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Post by Julia & Cocoa on Apr 6, 2017 10:44:38 GMT -7
Hi Dodgerslist! I will start with an introduction of my dog and follow with questions I hope someone can help me with. Cocoa is about 8 years old, a 41lb Boxer/Bassett or Dauchshund mix, very long back, short legs, not overweight and normally active. First IVDD incident with partial paralysis of back legs was 2014. First IVDD diagnosis was made by veterinary surgeon we were referred to by our regular vet. At that time we chose meds plus crate rest which was successful until recent relapse. During second week of March we noticed Cocoa, who has always had submissive urination issues, was losing control of her bladder and becoming lethargic, then lost the use of her back legs. Our regular vet determined Cocoa did still have deep pain response. They prescribed the same meds as in the previous episode: started March 15th - one intravenous Dexamethasome, then 3 weeks of Dexa .5 mg starting at 2 per day (+Pepsid 10 mg for each dose) then tapering off the last two weeks; Tramadol 50 mg at 2 per day for 3 weeks, strict crate rest. [41 lbs Dex IV on 3/15 Dex as of 3/16: 0.5mgs 2x/day for 7 days, then taper Pepcid AC 10mgs 2x/day Tramadol 50 mgs 2x/day Sulfatrimeth 960mg at one half tab
She seemed to be doing ok, tail joy wagging, eating, drinking water, normal poops, copious amounts of pee. We now deal with pee and poops by frequently (including nights) changing her pee pads and cleaning her with baby wipes. We still have a lot of snow here. Before I found out it was not a good idea, I tried using doggie diapers at night and that either started or made worse a bout of urinary tract infection. Back to the vet April 4th. Vets were unable to get a sterile urine sample via needle to bladder with ultrasound guide because every time they tried she completely voided her bladder as soon as they touched her. My vet also told me the dog was impossible to express manually because of her strong abdominal muscles and I would not be able to learn how to do that reliably for the same reason. The urine they were able to collect indicated a substantial UTI. X-rays showed multiple calcified discs but normal internal organs and no tumors. Blood work has not come in yet. Cocoa is now on 2nd day of Sulfatrimeth 960mg at one half tab twice a day for two weeks. I stopped Tramadol for the day of this vet appointment so they could test for residual back pain. She was/is so sensitive now that she yelps whenever her back end is touched but it doesn't seem to be her spine. Back to Tramadol twice a day. That seems to work. Her back legs are still not working but I don't find any blood or mucus discharge in her pee now so I hope the antibiotic is working. We return to the vet in two weeks when they will try again to get a sterile urine sample. How can I get through the next four weeks of crate rest with these added UTI issues (no more diapers)? My husband and I are tired but not ready to give up!
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PaulaM
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Post by PaulaM on Apr 6, 2017 11:27:48 GMT -7
Hi JK, and welcome to Dodgerslist. We are a small friendly group just going by first names. Mine is Paula what's yours? I'm sorry to hear your Cocoa is dealing with another disc episode. First thing is to verify that Cocoa no longer has any bladder control. When they do have full or some bladder control they will not like you expressing and fight it and that could be the reason the stomach muscles are tightening up. Lack of bladder control means if you lift them or use the sling there can be urine leaks on you or leaking in an inappropriate place, the place where they sleep! The only way for us humans to know if there is bladder control is with the sniff and pee test. Carry outdoors best you can with a 41 lbs dog or as little walking/footsteps as possible, 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. To truly tell if a dog is peeing requires visualizing them urinate at an appropriate time and place and then feeling the shape of the bladder for a relatively empty bladder. Let us know what you observe. If there is indeed no bladder control yet, there are meds to help relax the bladder walls to make expressing easier. Diazepam to relax muscles, bladder outflow relaxation agents to inhibit the internal urethral sphincter such as phenoxybenzamine or Prazosin Are you expressing for poop? This info has great tips and video as a review on manually expressing the bladder as well: www.dodgerslist.com/literature/Expressing.htmLet us know more detail about her neuro function. Can she move her legs at all such as to reposition in the recovery suite? Do her paws knuckle under? Can she move up to a stand by herself? Nerves 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.htmWhat date were the Dex tabs started? For how many days is the 0.5mgs 2x/day before a taper started? What did the vet think the backend pain was from: anal gland pain, pain from a UTI of burning sensation when urinating? Pain because not all of the spinal cord inflammation was yet gone? Dex taper days do not work on pan ful swelling. The taper days are to test to see if Dex needs to be back up at the original anti-inflammatory dose. This info will help you better to communicate to the vet and understand his treatment and what he is saying: www.dodgerslist.com/literature/healingsweling.htm
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Post by Julia & Cocoa on Apr 7, 2017 13:07:16 GMT -7
Julia in central Vermont here. Thank you for your reply and suggestions. I thought I posted a reply to you earlier today but I may have hit the wrong button. If my post doesn't show up anywhere, I will re-write.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Apr 7, 2017 14:14:45 GMT -7
Julia, when a post is made, it will appear right away. You can see all of your posts by clicking on the blue link "Julia & Cocoa" above the dog icon on the left side of the page. We look forward to your post to learn more about Cocoa, sorry the gremlins ate your last post!
