tasha
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Post by tasha on Jul 7, 2013 10:12:41 GMT -7
I am new to the forum and all the information on IVDD has me confused and overwhelmed at this point. A dog was surrendered to me by her owners last night after her back two legs became paralyzed. They had already seen an emergency vet and were told that the only options to help this little one were surgery (to try and regain use of her legs, bowel, bladder) or euthanasia. They could not afford the surgery and were taking her in to be put down when they called me as a last ditch effort to help her. This little four year old Dachshund is such an absolute sweetheart and I have done everything I can to try and remedy her situation in the only ways I know how (trying to fundraise, network, try to find more info on IVDD)...but I am 'stuck' at this point.
The vet I took her to yesterday after the owners brought her to me said that she required immediate surgery and referred me to a neuro specialist nearby. They said it will cost close to $10,000 (and 75% of that has to be paid up front immediately) to perform the surgery and that not doing the surgery right now will take away her quality of life permanently. The tech however said she might still have an OK life on wheels without surgery but there that there is no way to know for sure.
Not having the funds just sitting around and since this office offers no payment plan options at all (I begged!), I am devastated and don't understand why this dog's IVDD at stage 5 is a death sentence..? Can someone please explain why the vet's don't offer any other options? Are there forms of IVDD stage 5 that make a dog terminal? They said it is just one disc pushing on her spine in the lower back.. If surgery is not going to be an option (I have called multiple vets and most of them had some moderately lower prices, but still too much for me to be able to pay this morning), then what do I do? No one will tell me how to help her go to the bathroom or if a conservative form of treatment is cruel for her situation... all I keep being told is "surgery right now or put her down."
Can someone please help me make sense of this? I don't want to put her down if there is any way it can be helped, but I also don't want her to suffer if that is what I am doing by sitting on here looking for info while she lays beside me unable to move her back legs and leaking urine. ='(
I am located in So California. 626-232-0823 Any info, suggestions, advice...anything at all would be so greatly appreciated right now!Please help me figure out how to help her and what questions I need to be asking the vets to be able to do so. ='(
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Post by Linda Stowe on Jul 7, 2013 11:49:20 GMT -7
Hello and welcome to Dodgerslist. My name is Linda, what's your dog's name and yours? IVDD is definitately not a death sentence. In order to help you more, can you answer some questions for us. -- What was the date you saw the vet and started 100% STRICT crate rest 24/7? -- Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy? -- What are the exact names of meds currently given, their doses in mgs and frequencies? -- Currently can your dog wobbly walk? move the legs at all? or wag the tail when you do some happy talk? -- Do you find wet bedding or leaks on you when lifted up? -- Eating and drinking OK? -- Poops OK - normal color no dark or bright red blood? To help you get up to speed quickly on IVDD you can read our e-presentation www.dodgerslist.com/literature/IVDDcourse/index.htmlWe'll be here to help you through this and hopefully get your girl walking again or living a happy life whether she walks again or not. |
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tasha
New Member
Posts: 6
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Post by tasha on Jul 7, 2013 12:34:05 GMT -7
Hi Linda,
My name is Tasha and the dog's name is Lulu.
Her owners took her the vet yesterday morning (7/6) and then when she was brought to me I took her to my vet and then the referred neuro surgeon that same day (afternoon of 7/6). I started crate rest for her after seeing the presentation and website you have last night. Though the crate itself seems to make no difference since she has been laying on her side in the same position in the hours since. (Her front legs work, but she has chosen not to move, aside from lifting only her hear to eat or drink.) The vets all said they couldn't determine if she had deep pain sensation (DPS?) in her toes because she would look at them sometimes when they squeezed, but not consistently. She shivers/trembles off and on, mostly when she looks upward or turns her head to look at something that made her alert and causes her to lift her chest slightly in the process.She has not been outside to potty or gone anywhere whatsoever since getting back to my house from the vet last night. (They expressed her at the vet last night.) She has been urinating on the bedding (which i carefully lift her out of to change when it happens) since she cannot control it. She only yelps if she smells the urine and I haven't moved it just yet or if I don't stay beside her, but simultaneously she is very slow to move...perhaps "struggles" to move would be a better way to put it. Because she can't feel from the mid area back, she isn't doing much, but she also is nothing like the energetic dogs who can drag themselves and their hind legs all over the house. She had only tried once right before I crated her, and she got a mere three feet and gave up.
Her belly is hard near the pelvic area, but not so much in the middle. The vet the owners took her to yesterday morning did write "sensitive stomach" in their notes, but didn't say why.
Lulu has been given no meds since the owners took her to the vet yesterday am. At that vet Lulu was given a famotidine injection and solu-delta cortef 500mg. They sent them on their way with one IV bag of saline that the owners never gave nor used. They were headed to the humane society to euthanize.
No wagging, no movement in the back legs at all. She is wobbly in her front legs when she tries to walk, but she hasn't tried since last night right after getting home.
Wet bedding and leaks- yes. Strong Urine smell also lets me know.
Strong appetite, water sometimes.
No poop since the vet took her temp last night and one brown piece fell out. No bowels since.
