PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 16, 2019 11:22:25 GMT -7
Describe to your vet nearing the next doses of pain meds, Oscar is shaking. Any other confirmational pain signs due to the disc issue? Here are the signs of pain for a disc. Keep in mind peeing 1x/day may be due to pain of a UTI, pain of reluctance to move much at potty time, or too cold for him outdoors, so detective work with your vet is needed to figure out what is going on .
SIGNS OF PAIN
◻︎ shivering-trembling ◻︎ yelping when picked up or moved
◻︎ slow to move ◻︎ tight tense tummy
◻︎ arched back, ears pinned back ◻︎ head held high or nose to the ground.
◻︎ restless, can't find a comfortable position
◻︎ slow or reluctant to move much in crate such as shift positions
◻︎ not their normal perky interested in life selves
+ pain from neck disc:
◻︎ looks up with just eyes and does not move head and neck easily.
◻︎ not eating due to painful chewing or in too much overall pain
◻︎ holds front or back leg flamingo style not wanting to bear weight
Many times with a disc episode the pain of muscle spasm occurs. Discuss adjusting meds:
— Methocarbamol works on the pain of muscle spasms Rx'd for every 8 hrs.
— Tramadol is the general pain reliever. At 50mgs every 8 hrs (3x/day) is the max analgesic dose
— Gabapentin works on nerve pain. It may have room to move up in mgs every 8 hrs.
Within an hour when pain meds are correct, the pain would be in control. There should be no sign of pain from one dose of meds to the next. Look for your dog to be acting their normal, perky self when pain is fully under control round the clock.
A urine sample is analyzed in the clinic--- called a urinalysis. Sometime you can bring in a sample and other vets will want to collected an uncontaminated sample....discuss with your vet.
Some UTIs will show signs of burning sensation when peeing and thus a dog holds it as long as possible. Change in color or a foul smell. Other UTIs show us no signs and thus the reason to run a urinalysis to prove infection or no infection.
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Post by Karianne & Oscar on Jan 16, 2019 15:38:11 GMT -7
After calling the vet about the urination issue and pain and lack of drinking, she wanted to see him. Of course Oscar peed right before we went to the vet and drank water. The vet said it's not a UTI - that he's probably holding it because it's still uncomfortable to pee. She is upping two of his meds before adding any more or changing any. He's also improving on neuro tests. I think we're back up to right before wobbly walking. She also said to try to add liquid to his food to try to get more water - but he didn't look dehydrated
Meds:
Maintain 5mg Pepcid 2x/day 30 min before carprofen; 12.5mg carprofen 2x/day
Change: Increase ▲tramadol from 25mg to 50mg 3x/day as needed up to, increase ▲gabapentin from .6mls to .8mls 3x/day as needed
[Moderator's note: please do not modify
13.96 lbs
Carprofen as of 1/13: 12.5 mgs 2x/day for 5 days then FRI 1/18 STOP to test for pain/new neuro issues
gabapentin 100mg/mL: ▲80mgs (0.8mL) 3x/day
tramadol 50mgs 3x/day
famotidine 5mgs 2xday]
we are going to observe pain and urination and then determine if we need to change.
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Post by Julie & Perry on Jan 16, 2019 15:43:04 GMT -7
Karianne, since IVDD is known to be very painful I'd give Oscar the gabapentin and tramadol 3x daily.
Don't treat it as needed.
This could make a big difference if his current problems are because of pain.
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Post by Romy & Frankie on Jan 16, 2019 16:00:10 GMT -7
Julie has given you good advice. IVDD is typically painful and it is much harder to get pain under control once it has started than to keep it at bay. That is why we support giving the pain meds on a regular basis instead of as needed. These pain meds do not last long in the body and often have to be given 3x daily for full pain relief.
To encourage Oscar to drink try some tasty lo-cal, no-salt meat broth.
Making broth yourself is better nutrition than the store bought which very likely contains onion. Onions and Dogs: A Lethal Combination
---Simply boil up a hamburger patty or a bone with meat on it in about a cup of water, cool & toss the fat disc, trash all cooked bones.
