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Post by Susan & Demo on Jul 31, 2019 13:15:43 GMT -7
I have not stated taper due to travel all last week. [Moderator's Note. Please do not edit 15.4lbs prednisone as of 7/8: taper dose: 5mgs 1x/day for 6 days, as of 7/14: 5mgs 2x/day for 18 +? days; test taper when? tramadol 50mgs 3x/day Roboxin 125mgs 3x/day Pepcid AC 5mgs 2x/day ]
Current issues: Gaining weight from normal amount of food but almost no movement. Harder for me to lift him. Yesterday he was sticking his tongue in and out and sometimes panting. He changes positions a lot. Rare shivering. Does not want his spine touched. Lays around just staring at me : Depressed? In pain? Well medicated?
AND - he got away from me and skampered into kitche. When i tried to pick him up, he snapped at me! As for snapping, new behavior but he was headed for where he eats.
Can the meds cause any of these symptoms or should I assume he is in pain?
And he has to be pain free to start prednisolone taper?
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Post by Romy & Frankie on Jul 31, 2019 14:43:39 GMT -7
Sometimes it is hard to tell if a dog is in pain. I am going to put the signs of pai again here for your easy reference; ☐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?
If Demo is showing two or more of these signs of pain, it is highly likely to be pain. Changing positions, not being able to get comfortable is one sign of pain, Not wanting his back touched is another. Laying around staring could be pain or it could be the medications making him tired. But a dog that scampers out of his crate does not seem to be in pain. You know Demo the best so you are in the best position to determine if he is in pain.
Panting can be caused by pred but also by stress . Have you tried putting a fan near his crate (not pointing at him). this would help if his panting was caused by the pred.
It is important that Demo continue his regular diet. He needs energy to heal. You could cut back on treats or change them to low calorie treats like carrots or apples
It is too bad he got out of his crate, Every time this happens he is at risk of further damage. Is snapping something he has done before when picked up?
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Post by Susan & Demo on Jul 31, 2019 15:41:02 GMT -7
As for snapping, new behavior but he was headed for where he eats.
I have a very hard time labeling behaviors. He has been lying on his side and i can see his torso moving as he is beathing. Looks too fast to me???
He HATES riding in car and would likely hurt himself if i run him up to the vet.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Jul 31, 2019 18:40:54 GMT -7
It would be best to call the vet, and describe the things you report. Your vet knows Demo and may be more easily be able to sort things out to determine if the taper should procede tomorrow since being on an anti-inflammatory level of pred for 18 plus days. Let us know when the vet feels it ok to start the taper.
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Post by Susan & Demo on Aug 1, 2019 23:08:31 GMT -7
Went to emergency very last night when he was breathing funny. He was so squirmy there he may have hurt his back worse. Reg dr had approved pred taper to start so last night i gave him 5 mg and this morning 10 mg. He has been whining and not staying in one position long all evening and has not gone to sleep. I just called ER and they said 3 hour wait to be seen and i am not goung to put him through that. I went back up to 10 mg pred tonigh in case that taper was cause of his disckmfort today. I think he is in pain now. ER would not approve giving him more of any meds. He is 11 and I will be scared to let him go thru another surgery.
[Moderator's Note. Please do not edit 15.4lbs prednisone as of 7/8: taper dose: 5mgs 1x/day for 6 days, as of 7/14: 5mgs 2x/day for 18 + days; test taper when? tramadol 50mgs 3x/day Roboxin 125mgs 3x/day Pepcid AC 5mgs 2x/day ]
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PaulaM
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Post by PaulaM on Aug 2, 2019 7:05:56 GMT -7
Susan, alert your regular DVM vet about your having given a WHOLE 10mgs of pred in one dose this morning.That is not an anti-inflammatory dose but an immune suppressive dose used for diseases like cancer, autoimmune disease. The higher the pred dose the increased danger to the GI tract of bleeding ulcers. Prednisone is one drug owners should not prescribe the dose in mgs themselves. Prednisone needs to be dosed in mgs as per what the vet prescribed.
