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Post by Michelle & Jaeger on Feb 21, 2017 11:44:27 GMT -7
Hi, My name is Michelle from Utah. I'm so glad I found your site. It has not only given me the information I need to be an informed IVDD parent, but it has given us HOPE, when so many were telling us that there was none. So Thank you Thank you! Here is our story: Our little Jaeger is a 4 year old, 16 pound male Miniature Dachshund we adopted 2 years ago. In October 2014 we lost our little Gertie (15 year old 8 pound mini doxie) and after several months we could tell our older wirehaired doxie Izzabelle was not thriving as an only child. My husband and I work full time, and our kids had both recently left home for college, so after Gertie passed away Izzy was suddenly alone much more often. We decided to start "looking" for our new addition. I have done rescue for 16 years, and all our dogs have been rescues, so I knew that if we were patient the right little doxie would find his way into our lives. And sure enough he did. About 8 months after we lost Gertie, we stumbled upon Jaeger accidentally at a boarding kennel. He had come from a show dog breeder, but he flunked out of the show ring because well, he was scared to death of *everything* and *everyone*. He was dubbed a "nut case", but really he's just a very sensitive little guy, and I know now that the chaotic, stressful environment in a boarding kennel/breeding kennel, was just more stimulus than he could handle and with no regular affection, positive attention, etc. he just spiraled. The breeder was responsible enough to get him neutered, so I'll give her that much credit--oh and the fact that she introduced him to me when I mentioned doing Doxie rescue--I give her points for that also, but other than that, she did little for him. But I digress. As soon as I saw him I knew he belonged to us. He was covered with alopecia, had bite marks in various stages of healing (the breeder said "the other males don't like him and beat him up") and he was like a fish on the end of line he was so scared of us. My husband was flabbergasted I would even consider buying a dog from a breeder, but I wasn't leaving him there. I immediately wrote her a check and brought him home. It's taken us 2 years but he is no longer that same boy. He is beautiful--no more alopecia, and most of the old scars he had are covered in hair now. His confidence has soared and he and his 11 year old wirehaired doxie sister Izzabelle play together for hours. He has brought new joy into all our lives and especially Izzy's life. She is like a puppy again with him. We hike in the mountains, go for atv rides, horse rides, camping and road trips. He is a great little traveler and has left that other life far behind. So now the bad part....On Sunday February 5th we were on a walk around our neighborhood when a new neighbor's very large Anatolian shepherd was off leash (no fenced either) and came charging out in the street at us. My husband quickly scooped Jaeger up into his arms and Jaeger gave a quick yelp. Once we got past the dog my hubby put Jaeger back down, he was happy to walk, wagging his tail, etc. so we thought he had just been startled is all, so we finished our walk. Later that day my daughter made a quick trip home from college for a Superbowl Party and when she walked in the house Jaeger excitedly ran to greet her and when she bent down to him he gave a quick yelp again and ran to his bed trembling. Again we thought "what on earth?" But we chalked it up to his sensitive nature, since he otherwise seemed to be acting and moving normal, so the thought of a disc episode didn't even enter our minds. Thinking he was having muscle and/or pad soreness issues from the walk I gave him a Rimadyl [2/5]. The next morning he seemed to have a little more pep in his step, so I gave him another Rimadyl, put him in his crate and went to work. When I got home after work that night he was wagging his tail and excited to see me as usual, but walking wonky and his back legs kept knuckeling under. FINALLY my brain clicked in---HIS BACK!! (hand to forehead!) aack! We live in a rural area, so no emergency vets, but I was able to get him into our vet in Salt Lake City the next morning [2/7] and no surprise...he was diagnosed with IVDD. I was shocked and dismayed when we were quoted $6,000. for surgery. But then our vet said he thought he was a very good candidate to recover without surgery with aggressive meds and crate rest. So we opted for him to stay 3 days in the hospital to receive I.V. treatment and then on February 9th he came home and started crate rest (which our vet has suggested to be no less than 3 months).
