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Post by Ronnie & Snickers on Feb 27, 2017 15:02:39 GMT -7
★1 What breed? Hi I am Ronnie, Snickers dad. He is a Toy Poodle/Shih Tzy mix. We live in Wayne, PA USA a suburb 15 minutes outside of Philadelphia PA.
★2 Did you specifically get a diagnosis of IVDD,?His doctor, a DVM, diagnosed him with lower back problem/disc issue in his lower area. His xrays shows spine calcification which they think is what causing him pains. We are seeing a neurologist on Wednesday, Mar 1, 2017.
★3 What was the date you saw the vet for conservative treatment or the surgery date?Snickers showed symptoms on the night of 2/22/2017. We brought Snickers on the morning of 2/22/2017 to his Vet. They started conservative treatments right away. He is on crate rest. He is confined in his old ex-pen. I carry him to and from his pen when we go potty outside on the grass.
★4 Is there still currently pain -As of today, 2/27/2017: He was shivering on our way to the vet this morning (2/27/2017) for his recheckup. Generally, he is slow to move. He is usually on his bed. He will sometimes sit (and bark a little to call my attention) or stand up on all fours (to drink water). He will sometimes do the Flamingo stand on his left front leg when we pee outside. I did noticed an improvement in that he can move now by using his four legs, pee by raising one of his back legs, will turn over when I try to give him a belly rub and scratching his ears with his hind legs.
★5 Snickers normal weight is 15 to 15.5 lbs. He is at 14.6lbs this morning. He takes the following: All medicines where started morning of 2/23 except Tramadol which we started 2/22. 1/2 tablet 2x day of Tramadol HCL 50mg 1 tablet 2x day of Prednisone 5 MG until Wednesday, Mar 1, the Neurologist we are seeing him will decide when to taper. We started the taper 2/25. However, his vet decides to put it back to full strength after seeing him this morning. 1/4 table 2xday of Methocarbamol 500mg 1/2 tablet 1xday Metronidazole 250MG Addition 2/27/2017 PM
[14.6 lbs Predniosne as of 2/23: 5mgs 2x/day for 2 days, then taper as of 2/27: 5mgs 2x/day for TBA days, then taper Tramadol 25mgs 2x/day Methocarbamol 125 mgs 2x/day Metronidazole 125mg 1x/day Pepcid AC 5mgs 2x/da]
★6 Eating and drinking OK? Poops OK - normal firmness & color -no dark or bright red blood?He is drinking more than usual and is eating normally the last few days. That was not the case the first two days.
His first poop was on 2/24. His poop was firm, followed by loose and had some blood on it. Succeeding poop is still firm followed by loose but no more blood. I am picking up medicines tonight to help with the loose stool.
★7 He was wobbly this morning during checkup. I don't notice this on the grass when he relieves himself. As I said above, he can move his legs and in fact, started scratching his ears with his hind legs again two days ago. He was wagging his tail as soon as they get some meds in him (2/22).
★8 He can sniff and squat and/or sniff and raise one foot (he pees both ways). No bed wetting nor leaks. Before this injury, he will tell me when he needs to go by silent bark that will progress to loud bark when I ask him. Something like this.
Snickers: arf Me: What is it? You want to potty? Snickers: ARF Me: Really? Do you want to potty? Snickers: ARF, ARF Me: POTTY!? Snickers: ARF, ARF, ARF!
