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Post by Amy's Charlie on Jun 23, 2013 16:35:28 GMT -7
Charlie was diagnosed with Degenerative Joint Disease when he was 3. Over the past 7 years he's had 5 episodes in his lower back. When this happened he froze up, tremble, refused to move. We treated him with steroids. It usually took a couple weeks to recover. This april I notice after our walks he would be so excited to be home, he'd race to the front door and trip over his front paws. This happened 3 times, so I took him to his vet. After an xray - he showed me where in the cervical region he had a bone spur and a troubling looking disk. He was still able to walk without difficulty at this time. He put him on 20mg Rimadyl - 1 per day, told me to kennel him during the day. After 3 days on the Rimadyl, he deteroirated. He couln't stay up on the tile floors, and his right front leg became like a noodle. I contacted the vet again, we put him on 5mg Prednisone, 2 for 5 days, 1 for 5 days, and then 1 every other day. He improved within a week, still a little wobley, but able to walk on the tile floors. as he improved, i allowed him more freedom, if I had known that I shouldn't have done that, I would've definitely kept him in his kennel. After being out of the kennel a week, and finishing the prednisone, he deteriorated again. This tuesday I took him to a different vet, when we presented, he would not put any weight on his front legs, The vet gave us 2 options, medical management or surgery. I decided on the medical management because I had seen an improvement on the previous stint. This time, it is not going so well. First, I did not give him the full prescription of the prednisone. I started him back on 2 pills a day for 5 days, no improvement, on Friday I reread everything from the vet, he has prescribed 4 pills a day for 5 days, and then tapering off. I started give him the full dose Friday night. His condition does not seem to be improving. He has not wagged his tail in 3 days, will not sit up, or put any weight on his front paws. He is able to go the bathroom on his own, and his appetite was good until last night, he's only eating half of his food. I'm scared that I have set him back, and that he will not be able to recover. I had to change him from his kennel to a playpen, because It was getting too difficult to get him out of it. When I pick him up now, his entire body goes limp. I'm using a harness to hold him up outside so that he can use the restroom. He still has control over his back legs, and he tries to walk on his front, but they give out on him. The last vet said that he doesn't seem to be in pain. In the past if he was in pain, he tremembled and cried, he's not doing that now. But this is an entirely different,disease than what we've come up against before. I'm hoping someone else has been through these issues and can give me some advice. I cry everytime I come home, wondering what I'm going to find.
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StevieLuv
Helpful Member 
Conservative Treatment 3x. It really does work!
Posts: 1,335 
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Post by StevieLuv on Jun 23, 2013 17:38:16 GMT -7
Hi my name is Maureen, and Stevie is my peke, she has been through this twice. Welcome to Dodgers List, and I am sorry that your Charlie is dealing with disc disease. The first thing to firmly believe is that Charlie can recover from this and lead a full and happy life! Conservative treatment depends on 100% crate rest for 8 weeks, only out to potty, and restricted to as few steps as possible when out to potty, supported my a sling or harness to keep his back level and to keep from falling over. The crate or recovery suite acts like a cast to support his back and neck while it heals The fact that Charlie is still continent is excellent. Neuro function returns slowly. If you can give us a list and the doses of his medications we will be able to help you better. Does he have a medication to protect his stomach? Pepcid is available over the counter at the drug store and will protect hims tummy from the steroids. There is alot of great information here, so read, read, read. You will be better armed with info to help your Vet help Charlie. A good place to start is www.dodgerslist.com/healingindex.htm. Please try not to despair, you are not alone anymore, we are all here for you, and have all been through this, or are going through it now. Keeping you in thought and prayer (((hugs))) |
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Post by Amy's Charlie on Jun 23, 2013 18:31:15 GMT -7
Thank you for the quick response, and the healing index link.
Charlie is currently on (2) 5mg Predinsone a day for 5 days, and then starts tapering off. He just started this large dose on Friday night. He's also taking Anxitane (1/2) pill twice a day, for anxiety. Charlie is a very high strung, stubborn peke, keeping him calm in the kennel (now play pen), has been very difficult. When he shows any signs of pain, I give him tramadol (25mg). I'll pick up the pepcid ac tomorrow, this could be why his appetite has started waning. I just want to make sure I'm doing everything I can for Charlie. He means the world to me. Thank you so much for the prayers and hugs, we could really use them!!
