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Post by Danielle & Otto on Apr 23, 2019 12:17:09 GMT -7
Hello,
My dog is a pug not a doxie but was diagnosed with ivdd. On 1 week of gabopentin. Long term meloxicam. I ordered him a little pen for rest and am setting up today. Vet did not talk about strict crate rest i found it online. Hes naturally pretty inactive does not run and jump. He has had hip dysplasia for 4 years.
[Moderator's Note. Please do not edit 26.1 lbs 11 y.o. 4/11ish?: became reluctant to walk, had trouble getting up 4/13 yelped all night 4/17 up all the night yelping diagnosed IVDD 4/18 by DVM ER vet Meloxicam liquid since 2015 for hip dysplasia: 25lbs dose 1x?/day long term gabapentin 100 mgs 3x/day no GI tract protector Pepcid AC on board! ]
My problem is I try to treat him like glass but when I get him outside to pee and poop he falls leash or no leash. I dont know how to get him to do his business without falling. He always needs to walk a little to get it going. This is so heartbreaking.
What do I do?
Thanks,
Puglife
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Post by Julie & Perry on Apr 23, 2019 13:06:51 GMT -7
You need a sling for support. It's easy to make your own from a winter scarf or a stretchy exercise band. Use the sling for support in the back.
Also use a harness/leash so Otto can only take the fewest steps possible.
It takes a little practice holding the sling in one hand and the leash in the other hand.
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Post by Romy & Frankie on Apr 23, 2019 13:22:35 GMT -7
Welcome to Dodgerslist. We are glad you’ve joined us all. We’ve got valuable information we’ve gleaned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you!. I am very sorry that Otto is having a disc episode. It is important to know that disc disease is not a death sentence! Struggling with quality of life questions for your dog? Re-think things: www.dodgerslist.com/index/SDUNCANquality.htmWhat is your name? I am Romy and my boy is Frankie. What was the date you saw the vet for CONSERVATIVE treatment of meds and started crate rest? The most important thing you can do for your Otto now is super strict crate rest. The hallmark component of conservative treatment is the very STRICT crate rest part (no PT, little movement). With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. Those weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form. www.dodgerslist.com/literature/CrateRRP.htmSTRICT means: ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy whys: www.dodgerslist.com/literature/chiropractic.htm ◼︎no dragging or meandering at potty times. ◼︎no PT for conservative dogs during 8 weeks to heal disc ◼︎At home laser or acupuncture for severe neuro damage is best. Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment. Carry Otto to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog’s back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on! www.dodgerslist.com/literature/slingwalk.jpgMy Frankie also had the falling over problem during his disc episode. There are different types of slings but what worked best for Frankie was a figure 8 type sling. The picture below shows how to make one. This type of sling is not near the dog's penis and allows the dog to easily pee. You can also use this to help him poop. Frankie needed extra support when he tried to squat. Even with the sling he would start to tip over. During this period, I knelt down and supported his back legs while he did his business. www.dodgerslist.com/literature/cratesupplies/Figure8.jpgHow much does your Otto weigh? Please list the exact names of meds currently given, their doses in mgs and times per day given. You mentioned he was on long term meloxicam. How long has he been taking that? Is that for the hip dysplasia? Is Otto showing any signs of pain? IVDD is typically painful. These are the signs of pain we look for: ☐shivering, trembling ☐yelping when picked up or moved ☐reluctant to move much in crate such as shift positions or slow to move ☐tight tense tummy ☐can’t find a comfortable position ☐Arched back ☐ Holding front or back leg flamingo style not wanting to bear weight ☐head held high or nose to the ground ☐Not their normal perky selves? Full pain relief is expected in 1 hour and stays that way between doses. If not in control your vet needs to know asap to adjust meds. Is he eating and drinking okay? No signs of GI tract problems such as vomiting or diarrhea? All anti-inflammatories cause excess stomach acid that can lead to stomach damage. I know that Otto has been on the meloxicam for a long time but with the added stress of having IVDD because of pain and body changes it is important to have a stomach protector like IVDD on board. This is similar to how stress in humans can sometimes lead to ulcers. Ask your vet if Otto has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health” issues answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine). canigivemydog.com/wp-content/uploads/2011/10/can-i-give-my-dog-pepcid-ac-300x300.jpg