--- Boil some chicken parts. cool, de-skin/de-bone and toss the fat disc at the top.
--- Add 1-2 teaspoons of the meat on top of his kibble as added tastiness and nutrition
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Post by Karianne & Oscar on Jan 17, 2019 9:47:07 GMT -7
Great news! Oscar peed this morning and wasn't shaking and tense (I also soaked his water with some meat and he lapped it up too so he had more water as well). Looks like the higher doses of gapapentin and tramadol are working. We'll continue down this path until we have any changes and i"ll keep you updated.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 17, 2019 11:09:20 GMT -7
Karianne, so pretty clear, that the stop of Carprofen intended for 1/18 will not likely reveal all pain is really gone.
What does "continue Carprofen" mean? A vet must take a guess and precribe a course. Some choose a 7-day or even try a 14-day course, then the stop to reveal if all painful inflammation is gone. So how many days did your vet prescribe?
Carprofen as of 1/13: 12.5 mgs 2x/day for 4 days and still in pain on 1/16
as of 1/16: 12.5 mgs 2x/day for ? more days
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Post by Karianne & Oscar on Jan 17, 2019 11:24:18 GMT -7
We aren't stopping Carprofen tomorrow. We are talking tomorrow about how to proceed and if we need any med changes. So based on initial conversations, we will likely keep him on it for two weeks total until we stop.
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Post by Julie & Perry on Jan 17, 2019 13:11:21 GMT -7
I'm glad that Oscar is feeling better! It's terrible when they're in pain.
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Post by Karianne & Oscar on Jan 18, 2019 13:20:38 GMT -7
Talked to the vet - we are going to continue all meds at same frequency and will check in on Wednesday to discuss again if we will make any changes. He peed 3 times yesterday and once today so far (my fault, I fell back asleep this morning and was late on a dose of pain med - so he was in a little pain this [1/19] morning but pain meds have since caught back up.) So overall I think he's improving.
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Post by Romy & Frankie on Jan 18, 2019 14:00:13 GMT -7
Very good to hear that Oscar is improving and peeing more normally when not in pain. It is hard to see our dogs hurting.
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Post by Karianne & Oscar on Jan 23, 2019 21:01:18 GMT -7
Quick check in here - vet and I are playing phone tag so keeping all meds same until we connect live.
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Post by Karianne & Oscar on Jan 29, 2019 16:30:53 GMT -7
Finally talked to the vet today:
- We had been reducing the tramadol and gabapentin (a few times we didn't realize Oscar spit out the Tramadol and he didn't seem to be in pain, and I was running out of gabapentin, so I reduced his dose), and the vet said to take him completely off of both and watch him to make sure he's not in pain)
[Moderator's note: please do not modify
13.96 lbs
Carprofen as of 1/13: 12.5 mgs 2x/day for 17 days, no test for pain/new neuro issues
as of 1/19: 25mgs 1x/day for undetermined days,
famotidine 5mgs 2xday]
He will remain on [?] the Rimadyl - 25mg 1x/day along with the Pepcid (5mg 30 min before) starting today
- Knock on wood, he's doing really well - he's not wobbly when peeing and pooping and he's been doing both a few times a day.
- We will reconnect in 1.5 weeks to discuss next steps.
- Meanwhile, our srict crate rest continues...he is fine when I'm not home, but whines and barks whenever I come home or am in the house unless he is next to me in whatever room I'm in.
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Post by Pauliana on Jan 29, 2019 18:18:38 GMT -7
Karianne, did the Vet say when Oscar can stop the Carprofen? Since you have stopped the pain meds, it is the perfect time to stop Carprofen to see if the swelling is gone..He's been on it since the 13th.. Keeping Oscar on it when the swelling could be gone, could mean he is on it for no reason exposing him to the side effects needlessly. Discuss this with your Vet..
