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Post by Katie & Daphne on Nov 6, 2016 15:24:15 GMT -7
Hello, My name is Katie, we live in Athens, GA. We have 2 French Bulldogs, Daphne is 4 years and and her daughter Hera is 2. On 11/1 evening we noticed Daphne had some pain and hesitancy to lift her left foot, the next day, the vet gave her a steroid and nsaid, sent us home with oral nsaids, he did not think it was a disc as she did not react to any neuro tests. Unfortunately, on 11/3 we woke up and I knew it was IVDD. She was starting to lose function in her rear legs and could not squat to urinate/defecate. We are very fortunate to live in a major university town with a highly acclaimed vet hospital, University of Georgia so i took her right in. Daphne had surgery on 11/4 around 230 pm, the disc was at L4/5, slightly to the left, performed by a DVM Neuro resident, Dr Lau. Daphne never lost motor function, nor deep pain sensation so they say her prognosis is good. I visited her this morning and she looked good, abeit drugged. She is off the heavy sedation, leaking a lot of urine, not eating much, but she ate a treat for me. We are trying to prepare for the future at home. I am hoping she will come home in the next few days. I am very grateful for finding this page and the ample resources and IVDD community. Right now, my heart is extremely heavy. Like all owners on this forum, our dogs mean the world to us and I feel like our lives are about to change dramatically. I am a nurse and have a good understanding of the need for strict crate rest and following all advice. I am feeling a little overwhelmed right now. Thanks for listening.  |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Nov 6, 2016 18:26:58 GMT -7
Katie, welcome to Dodgerslist, we are glad you have joined us all. I'm sorry that Katie was having a disc episode but as you say, wonderful to have UG in your neighborhood! Do keep us posted on how your Daphne is doing. Do you have her recovery suite all set up? Great tips about supplies and ideas to make this part of recovery go smoother: www.dodgerslist.com/literature/cratesupplies.htmWhen you can please fill us in on the details as you learn them: ★5 How much does your Daphne weigh? Please provide an accurate med list with doses in mgs and how many times a day you are actually giving the prescription that Daphne will be sent home on. Please include the all important stomach protector such as Pepcid AC when taking any anti-inflammatory med (steroid or NSAID but never both at the same time). We follow vets who are proactive against not eating, vomit, diarrhea, bleeding ulcers by giving doxie weight dogs 5mg Pepcid (famotidine) 30 minutes before the anti-inflammatory. Just to understand was both a steroid AND a NSAID given to Daphne without a 4-7 days washout? IVDD is a disease a dog is born with. Some dogs have only one episode while other can have multiples. So it would be good to be clear about the use of steroids and NSAIDs during a disc episode. When there is neuro loss, the lessor of the anti-inflammatories the NSAID are not usually continued with. The most powerful of the anti-inflammatories the steroid class is considered. With emergency of loss of legs, then a vet may deem it worth the risk to dispense with the usual 4-7 day washout in order to save nerves from permanent damage. THIS IS VERY IMPORTANT: not only would Pecpid AC (famotidine) be on board as it would with any NSAID or steroid but also sucralfate as double protection from the double jeopardy of no 4-7 day washout. I bet lots of concerns, questions are swimming in your mind. Now is the time to jot those things down. Here's a starter list of questions to which you can add some of your concerns to ask your surgeon: www.dodgerslist.com/literature/dischargequestions.htm Discharge day can be very exciting and lots going on you want to make sure all your questions get an answer! This page is good reading by Dr. Isaacs, ACVIM (neurology) as he explains many post-op questions for our IVDD community: meds, crate rest, PT and discharge day. www.dodgerslist.com/literature/surgery.htm#medsLook forward to the surgeon's next update or when you've visited what you observe! |
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Post by Katie & Daphne on Nov 7, 2016 11:25:58 GMT -7
Hi Paula,
Thank you for making me feel welcome. Daphne weighs 26 lbs, she is not home yet but I have printed the questions to ask when she gets discharged. They said she stood up on her own today and is withdrawing even more from pain. She also ate a complete meal. It seems that they want her to have bladder control before they send her home. On
11/3, her regular vet gave her a steroid injection and a NSAID injection. She only had one oral NSAID the next morning before I realized that she was declining rapidly and I took her directly to emergency. The surgery was on 11/4. She is getting pepcid now at the vet hospital. They said they are thinking maybe wednesday for discharge. I am setting up the recovery suite which is a 36 inch crate. Going to buy the bowls and fleece blankets today. I have large unscented pads as well from my job. I am feeling a little more hopeful today and planning to visit her in a few hours.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Nov 7, 2016 16:01:04 GMT -7
