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Post by Angie Lee on Aug 12, 2019 18:19:52 GMT -7
Cervical Disc Ollie is a 9 year old dachshund. He weighs 17 pounds. He had IVDD surgery 5 years ago on his back. This morning (August 12th) around 1 a.m. I heard Ollie reverse sneezing so I woke up (he sleeps in the bed with me and my other dachshund named Oscar). I went to help him by rubbing his throat and sitting him up. When he sat up he fell over. I noticed his back legs were really stiff and his right arm/foot was really weak. I got us all in the car and drove to the animal hospital which is an hour away. This is the same place Ollie had his back surgery. A vet did the neurological tests and he was diagnosed with cervical IVDD with right-sided weakness and , and a heart murmur. The vet was surprised he was not showing a lot of pain symptoms and said the neck is very painful. He wasn't panting or shaking or making any noises. When he was walking he was sort of nose-diving and had trouble getting all of his limbs to move correctly. We were sent home with meds and directed to do crate rest and to call if anything worsens. Here is what Ollie was prescribed: Gabapentin can be given anywhere between 8 and 12 hours of last dose. I have been doing 8 hours. Gabapentin oral solution: 1.5 ml every 8-12 hours Carprofen 25 mg tablets: 1/2 tablet 2x/day Tramadol 50 mg tablets: 1/2 tablet 2x/day Famotidine 20 mg tablets: 10 mg 1x/day [Moderator's Note. Please do not edit
17lbs
carprofen 12.5mgs 2x/day
tramadol 25mgs 2x/day
gabapentin 50mgs / mL: 75mgs (1.5mL dose) 3x/day
famotidine 10mgs 1x/day]He has been crated all day since we got home. He did have a bowel movement and urinated around 9 a.m., but nothing since then. I tried using a sling to support him, but since his front right paw buckles, I am not sure how to support him for potty. I was able to give him the Gabapentin at 4:30 this morning and again at 12:30 this afternoon. I'm not sure if he took the Tramadol or Carprofen since he kept spitting them out. I tried everything my local vet suggested, but it has not worked. I don't want to force them on him and make him move his head wrong and hurt his neck worse. He has refused food other than a teaspoon of baby food that I was able to get him to lick off my finger. He has only drank about 1/4 cup of water so far today. He seems to be resting comfortably with blankets to help support his head. I'm a little confused about why surgery was not brought up. I am new to the conservative treatment and have been reading up on here about experiences other people have had. My main concerns are the not drinking, not eating, not taking medications, and potty since he is having difficulty getting into position and I am not sure how to best support him. I bought some pee pads to encourage him to go on those in the house (when he went this morning it was on the carpet). I'm also unfamiliar with the pain being in the neck. Thank you for your help! |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 12, 2019 18:51:24 GMT -7
Angie, glad you have joined us all here. Not wanting to eat/drink can be a sign of pain. Let us know if you see any others that would help to confrim pain and the need to call in for an adjustment on the pain meds.
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. Often for full round the clock, dose to dose pain relief the pain meds are Rx'd for promptly every 8 hrs
SIGNS OF PAIN: ◻︎ shivering-trembling ◻︎ yelping when picked up or moved ◻︎ slow to move ◻︎ tight tense tummy ◻︎ arched back, ears pinned back ◻︎ restless, can't find a comfortable position ◻︎ slow or reluctant to move much in crate such as shift positions ◻︎ not their normal perky selves
+ pain from neck disc: ◻︎ looks up with just eyes and does not move head and neck easily. ◻︎ not eating due to painful chewing or in too much overall pain ◻︎ holds front or back leg flamingo style not wanting to bear weight ◻︎ head held high or nose to the ground. Would you look at the gabapentin bottle for how many mgs of gaba are in one mL of the liquid.
