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Post by Michelle & Patches on Aug 24, 2019 17:20:02 GMT -7
Patches was diagnosed with IVDD stage 5 8/19/19 Need lots of prayersđ warning long post: My Husband called me 8/17 while I was out of town and said the dog was acting lethargic and having trouble walking and that he was taking him into emergency room. We thought he had Lymes since he had tested positive for it 2 weeks prior, but they said he had IVDD stage 1.. what? Heâs only 4 yrs old. They never told my husband to crate patches only to limit his activity. Everything you read says you must crate immediately! So mad because when I arrived home Sunday the 18th in the evening patches was paralyzed đŞ. He couldnât use his back legs or go to bathroom on his own. So we brought him in right away the morning of the 19th only to be told he was now a stage 5 and our options were surgery at the U of M for 8,000+ or put him to sleep. They used a catheter to empty his bladder ($45) and we scheduled the time to say goodbye that evening at 5:30 and went home to tell the kids and spend our last day with him. If anybody knows me I never give up without a fight, so I spent time crying and then Tim and I researched online. We found a Chrioprator who not only adjusts dogs but also does laser to reduce inflammation and she could see is at 3. We thought letâs see if this works and rescheduled his appt for Tues at 2:30. Went home and also gave him fish oil, Recover AI & extra strength Replenex. All supplements we take for inflammation and joint pain. Tues the morning of the 20th he lifted his tail a little bit and moved one foot. đ¤. We still go to the 2:30 appt because remember he canât pee on his own. She re-examined him and said he had deep pain back, But the chances of him recovering were less than zero. We decided we just had to give it one more day and had them do his bladder again and took him back for one more laser treatment and continued his supplements. Moved appt now to Wed 3:30. Wednesday morning he moved both legs, and had toe curl. We knew that we couldnât keep having them empty his bladder, so we watched videos and figured out how to express it without a catheter which is much safer and no fear of infection. This also bought us time to keep watching him. Every day he was improving a little and going against all odds. Thurs he even stood for a second and is partly going to bathroom on his own when I support his back legs đ. But this morning he tried to roll over and [yelped] hurt his back again. I also noticed a small trace of blood in his stool. The [8/17] ER doctor put him on Carprofen 25mg and Methocarbamol 500mg 2x a day. I talked to vet today and asked if he can get on steroids and she said we need to stop the Carprofen for 2 days first. Should I switch him over or not? He is a Shichon 17 lbs. Thanks [Moderator's Note. Please do not edit 17 lbs crate rest 8/24 Carprofen as of 8/17: 25mgs 2x/day for 8 days then test stop for _pain/_neuro methocarbamol 250mgs 2x/day no GI tract protector Pepcid AC on board! ]
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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 24, 2019 19:40:21 GMT -7
Michelle, welcome to the Forum. Could you please clear up a few details. That makes sure the comments do not go off in a wrong direction. 1. What date did you start crate rest? Limited movement of the back is the single most important care. That incles 100% STRICT crate rest 24/7 only out for a very, very few footsteps at potty time. And it includes the impact to the spine that chiro adjustment do. STOP chiro2.Does he stay dry expressing session to session? How often do you express? Are you expressing for poop too? tips and videos: www.dodgerslist.com/literature/Expressing.htm3. What exactly did you observe that you say he hurt his back again this morining? 4. Med list is very important in providing us some very important clues. --What date did carprofen start? for how many days? -- His stomach needs protection asap tonight if possbleProactive vets donât wait til there is lip licking of nausea, not eating, vomit, diarrhea leading to serious bleeding ulcers, red or black blood in stool due to the extra stomach acids anti-inflammatory drugs cause. Pepcid AC (famotidine) blocks the production of acid. The usual dose of Pepcid AC (famotidine) with a disc episode is 0.44mg mg per pound every 12 hours. Pepcid AC has a very limited potential for side effects. Ask if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesnât need it, we wait til there is problemâŚare NOT answers to your question!) If you get a âno healthâ issues answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine).