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Post by Julia & Cocoa on Apr 8, 2017 13:50:41 GMT -7
I hope I am doing this correctly now. Your feedback has helped me organize my thoughts and keep track of dates and medications. The first two weeks of this IVDD episode were mayhem and scary. I had to learn as events developed.
In answer to your questions: Dexa at 2 doses per day started March 16th and continued for one week, then tapered off with last dose April 3.
[41 lbs Dex IV on 3/15 Dex as of 3/16: 0.5mgs 2x/day for 7 days, then taper STOPPED 4/3 Carprofen as of 4/7: 50mgs 2x/day for TBA days Pepcid AC 10mgs 2x/day Tramadol 50 mgs 2x/day Sulfatrimeth 960mg at one half tab ]
Cocoa has some bladder control. Before the UTI developed I was working on getting her to pee on command after raising her hindquarters as she stood on her front legs on a pee pad indoors. Taking her outside for the sniff and pee test is postponed until I'm sure her back can handle a sling. She is too heavy for me to carry. She has fewer leaks since starting the antibiotics but will let go a lot of pee about twice a day. Tramadol turned out to be insufficient for the hindquarters pain when I tried to lift her. So my vet added Carprofen 100mg at 1/2 tab twice a day started April 7 (4 days after last Dexa). The vet did not think resuming the Dexa would be beneficial at this point. The Carprofen is working so far and I can lift her back end very gently (to clean her) without hurting her. I have tried expressing poop but my technique needs some work! She eventually poops on her own at least once a day.
Cocoa does not have use of her hind legs yet. One leg, the one that recovered well from the last IVDD episode, seems to have a little function but the UTI, vet visit and added pain meds have set her back some. She can move herself around on her bed a bit, curl her back and still has a good appetite. Tail wag has reappeared. My concern right now is keeping her clean and otherwise healthy for the next four weeks. She resists being rolled onto her back so I'm not sure I'm doing a good enough job with this. We don't want another urinary infection. I use unscented baby wipes or plain warm water to clean her behind. Is there anything else I can use to keep her fur and skin clean until she can stand to pee?