[16 lbs Rimadyl 2/5-2/7 name of IV anti-inflammtory as of 2/7-2/9 Prednisone as of 2/9 taper: 5mgs 1x/day, etc. famotidine 5mgs 2x/day Gabapentin ?mgs in one mL: ?mgs 2x/day Methocarbamol ?mgs in one mL?: ?mgs 3x/day Clavamox 125mgs 2x/day]
His Rx are as follows: 5 mg Prednisone, 1 tablet daily for 10 days, then 1 tablet every other day; Gabapentin 1 ML 2 x's daily; Methocarbamol 1 ML 3x's a day; Clavamox 125 mg 2 x's a day for 14 days; Famotidine 5 mg 2 x's a day. We are lucky in one respect and that is that Jaeger is already familiar with a crate. He loves his crate--it's his "den". So we haven't had to deal with the additional trauma of that. Though I will say now that after 2 weeks of it he's saying "um...hello?? I'm ready to come out now!"
Anyhow the good news is that a few days ago we noticed that his back feet have stopped knuckling and he's moving a lot better. Although he never lost bladder control, he was "squirting" in his crate and on us every time we lift him out of his crate for his potty breaks (the submissive peeing he used to do has returned), but that seems to be subsiding again I think. He's definitely come alive again in the last few days and moving around in his crate a lot more, rolling around onto his back and just generally trying to get our attention by being "cute" anytime we talk to him, so I'm worried he's moving too much. But obviously he must not be in too much pain anymore. His back is sensitive to touch though, because I wipe him off with baby wipes after his potty breaks and once or twice he has cried out when I've wiped down his back too vigorously--so I'm careful about that. Also I'm wondering about toys, chew bones, Kongs, etc. to lessen his boredom? He can't really move around much in the crate, but his chewing and play can get a bit enthusiastic. How much is too much? Also, how long do they generally stay on the meds? Although he's been weaned down on the prednisone to every-other-day, and the antibiotic will be done in another 2 days, how long do they generally keep taking the gabapentin and methocarbomal? Thanks so much!
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Post by Julie & Perry on Feb 21, 2017 12:17:17 GMT -7
Hi Michelle. Welcome to you and Jaeger to Dodger's List. Don't know how much you know about IVDD. There's a really good section called IVDD 101 on the main website, dodgerslist.com. Usually, when you start tapering the Prednisone is when you stop the pain meds. Pain equals swelling. So if you see pain on the Prednisone/pain meds taper Jaegers not ready to stop yet as there's still swelling. But of course check with your vet first. Best wishes to you both.
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Post by Michelle & Jaeger on Feb 21, 2017 13:10:09 GMT -7
Thank you so much for the info! 2 weeks ago I knew next to nothing about IVDD - I knew Dachshund's were susceptible to back issues and we've always been careful about protecting their backs when we carry them, minimize stairs, but other than that I figured that when their back "went out" it would be a very dramatic trauma of some sort that caused it and we would know immediately. DUH. I feel so stupid now--I've had Dachshunds for 20 years and have even done doxie rescue and fostered doxies for other rescues. But obviously, none of them had IVDD. Since Feb 5th I've been reading everything I can. I want to do the very best for our Jaeger and our Izzy and be a more informed mama.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Feb 21, 2017 13:45:46 GMT -7
Michelle, the usual way to use steroids with a disc episode is for the vet to make a guess how long the course of the steroid should be. Many will guess at 5 or 7 days and then call for the test-for-pain prednisone taper. Along with the taper all pain masking pain meds would be stopped. Your job at home is to be able to make a quick assessment if you should see any hint of pain surfacing.
With a test for pain taper going on and no stop of the pain meds the waters are muddy! With a yelp upon touching the back, I would think there is still swelling going on in the spinal cord. And the need to get back up to an anti-inflammatory pred level. It can take 7-30 days to get all swellling down. Any taper days such as 5mgs 1x/day and lower do not work on spinal cord swelling.
Have you reported the tender back and yelps to the vet. It appear only for two days was an IV steroid used at the anti-inflammatory level or maybe even a higher level beyond anti-inflammatory used. Since 2/9 the pred dose has been a tapering dose.
