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Post by Deb & Henry on Jul 16, 2014 20:16:23 GMT -7
Hello! I'm Deb and I have a 14lb miniature dachshund named Henry. (That's him in my profile photo.)
In 2011 Henry went down and had surgery to remove the material - he most definitely has IVDD. He was fine after the 8 weeks of recovery.
Last Saturday night he was lying around more than usual and his long-hair mini-brother Milo insisted on being next to him. He slept all night long but on Sunday morning I picked him up and he started yelping to beat the band. Off we went to the Vet where X-rays revealed 4 mineralized discs. He spent Sunday night and Monday night at the Vet where he was kept medicated and confined. On Monday morning the Vet called to say he was no longer turning his foot over when tested. Off we went to the University of Pennsylvania.
The neurologist looked at his X-rays and examined him. She said conservative had a 50% chance of success so we decided to try it. His bag of goodies contained:
14 lbs
Amantadine Syrup - 10mg/ml - 1.5ml every 24 hours
Prednisone - 5mg - 1 every 12 hours for 3 days, 1 every 24 hours for 3 days, 1 every other day
Methocarbamol - 500mg - ¼ every 8 hours
Gabapentin Syrup - 50mg/ml - .6ml every 8 hours
Tramadol - 50mg - ¼ every 8 hours
Pepcid - 5mg every 12 hours. They did not give him any so I added that in
(I have to say, cutting pills into ¼ is next to impossible even with a pill splitter. Quite a few of them disintegrated! I hope they don't think I'm doing something odd with them when I call for a refill.)
We are using a sling to do potties - everything is normal in that respect. No strange colors; no leaks in the Recovery Suite. He is a champion squatter and would walk more if I let him.
He is eating and drinking just fine.
He does not make a sound when I pick him up. His feet do knuckle on the grass but not on the pavement. When tested his left foot turns over immediately; his right foot is still not responding much. He can tell I touched it but isn't too concerned about turning it back over. His tail is active as ever.
The only time he seems to feel pain is the hour before his next dose. Then he whimpers slightly, breathes loudly, and shivers a bit. Once the meds kick in, he either goes to sleep or watches tv. (He likes CNN. Who knew?)
We have an appointment with an acupuncture/laser therapy vet next Thursday.
When he was recovering from surgery in 2011 his dose of Tramadol was ½ pill every 6 - 8 hours - any idea why this dose is less? I do not like to see him in pain - should I tell the Vet he needs a dosage increase?
I'm a nervous Doxie Mom but I also believe in the power of positive thinking - he will not need surgery because I'm going to do everything to help him recover without it! 
Thanks for any assistance you can give!
Deb
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Post by Pauliana on Jul 16, 2014 21:10:47 GMT -7
Welcome to Dodgerslist, Deb, so glad you joined us! 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. Are you ready? Here's the link www.dodgerslist.com/healingindex.htmYou are right that Henry needs his Tramadol adjusted.. 1/4 a tablet is a very low dose for his weight and size.. My Tyler is that size and his Neuro always prescribes half a tablet.. Pain free from dose to dose is the goal and a very important one for the sake of his healing. You are an excellent advocate for your Henry! I am glad you are adding Pepcid AC every 12 hours, 30 minutes prior to the Prednisone.. By now he would have started the taper on the Prednisone, and the fact that he is showing signs of pain tells me the swelling is not resolved yet. 3 days is usually not long enough for most dogs and too soon to taper down from the anti inflammatory dose of the Prednisone. Once it drops down from the 5mg twice a day to the once a day dose it is no longer at the anti inflammatory level so it is not working to resolve the swelling. It can take from 7 days to 2 weeks and for some dogs more like a month to get the swelling down.. A taper is a test to see if swelling has gone down so your vet will call for a taper when he or she guesses the swelling might be gone. At the time of the taper the pain meds are stopped so you can tell quickly if pain returns and if it does that means the swelling hasn't resolved and more time on the 5mg twice a day dose is needed along with the pain medications. It is not unusual to have to taper more than once.. It's a good idea to have a plan in place with your vet when you are tapering in case pain returns on a weekend or evening when they are closed.. Please let your Vet know about the pain during the taper and ask if Henry can return to the 5mg twice a day dose until the next taper. Did you start the all important 100% STRICT crate rest 24/7 only out to potty for this current disc episode? …. 