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Post by Nancy & Polly on Jun 23, 2013 18:41:38 GMT -7
You don't want to wait for signs of pain before you give him the pain meds. They work better if you can stay ahead of the pain. Follow the recommended dosing schedule to keep him from suffering needlessly. Healing can't really take place until the pain is under control, dose to dose.
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Post by Linda Stowe on Jun 23, 2013 19:03:13 GMT -7
Is surgery an option for you. With so many episodes and now deteriorating, it might be wise to consider or at least talk to a neurologist. With the problem now being his front legs, this may be a cervical problem.
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Post by Pauliana on Jun 23, 2013 19:42:09 GMT -7
Hi Amy! Welcome to Dodgerslist, so glad you joined us here. We all know how upsetting it is to see your Charlie struggling with a Cervical disc episode or any disc episode. 100% crate rest 24/7 for 8 weeks, only out to potty, there is every hope he can recover to live a happy life. It is important to be strict about the crate rest (a play pen is fine) as limited movement is what heals the disc and spine. Medications can treat the inflammation and mask the pain but it is limited movement in the crate that does the rest. Think of it as a cast on a broken limb only it takes longer for a disc heal than a broken bone and that is why 8 weeks is the more effective length of time. It is hard, I know, but this is the time for tough love and to create ways to make it bearable for Charlie. We have all had to do creative things to help our dogs to feel part of the family even while on crate rest.. www.dodgerslist.com/literature/CrateRRP.htm www.dodgerslist.com/literature/cratesupplies.htmWhat date did he start play pen rest?? I also agree with Linda that if you are able to afford surgery it would be a good idea in Charlie's case with all the repeat disc episodes he is had..Here is a link that tells you how to find an IVDD Vet (Neurologist or Orthopedic) www.dodgerslist.com/literature/VetchkList.htmCervical disc episodes are very painful but some dogs tend to be stoic. Pain signals, are trembling, yelping, reluctance to move, holding head up or down, tight hard tummy. Charlie likely won't put weight on his front legs because it may hurt to do so and also because he knows they won't support him right now. I would give him his Tramadol on a regular schedule. It is a very short acting drug and works best on a schedule of every 8 hours. What did his prescription say? If he is having any pain at all, he can't heal. www.dodgerslist.com/literature/cervical.htmCharlie is having stomach problems evidenced by a lack of eating his normal amount of food and this can be caused by switching from a NSAID(Rimadyl) to a Steroid (Prednisone). These drugs on their own can cause stomach acid irritation but switching from one to the other can be very problematic. Safe vets use a washout time of 4-7 days if needing to switch from one brand of NSAID (Rimadyl) or steroid (Prednisone)to the other to avoid serious stomach problems. Phrase the question to your vet in this particular way: "is there any medical reason my dog may not take Pepcid AC?" If there is no reason, we follow vets who are proactive in protecting the stomach by giving Doxie's or other similar sized dogs 5MG Pepcid AC (generic name is Famotidine) 30 mins prior to steroid and again 12 hours later. Ask him also about Sucralfate to heal the irritations in his stomach (given an hour before food) and always give Prednisone with his meal. This is very important for Charlie's sake, so please discuss this with his Vet ASAP. Dogs don't speak up at first signs of trouble like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach. We ask that all members read about each med their dog is on or may take as a safety measure. This directory is in alpha order: www.marvistavet.com/html/pharmacy_center.htmlHere is a video showing you how to lift and carry Charlie: . How to make your home back friendly for Charlie: www.dodgerslist.com/literature/protectback.htm Please let your dog know with your utmost confidence that things are going to be ok…because they will. With this disease self education is critical not just so you make sure the right things are being done for the best recovery but for your own emotions. The unknown is simply a scary place. Get ready to fight this disease now and in the future by knowing all things IVDD. www.dodgerslist.com/literature.htmWe are here to help and send lots of healing wishes for Charlie..