HEALTH ISSUES: âMar Vista Vet reports: Pepcid AC has a very limited potential for side effects, the reason of release to over-the-counter status. The dose of famotidine may require reduction in patients with liver or kidney disease as these diseases tend to prolong drug activities. There have been some reports of exacerbating heart rhythm problems in patients who already have heart rhythm problems so it may be prudent to choose another means of stomach acid control in heart patients.â marvistavet.com/famotidine.pml PAIN STATUS, let us know what you observe nearing next dose of methocarbamol or whenever he has to move to reposition in the recovery suite. If there is pain, then please contact your vet ASAP to advise of the pain that you're seeing so meds can be adjusted. Advocate that any of the pain meds be given 3x/day (every 8 hours). âMethocarbamol works on the pain of muscle spasms. â Tramadol is the general pain reliever. â 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: âťď¸ shivering-trembling âťď¸ yelping when picked up or moved âťď¸ slow to move âťď¸ tight tense tummy âťď¸ arched back, ears pinned back âťď¸ head held high or nose to the ground. âťď¸ restless, can't find a comfortable position âťď¸ slow or reluctant to move much in crate such as shift positions âťď¸ looks up with just eyes and does not move head and neck easily. âťď¸ not eating due to painful chewing or in too much overall pain âťď¸ holds front or back leg flamingo style not wanting to bear weight âťď¸ not their normal perky selves NEURO STATUS Where is Patches on the list below? As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order. 1. Pain caused by the tearing disc & inflammation in the spinal cord 2. Wobbly walking, legs cross 3. Nails/toes scuffing floor 4. Paws knuckle under 5. Weak/little leg movement, can't move up into a stand 6. Legs do not work at all (paralysis, dog is down) 7. Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors. 8. Tail wagging with joy is lost 9. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. If surgery is not an option (for whatever reason) then the best option is conservative therapy. Surgery can still be successful in the window of 12-24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance. Precious hours can be lost with a vet that gets DPS wrong. Trust only the word of a neuro (ACVIM) or ortho (ACVS) surgeon about DPS. So if surgery is an option for your family get to a neuro or ortho asap. A quick overview of conservative treatment vs. a surgery: www.dodgerslist.com/literature/healingsurgery.htm#surgeryVSconservativeWASHOUTs When there is neuro loss, the lessor of the anti-inflammatories the NSAID are not usually continued with. The most powerful of the anti-inflammatories the steroid class is considered. With emergency of loss of legs, then a vet may deem it worth the risk to dispense with the usua l 4-7 day washout in order to save nerves from permanent damage. THIS IS VERY IMPORTANT: not only would Pecpid AC (famotidine) be on board as it would with any NSAID or steroid but also sucralfate as double protection from the double jeopardy of no 4-7 day washout. You may find this little card handy to have with vet discussions to keep all the meds straight D/l here: www.dodgerslist.com/literature/MedCard.pdf what the ref card looks like: We look forward to your answers and being able to zero in on your questions better.
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Post by Michelle & Patches on Aug 25, 2019 9:14:21 GMT -7
for the week I just had him by me 24/7 but not in Kennel/Crate...I just found a large Kennel and put him in it yesterday the 24th. He only had one Chiro. on Monday the 19th. I stopped that as soon as I read not to do it. I'm expressing every 4 to 6 hours, he has leaked a few times but not often. When he wines I know he has to go potty and I take him out. The last 2 days I just support the back legs and rub his bladder and say go potty and I can feel is bladder tightening up and tail lifts and he pees. Today when I did that his tail lifted and he pooped. So I have seen a trace of blood in his stools since Fri. the 23rd. and a mucous around his poop. I stopped his Carprofen last night so he only had it in the morning. I also started Pepcid AC last night,
[Moderator's Note. Please do not edit 17 lbs crate rest as of 8/24 Carprofen 8/17 25mgs ?x/day for 8 days; 8/25 test stop for _pain/_neuro methocarbamol 500mgs 2x/day: correction has always been a 250mgs dose Pepcid AC 5mgs 2x/day ]and he had his second [Pepcid AC] dose this morning with his muscle relaxer Methocarbamol 500 mg. The pain I was talking about was on Friday morning the 23rd he was sleeping with me in the bed on his back and tried to roll over to his stomach and yelped with pain 2x before I got him on his stomach. I know now, no bed but in Kennel. That is the first sign of pain we have seen from him since Sat. the 17th when this all started. I'm worried he is only on a muscle relaxer right now and Pepid Ac, but he does not seem to be in major pain, just very sad and not wanting to be in Kennel. What do you think about a mucas lining around his poop? As far as Neuro status, he is sometimes going potty, he can't stand, but he does stretch his legs sometimes and tighten them up. No wagging of tail only moving up and down when going to bathroom. . I hope this helped answer your questions.
