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Post by Rob & Oliver on Jul 23, 2017 8:22:37 GMT -7
Great idea about leash clip. I have an extra leash and it's better if I move him into the pen rather than carrying him and leaning him over. Will be a gentler landing. As for me, that's good advise. I'm truly a nervous wreck with all the details in my head. Remember, I'm also dealing with his anal condition which is also a chronic lifetime condition so this adds an entire additional layer of concerns
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Jul 23, 2017 8:29:36 GMT -7
Rob, if we can have a better understanding of his anal challenges for you, then maybe we can offer better comments. What is the typical for you when caring for his flacid anus?
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Post by Rob & Oliver on Jul 23, 2017 9:25:56 GMT -7
LET me leave that question to the side for a moment.
I am FURIOUS. Been speaking to Blue Pearl on and off since 10AM, DR. Levitin was specifically going to come in today (this was our in person conversation yesterday) to meet with me and, provided remained stable, he would go through all of the discharge issues. But they told me that he [DR. Levitin] is now NOT going to be coming in and so I can't get any sort of proper discharge from the neurologist and go through the many many question I had. So after calming down through a friend, I consigned myself to the state of affairs and told them that I'll accept what's happening, and meet with Levitin tomorrow at 10am for the full discharge. But I wanted to talk to the finance people as I wanted a reduction in my fees for today as the reason he can't be properly discharged --as I kinda feel it would be irresponsible of me to not get the real deal discharge -- is because the Doc apparently decided he wants to enjoy his Sunday and not deal with work stuff. Which I can understand, but then he shouldn't have promised this to me yesterday. So the YOUNG office finance guy (doing this for 4 years) starts trying to explain to me, "well, but he is still getting the nursing care and inpatient care so we can't take anything off the price". So as a lawyer in a service profession for almost THIRTY years, I start explaining to him what it means to be in a service business, etc., and realized as he was young and brainwashed from independent thought, I just asked him for his supervisor and told him to call me to discuss.
Does anyone have any reactions to this? the propriety of providing some compensation since he doesn't NEED to be there anymore? He kept saying, "Well you can come and we can discharge him", which infuriated me even more a finance admin dude cannot give or provide and should not give or provide medical advise and whether and on what terms a medical discharge happens should not be part of the discussion with finance. I need to cool off....
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Jul 23, 2017 10:04:35 GMT -7
Oh, gosh, Robert, I'm so sorry this additional infuriating stress has landed in your lap. If you are OK with a Monday discharge, that is good. The key to taking him home today if that were your wish are a couple of things. ~~ The meds to be used at home since he has by now been transitioned to oral pain meds ~~ The hands on top of your hands expressing lesson by a vet, a vet tech there. ~~ A copy of his file, if you can get it. I can always get one from my own vet to include in my at home file after each visit. This way I have all the info at my finger tips.
Then on Monday look for a phone consultation or a trip for a face to face where you ask all of your questions to the neuro. Perhaps the Dr. will have heart and recommend a discount on your behalf?
Blue Pearl might be like City Hall in fighting battles. Being a large business enterprise, you may not get anywhere with a discount without battle stress. Then you have to consider your neuro who is the head of this department, did you say? What strain on your good working relationship will that cause?
Discharges on a Sunday can always be problematic. If you would want help, say in expressing, it's a long trip back and your local DVM vet is not open...so that would leave expensive local ER vet to help you.
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Post by Rob & Oliver on Jul 23, 2017 10:46:28 GMT -7
Exactly, you it the nail on the head, "the good working relationship". Which is why I want to keep this away from my neurologist and just deal with billing and admin.
CALL JUST CAME IN FROM BLUE PEARL: So speaking of advocating, the head of the finance called me back, the supervisor of the younger guy, and in 5 minutes totally understood and agreed with my point cut fees by 50% for today, which is fine, but more importantly, I just wanted a human discussion. So, Paula, apparently, if you ever need someone to fight City Hall for you, you know who to call. (-:
I also shared with this higher level admin guy that the junior finance guy was basically "providing medical advise" by claiming Oliver could be discharged without a proper discharge meeting with the appropriate staff and that really clicked for him. I wanted him to hear from me that that is highly inappropriate. He agreed and said "Im certainly going to deal with that."
So, I'm going to have a soda and relax. I feel like I've been battling all day. GEEZ. Thanks for ur support. Oh by the way, I've been meaning to tell you, your dachshunds looks GORGEOUS but I in particular love the name RosieToes. Super cute.....
Oliver returns tomorrow....
