Devon's Bonnie 5/17 conservative shih tzu Canada

Welcome to Dodgerslist Devon! 

So sorry to hear Bonnie is having a rough time. Yes, call the Vet!   She has lost the ability to walk and therefore she has lost bladder control and will need to be expressed. Here is a link that has info on how to express as well as a video. It is best to get a hands on lesson from the Vet or Vet tech from the clinic you go to, but in the meantime check out this link and give it a try.  www.dodgerslist.com/literature/Expressing.htm 
 
Please let your dog know with your utmost confidence that things are going to be ok…because they will. 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. Here's the link www.dodgerslist.com/healingindex.htm

In order to help you more, could you please answer these questions?

-- What was the date you saw the vet and started the all important 100% STRICT crate rest 24/7 only out to potty …. No laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no chiro (aka VOM)?

-- Is there still currently pain - shivering, shaking, crying when picked up or moved?

-- What are the exact names of meds currently given, their doses in mgs and frequencies? Please include the all important stomach protector such as Pepcid AC while Bonnie is on Metacam. I am surprised they didn't put her on pain medication as disc episodes are extremely painful. Here is some info on the medications normally used for IVDD.  www.dodgerslist.com/literature/healingpain.htm

-- Can your dog move the legs at all or wag the tail due when you do some happy talk?

-- Can your dog sniff and squat and then release urine or do you find wet bedding or leaks on you when lifted up? Helpful videos with tips on expressing both urine and poop: www.dodgerslist.com/literature/Expressing.htm

-- Eating and drinking OK?

-- Poops OK - normal color and firmness no dark or bright red blood?

 Laser light therapy, acupuncture and electroacupuncture which sends a microcurrent of electricity to and from acupuncture points (which are really big nerve bundles), can be very beneficial at helping to re-establish the nerve connections in the body. Any one of these therapies can be started right away if in your budget... they not only help relieve pain and inflammation but will kick start nerves to begin regeneration. Find a holistic vet here: ahvma.org/Widgets/FindVet.html www.serenityvetacupuncture.com/index.php/faq_/ [one vet's overview/prices] NOTE: Chiropractic is not recommended for IVDD dogs.

My Tyler is a Shih Tzu and he went through this at the end of January. He has recovered very well indeed and we wish the same for your dear Bonnie! Tyler's story is in my signature line below, I hope it gives you hope..

Devon, it would be best to not ice her back, really not touch her back at all....her meds should be adjusted so that there is no pain dose to dose of pain meds.  Your list does not include any pain meds only the anti-inflammatory, Metacam. 

Can you specifically tell us if you are seeing any signs of pain.--shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy, holding leg flamingo style not wanting to bear weight?  If there is pain, she needs for you to advocate and get an Rx for the typical pain meds used with a disc episode. You can get some good education on those meds here: www.dodgerslist.com/literature/healingpain.htm

We also could use a bit  more information on bladder control. The only way for us humans to know if there is bladder control is with the sniff and pee test. Carry outdoors, set on an old pee spot to sniff it.  See if urine is then released.  Make sure the sling or your hands are not on the tummy area as that can press on the bladder.   If urine comes out  bladder control is returning.   IF, however you are finding urine leaks in her bedding or she leaks on you when lifted, that is a sign of loss of bladder control and the need for a hands on lesson to manually express the bladder.    Let us know what you observe.   Review the expression video and tip before going for a hands on top of your hands type of expressing lesson from the vet or his vet tech.

If she has bladder control, then you should take her to potty likely every 4-6 hours as she would normally go.  You can soak her kibble in equal parts of water to make sure she is staying hydrated.

We  want to know exactly which neuro functions she has.  Can you tell us specifically if you do some happy talk to her that she wags her tail?  Can she move her back legs at all?  It is good for you to be able to monitor for the functions as well. 
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)
6. 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. 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 famiily get to a neuro or ortho asap.