When you can fill us in on the full details of his medication treatment
16 lbs Rimadyl 2/5-2/7 .NSAID that requires a 4-7 days washout before starting a steroid. OR use of two stomach protectors: famotidine + sucralfate if no washout. name of IV anti-inflammtory? as of 2/7-2/9 Prednisone as of 2/9 taper: 5mgs 1x/day, etc. famotidine 5mgs 2x/day Gabapentin ?mgs in one mL: ?mgs 2x/day Methocarbamol ?mgs in one mL?: ?mgs 3x/day Clavamox 125mgs 2x/day
Can Jaeger specifically sniff an old pee spot in the grass and then choose to mark or release urine there. That is the proof that he has bladder control.
Let us know what your vet says about the pain you observed and what changes to meds he offers.
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Post by Michelle & Jaeger on Feb 21, 2017 15:17:08 GMT -7
I don't have any info on this. I did inform our vet of the doses of Rimadyl that I had given him, so they were aware before they started treatment.
Jaeger: 16 lbs Rimadyl 2/5-2/7 Solu Medrol as of 2/7-2/9 Prednisone as of 2/9 taper: 5mgs 1x/day, etc. famotidine 5mgs 2x/day Gabapentin 250 mgs/mL: 250 mgs 2x/day Methocarbamol 100 mgs/mL: 100 mgs 3x/day Clavamox 125mgs 2x/day 2/9-2/22
**He was also given 2 Cerenia Injections and IV fluids during his inpatient stay 2/7-2/9.
Can Jaeger specifically sniff an old pee? YES he can and he will relieve himself on command.
So if I understand you correctly 5 mgs of Prednisone has been a tapering dose and it's been doing nothing for his inflammation all this time?! So all these meds I've been pumping into him since leaving the hospital on 2/9 have been masking pain is all? Aargh..This is so frustrating! My vet office has checked in with me several times in the past week to check on Jaeger and I told them that he has mostly been sleeping, which I think is a good thing for the healing process and he appears to be improving (walking better, less knuckeling, etc.) Other than the one time a few days ago that his back appeared tender when he yelped when I was wiping him down with a baby wipe, he has not seemed or acted like he's in pain. Should I take him off the methocarbomal and the Gabapentin and see what his pain level is?
I have a call into my vet, but he's out of the office today and won't return until tomorrow. :/
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Post by Romy & Frankie on Feb 21, 2017 15:51:04 GMT -7
The reason for a 4-7 day washout between an NSAID type of anti-inflammatory and a steroid type is that there can be serious drug interactions when both meds are in the body at the same time. This has sometimes led to very serious stomach damage. That would be the reason for the two stomach protectors, sucralfate and pepcid to be used.
Katrina R. Viviano, PhD, DVM writes in Small Animal Pain Management Clinical Pharmacology "NSAIDs have significant drug interactions with glucocorticoids (gastrointestinal ulceration is potentiated by glucocorticoids via inhibition of prostaglandin synthesis), benzodiazepines, salicylate containing herbs (meadowsweet or willow), gingko, garlic, ginger, ginseng, and aminoglycosides. ... Consider a minimum of a 7-day washout period between NSAIDs and either glucocorticoids or other NSAIDs. " SMALL ANIMAL PAIN MANAGEMENT CLINICAL PHARMACOLOGY Katrina R. Viviano, PhD, DVM
The paper can be found here: secure.aahanet.org/eweb/images/AAHAnet/phoenix2009proceedings/pdfs/01_scientific/025_SMALL%20ANIMAL%20PAIN%20MANAG.pdf
As Paula mentioned, with pain being present this is probably not the right time for a taper.
Keep us updated as to what the vet says when you speak to him.
