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Post by Navneet & Nikku on Jul 21, 2019 11:51:54 GMT -7
[Posted Mon 7/22/2019 12:30 AM India time]
Doxie exhibiting weakness in hind limbs
Please help! My doxie is an IVDD hero, he recovered from an episode of total paralysis of the hind limbs four years ago with conservative treatment, which was complete rest, massages and oral steroids. We have been very careful with him ever since. However, this year his hind legs seem wobbly and he tends to lose his balance. We have been resting him and also gave him steroid, Prednisolone for a fortnight. He is still wobbly and his back seems jiggly when we take him out to pee. He is now eleven years old. Please help us out with him. Should we give him physiotherapy? Any medicines?
[Moderator's Note. Please do not edit 27lbs Prednisolone as of 7/3: 20mgs 2x/day for 13 days, 7/16 taper to test for pain/neuro ]
We live in India where pet care is not highly specialised and we look after our pets ourselves with little help from the vets. Dodgerslist proved a great support for us during the last episode as well. Hoping for help with him so that he can recover well.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,538
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Post by PaulaM on Jul 21, 2019 11:56:55 GMT -7
Naveneet, sorry to hear about your doxie's disc episode. We'll need from you exact names of meds, the dose in mgs and how often you give each and always using dates rather than things like yesterday, fortnight, etc. Prednisone--- we'll need extra info. --- What was the orig dose in mgs on what date? --- What was the date there was a taper (reduction) in mgs and/or frequency? ADDED QUESTIONS: What is the name of the stomach protector used when Prednisone is on board? Nikku still have unknown cause of allergy with use of Famotidine? Aciloc (ranitidine)? Lansoprazol? Then use sucralfate
What is his current weight? 29.1 lbs
Let us know you are being VERY STRICT with rest: --- what date did get him into the crate to start conservative treatment? --- you carry him to and from the potty place and allow a very, very few foot steps? --- he eats and drinks inside the recovery suite? --- no meandering at potty time? --- if wobbly you use a sling as back up to catch in case his back legs give out and his butt falls down?
Is he fully out of pain dose to dose of medications for as long as it takes prednsione to get all the swelling resolved (in the range of 7-30 days---- pred taper days are excluded) ? If in pain AND in a pred taper, then clearly it is not time to taper pred but get another RX course of pred (5-day, 7-day are common length of a course).
Please contact your vet ASAP to advise if you are seeing painAdvocate that any of the pain meds be given 3x/day (every 8 hours). —Methocarbamol works on the pain of muscle spasms. — Tramadol is the general pain reliever. — Gabapentin works on nerve pain. There should be no sign of pain from one dose of meds to the next. Have no patience with pain as it does hinder healing. Look for your dog to be acting their normal, perky self when pain is fully under control round the clock.
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 ◻︎ 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 ◻︎ not their normal perky selves
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Post by Navneet & Nikku on Jul 21, 2019 22:42:36 GMT -7
Thank you for your prompt response and I am sorry for not having given complete information. He started showing some signs a bit around the 28th of June as he was not his usual self. As happens earlier too at times and attributing it to his increased activity as we had guests, we gave him Carodyl 25 mg ( an NSAID) to relieve him of any pain he may have, When he did not improve after two days and started becoming wobbly, we consulted the vet, who recommended continuing the medicine for another couple of days. Upon his starting to lose his balance and his hind legs giving way at times, he was put on Prednisone according to the following regimen: 3th July to 7th July: 20 mg BD 8th July to 10th July: 20mg morning and 10 mg at night. 11th July to 15th July:10mg BD 16th and 17th July: 10 mg morning and 5mg at night 18th July: 5 mg BD 19th July: 5mg OD The steroid had to be tapered off quickly as he was drinking too much water and needed to pee every hour which was increasing his exertion and he was not resting enough as he would walk around and pee. The symptoms had not subsided fully but the vet felt that he would recover with rest. We were giving him Ranitidine: 75 mg BD as a stomach protector. Thankfully, this time round he did not develop any allergic swelling of the head. He takes a syrup containing: Methylcobalamin 500 mg, Vit D3 200mg, Zinc 5mg, Niacin 5mg, Biotin 20mg and Folic acid 140 mg once a day. He is on glucosamine chondroitin maintenance tablet once a day.