Katie that is really good news about moving up into a standing position. Hope that bladder control will come soon as it classically precedes leg movement. If taking too long, you can always ask for a hands on top of your hands expressing lesson so that Daphne can come home. The criteria for discharge is having post op pain fully managed by oral meds. Video and tips on expressing: www.dodgerslist.com/literature/Expressing.htmNerves heal typically in the reverse order of the damage to the spinal cord: 1. Deep Pain Sensation (Only correctly identified by a specialist.) 2. Tail wagging with joy at seeing you or getting a treat or meal. 3. Bladder and bowel control verified with the "sniff and pee" test. 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 place the feet. 6. Ability to walk unassisted and perhaps even run. More info: www.dodgerslist.com/literature/healingnerves.htmDo make it a point to understand the deadly jeopardy Daphne was subjected to with the use of the most powerful of anti-inflammatory drugs, steroids, along with the lessor of the anti-inflammatory drugs, the NSAIDs. It is of great risk and that risk is only taken in an attempt to ward off further neuro diminishment..then it is worth taking the risk. But always two stomach protectors would have been on board. ■ All NSAID package inserts carry this similar FDA required warning : "should not be given with other NSAIDs (for example, aspirin, carprofen, etodolac, deracoxib, meloxicam, or tepoxalin) or corticosteroids (for example, prednisone, cortisone, dexamethasone, or triamcinolone).." www.fda.gov/AnimalVeterinary/Products/ApprovedAnimalDrugProducts/DrugLabels/ucm050105.htm■ " The primary cause of adverse effects from NSAIDs is incorrect dosing (eg, concurrent use with corticosteroids or another NSAID, changing NSAID without a suitable washout)." Systematic review of nonsteroidal antiinflammatory drug-induced adverse effects in dogs. Monteiro-Steagall BP Steagall PV, Lascelles BD. JVIM 27:1011-1019, 2013. ■ "Washout period (dogs, 5–7 days" Guidelines for safe and effective use of NSAIDs in dogs. Lascelles BD, McFarland JM, Swann H. Vet Ther 6:237-251, 2005.■ "It is also unacceptable to concurrently administer steroidal and nonsteroidal anti-inflammtory drugs (NSAIDs) to disc disease patients, as this combination increases the chances of severe gastrointestinal complications. Curtis W. Dewey, DVM, ACVIM Neurology Cornell University." A Practical Guide to Canine and Feline Neurology 2nd ed Blackwell Publshing 2008 Chapt 10 "Myelopathies: disorders of the Spinal Cord"; By Curtis W. Dewey p331-332. I would say the very best thing you can do for your Daphne is self education in the next days. She was born with disc disease so it is important to know how to live with it. Some will have only one episode while others can have several episodes during their life time. How to handle dentals with an IVDD dog for example is something likely to come up. Dodgerslist has taken quite some time to interview neuros, PT rehab professionals, dog trainers, collaborated with university researchers on articles, sought out professionals to write pertinent information for our IVDD community. There really is an unprecedented accumulation of the "best of best" information on IVDD. It is there all free just for the time you want to invest in your dog's disease and protect her. IVDD is one disease where owner knowledge is power to fight the IVDD enemy and win. All these wonderful topics are searchable on the website or just browse through them here: www.dodgerslist.com/literature.htm |
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Post by Katie & Daphne on Nov 7, 2016 18:06:44 GMT -7
Thank you again for so much helpful information. We would like to take her home soon, UGA is leaning towards wednesday, I think they err on the side of conservative. The cost is already up, but I want to make sure she is ok. I am comfortable with bladder expression and more complex care, so I will discuss with them tomorrow. She is urinating without expression but I believe that they are expessing the rest and she is not controlling her urine. I see the deadly risk of the NSAID and steroid now. I am sorry to think I should pursue a new regular vet amidst all of this, but I think it may be necessary. He did not think she had a disc issue when he administered, however that doensn't make me feel better at all. She has no signs of GI bleeding, and has been doing very well thus far so hopefully she will be ok at this point. I have been doing extensive reading and I understand that this is life long. I am trying to take this process step by step as it is very emotionally overwhelming. I have the recovery suite ready and will be prepared with questions upon her discharge from the vet school. In the meantime I am trying frantically to re-train the 2 year old Frenchie not to jump, no stairs, no pulling, and only use a harness. Thank you for bringing so many things to my awareness!