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Post by Amy's Charlie on Jun 24, 2013 9:10:23 GMT -7
Charlie started crate rest on Tuesday 06/18. I moved him to the playpen on saturday 06/22 because it was getting too difficult getting him out of the kennel to use the restroom. I called his vet this morning, he suggested I start charlie on 1/2 tagament for his steroid, and to lower his steroid dosage to 2 pills a day instead of 4. I started that this morning. I am also picking up a new presrip for tramadol, the prescrib I have is old, and probably does not have the potency he needs, although he doesn't seem to be presenting any pain, I will pick up the tramadol at lunch. I'm have a difficult time getting him to go the bathroom, Charlie and I are having difficulty getting into sync with the harness and sling, I'm afraid that this is what is setting him back. I'm trying to keep his back straight by using both, but this morning, I thought he was using the restroom, but he didn't, he had an accident in the play pen. I'm afraid that using the sling on his back is stopping him from going. Will a full body sling be more helpfull? Also, he hadn't wagged his tail for me in 3 days, but this morning, he heard another dog barking and immediately started wagging his tail. Guess he's just mad at me.
Unfortunatley, Sugery is not an option. I simply do not have the money. It breaks my heart to say that, but it is a reality.
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Post by bassetbabe on Jun 24, 2013 12:10:00 GMT -7
Hi Amy,
I'm so sorry for what you're going through, as my pup was recently diagnosed with IVDD. I hope my message may give you a bit of reassurance.
1. I've also been guilty of letting my pup do "just a little more" when she feels good. That's resulted in her feeling worse in the end.
2. I have personally been on Prednisone quite a bit for my own medical conditions and I see some of the same side effects I suffer in my pup. The steroids make me (and her) more thirsty (like cotton mouth ALL the time so never restrict water), more hungry and in me, I have more energy (haven't noticed that with my pup though). The steroids mess with my stomach (and my pup's), so I always give her a full piece of turkey with her steroid pill to coat her stomach.
When I have been in desperate need of the steroids, I have been happy to suffer the side-effects in order to take the full dosage for many days in a row! They honestly help like nothing else! I can see the same is true for my furry friend. I encourage you to not be afraid of what your vet prescribed.
Be thankful that you have a vet that seems to know your pup so well!
Best Wishes!
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StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
Posts: 1,335
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Post by StevieLuv on Jun 24, 2013 12:51:47 GMT -7
The tail wagging is an awesome sign!! Have you tried to take him out to potty using just the harness (since it his front end that is weak)he may not need the sling too. You will find a solution that works. I couldn't use both with Stevie either- just not coordinated enough  sounds like his medications are getting under control too - don't forget the Pepcid to protect his stomach. You are doing a great job! Keeping you in thought and prayer |
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Post by Pauliana on Jun 24, 2013 17:40:50 GMT -7
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Post by Amy's Charlie on Jun 25, 2013 1:52:43 GMT -7
I used a human leg sling for Charlie last night to use the restroom. It worked much better and he was able to have a bowl movement, but he did not pee. I gave him the new prescrib of Tramadol 1/2 50mg tablet, he slept soundly for 7 hours, so soundly, that when he woke me up at midnight to use the restroom, that by the time I got him outside (@ 1 minute), he was soundly asleep again. This alarmed me quite a bit. he woke me up again at 2:30am, he had wet the bed. Is this common? He's still up now, wanting attention, not happy that I'm in here on the computer. I'm wondering is using the sling is prohibiting him from going pee. In the beginning we only used the harness, but his back legs were becoming week, & I was afraid of not keeping his back aligned. Any suggestions? thank you for all of your time and concern, you've all become godsends for us.
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StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
Posts: 1,335
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Post by StevieLuv on Jun 25, 2013 6:33:40 GMT -7
Hi Amy, he might not like the sling if it is putting pressure against his penis - some dogs won't pee if that is happening. A figure eight harness to hold up his back end might help www.dodgerslist.com/literature/cratesupplies/Figure8.jpg , it's easy to make and may help. The sound sleep is not uncommon especially at first, when you have both been through so much. Keep an eye on him, and if he is still like that in a day or two ask your Vet if you need to change the dosage. Keep us posted. |
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Post by Amy's Charlie on Jun 25, 2013 6:59:20 GMT -7
Yep, the sling isn't going to work, he got up again at 5:30am, we went out, he peed all over the sling and himself, quite a mess to clean up. I am worried about him sleeping so much, I'm thinking this may be because of the steroids being changed. he was taking 2 tablets twice a day, the vet changed that today to 1 tablet twice a day. He had never been on such a large dose before, I'm wondering if weaning him off this time is going to have side effects.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Jun 25, 2013 9:50:40 GMT -7
Amy are you able to get him outside to potty every 3-4 hours during the daytime? Until he is off the steroids he's going to drink more and need to potty more. Did you try this figure 8 sling Steveieluv recommended…that will help to keep the pressure off of the bladder and away from the penis.  During the taper of pred (now down to 1x a day) you will want to be observant for signs of pain appearing. Pain could be evidenced by not wanting to move too much because it hurts. Shivering, trembling, yelping. Pain would mean that pred had not taken care of all the swelling and the need to stay on it a bit longer before trying another taper. Let us know if you are observing any signs of pain.
