Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Mar 28, 2015 14:08:48 GMT -7
I'm glad to hear that Newman's stool was more firm and he's not in pain. Not being in pain right at the moment is great. However, that lack of pain needs to continue throughout the time between doses of pain meds and there should be no sign of pain from one dose to the next. You had reported slowness to move when the medication starts to wear off so that means that at certain times of the day, Newman does have pain. And I know you don't want Newman to have pain at any time of the day. He should be lying comfortably in his crate, healing that disc, with no pain. We'd hate to think of Newman in pain at any time this afternoon or tonight or tomorrow morning so a call into the vet today is warranted. While certainly you would be unable to pull a surgeon out of surgery to speak to him, hopefully you'd be able to reach him after surgery as many vets will return phone calls after that. It shouldn't be necessary to actually bring Newman into the vet for his meds to be adjusted - a phone call today should suffice.
Even though the diarrhea has improved, it would be best to also let the vet know that it did happen so he can make a determination on how to proceed. Possibly the looser stool could be from eating more dry food but it could also be the beginning of GI distress. It's best to be proactive about getting a second stomach protector in place to prevent the problem from getting worse. GI problems can worsen so quickly and once bloody stools start, the problem has already become a dangerous situation.
We know that you love Newman and want nothing but the best for him. We, too, want the best for Newman and that's why we need to give you the best advice we can based on our experience in this. It is truly important to get pain under control ASAP, not waiting until an actual appointment occurs, and to get the needed stomach protection on board before a possible side effect worsens.
Blessings to both you and Newman.
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Shawn & Bruno
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M - Dachshund .. Bruno puppy ....Newman RIP
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Post by Shawn & Bruno on Mar 29, 2015 12:32:34 GMT -7
I spoke with the Vet last night around 6PM and told him I thought Newman was in a bit of pain near the end of the night when the pain medication was wearing off. I told him I wasn't quite sure how much of that was related to compression or the fact that he is bloated from water ingestion. He said to increase the ▲ Gabapentin to 3x/day. He ssaid that if Newman didn't have any back spasms that the Methocarbamol wouldn't do much. I told him about the loose stool and he told me to make sure I was giving him Pepcid 2x/day and 30 minutes before the steroid. He also said to give Newman some rice in his diet to bind him up. If it continues, he said we could talk about adding additional medication to protect his GI tract. I questioned stopping of the pain medication after the 4 days when the steroid is reduced and he advised against that saying that some dogs will react immediately to the change and a slight spike in compression (due to decrease steroid) could cause them to be in pain forcing some owners to put the dog back on a longer duration of steroid. He re-emphasized the side effects of the steroids and wants to keep Newman on pain medication an additional 3 days after the steroid Rx changes from 0.25MG 2x/day to .25MG 1x/day and then check on the 7th day. He is hopeful given Newman's current progress that the compression will be gone.
I am very pleased with Newman's progress. He is improving nearly daily with only a bit of drifting outside during potty breaks. He walks 90% as well as he did before and holds both legs nearly as good. His personality is nearly exactly the same except I get less affectionate and my wife gets none which she blames me as she is the pill given. I hope he 'forgives' us but his back is the most important. He also got cold laser treatment today which he seemed to really like as he was very calm while being rubbed with the laser. I have a renewed sense of optimism with the current condition. I believe he was return to the Newman that I know and love.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,892
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Post by PaulaM on Mar 29, 2015 14:28:59 GMT -7
Shawn, rice does contain fiber and fiber can help to control stools. Rice is a complex carbohydrate that tends to ferment. This can make Newman gassy, and rice often passes right through the GI tract undigested, exiting with the next bout of loose stool in exactly the same condition it entered.
If you are still seeing loose stools, you want to know why. Is it the Dex that is starting with red flag signs of loose stools? Is there now damage to the mucous lining that sucralfate is very good at bandaging and promoting healing? Neither you nor the vet know. Everybody in the medical community does know the bad reputation Dex has for very often damaging the GI tract. So I would be inclined to be proactive with Pepcid AC 5mg 2x/day AND not take any chances by adding in sucralfate. Your dog, your call on whether to further advocate.