Saw the information on IVDD from everything on the site, and now your presentation. I think I am most eager to know if this dog with these symptoms can be ok without surgery or if it's a non-negotiable? Based on the info, my heart wants to say "yes" since the info suggests several have had success with crating and meds alone, but I have never gone through this with a dog before and want to be sure the symptoms above don't suggest it's a bad idea. Basically, I want to make sure I don't make a decision at her expense that could cause her to be put down. =(
Thank you for your time and I hope to hear from you soon! I truly hope we can get her from point a to point b and have a happy ending one way or another!
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Post by Linda Stowe on Jul 7, 2013 12:57:57 GMT -7
Hi Tasha, shivering,trembling and yelping indicate a sign of pain. You need to call the vet and ask for some pain relief such as Tramadol. If that doesn't work entirely, there are more meds that can be added. Have you been trying to express her? The strong smell of her urine indicates she may have a UTI. You will need to get a sterile urine sample to the vet to have this checked asap. Have you tried to express her. While on the steroids, you should express every 2-3 hrs. www.dodgerslist.com/literature/Expressing.htm Last but not least, I would suggest you find a vet who will support you with the conservative treatment option and educate yourself on the disease so you can be an advocate for Lulu. I think once you get some pain relief for her, get her expressed and checked for a UTI, you will see a much different dog. |
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Post by Goonipaseo on Jul 7, 2013 13:03:54 GMT -7
Dear, dear Tasha, do not give up! Conservative treatment with crate rest and medications WORKS!! My Goonipaseo was in Lulu's situation on May 2nd, even a little worse as he was not poopin or peeing, and refused food and drink - both dangerous. You're already ahead of the game, comparing Lulu to Goonie. He did have to spend a few days in the vet hospital BECAUSE he needed IV fluids and medications that he could not do by mouth at that time. Then home to STRICT crate rest and our own difficulties trying to get him to eat, drink, pee and poo. You are SO FAR AHEAD with Lulu right now! He was completely paralyzed on the back end and our vet suggested that "at best, you should think about a cart", but she also was very happy that I refused to put him down... He had no reflex, and no bowel or bladder function/control the first couple of days. He is NOW WALKING!!! And running a little, getting better all the time! Read everything you can here on Dodgerslist so you will be well-armed with knowledge. And it sounds like you'd better take another trip to a GOOD vet to get the right medications going. (Get a list of recommended meds here on D-list- it may help to show the vet you really intend to help Lulu survive and get well!) I can already tell you have the 'heart' to make Lulu well. Its scarey, and requires consistent care, but you can do it! We did, and we're on our waaaay!
I'm here for moral support. The moderator girls here on Dodgerslist - their advice and knowledge will be invaluable to you. Just don't give up. We all care so much - you'll see...
From an island in Alaska,
Arilee and Goonipaseo
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tasha
New Member
Posts: 6
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Post by tasha on Jul 7, 2013 13:19:28 GMT -7
That is some very good knowledge to have! Thank you! I have actually hit dead ends with all the vets I called today and one last night. All of them refused Lulu any sort of medical stay because they say without surgery she is a liability. They also said I was irresponsible for not having the surgery done already. That seems to be the attitude with all the vets I have contacted thus far and I am saddened to know these symptoms (trembling, etc) are signs of pain. The vet said she was in no pain at all when she saw her.. =( I probably shouldn't have just gone with whatever they said.
I want to do everything I can to make her comfortable and to help her find some relief through this process. How can I approach a vet and ask for pain meds, steroids for her, and urine testing to be done when they have made it clear that they are only offering me a neuro referral and surgery? I even asked last night how I should help her go to the bathroom and the vet told me that " it wasn't something I should be doing myself" and that surgery essential. Will it hurt her if I try learning? Can it be done in a way that might accidentally hurt her to where I need to be extra extra careful? I will follow the link and see what I learn..
I called the vet to ask if her tail moving meant anything as far as prognosis/diagnosis (she guarded with her tail and then moved it a bit when I went to wipe her rear), but they told me that she still needed surgery immediately and that I needed to come in within the next hour. =/
July 8 update:
I am taking her to vet number six today. So far, no vet has been willing to try the conservative route, however they were kind enough to give me pain medicine for her when I asked (Tramadol and an NSAID). She is also on an antibiotic in case her urine culture comes back positive for UTI (due to the strong odor, it's being checked). But beyond that, no vet has been willing to guide me on a conservative route and are still insisting on surgery. The vet I am seeing today said already that they will suggest surgery but might be willing to work with me conservatively depending on what they see. They said the disc in question is in her lower region, causing a problem with her legs but not her bladder/bowel/tail presently. I will keep everyone posted, but at this point I am thinking I will have to reply on the experience of other owners of IVDD dogs to guide me if the vets continue to refuse.
July 9 update:
Yes I have read the article and I really persisted with the vet today in regards to it. The vet I saw today was pretty honest about the lack of guarantees even with surgery, and he was willing to come up with a conservative plan if I chose not to go through with any form of surgery - which I did. He wasn't thrilled about it since he is a surgeon, but I didn't let either him nor his staff sway me. The NSAID has been stopped as of her appointment today and she is now only still on the tramadol and the antibiotic from the prior vet. However, he was willing to give me the prednisone (5mg tapering format) and I went and bought pepcid original strength (10mg) to go with her meds. At the office before we left, they gave her solu-medrol (125mg) and an injection of dexamethasone (2 mg).
