surgery so you have some background on why you might be choosing surgery and things you might wish to discuss with the surgeon. www.dodgerslist.com/literature/healingsurgery.htmDr. Isaacs answered alot of questions we've had about surgery: "Surgery needs to be a decision an owner enters into recognizing the risk, but also recognizes the benefit. This way if something unforeseen occurs an owner can be comforted and at peace with the fact that surgery was the right decision and they did all they could for their dog." You will find it worthwhile to read the rest of his answers about surgery: www.dodgerslist.com/literature/surgery.htmHe may be a candidate to recover disc healing with conservative treatment. Nerves can continue to heal long after 8 weeks of 100% STRICT rest 24/7 the disc demands in order to heal. The problem is if you want surgery, a general vet often does not have the practiced eye to correctly identify what they observe regarding deep pain sensation. Only take the word of a board certified neuro (ACVIM) or ortho (ACVS) As 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 3. Nails scuffing floor 4. Paws knuckle 5. Legs do not work (paralysis, dog is down) <--- Chewie6. 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 as it is for nerves healing under conservative treatment. 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 and you see nerve function further diminishing get to a neuro or ortho asap. |
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Post by Sarah & Chewie on Jul 14, 2014 10:59:05 GMT -7
Thank you, Paula.
I checked with the vet today and they were going to give me a call back about a dosage amount for the Pepcid AC. The vet didnt necessarily think it was needed since his dosage is low and wont be on it long term, but stated she didnt have a problem with me using it for him.
Would the Tramadol and Methocarbamol be used together? Or separate? When I spoke to the vet they said his dosages were at a pretty good level for him already and that him tensing up could just be tensing because he thinks it may hurt like prior to pain meds. I will still check with them though.
Since Chewie will eat cheeseburgers and cheese slices for his meds, but not his grain free Blue Buffalo, what other options could I try with him? He is eager about eating... just not his dog food, lol.
Luckily, he has bladder control so he comes out of the crate long enough to potty (still no poop, but I'm going to try to stimulate him later when my husband is home and can help me support him. On the plus side today, when I touched his back legs he could feel me and looked back in the direction of whichever leg I was touching. Also, hes using his right leg to help him move around/adjust in the crate.
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Post by Cindi & Kytt on Jul 14, 2014 11:06:37 GMT -7
Sarah:
If surgery is an option for you, it is imperative to keep a close watch on your baby. As Paula posted, time is important regarding how successful surgical intervention is. If Chewie shows progress with the strict crate rest and meds, then brilliant!!! If he continues to deteriorate, have that surgeon on speed dial and be ready to go. These are just my opinions my friend. I'm not a vet, or expert, only a pupper mom who has had three dogs with IVDD. We have gone through three surgeries, and I have one on conservative measures right now. Hang in there!!! Healing prayers for Chewie!
Cindi and Keeghan
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Post by Sarah & Chewie on Jul 14, 2014 20:11:58 GMT -7
Thank you so much, Cindi!
Since you've been through multiple surgeries with your babies, was it done immediately or after a bit of crate confinement? I ask because right now the meds/confinement seem to be helping, but if things were to worsen would the surgery be as effective since time has passed? The vet stated 48 hrs, which at this point it has been. Chewie is only day 2 into strict rest. I keep weighing the pros/cons for what will benefit Chewie in the long run. My husband and I will do the surgery if he truly needs it. I guess right now we were just seeing if strict rest/meds would help. I sure don't want to do anything that will hurt him.
Is it ok for Chewie to be laying on his side? Hes been adjusting himself in the crate, laying on his side and even earlier tonight bearing weight on his back legs and turning himself around- then he wobbled. Luckily, he just sat and rested again after that.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Jul 15, 2014 4:04:22 GMT -7
The window of time issue concerning surgery is when they've lost deep pain sensation. At that point, the longer they go without surgery, the less chance the surgery will be successful. But Chewie obviously still has deep pain sensation (still has bladder control) so it's fine to continue trying conservative care since you have seen some improvement. Here is an article on when surgery should be a consideration: www.dodgerslist.com/literature/healingsurgery.htmYes, it's OK for Chewie to lay on his side and to move around a bit in his crate to get comfortable. Tramadol, Gabapentin and Methocarbamol can all be used together as a mix of pain meds to address pain. Tensing up when being picked up does sound like pain and not just anticipation of pain. Have no patience with pain as it hinders healing. Be sure to get the Pepcid AC on board, especially in light of the fact that he's not eating his kibble. Now isn't the time to try other foods to get him to eat. When trying other foods, if diarrhea occurred, it would be difficult to tell if it was from the change of food or from the side effects of medication. Plus Chewie's body has a lot of repair work to do so he needs his regular kibble and diet. Meds can cause constipation. Pumpkin can help firm up stools OR it can help to loosen stools. The amount of water in the diet makes all the difference. To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day. To firm up the stool, add 1 teaspoon pumpkin to kibble and no extra water 1x a day. Note alternatives for constipation: really ripe mashed fresh pear, just take off the peel; microwaved and mashed peeled sweet potato. Healing prayers for Chewie. |
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Post by Sarah & Chewie on Jul 20, 2014 20:34:42 GMT -7
Just thought I'd check-in and give a quick update.
Chewie started eating his food, then wouldnt poo so we took him to the vet for a suggested enema. At the vet he trembled badly and was able to poo... so no enema. They adjusted his pain meds and stopped Gabapentin and switched it to Tramadol, same dosage 1/2 tab every 12 hrs, 50 mg. The vet also prescribed a stool softener.