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Post by Michelle & Jaeger on Feb 21, 2017 16:49:57 GMT -7
Hi - thanks much for the info. I understand the need for washout, but What if anything can I do now about whether there was a washout or no washout at this point? It was 2 weeks ago. I guess if there was g.i. damage I would have seen bloody diarreah or something similar? or is there continued danger from that I should be looking for? His stool has been darker than normal--which I attributed to the meds--but otherwise normal consistency and normal frequency. He is eating, drinking and voiding normally. No nausea or vomitting. My invoice does not show whether they gave him pepcid/sucralfate--I guess they may have and forgot to charge me for it(?) At this point should I be concerned? I should be clear that the only sign of *any* pain or discomfort I've seen him display was that one time 3 days ago when I was wiping him with the baby wipe and I pushed a little too hard along his back. Otherwise he has shown no sign of pain at all. He has been being active with his toys in his crate, wanting to play, moving, rolling around, etc. None of the same signs he was showing when he was in pain before he started treatment (trembling, not wanting to move, groaning).
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Post by Romy & Frankie on Feb 21, 2017 17:06:27 GMT -7
I think at this point we can say that Jaeger dodged a bullet since we have not seen any sign of stomach damage.
It is really hard to tell from that small pain reaction three days ago if there is still swelling in the spinal cord. There may not be any swelling now.
Most often when a pred taper begins the pain meds are cut back or stopped so that it will be clear if pain, a clear indication that spinal cord swelling remains, returns. If it does not no more meds are needed only the remaining crate rest period. If pain return more time on the pred at the anti-inflammatory dose and all pain meds and pepcid is needed.
If it were my dog, I would keep him on the pain meds until I spoke to the vet tomorrow just to be on the safe side.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Feb 21, 2017 17:09:46 GMT -7
Michelle, Dodgerslist is all about owner education. We point about the danger of not protecting the stomach if no washout is done. Knowledge is how we protect and know when to question things in the future and to know if a vet appreciates potential for GI tract damage. If his stomach was not protected by famotidine + sucralfate, then Jaeger is certainly a very lucky dog.
The taper is the test for pain. At any point in the taper pain could re-surface as pred gets lower in the body. From what you report the spinal cord swelling may not be fully resolved. You are the eyes and ears for your vet, your feedback helps him to know if a med adjustment is needed. It is prudent to try a steroid course and then a test taper. No one wants a dog to be using any anti-inflammatory past the benefit point.
As you read from the links I gave, the medical reason for the taper is to signal the body to start making its own life-giving steroid hormone, cortisol. The steroid pill taper just happens to be a perfect window with IVDD to see how spinal cord swelling is being resolved or not.
Let us know what your vet thinks about your observation and what med changes he makes. --- continue to taper without pain masking pain meds OR --- in case the yelp when touching his back means there is still swelling, back up to a 2x/day pred anti-inflammtory dose for maybe 5-7 days and then a test taper.
In general, you would not touch his back, or do anything to cause extra movement of the back. Keeping the discs from being pressured by moving vertebrae is the goal. Discs only heal with limited movement and time of 8 weeks.
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Post by Michelle & Jaeger on Feb 22, 2017 17:55:57 GMT -7
Thank you Thank you so much for helping me understand all this so I can ask the right questions when I speak with my vet tomorrow. I will keep you posted! Michelle & Jaeger
I just got off the phone with my vet. I told him that in general Jaeger seems to be improving and gaining strength in his hind legs and wanting to move more, but I am worried that there may still be some swelling due to him yelping when I touched his back while wiping him down--but otherwise he appears to be pain free on his meds. Dr. Clavijo said that it not unusual for him to be sensitive along his spine and it's possible that may never leave. When I asked about whether we should stop the tapering and return to anti-inflammatory levels of Prednisone, he said no, that he wants me to finish out the Pred. at 5 mgs every-other-day and continue giving the methacarbamol and gabapentin doses as prescribed until they are gone and of course continue with crate rest therapy. I pushed him on this asking how we'll know if the swelling on the spinal cord is controlled if we continue pain meds during the taper and he said "no, no, you keep giving him pain meds"--He says he'll either be noticeably better or he won't by the time the meds are gone. If not, then we will start over at the beginning again with the steroid tx. He did suggest that it could be helpful for me to begin bringing Jaeger in for Laser Treatment therapy 2-3 times a week.
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Vita & Emmie
Helpful Member
Currently graduated for the 3rd time; walking and running!
