Marjorie
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Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Jul 16, 2018 14:21:43 GMT -7
Alix, Gretta could be feeling abnormal nerve sensations that are mild pins and needles but which could progress to painful burning, on-fire feeling that makes them bite to stop the pain. These are abnormal signals… neuropathic pain. Dogs have tragically chewed off body parts to stop the pain. An e-collar on or in a pinch a lengthwise folded towel, secured closed with duct tape can keep them from reaching their legs till you get vet help. Gabapentin helps with this kind of pain. Please let the vet know ASAP about this and speak to them about increasing the Gabapentin to three times a day. It's concerning that she licked enough to cause bleeding. www.dodgerslist.com/literature/neuropathy.pdfWhen you say spontaneous tail wags, were they in response to a happy voice or when given a treat or when someone she loves walked into the room? You need to see a brain connection to the tail wag to know that it wasn't reflex. I hope both were true tail wags! Good news on the diarrhea issue! |
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Post by Alix & Gretta on Jul 16, 2018 18:27:16 GMT -7
Thank you, Marjorie!
The first wag I couldn't figure out the source, so I figured it was reflex. The second was in response to a snuggle from her person (Michael) when we had her out. I was giving her scratches, so I am not ruling out reflex on that one, either, but I'm still excited about "might be."
[Moderator's note: please do not modify
19 lbs
dex IV on 7/6
dexamethasone injections at home as of 7/6: for 6 days unknown mgs; 0.5ml 7/8 6am (last dose)
prednisone as of 7/8: 5mgs 2x/day for 3 days then 7/11 taper showed pain
as of 713: 5 mgs 2x/day for 5 days then 7/18 taper to test for pain/neuro loss
Valium (diazepam) for muscle spasm pain: 2mgs 2x/day
gabapentin 100mgs 2x/day
Pepcid AC 5mgs 2x/day
sucralfate 500mgs 3x/day ]
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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 17, 2018 8:34:23 GMT -7
Alix, looks like the prednisone test for pain and any neuro diminishment taper will begin tomorrow 7/18. Which is your vet wanting? 1) to back off of the pain meds (valium, gabapentin) OR 2) full stop at the begin of the pred taper. Your job at home is to monitor for surfacing pain. You want to be able to get a quick assessment and not be slowed/hindered with pain-masking pain meds on board IF there were to be a need for another course of pred. Taper days are not high enough in mgs to work on swelling. RULE OF THUMB Pain= another course of pred + all pain meds back on board + stomach protectors No Pain= go to conclusion of pred taper...finish out the 8 weeks of crate rest for the disc to heal. The full details on how prednisone, an anti-inflammatory works with a disc episode. Good reading to be able to ask the right questions and discuss treatments: www.dodgerslist.com/literature/healingsweling.htm |
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Post by Alix & Gretta on Jul 19, 2018 15:37:41 GMT -7
We are still doing Valium 2mg 2x a day to keep her a little calmer in the crate (she has always been high anxiety - we had just started her on CBD oil when this happened, which was helping, but I worry masked discomfort she needed to have to not hurt her back).
We have tapered ▼ Gabapentin to 1x a day and will will go off it on the next taper (5mg Prednisone every other day starting 7/23).
[Moderator's note: please do not modify
19 lbs
dex IV on 7/6
dexamethasone injections at home as of 7/6: for 6 days unknown mgs; 0.5ml 7/8 6am (last dose)
prednisone as of 7/8: 5mgs 2x/day for 3 days then 7/11 taper showed pain
as of 713: 5 mgs 2x/day for 5 days then 7/18 taper to test for pain/neuro loss
Valium (diazepam) for muscle spasm pain: 2mgs 2x/day
gabapentin 100mgs ▼ 1x/day
Pepcid AC 5mgs 2x/day still ?
sucralfate 500mgs 3x/day still?
✚Enrofloxacin]
No signs of pain and she’s moving as much (or as little) as before.