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Post by Pauliana on Nov 7, 2016 21:46:11 GMT -7
Welcome Katie!
Glad you are here with us. A very overwhelming time, as I well remember what it was like when my Tyler had surgery nearly 4 years ago. He recovered very well and I wish the same for your Daphne! Sounds like you have preparations under control and she will be in great hands when she comes home.
We are here for you.. Any questions, don't hesitate to ask! Let us know when she comes home what medications she is sent home with, including dosages, how many times per day given.. Let us know what the surgeon wants regarding the post op crate rest and PT instructions.. Relax and get some rest while you can!
Healing thoughts and prayers!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Nov 8, 2016 10:45:31 GMT -7
Katie, it is certainly is a lot to take in emotionally and medically factually when you learn about an IVDD diagnosis. You are doing a good job in reading as time permits and getting ready for homecoming! About training your other Frenchie, here are video tutorials to help with that No pulling on the leash- www.dog-obedience-training-review.com/leash-training-a-dog.htmlNo sitting up or standing on back legs. sit down rather than jump
Keep all four feet on the ground
Training to use ramps to couch or outdoor ramp to grass: video and explanation: www.dodgerslist.com/literature/ramptrain.htmForum thread on making or purchasing ramps: dodgerslist.boards.net/thread/867/rampsLet us know if Daphne is overflowing urine or actually peeing...there is a huge difference. Overflowing is due to a reflex that kicks in when the bladder is filled to the stretch point. Peeing means the brain sent a message down the spinal cord to the bladder and Daphne peed by choice. 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 after sniffing, bladder control is returning. You should do a quick express check to verify there is full voiding until you are certain it is consistently happening. Let us know what the vet techs have observed and when you get home your assessment if there is still urine leaks in bedding (usually overflowing). Dog who can control their bladder do not want to void where the sleep unless they where not let out in tme. |
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Post by Katie & Daphne on Nov 9, 2016 18:18:42 GMT -7
Thank you Pauliana and Paula. We just got Daphne home and she is resting. The biggest struggle for us right now is that she is continously leaking large amounts of urine. I would say its overflowing but we are trying to express but her bladder is never palpable and the urine flow is almost constant. Her bottom is sore, we are trying to keep her clean, applying barrier cream but it seems like an every 5 minute pad change and when we try to express, we only get a little because it has already leaked. I feel confident we are doing it correctly. They [neuro or vet techs?]said this was how she has been at the hospital as well. Frustrating and upsetting, I'm fearful of a UTI because I think her urine smells off. I am going to call them in the morning.
She is taking:
[26 lbs]
Prednisone 5 mg once daily, will become 2.5 mg daily on 11/11.
Tramadol 50 mg q 8 hours next 7 days then as needed
Gabapentin 100 mg q 8 hr until finished
Trazadone 50 mg half or full tab q 8 hrs as needed
Omeprazole 10 mg once daily
Daphne weighs 26 lbs.
I asked all the questions on the sheet at discharge and I felt good when we left but feel incompetent now.
We are happy to have her home but definitely don't have a good handle on this right now.
Thanks for listening.