100% STRICT crate rest 24/7 only out to potty for a full 8 weeks means no laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no cart till all 8 weeks have been finished, 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. The recovery suite is the only surface that is firm, supportive for the spine, not inclining, always horizontal and keeps a dog from darting off at a TV doorbell and safe from other pets and kids from bothering them. A lap can easily shift and move around, that is one reason we say during a disc episode to avoid laps, couches and beds.. Anytime out of the crate is a dangerous time for a healing disc. The rest of the details of doing crate rest to ensure the best recovery in this excellent document: www.dodgerslist.com/literature/CrateRRP.htm 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. Sending comforting thoughts to you and Henry.. Conservative treatment works..and don't worry too much about those percentages.. Dogs don't go by percentages and often heal even better than those predictions.. "Dogs don’t know pity. They don’t know “can’t.” They don’t understand “may never.” They don’t give up. They don’t get discouraged. They epitomize “where there is a WILL, there is a WAY.” They will find a way! They don’t give up easily or quickly. They move forward in life in the best way they can." |
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Post by Deb & Henry on Jul 17, 2014 8:06:05 GMT -7
Thank you, Pauliana! Yes - we are on crate rest. He sleeps most of the time so he's not bored yet. Right now he's happy with an ice pack on his back and a fan blowing the smells to him. My biggest worry is that he will get used to this posh life and not want to leave the crate - ever!  Today is check-in day with the neurologist. I will tell her what you said about his meds. Again, thank you!! Not being alone in this makes all the difference for me and for Henry! |
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Sabrina
Helpful Member 
My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471 
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Post by Sabrina on Jul 17, 2014 10:31:21 GMT -7
Hi Deb, I'm Sabrina! Henry is such a cutie-pie! Just to clarify (as English typed on a forum can be so ambiguous, lol!) - is the ice pack next to Henry? Glad the fan is keeping his doxie-nose up-to-date on all the smells! (Best to have the fan blowing near him, not directly on him). Let us know the neurologist's plan for keeping Henry totally pain-free dose to dose! We're here to support you as you help Henry through this! ))Hugs!(( |
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Post by Deb & Henry on Jul 17, 2014 11:19:56 GMT -7
Hello Sabrina! My Mom gave us an old fashioned ice-bag (she keeps EVERYTHING!) and he likes it on the middle of his back. I let it be there for about 10 minutes at a time. And yes, the fan is indirect - he has to share with me and his long-haired brother. I have emailed the neurologist but I have upped his dose to what it was the last time -▲ Tramadol ½ pill . They will just need to give me some additional pills at some point. We just had potties and did the Foot Flip Test - the left foot goes back to normal almost immediately; the right foot takes a few seconds longer but he does flip it. This is a big improvement over Monday when he didn't flip the right foot at all! I am confident I made the right decision this time to go conservative. Of course, if he goes down we are in the car to the hospital for surgery but for now, he's a happy but wobbly sausage! Thanks again for the support. It's wonderful you do this! |
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Sabrina
Helpful Member
My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Jul 19, 2014 11:38:43 GMT -7
Hi Deb! Great to hear about the ice bag - that sounds nice and light.
How is Henry doing on his increased dose of Tramadol? I hope that it is keeping him pain-free dose to dose!
))Hugs!((
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Post by Deb & Henry on Jul 19, 2014 13:19:06 GMT -7
Hello! Thank you for checking in on us!
I heard back from the Dr:
The dose of the Tramadol is normally 2-4 mg/Kg every 6-8 hours. He is 5.2 Kg so 1/2 tablet for him is about 5 mg/Kg. It is a big dose, considering all the other pain medications that he has on board he shouldn't need an increase of the dose, but you can give it to him every 6 hours if you think that it doesn't last 8 hours.
I have increased it anyway and will talk to my local Vet this weekend to discuss. His weight is actually 6.8 kg [14 lbs]- not sure where the 5.2 came from...
We had a bit of an episode earlier today. He was breathing fast and panting while lying down, but no crying or whimpering. Once his meds kicked in he calmed down. He is not moving his back legs as much as he was yesterday and there was some knuckling in the grass - he is not "down" though so I'm not overly concerned. He is healing and is bound to have good days and bad days.
Also, I think my little sausage had the toots and the gas pains may have added to his discomfort. We did potties twice in a row - soft but not watery - and he has now settled down and is sleeping comfortably.
Thanks again for checking in! It is much appreciated!!
Deb
Good news: Henry can walk unassisted!
Bad news: I found this out when he got out of the crate, jumped off the sofa, and sashayed into the kitchen.
<facepalm>
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Post by Pauliana on Jul 19, 2014 21:07:26 GMT -7
Hi Deb,
Mention to the Vet about the soft stools, that is a red flag for stomach and GI tract problems from the Prednisone..Sucralfate should be addressed with the vet asap. It works in a different way to coat the irritated areas in the stomach.. It needs to be given on an empty stomach, then 30 minutes later give the Pepcid AC and 30 minutes after that give the Prednisone with a meal..