Is the vet a general DVM or a specialist surgeon: ACVIM neurology or ACVS ortho? Knowledge is the power to fight the IVDD enemy and win!! The very best thing you can do for YOU, the caregiver, and for your dog is to get up to speed on IVDD soonest possible. Begin absorbing the must-have overall sense of meds, care and how the treatment works. Your dog will be depending on your ability to learn - excellent video series here: www.dodgerslist.com/literature/theater.htmPRINT OUT this link and tape to your fridge: www.dodgerslist.com/literature/healingpage.htm--use the printout as your roadmap to avoid dangerous detours in your dog’s care --make notes/highlight to keep yourself on track --follow all the links in the next days to become the IVDD savvy pet parent your dog needs. --Use the “search box” to easily locate topics over at our Main www.Dodgerslist.com website: www.dodgerslist.com/index/searchBOX.jpg
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Apr 23, 2019 16:10:49 GMT -7
Hi, Danielle! Until you are certain you are solely dealing with a disc episode, do follow the good advice Romy is sharing about STRICT rest to protect a damaged disc with very, very limited footsteps at potty time. And most definitely using a sling Julie described to keep his butt from falling over and twisting his back further damaging a disc. Pugs can suffer IVDD and it can, as well, be just one component of the complex newly identified Pug Myelopathy disease. We are not vets and depend on a good diagnosis from a vet, then we know a lot about caring for IVDD dogs. We do want to make sure Otto has the correct diagnosis so he gets the right treatment. Dr. Smiler, DVM, has been a pioneer in efforts to get an understanding via clinical studies, promoting education about this disease for veterinarians and owners. She has a FB page where she will answer your questions as well as an informative Website with good information to read. QUESTIONS • What is Otto's age? How much does he weigh? • Xrays were taken to provide proof of hip dysplasia? • What were the specific signs of pain you observed on 4/23 that made the vet Rx gabapentin for nerve pain? • Is pain fully in control dose to dose of gabapentin. What is the dose in mgs and how often do you give? • For how long prior to the vet visit on 4/23 had you observed issues? Could you be specific what issues did you observe regarding pain or neuro diminishment? • What kind of vet diagnosed IVDD? A general DVM vet, a specialist vet (neuro-ACVIM or an ortho ACVS)?
Dr. Smiler, DVM's web page on Pug Meylopathy every pug owner should read and be aware of: www.pugrearataxiaparalysis.comDr. Smiler, DVM's Facebook page: www.facebook.com/Pug-Dog-Health-Rear-AtaxiaParalysis-218123938233440/Look forward to learning more about Otto with your answers to Romy's and my questions to best help.
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Post by Danielle & Otto on Apr 24, 2019 20:13:01 GMT -7
RE: Romy Thank you for your help. I have been soo worried over my little one.
hat was the date you saw the vet for CONSERVATIVE treatment of meds and started crate rest? 4.18.2019 diagnosed - likely IVDD, but as he it not paralyzed they do not do MRIs at this point. So he doesn't have a crate yet. I ordered one but it was not right, so I had to take it back and order another one which [crate] should be here tomorrow maybe. I have a stroller he can hang out in I guess? He's pretty inactive. Vet did not specifically mention a crate. I found info online.
Otto weighs 26.1 lbs. We are working on weight (calorie journal) since last week. I have a very hard time keeping it down since hip dysplasia. We did swimming before ivdd which seemed to be working (he lost 2 lbs) but then this happened. I think according to a couple vets he should weigh 21-22 lbs.
Meloxicam - dose for a 25 pound dog. maybe 2.5 mg? The measurement device they give you is by pound. gab - 100 mg 3x day
4 years meloxicam. yes, hip dysplasia. yes, he has so much pain. eating and drinking ok. no vomiting or diarrhea. vet was general/emergency.
RE: PAULA QUESTIONS
• What is Otto's age? How much does he weigh? Almost 11. 26.1 lbs • Xrays were taken to provide proof of hip dysplasia? yes • What were the specific signs of pain you observed on 4/23 that made the vet Rx gabapentin for nerve pain?
yelping, trouble getting up. falling • Is pain fully in control dose to dose of gabapentin. What is the dose in mgs and how often do you give? at night, its bad. dose is 100 mg every 8 hrs • For how long prior to the vet visit on 4/23 had you observed issues? he yelped all night starting 4.13. some days before that, became reluctant to walk, had trouble getting up. at first, we thought his hip dysplasia was getting worse but he was up all the night yelping on the 17th and then i took him to the vet. Could you be specific what issues did you observe regarding pain or neuro diminishment? Had trouble getting up, kept falling. getting up is better with gaba. yelps especially at night.