Unfortunately she does have a UTI - she didn’t tinkle at all the day she went down, so it may have started then, or the vet thinks it could have been the increased glucose from the steroids. He prescribed ✚Enrofloxacin 68mg 1x day for 14 days. Today I just brought in a sample from home, but wants us to bring her in on the 30th to make sure it’s cleared up, and I think just to check her out.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 20, 2018 4:11:42 GMT -7
The only time you need to be concerned about masking discomfort would be when tapering off of meds since you need to know ASAP whether there is still pain/swelling so meds can be resumed. Discomfort shouldn't be allowed so she doesn't hurt herself. When she's having a current disc problem, it's strict crate rest that protects the spine, not discomfort. Pain hinders healing.
Has she stopped the excessive licking she was doing that caused some bleeding? Gabapentin is the med that helps with neuropathic pain. If she's still excessively licking or biting or showing signs of having neuropathic pain, Gabapentin shouldn't be tapered at this time.
How are you doing expressing Gretta? Does she stay dry between expressings or does she leak on you when picked up or do you find wet bedding? When the bladder is not completely emptied, the urine lying in the bladder can breed bacteria and lead to a UTI. It can take some time to become proficient in expressing so if you're still finding wet bedding or if she leaks on you when picked up, keep trying to find the bladder if it slips away and keep pressing until the bladder feels flat.
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Post by Alix & Gretta on Jul 20, 2018 6:04:41 GMT -7
Thank you, Majorie. ❤
To be totally clear we stopped the CBD oil when she went down because of all the new meds. I meant that I was worried that's why she went down (like when you take a pain pill for a pulled muscle and then injure it more by doing too much). We are pretty sure she injured her back going after a ground squirrel (a pair of them ran for her and then split to run one on each side - so there was a process of WHICH ONE TO GO FOR?! and lots of sudden/different movements), so likely that's not the case, but... We were giving it to her for the anxiety, so I never really thought about the consequences with any pain relief it might do.
She stopped licking her feet 7/17. On 7/18 and 7/19 she was obsessively licking underneath herself from the UTI - she is still licking there occasionally, but not crazy like it was.
Bladder expression was going well - I would just sit and brush her until she relaxed and then I could find/re-find her bladder and feel it throughout the expression. I would do the whole process twice just to be sure.
On 7/18 expressing became more difficult: press and nothing comes out, and she was in obvious discomfort (turning her head to see what I was doing and nipping toward me). That along with the licking and the leaking was why we took the sample in.
Everything else seems to be going well. A little more herself each day and already giving her SONIC WHINE to get out of the crate.
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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 20, 2018 11:29:06 GMT -7
Alix, are you now able to resume expressing the bladder without pain? If Enrofloxacin is the correct antibiotic, the infection will be turning around in by now.
Any more happy tail wags? Any observations of atempts to use back legs such as to reposition in the suite?
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Post by Alix & Gretta on Jul 20, 2018 15:00:42 GMT -7
Hi, Paula.
She’s had her second dose of antibiotics (4pm) and our 5pm expression seemed pain-free. She seemed anticipatory of pain, but once I had her up and tinkling, it was fine.
We are still giving the Sucralfate 3x a day and the 5mg Pepcid 2x a day. The plan is to continue these until she’s fully off the Prednisone. Because of the interaction issue with sucralfate antibiotic absorption we’re giving the antibiotic in between her two evening doses of sucralfate.
We may have seen her use her left foot to push off from tonight, but it may have just appeared that way when really she was holding it locked and using her front feet to do the shifting. We are still seeing the occasional tail wag - so far nothing to *only* speech or treats, though. It’s always accompanying touching her in some way, so I’m still never sure if it’s reflex or response. There were 3 super wide tail wags tonight while lifting her up out of the crate for expression.
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Post by Romy & Frankie on Jul 20, 2018 15:20:10 GMT -7
Very glad that expressing her is going well again.