Also a home remedy to help with soft stools:
Pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation. 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: really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potato.
We always say dogs to the unthinkable in the blink of an eye.. Make sure Henry stays in the crate except for being carried out to potty. I hope he didn't damage his early healing disc. They are such rascals.. Do watch out for signs of pain, reluctance to move, shaking or shivering, tight tense tummy, yelping when picked up or moved, not his perky self.
Thanks for keeping us posted.
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Post by Deb & Henry on Jul 20, 2014 12:11:51 GMT -7
Thank you, Paulina! Poop back to normal today! Henry loves his pumpkin! He is a bit tender today but nothing dramatic after his Great Crate Escape. I really think he's Houdini reincarnated... We are going to keep him on the Prednisone for at least 5 - 7 more days and we have upped the Tramadol to ½ pill every 8 hours. He just licked the heck out of a Kong and seems to be resting comfortably now. We have a recheck with the local vet on Wednesday and will tell her about the stool issue. Thank you!! |
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 20, 2014 13:05:11 GMT -7
If you saw an increase in pain due to too much movement from his escape from the crate, then he could very well have re-injured the disc. Did you up the Tramadol due to increase pain after the escape? I see that you had previously upped it on 7/17. Was that when you increased it - before he jumped off the couch? If you feel he had any increased pain due to escaping yesterday, you should re-start the crate rest from today and continue for the full 8 weeks from today. You're only a week into his crate rest so extending it by a week would be a prudent thing to do to ensure that the damaged disc has the full 8 weeks needed to heal and form scar tissue. It's good that he'll be on the Prednisone for another 5-7 days to address any new swelling.
Please let us know if you feel he had increased pain following his escape and jump from the couch yesterday so we can re-start the date of the crate rest.
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Post by Deb & Henry on Jul 20, 2014 13:43:05 GMT -7
Hello Marjorie!
We had upped the Tramadol before his little adventure - my local vet agreed to the dosage amount despite what the neurologist said.
I don't think he's in much more pain now than he was before. Some slight shivering until the meds kick in but once they do, he sleeps/lounges comfortably. That's pretty much how it has been going.
I think it's ok to keep the clock going. Even if he seems ready to start moving again I am going to keep him crated at least part time after the 8 weeks. (Honestly, I think he likes all the attention...)
Thank you!!
Deb
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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 4:20:00 GMT -7
Deb, if Henry's shivering, even slightly, until the meds kick in, then the pain meds are still not right. There should be absolutely no sign of pain from one dose of meds to the next. Pain does hinder healing and must be completely under control and not rearing its head at all.
"Pain is a significant stressor, leading to all the deleterious consequences of stress, such as immunosuppression, slowing of the healing process and acceleration of disease processes. Thurman JC, Tranquilli WJ, Benson GJ. Perioperative pain and distress." In: Veterinary Anesthesia. Baltimore: Williams and Wilkins;1996. p 40–62.
Please speak to the vet today about the fact that Henry's meds are not lasting dose to dose and let us know what they say. They still have room to move up on the Tramadol.
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Post by Melea & Little Bit on Jul 21, 2014 17:06:00 GMT -7
Our vet is refusing to move our dogs dose up to half a pill. He is getting 1/4 a pill every 8 hours and he is still in some pain right now, not due for another tramadol until 9:30pm and it's 7pm now.
How in the world do you deal with a vet that says they are maxed out on a dose but everything you read online says there is room to go up? We just keep getting told that if the meds he is on don't manage the pain then we need to put him to sleep, when clearly the medication works... just not 100%. He also wants to take Little Bit off his tramadol in two days to see how he does. I do NOT agree with that and want to keep him on it for a full 2-4 weeks and wean him off slowly.
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Post by Deb & Henry on Jul 21, 2014 19:15:19 GMT -7
Home from the Vet!
She said his little escapade combined with the lower dose of steroids has probably set him back a few days. She gave him a shot of "Buprenex" ($30) and when we got home he drank a bowl of water, and is now resting. Not asleep but not crying or shivering.
New pill regimen:
12 lbs
Tramadol - 50mg - ½ tablet every 6 hours
Prednisolone - 5mg - 1 tablet every 12 hours for the next 3 days; 1 every 24 hours for 3 days after that
Methocarbamol - 500mg - ¼ tablet every 8 hours
Gabapentin Syrup - 50mg/ml - .6ml to .85ml every 8 hours
Amantadine Syrup - 10mg/ml - 1.5ml to 2.25ml every 24 hours
Pepcid - 30 minutes before Pred; 2 - 3 hours before Gabapentin
My fingers are crossed!!