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Post by John & Marley on Jul 23, 2017 11:11:11 GMT -7
Not sure on your budget, but I found this Awesome Crate Wood and Metal BEST CRATE OUT THERE.- Has a removable Lid , Has a side door, has wheels so he can be moved from room to room ( where a xpen cant ) Best of all it can be unclipped from its wheel base - and the sides still connected can be placed out side like a xpen - which helps - so you can clean the bottom of the crate ( Plastic ) I personally use fleece as a bottom on the plastic cause its absorbs fluids , very soft and I have a few on hand ez to change out and not have to wash and wash and use pads.. ( but thats my twist on it ) Not sure the size of your dog 25.2 long X 18.1 wide I got my guy the larger pen 36.8 Long X 24.2 Wide My guys weighs 19 lbs and the larger crate gave him room to stretch out completely, room for a bolster at one and a elevated water bowl out of the way as well as being Fed, . I think I have a video on this Dodgerslist showing him eating. Just make sure your dog when fully stretched out he has room to not touch ends of crate . Being able to move the rate on wheels helped my dogs state of mind , he rolled from room to room to have constant interaction. I got it on Wayfair delivered free shipping great $$$ in less than a week. www.richellusa.com/product/mobile-pet-pen-640/#fst-point-5Video below from Company shows how it works :
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Post by Rob & Oliver on Jul 24, 2017 9:43:22 GMT -7
Okay, so here's the story. Right now, my little boy is to the left of me -- IN HIS PRECISION CRATE -- and staring at me like he's Prisoner Number 02272009. That's his birth date btw. LONG story short, if you've been following along (and I know Linda, Paula, Rony and Paulina have been -- if I forgot anyone, my apologies), I was to meet with my Neurologist at 10AM today and, provided he was still stable or better, I would take him home and do the conservative method here. SO WHAT HAPPENED WHEN I ARRIVED TODAY? Oliver was WALKING around. Not just a step or two, but walking around, a bit wobbly on his right side, and stopping to sit at times, but fully walking, well, and on his own. AND, as soon as the tech and doctor carried him into the room where I was, HE WAS WAGGING HIS TAIL (Paula, I beat you to the capital letters button). (-: In all seriousness through, I feel this is a really textbook case for this site in strong advocacy and knowledge to be able to veritably compete with the more pro-surgical bent of a neurosurgeon or animal hospitals in general. I could have easily gone for surgery based upon the significantly reduced movement of Oliver on Friday and how earnest the well-intended doctor was in promoting for a surgery. But he was night and day from Saturday. WOW. I was stunned. He is now on Rymadyl, 25MG, 1/2 pill every 12 hours. Liquid Gabapentin, 50 MG/ML; 1ML 2-3x/dy for pain. Also on Metronidazole, 250MG tabs -- 1/4 pill 2x/dy, and the Pepcid of course [Moderator's note: please do not modify 15 lbs Relapsed disc on 7/20 true crate rest started on 7/21 Rimadyl as of 7/21: 12.5 mgs 2x/day for ? days, then test for pain stop Gabapentin 50mg/mL: 50mgs 2 or 3x/day Metronidazole 62.5 mgs 2x/day Pepcid AC (famotidine) 20 mg tab: 6.6mgs 2x/day] I am so glad I did what I did, and now he's home. IN H IS CRATE. But now I have to get that all right. I think he made need the next larger size. He can fully stretch but barely. So I'm going to only open crate to feed him 2x/dy, and take him out to my make shift indoor potty area. I don't think I need to buy that rear-harness thing, and am wondering at what point should I start carrying him in his carry bag outside to take a few steps and try to pee or poop outside, but am not going to consider that for at least a few days and see how his movement is. Thoughts on this all please? He is NOT happy in that crate, not sure how I can make it more comfortable for him. Thoughts please??? Paula, am going to send you Oliver's photo in jail (yes I know, it's not a jail) and ask you to put it up into this post. Have been a bundle of nerves. I can't believe he was walking. HE's looking a bit anxious in the crate, not sure, I think he may need a tad more space or perhaps the way the towels etc are. Oh, he ha been having diarrhea and that's obviously a concern. (a) I don't want him sitting in it ever, but also (B) he has a condition in which he will always have a butt/poop issue so I need to make sure the texture of his poop is such that it can come out fairy easily, otherwise he needs to be manually excavated. This condition is a longer post, I can explain in further detail another time. Too tired from a long morning. Thanks. Rob
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Jul 24, 2017 10:27:27 GMT -7
Rob, the diarhea is likely do to the Rimadyl. The antibiotic, Metronidazole, is to help settle his GI tract. The root cause of the diareah can be the extra acids of stress being in the hospital away from home and the extra acids Rimadyl will cause. Can you advocate via phone to get a 2nd stomach protector on board. SUCRALFATE ~~ works in a different way to protect. It forms a gel coat over any areas of the GI tract that have been disrupted. ~~ You will need to read to know how it is timed with food, with Pepcid AC AND to know why you are advocating for it. Good veterinary information: marvistavet.com/sucralfate.pmlWith Oliver's other poop issue, it may well be a good idea to get a probiotic on board to help repopulate soonest any reduction of good bacteria in his gut that the antibiotic has killed. It won't hurt and may well help. Which ever probiotic your vet has on the shelf you can get today is fine. The theory is you are just trying to outnumber the bad bacteria with any of the good bacteria. Forti-Flora is just one brand among many.