She may have pushed off with her back foot. Just keep watching for it and the wonderful tail wag.
Any wagging related to eliminating is probably reflex. When you say the tail wags when she is touched is it in response to petting or scratching her ears or something she would like or more moving her from place to place?
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Post by Alix & Gretta on Jul 20, 2018 17:17:10 GMT -7
Two days ago she started wagging and kicking when she poops. I know it’s reflex, but it’s also kinda cute? I know, I’m strange. She’s wagged a couple times while we’re just petting and scratching her. But still nothing [happy wag] with just treats or communication. This was her tail on Jun 14. ❤ |
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Post by Alix & Gretta on Jul 23, 2018 10:50:44 GMT -7
She just did her "I need to go outside!" bark for the first time since she went down. She didn't make it to the grass (we have to traverse the entire house and deck to get to it), but she didn't go in her crate, either. This is a good sign, I think?
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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 23, 2018 11:29:26 GMT -7
OK, now is the time to try the sniff and pee test to see the degree of repair of bladder control.
Just to clarify, you are carrying her all the way to and from the potty place?
The only way for humans to know if there is bladder control is with the “sniff and pee test.” Carry outdoors, set them on an old pee spot to sniff. Make sure the sling or your hands are not on the tummy area as that can press on the bladder. See if they will release urine on the old urine area. If urine comes out after sniffing, bladder control is returning. You should continue to do a quick express check to verify there is full voiding until you are certain it is consistently happening. Let us know what you observe.
As bladder control returns, you may find she is no keen on you expressing her. So just a quick express check to see if she has fully voided and if not squeeze that last bit out.
Let us know how the test goes!
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Post by Alix & Gretta on Jul 23, 2018 11:58:35 GMT -7
Yep, I'm carrying her the whole way. I did just order a stroller yesterday (Michael is also disabled, so we have ramps, etc.) to save my back a bit getting her in and out (plus letting me manage the door by myself without letting the kitter out!)
I will let you know how it goes, for sure. ❤
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Post by Alix & Gretta on Jul 27, 2018 9:45:32 GMT -7
Just a little update.
So far no go on sniff-and-tinkle, but I think my timing might be all off (there was a death in the family on Wednesday... that has made things more complicated).
The leaking has been clearing up as the UTI improves, and we can go 3 hours between expressions now.
There was an *almost definite* happy tail wag earlier. I got her out of the crate, set her down on the puppy pad, and while I was checking the crate for any wetness, her person got down on the floor to snuggle her. While he was still sitting down her tail went back and forth twice.
She rolled fully onto her back for belly rubs earlier. I was fretting for her back so I kept doing a quick rub, then righting her.
She is starting to get really restless in the crate, but so far we've managed to keep the Sonic Whine to a minimum.
Just 3 more doses of prednisone to go!
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Post by Romy & Frankie on Jul 27, 2018 13:18:36 GMT -7
That is good news about the tail wag if it was in response to seeing a favorite person. Any tail movement around eliminating is mostly reflex.
If she turns over on her back than she is comfortable like that and you don't need to move her.
Keep trying the sniff and pee test especially as she is wagging her tail now. Typically the next function to return after tail wagging is bladder and bowel control.
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Post by Alix & Gretta on Jul 30, 2018 14:57:57 GMT -7
We had a follow up with the vet today. She is very not-okay in the car most of the time, and strains to get out of her car seat, so we took her in her new stroller (mostly sidewalks). - She had a hookworm infection when she went down - that's totally gone.
- UTI much better, but still needs another 2 weeks of antibiotics and another re-check in 8 days (they gave us a collection deal so we don’t have to bring her in).
- He said she looked content, comfortable, and happy, and it was good to get verification that I wasn’t missing any pain signals.
- She lost 4 pounds with all of this, but less weight on her back is probably a good thing.
- She has a lump under her skin near her front right… legpit? that comes and goes - has for at least two years. It’s never been present during a vet visit before, but it was today, so we got it recorded so he can keep an eye on it.