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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 25, 2019 9:51:25 GMT -7
Michelle, the stop of carprofen is for the purpose confirming if all painful swelling is gone or not. If you are seeing signs of pain, then carprofen should resume. Otherwise there is nothing in his body to work on the painful inflammation. Inflammation/swelling is what is pressing on the spinal cord causing pain and can cause loss of neuro function.
QUESTIONS - What date did carprofen start? The carprofen was Rx'd for twice a day dosing? - How many mgs of Pepcid AC is each dose? Are you giving each dose every 12 hrs (2x/day)? - Do you, today, still see any signs of pain? If yes, carprofen needs to resume today. -
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Post by Michelle & Patches on Aug 25, 2019 10:04:06 GMT -7
I was stopping the Carprofen 25mg 2x a day, for 2 reasons. One I talked to the vet about switching him over to a steroid and she said he needs to be off the Carprofen 2 days before switching, and then the other reason was because of the blood in his stools. Should I not switch him over too steroids? I have read they work better for reducing the inflammation on his spinal cord?? The ER vet put him on Carprofen the night of the 8/17 so a week ago. Then the second vet kept him on the meds and neither of them said a thing about Antacids or crate rest??? Crazy, it's like the vet's have no clue. I'm the one who brought up steroids to her and she left a message saying sure, but we need to wait 2 days. I will be talking to her again tomorrow because I'm suppose to go pick up meds there..The Pepcid AC is 2x a day 5mg. just started this last night. I believe he has some pain, because he acts very sad. but he has not yelped out in any pain when I took him to the bathroom. Just his poop was funny with that lining all around it. like a stuffed sausage. (sorry don't know how else to describe it.)
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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 25, 2019 10:19:20 GMT -7
So any pain at all is not acceptable. Not only does carprofen need to be back on board, but also other pain meds that would be addressing the other two kinds of pain that comes with a disc episode. --- methocarbamol only adddresses muscle spasm pain. --- gabapentin addresses nerve pain --- tramadol addresses general painfulness and works synergistically with the gabapent to achieve better pain relieve than either on their own. BLADDER CONTROL confirmationThe sniff and pee test is the only proof that there is real bladder control vs. reflexes allowing some urine to escape. Carry Patches outdoors, set him on an old pee spot to sniff. Make sure the sling or your hands are not on the tummy area as that can press on the bladder and kinda expressing him. See if he will release urine on the old urine area. If urine comes out after sniffing, bladder control is returning. You should continue to do a quick express check to verify there is full voiding until you are certain it is consistently happening. Let us know what you observe. POOP
Clear (?) mucus in the poop is not related to bleeding ulcers. The blood in poop is a real concern as a RED flag sign of damage to either the stomach lining (bleeding ulcer and black tarry digested blood) or damage to the intestines and could be red blood. The type of movement you want to monitor for is purposeful movement of the hind legs that is brain directed. For us humans to be able to distinguish between reflex and brain directed, we have to see some sort of head level involvement with the tail, with a limb or with release of urine so we know the movement was done with purposeful thinking. --- Sniff (head level nose) then release of urine would be brain directed. --- Hear (head level ear) you doing some happy talk and then tail wags is brain directed. Tail movement during potty time can often be a reflex --- Itchy sensation at at neck and then tries to scratch would be purposeful movement. Tickling paws, etc can cause reflex leg movements. Please let us know if you are seeing any of these signs of pain: The pain meds are not yet right. Please contact your vet ASAP to advise of the pain that you're seeing so meds can be adjusted. Advocate that any of the pain meds be given 3x/day (every 8 hours). âMethocarbamol works on the pain of muscle spasms. â Tramadol is the general