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Post by Rob & Oliver on Jul 24, 2017 10:54:01 GMT -7
Paula -- Just spoke to the doc. Their response was precisely as your first paragraph states; that it is likely from both the Rimadyl and fro being out of home and in a stressed environment. But they consider Sucralfate is primarily for ulcers and they didn't consider Oliver as having one. They said 'lets see how he's doing tomorrow after the readjustment of being home", and I actually don't have a problem with that. From where I was Saturday, being as close to consenting to IVDD surgery as I've ever been, to now, where the chief concern at the moment is diarrhea and being a bit messy, Im fine with leaving it a day. HE's in no discernible distress.
In fact he's lying down sleeping in his crate; And in discussing the size of my crate issue with the doc, she said that as long as he can stand and turn if he so chooses, then it's the proper size as we want to confine his movements, strictly, something I know is a cornerstone of DL advise, right?
Note: did just have second call with the dr who called in as I was writing this and she said he was only on 5MG of Pepcid ONCE A DAY and I asked to increase that to 10 and she was fine. But for this particular drug and from what you know, I actually want to defer to you, Paula, you tell me the dose of that and I;ll do that. Shouldn't it be 10MG 2x/dy?
Question: In looking at the earlier posts about setting up the crate and putting the cushions in a plastic garbage bag, can you explain the purpose of that? IS that to make it easier for him to move around from the cotton towels he's sitting on, covered by a loose wee wee pad? If he has diarrhea for a day or two or so, I'm obviously going to be doing my fare share of cleaning, so I want to make this as easy for me as possible as I'm under enough stress.
Just had to clean his pen area. He peed quit a bit and also has poop leaking a bit, so I took him out of the crate, cleaned the area and put him back. Is that about what to do?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Jul 24, 2017 11:10:58 GMT -7
Rob, you have reported the best news ever. What you have witnessed is the power of doing 100% STRICT rest 24/7only out for a very, very few footsteps at potty time. STRICT crating is how the disc is protected from worse damage that can spell disaster to the spinal cord and avoid a surgery. I can imagine your surgeon may have envisioned worsening neuro function if there is true crate rest is something to give serious consideration to a surgery. So there is not a right or wrong choice, it all has to do with the IVDD comfort level of the owner and finances play a role too many times. If Oliver is OK about peeing/pooping in your ex-pen enclosed potty place inside the house, that would really ensure he is not moving his back any more than absolutely necessary vs. having to make a that trek you have to get outdoors. My red-pawed RosieToes sends best wishes to Oliver for a smooth recovery. I send the same! There are some very excellent ideas for "emergency crate training" to help Oliver relax and feel comfortable in his new recovery suite. Browse this link for the things you can make work for Oliver: www.dodgerslist.com/literature/EmergencyCrate%20Training.htmBeing able to fully stretch out his legs during next 8 weeks is an important thing. If the new crate is too small, it has not been wasted, as it will serve as a good transport crate for a vet appt during any disc episode. You have had some very stressful days and you have accomplished some big things of a good negotiation with Finance and learning more about IVDD than you thought you would ever need!. Just so you know you ARE on my list should I have an occasion to fight city hall here in Montana! LOL Wth walking and bladder control confirmed, Oliver is really a very good candidate for conservative treatment with your continued commitment for the next 8 weeks. Time now for you to relax in Oliver's presence to show his through your body language, your voice that things are as they should be. Oliver is a smart boy, he watches your every move to know what his pack leader feels. Every time you see him lying down or quietly sitting with his butt on the mattress, give him praise for being relaxed in his suite. Lots of happy talk, hugs and kisses when you take him out every 4-6 hours (or more til the diarreah is under control). Cleaning up you may need to cut with scissors any fur around his butt for easier cleaning with baby wipes or Marjorie's good tip from our supplies list page: Boil and cool decaf green tea to dampen a washcloth, neutralizes urine on skin and fur to avoid rashes from urine scald + clean earthy fragrance. Use white vinegar in a spray bottle to kill the bacteria and the odor they cause on floors, linens, carpets, etc.
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Post by Rob & Oliver on Jul 24, 2017 11:23:45 GMT -7
Thanks so much, Paula. You've really been super on top of my situation and I am indebted.....So, gonna go try to relax and eat something that's not take out as this last week has put my own self=-care way out of wack. now that he's here and under conservative treatment, its just about refinement. And you're right, the bout taught me a number of new lessons about the condition.
Oh, so question: His rear is already pretty raw to where they were using DESITIN, and I don't want to irritate that area when I have to clean him every few hours as even the nice organic normal handywhipes I feel are too abrasive, so what's the most gentle way to clean his butt and areas as he messes himself a bit??