During the taper off of pred, vets also back off or taper off the pain meds so there is a clear picture on any evidence of pain. Do discuss stopping or backing off of tramadol with your vet and let us know what he says. |
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Post by Amy's Charlie on Jun 25, 2013 14:37:53 GMT -7
We're just now getting to the 2 predinsone a day, he was giving him 4 a day. Not changing any pain meds yet, I'll wait until he goes to one a day. today is just his 2nd day of the 2 prednisone schedule of 5 days.
Thank you for the sling examples. I'll have to see how crafty I can be, may have to call in for recruits.
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Post by Yvonne & Billy on Jun 25, 2013 16:58:23 GMT -7
Hi!
My name is Yvonne and my baby boy is in week 3 of his crate rest.
I just wanted to say that you are a great mommy!
Hugs to you both~~~
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StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
Posts: 1,335
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Post by StevieLuv on Jun 25, 2013 19:33:11 GMT -7
Good luck with the figure 8 sling- it doesn't have to be beautiful, just has to do the job |
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Post by Amy's Charlie on Jun 26, 2013 22:23:57 GMT -7
I've found another issue. a couple of days ago I found a small puss filled red area near charlie's penis. (about the size of a pill) I clean it, used an antiseptic wipe and topical antiobiotic cream on it and it healed within a couple days. This evening I found 2 more on his underside. Could this be caused by his urine and not keeping him clean enough? I treated the two more the same way just now. I didnt find anymore on him. I'm having trouble keeping him aigned when I take him out. He's always done these figure 8's when he's had to go poop, and he's still trying to to that. He's still able to use the restroom on his own, but I'm worried if we don't get this under control, he's going to quit. Also, He's been in kennel a week now, and I'm not seeing any improvement in his front legs.
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Post by natureluva on Jun 27, 2013 6:42:42 GMT -7
Hi, those lesions could be caused by him being damp. Be sure to gently dry him with a soft, clean towel after potty breaks. And be sure to feel his crate for urine accidents. If he is having accidents in his crate, then he likely has lost bladder control. If that is the case, you will need to manually express him 4 to 6 times per day until control returns. Your vet can give you a hands-on demo on how to express the bladder, and watch our video here beforehand: www.dodgerslist.com/literature/Expressing.htm Don't worry, expressing is easy and convenient, it just takes practice. Be sure that any cream you put on him does not contain zinc, which is toxic to dogs. Is he licking the area? If so, keep an eye on that. Sometimes dogs with IVDD get neuropathic pain from their nerves misfiring. This causes shock-like pains and the dog will excessively lick the affected area - including the genitals and extremities. This licking can progress to gnawing and biting, so do watch for signs of neuropathic pain. There is a specific medication that soothes this pain called gabapentin. Do your best to limit his steps during potty breaks. It is worrisome that he has to do circles to poop, but not much you can do about that, unless you are expressing poop. Please let us know how things go. Hang in there, you're doing a great job with Charlie! Best wishes, ~Lisa |
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Post by Amy's Charlie on Jun 27, 2013 12:44:22 GMT -7
Could use your prayers....this morning charlie had bloody diarhea, immediately took him in. He has bleeding ulcers, laceration on his eye, and the sores on his belly are likely from the moisture of his bedding after I wash him down. I was not drying him well enough. the vet has taken him off the steroids/tramadol to treat the ulcers. he's on 3 medications for the ulcers and 3 medications for his eye. He's sleeping now, expect him to become lethargic because of the steroid withdrawal. has any had this come up & can you tell me what to expect?
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Jun 27, 2013 13:08:30 GMT -7
please let us know the exact names of his meds, dose in mg and how often you are to give them.