There is an improvement in his condition but he is still wobbly, rest is being continued, he is taken outside for potty and pee either with the support of a sling or carried out four to five times a day. He is not allowed to walk much at such times. Steroid and Ranitidine have been discontinued. Surprisingly, he has been pain free during this episode exhibiting no sign of pain and sleeping comfortably, sometimes on his back as well (He sleeps on a well padded mattress.) We have been advised to give him complete rest and continue with glucosamine and Methylcobalamin syrup and to massage his back lightly. I was wondering if some passive exercises of his hind limbs would help him regain strength in his legs. If so please guide. I would appreciate your advice and follow it completely. Thank you.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 22, 2019 4:34:05 GMT -7
Thank you for the additional information, Navneet. Nikku is having a mild disc episode this time and if you keep his movement very limited, he should recover well. Please always carry him out to potty, only allow a very few steps at potty time and carry him back in to his crate. A sling is not to be used to help Nikku walk to potty, he should always be carried. Once he is outside, a sling should be used to stabilize him so he doesn't fall from side to side. Also a harness and leash should be used to limit his steps to only a very few. It would be best not to massage his back at all and no passive exercise should be done during the 8 weeks of strict crate rest. Nikku is able to move to reposition himself in the crate and that is enough to help tone his muscles. Any muscle loss from the 8 weeks of crate rest will quickly return once movement is gradually reintroduced. The less movement of the spine, the better. Too much movement and the not-yet-healed disc could tear more or even rupture, possibly causing more nerve damage. Please confirm the date that strict crate rest started so we can keep track of the 8 weeks along with you. Some information for future use: Nikku was given a very dangerous course of meds at the beginning as it appears there was no washout period between the NSAID (Carodyl) and the steroid (Prednisone). A 4-7 day washout is necessary. However, should a vet feel that a switch is medically necessary, such a switch can be made with the addition of TWO stomach protectors. We usually recommend Famotidine and Sucralfate. I'm glad that Nikku did not have any adverse effects from this. It's best not to give any meds if Nikku should show signs of a disc problem, but rather immediately crate him to protect his spine from further damage and have him seen ASAP on an emergency basis for the vet to determine what meds are needed. Also, increase in thirst and urination is a very common side effect of Prednisone and that should not be a reason to stop it. It's very important that an anti-inflammatory be on board long enough to work on resolving the swelling pressing on the nerves of the spine. It's that pressure on the spine that causes the nerves to be damaged or even die. Nikku was given a very high dosage of Prednisone at the beginning. For his weight (still 29 lbs.?), 10mg 2x/day would be the anti-inflammatory dosage. So a taper from the anti-inflammatory dosage didn't actually start until 7/16. Again, Nikku was very lucky not to have had GI distress from the lack of a washout period, the very high dosage of Prednisone and not having two stomach protectors on board. The more you learn about how to treat IVDD, the better you'll be able to know when dangerous treatment is being recommended. Lots of information to read here: dodgerslist.com/healingindex.htmPlease continue to update us on how Nikku is doing.