Missed one question from you, as for using potty place , so far (and he's only been home for less than 3 hrs), he's been doing his business in his crate not in my potty area. And then I need to clean him up
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Jul 24, 2017 12:19:23 GMT -7
Pepcid AC should be at the aggressive end of every 12 hours with a disc episode! There are stresses even at home of not able to do his normal routine (he is in his recovery suite) and also the on-going Rimadyl. For a 15 pound dog 0.44mgs x 15 = 6.6mgs famotidine. You can round Pepcid AC down to 5mgs if splitting down a 20 mg tab. The mucous stomach lining is at risk when there are too many stomach acids. When you see one red flag sign (diarrhea) to us that is enough to double protect, we follow the proactive vets on this topic. So hope you do see a quick turn round of the diarhea firming even by later today. As long as he is not licking the toxic zinc in Desitin, that is a good barrier cream. NO ZINC product: Aquaphor Baby or regular Healing Ointment contain same ingredients: Petrolatum (41%) Inactive Ingredients: Mineral Oil, Ceresin, Lanolin Alcohol, Panthenol, Glycerin, Bisabolol aquaphorus.com/categories/Use the baby wipes in a blotting/ absorbing motion or dampened with green tea wash cloth to blot (not rub). Rinse cloth, repeat with dampened green tea til skin/fur is clean. Trim his fur (butt, thighs, etc) where needed to make clean up easier. So this diarrhea happened a day or so ago at the hospital, and it has not yet started to turn around when they started Metronadazole in the hospital. Now they say wait still one more day to see if Metron is gonna work?? Usually you would expect an antibiotic to start turning things around for a UTI in 48 hours, just a guess that might be the same for a GI problem they are thinking this is? LAuNDRY The trashbag covered mattress is to keep laundry down and protect a more expensive foam mattress. Actually for 8 weeks, consider avoiding pressure sores with what is used in hospitals --- memory foam. It's impossible to get urine out of foam, it needs protection. Memory foam available at upholstery shops, at fabric store and on-line. Some have found a memory foam pillow fits the recovery suite well, you will just have measure and decide what size works. Check our supplies list for some links and ideas about foam. It saves you a TON of work if you set up the mattress as explained. 1. Mattress in trash bag 2. Place a pee pad on top of mattress enclosed bag. This helps to absorb and hold any liquids (urine, diarhrea). 3. Place a synthetic fleece bottom sheet you have cut out of yardage from the fabric store or from a synthetic fleece blanket or throw. Fleece does not ravel so no need to think about any sewing. With this set up the bottom fleece sheet fleece is tucked around keeping everything in place. The bottom fleece sheet has wicking properties to keep moisture from the skin/fur. Then the pee pad below is designed to absorb and hold liquids. Cotton products are the opposite they hold dampness against the skin. They are a pain in the butt to wash and dry taking too much time. Synthetic (polyester) fleece (alpine fleece, Berber fleece) will wash and dry in a jiffy. Click to see synthetic fleece so you know what we are talking about here: JoAnn Fabric store JoAnns may be in your neck of the woods or on-line. Just about any fabric store carries synthetic fleece. Usual width of yardage will be 58 inches wide. You buy as many yards are you want and cut to fit his suite. Have several of these "bottoms sheets" on hand to make for quick changing of bedding. Make sure Oliver is safely contained in the fenced potty area while you are cleaning and changing his bedding.
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Post by Rob & Oliver on Jul 24, 2017 13:51:01 GMT -7
Just fed him. gave him his rimydil and Pepcid. I am burnt wiped for the day. this has been a lot. ill have to study this crate setup further as frankly I don't understand some of it. I'm also thinking of buying the 6 inch longer crate to allow him to fully stretch out unencumbered. what do you think?
Do I need to be checking on him all night? I'm exhausted, will be asleep from 10 to 6 or so. Should I be taking him out of the crate every few hours to stretch his legs etc or no?
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 24, 2017 16:40:10 GMT -7
Go to sleep, Rob, and get a good night's rest. You need it. Oliver will probably sleep all night, too. And no, you don't want to take him out to stretch his legs. Only out of the crate for potty time and then back in the crate. Feed him inside the crate, too.
When you're rested, please let us know tomorrow how you're doing expressing Oliver. Did you get a lesson from the hospital techs or vet?
From the photo you posted of Oliver in the crate, it looks like just the right size crate and he looks very cozy. As for the toy, does he play nicely with it - doesn't shake it with his head? If he tries to "kill" it by shaking it, then it will unfortunately have to wait until after crate rest is over.
Rest easy tonight. You accomplished so much today.
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Post by Rob & Oliver on Jul 24, 2017 16:48:27 GMT -7
Hey Marjorie. Thanks for the response. I've removed the toy earlier today. Tight enough in there without him. Good to have permission not to have to be taking him out to stretch etc.
Doctors did give me a PT regiment of stretching his legs all around, GENTLY, 3-4 times a day for 10 minutes. Where do you guys stand on PT?
And I've scheduled his first house call from holistic wonderful vet who does laser and acupuncture.