Is his pain now gone…. since he has been taken off the pain reliever… tramadol?
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Post by Amy's Charlie on Jun 27, 2013 13:48:49 GMT -7
I'm at work now, I'll be leaving soon to go back home, I don't have the names of the medications with me. He hasn't been presenting with pain, I've been giving him the tramadol just in case he was trying to sych me out (he was being "stoic"). Although, I'm sure the Ulcers (including his eye) present some discomfort. I'm more worried about what to expect from taking him off the steroids. Last time we reduced his steroids he became extremly lethargic (lasted a day and a half). The vet is hoping that we can clear his ulcers without causing him to relapse with his ivdd recovery.
I'll post the meds soon.
Thank you!
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Post by Amy's Charlie on Jun 27, 2013 15:10:58 GMT -7
charlies new meds are:
Famotine/pepcid 10mg - 1 a day
sucralfate 1gram - 1/2 tab dissolved in water - 2 times a day (couldnt get him to take it in liquid form, nearly bit my hand off - had to give it in pill form, hidden in cheese)
metronidazole 250mg - 2x a day
for his eye: (all drops)
ciprofloxacin 1 drop 3X a day.
remend corneal drops - 1 drop 3x a day
atropine sulfate - 1 drop 2x a day
I was able to get the 2 meds in earlier, when i tried the third he became agressive so I stopped, I was afraid the way he was moving his neck would injure him further. I have someone coming by tonight to help me put the drops in. He's had this happen to his eye when he was younger, it healed.
I left for work at noon, he was able to go pee outside before I left, although he has become so lethargic, it was hard for him to stay up. When I returned, 4 hours later, he had diarhea in his pen. He's not trembling, shaking, or crying. I'm afraid to take him out in the state he's in right now. Any advice?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jun 27, 2013 17:04:02 GMT -7
There is good hope that now the newer and more effective Famotidine (Pepcid AC) is on board along with a 2nd stomach protector… sucralfate. This is something to keep in mind for the future. I learned too that with a steroid my girl need to start right away with Pepcid AC and sucralfate to prevent problems…so always asked for it right up front. I believe the real problem for Charlie was the switch from Rimadyl to a steroid without a 4-7 day washout and nothing at all to given to protect the stomach as you saw almost immediate negative effects starting with the not wanting to eat.
If you need, do clip with scissors fur near his butt and elsewhere to make it easier to use a damp washcloth or non-scented baby wipes to keep him cleaned and dry.
Dr. Carry Frey, DVM column in the Dodger's Digest newsletter explained about steroids being withdrawn suddenly: "If steroids are suddenly withdrawn, the body may not have enough cortisol stores from the adrenal glands to support metabolic functions. This can lead to depression and lethargy." Do keep your vet apprised of your observations.
The good news is he is off pred and his pain pill, Tramadol and there are no signs of pain…meaning the swelling in the spinal cord seems to now be resolved!
We look forward to your next report on how Charlie is doing.
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StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
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Post by StevieLuv on Jun 27, 2013 21:14:41 GMT -7
Poor little guy - wow you have really had your hands full. Sulcralfate really does an amazing job to help clear up gi tract issues, so here's hoping Charlie feels better soon. Corneal ulcers are real drag aren't they- all of our dogs are of the buggy eyed variety and we have been through that too - I had to wait until one was asleep to sneak eye drops in, because she would fight so much. You are doing a great job coping with all of this, though you may not feel like it right now. Keeping you in thought and prayer. ps- we had to clip all of the hair off of Stevies backside too - she forgave us |
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Post by Amy's Charlie on Jul 1, 2013 7:10:57 GMT -7
Pretty bad weekend for Charlie. its taking him a long time to withdraw from the steroids. he's been horribly lethargic. when I pick him up, he's like a wet noodle. just this morning he actually got up on his torso and lifted his head, he's much more alert, being very vocal on not wanting to be in his pen. He's been eating/drinking; he held in his urine for over 24 hours, not being able to stand up outside, he wouldn't go. he finally let go in his pen early saturday morning. saturday night, my sister held him up outsite and he went, when I tried this sunday/today, he wouldn't go. He also hasn't had a bowel movement since thursday afternoon, so I don't know if his ulcers are getting better (other than he is still eating/drinking and has not had any vomitting). I'm hoping it takes this long to withdraw from the Steroids and I'll start seeing improvement in his motor functions. right now, he only shows movement in his torso and left hind leg. Has anyone had to go thru this?
