Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
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Post by Sabrina on Jul 23, 2013 12:48:43 GMT -7
Hello everyone!
Charley (will be 5yrs in Sept; male neutered)
Charley is a “midi” dachshund – at 15.5lbs he’s just a bit too large to technically be a “mini”. (His weight is “ideal”).
We live in a small town and got a diagnosis of “disc disease” from our general vet. The diagnosis was to my knowledge based on observation and lack of fever. An x-ray was taken and the vet said he saw what appeared to be one possibly two calcified areas (around L3) but that he is not specialized enough to interpret x-rays.
-- What was the date you saw the vet and started 100% STRICT crate rest 24/7?
Saturday, July 13: Called on-call vet because Charley appeared to have pulled hip muscle (he seemed “stiff” – no “drunken rear end” yet). Vet suspected strain/sprain – under observation at home, no trip to the clinic.
Sunday, July 14: On waking up Charley could/would not use his rear legs to stand up. He pushed himself up with his front legs and waited for me to bring his breakfast to him. Called vet – went into clinic. Vet observed Charley’s hunched back and dragging rear legs – started injected cortisol, Methocarbamol, and Tramadol.
Monday, July 15 to Wednesday, July 17: Trips to the clinic in the morning for 1x/daily cortisol injection. On Monday pain response in back feet checked – Charley responded to the first/ “lightest” test. Discussed options: the veterinary hospital is 4hrs away, and our vet did not judge Charley to be a candidate for surgery (vet was the first to say he’s not an expert).
Crate rest – started on Wednesday, July 17. I see now that it should have begun immediately. From Sunday, July 14 to Wednesday, July 17 we had Charley on “mat/blanket” rest. He didn’t try to move much and my husband had a few days off of work so we took turns sitting next to him to keep him calm. We carried him outside to potty and did not let him try to walk anywhere. As I got over my own initial shock and started researching, I found Dodger’sList. So we’ve set up a “recovery suite” for Charley.
-- Is there still currently pain - No
-- What are the exact names of meds currently given, their doses in mgs and frequencies?
Sucralfate (1 gram): ½ tab 2x/day
Prednisone (5mg): ½ tab 2x/day. We are scheduled to begin tapering tomorrow to ½ tab 1x/day
Methocarbamol (500mg): ¼ tab 3x/day
Tramadol (50mg): ½ tab 2x/day (He had been on 3x/day but we tapered to 2 yesterday because he is not showing any signs of pain.)
-- Currently can your dog wobbly walk? move the legs at all? or wag the tail when you do some happy talk?
Yes to all. He tries to walk while on potty breaks (we have his pelvis supported and limit his steps to 6). He can use his back legs to push himself up when he changes positions in his crate. He can scratch his ear with at least his right foot (haven’t observed him do that with his left)
-- Do you find wet bedding or leaks on you when lifted up?
No. He has urinated in his crate but that was before I started charting his input/output so I could take him outside at the right times. While his pelvis is supported he does a squatting motion to urinate.
-- Eating and drinking OK?
Yes.
-- Poops OK - normal color no dark or bright red blood?
Yes. He squats (while pelvis is supported) to poo. Poos are a bit firm so we have begun adding a tsp of 100% pumpkin per day.
My question:
Charley was on injected cortisol for the first four days, and then switched to oral prednisone. He has been on (5mg whole tab) ½ tab pred 2x/day. The taper schedule my vet has for the oral pred is: “½ tab 2x/day for 7 days. ½ tab 1x/day for 7 days. ½ tab every other day for 14 days.” Is this an adequate/reasonable course of prednisone? Charley is showing progress (able to take "steps" on potty breaks while supported, his back is no longer "hunched") and I am not wanting to taper the prednisone "too soon". I understand the risks of prednisone, but I haven’t found any resources to tell me if there is a recommended length of time for treatment with prednisone.
Thanks!