As for bladder expression lesson, I was prepared to get that today when I picked him up but the doc for the first time made clear he has full bladder control now so didn't do it. Most concerned about his rear and his pooping.
Question: when I take him to his fairly small potty area, which has Old pee soaked wee wee pads, he doesn't do anything. I just don't want him to be peeing and pooping in his cage too much.
And thanks for "you accomplished so much today". I feel that way as well. I really navigated the system, his condition, the doctors, the hospital, and got what I wanted, no surgery. Thank gawd.
Heard him moving about, checked on him. He peed pretty good through his wee wee and towel so I took him out, replaced the towel and pad and returns him. He literally won't look at me, that's how annoyed he looks. )-:
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Post by Pauliana on Jul 24, 2017 22:49:44 GMT -7
Hi Robert,
Soon as you can get some synthetic fleece to use in Oliver's crate.. Towels will hold the moisture against his skin and cause urine scald. Fleece resists wetness and they dry in a jiffy. Tyler loves his fleece blankies and I have quite a few of them.. As Paula mentioned you can get them at Joann's Fabrics and most likely other Frabric stores carry fleece yardage, but they are also sometimes available at drug stores and our Kroger Grocery store carries them sometimes and Walmart has them too..
Most Doxies like to burrow under fleece blankets also..so Oliver may like that too..
Hope you are getting some rest.. It takes some adjusting to get used to having a pet patient.. It's a whole new routine to get used to but you can do it, as we all have.. I still think about those early days 4 years ago when Tyler was first diagnosed.. It was a lot to take in all of a sudden and I too was in a panic.. Dodgerslist was there for me when we needed help and we will be there for you Oliver too..
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Post by Rob & Oliver on Jul 25, 2017 4:02:48 GMT -7
Hi Paulina. Yes, got some rest and feel a bit calmer. Ish. Okay, so the fleece goes where? Above the bed and below the wee wee pads? I've just been laying the wee wee pads on top of the towels (to be replaced by the fleece blankets I just ordered from Joanne -- of the movie Jaws, they had little else ) but after a while they're all moved around and not even under him. What am I doing wrong?
Okay, so, last night and this am: twice last night, first about 3am, I heard Oliver whining and even barked once. He used to bark to me when in the living room (I'm in adjacent bedroom) when he pooped in living room, wanting his place to be a bit cleaner. I checked that and he did have a few tiny areas of poo having come onto his pads but a very little. So I cleaned the setup. Then a little while later he did it again. I thought maybe he needed his Gabapentin as prior to 330am, his last dose was at least 10-12 hrs earlier and thought it would also help him sleep so so I gave him a dose and he went to sleep. No more barking.
Woke at 6:30-- again was a tad messy at his butt area but much lesss swollen than when I left the vet (put Bacitracin on him),but he needed a good cleaning --NOT A BATH -- so I first got him to take his Mexa, Rimydyl and Pepcid (should the Pepcid be spaced apart, I thought I remember something about this from prior episode), then gave him some of his food and he ate it. Just drank some of his water. I put him in his potty area but he's not doing anything when I out him there. I do feel he's got a real poop cooking and needs to defacate a decent one. Does anyone have an objection to carrying him downstairs and letting him walk a few steps to try to poop or should I just keep him inside, in the potty area he seems not to want to use, and just clean up messes for a period of time?
Thanks.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 25, 2017 4:50:40 GMT -7
Hi, Rob. Glad you were able to get some rest. Please - NO PT while on conservative care. The less movement of the spine, the better. Oliver can move around to re-position himself in the crate so that's enough to help keep his muscles and joints toned. Gabapentin has a short half life and doesn't work efficiently unless given 3 times a day. So be sure to give that to him every 8 hours so no pain arises between doses. The Pepcid should be given 30 minutes before the Rimadyl. You do need to try to express his bladder today. It's really not healthy for the bladder to be allowed to overflow. If you need to take Oliver back to the hospital to get a hands-on-your-hands lesson today, be sure to pad his crate out well so he doesn't jostle around too much when you turn corners or stop the car. Please let us know how you make out this morning with expressing his bladder. Here's more info and tips on that again for your review: www.dodgerslist.com/literature/Expressing.htmSince he's had diarrhea, he may not have to poop for a day or so, his system may have been cleaned out. But yes, you can carry him downstairs and allow him very, very few steps (3-5 steps) to do his business. He'll need a harness and short leash. Stand in one spot to control his steps. Use a sling to support his hind end if he's still wobbly. Every few days, you should take him to a spot where he or another dog has peed before, support his hind end but not under his belly, let him sniff and see if he can release urine on his own (brain to bladder connection and not just overflow). That way you'll know if bladder control is returning. It will get easier, promise. You just need to find a routine that works for you and Oliver.