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Post by Susan & Demo on Aug 2, 2019 14:27:03 GMT -7
MY MISTAKE! He is getting 5mg pred in am and 5mg in pm. So...2 nights ago [7/31] I started taper and reduced pm dose to 2.5. Next day very uncomfortable so i put it back at 5mg in pm. Vet said just lowering once could cause him to be in pain so they said wait a week before another taper trial.[Moderator's Note. Please do not edit 15.4lbsprednisone as of 7/8: taper dose: 5mgs 1x/day for 6 days, as of 7/14: 5mgs 2x/day for 17 days; 7/31 test taper √8/1 pain as of 8/1: 5mgs 2x/day for 7 days, 8/8 retest tapertramadol 50mgs 3x/day gabapentin ? mgs ?x/day Roboxin 125mgs 3x/dayPepcid AC 5mgs 2x/day ]my question: does the degree of pain after 3 weeks indicate the disc may not heal? or can all spine issues improve with conservative care? Thank you!
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Post by Romy & Frankie on Aug 2, 2019 14:58:02 GMT -7
It can take up to 30 days on the Full anti-inflammatory dose before the swelling that causes the pain is gone. I know that you were scheduled to taper before and you did not because he still seemed to be in pain. So could you confirm how many days in total that Dem has been on 5mg pred 2x daily. Many dogs need several tapers so the failure to taper in itself does not mean that Demo cannot heal with conservative care. I am not sure if you have had a chance to look at the page below. It shows when surgery might be a consideration; www.dodgerslist.com/literature/healingsurgery.htm
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PaulaM
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Post by PaulaM on Aug 2, 2019 16:13:00 GMT -7
Susan, let me add a bit to what Romy explained.
Conservative treatment seeks to reduce inflammation via an anti-inflammatory drug. Predominately, most dogs can get that swelling down within the typical 7-30 day range. Some few dogs have needed a bit more than 30 days on pred.
Conservative treatment seeks to allow the disc to heal by limited movement. That happens in 8 weeks of crate rest.
The hope with conservative treatment is that the damaged disc which may be protruding into the spinal cord area will with time be reabsorbed or shrink back enough that is no longer continues to aggrevate nerves in the spinal cord. At the end of 8 weeks once the disc has healed, there have been some few dogs who were still painful perhaps because the disc was still bulging and impinging on the cord. So those dogs continued on the lowest dose of an anti-inflammatory or maybe just a pain reliever so they could get back to enjoying life. Much like people with painful backs take a med so they can enjoy a good lifestyle. You and your vet would, if that were to be the case with Demo, work out what lowest possible dose of meds could give comfort in his daily life. But you are not there yet. It has not yet been 30 days of pred but only 18 days at the anti-inflammatory level. Let's see what happens after this additional course, a 7-day course, with the next test for pain taper on 8/8.
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Post by Susan & Demo on Aug 2, 2019 21:08:55 GMT -7
Demo started 5mg pred 2xday on 7/14, so 19 days.
[prednisone as of 7/8: taper dose: 5mgs 1x/day for 6 days, as of 7/14: 5mgs 2x/day for 17 days; 7/31 test taper √8/1 pain as of 8/1: 5mgs 2x/day for 7 days, 8/8 retest taper]
He also is on gabapentin. [how many mgs? how many times per day?] Thank you for explanation. Pain less today. More puzzle time, peanut butter and attention.
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Post by Susan & Demo on Aug 8, 2019 13:21:50 GMT -7
I AM WORRIED...
For the past week, after Demo peed, I have let Demo take a few steps onto the sidewalk so I could watch his feet. He usually takes a step or two, does a full body shake and takes two more steps before I pick him up. His back legs have always been quite bow-legged. Last night I "imagined" his right foot was pointed too far in. Just now, he did his big full body shake and his left back leg buckled.
We are a full month into crate life and are scheduled to start pred taper this coming Sunday.
I saw this symptom at the very beginning of his disc problem 2 years ago.
What could be going on? We have had a very good week otherwise.
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Post by Romy & Frankie on Aug 8, 2019 13:45:07 GMT -7
I know how scary that must have been. I think that there is cause for concern only if it happens more than once. For now, he may have just been having a bad day.
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Post by Susan & Demo on Aug 8, 2019 14:38:12 GMT -7
In hindsight, he has been moving less. After i open his crate he doesn't want to get out. He just lays in there. Yesterday i stood him on ground to pick up dropped leash and he sat down immediately rather than stand for a couple of seconds. I well keep a very close eye on him now. What constitutes emergency action? Demo hates car rides and ER vet routinely has 2-3 hour wait so just attempting that whole procedure could injure him. A mobile dachshund vet could make a fortune I bet!!!