pain reliever. â 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: âťď¸ shivering-trembling âťď¸ yelping when picked up or moved âťď¸ slow to move âťď¸ tight tense tummy âťď¸ arched back, ears pinned back âťď¸ head held high or nose to the ground. âťď¸ restless, can't find a comfortable position âťď¸ slow or reluctant to move much in crate such as shift positions âťď¸ looks up with just eyes and does not move head and neck easily. âťď¸ not eating due to painful chewing or in too much overall pain âťď¸ holds front or back leg flamingo style not wanting to bear weight âťď¸ not their normal perky selves STOP TEST of carprofen IF you do not see any signs of pain with the stop of carprofen, then the real test should be in effect. That is all pain meds are also stopped so that you have a clear view if any hint of pain should surface. RULE OF THUMB Pain= another course of carprofen + all pain meds back on board + Pepcid AC No Pain= no need of any meds...just finish out the 8 weeks of crate rest for the disc to heal. The full details on how carprofen, an anti-inflammatory, works with a disc episode. Good reading to be able to ask the right questions and discuss treatment: www.dodgerslist.com/literature/healingsweling.htmOnce nerves have been damaged a week ago and there is leg function loss then there is not any anti-inflammatory (carprofen or a steroid) that would heal the nerves. Nerves heal all by themselves. The time to switch to the more powerful class of anti-inflammatory drugs is in a matter of hours when there is neuro diminishment happening to prevent more loss. WASHOUTS From what I can learn from your posts Patches is not having any emergency loss of neuro function that demands emergency action in a matter of hours. No justification for the risky business of swtiching. This is how an emergency switch is done: With emergency of loss of legs in progress, then a vet may deem it worth the risk to dispense with the usual 4-7 day washout in order to save nerves from permanent damage as hours matter. THIS IS VERY IMPORTANT: not only would Pecpid AC (famotidine) be on board as it would with any NSAID or steroid but also sucralfate as double protection from the double jeopardy of no 4-7 day washout.
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Post by Michelle & Patches on Aug 25, 2019 10:27:42 GMT -7
Thanks so much. Ok I will call ER Vet clinic now and see if I can get the added gabapentin, tramadol and sucralfate. Should I give him his Carprofen right now or wait for the evening dose. since it's every 12 hrs. to get him back on the schedule of 8 am and 8 pm? Also, one last question I have Gabapentin on hand from when I had disc replacement surgery in my neck. can you take the human stuff or not? Just got off phone with ER Vet, of course the doctor he had last Sat. is not there! I have terrible luck So the doctor on call won't do anything without seeing him, I explained it is not good to move him with IVDD. They don't care..so maddening. Is there an online vet to get these prescriptions? I have a Walmart 15 min from me. Otherwise I have to wait till tomorrow morning with the regular Vet and hope she agree's to get these meds for me..I have not slept hardly in the past week and I just want to cry.. Why don't Vet's understand this and want to help those of us that can't afford the surgery.. Sorry I'm venting. slow or reluctant to move much in kennel such s shift positions, not wanting to drink water, the last time he drank water was at 9 am [8/25] when I fed him 2 eggs scrambled mixed with his dog food. not normal perky, I can tell he is very sad.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Aug 25, 2019 11:21:29 GMT -7
Thank you for providing essential details of observations PLUS exact dates so we understand the picture.
Call back the different ER vet on duty . On file is Patches folder that any vet can take a look at and thus be able to prescribe.
REPORT the essentials of details and dates to the current ER vet: --- Patches has been on your ER's Rx of carprofen since 8/17. --- you are seeing black (?) or you are seeing red(?) blood in the poop as of 8/23 --- Patches has not wanted to drink any water since 9 am 8/25 --- you started Pepcid AC (famotidine) to protect the GI tract as of 8/24. --- Stopped carprofen because of GI tract damage last night 8/24. --- Advocate for sucralfate in addition to the Pepcid AC to better protect his stomach.
