Ally's Stewart 5/23 conservative yorkie Canada

Hi, My name is Maureen I am sorry that your little guy is having an IVDD episode. Good job on the crate rest. Right now 8 weeks seems like forever I know, but it will go by and you are going to learn more than you ever thought possible about IVDD. There is a huge amount of information on this site, so read, read, read! If you can give us a list of his medications that will help us to help you. Does he have a medication to help protect his digestive tract from the anti-inflammatories? Try not to despair over the bladder and bowel control right now- there is still going to be significant swelling along his spinal cord and many functions will be inpaired until the swelling goes down. Functions come back in the reverse order of how they were lost.
Laser treatments and accupuncture are both excellent therapies for helping to heal the injured area- good job getting started on that right away too.
Which province are you in?? Maybe we can help there too! Keeping you in thought and prayer. ((hugs))

Welcome to Dodgerslist. I'm sorry Stewie is having such a hard time but you've come to the right place for information and support.

Here is a link to our IVDD101 page. There is a ton of info there and it's vital that you become informed about everything IVDD now so bookmark that page.
-- www.dodgerslist.com/literature.htm

Also a link to our page on conservative treatment for disc disease (non-surgical).
www.dodgerslist.com/literature/conservative.htm

Can you please tell us the names and doses of the medications the vet has prescribed for Stewy from the start of this episode and also clarify which ones he is still on? You mentioned he was initially prescribed nsaids then you stated he's on prednisone and that concerns me particularly since he's not eating. These two classes of medications are both incredibly hard on the stomach individually. When prescribed together or even with a few days of each other stomach problems are almost a guarantee.

If Stewy is still getting both STOP the NSAID immediately. Prednisone cannot be stopped abruptly and must be tapered but you can stop the NSAID so do not give one more dose of it if you have been giving both.

Stewy needs to be on a stomach protector such as Pepcid (generic name famotidine) 5mg twice daily about 30 minutes prior to his prednisone. This medication can generally be purchased over-the-counter at most any store that carries such things as tylenol or cold medicines. Ideally you should contact your vet to be sure that he has no health issues that would contradict your giving him this medication but Stewy needs this medication right away so if there must be a delay start it without contacting the vet. Since he isn't eating he really needs a stomach coating medication also (Pepcid reduces acidity in the stomach but doesn't coat it). Sucralfate is most commonly used for this purpose but needs to be prescribed by your vet. Contact your vet ASAP and ask for it.

Here is a link to our page on crate rest. Crate rest means in the crate 100% of the time except when out to potty. No exceptions! Cuddle time risks movement of his back and therefore further damage to that fragile disc.
www.dodgerslist.com/literature/CrateRRP.htm

Here is the info on expressing. Perhaps even the bladder info will be of benefit, give you hints. There is info there for the bowels as well.
www.dodgerslist.com/literature/Expressing.htm

Laser therapy is fabulous, I'm glad you have that available. If you have access to acupuncture I'd highly recommend that as well.

One bit of hope, most general vets are just not skilled enough at the techniques for detecting deep pain sensation so they will often say that it has been lost when if a specialist looked at the same dog they would say it is present. Obviously I cannot make that determination for certain but just giving you hope. Be sure you are doing the meds and crate rest properly and lets give this some time and see what happens. Even if DPS has been lost and he never regains use of his legs we have many many stories here of paralyzed dogs that are the happiest of any dog you will ever meet. First and foremost lets get his tummy under control and be sure he's comfy and ready for eight weeks in that crate.

This morning Stewy was about the same. He ate a little more and has been drinking more water.. We have been giving him pills in cheese or peanut butter and feeding him thick but soft  homemade vegetable soup mixed with plain yogurt. He eats quite a bit of this willingly at pill time. I tried soaking his kibble in broth, then soup, then even a bit of jam to coax him to eat but he refuses. I even tried some moist dog food, but he wouldn't eat that either. He still has no leg or tail movement. As far as I can tell he can't feel anything in his hind region.

He was in his crate today all day except for pee breaks. He stays dry between expression so far. Now he is off to laser treatment again. He will do that every other day for 8 treatments. I'm not sure if we should continue past that or not.

Initially he was prescribed an nsaid, but he only took one dose. By the following day at lunch we had to take him back to the vet and he prescribed us the steroids.  His meds are prednisone (he had 6   5mg tabs the fist day spaced over 12 hours, 2 tabs every 12 hours the second and third day, now we are on 3 tabs per day for 3 days) and tramadol (1/4 of a 50mg tab every 6 hours). We seem to have pain under control.  He is about 14 pounds. I am calling today about the Pepcid ac and sucralfate and hoping to hear back from the vet soon.