• What kind of vet diagnosed IVDD? general/emergency dvm.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Apr 25, 2019 5:14:50 GMT -7
Danielle, you have a pain emergency that must be dealt with ASAP this morning. Please call the hospital where Otto was examined. Any of the vets on call this morning can look up his records and adjust meds. Tramadol as a general pain med can be added. Methocarbamol which works on the pain of muscle spasms can be added. Pain should be completely under control within one hour of giving the new meds and remain completely under control from one dose to the next. Have no patience with pain as it does hinder healing and there's just no reason for it with the pain meds vet have available to them. Does it say on the bottle of Meloxicam how many mgs are in 1 ml? and how much of ml is given? Is this the dosage that Otto has been taking for four years? It may be a low dosage given long term and may not be high enough to be considered an anti-inflammatory dosage. Please check on this. Anytime a dog is on an anti-inflammatory, especially long term like Otto has been, stomach protection should be given. As Laura explained, pain and crate rest all cause added stress, which increases acidity in the body. So please do speak to the vet about adding Pepcid AC. Otto's body has a lot of repair jobs to do so continue his normal food rations that he currently gets and not try to decrease it any further until after crate rest. Good that you're watching calories. Treats, if any, should be low cal carrots, piece of apple or some frozen broth ice cubes to lick. While pet strollers can be a good thing for us humans and dogs alike during crate rest, they should be used with caution and certain restrictions. Inside use only during conservative care and never leave him alone in it. More info here: www.dodgerslist.com/literature/strollers.htmUntil you get a diagnosis other than IVDD, you should treat for IVDD. Please do limit his movement as much as possible until his crate comes. Use an ex-pen or a stroller with the restrictions above. Temporarily section off a space in a bathroom. The recovery suite/area should only be large enough for him to stand up, turn around and lie down with his legs comfortably extended. Any extra space needs to be filled in with rolled up towels/blankets. The less movement of the spine, the better. I do hope the crate comes today as that is the safest place for Otto. Healing prayers for Otto. Please do let us know what the vet says after speaking to them this morning.
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Post by Danielle & Otto on Apr 25, 2019 12:38:11 GMT -7
Hello,
I have some questions. I haven't called the vet yet but he was a bit better last night. He yelped a bit It's only before bed, but the time he does it has lessened. He does not do this during the day. Just before I go to sleep.
Okay, I have some questions.
1. Is it ok to use the stroller outside a little if we are careful? I live in an apt that is very strict and owner is a nightmare about dogs peeing. I have to transport him to an area that is too far for me to safely carry him. But I can put a pillow down in stroller and be careful. 2. I have an appt with a vet on Saturday. That is my day to go, as I don't have work. It is difficult for me otherwise. I made it before my emergency appt where he was diagnosed with ivdd (probably no mri). Should I still go for questions/second opinion/more pain meds, etc. or should I just keep Otto inside in the crate when it comes? It is only a few miles away. I think 3. 3. Do I transport Otto in his same rest crate to the vets with some towels?I don't have a plastic carrier or anything. I have a dog seat belt for him, but I don't want to mess with his spine.
Thank you,
Puglife
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Post by Merriem & Spike on Apr 25, 2019 12:51:27 GMT -7
Hi, and I just want to make a suggestion about the bathroom. It is important to not move your dog too much. Do you have any piddle pads? You could just put those on the floor perhaps in the bathroom and it would be better for your dog and you too. We have used them for our Spike in the winter as even though it is Arizona it can be chilly and rain, plus he doesn’t get wet.
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Post by Romy & Frankie on Apr 25, 2019 13:32:58 GMT -7
Yelping is a sign of pain. IVDD is typically painful and often other medicines in addition to gabapentin are needed to keep pain is control. Please let the emergency vet that prescribed the meds know that Otto is still showing signs of pain and speak about adding tramadol and methocarbamol to his meds.. Since Otto was seen at that facility and they have his records for this IVDD episode, pain meds can be adjusted over the phone. Otto should not be in any pain. Pain will only slow the healing process.
A stroller should not be used outside during the crate rest period. It is just too much movement and puts the healing disc at risk.
Merriem gave you good advice about a pee pad. Since during the crate rest period movement should be severely restricted you may want to give this idea some consideration.
I used a pee pad with my Frankie when his control was just starting to come back. AT first he did not want to use it. What I did was get some urine from another dog on a paper towel and put this on the pee pad. Most dogs love to go where other dogs have gone and this convinced Frankie to use the pad before I started taking him out.
It is best to avoid vet visits during the crate rest period. If the vet at the emergency hospital is responsive to your needs and willing to prescribe the meds that will keep Otto comfortable, I don't think it is worth the risk to take him to another vet appointment. In any case, he should be in the crate all the time except when out to potty.