Also, we found a new vet- I interviewed her yesterday.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Nov 9, 2016 19:05:09 GMT -7
According to Dr. Bagley ACVIM (Neurology) with lower motor neuron (LMN) damage where the damage to the cord is closer to the tail their will be leaking. Bladder tone is decreased, and the bladder feels flaccid. The bladder is easily expressed because there is little reflex to maintain tone in the bladder and may be little sphincter tone to keep urine in..thus the always leaking. Vertebrae illustration The neck C1-7, Chest T1-13, the low back L1-7  So just so you can get a handle on what Daphne’s situation is give the surgeon a call…. LMN damage or are you dealing with a possible UTI? Was the surgery at the low back lumbar area or closer to the tail, did the spinal cord damage possibly extend closer to the tail area to cause LMN problems? The idea with expressing when there is upper neuron motor damage (UMN) is as long as she is on pred and more thirsty, normally there is need to express every 2-3 hours to keep dry. Learning to express the bladder is a new skill. It takes being able to feel the bladder. When you are able to feel the shape you can fully void it extending the time til it fills up again. --- When the bladder is full, there is no real shape...the tummy area is filled by the full bladder --- At the last stage of expressing the bladder becomes so flat one hand can almost feel the fingers of the other hand. --- Don't hesitate to go back and get another hands-on-top-of-your-hands type of lesson --- Re-reading and re-viewing the video at this page: www.dodgerslist.com/literature/Expressing.htm Is the annus flaccid or the opening is closed tightly like normal? You can express for poop. It is not the health issue of keeping the bladder voided, but more that Daphne does not become anxious finding poop where she sleeps or poop next to her skin inside the diaper. www.dodgerslist.com/literature/Expressing.htm#poopWhile we don’t typically recommend diapers, until you can get handle on this problem, baby diapers can help you out as they have a pretty good system to keep liquid away from the skin. You will have to guess what size your Frenchie would take in a baby diaper. Diaper rash Zinc, can be toxic to dogs if licked and ingested. Aquaphor Baby or regular Aquaphor Healing Ointment contain same ingredients AND no zinc: Petrolatum (41%) Inactive Ingredients: Mineral Oil, Ceresin, Lanolin Alcohol, Panthenol, Glycerin, Bisabolol aquaphorus.com/categories/ |
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Post by Katie & Daphne on Nov 10, 2016 13:11:18 GMT -7
Hi Paula,
The disc rupture was Lumbar, at L4/5 and she has a UTI as well. So a double whammy. The neurologist says that she leaks so completely that we do not need to be trying to express her right now. It is very hard to get in touch with the surgeon for these questions as it is a large, busy teaching hospital. She does have rectal tone and has pooped once when my husband took her out of the crate to change her bedding, so I think she has some control over that.
As you said, we have to be able to feel the bladder, and that is just not happening due to the constant leaking. I am really hoping this improves because it is very hard to keep her clean and dry. I was prepared to express, but not for this. We have been using A&D ointment.
Thank you always for your quick response and helpful info.
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Post by Romy & Frankie on Nov 10, 2016 14:00:08 GMT -7
It may be that once the UTI is treated there will not be as much leaking. Finishing up with the pred may help that also.
I do not think the surgeon would be able to tell if the tone was permanently gone. It is still early in her recovery and there is still much healing that will take place.
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Post by Katie & Daphne on Nov 14, 2016 19:56:32 GMT -7
Thank you everyone,
Its been only 5 days since we have gone home but things get better day by day! Daphne's UTI is being treated with 250 mg clavamox q 12 hours which has helped tremendously. She regained a lot of continence on Saturday morning, she "sniffed and peed" and has been continuing to do so with a few accidents in her crate- she finishes prednisone tomorrow, has finished gabapentin and we have cut back on ▼tramadol. She has good motor in her hind legs (although we are not allowing her to walk more than a couple steps at potty break), but we can see it. She is also flexing her back legs on her own and fixing the toe turn when standing. She does not like being in the crate, but she is tolerating it, thanks in part to the trazadone and frequent attention from us. Any safe boredom buster tips for the crate? I feel like we are seeing some light in this dark time and it feels good. My husband leaves for work tomorrow (for a few days, hes a pilot) and I feel like I can do this! I am so grateful for all the wonderful advice this site and you all have given.