Wednesday is our last day of meds (other than the antibiotic).
[Moderator's note: please do not modify
▼15 lbs
dex IV on 7/6
dexamethasone injections at home as of 7/6: for 6 days unknown mgs; 0.5ml 7/8 6am (last dose)
prednisone as of 7/8: 5mgs 2x/day for 3 days then 7/11 taper showed pain
as of 713: 5 mgs 2x/day for 5 days then 7/18 taper to test for pain/neuro loss
Pepcid AC 5mgs 2x/day still ?
✚Enrofloxacin]
We are still working on sniff-and-tinkle. Mostly she goes ON me on the way out the door, so hopefully the stroller will make things clearer (and I'll stop having to wash so many clothes  ).
No more improvement with the paralysis so far. |
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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 30, 2018 19:07:18 GMT -7
Alix, when off of all meds and no pain shows, it will be time to begin some VERY, VErY light least aggressive passive range of motion (ROM) for her back legs until she graduates and more active PT can be used. The information highlighted in PINK pertains to a dog who can't walk. www.dodgerslist.com/literature/massagepassiveexercises.htmKeep a stack of inexpensive washcloths handy to her suite. As you lift her, move a cloth under her butt to catch any overflowing urine. That should save your clothes! Using a stroller indoors where floors are smooth is a good idea to keep her with you as you move around the house. Save outdoor stroller use until she has graduated. Sidewalk cracks, bumps, uneven terrain may cause too much movement to the back. Let us know all is well with the last day of meds this Wednesday!!!! |
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Post by Alix & Gretta on Aug 4, 2018 9:48:58 GMT -7
Hi, everyone. ❤
gretta is doing alright. We are down to just the Enrofloxacin 68mg 1x a day for prescriptions. I'm scheduled to take in another urine sample on Tuesday. She is still showing signs of UTI (primarily a small amount of leaking between frequent potty times - she is eliminating entirely on her own at this point), so I'm hoping he will change her antibiotic if it's still not cleared up by then.
We had a big scare on Thursday morning (8/2) - even harnessed and clipped into her stroller, she managed to leap out of it at a knock on the door, pulling the stroller over with her. She landed "on her feet," the stroller didn't land on her, and she's had no pain signs or neuro set-backs, despite the 1.5-2 foot fall. We're now double clipping, keeping it zipped, and keeping a hand on her when she's in there.
We were giving her CBD oil for anxiety before she went down. We re-started it yesterday (8/3). The dose is 3.3mg CBD total/day, half with breakfast, half with dinner. That's about ⅔ the recommended dose, but it works for us at this level (in other words, she doesn't get stuck in panic mode). We asked our vet his thoughts on it and other than not giving it to her while she was on the valium (which we weren't doing/wouldn't do), he said he didn't know enough about it to give any recommendations.
There is semi-frequent tail wagging which is getting to be more all the time and some leg movement/locking/kicking when she's in the sling or we're holding her sides, but no signs of walking. We are doing our massage & exercises in the evening when we brush teeth. Sometimes it seems like she's pulling her foot back from me when we do them, but I don't know how much of that is reflex. She still does NOT like laying down on her side, so we do the best we can to bribe her with small pieces of treat and whatnot.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Aug 4, 2018 12:25:52 GMT -7
Alix, what a scare! So glad to hear monitoring is showing no pain, no neuro set back.
Going potty on her own...does that mean you observe her able to sniff an old pee spot and she then decides to releases urine there?
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Post by Alix & Gretta on Aug 4, 2018 15:18:20 GMT -7
Yes! I put her down and hold her hips a little up and she might walk a step [with FrONT legs only] or two while sniffing, but then she tinkles - sometimes she'll lift her back left leg at the same time. If she's in her crate and we've overlooked a normal taking-her-out time, or she needs to poop, she'll bark at us to let us know.