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Post by Navneet & Nikku on Jul 22, 2019 8:55:42 GMT -7
Thank you again for your help. He now weighs 27 lbs and considering the medication given I am now very worried. I am glad he is safe. I shall make sure we follow your instructions on rest and steps to be taken at potty time. Do you suggest we give him an anti inflammatory medicine to help with the spine healing? He seems a bit better today as he is standing in his crate. We do not actually put him in a crate but block off a very small part of the room so that he may feel a part of the family. He is unable to move across the barrier and realising it keeps sitting or lying down on the mattress. Today he has been standing for short intervals and I have realised he is less wobbly. I am discouraging it though, trying to make him sit down again. His rest period began on the 30th of June, so he is barely three weeks into it and has five more weeks to go. We shall adhere to your instructions and keep you updated on his progress. Regards.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,538
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Post by PaulaM on Jul 22, 2019 9:52:37 GMT -7
Navneet, there is no problem if he wants to raise up to stand on all four legs in his recovery suite. Can you clarify about the actual amount of space in his blocked off recovery suite area? Should be only room enough for him to turn around in and when he lies down to fully stretch out his legs? More than that amount of space needs to be tightened up. An ex-pen can be used to surround a suitable size of dog mattress and allow you to have his suite in the midst of where the family spends time. Other options for recovery suites Pack N Play, baby crib or pet stroller when you are there to supervise and keep him by your side:WHY KNOWLEDGE? Gaining a grip on how things heal, what allows them to heal and how long it takes each of the four different healing phases during a disc episode can avoid confusion and gain you peace of mind. It also puts into a ready position to question things that don't make sense or to recognize harmful treatment and speak up on behalf of Nikku. Here's the short answer to what meds are used for and what things the body self heals. Anti-inflammatories (steroid or NSAID) do not help nerves heal. It would be excellent have the full info under your belt so here is that link: www.dodgerslist.com/literature/healingpage.htm Disc healing - the body does that all by itself without aid of meds....just limited movement of 8 weeks Spinal cord nerve healing - the body does that all by itself without aid of meds over time. Often best to think in terms of months rather than days/weeks for nerve functions to improve. Pain caused by swollen tissues around the cord - the body needs the help of an anti-inflammatory drug such as pred or a non-steroid (NSAID). But NEVER both at the same time nor in close proximity as it can be a deadly danger to the GI tract. May take in the range of 7-30 days excluding any lowered tapered days that are "the" test for existence of pain.
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Post by Navneet & Nikku on Jul 22, 2019 10:28:44 GMT -7
Hello, Paula Nikku's recovery suite is a semicircular area of about 4x3 ft. I have a lot of household help and one person is always sitting with Nikku to ensure he does not move around much. Following your advice, I shall stop massage as well as passive exercises and we shall rest him fully for eight weeks. Thank you for your reassuring words. I now feel positive that with help from you and our sticking to your advice, Nikku shall be fine again. Regards.
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Post by Navneet & Nikku on Aug 3, 2019 0:44:09 GMT -7
Hello! It has been four weeks since we started Nikku's rest period and I am glad to inform that he is much better. He can stand for longer periods and also when he goes out to potty, he can walk without stumbling. He was almost about to chase a squirrel yesterday but he had a leash on and we restrained him and carried him indoors. He is eating well and since stopping the steroids, he does not need to pee often and can sleep for longer periods of time. We shall continue resting him this entire month of August. Thank you very much for your help and support.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,538
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Post by PaulaM on Aug 3, 2019 7:13:11 GMT -7
Navneet, glad to hear off of all meds (pred) and no pain, improved neuro function and that you are committed to going the full 8 weeks to heal the disc. Thank you so much for stopping in to give an update!
Just around the corner then on Aug 25 will be graduation day. As you approach, we'd love another update so we can explain how to do that gradual re-introduction back to physical activity to begin on graduation day.
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Post by Navneet & Nikku on Aug 3, 2019 19:10:12 GMT -7
Hi, Paula I shall keep you updated from time to time. He has been sleeping in his favourite ,"all fours in the air" pose for the past few days.
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Post by Navneet & Nikku on Aug 18, 2019 20:38:34 GMT -7
Hi, Paula As promised here is my update on Nikku. He is almost normal now and back to his playful mood. Restraining him is now becoming difficult with his normal moods and excitability. He barks whenever there is someone at the door and has resumed jumping whenever he barks. We try to calm him down and divert him. We let him walk a little when we take him out for potty but not much and he is confined to his rest area as soon as we get him indoors. He experienced a bout of vomitting for two days on the 5th and 6th of August and the vet recommended 5ml of Ranitidine twice a day and Sucralfate 5ml twice a day along with small and four hourly meals. He did not vomit after that and his Ranitidine has been reduced to 5ml in the morning while Sucralfate is still being continued BD. We have resolved to give him his rest until the end of this month completing 8 weeks of rest. Thanks for your help and support.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Aug 19, 2019 5:24:21 GMT -7
So very glad to hear how well Nikku is doing! Please continue to keep Nikku's steps to a very, very few at potty time. He's almost to the safe point in time when movement can once again be gradually introduced but not quite yet. The damaged disc not only needs to heal but needs to form secure scar tissue before movement is gradually reintroduced. If Nikku is jumping up in the crate, you can try to drape a towel or blanket over the top of the crate to discourage him from that. Lower the blanket down to his eye level when standing so when he jumps up, he won't be able to see. Tips on calming Nikku during final days of crate rest: 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) You can start getting your house ready for graduation day. Tips on how to do that here: www.dodgerslist.com/literature/protectback.htmOnce August 25th is here, movement can once again be gradually reintroduced. Please do keep it very slow and easy. Should there be any sign of pain and too much movement has been done, it would be difficult to determine whether pain is due to sore muscles or another disc problem. Slow and easy does it! I found the schedule on the following page to be very helpful after my Jeremy's conservative care: www.dodgerslist.com/literature/AfterCrateRest.htmPlease do stop by on graduation day so we can celebrate with you!