And -
He has been taking 100 mg of Gabapentin every 8 hours along with his other meds.
[Moderator's Note. Please do not edit ▲16.8 lbs prednisone as of 7/8: taper dose: 5mgs 1x/day for 6 days, as of 7/14: 5mgs 2x/day for 17 days; 7/31 test taper √8/1 pain as of 8/1: 5mgs every 15 hrs in error of Rx for 7 days, as of 8/9: 5mgs every ▲12 hrs for ? days, then retest taper tramadol 50mgs 3x/day gabapentin 100 mgs 3x/day Roboxin 125mgs 3x/day Pepcid AC 5mgs 2x/day ]
Just off the phone with the vet. Demo is appearing to be in pain again, not comfortable, panting, whining. I need to know at what point I do what. Like I said, ER vet is a 2 hour wait. Im dreading a neurologist appointment because that is a two hour drive and he thrashes around in his crate.
We figured out I have not been giving prednisone every 12 hours, since I've been giving him meds 3 times a day, that means I have been giving it [pred] maybe 15 hours apart in the day time.
Vet suggested I do it [pred] every ▲12 hours and see if he improves. We will not be starting taper today. Vet also said if we change to Rimadil, it might cover pain better but not do as well at anti-inflammatory and said neuros will recommend a washout of the pred before starting rimadil.
I welcome all suggestions.
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Marjorie
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Post by Marjorie on Aug 9, 2019 5:42:58 GMT -7
I believe the vet has given you good advice in saying that you should wait to see how Demo is once he gets the Pred every 12 hours and not to start the taper.
I do not agree that a change to Rimadyl is advisable. Prednisone is a more powerful anti-inflammatory than Rimadyl. Anti-inflammatories such as Prednisone and Rimadyl are given to work on the swelling pressing on the nerves of the spine, which is the cause of the pain but are not given to cover pain. The sooner that swelling resolves, the better, so a more powerful anti-inflammatory such as Prednisone is preferable. Pain meds are given to cover pain and if there is still pain, then it's the pain meds that need to be adjusted.
Please don't allow Demo to walk a few steps to test his leg movement. The less steps taken at potty time the better. Only allow a very few steps to do his business, then carry back to the crate. You can observe his leg movement in the crate when he stands to re-position himself or takes a couple of steps to walk out of the crate and when he takes a few steps to do his business.
Adjustments to pain meds and tapering dosages of Pred can all be done by phone updates to the vet. Even a worsening of neuro function can be relayed to a vet by phone unless Demo loses use of his hind legs and is unable to walk and IF you're considering surgery. You're not at a point where surgery should be considered and you're doing just fine consulting with the vet by phone each time you have a concern.
I do hope that Demo is feeling much better today. Prayers for you all.
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Post by Susan & Demo on Aug 9, 2019 5:56:11 GMT -7
Thank you so very much!
One item I think could be not helping - Demo has gone from 15.4 lbs to 16.8 - just eating his normal diet PLUS 3-5 pill poppers a day. And he begs for more food - I assume due to prednisolone. Advice? He gets 1 1/4 cups of Science Diet R/D and at night a handful of frozen green beans for dessert.
He does not stand up in his crate. He used front legs to hold up half his body and drags back end to switch positions. I have to physically reach into crate and lift his back half up to pick him up and get out of crate. I was able to open door, have a firm cushion for him to step onto and then I could pick him up. He doesn't do that any more.
This morning I just took him out and he peed and pooped without taking another step - in the same place. I have never seen that before. Always has taken a few steps. His left back leg wobbled a bit during his big shake but did not buckle.
I had been allowing him to sit in his buggy and move him from room to room but will stop that as well.
This may sound selfish - but I cannot lose Demo so I would be nervous about him having surgery at age 11 but do not want him in pain. In the past 2 years, I have experienced one major loss after another, so between people and pets passing away or moving away, this pup is my primary companion.
Demo is 11 today!