Chewie went back to the vet this past Saturday for a progress exam and was able to stand using his back legs for a bit of time before needing rest and on the knuckle test this time he was able to correct himself, not super fast and on his weaker leg it took a bit longer but he did do it! The vet decided to keep him on the Prednisone like its been given and wait until this upcoming Saturday's visit to see about tapering it down. Whether she was being overly optimistic or not, she thought Chewie could possibly be walking better by then. Still 24/7 strict crate confinement.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 21, 2014 4:34:50 GMT -7
I'm glad he didn't get the enema, as an enema is not a good idea for a dog with a disc episode. It would make his back move too much and cause too much pain.
It isn't unusual for a dog to be constipated on pain medications. Did you add equal parts water to the meal along with the Pumpkin? The amount of water in the diet makes all the difference. To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day. What is the name of the stool softener that was prescribed?
Have the adjusted meds now gotten Chewie pain completely under control, with no sign of pain at all from one dose of meds to the next? Chewie is on a very light dose of Tramadol. Tramadol works best when given consistently every 8 hours. If Chewie's pain isn't completely under control, please speak to the vet about adjusting the meds again.
Is this now the correct list of meds? Please confirm that Pepcid AC has been added to this list.
25.2 lbs
Prednisone 10mg: give 1/2 tablet by mouth every 12 hrs until Sat. visit to see about taper
Methocarbamol 500mg: Give 1/2 tablet by mouth every 8 hrs
Tramadol 50mg: Give 1/2 tablet by mouth every 12 hrs
Pepcid AC ?? 5 mg 30 min before Pred & every 12 hours thereafter??
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Post by Sarah & Chewie on Jul 31, 2014 19:37:34 GMT -7
I think he was just in too much pain to poo, but once it was softened up, he had no problems. They had given him 2ml of Lactulose 3x a day for 7 days. Chewie is no longer on it anymore. When he was switched from Gabapentin to Tramadol he had no effects, it managed his pain much better. The vet at his last appointment (7/26) decreased his ▼prednisone and let his Tramadol run out- but he doesnt seem to be exhibiting any signs of pain or discomfort... hes actually acting more like himself. At the vet, he was able to improve on the knuckle test as well as walk around. He is still on strict crate confinement and this Saturday will make 3 weeks. Still no pepcid- the vet said I could add it, but said it would be more used if he were having troubles eating.
His current meds:
Prednisone 10 mg: give 1/2 tablet by mouth every 24 hours
Methocarbamol 500 mg: give 1/2 tablet by mouth every 8 hours
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Post by Pauliana on Jul 31, 2014 20:10:31 GMT -7
Hi Sarah, Your Vet would prefer to treat your dog for stomach or GI problems AFTER they happen as opposed to PREVENTING a stomach problem as we believe is the better course.. IVDD is more than enough for Chewie to deal with.. Steroids are notorious for causing stomach damage/GI tract damage. We follow vets who are proactive in protecting the stomach by giving small dogs 5MG Pepcid AC (generic name is Famotidine) 30 mins prior to steroid. Pepcid AC is a generally safe over-the-counter suppressor of stomach acid production for healthy dogs. Dogs don't speak up at first signs of trouble like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach. We ask that all members read about each med their dog is on or may take as a safety measure. This directory is in alpha order: www.marvistavet.com/html/pharmacy_center.htmwww.dodgerslist.com/neurocorner2/stomachProtection.htmwww.petplace.com/drug-library/famotidine-pepcid/page1.aspxI am glad Chewie is feeling so much better.. While he is on the Prednisone taper, it is best to stop the Methocarbamol as that could mask signs of pain that you need to know about while he is tapering the Prednisone..Tapering is actually a test to see if the swelling has been eliminated. The one way we know the swelling is gone is to test for pain.. If Chewie shows he is in pain, that means the swelling is not gone and he needs to go back on the twice a day dosage of the Prednisone and the pain medications immediately. If he doesn't show pain, that means the swelling is gone. Methocarbamol would be masking pain..so the true test of the taper isn't happening. Please discuss this with your Vet and ask if it's ok to stop the Methocarbamol. If he shows no signs of pain on the taper, continue until the taper is over and no further medications would be necessary. Just the continuation of crate rest. Fingers crossed Chewie shows no signs of pain.. |
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Post by Cindi & Kytt on Jul 31, 2014 21:06:55 GMT -7
Sarah,
Please forgive me for not answering your question "Since you've been through multiple surgeries with your babies, was it done immediately or after a bit of crate confinement?"
With Hunter and Oscar, my two previous IVDD dogs, there really wasn't a question about surgery. They were in incredible pain, and both went completely down, no bladder control, no ability to walk, etc, within hours.
My current IVDD pupper, Keeghan's, that is him in my profile pic. with dental floss hanging from his mouth....don't ask, I have no idea how he got it, episode manifested very differently. He showed a hesitancy to leave his crate, and he whined when I picked him up. I knew it was IVDD. We went to the vet that day, had cold laser, and started meds and strict crate rest.
Like you, I wondered, crate rest, or surgeon? Marjorie posted the link to the document about when to consider surgery, and that eased my mind that conservative treatment was the right road for Keeghan.
Again, forgive me for not replying sooner. I was actually out of town when you responded.
Hope things are looking up for Chewie!
Cindi and Keeghan
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