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Post by Pauliana on Nov 14, 2016 22:36:31 GMT -7
Hi Katie! I have no doubt at all that you can do this! You are taking wonderful care of Daphne! Dr. Becker, DVM, explains "During your dog's mandated rest time for recovery, her movements will be restricted, but her mind will still need stimulation. Teaching her tricks and games appropriate for her temporary physical restrictions will help relieve boredom." Choose only the activities that can take place inside the recovery suite and do not cause movement of the back or if a cervical disc to not cause movement of the neck: Dr. Becker's "Help Keep Your Pup Happy When She's on Crate Rest" and Dr. Horwitz' video demoing mind stimulation activities. If your dog is on Conservative Treatment or post-op crate rest, and your dog is not happy about being in the crate, you'll have to try a few different things to make them more comfortable with being confined. If your dog is making a big deal about being in the crate, I highly recommend not feeding your dog their meals from a bowl. All of his meals will be fed as part of his crate adjustment training. Some dogs prefer to be crated in a central location in the home where most of the activity in the home happens like a kitchen or living room. Some dogs do better confined to a crate in a more quiet area of the home like a bedroom or finished basement. Try different locations for their crate to see where they seem the most settled down. Ideally, have multiple crates in multiple locations. I recommend one in the main living area and one in the bedroom. Here is Dr Becker's article and video: healthypets.mercola.com/sites/healthypets/archive/2016/07/20/dog-rest-time-for-recovery.aspx?utm_source=petsnl&utm_medium=email&utm_content=art1&utm_campaign=20160720Z1&et_cid=DM111464&et_rid=1580566631 |
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Post by Katie & Daphne on Nov 16, 2016 17:34:57 GMT -7
Hi Pauliana,
She is has been eating her meals in the crate from bowls eagerly, should I discontinue this? It's one of the things I feel like we have a handle on.
Daphne is down to maybe one pee accident a day but is pooping in her crate often. She seems suprised when it happens. It's as if she'll only go outside if I'm lucky with the timing. Is this normal?
Our other dog, who is her daughter, growled and snapped at her today. No injury occured as I was directly blocking the door to the crate, but I found this very upsetting. I understand this is common, but does it continue when the injured dog heals? They have always been close with occasional rough play, but I'm worried about the post crate-rest life.
Thank you for the helpful article.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Nov 16, 2016 19:39:11 GMT -7
Hi Katie, the reason Pauliana recommended using her normal kibble ration as treats during training is to not gain weight. So if you want to subtract some of the kibble from a meal to train with then she can eat from her bowl the remaining at normal meal time. Are you expressing for poop. Sounds like she doesn't yet have bowel control. How to figure when to express for poop and a how to video: www.dodgerslist.com/literature/Expressing.htm#poopFor dogs the inborn instinct about weakness is for survival protection of the pack as a whole. There are two things that can happen in pack dynamics when a dog has been or is sick. 1. The healthy one may try to eliminate the weaker in the pack. 2. For the sick one, now the weaker in the pack to become more protective and aggressive because they know they are weaker now and may be subject to being attacked. Make sure that Daphne feels protected from her best buds when home alone... the crate will be that source of protection. Whenever you leave the house and they are not supervised, it is a good idea to crate them for their own safety. We have had many instances where a deadly attack among best buds could have been avoided by crating. One I recall is of two sisters who had grown up together and never showed any signs of aggression to one another. The two dogs were put in the kitchen while their owners went out to dinner. They came home to find the IVDD dog almost dead from the vicious attacks of the other. Keep up the good job of being cautious with Daphne around dog. Sounds like Daphne is on a good road to healing her nerves...with time and patience I believe you will see better bowel control and better ability to walk without any knuckling the paw under at all. |
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Post by Katie & Daphne on Nov 17, 2016 14:07:11 GMT -7
Thank you, Paula.