That's the time we go. Now is just silent arf, while sitting and looks at me the way he normally does when he wants to go
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Feb 27, 2017 17:59:46 GMT -7
Ronnie, welcome to Dodgerslist, we are glad you've joined us all. I'm so sorry that Snicker is suffering with a disc problem. Sounds like you have an emergency now of pain and likely GI Tract damage happening. We'd really encourage each member to learn all they can about IVDD. This is not only a safety precaution when caring for your dog now but also to the many happy years together. So do read as much as you can as fast as you can in the next several days where our treasure trove of IVDD information is housed on the main website: www.dodgerslist.com/healingindex.htm Knowledge truly is the power to fight this IVDD enemy and win. For right now to get things right for Snickers, you will want to get in touch with a vet, maybe even an ER vet tonight. The pain meds are insufficient for Snicker's needs. He is in needless pain. Typically three different pain meds would be used. Each addresses a different source of pain. They all would be prescribed for three times per day as these pain meds have write a short half life. --- Tramadol 25mgs is too low a dose for a 15 pound dog as the general analgesic. Adovcate for the full 50 mg tablet and at 3x/xday --- Methocarbamol, advocate for it to be Rx'd 3x/day for muscle spasm pain --- Gabapentin advocate for it to be added 3x/day to deal with nerve pain --- Prednisone may take 7 to 30 days to resolve swelling. The taper is when there is a test to see if all inflammation is gone. For how many days is Pred at 5mgs 2x/day prior to a taper?--- Stomach protection: Pepcid AC should be on board at the get go of any use of prednisone. Read to understand your dog does not have heart, liver or kidney issues at Marvista Vet website that might require a smaller dose of this relatively safe acid suppressor that is now over the counter: marvistavet.com/famotidine.pml Start the famotidine tonight AND as soon as you can contact your vet let him know of the adverse side effects and early warning signs (blood in stool AND loose stool) and that you have famotidine on board. Pepcid AC (famotidine) 5mg 2x/day. Give prednisone wth a meal as added protection The usual dose during a disc episode is Pepcid AC (famotidine) for dogs is 0.44mg per pound 30 mins before the anti-inflammatory and thereafter every 12 hours. Give the anti-inflammatory with a meal as added protection. www.1800petmeds.com/Famotidine-prod11171.html
It really sounds like this may be a a neck disc. They are more painful and can take longer to heal. Holding a leg like a flammingo because it is painful to bear weight and not wanting to bark because it hurts to move the head are often seen with a neck disc. Any time out of the recovery suite can be a danger to the early healing disc. So all vet visits need to be carefully weighed for the risk to be gained vs. the potential set back to a weak healing disc. Things like med changes are often changed by giving the vet feedback and he calls in the Rx or you pick it up at the vet's clinic. Even if this is not a neck disc, these things can still be helpful in caring for Snickers: www.dodgerslist.com/literature/cervical.htmWhat is the reason you are going to see a Neuro. There are many reasons --- Your local vet is not comfortable in using IVDD meds, and you need a neuro to prescribe the proper dose and x/day to get Snickers in full pain relief. --- You are considering surgery. An $1000+ MRI picture would precede surgery. --- Your vet has a suspicion this may not be a disc episode, but another disease that could mimic IVDD. An MRI would help to give a firm diagnosis. XRAYs and other advanced imaging Pressure to the spinal cord does not have to be a disc herniation; it could be a spine fracture or dislocation, a tumor, or a disk infection. Xrays should be used with caution with a suspected disc episode. The dog's main defense from further disc damage depends on controlling their trunk muscles. Anesthesia puts those muscles to sleep.
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Post by Ronnie & Snickers on Feb 27, 2017 18:14:54 GMT -7
Hi Paula,
His Vet suggested Specialist because he thinks Snickers didn't get better and he can only do so much. He thinks a Neuro will be able to diagnose it better.
We did say we possibly can't afford an operation. He didn't know the exact numbers but he said $4000 to $8000. The Neuro visit, including the MRI will cost around $1000.
It seems to me he is getting better. There were some improvements I saw - will stand if he wants to move, will stand to go to his food. The shivering and initial blood in stool worries.
It's 8Pm here now so our only option is ER Vet (it will be the same hospital where he will see the specialist). Should we do this now or wait until the morning?
I am sorry for all the questions even if though it seems you've answered. I just wanted to be sure before we go visit the ER Vet as they are significantly more expensive versus taking him there in the morning.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Feb 27, 2017 18:39:10 GMT -7
Ronnie, we may miss you updates if you go back and edit a post after we have bold faced it. Better is to just make a new posts with updates.
Your local DVM vet is telling you he is not comfortable in treating IVDD. So.....that means either you bone up on it and are able to bring to the table ideas and basically dirve the treatment. It is not rocket science. OR you go get a 2nd opinion, where that vet feel comfortable in precribing meds.
If there is to be no surgery IF it would be at the point that it might be indicated, then the only reason to see an expensive neuro (about $125 for consult) is to get the right prescriptions to get Snickers out of pain. Pain actually will hinder the healing process as well as being torture. There is not a need to know which disc via an MRI. MRI's are reserved for prior to surgery or if there is suspicion there is another disease.
You will have to decide whether to go ER to night and get the needed Rx or get with your local vet and very strongly advocate for what is needed. Waiting til Wednesday is TOOOOOO long to wait in pain.
Does he have a UTI? What is the reason for this antibiotic?
Do get a 2nd opinion on whether a back or neck disc. Flamingo leg not wanting to bark sound much like it may be a neck disc.