If you are not going to advocate for sucralfate, then you can hide the symptoms of the loose stools by adding fiber. Pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation. And the plus is there will be very good nutrients and vitamins for Newman's body to absorb! The amount of water in the diet makes all the difference.
--To loosen the stool, add equal parts water to soak overnight each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day.
-- To firm up the stool add 1 teaspoon pumpkin 1x a day to kibble and no extra water.
Note alternatives: really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potoato.
Is the Gabapentin being increased to 50mgs 3x/day?
Sounds like a plan to stop pain meds 3 days into the taper. Please do keep us posted.
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Shawn & Bruno
New Member
M - Dachshund .. Bruno puppy ....Newman RIP
Posts: 45
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Post by Shawn & Bruno on Apr 4, 2015 15:54:25 GMT -7
Newman had a set back last night. I can't think of anything specific other than my wife accidentally banged into the door and Newman sprang up. In the morning, he was slow to walk outside during potty and groaning/shaking. We brought him back to Pompton Animal Hospital but Dr. Cattiny was not available so we saw Dr. Kristen. She seemed very knowledgeable about IVDD and gave me a refill of
[10 lbs]
Gabapentin 50mg 2x/day and
Tramadol 25mg 3 times a day which are to be taken together to manage the pain.
1x/.25MG Dex daily for the next 8 days then taper remove the pain killers about 3 days after the taper off period
Denamarin 90mg
[Pepcid AC 5mg 2x per day dosage.]
This is different from the Dr. Cattiny who said only Methocarbamol unless Gabapentin is needed due to the pain (Tramadol as last resort). She was very clear that it is cruel to keep Newman in pain. I completely agree with her but not sure why the original Vet didn't combine the two pain medications to be sure he wasn't in pain at all. She was debating returning Newman back to the 2x/.25MG Dex daily but was concerned for his liver.
She advocated for a blood test to check his liver which came back with slightly high levels.
Instead, she said for him to continue with the 1x/.25MG Dex daily for the next 8 days as it was still an inti-inflamtory dose based on Newman's 10lbs weight. Then, 1x/.25MG Dex every other day for the final 8 days. She was also clear to remove the pain killers about 3 days after the taper off period to make sure the lower dosage didn't trigger a quick/slight response of pain forcing him back on the steroids. To help his liver, she prescribed Denamarin 90mg which she said was all-natural.
Newman got a nice cold laser treatment and he appears to be nearly back to normal. Dr. Kristen also said not to see a chiropractor and money is better spent on acupuncture. She also mentioned "Standard Process Canine Musculoskeletal Support" and Vetri-Disc (http://www.vetriscience.com/index.php?l=product_detail&p=900580180) as supplements.
It is interesting to note that he appeared nearly identical in terms of personality/walking around 1-2PM when using potty before going to the Vet rather than the pain and slow movement he exhibited this morning. If I didn't know what know that he got startled last night and the pain in the morning, I wouldn't have thought differently.
It is a slight hiccup in the road to recovery!
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Apr 4, 2015 16:28:16 GMT -7
So sorry to hear of this, Shawn. When there is the return of pain after a sudden movement like this during conservative care, it could be that the not-yet-healed disc has re-torn and basically you're back to square one. Unfortunately, the 8 full weeks of crate rest do have to start over again as of 4/3.
It does sound as though this vet is more knowledgeable about IVDD. I'm very glad that she has advised against chiropractic treatments. I would hold off on starting any supplements, though, until Newman is no longer on any meds. If he has any reaction to the supplements, such as vomiting or diarrhea, it would be impossible to tell whether it was from the new supplements or the Dex.
Did you speak to her about continuing with the Pepcid AC to protect from the excess acid caused by the Dex? With the higher levels showing in the liver, she may want to give something else other than Pepcid AC as a stomach protector, possibly Sucralfate. I would check with her on that.