They also did an xray too. It showed which disc was causing her current issue, however it also showed a beyond blown disc that has already calcified heaven knows how long ago, as well as another disc on the verge that could go at anytime (or never). Tonight little Lulu is tucked in peacefully in bed and has already gone to the bathroom. I will be checking through the night to see if she soils herself again so I can clean her up as quickly as possible before she gets uncomfortable, but she seems content for now since she has had quite a long day. Even though she doesn't get to move much in her carrier or in her crate here, I think she is just happy to relax.
I am in LA county near Pasadena. Know any good vets around there? And please, let me know if the meds she is on are ok or if there is a mistake... and what types of signs or symptoms would she present if her stomach is distressed? Vomiting? She seems pretty normal and calm to me, but I don't want to miss anything important..
Thank you again for the support! I cannot at all imagine myself, or anyone else, trying to figure this out without a knowledgeable resource such as yourself. You are such a blessing to Little Lulu and I, thank you so very, very much!
Rushing off to the vet.. she went potty and there is some blood in her urine.. hoping it's just a UTI as suspected and that the antibiotics simply needs to be changed. The pred was started last night. The Dex is nothing I can stop or undo since they gave it to her as an injection in the vet's office yesterday. Is that dangerous??? I am pretty worried. I will post on here and in the forum as soon as I have an answer. Paws crossed that Lulu will be fine.
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Post by Pauliana on Jul 7, 2013 13:25:52 GMT -7
Hi Tasha welcome to Dodgerslist! Bless you for taking her and trying to do your best to save Lulu. There is every hope for her! She needs a vet that knows IVDD and that conservative therapy can work. 1000's of Dodgerslist dogs are living proof of this. How to find a IVDD Vet: www.dodgerslist.com/literature/VetchkList.htm Read some of these success stories to see how our dogs have recovered. www.dodgerslist.com/monthstory.htm As Linda mentioned Lulu likely has a UTI and to get a urine sample to your vet as she will need antibiotics to deal with that infection. If it gets out of hand it can lead to a kidney infection and worse. Ask the tech to teach you how to express Lulu. As Lulu's advocate sometimes it is necessary to be pushy to get her needs met, especially with the vets that have a surgery or PTS mindset. Demand Steroid meds to take home and pain meds.. Read below to learn about the meds commonly used for IVDD. The swollen, herniated disc puts pressure on the spinal cord and other nerve fibers in the area. This is painful and the pressure on the spinal cord prevents nerve impulses from passing between the brain and the rear part of the body. The animal may be unable to walk or control its colon or bladder. Severe damage to the spinal cord can lead to total paralysis. Quoted from Drs. Foster & Smith Pet Education In conservative treatment it is IMPERATIVE to get pain and inflammation under control so Lulu can begin to heal in comfort. With pain control and Steroids to deal with the swelling and inflammation along with conservative crate rest, Lulu can get on the road to recovery. 8 weeks of crate rest and medications until the swelling and inflammation are gone. www.dodgerslist.com/literature/CrateRRP.htm1. PAIN control happens in approximately an hour when a prescription is customized to your dog for the dose, the frequency and combination of pain meds. There is no one-size-fits-all pain relief. Make sure the medications are fully controlling pain from dose to dose with no break through in pain. Continued feedback to your vet is vitally important until the pain medications have been properly adjusted for your dog. Signs of pain are holding the head in an unusual position...head held high or nose to the ground, shivering/trembling, not wanting to move much or moving gingerly, yelping, tight/tense stomach muscles, holding leg up flamingo style...not wanting to bear weight on the leg, just not their usual perky-interested-in-life self. These are some of the more typical pain medications used to treat IVDD: Tramadol as the general pain reliever. It has a short half life of 1.7 hours and may need to be prescribed at a minimum of every 8 hours. Methocarbamol treats muscle spasms stemming from aggravated muscles due to nerve trauma related to the spinal cord inflammation. Gabapentin may be added to the mix for hard to control pain. Veterinarians are finding this medication works very well in combination with Tramadol. Prescription of an anti-inflammatory such as a steroid (Prednisone, Dexamethasone, etc.) or a NSAID (Rimadyl, Metacam, Deramaxx, etc.) should be accompanied by a stomach protector such as Pepcid AC (Famotidine) to avoid serious gastrointestinal damage. For some dogs Pepcid AC needs to be accompanied with yet another protector, Sucralfate, when there are signs of GI problems of diarrhea, vomit, bloody stools. An anti-inflammatory can take 1-2 weeks or longer to resolve all pain. During the taper prior to termination of a steroid is the time to watch for any signs that pain is returning which would indicate that more time on the steroid is needed. After repeated attempts to go off any anti-inflammatory, if pain cannot be totally resolved, surgery should be a consideration. NOTE: $4 for 30 tabs Generic Rx Programs at Walmart, Target, Kroger's and other stores. Offerings can change, call to verify Prednisone* 2.5 mg, 5 mg (steroid anti-inflammatory) Famotidine 20 mg (stomach protector) Tramadol 50 mg (pain reliever) Meloxicam* 7.5mg (Non-steroid anti-inflammatory -NSAID)
* Steroid and NSAID class of anti-inflammatories should not be used together. They require a 4-7 day washout from the body before switching between these two classes of anti-inflammatories. Acupuncture/laser light therapy can be started right away to help reduce pain and stimulate the nerves to repair. Studies show pain actually slows the healing process not to mention enduring the pain from a disc episode is torturous. We are here to help! |
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Post by Goonipaseo on Jul 7, 2013 15:42:01 GMT -7
Tasha, I'm sure your head is spinning. Finding a vet familiar with IVDD and successful conservative treatment looks like a very necessary next-step. The next best thing I could think of is to jump on the dodgerslist page on facebook and post your need for a good vet in your area. I'm betting anyone who has been thru this heart-wrenching trial will surely help you. Hopefully by morning you'll be on your way to get her meds to help.