Sabrina
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PaulaM
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Post by PaulaM on Jul 23, 2013 15:43:21 GMT -7
Sabrina, welcome to Dodgerslist. Since he still has control over his bladder and can move his legs, scratch his ear, he may well be a candidate for conservative treatment. I'm so glad to hear you ARE reading…as you guys will play an instrumental part in his healing opportunity. Now that you are doing 100% STRICT crate rest 24/7 only out at potty times for 8 weeks his chances have improved! Keep up the reading by checking out our core of IVDD knowledge here: www.dodgerslist.com/literature.htmPumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation. The amount of water in the diet makes all the difference. To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day. To firm up the stool add 1 teaspoon pumpkin to kibble and no extra water 1x a day. Note alternatives: really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potoato. It is prudent of your vet to try one course of Pred, a 7 day course, and then try a taper if is meds have been control pain fully. Have they….no shivering, no yelping, no reluctance to move in his crate? It is guess work as to when all the swelling in the spinal cord is gone. The taper is the only way to find out. On the taper it is normally called for the pain meds to also be backed off or stopped so there is a clear picture on assessing for pain. 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. On the taper the dose is lowered to less than the anti-flammatory dose and that is the time to assess just how well reduction of swelling is going by observing for pain. 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. |
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Jul 24, 2013 9:04:07 GMT -7
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. Thank you so much, Paula! That was exactly the info I was looking for. -Sabrina |
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Jul 26, 2013 10:31:00 GMT -7
Yesterday was the start of the pred taper (from 2.5mg 2x/day to 2.5mg 1x/day) - yesterday his tramadol was also decreased from 25mg 2x/day to 25mg 1x/day.
This morning Charley is not really trying to use his back legs. Yesterday I had to limit his potty break steps, and this morning he's only trying to take one or two. He just stood there to pee and didn't try to "squat". He also seems slightly uncomfortable when I pick him up. So I have a call in to the vet to see about going back to the pred 2x/day and tramadol 2x/day.
I know it's common to have to go back up on the pred, so I'm trying not to be discouraged. But I'm so very tired and I kinda just want to sit down and cry.
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Marjorie
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Post by Marjorie on Jul 26, 2013 11:36:43 GMT -7
I know the feeling, Sabrina. There are often so many ups and downs with this disease. But keep your chin up. It's only been a little more than a week for Charley. He probably just needs a little more time on the pred. Try not to get upset and stay positive for Charley. We're here for you. Let us know what the vet says.
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StevieLuv
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Post by StevieLuv on Jul 26, 2013 11:41:35 GMT -7
Try not to despair - it is very common to have to extend the time on prednison to get the swelling under control. You did a great job of watching for signs of pain - so his medical management can stay right on top of his condition! Hang in there and keep us posted  |
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Jul 26, 2013 13:49:14 GMT -7
Aw, thanks guys! I am so thankful for Dodger'sList - without it I'd have no perspective at all!
Charley's vet is off today, but the tech said to go back to ▲ pred 2x/day and tramadol 2x/day, and check with the vet tomorrow morning (the vet will be in the clinic for a half day).
It's a rainy day here and Charley is snoozing comfortably in his recovery suite. Thanks so much for the support! I will keep everyone posted.
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Post by Nancy & Polly on Jul 26, 2013 17:17:15 GMT -7
This can be a real roller coaster ride. As our dogs improve or decline, so do our moods. Hang in there!
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Jul 27, 2013 9:02:39 GMT -7
Hi everyone! Thanks so much for the support! Charley is using his back legs a bit more this morning - he's not back to where he was on Thursday but he's better than he was yesterday. He's also more comfortable when I lift him to carry him out for potty breaks.
The vet confirmed that we should stay at the pred 2x/day and tramadol 2-3x/day for another week before trying to taper the pred again. So we're at this med schedule again:
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StevieLuv
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Conservative Treatment 3x. It really does work!
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Post by StevieLuv on Jul 27, 2013 9:17:28 GMT -7
Good Morning, I'm glad to hear that Charley is feeling better now that his prednisone has been continued for a longer period. This is a very common occurrance, and each dog responds differently over time. Sounds like your spirits have been lifted too! Keep us posted |
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Jul 29, 2013 12:46:01 GMT -7