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Post by Karianne & Oscar on Jan 30, 2019 21:23:57 GMT -7
He said to take him off the pain killers first and see how he does for a few days and then we'll talk about getting him off of the carprofen.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Jan 31, 2019 7:13:07 GMT -7
Karianne, so if there's no sign of pain today or tomorrow, you can then call the vet today or tomorrow and discuss stopping the Carprofen and not have to wait to re-connect with him in in 1.5 weeks? Please speak to the vet soon about stopping the Carprofen to test for pain. As Pauli said, the swelling may well be gone by now and there may no longer be a need for the Carprofen. The only way to tell whether the swelling is gone is to stop the Carprofen and see if there are signs of pain. If no signs of pain, then meds are no longer needed. If there are signs of pain, then all meds need to be restarted for awhile longer. You don't want Oscar on Carprofen for any longer than absolutely necessary.
Prayers for a pain-free stopping of all meds at this time.
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Post by Karianne & Oscar on Feb 2, 2019 21:08:04 GMT -7
So we stopped everything today (last dose of pepcid/carprofen was yesterday 2/1/19 at 9:15/9:45am). He seems comfortable and is standing on his own and peeing and pooping normally. He definitely has some weakness in his back legs, but so much better than what we started with a few weeks ago.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Feb 3, 2019 5:34:57 GMT -7
Wonderful news, Karianne! So glad to hear it. Now all that's left to do is to finish out the full 8 weeks of strict crate rest. The weakness in his hind legs should improve once movement is once again gradually reintroduced after the 8 weeks of crate rest.
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Post by Karianne & Oscar on Feb 22, 2019 10:51:49 GMT -7
Hi Everyone,
Wanted to give everyone an update - we've started accupuncture (they wanted electro accupuncture, but he refused to tolerate it) and water therapy under the supervision of a rehab vet and I do some very basic home PT that they taught me in the crate. They wanted Oscar standing out of the cage for 5 minutes each day and walking (under strict supervision with harness).
He's doing fantastic - he has almost no deficits and can walk straight with no limping/etc. He has a little weakness but it's almost not noticeable. He's got about 2 more weeks go of crate rest (I'm so nervous to let him out when it's over!)...and he lifted his leg to pee the other day.
He is now on Omega 3 supplements - Nordic Naturals for pets 1x/day and Curcumen pills 1 pill 2x/day as a natural anti-inflammatory.
Karianne
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Feb 22, 2019 13:26:54 GMT -7
Karianne, if you intend for there to be no relapse (retear of the disc) during the period the disc is trying to form secure scar tissue you will get Oscar back inside his recovery suite PRONTO. Bone up on IVDD so you have the ability to recognize maybe well intentioned but VERY HARMFUL advise from the PT person! There is no such thing as doing STRICT crate rest but employing activities that required movement. So far Oscar is one heck of a lucky to not have re-torn his early healing disc. Graduation date is March 10. To quote Marjorie: " Now all that's left to do is to finish out the full 8 weeks of strict crate rest.
With too much movement of PT before the end of the 8 weeks of disc healing..this is what often will happen to the dog...a relapse, a retear of the early healing disc:
We see dogs doing less than 8 weeks of conservative crate rest, have a relapse to the early healing disc. We do also see that some few dogs whose owners prefer less crate rest do fine with fewer weeks of rest. There is no way to tell ahead of time which category the dog will be in. At Dodgerslist we are very cautious and follow the vets who do recommend 8 weeks of rest having seen too many dogs on the Forum re-injure a disc with less crate rest ending up with more pain and may need a $4000-8000 surgery. 8 weeks of rest is of course not scientific proof, just an observation over many years and many, many 1000's of dogs. The focus of the 8 weeks is getting the disc to form good secure scar tissue. Nerve healing may or may not happen during the short 8 weeks a disc can heal in. Muscles may atrophy during crate rest, but when it is safe to do active PT, muscles soon bulk up.
How long does a disc take to heal?