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PaulaM
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Post by PaulaM on Jul 1, 2013 19:22:31 GMT -7
Amy, what is like a wet noodle…. is it his front legs are limp? Limp legs are from nerve damage. Also not being able to lift his front and head can be due to nerve damage. Eating/ drinking and being his vocal self sound like very good signs he is alert and interacting with his world. Not releasing urine about every 6-8 hours is not a healthy thing…. the longer urine remains in the bladder the more invitation for bacteria to breed and cause a urinary tract infection. Please do confirm for yourself and us that you have specifically seen Charlie sniff an old pee spot or attempt to lift a back leg or try to squat and then urine came out. That would show he has bladder control. It is worrisome to us to hear he has urinated in his crate…typically that shows a dog is not in control of theri bladder to be able to wait until in an appropriate place to release urine… where they sleep is not an appropriate place. Do let us know what you are observing. If he has not pooped outside, he may be constipated…sucralfate can do that. Are you giving him 1 teaspoon of plain pureed pumpkin 1 x a day (or microwaved/mashed sweet potato or even instant
mashed potatoes) along with soaking each of his kibble meals in equal parts of water/broth. It is the extra water that makes all the difference when adding high fiber to the diet to combat constipation. If you find he does not have bladder control, it is likely he also does not have bowel control. In that case you would want to express for poop. www.dodgerslist.com/literature/Expressing.htm#poop Let us know what you think is going on. Steroids do not help to repair nerves cells. To return nerve functions the body must self repair nerve cells and that often is a long processes. We focus on crate rest to allow the disc to self repair by little movement and time. During crate rest nerves may possibly heal as well, but do not be disappointed if they do not…think in terms of months with nerve healing. We look forward to hearing your thoughts about his bladder and bowel control. You may wish to read the story about Travis who had surgery and still it took a long time for his nerves to heal. www.dodgerslist.com/monthstory/TravisVilardi.htm |
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Post by Amy's Charlie on Jul 7, 2013 8:50:30 GMT -7
Update on Charlie - He still has bowel/bladder control, he's just so stubborn, he won't go if I hold him. Since he only has function of one of his hind legs, its been a chore. I usually have to sit with him on the lawn for @ 15min to coax him. He's had 2 bowel movements since his ulcers, they are formed, no blood, but has a yellowish film around it. The vet told me that was OK. Had to take him back to the vet yesterday morning, he refused to eat for me. The vet gave him a b12 shot, which worked. When we came home, he at rice mixed with a fatty mixture the vet gave me to help with his appetite. He ate a total 8 ounces of food yesterday. Right now, the vet only has him on the sulcralfate and tramadol. this morning @ 1 hour after giving him the sulcralfate, he vomitted. It was not bloody, it had some "foam" (from the sulcralfate) still had undigested rice from the night before and the yellow stomach juices. Since it is Sunday, I'm hoping that someone has an answer for me, his last antacid (pepcid) was yesterday, could this vomitting be a result of not getting the pepcid? He's resting, not showing any signs of pain, he's not due for Tramadol for an hour, not sure that i want to give it to him at this point.
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Post by Linda Stowe on Jul 7, 2013 11:40:41 GMT -7
Hi Amy, I always learned that the yellow bile was due to the stomach being empty. Here is a good link as to why the yellow bile and foam can happen. It looks like some of these could be what caused Charlie to vomit. www.buzzle.com/articles/dogs-throwing-up-yellow-bile.htmlHope this helps. Linda |
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PaulaM
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Post by PaulaM on Jul 8, 2013 8:02:37 GMT -7
How is Charlie today? You might want to avoid grains, such as rice. They can sit in the tummy and ferment because dog's don't digest grains very well. Microwaved and mashed sweet potato is a better choice also nutrition wise. Do a void oils and fats which can cause diarrhea. Boil up some hamburger or a piece of chicken. Let it cool and remove the disc of fat.
How is his pain…is he taking his pain meds now?
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sounds like his medications are getting under control too - don't forget the Pepcid to protect his stomach. You are doing a great job! Keeping you in thought and prayer 