Speaking only from my experience with Goonie's injury and having had to wait an extra day to fly to another island for help, try to keep her calm and resting as comfortably as possible.
Continue to offer her fluids since she is peeing. I wouldn't be pushing solids too much right now since you're unsure of her bowel functions. Most important NOW is fluids. She'll be okay if she doesn't eat much for these first few days. Goonie didn't eat anything solid for 5 days after his injury and our vet said that was fine, focusing on fluids instead. Lulu is drinking, so you should be okay. Goonie had to stay in-hospital for IV fluids, and I had to 'force' with a syringe for quite a while when he came home. You're already way, way ahead with this critical issue!
We used only pee pee pads for almost 2 weeks (or more??!!) so I wouldn't hurt him worse by moving him or trying to make him stand to piddle. Sounds like that would be the better plan for Lulu as well.
I'm going to try to follow your posts closely in case there's anything I can offer to help you. It's all fresh in my memory - the first frantic weeks of trying to learn as much as possible to help him. I can't imagine what's going thru Lulu's mind right now - losing her health, mobility, being in pain and nothing is familiar any more. You are an exceptionally wonderful heart to take her in.
God bless you Dear. I'll help all I can.
Arilee
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Post by jochs311 on Jul 7, 2013 17:46:38 GMT -7
Hi Tasha. We all know what you are going through. Our Tucker was in the same place Lulu is 3 weeks ago. Your first step should be finding a new vet that knows about IVDD. Look into accupuncture too if you can. It has done wonders for Tucker. Our accupuncture Dr. Is very versed in this disease and we love her. She has gotten his pain managed and is just great! Tucker has now gained his bladder control back and is also getting himself in a wobbly standing position in just 3 weeks. All dogs heal at their own pace but don't give up!! Sending healing prayers to Lulu!!
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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 Jul 7, 2013 19:27:30 GMT -7
Hi Tasha, my name is Maureen. I am so sorry that you are having such a horrid time finding a Vet that will help you with Lulu. Their refusal to help you with pain control amounts to malpractice through sheer ignorance, and a "how dare you" attitude because you question their lofty pronouncements. (that was one thing I really hated when I still worked as a Vet Tech)Utter rubbish!!! Get loud, get insistent - don't take no for an answer. I have seen first hand with my Stevie that Consevative treatment works! I am looking for the link to an article about conservative treatment for you. You can do this and we will do everything that we can to help. You are not alone! Keeping you in thought and prayer (((hugs))) Here is the link - this is a good one! www.veterinarypracticenews.com/vet-practice-news-columns/complementary-medicine/non-surgical-options-for-ivdd-keeping-hope-and-dogs-alive.aspx |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 8, 2013 8:23:36 GMT -7
Tasha, glad to hear you DO have a vet on board that will support Lulu during conservative treatment. Because there has been a switch from the NSAID to the steroid and we do not know if there has been a 4-7 day washout PLUS some really high power steroids (Dex and Solu-medrol) have been use, PLEASE advocate for a 2nd stomach protector to be on board. This one is called sucralfate. There is a timing to it when use with Pepcid AC, other meds and food. Please read about the timing here: www.marvistavet.com/html/pharmacy_center.htmlDid you get a hands on top of your hand lesson on expressing the bladder? www.dodgerslist.com/literature/Expressing.htm Are you expressing every 2-3 hours , is she now staying dry? Getting pain under control is the first level of healing that has to occur in 1 hour after the right meds are on board. She should be pain free thereafter dose to dose. Once pain is controlled then you can properly care for her in comfort. Get up to speed as quickly as you can so you can advocate properly for Lulu with those who may not be as up to date on IVDD as they can be: www.dodgerslist.com/literature/healingpage.htmWe look forward to hearing more about Lulu this afternoon if you can.  |
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Post by Linda Stowe on Jul 9, 2013 11:22:06 GMT -7
Tasha lives in the Pasadena CA area. If anyone knows of an IVDD knowledgeable vet, please reply
Thanks
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Post by momfortimmie on Jul 11, 2013 4:56:33 GMT -7
Tasha my name is Rhonda and my thoughts, prayers and heart goes out to you and Lulu. Vets who do not care enough to allow you to make the decision whether surgery or conservative treatment is just wrong. Hang in there as a vet wanted me to put my little guy to sleep and we both are determined to prove him wrong and so far, Timmie (my yorkie) is doing just that so conservative does work.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 11, 2013 6:55:03 GMT -7
Tasha, I don't know if you've found a knowledgeable vet in your area yet. I live in NJ so am not familiar with the vets in your area. However, an online search found glowing reviews for the Pasadena Pets Veterinary Hospital. I hope that's not the one you went to. Scroll down to Rhonda B's review toward the bottom of the page. Her dog had a back injury - it doesn't say it was IVDD but her dog's hind legs were paralyzed - and this vet (Dr. Stan) helped him walk again without surgery. If you haven't found a vet yet, this place might be a good place to start. Again, I've never been there - just going by all the 5 star reviews on this site. www.yelp.com/biz/pasadena-pets-veterinary-hospital-pasadena#query:Best%20VeterinarianMarjorie |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 11, 2013 7:30:08 GMT -7