There are no clear cut research studies to answer this question about disc tissue. Usually there would be no $1000+ MRI with conservative treatment to look at the disc's progress. So again it is a guess for each dog how long disc healing takes. Dodgerslist does err on the side of being conservative on crate rest time. Since 2002 and well over 8000 dogs we observe dogs who complete the 8 weeks more often avoid a relapse during the conservative treatment period than dogs who have a shorter confinement period. Here are comments that give some sense of disc healing and how much crate rest.
All of life is a weighing of the risks vs. benefits. Is 8 weeks to give the most assurance the disc has healed too much? Is 8 weeks in the total life span of a dog too much time to invest? I can say that I've not observed since being here in 2007 a dog harmed from 8 weeks of rest, but I have observed too many being harmed with less crate rest.
Spinal cord protection trumps maintaining muscle atrophy!
Once crate rest has been completed then it will be safe for the conservative treated dog to be a slow introduction back to activity. Muscles will bulk up again. click to enlarge picture.
Seeing IS believe muscles will bulk up again
when it is safe upon graduation on March 10th: REFERENCESPlease let us know that you will consider giving Oscar every single possibility to have a good recovery of his disc by ensuring he gets back to 100% STRICT crate rest 24/7 only out for a very, very few footsteps at potty time until graduation day of March 10th. No PT, no walking, no water therapy...just crate rest for the disc until March 10. |
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Post by Karianne & Oscar on Mar 10, 2019 19:15:27 GMT -7
Hi Everyone, Oscar is off crate rest! He's walking with no deficits (can't believe it!) and we are now beginning our super cautious re-entry phase. I've blocked off all our furniture, bought lots of dog beds for each room and ordered a ton of yoga mats for our wood floors. I still keep him crated when we leave the house or I can't strictly observe him in one of our enclosed rooms so I can ensure he's safe. Since it's so cold and wet outside, we'll be doing our walking practice inside the house. Thanks all for your support and information! Ironically, my sister's 11 year old Boxer just had what they think is an IVDD episode and guess what was the first thing I told her to do (well, the second after telling her to crate Lucy). Of course, go to Dodgerslist. F Karianne  |
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Post by Julie & Perry on Mar 10, 2019 19:44:29 GMT -7
Woohoo, that's terrific! Great work. 😀
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 10, 2019 19:57:16 GMT -7
Karianne, you and Oscar made it...saw crate rest to completion. What a very excellent report of how well he can walk!! You've got the idea right to gradually give more freedom under controlled conditions. Not free reign of the house and yard immediately! LOL Take a look at our information and then come up with a plan to gradually increase activity over about a month's time following the end of crate rest. Also check out how to teach four paws on the floor! www.dodgerslist.com/literature/AfterCrateRest.htmCheck over these home modifications so that you can reduce the stress on the spine in the future. No more stairs, ramps up to furniture, or blocking furniture all together. All those ideas and more are in this link: www.dodgerslist.com/literature/protectback.htmwww.dodgerslist.com/literature/aftercraterest/furniture-blocker300.jpgI'm so sorry to hear about Lucy and how you knew to give good information about crating. Hope your sister will join us all on the Forum |
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Post by Karianne & Oscar on Sept 14, 2019 16:43:25 GMT -7
Hi Everyone,
Just wanted to make a quick post about Oscar. So far (fingers crossed) he's been great. He has very little deficit (sometimes he stumbles a little in longer grass) but you would never know he was down. He can run, although in his older age, he does this less often. His stamina is definitely not where it used to be but we are incredible grateful with his recovery. Occasionally, if I think something might be acting up, we'll give him some Tramadol and crate him for a day or two, but I think I'm hypersensitive to it.
Just so you all know - we elected conservative treatment - he was down all the way to both back legs paralyzed (never lost bladder control and deep pain).
Karianne
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 14, 2019 16:48:07 GMT -7
Karianne, how wonderful to hear Oscar is continuing to do well after both legs affected back in Jan 2019. Conservative does work..it works to reduce the swelling in the spinal cord. and then just like with a surgery, it is up to the dog's ability to self heal nerves. Oscar's body did quite well. Thank you so much for giving us an 9 mo update!!!
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