The FDA and manufacturer pkg insert indicate gastrointestinal problems are side effects of using NSAIDs.  The natural defenses of the stomach to shield against stomach acid is hindered when taking NSAIDs. Serious gastrointestinal toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms.  Phrase the question to your vet this particular way:" Is there a medical/health reason for my dog not to take Pepcid?"   If there is no reason, we follow vets who are proactive in stomach protection by giving  doxies 5mg Pepcid (famotidine) 30 minutes before the NSAID.

Please let us know you did get in touch with the vet and what he said/prescribed and if you needed a lesson on expressing.

Pain should be none... not "not in a lot of pain" So it is in your hands to correctly assess for any sign of pain and get that Tramadol on board. yelping, shivering, does not want to move very much in her crate, won't bear weight on a leg.

Things that should be addressed today:
1. Get stomach protector Pepcid AC on board
2. No more tickling feet as it can cause undo movement of the back/neck. The ONLY pt you should be doing is the very, very lightest least aggressive range of motion and leg massage necessary for paralyzed legs during conservative treatment. The information highlighted in PINK pertains to a dog who can't walk.
www.dodgerslist.com/literature/massagepassiveexercises.htm

3. If you are needing to ice her back, then in lieu of that get the right pain meds on board/ on hand for this weekend when vets are not open .... Tramadol and possibly methocarbamol.... disc episodes are very painful. Healing can't go forward as long as there is pain.

Let us know what the vet says this Saturday morning.

Better today, she peed in her crate on the way to the vet for expression or catheter; what a relief. She also is taking weight on her hind end and moves her tail. Now that she is feeling better she is complaining about crate time, but i am determined. Vet says she has osteoarthritis of the spine and a spur on the vertabrae near her tail. Got the pepcid ac, how much of the chewable tablet do I give her? No tummy upsets yet.

Devon, make sure the Pepcid AC has only the active ingredient of famotidine, is that what you have… Pepcid AC is not really a "chewable" tablet but one that is just swallowed.

Did you get a lesson on manual expression of the bladder? Do give us evidence that she definately has bladder control with the sniff and pee test, otherwise leaking in the crate is not a good thing.

We are also concerned about pain…. update us on what you are observing regarding any signs of pain

Good news on not being in pain. So you are now expressing her bladder…how often do you do that? Her bed is staying dry in between expressing?

Hi Devon,
I also have a shih tzu 7 years of age and his issue started exactly the way yours did two weeks ago. One day he was fine the next day I noticed his hind leg was weak. Since then I've gone to the ER several times and the vet and the neuro. So for I've only had an x ray done which they said they couldn't see anything on but due to the symptoms they said it is IVDD. As long as my tzu is on dexamethasone he does pretty well it seems. Once I try and taper it off is when he loses strength in his leg(s). He has control of his bladder and wags his tail (as long as he is on his dexamethasone). He is also on gabapentin and tramadol. I have yet to feel like I have a handle on this. I'm pretty stressed out so I'm glad you are feeling better than me! Gives me hope! But you said your vet said your dog had osteoarthritis? So it's not IVDD? They determine this from a regular x ray?

A disc can bulge without rupturing, causing pressure on the spinal cord. It's hard to know for sure without an MRI or myelogram.

Just wanted to update on Bonnie. She has some strength in her hind end, bladder and bowel control, but when she needs to go there is little time to get her out of her crate and to the toilet spot. In other words she can't hold it long. No pain and is eating and drinking fine.

Thanks Paula; i am so pleased with her progress. I have been using the 4 to 5 hour method, but this morning I took her out first thing as usual and she peed...then 2 hours later is when she asked to go out , but couldn't hold it long enough.

Good news on beginning of ability to push up in to a standing position. The recovery suite is what will limit her movement… only enough room to stand up, turn around and when lying down to fully stretch out her legs. So it is ok for her to try to push up to a standing position.

Those sound like very encouraging signs. You must be thrilled!

I have been reading through all the material on site but can't find anything about when to take a dog off the NSAID metacam. Bonnie is pain free and doing well with her crate rest. Do I check with the vet? She only said 2-3 weeks of crate rest? She is just a regular vet and not a specialist. Thanks.

Thanks Pauliana; i will give the vet a call. We are at the wobbly steps stage and i will do the 6-8 week crate rest for sure.