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Post by Rob & Oliver on Jul 25, 2017 5:21:13 GMT -7
As for no PT, The Neurologist specifically told me to move his legs, so I'm going to check with him as well. His crate really doesn't provide him the ability to move around, I suppose he can "reposition" himself, but wonder if that's ample?
As for bladder expression, I thought he doesn't need expression if he has bladder control, which he does? I really can't go 60 blocks for an expression lesson with him; I don't want to put him through that. I just called my local regular DVM who is quite good as a general vet and knows Oliver's conditions. I asked if they would do. house call and I believe they would. I've also asked her to call me anyway just to discuss some of these issues.
This dog is such a brat (dachshunds), so I elected to give it a shot and carried him downstairs in his nice carry bag, and lifted him onto the street, and he really wouldn't move. For Oliver, that is the first indication of any IVDD feeling so I see he's in a very delicate state and just came back up. I think its' more important that his back starts to heel than peeing outdoors. I also noted that Oliver being out on a NYC cement street is different than taking some steps on my plush shag carpet as the cement has no pliability for him. I noted when I took him out of his crate that he really didn't feel comfortable moving/walking AT ALL. So I think he knows even better than me how he feels -- if you can read the signs -- so that experiment is done and I[m going to keep him indoors for some time.
Good point about the pooping, may not have to really go till tomorrow.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 25, 2017 6:00:33 GMT -7
If Oliver has bladder control, then no, you don't need to express him. I know they told you at the hospital that he had control but I also was told that my Jeremy had bladder control when he was discharged from the hospital but he most definitely didn't. From what I've read, unless I missed something, he's been urinating in his bed but not on the pee pad. Unless you've seen him specifically try to squat and pee in his bed, then it's likely bladder overflow that he's doing in his bed. The bladder fills up to the point where it can't hold any more and then spills out. That can stretch the bladder out of shape and can lead to urinary tract infections. When a dog has bladder control, he usually will try to hold it until he's in a potty area outside or on a pee pad and will not urinate where he sleeps. Finding wet bedding or leaking urine when picked up indicates loss of bladder control.
When you say that Oliver wouldn't move when lifted out onto the street and that you see he's in a very delicate state, do you mean that you think he has pain? If you feel he still has pain, then his pain meds aren't quite right yet. Gabapentin is a medication used for nerve pain. Tramadol is the general pain med that we usually see prescribed. Also Methocarbamol can be added - that works on the pain of muscle spasm. Not wanting to move is a sign of pain so if you feel he has pain, please contact the vet this morning to alert them of the pain so the meds can be adjusted. Pain does hinder healing so have no patience with it. It can sometimes take a few adjustments of pain meds to get them right.
As for the PT, in order for conservative care to be successful, the spine needs to be strictly restricted from movement. Moving the legs causes the spine to move, which can prevent the torn/ruptured disc from healing or can cause the damage disc to tear more, resulting in more pain or possible nerve damage. A lot of vets are trained to treat IVDD with surgery and are not really familiar with conservative care. They become concerned about loss of muscle tone while on restricted crate rest. Muscle loss does occur but it comes back quickly, within weeks, once conservative care is over and movement is gradually reintroduced. The priority right now is to protect the spine from further damage.
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Post by Rob & Oliver on Jul 25, 2017 6:18:05 GMT -7
Will not do PT. I'm with you.
as for Bladder control, he has not been dripping at all, but yestrday afternoon he peed on his bedding pretty good; I was not able to watch to confirm he squatted however.
Dont find him to be in pain. I have TRamadol so if I consider him to have any pain signs I;ll call the hospital and administer.
He is not happy in the crate.
Question: How often each day should I take him out of crate and over to potty area where he won't go?
Now, he's barking as he wants to get out, and whining. I walked by him so as not to support that. But I'm worried
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Post by Rob & Oliver on Jul 25, 2017 8:12:10 GMT -7
Totally losing it. He was whining and barking before, wanting to get out of the crate. It is soooo hard to hear that. I'm also now concerned about the liquid Gabapentin I have which they said was chicken flavored. I tasted it and it's fairly bitter, almost sweet. Definitely not like chicken. But rhe problem is when I squirt it into his throat he abhors it and pretty violently shakes his head which is really bad and something we don't want so I've already called the hospital to speak to the doctor about it and am waiting for the call.
But rally losing it with fear for him and feeling super overwhelmed with all the things I have to do for him.
