jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38 
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Post by jiorio on May 8, 2013 16:18:06 GMT -7
Hi! It's been awhile since I have been active but we're back for the 3rd time!
The facts:
Name- Lily, Age - almost 8, breed-wirehaired doxie. Date of strict crate rest - 5/8/13. Date symptoms first noticed-yelped when jumped on the couch last Wednesday, May 1.
History -Was acting fine until last night/early this morning. She jumped off a low bed and yelped at about 4:30am. We immediately crated her and my daughter called the vet as soon as they opened. Got in by 9:15am. Regular vet immediately suspected IVDD episode based on her history and presentation of the symptoms. Had significant pain when touched but still has movement. We decided to do conservative treatment as she had her first episode 5 years ago and was good for three years. Had another episode Sept. 2011 and had surgery. Recovered well until today. Vet did x-rays. Showed a small area of disc material in her lower back. It is below the T11-T12 area where her first two episodes (and surgery) were. Looks like lumbar area Affecting primarily her right side when past episodes where primarily on her left. At the vet's office she was given a shot of steroids. She was home by 11:00am and has been in her crate since except to go out and urinate. According to my husband and daughter, she tried taking a few steps, yelped but was able to urinate on her own. She is wagging her tail but is pretty mellow due to the meds she is on.
Medications: Misoprostal, 100mcg, 1/4 tab 2x/day (stomach proctector)
Robaxin 500mg, 1/4-1/2 tab 2-3 times/day (muscle relaxer)
Predisone 5mg 2x/day for 7 days and then taper based on symptoms (inflammation)
Torbatrol 15mg 1/2 2x/day (pain)
Plan: Strict crate rest. The vet told me 3 weeks. I told her that Dodgerslist recommends 8 weeks and that's what we'll be doing. Vet wants us to call daily with updates to see how she is responding and see her weekly for the next few weeks. I also plan to get her back to acupuncture but the main vet there who does it is out on a family emergency. If he is not back in a few weeks I may look for someone else for the time being.
Feelings: Scared and sad but feel much better equipped at handling it since we have been here before and had support from Dodgerslist both times. As a family we have made the decision to try conservative (can't really afford another $4000 surgery only to have it happen in another area of the back.) Will not consider putting her down even if paralyzed unless she is having uncontrolled pain.
Thanks for your support!
Jill and Lily
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StevieLuv
Helpful Member 
Conservative Treatment 3x. It really does work!
Posts: 1,335
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Post by StevieLuv on May 8, 2013 17:48:27 GMT -7
Hi Jill, my name is Maureen. My Stevie is going through her second IVDD episode this year. Like you, I sure feel better equipped to deal with it this time around. Keeping you and Lily in thought and prayer  |
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Post by Nancy & Polly on May 8, 2013 18:34:07 GMT -7
Poor Lily! Poor you! I think we all live in fear of "it happening again.". How fortunate for Lily that you know just what to do. Have courage!
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Post by Linda Stowe on May 8, 2013 19:08:13 GMT -7
Hi Jill Very sorry to hear Lily is having another episode. Great you caught it early and took action to prevent any further damage. Is the pain under control now?
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Post by Pauliana on May 8, 2013 19:29:56 GMT -7
Hi Jill! Welcome to Dodgerslist new forum! A third time, I am sorry to hear.. At least you know the right things to do to get Lily back on the road to recovery and good for you telling the Vet you will do 8 weeks of strict crate rest! How is Lily doing on the medications she is on. Is she still in any pain? Hope the medicines are helping by now. If not get back with your Vet and make some adjustments until she is pain free dose to dose so she can heal in comfort. There have been some updates and changes to the Dodgerslist website so be sure to take a look. www.dodgerslist.com/healingindex.htmPlease keep us posted on how she is doing. |
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 9, 2013 6:39:31 GMT -7
Lily woke up with some pain this morning but according to my daughter, who was sleeping next to the crate, she slept well. Lily yelped a bit when she first got up at 5:00am. I fed her and gave her morning pills (steroid, muscle relaxer, and pain med). 1 hour later I gave her the stomach protector. She seemed to be comfortable after the meds kcked in again. At. 6:30am, my husband and daughter took her out. She yelped once but was able to take a few steps. She refused to go to the bathroom. (she has not urinated since yesterday @5:00pm). Tried again to take her out before we left for work at 7:15. She took a few steps (noticeably favoring right leg), no yelping but then hightailed it back to her crate (less than 5 feet away) and got back in. No yelping then but she still has not urinated or pooped since yesterday. She laid down in the crate and was able to reposition herself without yelping. Called the vet at 8:00am to give her an update. As long as she is not declining we are comfortable with how she is doing. Only feeding her once/day but giving her a spoonful of canned pumpkin mixed with low salt chicken broth in the evening and giving her meds with a tiny bit of shredded cheese or yogurt. Vet said this plan sounds good. I will call her again tomorrow to update her. When we left for work she was resting comfortably. My daughter will be home just after 1:00pm so I think she will be fine until then.