If transport during crate rest is absolutely necessary secure Otto's crate firmly in the vehicle and pad out any extra space with rolled up towels.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Apr 26, 2019 9:16:57 GMT -7
Danielle, getting pain in control TODAY is important. Can you call ER where he was seen and alert them to the pain. Any vet there at ER can access Otto's files and prescribe additional pain meds (tramadol-general analgesic, methocarbamol-muscle spasm pain) to provide round the clock dose to dose freedom from any pain ( yelping!!) Gabapentin works only on nerve pain source. Saturday, appoint may be a good idea as a 2nd opinion about if this is Pug Myelopathy (complex newly documented disease which can include IVDD) or solely a disc episode. You need a go to vet who will be familiar with Otto's health. Have you been to Dr. Smiler's webpage to have a bit of understanding about Pug Myelopathy so you are best able to ask question and understand the vet's thinking, what he is sayiing? www.pugrearataxiaparalysis.comPad out the crate with a rolled up blanket snug to Otto's body so that when you take a corner or stop his body will not shift, his back will remain pretty much without movement. You are doing this to protect a damaged disc from worsening due to too much movement. Let us know you called ER and got pain meds adjusted and the details, please. Let us know what your Sat vet diagnosis in light of the information you have shared about the timeline for this recent issue: 4/11ish?: became reluctant to walk (pain), had trouble getting up (neuro issues and or pain) 4/13 yelped all night (severe pain) 4/17 up all the night yelping (severe pain) diagnosed IVDD 4/18 by DVM ER vet 4/23 falling over (increased neuro diminishment)
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Post by Danielle & Otto on Apr 27, 2019 16:05:15 GMT -7
Hello,
I went to another vet and got a completely different diagnosis. She examined him and did not think he had ivdd. She said he did not exhibit signs of pain when she examined his spine. She also took x-rays and said the spine looked ok in the x-rays (I know you are supposed to have mri). She said it was just progression of hip dysplasia. I don't know what to do. She just kept him on the same dosage of gabopentin. She said he should start dieting right away. He still falls when I try to walk him. Should I just return the crate? The company I bought it from said 2 day shipping at most but its still not here. They sent it ground...
[Moderator's Note. Please do not edit 26.1 lbs 11 y.o. 4/11ish?: became reluctant to walk, had trouble getting up 4/13 yelped all night 4/17 up all the night yelping diagnosed IVDD 4/18 by DVM ER vet Meloxicam liquid since 2015 for hip dysplasia: 25lbs dose 1x?/day long term gabapentin 100 mgs 3x/day 2nd opinion DVM 4/27 diagnosed progressive hip dysplasia no GI tract protector Pepcid AC on board! ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Apr 27, 2019 16:19:15 GMT -7
Danielle, we are not vets, thus we have no way to diagnose. We depend on a knowledgeable vet giving a diagnosis, then we know alot about disc episodes, caring for a dog.
With so much pain and getting two very different diagnosis, it may be time to see a specialist who has a higher degree of training and more experience with neuro issues and detecting them.
It is always good to have a recovery suite and a dog trained to like going in there in case there is a need in the future also for any other kind of disease that requires resting. So it is your call, your budget.
It is not necessary to have an MRI when a knowledgeable IVDD vet does the exam...they mostly can correctly identify a disc episode by the hands on neuro exam, the breeds prone to being born with IVDD.
Is a consult with a specialist doable to find out for sure you are not dealing with a disc episode nor with Pug Myelopathy?
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Apr 27, 2019 18:38:06 GMT -7
Danielle, just some thoughts on this.
Did the vet who first diagnosed Otto with IVDD find spinal pain upon his examination on 4/18?
Did you give the usual dosage of Gabapentin before your visit with the new vet? If Otto did get a dosage of Gabapentin before the new vet visit, that may be the reason the new vet didn't find any spinal pain - the Gabapentin was masking the pain.
When was the last time he yelped? When you mentioned his yelping on 4/25, you said it was lessening. Possibly the swelling is starting to resolve and is not pressing on the spine as much. That might also be a reason the new vet didn't find spinal pain. That doesn't mean if there's a damaged disc that it's healed yet.
If there is still yelping, the pain meds aren't right yet and need to be adjusted. Call the vets and advocate strongly for pain meds to be adjusted. Tramadol as a general pain med and/or Methocarbamol for the pain of muscle spasms can be added. Otto shouldn't remain in pain no matter what the diagnosis is. Vets have ways of controlling pain and have a responsibility to get pain under control.
I agree with Paula that you should seek a consultation with a specialist, if at all possible. This must all be very confusing to deal with.
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Post by Danielle & Otto on Apr 28, 2019 18:11:16 GMT -7
RE: Pain. I am not sure he is in pain. Right now, in the evening, he is not barking or yelping at all. He seems happy but has coordination issues. He might bark to be moved/having trouble moving. It is only at night when I am trying to go to sleep. He didn't bark that much last night. A vet tech at the er place called me for a follow-up. I can only get another pain med other than gabo with an exam. So please, hold on. I talked to the vet tech about seeing a neurologist and she told me the two places in town where they would have one. I can see one. I might want to wait and let him rest a bit and see if it gets better first. 1st vet said neck pain. On Saturday appointment, he had not had gabapentin in over 24 hours. His prescription ran out on the 25th at night. I refilled at Saturday appt (27th). It is a possible there was natural recovery though. Yes, there could be a healing disc. I am so confused. But I want to just kind of rest him for another week. If things worsen and he is up late barking, I may take him to the specialist clinic.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Apr 28, 2019 18:38:50 GMT -7
Waiting on getting a more trustworthy, specialized trained specialist diagnosis for a week or so, means waiting to provide the correct treatment for the matching disease, getting the right meds on board. There is simply too much confusion going on. IF you have to bring Otto in to get pain meds adjusted at a place he has already been seen, then why not make the transport to a specialist if it can be done tomorrow or very soon.
