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Post by Julie & Perry on Mar 17, 2018 17:33:55 GMT -7
Well here I am again. Only this time my 4 year old Shihtzu, Perry, has been diagnosed with probable IVDD. He's 17 pounds.
Got home this morning from work and bouncy boy is quiet and not eating or drinking.
Called vet and couldn't see him. By afternoon he was shaking and back legs were wobbly.
Went to emergency vets. Probable IVDD by vet there. Back feet slow to turn back up.
Got buprenophren shot for pain and sub cutaneous fluid for dehydration.
Started: prednisolone 5mg 2x daily for 5 days. Gabapentin 100 mg 3x daily, tramadol 25mg 3x daily, robaxin 125mg 3x daily, and will give pepcid ac 2x daily. Got trazadone in case he needs it to stay in pack and play.
Got him in a pack and play now. Still not eating and drinking when I left at 6:30p to work. Neighbor checking on him. Hopefully he'll be feeling better at 11p when I get home and eat/drink.
Moderator notes please do not edit
[17 lbs
Buprenophren shot for pain on 3/17 at ER
Prednisolone as of 3/17: 5mg 2x/day for 5 days. then 3/22 taper to test for pain/neuro loss
Gabapentin 100 mg 3x/day
Tramadol 25mg 3x/day
Robaxin 125mg 3x/day
Pepcid ac 2x daily.
Trazadone ?mg ??x/day?]
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Post by Pauliana on Mar 17, 2018 18:22:41 GMT -7
Julie, so sorry to hear about Perry being diagnosed with IVDD. He is in great hands with you! His medications look right..other than Tramadol being low.. 50mg would be more typical for a 17 lb dog.
If his pain is under control with these dosages, that's great but if not there is room for Tramadol to be increased, so please do let the Vet know if Perry isn't pain free from dose to dose.
Not eating and drinking can be a sign of pain. That's one of Tyler's first signs of a disc episode even before meds are on board.. Once he is on his medications his appetite returns..
Glad you have a neighbor to check in on Perry until you get off work.. Please let us know when you get a chance how things are going.. I am sure Nala is worried about her best pal.
Sending healing prayers to Perry and comforting thoughts for you..
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Post by Pauliana on Mar 17, 2018 18:33:44 GMT -7
What is the taper information on the bottle for the Prednisolone? What is the dosage for the Trazadone and how often is it to be given?
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Post by Julie & Perry on Mar 17, 2018 21:43:18 GMT -7
Here is the updated med list:
Trazadone 25mg, as needed for anxiety/sedation
Prednisolone 5mg, 1 tablet 2x daily for 5 days. 1x daily for 5 days, then then every other day until gone.
Robaxin 125mg every 8 hours
Tramadol 50mg, 2 tablets every 8 hours
Gabapentin 100mg every 12 hours
Do tramadol and gabapentin sound right to you?
And of course pepcid ac 2x daily.
[Moderator notes please do not edit
17 lbs
Buprenophren shot for pain on 3/17 at ER
Prednisolone as of 3/17: 5mg 2x/day for 5 days, then 3/22 taper test for pain/neuro loss
Gabapentin 100 mg 3x/day
Tramadol 100 mg 3x/day
Robaxin 125mg 3x/day
Pepcid AC 5 mg 2x daily.
Trazadone 25 mg as needed for anxiety/sedation]
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Post by Julie & Perry on Mar 18, 2018 4:38:15 GMT -7
Expressed some last night. Seems as if bladder is going to need it. Tail limp.
Well this morning the fluids kicked in, wet boy.
Just gave second dose of prednisolone. Hopefully it starts to work.
Perry ate some meat food and seems to be more comfortable.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Mar 18, 2018 4:58:23 GMT -7
So very sorry to hear about Perry, Julie. It would seem that having two dogs with IVDD is above and beyond what should be. But as Pauliana said, Perry's in good hands with you as his caretaker.
When you said Tramadol 50 mg, 2 tablets every 8 hours, did you mean 2 25 mg tablets or 2 50 mg tablets? Is it a total of 50 mg every 8 hours?
