L's Carmella 9/26 Conservative

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Carmella the Dachshund
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L's Carmella 9/26 Conservative Sept 30, 2019 19:34:13 GMT -7 via mobile

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Post by Carmella the Dachshund on Sept 30, 2019 19:34:13 GMT -7

[Original thread: IVDD Flare Up - getting worse?

QUESTIONS
☆ 1 12 pounds
Meds started on Friday, Sep. 27. Give her 2 times a day.
- Prednisolone 5 mg tablet
- Tramadol 50 mg tablet
- Robaxin-v/Methocarbamol 500 mg
- Gabapentin 50 mg tablet

[Moderator's note: please do not edit
12 lbs
Prednisolone 5 mg 2x/day for how many days? and then taper to test for pain/neuro
Tramadol 50 mg 2x/day
Robaxin-v/Methocarbamol 500 mg 2x/day
Gabapentin 50 mg 2x/day
No stomach protection on board!]

☆ 2 - Miniature dachshund. 8 yrs old. Her name Carmella. I’d like to go by L.
☆ 3 - Diagnosed with IVDD in March after a ton of pain and yelping and an arched back. - Vet is a general practice DVM

☆ 4 - We started crate rest on the 26. Doc only said 2 weeks, and then after 2 weeks we would reevaluate and probably go for 2 more weeks.

☆ 5 - I do believe there is pain. Although she isn’t crying her yelling like last time, she is shivering and just not... herself.

☆ 6 - Friday through Sunday, she could walk although wobbly and a bit like a drunk. Then, today, she started falling over. I only let her walk herself out of the crate so I can pick her up to take her outside where she takes a few steps to go potty.

☆ 7 - So far, she still has bladder control, but today she was having trouble holding herself up.
☆ 8 - Eating and drinking have been okay so far- except for today.

I’m worried that she has gotten worse. Does it get worse before it gets better? When I took her to the vet on Friday, she saw that there was a bit of a delayed reaction in Carmella’s back legs so she gave us the meds and suggested crate rest. She said that they only suggest surgery as a last resort. I’ve been googling all evening and I’m so scared. Should I wait it out? Should I go ahead and take her to ER? Has anyone else experienced a decline and then an improvement? It seems like every story I’ve read had resulted in surgery or full paralysis. I’m so so stressed.

Sorry for all the typos- I’m doing this from my phone.

I’d also like to add that Carmella still has some feeling in her back legs. I put my finger between her toes and she reacted, so that’s a good sign right? I’m trying to remain patient and level-headed, but I’m a bit anxious about her falling over since this hasn’t happened before today.

I’m prepared myself for the worst, but please tell me someone has experienced this before.

Last Edit: Oct 1, 2019 7:51:14 GMT -7 by PaulaM

Julie & Perry Care Advocate MALE - Shih Tzu Posts: 1,822	L's Carmella 9/26 Conservative Sept 30, 2019 20:48:34 GMT -7 via mobile Marjorie likes this Reply Quote Select Post Deselect Post Link to Post Back to Top Post by Julie & Perry on Sept 30, 2019 20:48:34 GMT -7 If there is a decline in neurological function and surgery is an option, I would get to an emergency vet ASAP.

Marjorie
Moderator~

Member since 2011. Surgery & Conservative

Posts: 5,724

L's Carmella 9/26 Conservative Oct 1, 2019 6:15:29 GMT -7 Julie & Perry likes this

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Post by Marjorie on Oct 1, 2019 6:15:29 GMT -7

Welcome to Dodgerslist, L. So glad you’ve joined us all. We’ve got valuable information we’ve gleaned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you.

**Disc disease is not a death sentence! ** Struggling with quality of life questions? Re-think things: www.dodgerslist.com/index/SDUNCANquality.htm

Please immediately make the vet aware of the worsening of Carmella's condition. Discuss the possibility of a switch to the strongest steroid - Dexamethasone. As Julie wisely said, if surgery is an option for you, contact a Board-certified neurologist and make an emergency appointment with them to evaluate Carmella. If surgery is not an option, please know that conservative care can work and Carmella can heal from this. It takes a full 8 weeks of strict crate rest if on conservative care for a damaged disc to fully heal and form secure scar tissue.