Tasha, can you let us know about Lulu, how she is today? Are any of these vets near you: dodgerslist.boards.net/board/10/guidelines-posting?q=+%2CCAAnother choice would be to get a specialist's consultation (neuro ACVIM or ortho ACVS). When you get there tell them up front surgery is not an option for your family. You came to get the proper support for doing conservative treatment and the pain meds to provide full comfort while swelling is being resolved by one of the two classes of anti-inflammatories (NSAIDs or steroids) because you could not find a general DVM vet who knew about conservative treatment. Directory of neuro specialists: www.acvim.org/ [Neuro specialists] |
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tasha
New Member
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Post by tasha on Jul 27, 2013 1:56:48 GMT -7
Hello again! So, lots happening with Lulu... some good, some not so good.
The good news is that the vet and I both think conservative treatment is working. She is on one prednisone a day (with pepcid of course) and strictly confined to her crate, aside from her water therapy/prescription baths. When it is feeding time, I allow her to move about a foot or two to get to her dish, and in doing so she has shown me that she can stand, wag her tail, and walk (rather quickly I might add) all on her own without my help ( though I still try to support her belly/back when she stands up for more than a moment or is pooping). I have her set up with potty pads within the crate so that she can go as she pleases without having to go outside, and we have a pretty good system for that.. she barks once to let me know she is about to poop, and then stands up and does so (when the stool is solid) and then will lay back down and beg for a belly rub after. When she urinates, she goes on her own and simply moves away from where she pee'd so I can remove the pad and clean up as needed.
Physically, her strict recovery has been a success thus far I think. Emotionally.. I think it will be worth it in the long run. I felt terrible for her the other day when she got so excited to see me that she tried to jump up toward me when I walked over to her crate... I cried out in panic, fearful that she might hurt herself, begged her to "sit" ...and it scared her. Given her background, I know she had to be confused..she was used to getting yelled at for all sorts of things (and pretty roughed up too) but never for being happy to see someone. We have found a common ground now though..she understands that if she stays calm, she'll get a treat in return when I get to the crate. I am truly stunned by her progress and cannot tell you enough how many happy tears I have shed seeing this change in her. Not having to look back at her legs in confusion has truly lifted her spirits. Though, she isn't my biggest fan since I make her stay in the crate when she would much rather chase my cat (she tried to take of after him once while I was changing the pads but my leg was in the way of her getting very far...sneaky gal!), I think deep down she understands that I am trying to help since she is cooperating.
The vet has not told me for how long she should be on the pred, nor when to taper, if at all. In fact, his assistant even told me to try out 1 pred a day or half a pred and see whatever I feel is working.. I didn't like that approach. I don't agree that steriods should just be messed with on a whim but she insisted that the vet would think highly of me if I tried a lower dose on my own and reported if it worked or not to save him time. How on earth I would know what dose "works" is absurd to me. *sigh* I just hope that the once a day he left me with for now is ok for her to be on. Last instructions I got were to give her pred once a day and report back in two weeks. I think since I refused the surgery, he just gave in and is letting me ask for whatever...which terrifies me because I know not what is best nor am I a vet... thank goodness I have your experiences to guide us or else Lulu would have been in dire straits and I would be desperately searching google for answers!
Now, on to the not so good news..
There is a strange "lump" that showed up a few days ago.. in a 24 hour period it went from a bug-bite type of spot into a pustule/pimple-looking bump...into a sole brown mole looking lump that felt cyst-like with a giant red ring around it ( about an inch outside of the lump itself)...and now it's just a cyst-looking lump that you couldn't otherwise see if you hadn't been there to see the progression of it. She doesn't react when I touch it, but being that she is passive I don't know that she would tell me if it hurt. Her Rx shampoo of ketohex is used for every bath/water therapy session, so the vet said that prevents infection, but for now the nurse told me to "keep an eye on it." I don't know if that is a good idea..nor do I know if this is something that happens with IVDD dogs because they are laying so often or maybe if they aren't "cleaned" well enough after soiling themselves? My gut says it's an isolated issue outside IVDD, but what do I know? I think that is what a good vet is for...right?