Thank you again! Susan
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PaulaM
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Post by PaulaM on Aug 9, 2019 7:40:06 GMT -7
Susan, it would be ok to use a pet stroller in the house to keep him by your side as you change rooms. It would be good for his spirits to be near you. So pet stroller is ok as long as you stay with him to supervise. buckle vs. knuckling paws. ---Can you tell us more. Do is back leg paws knuckle under, can he right them if they do knuckle under? ---Buckle- what do you see that makes you use this term? Monitoring neuro functions As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. 1. √Pain caused by the tearing disc & inflammation in the spinal cord 2. √Wobbly walking, legs cross 3. √Nails scuffing floor 4. ? Paws knuckle under and ? dog is slow to right them or ? can't right them at all. 5. Legs do not work at all (paralysis, dog is down) 6. Bladder control is lost 7. Tail wagging with joy is lost 8. Deep pain sensation, the last neuro function, a critical indicator for nerves to self heal with a surgery or with conservative treatment. GOOD READING to refresh on surgery vs. conservative treatment: www.dodgerslist.com/literature/healingsurgery.htmLow cal treats in addition to frozen green beens are: pieces of carrot, apple, broth ice cube to lick on. Happy birth day Demo!
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Post by Susan & Demo on Aug 9, 2019 13:07:42 GMT -7
Neuro function #2-5 are hard to evaluate if he never walks. That is why i was letting him take a few steps after pottying.
Past 2days i have witnessed his back legs crossing, the left foot sliding under his body and not holding up his rear left side.
This morning he took no steps to pity.
Ive been home half hour sitting by his crate w door open and he has not tried moving to get out.
The stroller concerns me because he will put paws on side and stand up on his back feet??
Main concern is what do i do if his pain or symptoms increase over the weekend. My vet is open Sat morning. There is nearby ER that well be a 2 hour wait. The neuro surgery center is over an hour drive from here.
At what point do i do more than watch him?
I believe we are at max med amounts unless his weight gain allows for more?
Thank you, Susan
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Post by Romy & Frankie on Aug 9, 2019 13:44:16 GMT -7
Happy Birthday to Demo.
We are not vets and do not know the specifics of each dog's health. The dose of pred (5mg 2x/day) is consistent with what we often see prescribed for a dog Demo's weight. I agree this is not the time for a taper.
I think what to do over the weekend if Demo's symptoms increase is something that you can discuss by phone with your vet. By tomorrow morning you will have a better idea as to how Demo is doing when he has had the pred every 12 hours.
If Demo stand up on his back feet when he is in the stroller then best not to use the stroller. You can give it a try and watch to see how he does. If he stays quiet continue to use the stroller. Moving him around the house with you will give him a change of scene and he will be near you.
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Post by Susan & Demo on Aug 10, 2019 7:56:57 GMT -7
Sat 9:30 am
Demo finally settled around 2 am after i gave him some green beans and he licked some peanut butter. He woke me at 6:30 am, whimpering. I fed him 1/4 c food and gave meds: Pred 5mg Pepcid ac 5 mg Tramadol 50 mg Gabapentin 100mg Robanix-V 125 mg He settled and slept til 8 after i laid on floor by crate.
He went out to potty and legs worked better.
Took a while finding comfortable position in buggy, now lying down awake and breathing fast enough that i can see chest moving. He briefly pushed himself up on front legs with open mouth panting.
Waiting for call back from regular vet.
---- Post by Susan & Demo Fri 15 hours ago Like last weekend, Demo is again panting and heart beating fast OFF AND ON.
Is this dangerous? Is there a recommended time period to watch or does this always require ER visit?
I called the ER and they read the notes from last weekend to me that said it was all normal but they could not rule out cardio- pulmonary problem. THEY DID NOT SAY THAT TO ME WHEN WE WERE THERE.
I hate weekends.
--- Post by Susan & Demo on 12 hours ago Its late now. He has not slept and he doesnt seem to be able to stand up on all four legs or he chooses not to. Sits down going one side or the other. Once in a while he pants for a while.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Aug 10, 2019 9:15:14 GMT -7
Susan, from this side of the computer it is difficult of course to know what going on with Demo.