Thanks for the support!
Jill
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Post by Pauliana on May 9, 2013 8:01:20 GMT -7
Hi Jill, If Lily isn't urinating she needs to be expressed. Please have the Vet tech give you a demonstration. Since Lily is on Prednisone or another steroid, they will likely need to be expressed every two to three hours until off this medication. Steroids create thirst and thus more urine production. Always provide access to water while on steroids. Here is a link that has a video and other info. www.dodgerslist.com/literature/Expressing.htm
Urine sitting in the bladder can cause a Urinary tract infection. Also once it gets filled up to capacity, it will overflow and that can cause loss of bladder tone as time goes on which is not a good thing..This is something that needs taken care of ASAP. I am concerned she is still showing signs of pain. Never be patient where pain is concerned. Her meds need adjusted until she is pain free. Please read this link.. www.dodgerslist.com/literature/healingpain.htmSending healing thoughts your way.. |
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Post by Linda Stowe on May 9, 2013 9:02:25 GMT -7
Hi Jill, I'm concerned too that Lily hasn't urinated recently. With the steroids she will need to more. Just be sure she still has bladder control. If the pain isn't under control she may not want to urinate so make sure she is not in pain during any time of the day. The vet has options to change the frequency or add other meds.
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 9, 2013 9:26:39 GMT -7
She did have bladder control late yesterday afternoon. My daughter said she went out and urinated without a problem. That was about 6 hours after the steroid shot and 5 hours after her first dose of muscle relaxers and pain medication. It sounds like you are right about the pain and her not wanting to go because it hurts. My daughter gets home at 1:00pm so I will have check and take her out. I think part of the problem is that I make her nervous whereas my daughter can get her to do just about anything. She may be more relaxed with her. I also tried offering her water several times before we left but she refused. I put low salt chicken broth in it and she still refused. I put a water bottle on the side of her crate but it kept leaking so I took it down. Any suggestions as to how to make sure she gets enough water in the 4-5 hours that someone is not with her? I will try picking up another water bottle at the pet supply store on my way home and I will have my daughter offer her fluids as soon as she gets home.
Thanks!
Jill
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Post by Linda Stowe on May 9, 2013 14:38:38 GMT -7
Jill how is she doing now. Did she urinate on her own with your daughter? Is she still eating. YOu can put water on her food to get more liquid in her. I'm concerned that shes not drinking now. This could be because she is in pain. A dog can go without food for awhile but needs to drink.
Please let us know asap.
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 9, 2013 15:24:59 GMT -7
Linda,
She is drinking a bit and my husband and daughter got her to eat and take her prednisone and pain medicine. She finally urinated all over the living room floor but they said she yelped when she did. Not sure if it was voluntary or she just couldn't hold it any more. Laid in the yard sprawled out for about 1/2 hour and did not want to move. They got her back in her crate and she is not leaving until tomorrow. She shows no signs of wanting to move right now. We will give her the muscle relaxer closer to bedtime to help her sleep. Will also give her the stomach protector. I will call the vet first thing in the morning to get pain meds adjusted. My daughter did say when she came home from work she was wagging her tail and smiling. She also wagged her tail for the neighbor who came over. I thought it might get easier the third time around but it isn't. My poor daughter, who is so attached to Lily and vice versa just sat and cried for about 1/2 hour! It just breaks my heart!
Thanks for your support!
Jill
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Post by Linda Stowe on May 9, 2013 16:12:50 GMT -7
Jill good she is eating and drinking now. Maybe because she urinated. She might have a UTI and maybe that is why she doesn't want to urinate and it may hurt. Did her urine smell normal? Remind your daughter not to cry in front of her. She'll pick up on it. I'm glad to hear she wagged her tail.
Let us know how she is doing in the morning and what meds the vet adds or how she adjusts.
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 9, 2013 22:07:42 GMT -7
Lily seems to be getting worse! I gave her muscle relaxer around 10:00pm and 1/2 pain pull a lttle after that as she yelped when in the crate. It is now 1:00am and she will not stop shaking! She was in the crate next to my daughter and she woke me up because she could hear her panting. Her breathing is very fast and she looks so scared! Will try to hang on another few hours before calling the vet. I am scared!!!