Additionally, her bowels changed a couple days ago. I thought it may have been the change in food, but it was done so gradually that it wouldn't make sense to have no issue til the end of the transition. The dogs had a snack from the very same can the day it started... My youngest dog (healthy 4 year old rescued jack russell) started having diarrhea the same day Lulu did, but my medical needs fox terrier had no issue til a couple days later. My fox terrier had only one runny bowel and was normal thereafter ever since. My jack russell had diarrhea the entire day after they ate it and now is back to normal. But Lulu... it's like every other bowel is an issue. Her bowel last night was solid and this morning it was too, but then about three hours ago she had a nasty round of diarrhea. And it isn't helping that she tries to "clean it up" herself while I scramble to clean it, because then she vomits up the crap she just tried to clean up... just one big mess. ='( Oh poor Lulu...
Anyway, the vet said if it lasted consistently for more than 24 hours, then bring her in, but because it's so inconsistent they said it might "just be the meds" and that she is "fine." Any thoughts on that? Can pred with pepcid do that?
She is drinking her water normally and eating all her food too. She isn't trembling anymore which is a good. My gut just wonders if I am missing a major sign here or if I need to just wait like the vet tells me to do so. Some insight would be great..I only want to do right by her and my goodness has she been through enough in her four short years before she met me..and now all of this!?
And please know, you all have been such an absolute blessing for Lulu and I...we wouldn't be getting through this at all without the support and advice.
I am going to check out the Pasadena Vet mentioned above, however I hope it isn't the one I called when this began..if it is one and the same, their prices were sky-high. Paws crossed it is not!!
I knew I had forgotten something...
1. Her urine culture came back negative and the vet said there is no infection/uti/etc, but that since the culture was taken before the odor/symptoms were fully blown, we were covered my the antibiotics (amox.) she had been on and is fine now.
2. I had an xray done of her spine. It shows three discs with issues....
A. one disc was beyond blown and has calcified/scarred. The vet said it looks like it happened sometime in the last year, probably even in the last six months. He said that she has probably been in excruciating pain since that injury didn't paralyze her and make her numb to the pain. Based on a conversation I had with the owner (via telephone while I was still at the vets), they certainly didn't make life easy for her. The owner told me about all of Lulu's "odd" behaviors that started around the same time her first disc injury was estimated to have occurred - not wanting to go on her daily walks, refusing to voluntarily walk through the doggie door because it caused her pain, refusing stairs, yelping in pain - So I suppose to be blunt, all the signs were there but they didn't care enough to think anything of it or take her to be checked out.
B. The vet noted the disc having the issue now and said this disc has in fact caused the paralysis and was a candidate for surgery (we are choosing conservative treatment.)
C. The vet noted a third disc that is nearby the one that is acutely causing her current symptoms. This disc would make her a poor surgical candidate because he said that he couldn't do surgery on her current failed disc and this third one without "making her a jellyfish". The third one could go at any time, but hopefully with proper care and a dachshund-friendly home it may never become a problem.
If I think of anything else, I will add it here. Thank you all again!
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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 Jul 27, 2013 9:36:22 GMT -7
Hi Tasha, thanks for the update. I am so happy that Lulu is showing progress  Can you clarify some things for us? What exactly is her water therapy? Is she taking 5mg of prednisone once a day, for 2 weeks, and the Vet hasn't given you a tapering schedule? Did all of your dogs get the diarrhea? It can be caused by medications, but perhaps something else if it happened to eveyone. You have done such a good job being her advocate and getting her the help that she needs - you are amazing!!! |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 27, 2013 12:12:41 GMT -7
Tasha, first thing is do not give Lulu any baths where she set into water or water therapy. It is way too dangerous a situation for her early healing disc. If you need to clean her up a damp washcloth with the Kethohex or non-scented baby wipes will have to do the job for now. She is on such a good healing path, don't want anything to cause a set back…the focus is on 100% STRICT crate rest 24/7 only out to potty and vet visits. Prednisone is one med that needs to be used with the supervision of a vet. An assistant is not a vet. Please speak personally with the vet and discuss a tapering schedule. Often it takes being at the anti-inflamamtory dose of prednisone (5mg 2x/day) for 1-2 weeks or even for some dogs more like a month before all the swelling is gone. When it is thought all the swelling might be gone, a taper is started. On the taper the dose is lowered to less than the anti-flammatory dose on a certian schedule and that is the time to assess just how well reduction of swelling is going by observing for pain. To have a clear picture on a taper, pain meds are also stopped or back off too. Rule of thumb is: pain = swelling = more time on Pred needed. If there is no pain on the taper then it goes to completion. Then no meds at all are needed any longer. If she is moving in her crate, turning around, then it was not very likely a pressure sore…maybe a bug or spider bite? Why was her food changed. We don't recommend food changes because then it is confusing why the diarehea. I would not take any chances that Prednisone may possibly have caused it..assume the worst that is was not just a food change. Ask for a 2nd stomach protector…sucralfate. YOu can read more about this med here: www.marvistavet.com/html/sucralfate.html |
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Post by Yvonne & Billy on Jul 27, 2013 13:38:58 GMT -7
Dear Tasha,
Hello and bless your heart! I live in Pasadena too and my baby boy Billy is finishing his 8 week crate rest next week. I go to Community Companion Animal Hospital in Temple City (626-287-0527) and get acupuncture from Dr. Wong. Acupuncture helped my Billy immensely! Dr. Wong isn't a specialist so she isn't as knowledgeable as one but she suggested conservative therapy before I found this wonderful forum. As with all vets including Dr. Wong, you need to be on top of the information and be a team leader for Lulu's well-being but I've had no issues with Dr. Wong. Hope this helps!