Charley is still doing well - we are back to having to limit the number of steps he takes on potty breaks (he wants to go go go!  ) I'm having trouble with potty breaks - since the start of Charley's disc episode he's only peed 3-4x/day. He's not dehydrated because he always has water and I give him homemade (no sodium) broth in measured amounts during the day. When he pees, it's a huge amount and always light-to-clear (and not stinky). However, even charting his input/output I can't predict when he's going to need to pee. On two different days where I do everything I can to have exactly the same schedule (feeding, broth, meds) - one day he'll pee first thing in the morning, the next not until 11 or noon. One day he'll go 6-7hrs better peeing, the next 4. And he holds his urine until he absolutely can't anymore. So, that means he can act uncomfortable like he has to pee (whining/moving around in his crate/pawing at crate/staring at me), I take him out, and he doesn't pee. But once I get him back in his crate if he doesn't calm down, I can take him out 15-20mins later and he'll pee a lake. Or he doesn't pee at all. Or he pees his crate. I really can't predict anything! I take him to places in the yard where's he's peed recently, but he really wants to "choose his own spot" and that requires many more than 6 steps. My husband's in human healthcare, and he said that both tramadol and prednisone can cause either the need to pee more or urine retention. So maybe it's the meds? Before this disc episode, Charley was always a big "marker" - he'd rarely pee all in one place if he could mark in five or six. So maybe he's holding his pee because he's hoping the next time I take him out I'll let him wander all over the place and pee wherever he wants? If anyone has any ideas at how I can better predict when he'll pee, I'd be so thankful! I don't want to take Charley out of his crate more than necessary, but if I wait too long and he pees his crate he's very upset about it and hates going back in the crate even after all the pads and blankets are changed. Thanks! -Sabrina |
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PaulaM
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Post by PaulaM on Jul 29, 2013 13:31:53 GMT -7
Prednisone will cause thirst and the need to urinate more frequently. Tamadol slows the digestive tube down and can cause constipation. Any trouble with too firm poops? Sometimes there are signs to indicate a UTI, such as smelly, change in appearance of urine. Other times there are not visible signs. I would rule out a UTI by bringing in a sample of urine. A UTI can burn making urinating painful and something to avoid. Since he has bladder control, do take him outside for a potty break every 3-4 hours while he is on pred. Set up an ex-pen in the grass or some of that poke in the ground wire garden edging fence to form a 6 foot diameter area… That way Charlie will know there will be no sniff fests. You can train him to potty on command. Just as you see is is about to potty, give the command "go potty" When he does potty, praise lavishly. Soon he will be more likely to attend to business promptly.
Are you using white vinegar with a little hand sprayer to spritz hard surfaces, floors the recovery suite? You can even put some vinegar in the rinse cycle to get rid of the urine's ammonia smell…maybe you can't smell it but Charley can. Sorry if I missed it, but can't read where you have Pepcid AC on board. 5mg Pepcid AC (famotidine) 30 mins before Pred. Let us know. |
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Jul 29, 2013 13:40:57 GMT -7
Hi Paula! Thanks for the ideas about the garden fencing and using white vinegar in the laundry!
Charley is on Sucralfate (1gram) 1/2 tab 2x/day, so we have been giving this at least 30mins before each dose of prednisone. Does he need to be on Pepcid AC, too? I had asked about Pepcid but the vet gave me the Sucralfate instead.
Edit: I forgot - yes, his poo is still firm so we are giving him pumpkin with both meals now to see if that helps.
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PaulaM
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Post by PaulaM on Jul 29, 2013 14:29:06 GMT -7
Sucralfate demands a special timing with food and with other meds. Did you read up? www.marvistavet.com/html/pharmacy_center.html This med requires any empty stomach to for the gel like coating. If you are not seeing warning signs of problems (not eating, vomit, diarrhea) , then sucralfate is good help. Have you been soaking each of his kibble meals in equal parts of broth/water? Have you been giving 1 teaspoon of plain pureed pumpkin 1x a day? It is the extra water and the high fiber of pumpkin that absorbs liquid to help with constipation. |
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Jul 30, 2013 7:29:59 GMT -7
Thanks again, Paula! I had thought that the sucralfate should be given at least 1/2 hr before his meal/meds, but I see from that link that it should be at least 1hr. We have adjusted his schedule accordingly.
Charley is not having any GI problems other than the dry/too firm stools.
Charley is on a raw diet (same diet as before disc episode), so I can't soak his food. I am giving him broth before meals instead.
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Jul 30, 2013 13:31:56 GMT -7
Hi everyone!
I just received a call from our vet. He had called and discussed Charley's case with a neuro vet at the animal hospital that is 4 hrs away from us. Charley has not been seen by the neuro vet.
According to our vet, the neuro vet said that since we had tried to taper Charley's pred last Thursday and symptoms worsened, that Charley would be a candidate for surgery. Our vet said that the neuro vet said his feeling was that surgery was Charley's best chance for recovery.
Charley is currently on pred 2/xday (since July 18, with only July 25 at 1x/day). He can wag his tail, push himself up to standing, walk (with his pelvis supported), has bladder/bowel control.
My head is spinning because our vet said that the neuro vet said that if we were willing to explore surgery as an option, we would have to make the trip to the hospital tomorrow - for evaluation and then surgery if the tests indicated that he was a good candidate.
Just as I was getting my head wrapped around conservative treatment, I have this to consider! We want to do the best we can for Charley, and from what I've read here it's not uncommon to have to stay on the full dose of prednisone for more than a week. But our vet said the neuro vet said that if we waited to see if another taper was successful, the surgery would potentially not have as good of an outcome.