--- Pactches is slow and reluctant to move in his, not his normal perky self, he may be in pain. --- he is only on one pain med (methocarbamol)
NOTE: Verify you are actually giving an entire 500mgs tablet of methocarbamol twice a day for a 17lbs dog!!! Double check the methocarbamol bottle's Rx. That may be the reason he is lethgaric it is a rather high dose and he may not be in pain. More common is methocarbamol 125mgs every 8 hrs. Talk to the current ER vet about moving to 125mgs 3x/day -- Adovcate for gabapentin and tramadol to bring pain fully in control, if you both are sure he is in pain and not overdosed on methocarbamol
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Post by Michelle & Patches on Aug 25, 2019 12:30:18 GMT -7
They want me to bring him in. I told them he should not be moved. They said they canât prescribe any medication without seeing him first. đ. Told me to call the regular vet in the morning đŞ. Is there certain foods I can give him tonight that will help with his stomach? Also should I cut his Methocarbamol in half for tonight? I will also start him back on his Carprofen tonight . By then he will have 3 dosea of Pepcid in him, tell I can talk to vet in the morning. Thanks itâs good to know there are people like you who care more about the animals than the money for an office visit still out there đ OK. lol. As you can tell I'm very coachable . I trust everyone on here way more than the Vet's in my area at this point..I know your not doctors, but the doctors won't even talk to me, just the vet tech relaying messages. Really! Once again Thank you and yes take your time.. he has been sleeping for the past 3 hrs. and seems to be ok. but maybe it's because he's drugged on muscle relaxers. omg. it's either laugh or cry at this point...
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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 25, 2019 12:45:42 GMT -7
He has been on carprofen for 8 days now. Normally there would be a test stop with a 5 or 7 day course which you can discuss with your own vet on Monday when he reopens.
See if you can proove if not moving much is due to being over dosed with a muscle relaxer at 500mgs twice a day for a 17lbs dog. Try giving 125mgs at the next regular dosing time and then again in 8 hrs. (that is: 500mgs you already gave and then 125mg at the next dose time.) Do you see he is more able to reposition himself, able to move in his recovery suite, less drugged? Observe if any other signs of pain reveal themselves-- you have the list above in other posts.
No signs of pain then, no need for carprofen, no need for methocarbamol.
You do see any hint of pain surfacing that is more or new, then back to methocarbamol and the carprofen. Call your vet promptly in the AM to discuss --- another course of carprofen---maybe a 7 day course and then another test stop. --- if methocarbamol at a lower dose but every 8 hrs would keep him relieved from pain. --- if there needs to be two other pain meds on board.
TODAY, Sunday, monitor for further signs of GI tract damage increasing: not wanting to eat/drink, vomit, then loose stools, then bleeding ulcer, then moving to diareahea with red or black blood, then moving to the deadly perforated hole in the stomach lining. ANY increse in GI tract damage needs to be stopped in it's track with the addition of sucralfate along with the Pepcid Ac you are now giving.
Have you seen any increase today in GI issue. If yes, then I can further discuss a strategy for today, Sunday, til your vet opens Mon A.M.
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Post by Michelle & Patches on Aug 25, 2019 12:49:46 GMT -7
Ok I rechecked the 500 mg the pill is cut in half so 250mg every 12 hrs. That's better..whew, good thing my husband came home and reread everything..
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Aug 25, 2019 12:54:14 GMT -7
Please do clarify. You wrongly gave 500mg doses. Now you see it needs to be a 250mg dose you will be using instead? OR you have been giving 250mg doses all along?