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Apr 8, 2017 16:50:36 GMT -7
Julie, thank you for re-posting your lost post and all of the good information on meds. Very glad to hear that now pain is in control Do know that both the steroid, Dex, and the non-steroid anti-inflammatory Carprofen with IVDD are not pain relievers as such. I say that because it can take 7-30 days of anti-inflammatory use to resolve all the painful swelling/inflammation. So far she had 1 day of Dex injection, 7 days course of dex pills and how many days of carprofen? It is a prudent thing to taper steroids and stop NSAIDs after a course. The taper days of a steroid do not work on painful swelling. The taper is a test for pain to see if another course is needed. No one wants to use any steroid or NSAID a bit longer than getting all the swelling down as they all carry some adverse side effects. I can well believe tramadol at such a very low dose and only 2x/day for a 41 pound dog did not control pain. If the vet had used the usual aggressvie Tramadol dose + likley 1-2 other pain meds there would not have been need for pain on the Dex taper nor a need to even be waiting for a 4 days washout before switching between the steroid and the NSAID class of anti-inflammatory drugs. What is done is done and Cocoa is in comfort. Important to understand as some dogs may have more than one disc episode in their lifetime as you have experienced. The more we know the better we can advocate for our dogs. How many days is the carprofen prescribed for? You will want an understanding of what the stop date of carprofen is used for with a disc episode. Great informative article: www.dodgerslist.com/literature/healingsweling.htmBig pain requires big pain treatment that Gracie did not get initially. A disc episode is a very painful thing. The best pain control during a disc episode, as in people, comes with multimodal pain management: using more than one approach that addresses pain from multiple fronts. Good to have this information under your belt to best advocate for her: www.dodgerslist.com/literature/healingpain.htmBaby wipes are good for clean ups. Brewing a pot of green tea and cooling it for dampening a washcloth will counter act the urine and leave a nice early fragrance. If she does not want to roll on her back, that could be a sign of pain, needing an adjustment in pain meds. Do you see any 2nd confirming signs: shivering, trembling, yelping when picked up or moved, reluctant to move much in crate such as shift positions or slow to move, tight tense tummy, can’t find a comfortable position, Arched back, pinned back ears. Holding leg flamingo style not wanting to bear weight, head held high or nose to the ground. Not their normal perky interested in life selves. Never have any patience at all with pain. When meds are correctly dosed for your dog’s body, pain is covered dose to dose and when having to move such as at potty time. It is ok if she turns by herself on her back, but I would not recommend you do that as it may be too much movement for the early healing disc. Just clean as best you can by sliding a tea-dampened washcloth or a baby wipe to remove any urine from fur or skin and around the private areas. IF you are worried about urine scald a barrier cream without toxic to dogs zinc if too much is ingested can help. Here is one: Aquaphor Baby or regular Healing Ointment contain same ingredients: Petrolatum (41%) Inactive Ingredients: Mineral Oil, Ceresin, Lanolin Alcohol, Panthenol, Glycerin, Bisabolol aquaphorus.com/categories/Stay the course with strict rest as much as possible as it is with a too heavy to carry dog. Limited movement is how the disc heals...there are no meds to heal a disc. How are you doing with expressing, does she stay dry session to session?
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Post by Julia & Cocoa on Apr 10, 2017 7:04:04 GMT -7
Thank you again, Paula, for the feedback. I did read the articles you cited. Here is where we are now in the 5th week of crate rest:
Cocoa did not seem to be in any pain when the steroid course ended April 3. She had developed a UTI. After the vet appointment April 4 to collect a urine sample and start antibiotics, she became very sensitive to being touched or moved especially on the left back hindquarters. This has been an intermittent problem for years, not obviously connected to her back but most likely is spine related. It comes and goes and I usually just avoid touching her there until it subsides. Right now I have to move her to keep her and her bedding clean. So Carprofen (no course -just as long as needed) was added to the Tramadol - both given twice a day. After two days on Carprofen April 6 & 7, the pain was gone but she had developed diarrhea. Carprofen was stopped and we switched to ▲Tramadol every 8 hours instead. After two days on this dosage Cocoa seems back to no pain when moved gently and no diarrhea. I can clean her well enough, get her to stand with support and gently massage her legs.
[41 lbs Dex IV on 3/15 Dex as of 3/16: 0.5mgs 2x/day for 7 days STOPPED 4/3 Carprofen as of 4/6 NOT 4/7: 50mgs 2x/day for 2 days STOPPED 4/8 Pepcid AC 10mgs 2x/day Tramadol 50 mgs ▲3x/day Sulfatrimeth 960mg at one half tab]
If things remain stable after a few days, my plan is to very slowly get her to stand with the help of a sling so she can move a couple of steps to pee and poop on the doggie papers. I have not learned to express her urine yet and am not sure how much control she has. She is confused and I am too but we'll work something out.
I hope all this information will help someone else dealing with IVDD to be patient, not give up and take things one day at a time. I realize we may not reach our goals but I can deal with that as long as I know I gave my dog her best shot at recovery.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Apr 10, 2017 8:32:14 GMT -7
Julia, about the carprofen, is it no longer being given, it was stopped on 4/8 after 2 days of use?
Carprofen was started on 4/6 NOT 4/7? In other words there was only a 3 day washout from the stop of Dex on 4/3 and the start of Carprofen on 4/6?