I am writing this in the vet emergency room waiting area - Henry is being looked at and I'm repeating to myself "I won't agree to surgery yet. I won't agree to surgery yet."
I really do want to give the crate/meds time to work - he's quite comfortable for the first few hours after a dose so that leads me to believe the meds need adjusting.
I don't want to be the "crazy dog lady" but I'm not leaving here without someone telling me why they cannot control his pain.
It really makes me mad that they don't want to use the max dose and won't tell me why. Do they get points for NOT prescribing pills??
I'm not rushing into surgery!!!
Melea - can you get to a different Vet? It sounds like you'd be better off with someone who'd rather treat than euthanize.
Stay strong! Your furbaby needs you!
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Post by Pauliana on Jul 21, 2014 19:47:23 GMT -7
Hi Deb, Great job on advocating for Henry with the ER vet for more pain control for Henry. I hope this does the trick for him and he can get on with healing. |
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Post by Melea & Little Bit on Jul 21, 2014 21:14:21 GMT -7
So glad the vet is working with you on adjusting his meds! It's so hard and frustrating finding what works for YOUR dog.
Our vet is the leading vet around for pain management. Got to love small towns. IMO, he should give my dog whatever I ask. He gets paid, my dog is out of pain, it's a win for everyone.
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Post by Deb & Henry on Jul 22, 2014 14:08:34 GMT -7
Today was SOOOO much better than yesterday! No shivering, no crying - just sleeping and the occasional whine for attention. (A DogMom knows the difference between a pain whine and an 'I need an ear rub' whine...) He is not crossing his legs when he walks anymore although he is still wobbly and knuckling. A long way to go but at least we are on the right road now! Check up at the Vet tomorrow; acupuncture on Thursday! |
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Post by Cindi & Kytt on Jul 22, 2014 14:24:28 GMT -7
Hi Deb!
I just wanted to offer my support to you and Henry! I've had three dogs with IVDD. Two underwent surgery, one of them twice, and my current IVDD pupper, Keeghan is in his 5th week of conservative treatment with strict crate rest. Keep that boy pain free and confined except for potty time, and I have a feeling you guys will avoid the knife. Keeghan had 6 laser treatments starting day one of his episode, and they really seemed to help him with pain and healing. Oscar, one of my previous IVDD pups, had acupuncture. Let us know how the acupuncture goes on Thursday.
Cheers!
Cindi and Keeghan
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Post by Deb & Henry on Jul 22, 2014 15:36:59 GMT -7
Thanks, Cindi (and Keeghan!) Happy to hear your Camp Recovery is going well! I really do appreciate your message - it's so nice to know we are not alone! This hasn't been easy but I think now we have the meds right and are making good healing progress. I feel badly for those not near a large city as the choices of Vet are so limited... I'm telling you, it's a good thing doxies are so darn cute!  |
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Post by Melea & Little Bit on Jul 22, 2014 22:23:18 GMT -7
We are over an hours drive from Dallas, Texas so our vets are limited as well. It's so hard! I called today asking if there were any meds I could give him through a shot form since he refuses to eat randomly and I can't push the pill down his throat without getting bit to the point of blood. They were so rude and said NO, my only choice was to just force him to take the pill or make the choice (put him to sleep) OR they would keep him there with an IV. She just said, well find something he likes to eat. Like I'm not already trying that.
Does Henry struggle with not wanting to eat during pill time or it only my weird little guy?
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Post by Deb & Henry on Jul 22, 2014 23:36:38 GMT -7
Melea -
So sorry to hear your Vet is a jerk. You have incredible restraint - if someone said I should put Henry to sleep he'd need to have my shoe removed surgically.
Here's a secret I learned from the neurologist - pills can be made into a liquid if you order them from a "compounding pharmacy." Costs a bit more but it might be worth it. Your vet will probably balk at the extra work but ethically I think they need to do this for you.
As far as Henry, Greenies makes these pill pocket things and we have had great success with them. They come in a bunch of flavors that all stink to high heaven and he doesn't even chew it - swallows it whole. (Then I have to wash my hands because I smell like a meat factory...) They are very mushy and cover the pill completely. I got mine at Pet Smart.
Good luck! Prayers to you and Little Bit!