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Post by Michelle & Patches on Aug 25, 2019 13:08:10 GMT -7
I have been giving him 250 all along, I was just writing what the bottle said and not opening it up and seeing their all cut in 1/2 and we only give him 1/2 in morning and 1/2 at night. He has only went poop once this morning and it was soft not diarrhea. I just took him out and expressed his urine. It has a strong odor, but it has been that way since Tues.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Aug 25, 2019 13:21:25 GMT -7
Michelle, even 250mgs for a 17 lbs dog is alot. My own 17lbs was Rx'd 125mgs (1/4 of whole 500mgs tab) every 8 hrs. So you might hold off for today and give 125mgs in the a.m. Monitor for pain to find out if he is overdosed and the reason for not being able to move. If new signs of pain reveal, then you know he is in in pain (not overdosed). Thus the need in the am right away to call your own vet to get the right methocarbmaol dose & frequency Rx'd, the right other pain meds and back on another course of carprofen. Do your own homework by reading up how anti-inflammatory drugs are used with a disc episode. Puts you in a better position to understand what your vet is saying, ask questions when things don't make sense, etc. Reading: www.dodgerslist.com/literature/healingsweling.htmPlease keep us update until bed time how things are going with Patches, pain or lethargy. And poop--- was it a kinda of normal little bit soft or SOFT, really soft? I think on Monday, Patfches will need a urinalyis at your vet. He may already have UTI going on which can also make them feel crudy. Learning to express properly---that is often enough, voiding the bladder fully so that one hand can almost feel the other as you press, is a new skill for you. Many time owners in the process of learning are not yet at the peak proficiency level and a UTI till develop. Review expressing, and on Monday express in the office and have the vet tech or vet check your skill/technique and provide further tips.: video here: www.dodgerslist.com/literature/Expressing.htm
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Post by Michelle & Patches on Aug 27, 2019 7:51:17 GMT -7
Hi, just giving you an update. Talked to Vet yesterday and she does want to switch him to steroids, Prednisone 5mg 1/2 tab 2x daily for 5 days then 1/2 tab 1x daily for 5 days the 1/2 tab every other day till gone.
I asked her what can we do for him during the waiting period. She is starting him on âGabapentin today [8/27], 100mg 1 tab 2x a day for 7 days and then starting steroid on Thurs [8/29].
[Moderator's Note. Please do not edit 17 lbs crate rest as of 8/24 Carprofen 8/17 25mgs ?x/day for 8 days; 8/25 STOPPED methocarbamol 250mgs 2x/day Pepcid AC 5mgs 2x/day ]
Last dose he took of Carprofen was Sat Morning [8/24]. So a 5 day washout period. She does not think he has a bladder infection because there is no blood in urine. She thinks the reason for blood in his stool is intestines not stomach lining so she is putting him on a probiotic. Proviable Forte Capsule 1x a day with food. I will continue giving him Pepcid AC 2x a day.đ PS. The last time he pooped was Sat morning the 25th. Then nothing all day Monday so I gave him a fish oil and yogurt. He finally pooped at 4 am this morning. It was firm and no blood. đ I believe that Pepcid Ac has really helped him. đ¤. The only thing that concerns me now is he leaks pee. Even though Iâm expressing him every 2 to 3 hrs and heâs not drinking any more water than normal. đ¤
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Aug 27, 2019 9:02:44 GMT -7
Michelle, blood in the urine would be a UTI gone very long and a really bad thing. Some UTI's have observative signs of dribbling, foul odor, change in color. Other UITs show NO SIGNS. And that is the sound, prudent reason to have a sample of his urine for your vet's in house urinalysis. The urinalysis will give proof of bacteria or not. UTI's unattended to will move up into the kidneys where it becomes life threatening. Since you are finding him still overflowing, that is relfexes can allow release of some urine but not all, the remaining urine can quickly become a breeding ground for bacteria in the bladder (UTI).
Glad to hear poop is back to normal firmness and no blood. So it seems that Pepcid AC has reduced stomach acids. Stomach acids as well as food will, of course, exit the stomach to move through the intestines and finally out through the anus. Glad you were able to get Pepcid AC on board to protect the GI tract (comprised of stomach and intestines)!!
Let us know you see all signs of pain in control round the clock as the 5 washout days are in effect before prednisone starts.
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Post by Michelle & Patches on Aug 27, 2019 9:18:08 GMT -7
Ok. Thanks đ
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Post by Michelle & Patches on Aug 29, 2019 11:26:59 GMT -7
Good afternoon. Update: We are suppose to start steroids and Gabapentin tomorrow 8/30. He does not yelp with pain anymore and all he is on right now is the muscle relaxer 1/4 of a tablet 2x a day so a total of 250mg. I gave him a probiotic last night just to get a jump start before giving him meds on Friday and he woke up [8/29] with diarrhea đ. Is this normal?