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Post by Ronnie & Snickers on Feb 27, 2017 18:58:09 GMT -7
No he doesn't have UTI. I mentioned the blood in the stool in his first poop and succeeding loose stool. He suggested bland diet but I asked for something to help with it and they gave him Metronidazole.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Feb 27, 2017 19:02:13 GMT -7
Can you get Pepicd AC on board tonight? Buy it at the grocery store. Same stuff people use of acid caused heartburn. Look for a single active ingredient (famotidine) 5mgs 2x/day Acids damage the GI tract. Pepcid AC (famotidine) suppress the stomach acids.
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Post by Ronnie & Snickers on Feb 27, 2017 19:08:00 GMT -7
I just gave him 5mg of Pepcid AC.
Btw, I always give him his meds right after eating.
He is asleep now. He did get up and sat down when I came back from buying Pepcid AC.
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Vita & Emmie
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Post by Vita & Emmie on Feb 28, 2017 10:39:53 GMT -7
Hi Ronnie, I'm glad you found Dodgerslist to help you with Snickers. The moderators here are amazing and can help you get Snickers what he needs to get through this. The financial concerns are a huge part of the stress of this so it's important that you keep in mind what is important; Snickers having no pain and you making sure to do all you can to advocate for him. If Snickers really has a back or neck issue (IVDD related) then you can opt for crate rest, strict crate rest for the full recommended time (8-12 weeks depending) for the best outcome for him. My Emmie has done this 3 times with different IVDD episodes and it was best for her. I say best for her as some dogs/owners select surgery as the best option for their dog/situation. You need to get a vet who will provide the correct meds so Snickers is not in pain then you can decide about following conservative or surgical paths. Please let us know how Snickers is doing so we can help you! My little weenies and I send healing hugs to Snickers!
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Post by Ronnie & Snickers on Mar 1, 2017 18:36:49 GMT -7
3/1/2017 Update: We saw a Neurologist this afternoon. Here's what is on his discharge sheet. Physical Exam: QAR, BCS 5/9; Weight: 6.7KG T:101.4 R: pant; CRT < 2 sec/pk/moist EENT: pupils midrange,normal menace OU, tear staining OU Lymph nodes: no lymphadomegaly detected; Cardiovascular: no murmur or arrhythmia ausculted; pulses synchronus; Respiratory: eupneic, lung sounds clear; Genitourinary: NSF; Abdomen: soft, no masses or organomegaly noted, non-painful; Musculoskeletal: no lameness appreciated Integument: NSF
Neurologic: Mentation: QAR Gait: no paresis or ataxia appreciated Posture: normal Postural reactions: normal placing x 4 Cranial nerves: normal menace, palpebral and PLRs Reflexes: Normal x 4 No spinal hyperesthesia noted His medicines were increased per my request. Prednisone 5mg every 12 hours Tramadol 25mg every 8 hours Methocarbamal 125mg every 8 hours Gabapentin 50mg every 8 hours
They did all sorts of physical test on him which I am sure everyone is familiar with. I can give details if you are interested. Surgery option was discussed and it will cost $6,500 to cover CTScan, MRI, Surgery and Stay. We will start our taper on Saturday and was instructed to call back and report.
[14.77 pounds Predniosne as of 2/23: 5mgs 2x/day for 2 days, taper as of 2/27: 5mgs 2x/day for 6 days, then taper dose Tramadol 25mgs ▲3x/day Methocarbamol 125 mgs ▲3x/day ➕Gabapentin 50 mgs 3x/day Metronidazole 125mg 1x/day Pepcid AC 5mgs 2x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Mar 1, 2017 19:48:34 GMT -7
Ronnie, is he still on Pepcid AC 5mgs 2x/day? How is the diareah now with hopefully that you do have Pepcid AC on board?
How is the pain control with the changes to the med list?
Did the neuro think a possible disc was invovled? In the back or the neck (silent arf, holding front leg flamingo like)?
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Post by Ronnie & Snickers on Mar 2, 2017 2:16:20 GMT -7
Hi Paula.
He is still on Pepcid AC 5mg 2xday. No more diarrhea for a couple of days now.
He doesn't show any symptoms of pain anymore. He was doing fine even with the 2xday.
The Neuro think it might be a disc on the back but not on the neck. She says Snickers doesn't show any sign of neck issues.
She did say, actually her assistant who mentioned it, that we tapered too quickly the first time around.