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Post by Julia & Cocoa on Apr 11, 2017 7:21:32 GMT -7
Quick update! Just checked Cocoa and constipation is over - lots of big normal poops - no diarrhea. I had added lots of fiber to her food and it seems to have worked. I will clean her up as gently as I can manage. Ah, small victories are sweet.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Apr 11, 2017 7:38:11 GMT -7
Julia, glad to hear no diarrah.
About the carprofen, is it no longer being given, it was stopped on 4/8 after 2 days of use?
Carprofen was started on 4/6 NOT 4/7? In other words there was only a 3 day washout from the stop of Dex on 4/3 and the start of Carprofen on 4/6?
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Post by Julia & Cocoa on Apr 11, 2017 10:55:46 GMT -7
Another of my posts got lost. Here is our current status:
Last Dexa 4/3 am, first Carprofen 4/7 pm with instructions 'as needed for pain, discontinue if diarrhea or vomiting' Not enough washout? Is this what caused diarrhea?
Last night while trying to change her bedding Cocoa got away from me and dragged herself a couple of feet away twisting her back. When I tried to touch her she yelped, shaking, baring her teeth. I gave her Carprofen with Pepsid and she slept quietly all night. [41 lbs Dex IV on 3/15 Dex as of 3/16: 0.5mgs 2x/day for 7 days STOPPED 4/3a.m. Carprofen as of 4/7p.m.: 50mgs 2x/day for 2 days STOPPED 4/8 as of 4/10: 50mgs 2x/day for 1 day Pepcid AC 10mgs 2x/day Tramadol 50 mgs ▲3x/day Sulfatrimeth 960mg at one half tab]
Obviously she needs this added pain med if I am going to be able to lift her once or twice a day. How long can she continue on Tramadol X 3 a day plus Carprofen X 2 a day? Does this incident mean I need to start the 8 weeks of crate rest over? Her legs seem weaker now than when we started crate rest in March and I worry about atrophied muscles. As I mentioned in the post that did not get lost, diarrhea did not happen this morning after the one Carprofen dose last night. I have not given her Carprofen today, just Tramadol plus antibiotic.
I have an excellent vet. However, she believes the dog should be put down. The closest IVDD specialist is 2 hours away and my finances are limited. My vet will respond to my questions usually within a day or two but I need more support and advice to get through Cocoa's rehabilitation as these things happen.
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Post by Romy & Frankie on Apr 11, 2017 13:34:31 GMT -7
I am very sorry that Coco twisted her back. Our dogs can do the unexpected in a heartbeat. I am not sure if you have seen this video which shows how to use an ex-pen to make clean up easier.
It is likely that the diarrhea was caused by an insufficient washout. Thankfully she is no longer having diarrhea. If you are giving the Carprofen continue the Pepcid AC.
I am not sure why your vet thinks that Coco should be put down. Her pain is under control, except for the incident last night). Is she happy and excited to see you? Does she enjoy having a treat? This is what quality of life is for a dog. I always like this video which shows how much an IVDD dog can enjoy life.
It can take up to 30 days on an anti-inflammatory before the swelling in the spinal cord is gone. Even after that a very few dogs have taken a small dose of anti-inflammatory long term. This is similar to how some people treat arthritis. The tramadol should be given 3X a day until there is no pain. Once the swelling in the spinal cord heals the pain should be gone.
I am not sure what to advise about the crate rest. It would depend on whether you see a real relapse going forward or not. If tomorrow she is as she was before the incident, you can continue crate rest from that point. If you are seeing a relapse, than the 8 weeks must start again. It does not hurt a dog to do crate rest but it can hurt the dog if crate rest is stopped prematurely. Dodgerslist always errs on the side of caution for crate rest. Any muscle atropy you are seeing will go away quickly once she returns to activity. Muscles build up fast but nerves heal very slowly.