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Aug 29, 2019 12:37:47 GMT -7
Michelle, best to not go back to edit any previous posts. We may miss your updated info once we have already bold marked a post.
So Gabapentin was never started on 8/27? Gabapentin can cause diarrhea So prednisone was never started on 8/29? It started 8/30
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Post by Michelle & Patches on Aug 29, 2019 12:50:37 GMT -7
Correct he has not started Gabapentin or steroids yet. There suppose to start tomorrow. We waited an extra day because he seems to be in no pain and just giving him an extra day to get other meds out of system. So the only thing I changed yesterday was adding probiotic.
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Post by Romy & Frankie on Aug 29, 2019 14:05:58 GMT -7
Probiotics can cause diarrhea when first started. It may be a good idea not to give any supplements right now because we have no way of knowing if it is the prescription meds or the supplement causing any problems. How is the diarrhea now?
It may be that all the swelling in Patches spinal cord is gone. We would know this if, when all mediications are stopped, there is no pain. You may want to speak to the vet about stopping the methocarbamol and seeing if Patches shows signs of pain. If he does not have pain, no medications at all are needed just the remainder of the crate rest. Since all meds can cause side effects it would be best if Patches does not take meds he no longer needs. If pain is seen when methocarbamol is stopped, all the swelling is not gone and an anti-inflammatory is needed along with the pain meds and Pepcid.
Unfortunately, there is no medicine that can improve neuro function. Only time will do that.
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Post by Michelle & Patches on Aug 29, 2019 15:22:34 GMT -7
Ok thatâs what I thought. I called the vet and she said letâs still try the steroid and see if anymore feeling comes back. I told her his tail is hard again and moves up and down. today he even moved it to one side. He also tried to stand using his back left leg. I made him go back to laying down. I can also feel his bladder muscle try and it pushes out a little and then I have to finish it by expressing him. She also wants me to keep giving him the probiotic that she prescribed. But Iâm sure thatâs what caused the loose stools. đ¤. He has not pooped anymore today. Eating and drinking normal. When I take him out to the bathroom and hold up his back legs he wants to take off running. đ
[Moderator's Note. Please do not edit 17 lbs crate rest as of 8/24 Carprofen 8/17 25mgs 1x/day for 8 days; 8/25 STOPPED methocarbamol 250mgs 2x/day Pepcid AC 5mgs 2x/day ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Aug 29, 2019 17:58:59 GMT -7
Michelle, the time to use a steroid is in a matter of hours from the worsening/new neuro damage. Not days later. Once the nerves have been damaged it is a matter of the body self healing...it can be a slow process which owners should think in terms of months rather than days/weeks.
What prednisone or carprofen do is resolve all painful swelling around the spinal cord. With the swelling subsiding and finally gone the nerves can begin to self repair. What using prednisone within hours of the nerve damage happening is to hopefully get the swellling down quickly and prevent futher worsening or new nerve function damage. Neither anti-inflammatory will heal nerves... the body does that all on its own.
The more prudent action would be to find out if all the swellling is now actually gone. You've stopped the carprofen, but have not stopped the pain meds. So blinders are on about the real story of painful swelling still being there or now gone.
IF with the test-stop of carprofen and pain meds for pain, there is surfacing or new neuro issues, then the vet can make a choice to chose prednisone or continue on with carprofen to complete getting all swelling resolved.
If you have similar concerns of using a med that carries quite a few serious side effects past the benefit of all painful swelling gone, then ask what harm does it do to find out if for sure if a course of anti-inflammatory is needed to still work on swelling?
Good positive progress points --seems to be in no pain on one med that only addresses one kind of pain ---muscle spasm pain Is all painful swelling (nerve pain gone?) there has been no gabapentin for nerve pain. --his body is working on leg neuro function evidenced by left back leg attempted to stand Nerves are slow to heal and not expected to happen during the short 8 weeks it takes the disc to heal. Yet, Patches' body is moving forward with nerve healing!