So we are supposed to decide by early tomorrow morning if we want to make the trip to the hospital and explore surgery as an option.
Any help greatly appreciated!
-Sabrina
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PaulaM
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Post by PaulaM on Jul 30, 2013 14:37:06 GMT -7
from: www.dodgerslist.com/literature/healingsurgery.htmAs damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order. 1. Pain caused by the tearing disc & inflammation in the spinal cord 2. Wobbly walking, legs cross 3. Nails scuffing floor 4. Paws knuckle 5. Legs do not work (paralysis, dog is down) <--- Charley is here6. Bladder control is lost 7. Tail wagging with joy is lost 8. Deep pain sensation, the last neuro function, a critical indicator for successful surgery. Only take a neuro's assessment for this function as most DVM's do not get it right. After a dog is paralyzed, the existence of deep pain sensation is an indicator that surgery could STILL be successful. That window of time is 12-24 hours from losing deep pain sensation (DPS). Even after that window of time, surgery is often successful. The spinal cord is very fragile, the more hours after the window, the less chance of a complete neuro recovery. When the pred was tapered, the med that worked on reducing inflammation had been decreased to way less than the anti-inflamamtory dose. 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. Charlie had been on actually less than an anti-inflammatory dose at 2.5mg 2x/day and it was for about 10 days and then a reduction/taper was called for on July 25. Due to signs of pain and neuro diminishment he went back up on pred. After increasing Pred, you reported he was using his legs more and more comfortable pain wise. So it is possible that he could recover with conservative treatment. No one can give you a guarantee with conservative nor with surgery. I would re-read the link above on the pros cons. Come to a determination what is right for your family, your budget. Being well-read and not being pushed into a decision will mean you came to the right decision and if things do not go as expected you will know in your heart you gave serious consideration for the information you had at the time. Reading what Dr. Isaacs (neurology) says about surgery will also give you some perspective. www.dodgerslist.com/literature/surgery.htmI know you would like a firm answer. My dog had three surgeries:Oct, 3 months later and then 1 week later..he is paralyzed because something went wrong on surgery 2…surgery has it's risks Another had surgery at age 1 and came out walking and never had another problem during her 17 years. If Charlie were my dog, I would try conservative, monitoring closely if he would loose bladder and tail function to consider surgery at that time. Do know which treatment you choose, we are here to support you. |
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Jul 31, 2013 6:44:19 GMT -7
Paula, thanks so much for the info, support, and sharing your experiences.
My husband and I have decided not to pursue surgery at this time. We've been reading everything on Dodger'sList and are so thankful we are able to make an informed decision on this matter.
Charley is doing well today. I will keep you all updated!
-Sabrina
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Aug 1, 2013 13:45:07 GMT -7
Using garden fencing to make a potty spot is working! Charley is starting to understand that he's not going to get to walk all over and choose his own spot - I really think this is due to the visual/physical barrier of the fencing.
He isn't peeing any more frequently yet (still 3-4x/day) but it's taking less trips outside to get him to pee.
We haven't done a urine test because Charley doesn't exhibit any signs of pain when urinating (urine still light-to-clear, no foul odor) - I know none of this is 100% sure he doesn't have a UTI, but I am observing him very closely and at any sign of one I will get a urine test done asap.
We are scheduled to try tapering the pred again tomorrow - I will keep you posted!
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Aug 3, 2013 9:01:47 GMT -7
Yesterday we tapered Charley's pred down to 2.5mg 1x/day and his tramadol down to 25mg 1x/day. I was so nervous this morning, but he does not show any signs of pain or having lost any ground. He still lifted his leg to pee this morning (his pelvis was supported) and isn't showing any "hunching" (like he was when we tried to taper last week). I'm encouraged - I'll let you know how we get on! |
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Post by Nancy & Polly on Aug 3, 2013 19:10:57 GMT -7
SOunds like you're making progress!
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Deborah & Angel
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No current back issues... Living Life.. <3
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Post by Deborah & Angel on Aug 4, 2013 12:48:23 GMT -7
GREAT news.. |
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Aug 4, 2013 13:21:04 GMT -7
Thanks so much for the encouragement! Charley is still doing well. This is day three of the 2.5mg pred 1x/day, so I am hopeful!
I will be checking with his vet tomorrow to see:
- if we can stop the tramadol (currently: 25mg 1x/day) and
- either reduce or stop the methocarbamol (currently: 1/4 a 500mg tab 3x/day) so that we can be sure he doesn't need a higher dose of the pred.