Healing thoughts for Cocoa
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Post by Julie & Perry on Apr 11, 2017 14:17:42 GMT -7
Julia, your vet may be proficient technically but if he/she suggested putting Cocoa down because of IVDD they aren't educated about this condition and aren't comfortable treating it. You need a vet who will fight for your pup to get better. Not give up on them. My dog, Nala, has fought IVDD for 9 years and still has a good life. She enjoys treats, walks, and just went on an overnight road trip. I would seriously consider looking for a vet who will aggressively treat Cocoa and help her to fight! www.dodgerslist has a vet recommendation link on its main page. Best healing thoughts and prayers.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Apr 11, 2017 17:28:33 GMT -7
Julie, when you use the "quick Reply" area to write in (located at the bottom of the Forum page), the button that sends your post to the Forum is the "POST QUICK REPLY" white button on the bottom left. Julie, you have a less than ideal situation going on with your vet in regard to the disease, IVDD. --- Any vet who is not knowledgable that putting a dog down for IVDD is not a treatment, is not the vet for Cocoa. However, your circumstances may call for you to muster up all you have to insist on the treatment you want support for. --- It is likely that long lasting Dex may have needed the full 7 days washout AND double stomach protection of not only Pepcid AC on board but also sucralfate to try and prevent the GI tract damage of diarrhea Cocoa had. --- Choosing to switch from Dex to a lessor anti-inflammatory, having to deal with washout, stomach protection....Why???? the switch in the first place is the question! --- Now that you know Cocoa has shown one or both of these anti-inflammatory drugs cause her problem, then take no more chances. Call and advocate for sucralfate to be on board. --- The anti-inflammatory really should not be hap hazzardly given, it needs to be given on time daily to fight the pain of inflammation over the course of 7-30 days, that is why we do NOT consider it a pain reliever. Two stomach protectors on board can very likely make it possible to dose carprofen on time every day. -- Cocoa is on only one pain med. Because a disc episode has three (3) sources of pain, that is why three different pain meds are typically used. Advocate for methocarbamol and gabapentin to be added. -- The dose of tramadol being prescribed is almost like not prescribing any tramadol for a 41lb/ 18.6kg dog! The usual in controlling pain is to Rx Tramadol at the higher end of the mg range AND promptly every 8 hours which may be even two 50mgs tablets every 8 hours for Cocoa...see the references below. They are not for you to self prescribe but to able to advocate for Cocoa to get her pain in control. In this day and age there should be no debate in the veterinary community on medically managing pain with IVDD. Pain just can't be allowed PERIOD just the same as it is understood pain must be managed for human patients. Any vet that is not up with current standards of pain management is not the vet for an IVDD dog. You will have to do steady battle instead of getting support. It will make all the difference in the world to hire a more IVDD knowledgable vet if you have another in your town or a nearby one. If you are a strong person, have good persuasion skills, have done your homework, you may be able to work with your current vet present the kind of help Cocoa needs. Vets take an oath to help animals not railroad you into killing yours. Keeping a med chart can help you see the relationship of med times and pain. Have that info readily available to as feedback to the vet on what you want to see in med changes (advocating on behalf of Cocoa, just the same as you would do for yourself to your own doctor.) D/l and print from here: www.dodgerslist.com/literature/crateRRP/medchart.pdfLet us know what you are observing with that escape on the night of April 10. I hope she dodged the bullet and did not injure the early healing disc. What has her pain status been today, tomorrow?
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Post by Julia & Cocoa on Apr 12, 2017 8:07:14 GMT -7
Just spent an hour writing you all a post. Hit the 'post quick reply' button. Error signal appeared saying I was not logged in and my post was not accepted then disappeared! I was logged in. I will take a break then re- write. The summary is that I am looking for an IVDD vet and things have gone well for Cocoa the last couple of days - she is not in pain when moved or cleaned up.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Apr 12, 2017 8:18:34 GMT -7
Julia, I recommend BEFORE pressing the "Post Quick Reply" to first copy your post. That way should the computer gremlins mess up you will still have what you have written in memory and can just paste it into a new post and try again. So sorry you are having these problems....very, very frustratiing. Let us know your city in Vermont. You can also check out our member directory for vet recommendations: www.dodgerslist.com/literature/surgerycosts.htm Sometimes a consultation with a specialist even if surgery is not a consideration is to get meds right that a local general vet does not feel comfortable in prescribing. But sounds like now pain IS in control and you are looking for a new vet. A specialist could also help you through conservative treatment if another DVM is not near enough to your home in central Vermont. Check adjacent states that may still be close enough to you.
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Post by Julia & Cocoa on Apr 12, 2017 12:22:21 GMT -7
Maybe I am just not quick enough. I want you all to know I have read your suggestions carefully and taken notes. Thank you so much! I am in Barnard, Vermont in Windsor County. I have emailed my vet for a referral to a specialist. I am sure she understands and will help. Right now my Cocoa is comfortable and even playful. Tail is wagging again. I feel better prepared to ask the right questions now when I find the right vet. You have helped me a lot!