As for whether the Tramadol and Gabapentin dosages sound right, if Perry's pain is completely under control, then they are right. Is that the case - no sign of pain at all? If not, Gabapentin does work best when given 3x/day (every 8 hours) so if pain is not under control, speak to the vet about giving 3x/day.
You're giving 5 mg of Pepcid AC 2x/day?
Healing prayers for Perry.
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Post by Julie & Perry on Mar 18, 2018 7:03:26 GMT -7
Vet said 2 tablets of 50 mg each of tramadol.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 18, 2018 7:34:27 GMT -7
Julie, glad to hear his pain is fully in control. The ER vet has used an pretty aggressive approach with the pain meds. As mentioned a vet could Rx gabapentin for every 8 hours...but as long as Perry is not showing any pain, then the current pain meds are correct for him. And the ER called for a prudent 5-day course of prednisone with the test taper to begin on 3/22. What directives where given with the test for pain taper? Are you to back off the pain meds or do a full stop on 3/22?
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Post by Julie & Perry on Mar 18, 2018 8:03:56 GMT -7
Will have to check with vet in Monday. Was so overwhelmed at the time I didn't clarify.
It's sad to see him completely down in back legs now. Am expressing.
Surgery isn't financially possible. I've spent so much on Nala's condition.
At least he's pain free. It was awful yesterday seeing him shaking.
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Post by Ann Brittain on Mar 18, 2018 8:12:07 GMT -7
So sorry to hear Perry is having an IVDD episode. It is an agonizing thing to see your dog unable to function normally as you know. But you're on the right track to help him get back on his feet. You acted early to get him the meds he needs to heal. Perry is lucky a good pet parent like you.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 18, 2018 8:22:10 GMT -7
Julie, because you acted so quickly to get vet help and meds on board, there is real potential for the body to self repair the neuro damage you are observing. It is, of course, waiting and patience to see what the body can do over time. Perry is obviously in good hands. Your knowledge of expressing and the need for really strict rest for the back will give Perry the chance he needs. There are many dogs whether health issues or not a consideration for the family where surgery is just not an option. There are some dogs who have had surgery where the surgery introduced something unexpected...that happened to my Clark. There just are no quarantees...so put away the guilt. You ARE acting in a prudent manner. Davies Veterinary Specialists confirm what we see all the time on the Forum: "Although surgical treatment is often preferred, 4 out of 5 dogs that are weak or paralysed in their back legs will make a good recovery without surgery provided that they have good sensation in the affected limbs." vetspecialists.co.uk/factsheets/Neurology_Facts/Slipped_Disc.htmlA recent comparison of reports on conservative therapy vs decompressive surgery reflects what we see on the Forum. Freeman and Jeffery’s (1) paper on fenestration reveals that there is a high rate of recovery to walk again with dogs treated conservatively after an acute herniation. (1) Freeman, P. and Jeffery, N. D. (2017), Re-opening the window on fenestration as a treatment for acute thoracolumbar intervertebral disc herniation in dogs. Journal of Small Animal Practice, 58: 199204. April 2017 |
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Post by Julie & Perry on Mar 18, 2018 9:35:15 GMT -7
Thanks all for the support. It's much appreciated.
Perry had an accident when the fluids kicked in.
Isn't it decaffeinated cooled green tea and unscented baby wipes to clean up?
I had a groomers appt. He's quite shaggy. Can I gently brush?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 18, 2018 9:39:29 GMT -7
Julie, decaf tea because if a dog like liking the tea, caffine is not good for dog.
You will have to judge about too much movement for the back in brushing or a quick clip with scissors where necessary. The back, the spinal cord takes priority over beauty any time.
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Post by Julie & Perry on Mar 18, 2018 9:56:55 GMT -7
Yes, I agree. Not concerned about looks, but matting and rear end issues with fur.
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Post by Romy & Frankie on Mar 18, 2018 11:03:41 GMT -7
I am sorry to hear that Rabastan is now having a disk episode. He is lucky to have you to care for him.