Snickers was himself during the Neuro visit. All happy, walking right, barking at me (he wanted to poop), kissing if you let him etc
On a related note, Snickers Neuro knows about dodgerslist and she thinks highly of this site.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Mar 2, 2017 17:11:29 GMT -7
Ronnie, we are always looking for entries to our member vet recommendations. Would you consider adding your Neuro to the directory incase someone is looking for support in getting the right meds on board with conservative treatment their local vet is not comfortable in doing and not necessarily wanting a surgery. Here is the link to our member directory: dodgerslist.boards.net/board/10/guidelines-posting vet recommendations: Name of Vet Name of Clinic Street Address City: State or country: Type of vet (general/board certified surgeon, acupuncture, etc.) Comments: We will have our fingers crossed on the taper of pred on March 4 that a total of 7 days (2 courses of pred will have all swelling resolved. However, do not be alarmed if pain surfaces as no one knows how many pred courses it will take... somewhere in the range of 7-30 days exclusive of any taper days. So that the test for pain will be accurate and fast, vets either back off or stop the pain-masking pain meds meds (methocarbamol, tramadol and gabapentin) on the start of the taper. Which does you neuro want?
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Post by Ronnie & Snickers on Mar 5, 2017 7:07:58 GMT -7
Mar 3 Update:
Previous night [3/2], he was "digging" his crate bed like his normal self. I quickly told him to stop, he did with some protestation.
Woke up @ 4AM today [3/3] to start our day e.g. Snickers potty time, 4:30AM Pain Meds, 6AM Pepcid AC and Pred . It is extra chilly today (low 30s). I woke up Snickers. I thought I saw a brief shiver when he sat up. Took him out for a quick pee. He was fine even did a little hop (which I quickly told him not too - looked at me as if to ask, what was that? - we do that). Picked him up and was (definitely) shivering a bit. I put him down in his crate. Shivering stopped not too long after.
Everything was back to normal thereafter.
We begin his ▼Prednisone taper today [3/5] ie 1xday versus 2xday.
I was instructed to call Monday to report his condition and if he gets worse, that to go back to 2xday.
Is there anything specific I should be looking out for?
Thanks.
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Mar 5, 2017 7:23:41 GMT -7
You'll need to be on the close lookout for any sign of pain returning or any worsening of neuro function. Good that you have a plan in place should you see a worsening of condition. Should you see any sign of pain return or any worsening of neuro function, that would mean that there is still swelling pressing on the nerves of the spine and therefore there would still be a need for the anti-inflammatory dosage of the Prednisone (5 mgs 2x/day).
Has the vet given you any instruction about tapering or stopping the pain meds during this taper of the Prednisone? Usually during a taper of the Prednisone, the pain meds are also tapered or stopped completely so a true test for pain can be made. Otherwise, the pain meds will mask any pain and it will be difficult to determine if there is still swelling/pain and therefore still the need for the anti-inflammatory dosage of the Prednisone. If the vet hasn't given you any instructions as to stopping the pain meds during the taper, I would recommend that you speak to her ASAP about stopping the pain meds so a true test for pain/swelling can be made. If no pain returns by the final end of the Prednisone taper, then the swelling has resolved and no meds at all will be necessary.
Pain = swelling = more time on all meds.
Please continue to give the Pepcid AC 2x/day for as long as Snickers is on the Prednisone, even during the tapering.
For how long a period of time does the vet want Snickers on 5 mgs 1x/day?
Prayers for a pain-free taper off of all meds for Snickers.
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Post by Ronnie & Snickers on Mar 8, 2017 15:22:01 GMT -7
We are doing a 7 day Prednisone 1xday taper (until 3/10). After that we will do an every other, I think until all Prednisone were consumed.
I spoke to them the other day about his pain medication. They stopped methocarbamol yesterday, 3/7. He is still on Tramadol and Gabapentin. I still give him pepcid AC 2xday.
He was panting a bit when I went home at lunch today. This was after he was barking trying to get my attention. It stopped as soon as I took him out for potty.
[14.77 pounds Prednisone as of 2/23: 5mgs 2x/day for 2 days, taper as of 2/27: 5mgs 2x/day for 6 days, then taper dose Tramadol 25mgs ▲3x/day Methocarbamol 125 mgs ▲3x/day STOPPED 3/7 Gabapentin 50 mgs 3x/day Metronidazole 125mg 1x/day Pepcid AC 5mgs 2x/day]
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Post by Romy & Frankie on Mar 8, 2017 15:30:59 GMT -7
Do you feel that Snickers is pain free now that the pred is being tapered? Panting can be a sign of pain, but it may not be in this case. Is he showing any other signs of pain?
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Post by Ronnie & Snickers on Mar 9, 2017 5:47:50 GMT -7
He whines a lot in his crate especially when I am around. My wife says he is usually just sits there until I walk in the room.