We live in NB and surgery is in PEI and costs about $4000 plus the trip and after care. Simply put, we can't afford it. I wish so much that we could.

Thanks so much for all the info and support, I really appreciate it.

Stewy is now not staying dry in between expression. We also haven't been able to express poop yet. He's not eating a lot but Im still starting to worry. Is it possible for a dog to regain bladder and bowel control?

Hi Ally!

How often are you expressing Stewart? While he is on Prednisone he will be very thirsty and have to urinate often such as every 2 to 3 hours and that may account for him not staying dry in between..

It would  also be a good idea to take in a urine sample to your vet to check for a urinary tract infection. It is very common in IVDD dogs and the fact that he is leaking in between expressions is a symptom.. It's better to be safe than sorry because UTI's can turn serious quickly..

Yes it is possible for bladder and bowel control to come back.Regaining neurological function has no time limit for nerves to heal. Nerve repair is individual as each injury is different and each dog’s ability to heal is different. If deep pain perception (DPP) is present, even in paralyzed legs, there is a chance your dog may be able to walk again. For those dogs who have lost DPP, do know nerve regeneration can take place and that function may return. Once deep pain perception is regained, your dog has a chance at a walking recovery. Thousands of dogs on Dodgerslist have regained functions in as little as 2 weeks, others 11 months, and still others 3 years later. IVDD is a disease of patience to allow the body to heal on its own terms. Acupuncture and Laser Therapy stimulate the cell’s metabolism that leads to the body’s natural repair abilities and can be started at any time.

1. Deep Pain Sensation (Only correctly identified by a specialist.)
2. Tail wagging with joy at seeing you, getting a treat or due to your happy talk.
3. Bladder and bowel control proved by passing the "sniff and pee" test.
Take your dog out to an old pee spot in the grass. Let him sniff and then observe for release of urine.
4. Leg movement, and then ability to move up into a standing position, and then wobbly walking.
5. Being able to walk with more steadiness and properly placed paws.
6. Ability to walk unassisted and perhaps even run.

Ally, his pain meds are simply not YET properly adjusted. Pain control is not a one size fits all deal. The very first phase of healing HAS to be pain fully under control dose to dose of the pain meds. That should have happened in 1 hour with the very first dose and thereafter fully dose to dose of pain medications.  By giving your observations and comunication to the vet, only then does the vet know further adjustments are needed.

Advocate strongly for the typical pain meds used with a disc episode in addition to his current tramadol.
-Tramadol is the general pain reliever. It has a short half life of 1.7 hours and may need to be prescribed at a minimum of every 8 hours.
-Methocarbamol treats muscle spasms stemming from aggravated muscles due to nerve trauma related to the spinal cord inflammation.
-Gabapentin may be added to the mix for hard to control pain. Veterinarians are finding this medication works very well in combination with Tramadol.

So as you see your vet still has plenty of options to get pain control just right for Stewart.

5mg of Prednisone 2x a day IS the typical anti-inflammatory level of dose. Often it takes being at the anti-inflamamtory dose of prednisone (5mg 2x/day) for 1-2 weeks or even for some dogs more like a month before all the swelling is gone. On the taper the dose is lowered to less than the anti-flammatory dose and that is the time to assess just how well reduction of swelling is going by observing for pain.

Rule of thumb is:
pain = swelling = more time on Pred needed.

I looked back through the writings and did not see you have a stomach protector on board….. do you give Pepcid AC (famotidine) 5mg 30 mins prior to Prednisone.  Do you also give prednisone with a meal. Did you get an Rx for sucralfate?  How are his poops normal firmness?  Not wanting to eat can be an adverse sign of steroid use when no stomach protection has been provided… nothing to fool around with.

At potty time can you use a sling or your hands on his thighs to support him. Often male does do not like anything near the penis so a figure 8 sling is a good idea.

Ally, can you get to ER today to get the proper pain meds on board for Stewart if your local general vet is not open today.
Understand your vet is simply not comfortable in treating this disease. Make sure you have in your mind what the purpose of prednisone is and how long it can take to achieve the expected results: www.dodgerslist.com/literature/healingsweling.htm.