Julia
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Post by Romy & Frankie on Apr 12, 2017 13:18:08 GMT -7
Good news that Cocoa is now comfortable.
There is so much to learn about IVDD and we pet parents have to learn this when we are worried about our dogs and how best to care for them. The more we learn the better we can help our dogs.
My Frankie was paralyzed overnight a few years ago. I was in shock and I remember how much there was to learn and understand. Let us know what the specialist has to say. We will be looking forward to hearing.
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Post by Julia & Cocoa on Apr 18, 2017 15:20:50 GMT -7
Hello everyone. I have still not found any specialty vet practice closer than two hours away. So I had a conversation with my general practice vet - they will support my efforts to keep Cocoa as healthy as possible and help her regain whatever level of mobility she can achieve. I will keep reading the Dodgerslist forum and any other information I can find. I will make this work.
We are into 6th week of crate rest. A vet checkup showed her urine is now clear so the UTI is gone. Cocoa is
still on Tramadol X 3 per day and Carprofen with Pepsid X 2 per day and does not seem to be in any pain. I have ordered a Walkabout combo harness for front and rear so I can lift her by myself and help her re-learn where and when to pee - first on doggie pee papers indoors and then outside. I really hope this works! It has been difficult to keep her clean and dry and I don't want more UTI problems. I do think she has some bladder control. So I will report back after we try the "sniff and pee" test - might take a few more days. Maybe there is an Eddie's Wheels cart in our future.
Thanks for all your help. A month ago I was in a state of panic and so tired and worried. Still a bit tired but we have a better routine now and everyone is currently getting a decent night's sleep (mostly).
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Post by Joann & Baxter on Apr 18, 2017 17:13:47 GMT -7
Julia...my Baxter has had an eddies wheels for 6 months...he loves it! He zooms down the driveway every morning chasing deer and squirrels. It provides so much exercise for him. Good luck with cocoa.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Apr 18, 2017 18:36:50 GMT -7
Julie, kudos to you for strongly advocating for help with Cocoa. So glad your vet is open to supporting you and Cocoa! Good job.
Now, can you bring us up to date on her meds. See if the med list below is now what you are currently giving Cocoa:
41 lbs Dex IV on 3/15 Dex as of 3/16: 0.5mgs 2x/day for 7 days STOPPED 4/3a.m. Carprofen as of 4/7p.m.: 50mgs 2x/day for 2 days STOPPED 4/8 as of 4/10: 50mgs 2x/day for 1 day as of 4/11: 50mgs 2x/day for 8+ days?? Pepcid AC 10mgs 2x/day Tramadol 50 mgs 3x/day
It looks like you started carprofen on April 11. For how many days is the course? It's now been 8 days on 4/18.
To know if all the painful swelling is gone and no more need of any meds, then a test-for-pain stop of Carprofen and all pain-masking pain med, tramadol, is needed. This way you can accurately report any unmasked pain re-surfacing.
The hope would be now after 18 days on a combo of steroid dex days + the carprofen days, the spinal cord inflammation would be finally gone. Carprofen has serious side effects. It is good to use when there is a benefit to be gained. Once all swelling is gone, then all that remains from carprofen is the adverse side effects.
May 10th will be the graduation date as then the disc will have formed good secure scare tissue. Nerve healing may or may not self repair in the short time of 8 weeks the disc can heal in. So do not loose hope in that department... it is still early as nerves can take months to see who much they can self repair.
Do let us know what the sniff and pee test reveals.
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Post by Julia & Cocoa on Apr 19, 2017 7:38:39 GMT -7
Thanks Joann and Paula, for your replies. Joann, I've been in touch with Eddie's and they would welcome a visit to measure and evaluate Cocoa whenever we are ready. They seem like great people to work with.
Paula, your meds list plus dates given to Cocoa matches my notes. I will try a medication stop as of this evening (she has had the Tramadol plus Carprofen/Pepsid this am 4/19).