Please also immediately alert the vet of the pain that you're seeing so he can adjust the pain meds. Each of the pain meds, Tramadol, Robaxin and Gabapentin, work best when given every 8 hours (3x/day). Have no patience with pain as it does hinder healing. Pain should be completely under control within one hour of giving new course of meds and remain completely under control from one dose to the next.

Please check the dosage of Methocarbamol. That seems to be a very high dosage. Are full tablets given of each of the pain meds?

PEPCID AC: Anytime a dog is taking an anti-inflammatory, stomach protection must be added. You mentioned that Carmella has been eating well until today. Not eating is a red flag sign of GI distress. Ask if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health” issues answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine). canigivemydog.com/wp-content/uploads/2011/10/can-i-give-my-dog-pepcid-ac-300x300.jpg

Doxie weight dogs: 5mg Pepcid AC (famotidine) every 12 hours. NOTE: Pepcid AC (famotidine) for dogs is 0.44mg per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory. www.1800petmeds.com/Famotidine-prod11171.html

Did the vet mention how many days he wants Carmella on the Prednisolone until a taper is started?

Can Carmella still move her legs to re-position herself? Wag her tail when spoken to in a happy voice or when given a treat? It's very difficult to know whether deep pain sensation is present by touching the feet. If Carmella can move her legs or still wag her tail, then she still has deep pain sensation.

Did the vet mention whether this is a neck or a back problem? If it's Carmella's neck, there are several other things that you should be doing to help the neck heal, such as softening hard kibble, raising food/water dishes so she doesn't need to bend her head, etc. Tips here: www.dodgerslist.com/literature/cervical.htm

Knowledge is the power to fight the IVDD enemy and win!! The very best thing you can do for YOU, the caregiver, and for your dog is to get up to speed on IVDD soonest possible. Begin absorbing the must-have overall sense of meds, care and how the treatment works. Your dog will be depending on your ability to learn - excellent video series here: www.dodgerslist.com/literature/theater.htm
 PRINT OUT this link and tape to your fridge: www.dodgerslist.com/literature/healingpage.htm
 use the printout as your roadmap to avoid dangerous detours in your dog’s care
 make notes/highlight to keep yourself on track
 follow all the links in the next days to become the IVDD savvy pet parent your dog needs. Use the “search box” to easily locate topics over at our Main www.Dodgerslist.com website:

http://www.dodgerslist.com/index/searchBOX.jpg

We encourage you to register and become a member of the Forum so you have full use of the Forum. That way it will be easier for you to reply and make it easier for us to track your dog and give the best of comments and support. Tips on registering:
~~dodgerslist.boards.net/thread/406/login-registering-help~~
link correction: dodgerslist.boards.net/thread/406/login-registering-help

Please let us know what the vet says after speaking to them this morning or whether you will be getting Carmella in to see a Board-certified neurologist on an emergent basis today. Healing prayers for Carmella.

Last Edit: Oct 1, 2019 7:58:06 GMT -7 by PaulaM: registering link correction: http://dodgerslist.boards.net/thread/406/login-registering-help

Order free literature for yourself & others: dodgerslist.com/free-literature-2/

Carmella’s Mom
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L's Carmella 9/26 Conservative Oct 1, 2019 15:08:07 GMT -7 via mobile

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Post by Carmella’s Mom on Oct 1, 2019 15:08:07 GMT -7

Hi all, Carmella update:

Today, she seemed to be feeling a little better. She’s eating, drinking, and with a little help,

she used the bathroom.
She even wagged her tail! However, she
still can’t pick up her back legs.

I did call the vet this morning and they expressed some concerns. They discussed the very real possibility of sending her to a neurologist, but it’s an hour away and I don’t have a car. Of course, I was 100% determined to get her there any way I could.

Then, I called my mom who lives about 2 hours away and we discussed our options.

Tonight, I will be taking the train to my mom’s and I am taking Carmella with me. At my mom’s house, there are many people with cars who will be able to get her to any and all of her appointments. We have a trusted vet (15 years of taking our pets to him) and there is a neurologist in his office/hospital who has already set an appointment for Carmella.