These are the extra things you can do at home to help with a neck disc: www.dodgerslist.com/literature/cervical.htmUse a front sling and a back sling if necessary at potty time to keep butt from tipping over. So that he can potty, you may need to use your hands just as he starts to go so that there is nothing pressing on his belly. Use your hands to support his thighs into a squat position. A sling is used as back up to catch a wobbly dog's butt and prevent twisting the back. Any sling needs to be accompanied by a front harness and leash to control speed to the very slow minimal footsteps at potty time especially during conservative treatment or the post-op crate rest period. 1) Try DIY sweatshirt front leg sling. Or use same concept with cut out leg holes in a long strip of towel: www.lyonpuffpetsit.com/htmlslp/sling.html2) A figure 8 DIY rear sling works especially well for the male dog anatomy at potty times as they do not like anything touching near their penis.  Neuro issuesDo his front legs give out buckle/collapse? OR do his front paws knuckle under. That is he is slow to correct or can't correct his paw to the correct flat position on the ground? Describe what is going on with those back legs/paws Giving medicationsMed ball: Put the pill into the well of a small mashed banana ball, a cream cheese ball, liverwurst ball, Gerber Lil' meat sticks, or inside of a sticky small marshmallow and sealed completely so no taste is on the exterior. For extra yumminess, drape a piece of thin deli meat around ball. Use the three treat method. Prepare 2 treats with no meds inside PLUS the med ball. Give plain treat while holding med ball in front of eyes. The idea is your dog will be greedy after the first treat to get the 2nd. Immediately hold the 3rd plain treat so she will hurry to swallow the med ball to get to treat #3. How to quickly and effectively get a pill down the throat The guest board is a temporary Guest courtesy to get immediate help until you can register. I encourage you to register and login. That way all the features of the Forum are available to you, making it faster to reply and get an email alert about replies. It also makes is far easier for us to track your dog and give the best assistance. Illustrated what to expect during registration: www.dodgerslist.com/forumads/RegisterFORUM/register.htm |
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Post by Angie & Ollie on Aug 12, 2019 19:18:35 GMT -7
His front right foot buckles [KNUCKLES] back. He is unable to correct it. The back legs are really weak. He is not able to stand up much on them.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 12, 2019 19:22:43 GMT -7
Paws that do not right themselves is called knuckling.
Do the back legs have the ability to move at all. Such as when in his recovery suite, he can use the to push, to reposition himself side to side, turn around in the suite?
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Post by Angie & Ollie on Aug 12, 2019 19:25:06 GMT -7
Yes. He is able to move into a different position in his crate. Do you think I should take him back to the animal hospital?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 12, 2019 19:28:07 GMT -7
Look at the gabapentin bottle for how many mgs of gaba are in one mL of the liquid.
Besides not eating/drinking do you see any other confirming signs of pain from the list I gave above?
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Post by Angie & Ollie on Aug 12, 2019 19:30:59 GMT -7
He is slow to move and is not moving his head much. Just his eyes.
The Gabapentin bottle says 50 mg/ml #30
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 12, 2019 19:43:42 GMT -7
Angie, Ollie is in real pain. He is being undermedicated for a 17 lbs/7.71 kilograms dog with these very painful neck discs. CALL/phone to avoid risky to the healing disc vehicle transports. Is the Animal Hospital open at night staffed with an ER vet? They can refer to Ollie folder and adjust his meds. The correct amount to administer can depend on several factors including your dog’s breed and medical history and thus a reason to never self prescribe for you dog. Advocate for using the aggressive range for tramadol every 8 hrs. Look for the dose to be more in line with a minimum of a full 50 mg tramadol tablet to the max analgesic dose Advocate for the med that works on very painful muscle spasm which accompany neck discs! Methocarbamol - expect it also to be Rx'd for very 8 hrs. Be up to speed on all meds your dog takes. I love the Mar Vista Vet page for their drug directory: www.marvistavet.com/pharmacy-center.pml
D/l and print med chart from here to track cause and effect: www.dodgerslist.com/literature/crateRRP/medchart.pdf |
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Post by Angie & Ollie on Aug 12, 2019 20:12:25 GMT -7
They are 24 hours. I called and talked to the same vet who saw him today. She said since he is not eating or drinking or taking meds I can bring him in and they can do meds and fluids through and IV and I can meet with the neurologist to discuss if surgery would be best. She mentioned since he has had IVDD surgery in the past that maybe it would be the best option and since he is not getting any meds in him other than the Gabapentin.
What do you think?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 12, 2019 20:40:08 GMT -7
I think you have a vet not very confident in their knowledge of IVDD!
IVDD KNowledgeable vets would not call for a risky to the disc transport in. They adjust meds after listening to observations of the owner over the phone.
Ollie is not at the point of surgery. Go back and read the link about convervative vs. surgery I gave at the end of monitoring for neuro diminishment.
Why think about a transport when CLEARLY he is way under medicated for a disc episode. First you try aggressive pain med approach. The things she mentioned are not the first things you do.
- Tramadol at MAX ANALGESIC dose every 8 hrs is the norm with a NECK disc!
- methocarbamol for the painful muscle contractions every 8 hrs
- gabapentin is good.
A risky transport or a safe phone RXing the appropriate more aggressive, more typical approach. See what you can do to get his meds adjusted over the phone for tonight. Tomorrow you will monitor and report back if still not in control...there are still other meds that can be used.
Tonight is a emergency to get, try to get that pain in control!
Please let us know you were the squeaky but polite advocate and that you successfully got what Ollie needs.
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Post by Angie & Ollie on Aug 12, 2019 20:43:18 GMT -7
I can't get his pain under control if he won't take his meds. I have tried everything including pushing it down his throat. What do I do if I can't get any in him?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 12, 2019 20:46:18 GMT -7
If there is no way you can get any pills down him, then you may need to go to ER tonight where they can give a shot or IV the meds.
Pad out the crate from extra space with a rolled up blanket. The blankets should keep him snug as you take corners you come to a stop so that his body does not shift
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