This too shall pass~~~
Warmly,
Yvonne
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tasha
New Member
Posts: 6
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Post by tasha on Jul 28, 2013 3:27:39 GMT -7
Ok, this may take a moment to write everything out.
StevieLuv - Her water therapy consists of letting her lay in some warm water and gently massaging her legs while checking their range of motion. The vet instructed me to do it every other day (but daily if she soiled herself because he hadn't received the uti results yet) and showed me how he wanted it to be done. He said it would help determine if the meds were working, but also keep her from being so stiff since she isn't getting much movement otherwise.
The prednisone prescribed was intially on a taper when he first gave it to me. But I guess to make it easier to see the big picture, I will just write it all out from start to finish regarding the steroids/antacids.
When with her owners, the emergency vet gave Lulu :
-Famotidine Injection (.40 mL)
-Solu-Delta Cortef Injection (.5 vial)
When at the regular vet once in my care she was given:
Rx for Tramadol
Rx for Rimadyl
Rx for Amoxicillin
When we went to the specialist [What was the date?] who is overseeing her now the following day, she was given:
125 mg of Solu-medrol
2mg injection of Dexamethasone
Injection of famotidine
Rx for (5 mg) prednisone
And I went and bought some pepcid ac (10 mg) too.
Her instructions for the prednisone ( to replace the rimadyl in her med schedule) were:
1 tablet orally twice a day for 5 days (every 12 hours).
Then one tablet once a day for 5 days.
Then call for further instructions.
Now.. Lulu ran out of tramadol and amox the night before we started only taking pred once a day [What was the date?]. I called into the vet that morning to ask for more pain meds (because she started trembling and was acting uncomfortable) and to ask whether or not we needed to continue any sort of antibiotics (since no one gave me the results of the uti culture yet). When I called, they said the vet would call me back with his answer. When he did, he said the uti results showed no infection and said I could come pick up some tramadol from his office and some more pred. He told me we would continue at one a day for now and keep at that til I am about to run out of pred again, at which point he would make an appointment to see her. He then passed me to his assistant since he was headed into surgery, and his assitant told me how much it all would cost and what time I could pick it up. She started to review what the vet told me to do with the pred, and that's when she started making other suggestions, like trying lesser doses or fooling with it. I have stuck strictly to the once a day the vet said to, but only hope that is enough for her injury. I have only felt any confidence in his opinion because of her improvements thus far. So as it stands now, she is being given one 5 mg tablet of pred and one 10 mg tablet of pepcid ac with dinner each night about two hours before bedtime. I hope that info helps..
As for the diarrhea, all three of them got it. Lulu and my jack russell at around the same time, and my fox terrier later. However, everyone has recovered but Lulu. She had two normal bowel movements today (yay!!), so I am hoping that it the end of it, but I won't know for sure until tomorrow probably.
And the growth/bump/strange skin thing.. it could have passed for a bug/spider bite when it first appeared, and truly I thought that was all it was at first too. But now... this looks like a strange warped mole or skin reaction with a cyst-like lump in the middle. It's unlike anything I have ever seen before on a dog. I am going to have the vet take a better look at it asap because it's beginning to freak me out and I would much rather they look at me like a hypochondriac than find out I waited too long to prevent something potentially serious from becoming a bigger problem that it may be now. I wish there was a way to put a photo on here..maybe I will put in on my facebook or in our message? Would that work?
Paula - Is the type of water thing the vet has me doing dangerous for her? She wags her tail when she sees what we are about to do, but of course she wouldn't know if it was best for her or not.. =( I have tried just wiping her down but with the diarrhea, it has become nearly impossible to clean her properly otherwise. She has to be moved less when in the water than when being wiped I have found. I hope that the diarrhea has passed so we can get by on just the wipes I bought or a rag.
As for the food change, I think it had to be done. I hate creating more possible causes when starting new meds or in the midst of medical issues, but her diet needed serious help. Aside from the fact that she eats every meal as if she will never see food again, the food the owners gave me to feed her was less healthy than a hot dog. The owners admitted to forgetting to feed her several times a week and stated that they preferred the food they bought her because she didn't have to go out to potty as often as when she was on the other brands. The first vet we saw noted how constipated she was and we all assumed it was due to her possibly not having control of her bowels, however we later found out that the food had made her so constipated that she couldn't go until enough "piled up" to force it out of her. The vet had me give her 1/4 tsp of veg oil with all her meals because he was so worried about the pred complicated the already bad constipation. After seeing her first strained episode, I started to gradually transition her by adding some of the better food we have little by little (keeping the total portion size the same of course, just changing the ratio of good and bad food gradually). She made it easy too because once she started eating the better food mixed in, she refused to even touch her old stuff at all. After many days, we completed the transition and her stools became much more regular, they smelled better than the prior ones, and she wasn't struggling to go at all anymore. We haven't needed the oil at all either now that she is able to pass comfortably on her own. So, other than the freak-diarrhea from the one can, everything else had been fine. But the growth showed up around the same time as her diarrhea, so I am still pretty concerned...