As you know both prednisone and tramadol have the side effects of causing panting. So... you might try --- placing a fan near the buggy but no pointed at Demo. The idea is just to get some air moving/circulating that might provide some cooling. --- giving him a broth ice cube to lick on if you have on hand or some cool water to lap up. --- dogs can only sweat from their paws. Daub a bit of water on paw pads to see if that helps.
Panting can also be a sign of pain.
When he went out to potty his "back" legs worked better. What could he do better-- less wobbly, less nor no knuckling under of the back leg paws?
For how many days does the vet want hin to take pred 5mgs 2x/day which started on 8/9?
Let us know what your vet thinks about the panting and any changes to meds, etc.
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Post by Susan & Demo on Aug 10, 2019 11:52:29 GMT -7
Have done fan, water, etc.
His back legs have crossed or the left given way under him. Did neither when he pottied today.
Sent video to my vet who said to go to ER vet. We have been waiting for over an hour and wait may be 3 hours...
They checked vitals while he was not panting or shaking so not urgent. Said he was in pain. We are 2 hours til more pain meds now.
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PaulaM
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Posts: 19,493
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Post by PaulaM on Aug 10, 2019 12:26:15 GMT -7
Susan, good to hear you were able to rule out panting for other reasons and got him into ER for pain meds adjustments. There are stronger pain meds such as the Fentanyl patch, amantidine. Click on the blue links to learn more while you are in the waiting room.
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Post by Susan & Demo on Aug 10, 2019 13:25:56 GMT -7
Vet is saying he may have cushings disease and needs work up which is hard to get scheduled.
She wont give him anything else for pain. But will add trazadone.
Im not happy here.
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Post by Romy & Frankie on Aug 10, 2019 13:58:08 GMT -7
I am sorry that your emergency vet visit was disappointing. If you are not happy with a particular vet, know that you are in charge of your dog's health care and you can choose to hire a different vet.
Earlier in the visit the vet said that Demo was in pain. Did she say why she will not adjust pain meds for a dog in pain? Trazadone is used as a sedative for dogs that have trouble staying calm. It will not help with pain. At Dodgerslist we only know one disease, IVDD, but no matter what Demo's diagnosis is pain will only interfere with healing.
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Post by Susan & Demo on Aug 10, 2019 14:11:02 GMT -7
I got nowhere. They didnt put initial paperwork in right place so did not *work us in" i asked 4 times in 2 hours whem our turn was. The vet, looked 15 yrs old and never came back to the room after initial talk, so we left at almost 4 hrs w some trazadone. She flat out refused to change his med protocol even though it might take weeks to see internist and get cushings dx.
I was up most of last night w him....we both may take trazadone tonight.....
Thsnk you so much for your support.
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Post by Romy & Frankie on Aug 10, 2019 14:29:52 GMT -7
The trazadone should help him sleep. Then you will be able to sleep. You have to take care of yourself so you can continue to take such good care of Demo.
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Post by Susan & Demo on Aug 11, 2019 9:07:31 GMT -7
At this point i dont even know if Demo has a back issue going on since symptoms could all have been cushings OR he got cushings from being on prednisone so long.
I was afraid to give him trazadone.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Aug 11, 2019 9:28:49 GMT -7
Susan, I'm so sorry Demo did not the get the attention you expected he would at ER. You are in a position of needing a vet who can work with you, give Demo attention if there would be possibilty of a cushings diagnosis with test to proove type of Cushings. Hopefully on Monday you can zero in on that vet who will have time for Demo and get things properly sorted out for you.
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Post by Ann Brittain on Aug 11, 2019 9:44:48 GMT -7
I'm sorry you and Demo are going through this. It is never easy to see your pet in pain and not be able to stop it. Hopefully this issue will be resolved soon so you both can rest.
Our Buster had signature nerve pain in his shoulder after disc surgery. At times, he was screaming in agony. We were at our wits end until we finally got it under control. I know it seems like things will never get better, but there will be a brighter day for you and Demo.
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Post by Susan & Demo on Aug 12, 2019 7:21:37 GMT -7
We're starting over here. I was taking panting and not being comfortable in any one position, new leg weakness and staring into space instead of sleeping as indications of pain. ER vet said all those are symptoms of cushings so the last month of prednisone and pain mgmt meds might have done him more harm than good. The rest of weekend he just laid in his stroller. Have already placed call to his regular vet. We shall see.
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