I'm glad you see this as a slight hiccup in the road to recovery because that's exactly what it is. Good to know that he's feeling so much better on the meds.
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Shawn & Bruno
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M - Dachshund .. Bruno puppy ....Newman RIP
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Post by Shawn & Bruno on Apr 4, 2015 17:29:58 GMT -7
I forgot to ask about the Pepcid AC as I just automatically give the 2x/5MG per day dosage. His stool is much better as of the last 3-4 days. Honestly, I am confused as to what really happened. There's no difference in medication from today than yesterday so I an not sure why the pain occurred except the sudden movement. However, I am quite surprised to see him 'recover' so fast. I just brought him out to use the bathroom and he was quick on his feet. I stand 2-3' away while does his business or he just stares at me ("Why you looking at me?") and as soon as he gets done, he 'sprints' (light jog) away until I catch him. I get a slight glimpse into his recovery at this point and it was surprising to see him back to normal given his set back. I can't explain how he is back to normal so fast.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Apr 4, 2015 19:57:07 GMT -7
Shawn, you're letting him have too much movement during potty times. This is not conservative care. Conservative care requires very strict 24/7 100% crate rest being carried in and out to do potty with only a very few steps taken at potty time. You need to use a 6' leash with harness, stand in one spot and only let him take a few steps to do his business. Or you need to use an ex-pen outside or push-in-the-ground fencing to create a 6' potty spot where he can do his business. You MUST restrict his movement. In reading what you just said about potty time, we DO need to start his crate rest over as strict crate rest has not been implemented.
Too much movement can prevent the disc from healing or can cause it to tear more. That may well be the reason for the increase in pain that you recently saw. Also, it may well be that pain is still not completely under control and there was pain due to the fact that it was morning and the pain meds had worn off from the night time and once the pain meds kicked in, there was a sudden "recovery".
Please let us know whether his pain is now completely under control and not wearing off as it nears the time for the next dosage. And please do all that you can to restrict his movement during potty time.
Please read up and become educated on IVDD so you have a good understanding of the disease. Newman will have this disease for the rest of his life so you must become educated so you know what to do now to help him recover and in the future to help prevent another disc episode. Start here and read all that you can:
www.dodgerslist.com/healingindex.htm
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Shawn & Bruno
New Member
M - Dachshund .. Bruno puppy ....Newman RIP
Posts: 45
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Post by Shawn & Bruno on May 21, 2016 8:53:52 GMT -7
My apologies as I thought I responded with updates but I guess I forgot. Newman is now 11.5 years old but while he has some gray hair on his paws and face, he is still the puppy I know and love. He is a bit lazier and sleeps a bit more but I think that is due to his older age. My 19 month old daughter chases him constantly so he is probably exhausted. 99% of people who look at him wouldn't know that he had 3-4 relapses as only a slight bump in his back exists. The vet says he is in 'outstanding health' so I am thrilled. For anyone reading this, please listen to the fine people of this forum who know more about this terrible disease more than any VET that I have ever known. Newman endured through multiple bad episodes and bounced back each time with some rest and medication. I cannot thank everyone enough. Thank you from the bottom of my heart.  |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,892
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Post by PaulaM on May 21, 2016 18:17:40 GMT -7
Shawn, we love to get year follow updates to know how our Dodgerslist family members are doing. How wonderful to hear Newman is in good health, no more disc episodes and enjoying life with this family! Thank you for stopping by. May your Newman have many, many more happy years ahead. You may want to review some of these very useful ideas to make your home back friendly, teach Newman four feet on the floor, not to pull on the leash and how to use a ramp. Scroll down to the list to check out #7 and #8 www.dodgerslist.com/literature/AfterCrateRest.htm Consider some home modifications if you've not already done that. No more stairs, blocking furniture. All those ideas and more are in this link: www.dodgerslist.com/literature/protectback.htm |
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