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 10, 2013 4:08:13 GMT -7
Update on Lily. I made the decision to take her to the emergency vet at 2:00am this morning. She was panting and shaking and as we were going over the bumps in the road, she yelped once or twice. We didn't even take her out of the crate, we just put in the back of the SUV and my daughter sat in the back with her. At the ER vet she walked for them, albeit wobbly. She did not seem to be in quite as much pain. She peed and pooped, I think from nervousness. They gave her a shot of hydromorphone. After they gave her the shot and brought her back to us, she was wagging her tail! We got home just after 3:00am. She is resting comfortably now but refused food and growled when my daughter tried to encourage her to eat, or at least take the prednisone. I left a message for the regular to vet and my daughter is taking her back in. Will update after the vet visit!
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Post by Sherry Layman on May 10, 2013 6:56:56 GMT -7
I'm so sorry you had such a rough night. Indeed this can be a difficult road just getting the pain under control but don't give up. Just as humans are different so are all dogs and sometimes it takes some adjustment of the meds to find what works just right. Dont' be afraid to be Lily's advocate and ask your vet about changing the medications to see if something else controls her pain better. Ask if the pain meds are at max doses or if switching meds is an option. Sometimes increased doses of steroids are briefly necessary also just to get that inflammation down. Ask questions to put thoughts in your vets head.
One thing that also concerns me is Lily's lack of eating and drinking. Indeed this is often due to pain but can also be a sign of stomach upset from the Prednisone. Since dogs can't speak we can't determine for sure the cause so we just have to take all the precautions. The misoprostol is indeed a stomach protector but it is generally used specifically with NSAID's. It's possible your vet has used this drug with steroids before and had great success but many dogs take NSAID's or steroids with no stomach protector and don't experience stomach upset just as humans who take Ibuprofen or steroids often don't experience problems. The issue is that dogs can't tell us what they are feeling and they are stoic and will mask a problem until it is severe so we must be proactive. I would politely question the vet in light of Lily's symptoms and ask about a change in stomach medications. Something we commonly see is a stomach coating medication called sucralfate. Also a more common stomach protector in lieu of the misoprostal is Pepcid (famotidine) which you can purchase over-the-counter most any place quite inexpensively. The dose is 5mg twice daily about 30 min before the Prenisone. You could also politely question your vet about the possiblity of switching to this medication. Just some thoughts since we can't say for sure why she isn't eating and drinking and we don't want to assume.
Let us know how she's doing as the day goes.
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 10, 2013 14:41:03 GMT -7
Update for the day on Lily. Called the primary vet at 7:30am. They told my daughter to bring her right in. Lily still groggy from the dilaudid at 3:00am but still showing signs of pain. Got her to take her prednisone with a little bit of shredded cheese and low salt chicken broth. Regular vet and tech saw that she is still having alot of pain. Recommended neuro consult. Called and got squeezed in for an 11:00am appt. I left work crying and so was my daughter as she can't stand seeing her furbaby in pain. Neuro vet did the exam and reviewed the xrays/meds from the regular vet. His exam showed "an alert dog with mild paraparesis without ataxia. Left pelvic limb non-weight bearing lameness. Normal postural reactions and and pelvic limb spinal reflexes. Normal cranial nerve exam. Painful caudal lumbar spinal palpitation and extension of left hip." Without a CT/MRI it is impossible to tell for sure if it is indeed another disc episode. xrays from regular vet showed calcified disc in situ at L6-L7. He said the exam is most consistent with left-sided caudal lumbar spine problem and he is most worried about disc herniation. without further testing other things such as meningomyelitis, tumor, cyst, vascular disease, or orthopedic problem could not be ruled out. We opted for conservative again as we just cannot afford another $4000 surgery less than 2 years after the first. He reviewed all the meds and could not find anything wrong with how she was being treated by the regular vet. He did say this type of disc injury is usually more painful than farther up in the spine but because it is so low in the spine, it does less damage. He said he doesn't like putting dogs on more than 3 meds but if she is still really hurting over the next few days to add Gabapentin 100mg, 1/2 tab every 8 hours as needed. Of course, strict crate rest. Wants us to call in a week to update him. Got a refill on the pain meds from regular vet. I also asked who they could recommend for acupuncture since the doctor who does it at our regular practice is out until at least June 1. (Don't want to wait that long!) When my daughter got Lily home around 1:00pm she gave her a muscle relaxer and pain pill. She ate and drank for her. I guess for the next few days we just keep her calm and comfortable. She was chilling when I got home at 5:00pm. Will let you know how the weekend goes! Couldn't do this again without you all! I wanted to hurt a coworker when she basically told me I was being ridiculous about this dog and I shouldn't have taken her to the ER at 2:00am and then to the neuro vet. I told her unless she's had a dachshund go through this she shouldn't talk. Also, I have to give kudos to my 22 year old daughter through all this!!! She has been great and she can get Lily to do things no one else can. She's the one Lily walks to when the vets want to see how she moves.