Posts: 189
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Post by Vita & Emmie on Feb 23, 2017 9:28:10 GMT -7
Hi Michelle! My Emmie is a graduate of conservative crate rest for a number of IVDD episodes. I'm not a vet and don't know about the drugs - the moderators on here are good at that! I just wanted to say you have to make sure Jaeger is pain free, that the inflammation goes down and that you keep him on strict crate rest for the full time. Even if he acts "better" or strong; you don't want him to further damage himself. My Emmie went from completely paralyzed in the back end (after the yelping, screaming etc) to full on walking and running now. But I followed the rules and couldn't have done it without the support of Dodgerslist. I did take Emmie for electro-acupuncture during her crate rest and that as well as Vitamin B injections helped the nerves come back. Best wishes to Jaeger!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Feb 23, 2017 10:16:53 GMT -7
Michelle, walking better, less knuckling means Jaegar is on a good path of nerve healing. Each and every vet visit needs to be weighed for the potential risk to an early healing disc vs the benefit to be gained from a visit.
When there is severe nerve damage it may be quite a benefit to get acupuncture or laser therapy. Anytime out of the crate is a dangerous time for the early healing disc. With Jaegar having the ability to walk and showing improvement of less knuckling, weigh carefully a 2-3x/week transport and the potential for the disc to receive too much movement.
How many days are left of the every other day Prednisone dose? Hopefully just a few days are left and you can then quickly get real proof you need if Pred is needed back at the anti-inflammatory dose or not with the stop of all the pain meds.
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Post by Michelle & Jaeger on Feb 23, 2017 16:24:26 GMT -7
25! So that's 50 more days ["wants me to finish out the Pred. at 5 mgs every-other-day"]! With all I've read and all you've told me that does not equal the standard of care for IVDD. So I think I need to seek a second opinion, or choose to go off script from my vets instructions and test Jaeger's pain level with no meds on board.
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Post by Romy & Frankie on Feb 23, 2017 16:49:18 GMT -7
Nobody wants to keep a dog on powerful medicine like pred a minute more than needed. It typically takes 7-30 days to heal the swelling in the spinal cord When the vet thinks the swelling is gone then a taper is begun. The taper is done for two reasons; as a test for pain which shows if swelling is still present and also to signal the body to begin making its own cortisol. A taper that long is really unusual. You may want to consider a second opinion.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Feb 23, 2017 20:17:09 GMT -7
Michelle, please double check the number of every other day pills you are are supposed to give as the final taper dose. There is something VERY wrong with doing every other day for 50 days. Prednisone is a hormone, not your every day drug. It is one med an owner should never self prescribe. You need to verify the 50 every other day dose. It that is correct you need to find another 2nd opinion vet to help you taper Jaeger off pred properly.
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Post by Michelle & Jaeger on Mar 30, 2017 16:23:22 GMT -7
Hello! Just wanted to check back in and update you on Jaeger's progress. We are in our last week of crate rest (April 4th will be 8 weeks!) and our boy is doing fantastic. We have kept him on very strict crate rest, and slowly weaned him off all his meds by the end of February. He of course is a bundle of energy and gets digging in his blankets and rolling around and turning in circles at times, but that to me is a sign that he feels good and is pain free. But how do we know for sure the vertebrae has fully healed? I'm quite nervous about letting him have freedom again and plan to work him slowly back into shape with some water therapy and slow, short walks. Anything we should know at this point? Thanks so much! Michelle & Jaeger
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Post by Pauliana on Mar 30, 2017 22:21:40 GMT -7
Hi Michelle! Sounds like Jaeger is doing very well and it sounds as if he is pain free with all that rolling around and digging in his blankets.. The disc has formed more secure scar tissue by now.. I can understand your nervousness about crate rest graduation.. I felt the same way the first time, our Tyler was released from the crate.. I watched him like a hawk but I followed this article to a T and he did very well, he doesn't try to do things he shouldn't, I am lucky that he is a cautious spirit. Crate rest is over, now what? dodgerslist.com/literature/AfterCrateRest.htmin the above article there is also a link to our article on coping with the fear of IVDD, it is well worth reading, it helped me see things in a whole new way.
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