)))Hugs to everyone!((( I will keep you posted.
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Aug 6, 2013 8:07:34 GMT -7
Yesterday the vet confirmed we can:
- stop the Tramadol
- taper the Methocarbamol (dose = 1/4 of a 500mg tab) from 3x/day to 2x/day
That makes his current med schedule:
- Sucralfate 1 gram: 1/2 tab 2x/day
- Prednisone 5mg: 1/2 tab 1x/day
- Methocarbamol 500mg: 1/4 tab 2x/day
So far so good! Charley can still lift his left leg to pee (his right leg seems stronger), take steps with his pelvis supported, and push himself up to standing in his crate.
Question: the "bridge" of Charley's nose - the area right before his nose proper - looks slightly puffy to me. The fur looks like it's standing up a bit. I don't think it's painful to touch but Charley has never much cared for his nose being touched so it's hard to judge. Charley's in a wire crate, and every once in a while I'll see him with his nose pressed up to/between the wires, but usually his nose isn't touching them. Is this something to be concerned about?
I've found a great calming aid - music cds from "Through A Dog's Ear". I'd been thinking about them for awhile, even before Charley's disc epsiode - Victoria Stillwell, a trainer I really admire, highly recommends them - so I went ahead and got the cd series "Music to Calm Your Canine Companion". I'm quite impressed - they really do help Charley relax. They of course aren't a magic fix and he still has episodes of barking/restlessness, but he calms down quicker with the music playing and he settles down to sleep quicker at night, too. And it's helping me to be less anxious, too!
)))Hugs((( to everyone!
- Sabrina
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Aug 10, 2013 9:11:54 GMT -7
Charley is still doing well - no pain, no regression! - so the vet has given us the green light to continue tapering the pred - we're going ▼ down to 2.5mg pred every other day.
And his nose looks normal now - we're thinking maybe he'd slept with it pressing against the crate or something.
)))Hugs!((( to everyone!
-Sabrina
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Deborah & Angel
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No current back issues... Living Life.. <3
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Post by Deborah & Angel on Aug 10, 2013 9:51:27 GMT -7
Hi...Didn't see your name anywhere, but mine is Debbie. As far as the "nose" issue, Mine would sit in the crate with her nose and mouth pressed aganist the wire part of the door on the crate, looked really funny from my end..lol. Don't know if she was looking for sympathy or what, she had NEVER been crated, and is spoiled rotten, but we made it through..Good to hear Charlie is doing so well, keep up the good work, it will all be over before you know it.. |
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
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Post by Sabrina on Aug 11, 2013 18:33:25 GMT -7
Hi Debbie! I'm Sabrina! Thanks for the encouragement! Before this disc episode Charley was only in a crate for traveling in the car. So it's definitely a new experience for all of us, but he's doing so much better with the strict crate rest than I anticipated, and thanks to Dodger'sList I'm doing so much better than I anticipated, too! |
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Deborah & Angel
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No current back issues... Living Life.. <3
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Post by Deborah & Angel on Aug 12, 2013 7:54:08 GMT -7
Hi Sabrina...Same here...we NEVER did the crate thing with either one of ours, but she adjusted very well...hang in there, we are here for you.. Many (((hugs))), and lots of prayers coming your way.. |
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Sabrina
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My Charley-dog, a Dodger'sList grad enjoying life!
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Post by Sabrina on Aug 17, 2013 8:05:24 GMT -7
Wow - we passed the 4 week point this past Wednesday! More than half-way there! Charley is definitely improving. He'll sometimes push himself up to standing in his crate and hold that for a second or two. On potty breaks he sometimes lifts a leg to pee, and sometimes he even lifts his right leg (supported so he doesn't fall)... meaning he's standing on his left... and his left leg is the one that had been looking weaker to me before, so I'm encouraged! Ha! My dog lifting his leg to pee can totally make my day!  We're on every-other-day 2.5mg pred until the 23rd (with sucralfate an hour before). The vet also wanted us to taper the methocarbamol, so Charley is on 125mg once a day until we stop that on Monday (19th). No signs of pain, so I'm hoping we'll be done with all the meds on the 23rd! )))Hugs to everyone!((( - Sabrina |
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Marjorie
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Post by Marjorie on Aug 17, 2013 9:11:49 GMT -7
That all sounds very good, Sabrina! You're doing a great job with Charley and it shows. It's wonderful that you're seeing these signs of improvement - and no pain! Before you know it, you'll be writing to us saying the crate rest is near its end. I know how much you're looking forward to that day. Great update. |
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