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Post by Sherry Layman on May 10, 2013 16:36:24 GMT -7
You got good advice from the specialist. It is indeed impossible to make a true diagnosis without the MRI or CT scan so treating as though it is a disc episode is the most prudent course of action.
Do keep a close eye on Lily's eating and drinking as well as her elimination (pee and poop). Again, the reluctance to eat/drink can be a cause of pain but also stomach upset and stomach upset from the meds can quickly become life threatening to watching for symptoms will be important. If her pain appears to decrease or become controlled and she still will not eat you need to take quick action to get better/more stomach protectors on board.
As was mentioned above do be very careful about your emotions around her. Dogs are very adept at picking up on the slightest change in our emotions and will mimick them but they have no ability to fully process those emotions so it can become very confusing and upsetting to them. It is vital to be upbeat and happy around her as negative emotions will not help her healing process right now. I understand your concerns, I love my dogs like children. But part of the process of loving them is being strong around them and helping them heal. Remembering that dogs are not four legged humans and do not have the same brains or emotional processes that we do. I know saying this is much easier than putting it into practice but for Lily's sake I know you can be strong.
Keep us posted on how she's doing.
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 11, 2013 3:15:09 GMT -7
So far, last night went much better than the night before. Lily was given her pain meds at @ 1:00Pm when we got home from the neuro vet. My daughter gave her another dose @ 2:00am as she woke up whimpering. She ate and drank well. This morning I got up around 5:00am and gave her the stomach protector. About an hour later I gave her a small handful of dry food mixed with vanilla Activia yogurt and a sprinkle of shredded cheese. She ate it right up. Will give her the prednisone and muscle relaxer in a little bit. I think I might get the Gabapentin filled as both my husband, who is a nurse and the doctor he works for were thinking along the same lines as the neuro vet yesterday even before I told him the recommendations.
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 11, 2013 6:14:48 GMT -7
She peed on her own! When my daughter picked her up, she yelped a little, that first initial change in position scares her. My daughter put her down in the front yard, she took a few steps, squatted and went! We all yelled "Good girl!" Some of the neighbors looked to see what we were so happy about. She laid in the grass for a couple of minutes on her side and was shaking a bit. We picked her up and put her back in the crate without incident.
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Post by Sherry Layman on May 11, 2013 6:16:33 GMT -7
Lily does seem to be feeling better...great news!
Keep in mind that the Prednisone should be given with food as added protection for her tummy.
The Gabapentin is effective many times in cases of difficult pain so it wouldn't hurt to fill it and give it. Pain is detrimental to the body not to mention just plain miserable.
Good to hear that she seems to be turning the corner a bit though.
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 11, 2013 6:33:18 GMT -7
Gave her the prednisone and muscle relaxer about 2 hours after the stomach protector and 1 hour after she ate. Gave it to her with a little bit of Activia yogurt sprinkled with a few pieces of shredded cheese. Lily will eat anything if it is given with cheese. So she doesn't get bound up we give her a little bit of canned pumpkin mixed with low salt chicken broth in the evening for dinner. The vet said that since she is not going to be as mobile to give her less to eat. I am happy to report that is down about 3 pounds since her surgery 18 months ago. She's at 11 lbs, 5 oz which both the regular vet and ER vet said is a good weight for her.
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Post by Sherry Layman on May 11, 2013 7:06:59 GMT -7
Be careful what you are feeding her and in what amounts right now. Indeed she is less mobile and burning fewer calories. But nutrition is vital for healing so this isn't the time for a diet. If she were to put on a pound or two she will lose it quickly when crate rest is over. If she is at a good weight now I wouldn't worry about her weight during crate rest except to avoid "over treating" which can be an issue as some people like to spoil the poor pup in the crate with extras. Stick to her regular diet and she'll come out in good shape.
Keep us posted on her pain control. The shaking you noted above when she was out to potty can be a sign of pain so watch to see that it resolves. It does sound like you've turned the corner though!