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Post by Danielle & Otto on Apr 29, 2019 18:49:49 GMT -7
Thank you for your advice. I can take him to a specialist but it would be difficult for me to do so which is why I would like to wait and see as I am not sure if it is necessary or if will provide ne any answers.
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Post by kathleens on May 1, 2019 11:00:49 GMT -7
Hi, Paula and Linda asked me to look in on the posts regarding Otto and I hope by now he has been seen by a neurologist competent with pug spinal disease. I think the several visits he had, with different veterinarians, that observed different symptoms at the time make this easily confusing. The disagreement whether he was experiencing pain was obviously stressful to the owner. When pugs are found to have an acute cervical (neck) IVDD episode, it is painful and fairly easy to make that diagnosis when manipulating the neck. Any veterinarian should have sufficient experience to treat the symptoms. Often it is good to get advanced imaging especially if there is evidence it is affecting the dog's overall neurological function. Acute Hansen's Type I IVDD disc disease does occur in pugs but it is unusual. Acute onset and pain are clues. However, the majority of purebred pugs are affected by the lesions of Pug Myelopathy if they are affected with ataxia, and the lesion is localized by a neurologist to the T3 to L3 segments of the spinal cord. The general term for a pathological involvement of the spinal cord is called myelopathy. However in the purebred pug the lesions that cause the thoracic spinal problem are most likely between T10-T13 and are the progression of a slowly developing neurological deficit that may lead to rear limb paralysis. The symptoms of Pug Myelopathy are explained on my website pugrearataxiaparalysis.com The best way to develop a treatment plan is obviously to see a neurologist and receive a definitive (actual) diagnosis, but this almost always requires an MRI to be sure. Some neurologists won't discuss the diagnosis without an MRI, just give you a list of differential (all possible diagnoses that have been seen in all breeds). Without an MRI some neuros just stop advising you until the MRI. Those with significant expertise and experience with purebred pugs however, have a good idea of what your dog has from the examination, and if there is nothing unusual about the case, can counsel the owner with the long term prognosis, the benefits of a medical management approach, and mention surgery. However without an MRI surgery is not a consideration. Surgical management is very controversial in the US, although it is attempted more frequently in the UK. As I collect information from owners, surgery may produce some short term improvement, but publications (and my personal communications) indicate spinal surgery on purebred pugs is not successful long term. Any owner considering surgery should seek a second opinion from another neurologist first. Also they should ask for detailed information on the success rate, at that hospital, over 2 years follow up, for other purebred pugs with very similar lesions. Otto has potentially several problems and the "best" therapy for each condition are somewhat in conflict. If Otto only has the chronic form of slowly progressing Pug Myelopathy, an evaluation by a veterinarian credentialed in rehabilitation, experienced with pugs, should be scheduled. Otto can be assessed for a physical therapy program the owner does daily at home long term, and early introduction of a therapeutic cart engineered for pugs with Pug Myelopathy to provide daily exercise of the rear limbs at home. If the muscles of the rear limbs can be kept exercising and not atrophy, the dog usually can develop a spinal walk and keep up and moving longer.
Also, often x-rays of pugs with Pug Myelopathy show nothing, or they show lesions obvious on x-ray that maybe unrelated to compression on the spinal cord which cannot be seen on an x-ray. 65% of pure bred pugs have hip dysplasia and it should not cause any neurological deficit. They can become a little arthritic but it rarely causes an effect on mobility.
This will be part of his home nursing care program that also requires detailed monitoring of the function of his urinary tract. Most pugs with Pug Myelopathy develop urinary retention incontinence that means they are unable to completely void their urinary bladder. They become very vulnerable to UTIs, bladder stones, bladder sediment,and skin and hygiene problems and they are leaking urine. The owner will learn to manually express the bladder 2-3x per day, and stimulate defecation, to manage their bowel and bladder function. We completely discourage using diapers as they just exacerbate the growth of bacteria and risk of UTIs. You discuss a lot of medication, and veterinarians are unable to discuss medication online, so I can't comment on that. I can say that the value of gabapentin is some what in doubt and many dogs become more uncoordinated under the influence which may appear that they are getting worse. Also I personally think it can depress the spinal pelvic reflexes that are part of the mechanisms that keep them walking. So I hope this is helpful and you have obtained an accurate diagnosis for your pug. If our information resources at my website and the Facebook page Wheelie Pugs can help you with Otto's long term disease please contact us for assistance. Kathy Kathleen L. Smiler, DVM, DACLAM PO Box 429 Lakeville, MI 48366 248-953-3182 FAX 248-751-5900 smilerk@mindspring.com pugrearataxiaparalysis.com/ www.facebook.com/Pug-Dog-Health-Rear-AtaxiaParalysis-218123938233440/ Pug Myelopathy Project at MSU on AVMA Clinical Study Database: ebusiness.avma.org/aahsd/study_search_detail.aspx?sid=312Wonderful Support Group www.facebook.com/groups/wheeliepugs/
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Post by Danielle & Otto on May 2, 2019 7:03:42 GMT -7
Thank you. We have an appointment for the neurologist Monday.