Healing thoughts for you all.
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Mary & Mila
Helpful Member 
FEMALE— DACHSHUND
Posts: 218
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Post by Mary & Mila on Mar 18, 2018 12:26:47 GMT -7
Hi Julie,
I'm so sorry to see that Perry is having an IVDD issue. Nala must be upset too, her little buddy. Sounds like you acted pretty quickly in getting him the help and care he needed. I'm sure that will pay off. Hope his appetite comes back real soon and that in no time he is on the road to recovery. Such a stressful time for you, stay strong, you and Perry will get though this,
kindest regards
Mary and Mila <3
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Post by Julie & Perry on Mar 18, 2018 19:09:14 GMT -7
I'm finding out it's different expressing a male dog. Pee seems to squirt everywhere.
I'm trying to use a pee pad on the floor next to his recovery suite.
But trying to get his back feet in position when they're completely non-functional and keep him still is difficult.
Also, it's hard with work. Am having to try to work out a use lunch break and maybe sick time during the week.
I don't want to do medical boarding, expense/ moving Perry.
Then I'm still trying to work out my 3p to 7a Saturday shift I do every week.
Checked out local vets hours, thought maybe I could hire a vet tech to come over but they all close at 12 at the latest.
I'm still struggling to get in the groove with Perry so i don't feel my neighbor who checks on them will work for expressing.
Any ideas would be greatly appreciated.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 18, 2018 19:54:41 GMT -7
Julie, rest Perry's butt up against your thigh as you are on bended knee. That way both hands can deal with expressing on each side of the tummy area. Getting the squirt to go straight is a matter of practice in aiming.
The Saturday shift is VERY long at 3pm to 7am on Sunday morn? Would you be able to take him to work with you, if your employer would allow?
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Post by Julie & Perry on Mar 19, 2018 4:25:48 GMT -7
Unfortunately, taking him to work is not allowed.
I'm trying to get creative.
How do I help aim? It seems to go everywhere, his foot, my pants, ECT.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 19, 2018 5:37:26 GMT -7
Oh, my, Julie, the same thing happened to me with Jeremy when I was first learning how to express him. It went all over him and me. I think I was pulling on the skin and pulling the penis to one side or the other. What works best for me is to find the bladder and then push and press from behind it, pushing it ahead of my fingers. That keeps it from slipping back to the pelvic area and keeps the penis from turning from side to side. It's just a matter of technique that you'll have to work on to get right.
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Post by Julie & Perry on Mar 19, 2018 10:32:01 GMT -7
Thanks everyone for the tips. Beef broth in water is getting Perry to drink!
Finally got a good stream of urine going and got it on the potty pad not me.
However, Perry kept turning around and looking at me and yelping.
He's constipated, 3 days now, maybe it's painful when I press?
Doesn't like pumpkin and don't know if he'll eat fruit.
He's being very picky. Can I give him a laxative?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 19, 2018 11:49:04 GMT -7
Julie, microwaved and mashed white potato or a sweet potato also have high fiber content like pureed pumpkin. You can mix some jarred beef or chicken baby food in with the pumpkin and he may then like the pumpkin
Best is to use 1/2 to 1 teaspoon high fiber once a day and his naturally drinking more water to help with constipation. Some laxatives can cause awful gas pain/cramps.
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Post by Julie & Perry on Mar 19, 2018 16:38:17 GMT -7
Emergency vets just called this afternoon and said,"Oops, we put down 100 mg of tramadol 3x daily and it should have been 25mg."
Really, for this I paid $300?
Is the 25mg of tramadol enough for a 17 pound dog that was in severe pain Saturday and was paralyzed and lost bladder control the next day?
Also, since it seems that I'm dealing with a severe episode, possible rupture, from symptoms and rapid decline, should I ask about a 7 or 14 day dose of prednisolone?
He's had 2 days of [pred] twice daily and so far haven't had any improvement.
Post by Julie & Perry on 5 hours ago
Got the pumpkin and mixed a teaspoon with water, kibble, and meat food. Success.