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Post by John & Marley on Jul 25, 2017 8:41:43 GMT -7
Never been a fan of liquid meds. I gave my guy GABAPENTIN in a pill / soft chew form Id asked about getting it that way. Giving Pills - My guy got wise , so I would get 3 - 4 marble size soft treats ( in his case his RAW FOOD rolled up in a ball ) give him 1 ball ,then another ball then in ball # 3 was the pill and ball # 4 nothing he would just woof it down If i tired one pill in one ball, he'd spit out the pill, boom booom right after another, greed( PIGGYNESS) on his part got him to woof it down... Good Luck
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Post by John & Marley on Jul 25, 2017 9:01:29 GMT -7
Robert, It is a nightmare at times, juggling meds, timing his P's + Poos, a good worksheet with timetables will help some. Conservative Treatment works, Ive done it 2 times in 3+ years- unless the dog has no sensation and the Surgeon says surgery is a must, CONSERVATIVE can return a dog to normal. Must remember no short cuts , no giving in , no feeling sorry, he looks better he is moving,,, blah blah blah,, 8 Weeks not 7, not 6 not 5, I have had Vets say only need 4, Not going to work from my history. the damaged tissue - NERVES SHEATH needs time to heal. Each time you feel guilty and give your dog freedom, time out sniffing on grass , lolly gagging more steps then needed you risk the tissue tearing again. use a sling for support. First time with my dog he was walking gingerly and so I let him walk in and out of house maybe 20 steps,, did biz came in, each time after for next 2 days he tried stepping in his bed and got worse , then didnt want to move, <MY BAD> Total House Arrest after. Carried in P- In crate - no couch time no bed time picture it as time in a cast when you break a bone. its only been 5 days, after 8 weeks it will seem like a bad dream - now its a nightmare a year out youll think what a learning experience and do things to limit risk factors for future.
{ I noted when I took him out of his crate that he really didn't feel comfortable moving/walking AT ALL. So I think he knows even better than me how he feels -- if you can read the signs -- so that experiment is done and I[m going to keep him indoors for some time. }
Dont let him dictate his recovery.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Jul 25, 2017 9:09:22 GMT -7
Rob, the first week at home is getting the routine down. With a routine your brain doesn't have to concentrate on every little thing as you are having to do now. CALMERS Oliver may need a calmer to help him relax in his suite. For today, you may need to call in and get an Rx for Trazadone or ACE for immediate help. Calmers below may then be implemented and likely work for Oliver. Using any oral calmer in combination with a Pheromone diffuser seems to work best. It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid long term heavy duty prescription sedatives such as ACEpromazine , Trazodone, etc. Of course always keep your vet in the loop on all things you give your dog. Other product brands may be available in your area or on-line… just shop by the active ingredient(s) on the label and the quantity for best price. Place a DAP pheromone diffuser at floor level where the recovery suite is. Some brands to consider: --Comfort Zone (DAP) wall plug-in diffuser 48ml www.drsfostersmith.com/product/prod_display.cfm?pcatid=13043 --Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/Use a diffuser with one oral calmer from below: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed www.virbacvet.com/products/detail/anxitane-l-theanine-chewable-tablets/behavioral-health 2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. www.vetriscience.com/composure-soft-dogs-MD-LD.php POTTY TIME Begin by taking him out of his suite every 2-3 hours after his last accident in the crate. This is trial an error in timing and you are dealing with diarrhea AND we are uncertain there has been proof of bladder control. You may need to give him a potty/poop break sooner if he is not staying dry/clean in his crate. Priority for today. You will need to observe that he has the ability to sniff an old pee spot, look for him attempting to lower his body to squat and then watch for him marking/releasing urine. The surgeon may not have observed for himself this kind of proof and is relying on bad information from vet techs...this has happened confusion over what is an "overflowing" bladder due to reflex VS. actual brain messages going to the bladder that say hold it in until in an appropriate place. To most dogs an appropriate place is not where they sleep. Dogs abhor having body waste in their beds, it usually causes them great anxiety. Why overflowing is a bad thing. Overflowing releases only some of the urine. What's remaining quickly becomes a breeding ground for bacteria (urinary tract infections). 2nd reason is overflow does not happen til the bladder wall is overstretch to kick in reflexes. Too much overstretching ruins muscle tone of the bladder where it won't function properly when brains messages to the bladder reconnect. A dog who is overflowing MUST be manually expressed. DIARRHEA Have you seen any evidence that whatever bit of poop comes out, is going in the firmer direction? PAIN MEDs The time to back off or stop pain meds is when there is the test-for-pain stopping of Rimadyl. What does your Rimadyl bottle say? How many days is the Rx for? Rimadyl as of 7/21: 12.5 mgs 2x/day for ? days, then test-for-pain stop Until then with a painful disease, one ought to assume there is pain by using the pain meds at their aggressive higher end of the RX...because gabapentin does not stay in the body long. Every 8 hours keeps the level of this pain med for nerve pain level round the clock. There should be no signs of pain surfacing dose to dose. Oliver