Again, what harm would it be to verify if all painful swelling is really gone by stopping methocarbamol or if not gone, then get that 5-day course of pred on board with all pain meds on board?
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Post by Michelle & Patches on Aug 29, 2019 18:42:24 GMT -7
Ok. I totally understand. Is it normal that he has some feeling coming back? Is there anyway he could of been misdiagnosed and he really has a tick disease? But then how would that be getting better with no meds? Just thinking out loud here. Itâs all a mystery. đ¤
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Aug 29, 2019 19:21:01 GMT -7
Many dogs can get the swelling down in the range of 7 to 30 days on an anti-inflammatory drug. Patches was on carprofen for 8 days. Did you get to read how anti-inflammatory drugs are used during a disc episode? LINK: www.dodgerslist.com/literature/healingsweling.htmAgain crate rest is for 8 weeks to get the disc to heal with limited movement. It is not expected that in such a short time that nerves would heal...they may or may not depending on the severity of neuron damage. Looks like Patches is in the category of nerves are attempting to heal.
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Post by Michelle & Patches on Aug 29, 2019 19:37:34 GMT -7
Ok. Thanks đ. I donât know what I would do without you â¤ď¸
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Post by Michelle & Patches on Aug 31, 2019 6:29:30 GMT -7
Started patches yesterday on âPrednisone and last night he had 2 poops one very soft and one diarrhea. He feels very hot this morning and wonât drink water very lethargic đ. Yesterday he was fine moved his tail a couple times side to side and even stood up in his crate.
[Moderator's Note. Please do not edit 17 lbs crate rest as of 8/24 Carprofen 8/17 25mgs 1x/day for 8 days; 8/25 STOPPED âPrednisone 5mg tab as of 8/30: 2.5mgs 2x/day for 5 days 9/4 taper test for _pain/_neuro methocarbamol 250mgs 2x/day Pepcid AC 5mgs 2x/day ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Aug 31, 2019 9:41:07 GMT -7
Michelle, diarreah is quite concerning. The washout is for 5-7 days. Some dogs metabalize drugs faster than others. Maybe Patches is one who is slow to wash the Carprofen out of his body and not all was gone before prednisone on 8/30? Can you get a hold of your vet today to strongly advocate for a 2nd GI protector to be on board? prescription SUCRALFATE (to coat stomach lining) in additon to the current Pepcid AC (to suppress acids) Sucralfate reacts with stomach acids to form a protective paste at the site of any ulcerations. ~Ideally give Sucralfate on an empty tummy at least 1 hour before feeding or 2 hours after feeding ~If possible, it should be given 30+ minutes prior to the administration of Pepcid AC. ~Give Pepcid AC 30minutes before Prednisone ~Give prednisone with a meal. Pred could be given along with pain meds IF also due at that time. resource: www.marvistavet.com/sucralfate.pmlWatch for not eating, vomit moving to bleeding ulcers, then black tarry digested blood or red blood down lower in the intestines moving to a perforted stomach lining. So best to get help before this gets worse with an Rx for sucralfate. Good to read sucralfate link above so you understand and can best advocate for sucralfate with a vet. I'm sorry to hear prednisone went forward instead of giving a good carprofent test stop re: pain by stopping methocarbamol. For a 17 pound dog, 1/2 of 5mg pred tablet (2.5mgs) is on the very low side and may not work well on painful swelling (well, if there is any left...no one knows because there was never a proper carprofen test stop.) For a disc episode to get painful swelling down (remember pred does not heal any nerves) it is used at the upper end of the mg dose range 2x/day. Take his temperature so you can report that to the vet as well. Normal rectal temperature is 100.5 to 102.5 degrees Fahrenheit.
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Post by Michelle & Patches on Aug 31, 2019 9:55:33 GMT -7
Called Vet. His temp is 100.5 so they said they want to put him on a 5 day antibiotic just to make sure itâs not urine infection. Im driving over there now and will talk to them about stomach đ
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Aug 31, 2019 11:04:39 GMT -7
Ask about getting another hands-on-top-of-your-hands type of expressing lesson since he is leaking even after you express him every 2-3 hrs.
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