Hopefully that helps.
He is still yelping when I expressed him.
Getting a good stream out now.
Do you think it's because he's constipated and it hurts when I'm pressing?
He couldn't have a UTI already could he?
Thanks again for your help.
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Post by Pauliana on Mar 19, 2018 17:42:08 GMT -7
I doubt 25mg 3x/day of Tramadol is going to be enough.. How has he been getting along on the 100 mg 3x/day?? 50 mg is what we usually see for a dog his weight. I think I would discuss with the Vet about 7-14 day Prednisolone. dose..
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Post by Julie & Perry on Mar 19, 2018 17:52:25 GMT -7
He seems fine on that [tramadol] dose, maybe a little sedated.
If 50mg is the norm I'll run that dose by my regular vet.
Wondering if the higher dose is why he's constipated?
And he keeps turning around and yelping when I'm expressing him.
Could that be from constipation?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 19, 2018 18:12:44 GMT -7
Side effect of tramadol is constipation because it slows the digestive tract down. The longer feces stays in the intestine the more water is absorbed from it. The use of pumpkin should help increase the moisture in the intestines to loosen stool.
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Post by Julie & Perry on Mar 20, 2018 10:24:09 GMT -7
Poor Perry now has a red rash around his genital area.
I got decaffeinated green tea last night and put it into the unscented baby wipes and have been washing up with it. Applied coconut oil on the rash.
Should I be using anything else?
Also, he continues to yelp when I'm expressing him? This worries me.
Is it because he's still constipated? Started pumpkin last night.
Or should I check for a UTI?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 20, 2018 10:50:14 GMT -7
Try using a barrier cream to prevent the urine from contact with skin. As good as you wipe up after him, there is obviously some urine contacting the skin. Aquaphor Baby or regular Aquaphor Healing Ointment are one brand that does not contain toxic zinc if a dog licked too much of it. There might be some possibility that a some neuro function is coming back with the bladder. When that happens a dog won't like you pressing on their sides (bladder). Have you had a chance to take him outdoors to an old pee spot to see if he is able to sniff and then choose to release urine there? Does he leak on you when lifted? Are you able to explain your financial situation to your own vet via the phone. See if he thinks it worthwhile to try a urinalysis. Seems like you have been reporting good success in voiding his bladder so as not to leave urine remaining to iinvite infection. As you can see the intestines are located above the bladder. Have you been trying to express for poop? Can you feel anything at all, feel the crown of the feces as you give it a try to express for poop? |
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Post by Julie & Perry on Mar 21, 2018 8:33:09 GMT -7
Just back from vets and Perry has a bladder infection. Got ✚clavimox 125mg, 1 every 12 hours for 7 days.
[Moderator notes please do not edit
17 lbs
Prednisolone as of 3/17: 5mg 2x/day for 5 days, then 3/22 taper test for pain/neuro loss
Gabapentin 100 mg 3x/day
Tramadol 75 mg 3x/day
Robaxin 125mg 3x/day
Pepcid AC 5 mg 2x daily
✚Clavamox 125mgs 2x/day @ 7 days
Trazadone 25 mg as needed for anxiety/sedation]
March 20 post:
I've been trying to express for poop just like I do with Nala but I can't feel anything in there.
Just a few little rabbit pellets in 4 days.
He usually goes 2x a day, morning and afternoon.
Granted he didn't eat or drink much for 2 days but still it seems like he must be pretty backed up.
Perry always used his pee pads independently or peed while out on a walk.
He doesn't seem to have bladder control.
He's not going independently on the pee pads.
I really don't want him moving much at all
Right now.
Have been lifting him out of pack and play and expressing on a pee pad right by his suite.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 21, 2018 9:52:19 GMT -7
Dang it about the UTI, glad your vet has him on an antibiotic.
Is your vet ok with another course of pred should the test for pain taper to begin 3/22 reveals still existing pain. Which does your vet prefer on the test for pain, backing off the pain meds or a full stop of gabapentin, tramadol and robaxin?
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