41 lbs Dex IV on 3/15 Dex as of 3/16: 0.5mgs 2x/day for 7 days STOPPED 4/3a.m. Carprofen as of 4/7p.m.: 50mgs 2x/day for 2 days STOPPED 4/8 as of 4/10: 50mgs 2x/day for 1 day as of 4/11: 50mgs 2x/day for 8 days STOPPED 4/19 Pepcid AC 10mgs 2x/day STOPPED Tramadol 50 mgs 3x/day STOPPED]
Tomorrow I expect to get the rear and front harnesses and I'll see how she responds to going a few steps and being off meds. She is not stoic and will let me know if anything hurts. Earlier, I tried a towel but that slipped out of my hands and a homemade sling didn't work at all. Her little butt needs some fresh air! I did get the Aquaphor ointment. I amazed at how much I didn't know before about that end of my dog.
My last vet visit to check Cocoa's UTI went well but I really should have asked about her meds - I was so happy to hear about the urine results I forgot to ask. We did discuss ways to prevent that happening again and also issues related to my 15yr old Border Collie/Keshund mix - Paula, you are good at keeping me focused.
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Post by Julia & Cocoa on May 2, 2017 10:20:18 GMT -7
Just an update here on Cocoa and her human. After a few unsuccessful attempts at stopping pain meds to see if she still needed them, I was able to discontinue both Tramadol and Carprofen (Carprofen on hand if needed). Cocoa now on Gabapentin 100mg per day given in the evening. This has worked to calm her anxiety during clean up/skin inspection before bed and lasts long enough for the same morning routine. She sleeps all night and does not seem to be in any discomfort during the day. Having paralyzed back legs makes this cleaning routine important to keep her healthy. I have tried to use her new rear harness to go for short pee breaks but she hates it and tries to run away (front legs are strong). Expressing poops twice a day works ok. I am trying to encourage a pee routine 4 times a day indoors on pee papers - we need more practice. We have an appointment with a PT who offers acupuncture and home therapy advice. And an appointment with Eddie's Wheels. Heading into week 7 we are getting into a routine - what a difference from a few weeks ago. Dodgerslist folks have been a great help so thanks to everyone who has responded to my posts.
[41 lbs Gabapentin 100mgs 1x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on May 2, 2017 10:38:30 GMT -7
Julie sounds like things are settling into ago routine for all. Before any least aggressive range of motion PT would start it is normal to be off all pain meds (gabapentin). The 100mg dose 1x/day is like not giving any if it were for pain AND you are not reporting pain during the day when gabapentin would have worn off. What specifically do you observe that shows she anxious that gabapentin is solving as an aid to keeping her clean? So here is the type of least aggressive passive PT to begin and do until she is off of crate rest (graduated on May 10) The information in PINK applies to paralyzed legs during conservative treatment: www.dodgerslist.com/literature/massagepassiveexercises.htmAt graduation day, then you can begin a gradual intro back to active PT safely as the disc has healed (see in the video below)...do check it past your PT person. There area very useful therapies like underwater treadmill if available in your area. On graduation day do let us know we can offer other things you can do at home. Appropriate physical therapy can help maintain the muscles with lost nerve connection. Therapy keeps muscles in optimal condition while in wait
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Post by Julia & Cocoa on Sept 3, 2017 16:08:01 GMT -7
upload image gif Julia here. Just wanted to update our adventures from spring 2017. Cocoa finished her 8 weeks of rest, got a wheeled cart from Eddie's Wheels in Shelburne, MA and, after a slow start, enjoyed two months of being mobile even without the use of her back legs. Gradually, those paralyzed back legs began to move again and we were able to remove the stirrups supporting them. Eventually we switched to using a GingerLead sling for short excursions and the cart for longer ones. Her legs, bladder and bowel control continued to improve. By mid-August she was able to walk without assistance, although her gait is still wobbly. No more steps, stairs, jumping up or down or rambles through the rough woods, but short walks on open terrain or maintained trails work fine. I carry the sling to use in case Cocoa gets tired or the ground is too uneven. Thank you to all who offered support and advice back in April and May. I hope we don't have to go through this ever again but, just in case, I am holding on to my 'conservative rest' supplies and my Dodgerslist address.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Sept 3, 2017 17:35:37 GMT -7
Julia, thank for the update. We always wonder how one of the Dodgerlist family is doing. So glad to hear Cocoa is now able to wobbly walk!
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