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 12, 2013 3:22:10 GMT -7
Lily had a good day and night! She peed 2x yesterday on her own and pooped/peed this morning when my daughter just took her out at 6:00am! She yelped a little but it was because her last does of pain medicine was at 3:00pm yesterday afternoon and her Prednisone and muscle relaxer at 6:30 last night. Because of the trip to the ER vet the med schedule got thrown off a bit. My daughter said she did not get up during the night and when I went to give her the stomach protector at 5:30am she was wagging her tail at me! This is a great Mother's Day gift! I think I may need to acknowledge my daughter today too for her hard work as Lily's mom. I am so proud of both of them! A shout out to the ER vet and the regular vet too! The ER vet called yesterday to check on her and my daughter said when she was the primary vet on Friday and she was in so much pain, the vet almost gave her $150 worth of meds free. Apparently they had a patient who was given some strong pain meds but unfortuneately didn't make it. The owner donated the meds back to the vet and the vet was going to give them to us for Lily. Luckily, we were able to get Lily right in the neuro vet so we didn't need them.
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Post by natureluva on May 12, 2013 5:49:10 GMT -7
Good morning! I'm so happy to hear that Lily is feeling GOOD! That tail wagging is precious! And sure proof that nerve messages are being able to travel from the brain through the spinal cord. Keep that healing trend going by continuing to practice strict crate rest so that her disc can fully heal. Kudos to you AND your daughter - you are doing such a great job with Lily. Happy Mother's Day! ~Lisa
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 12, 2013 13:52:07 GMT -7
Lily seems to be in a bit more pain this afternoon. When we took her out this afternoon to pee she yelped but was able to walk and pee on her own. I think I may have given her the stomach protector too soon before the prednisone and pain medication this morning and they weren't as effective. We were told to give the stomach protector either 2 hours before or 1 hour after the other meds and I gave them only 1 hour after the first dose of the stomach protector this morning. Since she is in pain I gave the meds first and will wait an hour to give the stomach protector this time around. I hope this makes sense! When I heard here yelp I started to get nervous again as I thought we had turned the corner. We will call the vet tomorrow for an update and I am going to get the gabapentin filled tonight.
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Post by natureluva on May 12, 2013 13:58:38 GMT -7
The pain may also have been caused by allowing too much movement. Are you limiting her steps on potty breaks? Here is the correct way to pick up and hold an IVDD dog (supporting both ends of the spine): youtube.googleapis.com/v/kyD2IW5m0qY Remember, that disc is not yet healed, so try limiting her movement at all costs so that disc can form some "scar" tissue. It takes longer for disc to heal than even bones due to their low blood supply. I hope Lily will be more comfortable by this evening. after you try the gabapentin. Please let us know! Best wishes, ~Lisa |
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 12, 2013 14:13:27 GMT -7
She takes about 10-15 steps as she looks for a spot to go. Then she sits down on the grass and we pick her up to take her in the house. She's been laying on her left side alot, which is the side that has the most pain. When we laid her back in the crate this time, we put her on her right side so she has the pressure off that area. My husband is going to drop off the script on his way to see his mom tonight. If we give her that I might stop the muscle relaxer or at least not give her as much.
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 12, 2013 14:45:27 GMT -7
My husband just went to 2 Walgreen's in our area looking for the 100mg tablets. I guess it more commonly comes in capsules for humans. Any suggestions? It's been an hour since I gave her the pred and pain med and she seems to be resting comfortably. Just gave her some vanilla Activia yogurt mixed with canned pumpkin and chicken broth. Sounds gross but she took it right down! Also, I looked at the video as to how to support an IVDD dog and that's how we always pick her up. She may just have overdone it earlier when she was looking for a spot to go.
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Post by natureluva on May 12, 2013 16:10:58 GMT -7
Just FYI, 15 steps is a lot for a dog to take at potty breaks on conservative treatment. I know this sounds crazy, but try to limit her steps to only a few. Some members have used a 6' ex-pen outdoors and put their pup inside it to limit the amount of steps for potty breaks. Every step a dog with a "hot" disc takes can cause it to further bulge or herniate. Not trying to scare you, just sharing what I've learned from my years here on Dodger's List.
I think you're talking about the gabapentin being for 100 mg capsules? I think that is the smallest size for gabapentin capsules, however, it was too much for my doxie who weighed about 14 pounds. I had to have a compounding pharmacy make the gabapentin into liquid form (I forget the exact dosage, maybe half or one-third of 100 mg). You could ask your vet if you can open the capsules and divide the powder in half? Then mix into food? Please do call your vet - what does the prescription call for? I hope others will chime in on this with advice.
Hang in there, glad she seems comfortable at the moment. ~Lisa
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 12, 2013 17:54:41 GMT -7
Thanks! She's been sleeping since my last post. Will deinitely not let her take more than a couple of steps! My husband actually has some 100mg capsules of the gabapentin so I will call the vet to see what we can do. I thought going through it a third time would be easier but it's not. Thanks for the support!
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