I will start fresh with expressing, and hopefully get the hang of it. It is upsetting to her when she does it, so I hope to be successful. It is hard to think of the dogs being supervised or crated but it's a risk we are not willing to take. Daphne gets her staples removed Friday, I think they will be impressed with her progress. I am proud of her. She is coping well for being crated for the first time in her life.
I am going to ask the vet, but are cones allowed in recovery? Daphne has allergies and she wants to chew her paws in the crate more than usual with nothing to distract her. She takes apoquel daily which helps but doesnt eliminate all the chewing. She did this before surgery, I do not think it is nerve related.
Thank you.
[26 lbs
▼Tramadol ? mg ?x/day
Gabapentin STOPPED
Trazadone 50 mg half or full tab q 8 hrs as needed
Apoquel]
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Post by Romy & Frankie on Nov 17, 2016 14:35:17 GMT -7
When my Frankie had his disk issue, the last function to return was bowel control. Just like your Daphne, he seemed surprised that he had pooped. In addition to expressing, you can consider low residue dog food. This is a type of specialized food that is designed to reduce the volume and frequency of stools. Sometimes dogs with IVDD chew their paws because of abnormal nerve sensations that can range from mild pins and needles to quite painful burning, on-fire feeling. This is called neuropathy and can make them bite to stop the pain. Gabapetin is the medicine that helps this type of pain. I see that she recently stopped taking Gabapentin. I know that she did this before her disk episode, but if you think it might be something different and that this might be the cause of the chewing ask the vet about continuing Gabapentin for a while longer. We have some information about neuropathic pain here: www.dodgerslist.com/literature/neuropathy.pdf E-collars are fine during recovery and should be used if she is chewing too much on her paws. |
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Post by Katie & Daphne on Nov 20, 2016 15:20:48 GMT -7
Thank you! She is no longer taking tramadol, she does not seem to be in pain at all. Last dose of clavamox for UTI will be today. Things are much better now that I know how to stimulate her bowels and I even feel like she is holding it better. We have gotten to the point where she "feels like herself" and wants out of the crate. Trying to distract her with the kong and bones and a lot of love. Even on a full trazadone, she trys to claw the crate open.  I'm glad to know we can use a lightweight cone, the vet also told us this when we got her staples removed on friday. Her paw chewing seems to be exactly like it was before surgery and the apoquel helps as much as it used to (about 75% better for 8 or so hours). She was also doing it while on gabapentin. We are working on trying to find someone we trust to watch her when we are both at work and in the future when we travel. My mother used to, but at 70, she can't pick her up and carry her like she needs to be carried for potty breaks. After the crate rest is what is looming on my mind. Frenchies are very stubborn dogs, very smart and they can learn anything but do not listen well. I am feeling like I want to throw our couches away and just sit on the floor! We have baby gates to block the stairs. The biggest issues are jumping on and off couches. Thank you all again, for great advice. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,535
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Post by PaulaM on Nov 21, 2016 9:00:10 GMT -7
Katie, you might want to get a headstart on contemplating ideas to make your home back friendly once crate rest is at an end. Do you know if your surgeon is wanting 4 weeks or 6 weeks of post op crate rest? We like to include that information in the subject line. Determining how you are going to ease her back into more normal activity at post-op crate rest graduation. The idea is to gradually give more freedom under controlled conditions. Not free reign of the house and yard immediately! LOL Take a look at our information and then come up with a plan to gradually increase activity over about a month's time following the end of crate rest. Also check out how to teach four paws on the floor! www.dodgerslist.com/literature/AfterCrateRest.htmThre are some home modifications you can make to reduce the stress on her spine in the future. No more stairs, ramps up to furniture, or blocking furniture all together. All those ideas and more are in this link: www.dodgerslist.com/literature/protectback.htm State: Hospital: Address: Cost: Date of surgery: What was included in cost (MRI?, days stay, ER? PT? meds for home, sling, etc.) Comments: |
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Jan 21, 2017 6:19:02 GMT -7
Posted on behalf of Katie on 1/21/2017: Daphne has recovered very well and would probably be considered graduated. She has full function and good continence. She can run and squat and enjoy her life again. 
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