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Post by Navneet & Nikku on Aug 19, 2019 9:15:11 GMT -7
Hi, Paula Thanks for your advice. I have started him on Bach's rescue remedy as I have used it earlier too for him and it had worked. I am not allowing him to walk much. As far as his comfort is concerned, we had got ramps installed in the backyard and also to the car park so that he does not fly off and we also have a cushy floor bed so that no jumping up happens. We had taken these steps after the first episode four years ago. The episode this time was triggered by chasing a baby bird and my trying to restrain him. I guess his straining forward and my restraining him by pulling him backward resulted in a disc episode; however we shall be more careful in the future. Thanks for your help and advice.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,538
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Post by PaulaM on Aug 19, 2019 18:28:31 GMT -7
Navneet, good that that potty time is still quite limited to no walking....just the very fewest of footsteps to take care of business.
Graduation day is just around the corner, please do stop in and let us know what plan you have worked out to ease him into family life gradually over a couple of weeks after graduation. Don't want your little couch potatoe to over do things!
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Post by Navneet & Nikku on Aug 26, 2019 21:11:47 GMT -7
Hi, Paula Nikku's rest period is about to be over and I have decided to start letting him move around the room to begin with and allowing him to walk a bit in the grass when he goes out to potty. I have started giving him glucosamine and chondroitin with omega 3 and 6 supplement along with his nerve tonic, that is mainly B12 vitamin with zinc in it. I hope this will help build his muscle strength so that disc episodes are prevented in the future. The vet has also recommended green lipped mussel supplement to help keep his joints fit. Thank you very much for helping Nikku recover. www.dodgerslist.com/forumads/Graduate.jpg
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Aug 27, 2019 6:01:16 GMT -7
Yes, graduation day was August 25th so congratulations to you and Nikku! You did it! I previously gave you the links to how to protect Nikku's spine from further damage (no more steps/stairs or jumping, etc.) and how to make your home friendly so you're all set to continue on your journey with Nikku. Take it nice and slow for the next few weeks. It sounds like you have a good plan in place. Here's our page on supplements if you'd like to take a look: www.dodgerslist.com/literature/Supplements.htmWe love it when members have a mind to pay forward and help another. We invite you to hop on to our educational bandwagon team in any way that makes you happy. Education about disc disease is our number one mission! We wish we did not have to hear of another dog that was put to sleep because of disc disease nor one denied the correct principles of crate rest to help them heal.
--- You've been there, and are doing it....if you see another member on the Forum needing support or information share what you know to be true or point them to one of our many IVDD articles. The "search box" on each page makes quick work to find the right helpful link: www.dodgerslist.com/-- "Share" our FB/twitter/ posts to widen the reach of IVDD knowledge www.facebook.com/Dodgerslist twitter.com/DodgersList-- Hand carry our literature and introduce us to your vet. When in conversation at the grocery store line or wherever you meet breeds most prone to IVDD (Dachshunds, Beagles, Poodles, Spaniels, Shih Tzus, Pekingese, and Chihuahuas) to give out our little cards. Ask Linda to send you our free packet: www.dodgerslist.com/literature/litorder.htm
-- We have a store where you might find something you absolutely need! Our earnings go to paying for our webpage and literature to hand out. www.dodgerslist.com/store.htm-- Don't forget to add a photo to the gallery and 1-2 sentences. Give inspiration to others just starting a scary IVDD journey. Directions to u/l here: dodgerslist.boards.net/thread/2262/put-dodgerslist-photo-gallery-calendarPlease keep in touch. We love to hear from our graduates. Prayers for many happy and healthy years ahead for you and Nikku.
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