Deb
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Post by Melea & Little Bit on Jul 23, 2014 6:23:11 GMT -7
We have a pet sense here, I'll go check it out today to see if I can find them!! Little Bit won't take liquid either, I feel like I'm hurting him more by fighting with him instead of sitting there for sometimes an hour, talking all nice to him and getting him to finally eat the pills that are hidden in something. These guys sure are lucky to have such awesome pet parents  |
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Post by Deb & Henry on Jul 23, 2014 10:45:55 GMT -7
We just got back from our Vet checkup and I have no idea what they did to him but he's very uncomfortable. Clearly in pain and not a happy wiener at all... On top of that, they are giving him one more week before they want surgery. I am one furious Doxie Mom right now! Maybe the compounding pharmacy - or you - can add some bacon flavoring? Hopefully the Pill Pockets will do the trick! Especially if you just randomly hand him one without a pill. If these wiener dogs weren't so darn cute... And yes, we are indeed awesome pet parents! |
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 23, 2014 14:02:55 GMT -7
I don't blame you for being upset, Deb! I take it you weren't in the room with him during the exam? I would call them and ask just what happened during the exam. Most vets will not do surgery on a dog that can walk. Do they expect him to be 100% in another week?? Nerves can takes months, even a year or more, to heal. Take a look at this page detailing when surgery should be a consideration so you'll be better equipped to discuss this with them: www.dodgerslist.com/literature/healingsurgery.htmHenry has shown improvements is just 1-1/2 weeks on conservative care. He's obviously moving in the right direction. It may well be in Henry's best interests to find a vet who is more familiar with treating IVDD. I don't recall if you've been shown these links before but here they are if you need them: Board-certified neuros (ACVIM) and ortho (ACVS) surgical specialists can be found at University vet teaching hospitals. You can locate others in your area here: www.acvim.org [neuros] online.acvs.org/acvsssa/rflssareferral.query_page?P_VENDOR_TY=VETS [orthos] Dodgerlist Members' vet recommendations - dodgerslist.boards.net/board/10/guidelines-postingPlease keep us updated on Henry's pain. Hopefully, he will not have to re-start the 8 weeks of crate rest but if his pain has worsened, he may well have re-torn the disc. Let us know what the vet says happened during the exam. |
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Post by Deb & Henry on Jul 24, 2014 9:06:20 GMT -7
So we went to have a laser treatment today - $20 at Rau Animal Hospital in Glenside, PA - and spoke with his new vet. She recommended we see the neurologist at Cares in Levittown, PA because he is now worse than he was immediately after his recheck yesterday: he is not using his back legs at all on the grass, he does not flip his right foot back, and he is hesitant to put his left foot down. We have an appointment at Cares today at 3pm and if he recommends the surgery we are going to go ahead and do it there. As much as I hate to put my little sausage through surgery again, I think something has happened to move from a protrusion to a herniation...  |
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Post by Cindi & Kytt on Jul 24, 2014 10:46:41 GMT -7
Deb,
Moving fast when things turn for the worse is so important, and you are doing just that! My Hunter had two surgeries and bounced back beautifully after each one. If it brings you any hope, his second surgery was the last time he had any problem with IVDD for the rest of his life. Keep us updated and know that you and Henry are in my prayers.
Fingers and paws crossed!
Cindi and Keeghan
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Sabrina
Helpful Member
My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Jul 24, 2014 11:41:05 GMT -7
So sorry to hear of Henry's worsing neuro functions, Deb - but so glad you are getting into the neurologist today!
I'm sure everything is crazy stressful for you today, but do take some time to read over the surgery link Marjorie shared - that will help as you work with the neurologist to decide on the best course of action for your sweet Henry.
))Hugs!(( Take care, and let us know how things are going as you're able.
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Post by Deb & Henry on Jul 24, 2014 15:59:59 GMT -7
Thank you everyone!! Henry is at Cares tonight and he will have the MRI/surgery tomorrow. Hopefully we can pick him up on Sunday. Fingers crossed! |
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Post by Pauliana on Jul 24, 2014 20:33:00 GMT -7
Hi Deb, We will all keep Henry in our prayers. I am so sorry it has come to surgery.. I really wonder what they did to him in that exam. Comforting thoughts across the miles. |
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Post by Deb & Henry on Jul 25, 2014 16:17:42 GMT -7
Thank you for all the prayers and healing thoughts!
Henry is resting after his surgery this afternoon. The neurologist said the problem disc was just below the last problem area and there was quite a lot of material to scrape out. (Ick!) He said Henry should recover 90-100% of his mobility in time.
After 6 months of unemployment I start a new job on Monday - Henry has some wonderful timing! Good thing dachshunds are so cute...
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