BillyMommy - Did you start your little one with Dr. Wong from the start or did he have to wait til near the end of crate rest? Can Lulu do acupuncture now? Temple City isn't far at all and I would sure like to give Dr. Wong a shot if it will help her. Are his prices reasonable?
Ok, hope that all clarifies things a bit..if not, let me know. Do you think I'm on the right track with her meds or do they need to be revised? The vet mentioned the injections could last awhile, but never said how long.. The last ones were given July 8th and that was quite a bit ago. =/
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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 Jul 28, 2013 10:12:24 GMT -7
Thank you for taking the time to type all of that out!!! As Paula mentioned the baths/water therapy should wait until after the 8 weeks of crate rest are over - but I totally understand the need to clean up after the diarrhea (been there-done that, Had to, Stevie has long fuzzy hair and the baby wipes were just distributing the mess evenly through her fur) The danger with the water therapy is that the movements can cause the newly healing scar tissue to tear, and you are back at square one, especially if the water triggers the shake off to dry response  . When it comes to starting the taper of prednisone, ask the Vet - his assistant needs a smack upside the head for muddying the water with regard to steriod use. When the taper does start watchout for signs of pain that indicate a longer course of prednisone is needed to get all of the swelling under control. We follow proactive vets and give our approx 13-20 lbs doxies 5mg 30 mins prior to Prednisone, rather than the 10mg- you can just cut the tablets in half. You did an amazing job of getting her diet switched in the niddle of all of this too - WOW! Let us know what the Vet says about her weird little growth - hopefully it tturns out to be nothing - but I would have it checked out too - it's not being a hypochondriac, it's being a good advocate!!! Keep us posted |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 28, 2013 10:15:48 GMT -7
July 8 - NSAID
July 9 - Steroid (solu-medrol, dex and prednisone)
july 28 - ▼ Pred 5mg 1x/day
What is the assistant's title, a receptionist, a vet tech, a DVM?
What letters in addition to DVM does the specialist have, ACVIM or ACVS?
Putting a dog into water is a dangerous thing. Most dogs will want to shake water off, wet dog is slippery… It is just simply not a safe idea during conservative treatment while the dog is still on meds. Wipe her down best you can with a damp washcloth. Safety is number 1 always to protect the disc and the spinal cord.
Since, if I read correctly, she can walk with her back legs there is no need to do any massage or ROM. She is moving her legs enough. Again during conservative treatment while the dog is on meds and will feel good, we need to do everything possible to protect the early healing disc and the spinal cord. Lulu is really going in a good direction of healing with your care…just do not want to invite any unexpected movement… any time out of the crate is fraught with potential dangers to the disc and the spinal cord.
Can you recap/update with a brief answer on on these things so we can follow more easily what the current situation is:
-- pain today? any showing after moving or nearing dose of meds.
-- She is not currently on any pain meds, just prednisone and pepcid AC, right?
-- Can she walk now even if wobbly with back legs? Has bladder control proved by being able to sniff the grass and then release urine?
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Post by Yvonne & Billy on Jul 29, 2013 15:20:12 GMT -7
Dear Tasha,
Dr. Wong was with Billy from day 1 of his ruptured disc treatment. She started him on Rimadyl at first (though she did give him a shot of steriods right before, which she wasn't supposed to do) and after one week and Billy got a little worse, she started him on acupuncture. Even though I started Billy's crate rest a week before he started his acupuncture, I started counting his crate rest when he started his acupuncture. So, yes, I started acupuncture before he finished his crate rest.
Dr. Wong is around $40 per visit for the acupuncture. That's including the needle disposal. After the initial visit she hasn't been charging me the office visit so I've been paying $39.30. That is the cost without the Chinese herbals she put Billy on: Double P II and hindquarter weakness. I saw the acupuncture work wonders on my Bills. Billy has had six sessions. The first three were five days apart; fourth one a week later; fifth one two weeks later; and the sixth one two weeks later. We have another appointment three weeks later.
I hope this helps! If you want to talk more or want more info please feel free to email me yvonnesong78@hotmail.com and I would be happy to give you my phone number and we can chat!
Hang in there! You are awesome!!!!!
Warmly,
Yvonne
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kimkiernan
New Member
Poppy walking well and gaining strength. Able to walk 30 minutes now.
Posts: 24
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Post by kimkiernan on Jul 30, 2013 0:30:37 GMT -7
What an amazing advocate you are Tasha! Lulu is so lucky to have found you. I live in Orange County. Poppy is seeing a rehabilitation specialist in Orange that is comfortable with conservative treatment. They also do laser therapy there. Let me know if you want more info. I know Orange is at least an hour away from you, but thought if all else fails, you may choose the drive.
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