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Post by Danielle & Otto on May 6, 2019 18:46:39 GMT -7
Update- went to neuro. He does not have a neuro degenerative disease. She thinks a stroke or herniated disc in neck (same as er). Looking for underlying issue in case of stroke. Dogs with strokes improve, but could re occur.
As it seems there is a good chance he has a herniated disc in neck, he is on crate rest.
He is doing better and she could see he did some good walking for us. She said no to additional meds, as she is not sure he is in pain. Barking at night may be stroke? Or she mentioned he may be struggling to move to comfortable position. Can try melatonin. Im tired, as he keeps me up all night but will update on our current routine sometime soon. For instance weve added ✙pepcid at least while recovering.
[Moderator's Note. Please do not edit 26.1 lbs 11 y.o. 4/11ish?: became reluctant to walk, had trouble getting up 4/13 yelped all night 4/17 up all the night yelping diagnosed IVDD 4/18 by DVM ER vet Meloxicam liquid since 2015 for hip dysplasia: 25lbs dose 1x?/day long term gabapentin 100 mgs 3x/day 2nd opinion DVM 4/27 diagnosed progressive hip dysplasia 3rd opinion Neuro 5/6 diagnosed stroke or neck disc ✙Pepcid AC ?mgs ?x/day]
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on May 7, 2019 5:08:15 GMT -7
Since the neuro is not sure whether this was a stroke or herniated disc in the neck, it's wise to continue with the strict crate rest for the full 8 weeks to protect the spine from further damage in case this is IVDD. There seems to be some conflict though as the neuro said she's not sure Otto is in pain but that the barking may be that he's struggling to move to a comfortable position. Struggling to move to a comfortable position IS a sign of pain and yet the neuro has made no change in pain meds. For how long does she want Otto to continue with the meds? Since the neuro did say you could try melatonin, you should do that. Melatonin can help dogs relax and it may help with the barking at night. Be sure to do the extra things to help a neck injury heal, such as raising food/water dishes so Otto doesn't need to bend his head, softening hard kibble, etc. More tips here: www.dodgerslist.com/literature/cervical.htmI'm glad to hear that he's doing better walking. Please keep us updated. And I do hope you get some rest.
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Post by Danielle & Otto on May 12, 2019 23:18:11 GMT -7
He was frustrated by not being able to get up. Not in physical pain. Thats what she meant. He is off all pain meds except lt meloxicam. She said we could stop gaba. Started ✙melatonin instead.
Heres our routine
Bf Dinner At one of the meals, gets 5 mg pepcid ac then meloxicam 25 lb dog dosage. 500 mg glucosamine supplement. At night, 1 to 3 mg melatonin in pill pockets. Trying to avoid snacks but sometimes will give one. Avoiding anything chewy. Still goes to do business outside 3 to 4 x a day. Doesnt like potty pads. Improving. Getting traction on linoleum, falling less, etc.
[Moderator's Note. Please do not edit 26.1 lbs 11 y.o. 4/11ish?: became reluctant to walk, had trouble getting up 4/13 yelped all night 4/17 up all the night yelping diagnosed IVDD 4/18 by DVM ER vet Meloxicam liquid since 2015 for hip dysplasia: 25lbs dose 1x?/day long term 2nd opinion DVM 4/27 diagnosed progressive hip dysplasia 3rd opinion Neuro 5/6 diagnosed stroke or neck disc ✙Melatonin 1-3 mgs nighttime Pepcid AC 5mgs 1x/day]
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Post by Merriem & Spike on May 13, 2019 6:58:56 GMT -7
I have been giving melatonin about 7pm to Mike, and it has really helped. He is sleeping better which means we are too.
‘’Glad to hear it is helping.
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Post by Julie & Perry on May 13, 2019 12:54:04 GMT -7
Melatonin is wonderful My Nala stopped sleeping well and so did I! Melatonin got her back to snoozing great.😀
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on May 14, 2019 5:41:49 GMT -7
Thanks for the clarification as to what the vet meant about the barking.
Since the Gabapentin has been stopped, then Otto is no longer on any pain meds at all. Meloxicam is not a pain med - it's an anti-inflammatory. Do you now see any sign of pain with the stopping of Gabapentin? If so, please let the vet know ASAP so Gabapentin can be restarted. Signs of pain to be aware of are: ◻︎ restless, pacing, can’t find a comfortable position ◻︎reluctant to move much in crate such as shift positions ◻︎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. ◻︎looks up with just eyes and does not move head and neck easily. ◻︎ not eating due to pain of moving jaw with a neck disc or pain of back disc ◻︎ holds front or back leg flamingo style not wanting to bear weight ◻︎not their normal perky selves
The Pepcid AC should be given 5mg 30 min before the Meloxicam and then every 12 hours thereafter (2x/day) for as long as Otto is on Meloxicam.