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Post by Alix & Gretta on Aug 6, 2018 16:50:11 GMT -7
She just used her back left foot to reposition herself, then tried to use it to scratch behind her ear! It was clumsy and didn’t work really well, but that’s the first definite movement we’ve seen. Her tail wag speed is picking up a bit, too. ❤
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Post by Julie & Perry on Aug 6, 2018 21:41:26 GMT -7
Woohoo!! That's terrific!! Go Gretta go!!
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Aug 7, 2018 4:57:24 GMT -7
Such wonderful signs of nerve healing, Alix! Very happy for both of you.
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Post by Alix & Gretta on Aug 7, 2018 14:35:54 GMT -7
Medication update: UTI recheck today (8/7) showed she still has an infection, so today we are starting on Amoxicillin/Clavulante Potassium 125mg, every 12 hours with food. Our first dose will be 6pm with her dinner. We'll re-test for UTI on the 14th. Otherwise things are going alright.  |
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Post by Julie & Perry on Aug 7, 2018 15:20:51 GMT -7
So did the vet culture a sample of urine from Gretta so they know exactly what bacteria is causing the UTI?
Also, antibiotics kill good and bad bacteria so I'd give her either dog probiotics or some plain yogurt with active cultures to restore the good bacteria.
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Post by Alix & Gretta on Aug 8, 2018 19:17:39 GMT -7
I thought he would have on the second sample, but I'll ask for sure when I bring in the next one. I have a short video on Instagram of her tail wagging from the other day. ❤ |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Aug 9, 2018 8:52:54 GMT -7
Alix, good happy tail wag. AND I see purposeful movement of upper thighs to try and move in a walking motion. Paralyzed dogs can dart/scoot in a blink of an eye. Consider always having a leash connected to the harness when outdoors. And of course when possible only take her out to potty when there are no other dogs about to agitate Gretta into moving too much. Limited motion of the back is key to getting it to heal. How are you doing with that very, very light range of motion with the back legs as described? — The information highlighted in PINK pertains to a dog who can't walk. www.dodgerslist.com/literature/massagepassiveexercises.htm |
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Post by Alix & Gretta on Aug 9, 2018 12:19:24 GMT -7
❤ I will definitely start using the leash! She got away from us indoors for the first time this morning zooming to get snuggles when I got home from the dentist and we started cleaning her crate right away because she excited tinkled (not sure if this is UTI-related, or IVDD-related, but the excited tinkling is new since she went down). Snuggles then cleaning, so orders gretta. The neighbor dogs are often outside in their fence this time of year, so we take her the other direction. Of course that way is where the grocery store and sidewalk are! ;D So we try to go when it's quietest. The first night (Friday, Aug 3) with her exercises was a little concerning. She was doing a really slight whine through most of it, almost inaudible, so we did a really abbreviated version (just massage, really). The second night (8/4) she seemed fine going through the whole routine, but the third (8/5), whining again. Ever since she's been fine and tolerating a little more each night. She's even laying on her side sometimes when I ask. Of course she now "knows" "ten" means "treat" when I'm counting out pumps.  I feel her muscles(?) jumping around sometimes, especially with the toe exercises. She likes the toe touches the least, I'm guessing because of the involuntary(?) kicking. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Aug 9, 2018 12:40:43 GMT -7
Alix, do not do the moving of each toe up and down during conservative treatment if they are causing too much movement possibly to the back of kicking out. Sounds like you may be inadvertently tickling the pads.
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Post by Alix & Gretta on Aug 9, 2018 13:40:56 GMT -7
Thank you, Paula! She's not kicking on the toe lifts "Move each toe up and down 10 times" (that's when I feel the muscle movement [edit: in her thigh area]), but she IS with the toe touch "lightly between toe pads up to 1 minute to stimulate the nerves." I bet you're right - she's always been ticklish there. It's hard to tell what's excessive kicking, so I've just tried to keep it short, but I'll omit it altogether.
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