On the phone, the vet told us that he still doesn’t believe it’s a “surgery or nothing” situation, so we shouldn’t freak out yet. But if it does come down to surgery, a family friend has offered to pay for it on the condition that she gets to adopt her. It’s heartbreaking to think about letting her go, but I would feel selfish keeping her with me instead of giving her the best chance at life.

I’ve been feeling like such a bad dog mom because she LOVES being with my family and around people, and she spent a few months over the summer with them. Then, I brought her home with me to my single apartment and I work full time. I feel like it’s been downhill since she’s been back 😞 I’m trying not be selfish, and put my dog-mom-guilt aside to make sure she is getting the best care. Even if that means she’s not with me 😞

Last Edit: Oct 1, 2019 17:39:27 GMT -7 by PaulaM

Julie & Perry
Care Advocate

MALE - Shih Tzu

Posts: 1,822

L's Carmella 9/26 Conservative Oct 1, 2019 17:30:16 GMT -7 via mobile

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Post by Julie & Perry on Oct 1, 2019 17:30:16 GMT -7

You are a good pet mom! Surgery isn't the only answer.

Strict crate rest can work.

Take your time and don't rush into any decisions.

Many people have to work long hours. Maybe down the road a pet sitter might be an option or a neighbor could stop by for a small fee.

Hang in there. It will get better.

PaulaM
Moderator.

Member since 2007: surgery, conservative . Montana, USA

Posts: 19,528

L's Carmella 9/26 Conservative Oct 1, 2019 17:34:29 GMT -7 Julie & Perry likes this

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Post by PaulaM on Oct 1, 2019 17:34:29 GMT -7

L, it sounds as htough you may be jumping the gun with a risky to the disc 2 hr train ride and a car ride!

Review, rethink to make sure carting her off for a neuro appt is the best avenue to take at this point in time or if better to stay at home with least movement of the back and let the disc heal and let the nerves self heal over time. If things are not continuing to worsen neuro wise, then they are holding...a good thing!

The focus during crate rest is to get the disc to heal in 8 weeks. Nerve healing may or may not happen in that short time as nerves can take months to self heal.

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. YES Pain caused by the tearing disc & inflammation in the spinal cord
2. YES Wobbly walking, legs cross
3. YES Nails/toes scuffing floor
4. YES Paws knuckle under
5. YES Weak/little leg movement, can't move up into a stand
6. ? Legs do not work or move at all (paralysis, dog is down)
7. NOT YET Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors.
8. NOT YET Tail wagging with joy is lost
9. STILL HAS 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.

AN EXCELLENT and A quick overview of conservative treatment vs. a surgery: www.dodgerslist.com/literature/healingsurgery.htm#surgeryVSconservative

QUESTIONS
1. check the methocarbamol bottle. a 500mg dose would be VERY, VERY high for a 12 pound dog. LEt us know what is correct.
2. Is there any hint of pain nearing next dose of meds? If so advocate for pain meds tramadol, robaxin and gabapentin be given every 8 hrs. No dog should suffer with needless pain.
3. Is Pepcid AC (famotidine) now on board to suppress the extra acids of stress and prednisone?
4. For how many days will she take pred 5mgs 2x/day? The taper is the time for you to test if all pain is gone.
5. Can you register and log in to reply?
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

Last Edit: Oct 1, 2019 17:36:04 GMT -7 by PaulaM

Hi there Guests❗️ REGISTERING would help us to help you and your dog best: dodgerslist.boards.net/thread/7353/register-bookmark-dogs-post-thread

Disclaimer:
This information is presented for educational purposes and as a resource for the IVD dog community. The coordinators are not veterinarians or health care professionals. Nothing herein should be interpreted as medical advice and all should contact their pet care professionals for advice. The coordinators are not responsible for the substance and content contained herein and do not advocate any particular product, item or position contained herein.

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L's Carmella 9/26 Conservative

Post by Carmella the Dachshund on Sept 30, 2019 19:34:13 GMT -7

Post by Julie & Perry on Sept 30, 2019 20:48:34 GMT -7

Post by Marjorie on Oct 1, 2019 6:15:29 GMT -7

Post by Carmella’s Mom on Oct 1, 2019 15:08:07 GMT -7

Post by Julie & Perry on Oct 1, 2019 17:30:16 GMT -7

Post by PaulaM on Oct 1, 2019 17:34:29 GMT -7