Has the Melatonin helped Otto sleep at night? Is he still barking at night? I hope you're both getting some rest now. Glad to hear he's shown neuro function improvements.
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Post by Danielle & Otto on May 14, 2019 22:52:47 GMT -7
No signs of pain right now. It's his barking time so he is chipper. The melatonin is helping though. We can usually get him to bed before 12, which is acceptable. Before it was 1 30 if we were lucky!
Radiology report came back. It was very thorough. Consolidation in left lung. Incidental spinal bifida on t1. Some hemevertebrate which apparently is in almost all pugs. I am waiting for more analysis on this. The consolidation in left lung is neurological radiologist consult thought. Everything is on the left. Does the one side thing ever happen with ivdd or is this looking more and more like stroke?
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on May 15, 2019 5:10:37 GMT -7
Are these MRI results? It may well be that the hemevertebrate is causing Otto's problems. I have some information to share with you about that.
Hemivertebrae can occur in any breed but are most common in brachycephalic, screw-tailed dogs such as French bulldogs (also English bulldogs, Pugs and Boston terriers) – any dog with a kinked tail.
The deformity of the bony vertebrae can lead to painful pressure on the spinal cord which can well lead to loss of neuro functions in legs, bladder. The misaligned vertebrae could also cause enough pressure to a disc so that it tears and disc pieces squish the spinal cord too. X-ray would not prove pressure to the soft tissues such as spinal cord and the disc...but might help to suspicion such. It is the MRI that was taken that can show both the hard tissue of the bony vertebrae PLUS show what is going on with soft tissue of the spinal cord and the discs. While the disc material might be reabsorbed over time so that it is not pressuring the spinal cord, the skeletal deformity will be permanent unless intervening with a surgery.
So you have different choices to make than we do with our degenerative disc disease (IVDD) dogs. You will need to read up on Hemivertebrae so that when you speak with the neuro you can best understand what she is telling you, ask pertinent questions such as: --- Will the skeletal deformity continue to develop and more severely affect the spinal cord/discs or have the bones finished growing and now fully developed where you have what you have? --- What are the pros and cons of putting off a surgery till you could save up money. How much longer could you put off surgery? --- If the deformed vertebrae is pushing on the disc, can the disc ever heal by forming scar tissue with the aid of crate rest? Did the extruded disc material look jelly like and likely could be reabsorbed by the body. Or was it calcified (hardened) and would be less likely for the body to reabsorb it? --- With this current situation which is pressuring the spinal cord most...the deformed vertebrae or the torn and extruding disc?
We know only one disease that we feel confident of being able to give good and accurate advice...that is the premature aging of discs (Intervertebral Disc Disease.)
If we can be of help with portions of care that are the same for an IVDD dog as a Hemivertebrae dog, we have lots to share with you. Please let us know what you and your neuro decide on regarding surgery or if Otto would benefit with continued time of limited movement rest to let the disc heal over the course of 8 weeks.
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Post by Danielle & Otto on May 15, 2019 17:45:20 GMT -7
X Ray results. I was curious if you guys ever see hemiplegia in ivdd from folks on the board. The left side is neurologically weaker, like a stroke. He also seems to have sudden onset of doggy sundowners.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on May 15, 2019 19:29:34 GMT -7
Danielle, there are symptoms which can appear to be the same in several disease. It is a vet’s diagnosis that explains the underlying cause of the symptom which would be different for each type of disease.
With a disc episode very typically, the underlying cause is a bad disc pressuring one side of the cord causing more neuro damage on that side. Stokes have a different underlying cause but also one side can be affected neurologically.
X-rays are very good at showing hard tissue such as bones, mineralized areas, but do not show soft tissue. MRI’s, CTs are the kinds of advanced imaging which show soft tissue of nerves, discs, muscle tissue as well as hard tissue of bones.
Strokes, brain injuries, spinal cord injuries, infections, and a handful of other conditions affecting the central nervous system can be the cause of hemiplegia. Hemiplegia means paralysis of one side of the body.
Can you share the Neuro’s written diagnosis if that was forwarded to you….did the radiology analysis come in?
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Post by Danielle & Otto on May 23, 2019 21:21:45 GMT -7
Help. My dog was doing so well. But now he is struggling on his left side again. It started maybe 2 nights ago. I admit I have had trouble implementing the crate. It does more harm than good. He thrashes around in there and wont stay still. He tries to bite off the door. I think he hurt his bulgy eye in it thrashing so I took him back to the primary last weekend for ✙antibiotic. He keeps falling again. This is sooo frustrating.