He is a spinner so I get to watch him when he poops. No tell tale signs of pain [still on pain meds!].
We are on 2nd week of his crate rest. Things seems to be progressing well. We have a Hollistic Vet in the area that will do house visit. She offers Accupuncture and Laser Therapy services. Will this help Snickers recovery/healing? Can this be done now or should I wait after the 8 weeks of crate rest.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Mar 9, 2017 8:47:42 GMT -7
Ronnie, the quicker and more accurate the test for pain pred taper is done, the faster you find out if Pred might need to go back up to the original anti-inflammatory dose. Taper doses do not work in spinal cord inflammation. Doing the test for pain pred taper with pain meds on board just muddies the water as to if there is still pain and delays getting that swelling worked on.
So right now you are doing a test for pain with pain-masking pain meds on board! Can you advocate for all pain meds to be stopped so that you can give a clear and accurate report should pain resurface. Pain would tell you and the vet that pred back at the original dose is needed for a bit longer. If you continue to see no signs of pain without any pain meds on board, then you just continue on to the full completion of the pred taper with no meds at all needed at the conclusion of the pred taper.
Acupuncture and laser are to help with pain if pain meds are not doing the trick. Right now you are trying to get an accurate test to see if there is pain.
Acupuncture and laser are also very good in kick starting nerve cells to self repair damage. The Neuro report as of March 1 was: no paresis or ataxia appreciated. Is he still on the antibiotic Metronidazole 125mg 1x/day?
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Post by Ronnie & Snickers on Mar 12, 2017 7:27:08 GMT -7
We had a setback.
My parents are in town in visiting us. They arrived last night. Snickers got too excited when they saw them. He tried to run to them when I took him out of the crate for his potty time. He was fine walking and peeing on the snow. However, when I put him back to the crate, he seems to be favoring his back legs again i.e. fidgeting a little bit. He still can stand and move but I do notice some discomfort.
His Neuro won't be available until Tuesday. I do have an instruction to put him back to regular dose of everything if he gets worse (is this considered getting worse?). However, the Prednisone will run out by Tuesday.
Are we restarting the 8 weeks crate rest from today? I have no problem doing that just want some advice.
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Post by Ann Brittain on Mar 12, 2017 7:58:53 GMT -7
Hi Ronnie, I'm sorry to learn Snickers has has a setback. It is hard to keep a dog calm when company comes. You're taking the right approach to extend his crate rest time and resume his former dosage of pain medication.
This could be a minor incident and Snickers will get back to where he was soon. But erring on the side of caution is always the way to go with any disc injury. If he doesn't show improvement within a day or so, you should consult with you vet.
Don't feel guilty because this happened, but learn from the experience to help your dog avoid situations that might be stressful while he recovers.
Good luck to you both.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Mar 12, 2017 9:31:43 GMT -7
Ronnie it is a tough call. I would observe him for two confiruming signs of spinal cord pain and any neuro set backs that would signal the disc re-damaged during the run and of course a need to restart the count of 8 weeks, bring anti-inflammatory and all meds back on board and of course letting your vet/neuro know what happened. How far did he run before you caught him? Hopefully, your monitoring him, you will find out that perhaps he over did use of his leg muscles being a couch potato these last weeks vs. actually re-damaging his early healing disc and you will be able to continue tapering pred. Let us know what you observe '
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Post by Ronnie & Snickers on Mar 22, 2017 10:21:28 GMT -7
Today is the first day that Snickers won't be taking any medicine.
Besides the episode on the 11th, it's been uneventful. He hasn't shown any pain nor any nerve damage.
He lays around in his crate pretty much all day (I have a webcam pointing to his crate) when I am not around.
He will starts whining and complains a lot when I am around. He does not do this with my parents nor my wife.
I still carry him to and from his potty place. I've even given him some luxury of walking a few steps to another potty spot. A couple of times now, he tried running and chasing a squirrel.
We still have one more month of crate rest.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Mar 22, 2017 16:50:58 GMT -7
Ronnie, very excellent news of being off all meds and no pain. Now just to continue being really strict about rest including at pottytime. I'm not sure how far a few steps to another potty spot is. Do what you can to keep those footsteps to the very, very minimum. I chose an ex-pen enclosed potty place so my dog would know there was not going to be any walking around, darting off nor sniff festing during poitty breaks. At your hardware store of one of the big box stores you can find some of the inexpensive wire garden edging poke-in-the-ground fence to make a 6 foot diameter potty place.
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