Can you hire another vet, one who can support Stewart and you through this disc episode: www.dodgerslist.com/literature/VetchkList.htm

Can you tell us the city you live in perhaps someone on the Forum can recommend an IVDD knowlegeable vet for you. Have you checked here to see if someone has already posted their vet recommendations: dodgerslist.boards.net/board/10/guidelines-posting

Can you tell us these specific things:
-- Does he have a temperature (normal rectal temperature is 100.5 to 102.5 degrees Fahrenheit)
-- can he hold up his head, can he hold his body to be in a sitting position
-- Are you giving sucralfate each time on an empty stomach about an hour before food and meds? For full dose information, please read the Mar Vista Vet entry for sucralfate: www.dodgerslist.com/literature/healingsweling.htm

We are worried about the pain, so as soon as you can do keep us all updated.

Ally,

So glad you got another Vet for Stewy and he has more pain relief on board. Once he is pain free dose to dose he can start to heal.  Believe me when I say that IVDD is NOT hopeless. I have a little dog laying at my feet that was diagnosed with IVDD on January 28th and is now recovered, walking, playing (carefully) and living happily. It takes time for them to heal with conservative 8 weeks of crate rest 24/7, only out to potty, but as many have experienced, it works.. This is a disease that requires education and patience.. but never be patient with pain. I hope he is comfortable now..If not talk with your new vet and keep adjusting the medications until they are right. Sometimes it takes several adjustments to find the right mix of meds and dosages to help. Keep that line of communication with the vet going and be a strong advocate for Stewy.  Don't believe for one second that euthanasia is the answer..

 Sending soothing thoughts and healing wishes over the miles..

I have a friend who lives in Fredericton NB and shes had a couple of IVDD dogs. Is that anywhere near you?

Pain is totally under control now. He seems to be comfortable.

However, I fear the worst. Stewy can't sit up. His rear end seems to be wasting. Not only does he not have bowel control, but that end of things seems to be open all the time now.

He can't get up at all now. We will take him to the vet tomorrow, and have told our kids this may be it.

We are all devastated, my son in particular. He is 12 and Stewy really is his. . I assumed when the pain meds were on he would have a bit more mobility but he can't even turn over to drink.

We are all so sad.

Ally, a disc episode would definatetly NOT be a reason to put a dog to sleep… dogs and owners learn to live with this disease and life get into a routine … the new normal.   It is normal for leg muscle to atrophy during crate rest. It is so good to hear that his pain is fully under control finally!!!  Do let us know how his breathing is.

There is only one disease that can follow on the heals of any injury to the spinal cord whether by a car accident or a disc episode that release from this life is a must. The disease is called myelomalacia… there is no cure from it and only ends in pain and death if it ascends upwards. With Myelomalacia, what happens basically is that the spinal cord starts to die from the point of the spinal cord trauma moving forward toward the head. It is very painful as the cord dies and it will eventually make him unable to breathe.  www.dodgerslist.com/literature/Myelomalacia.pdf   I tell you not to scare you, but so you are educated to know what to observe for and if need be get into ER tonight 

Myelomalacia can be easily confirmed by your DVM with the following:

* about 3-4 days into recovery, they become painful.   Within the first week, they are in a LOT of pain.  
* development of excruciating pain (more than just pain from the original disc herniation)
• even the strongest pain meds do not help
* acute disc extrusion with no deep pain sensation
* loss of anal tone, the anus hangs open, (anal flaccidity) and areflexia (below normal or no reflexes)
* loss of cutaneous trunci reflex at a level more cranial to a previous evaluation over a period of hours to days with or w/o surgery
* development of fever (normal rectal temperature is 100.5 to 102.5 degrees Fahrenheit)
* sudden twitching or jerking of the neck and/or head
* loss of voice, hoarse bark
* can't hold body up, can't hold head up
* increased respiration/ labored breathing
• hyper-esthesia (over-reaction to any touch sensation on body)

We hope you will stay in touch, so we know Stewy is ok.

Keep in mind that euthanasia is irreversible. If you aren't sure he is suffering from myelomalasia then don't make a decision you cannot undo based on fear.

Remember that Stewy suffered a great deal of pain for a long time before it was under control from the new meds so he could very well be exhausted. While that is not the cause for the lack of anal tone I would certainly not judge his lack of energy to be myelomalacia until you have other definite signs. Be cautious in walking the line between observing him closely and seeing things that aren't really there.

If it becomes blatantly obvious then you would indeed want to end his suffering. Until that time just keep giving him the medications and keep him comfortable. And as Pauliana pointed out, pain control was the immediate goal but we didn't expect him to recover use of his legs or any other nerve functions right away. Healing will be a process of time but pain control needed to be immediate, the two are very different. Patience is vital with IVDD.

Please do keep us posted on how things are going.

Thank you!!!!! Much appreciated! I will call in the morn!

Hi were you able to get Stewart into see a new vet.