[Moderator's Note. Please do not edit 26.1 lbs 11 y.o. diagnosed IVDD 4/18 by DVM ER vet Meloxicam liquid since 2015 for hip dysplasia: 25lbs dose 1x?/day long term 2nd opinion DVM 4/27 diagnosed progressive hip dysplasia 3rd opinion Neuro 5/6 diagnosed stroke or neck disc Disc relapse 5/22- new neuro dimishment Melatonin 1-3 mgs nighttime ✙name of antibiotic? Pepcid AC 5mgs 1x/day]
Post by Danielle & Otto on May 22, 2019 at 8:00pm I finally received her records. She basically says stroke vs cervival ivdd. She reviewed the x rays but wasnt very worried by them. Says continue conservative treatment.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on May 24, 2019 6:30:26 GMT -7
I'm very sorry to hear that Otto has had a relapse, Danielle. You'll need to let the vet know ASAP if you haven't already. She may want to make an adjustment to his meds. Do you see any sign of pain? If so, Gabapentin will need to be restarted. Unfortunately since there has been loss of neuro function and in the event this is IVDD which would mean that the damaged disc has torn again, the 8 weeks of strict crate rest will have to start over. Since the vet recommended conservative care whether this is a stroke or IVDD, you'll also need to let her know of the difficulties Otto is having on crate rest. A mild sedative may need to be prescribed so Otto can rest in his crate. Here are some other tips to help calm him during crate rest. To calm your dog in the crate, it would be a good idea to cover the top with a towel. That should mellow him. It also creates a den like feeling that dogs love. Using any oral calmer in combination with a Pheromone diffuser seems to work best. It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives such as Acepromazine, Trazodone, etc. Of course always keep your vet in the loop on all things you give your dog. Other product brands may be available in your area or on-line… just shop by the active ingredient(s) on the label and the quantity for best price. Place a DAP pheromone diffuser at floor level where the recovery suite is. Dogs: Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/us/Products/ADAPTIL-Calm-Home-Diffuser with dog pheromones Use a diffuser with one oral calmer from below: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed 2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. 3) Bach's Rescue Remedy is a liquid 5-herb combo to help with relaxation (Star of Bethlehem – Orithogalum umbellatum, Rock Rose – Helianthemum, Cherry Plum – Prunus cerasifera, Impatiens – Impatiens gladulifera, Clematis – Clematis vitalba) Be aware you might be inadvertently training for unwanted behavior. To dogs rewards are: food, looking at them, talking to them, eye contact, approaching the crate, petting. So anytime you see unwanted behavior ignore it, turn your back, leave the room if you have to. Preferable is to start teaching what you do want before there is too much practice in doing the unwanted behavior. Anytime your dog is sitting or lying down quietly, give a reward. Soon your dog will see they get rewards for four feet on the floor, quietly sitting, etc. Consider some of these ideas: -- Many members have found a pet stroller to solve the whining problem because the stroller can be wheeled from room to room as you go about your activities. Pet strollers, however, should only be used when you are directly supervising. More details on strollers: www.dodgerslist.com/literature/strollers.htm--Caster wheels can be added to a wire crate so the crate can be wheeled from one room to the next so your dog can stay with you. -- Put a garment you have been wearing and have not washed in the crate. -- Nan Arthur, CDBC, CPDT, KPACTP writes: "According to the book, Stress in Dogs, by Martina Scholz & Clarissa von Reinhardt, the most well-behaved dogs get 17 or more hours of rest and sleep per day. Teaching self-calming exercises can also help your dog to relax more. You can make something as simple as eye contact a very rewarding behavior that also acts as a way for your dog to “ask permission” when he wants something. When dogs have a focus and an understanding about how to behave to get what they want, they are much calmer overall. To do this, each time your dog looks at you, say, something like, “Yes!” or use a clicker to mark the second he looks at you, and then give your dog a high-value food reward. Wait for your dog to look up at you again, say, “Yes,” and reward again. Do this exercise 10 or so times and then say, “All done,” and put the treats away. Come back later and do it again until you can see that your dog is really starting to make automatic eye contact in hopes you will say, “Yes,” again and give him his reward. " [NOTE: treats should be subtracted from the normal daily kibble ration so as not to gain weight during crate rest.] wholedogtraining.com/images/stories/Are_all_dogs_trainable.pdf -- If your dog won’t get too excited seeing what’s happening outside, during the day try putting the crate on the coffee table or the dining room table so there will be a view out a window and a better perspective on what is going on in the house from on high. -- Play classical music or one of the wildlife TV shows. If a dog is jumping up at the sides of the crate, you can lower the ceiling of the crate. Cut a piece of cardboard the size of the top of the crate, punch holes in the corners and tie the cardboard down into the crate to the level of the top of the dog's head when standing. Or cover the top of the crate with a blanket or towel, bringing the blanket/towel down to the level of the dog's eyes so when he/she jumps up, he won't be able to see anything. That may discourage him/her from jumping up. www.dodgerslist.com/literature/EmergencyCrate%20Training.htmI know how terribly hard this all can be. Try to take it one day at a time and hopefully things will improve for you both soon. Please let us know what the vet says after speaking to her about Otto's present status. Continued prayers for both of you.
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