won't want to move much, he won't like you caring for him (lifting him) because it causes pain. So assume there is pain until the test-for-pain stop off rimadyl is conducted. If you are dosing Gabapentin 3x/day and still see any one of these signs of pain, then get tramadol on board. Look for it to be Rx'd at the more typical, aggressive 50mgs per dose 3x/day. Any one sign of pain, means alerting your vet to adjust pain meds. ◻︎ restless, can't find a comfortable position ◻︎ slow or reluctant to move much in crate such as shift positions ◻︎ When set down at potty time, will not move ◻︎ shivering-trembling, yelping when picked up or moved ◻︎ tight tense tummy ◻︎ arched back, ears pinned back ◻︎ not eating due too much overall pain ◻︎ not their normal perky interested life selves MATTRESS SETUP ------ Fleece bottom sheet tucked in all around tightly and a bit under the mattress keeps pee pad from shifting. +++ Pee pad on top of mattress ~~~~ Mattress enclosed in trash bag to protect and avoid having to clean At suite cleaning time, dispose of pee pad , put the bottom sheet in the washer. Having extra fleece bottom sheets means you have them near by and can quickly remake his bedding. PT As long as Oliver can move his legs on his own, can walk even if wobbly, the very, very few footsteps you allow at pottytime several times a day will keep the joints flexible and the muscle circulation up. MED CHART A chart is not just to make sure no dose is skipped, but it allows documenting cause and effect, progress. All handy details when discussing things with the vet to get pain meds adjusted, how GI tract issues are doing, etc. D/l a sample and print from here: www.dodgerslist.com/literature/crateRRP/medchart.pdf
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Jul 25, 2017 9:26:08 GMT -7
Gayle's Elmer just gave a good tip on pilling. If pushing a pill, a capsule down Oliver's throat does not work, if the very excellent idea of the 3-4 treatballs John gave you does not work, here is what Gayle and her vet came up with. "The reason I couldn't get the Gabapentin capsule down his throat is that the capsule stuck in his throat. Today we explored several ways to do it. We settled on coating the capsule with a little piece of chicken flavored Pill Pocket, putting it in his throat and squirting some water inside his mouth. The water makes it slimy so it slides down. " dodgerslist.boards.net/thread/5255/gayles-elmers-7-15-conservative
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Post by Rob & Oliver on Jul 25, 2017 10:03:59 GMT -7
I'm on the fence. Should I get 50MG capsules or should I get liquid form, but this time ina flavor he'll go for like bacon or chicken?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Jul 25, 2017 10:15:10 GMT -7
Who knows what bacon or chicken flavor tastes like to Oliver. Compounding usually takes a couple of days, UNLESS the hospital has compounded gabapentin on the shelf. Gabapentin capsules are on the shelf at every pharmacy in town and you can get them now, today with an Rx from your vet. He could call in the Rx or you can go get the Rx. OR maybe he has gabapentin on his shelf in the clinic, the hospital. As far as I know gabapentin comes the smallest size of 100 mgs/per capsule. Discuss with the vet if 100mgs dose is within the range for a 15 lbs dog. If not....you, yourself could open the capsule and divide into 50mgs. Get some extra empty capsules at the Pharmacy. The pharmacist may even do this for you if requested by your vet. Any compounding not done by a veterinary pharmacy must have the Rx written "NO XYLITOL" for a human pharmacy. For dogs the sweetner Xylitol" can be deadly. Then double check when picked up specifically with the pharmacist himself that no xylitol was used.
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Post by Rob & Oliver on Jul 25, 2017 11:10:57 GMT -7
I'm all set. Chicken flavored Gabapentin here by 7pm. I guess u can get anything in NY. (-:
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Post by Rob & Oliver on Jul 26, 2017 4:18:38 GMT -7
Going back to the hospital at 245 appt today. Aside from IVDD, Oliver is lucky enough to have TWO chronic conditions, the other being perianeal hernias, bilateral. He had surgery for this 1.6 years ago and one of the two sides didn't fully 'take but with daily lactalose with each meal (3 ML per) and Metamucil, his poop was sufficiently soft to still be eliminated in a mostly normal manner. Every two to three months. However it still starts to accrue and then i need to take him to my regular DVM who manually uses a finger to remove more hardened poop.
[Moderator's note: please do not modify 15 lbs Rimadyl as of 7/21: 12.5 mgs 2x/day for ? days, then test for pain stop Gabapentin 50mg/mL: 50mgs 2 or 3x/day Metronidazole 62.5 mgs 2x/day Pepcid AC (famotidine) 20 mg tab: 6.6mgs 2x/day For perianeal hernias: Lactulose & Metamucil daily]
So with this IVDD recovery, and my sense that the inpatient techs simply didn't properly keep up with that condition, even though I made everyone well aware of it like 10'times, in being home now, I can see the condition is in a bad moment. I was up every hour last night with his crying, and quickly realized this was not simple crate anxiety. His butt was kinda leaking and then he would excrete some poop, was up hourly overnight and changed him about a dozen times. Cleaned him with towelettes and a wet rag as best as I can as I can't give him a bath at this stage of his IVDD recovery, which remains fine on that front. But this is all so troubling. I hear him whining now so he must have messed himself again and I'm gonna change the pads etc.
As part of diarrhea/poop issues is the rimadyl, perhaps it's not too early to try a pain-stop test and take him off of rimsdyl and Gabapentin??? Thoughts???
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