PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Dec 7, 2019 12:55:51 GMT -7
Laura, is your dog currently experiencing a disc episode? That is our first concern. Then we can address about surgery. If a current disc episode, would you be kind enough to fill us in on all the details. It will help us work together with you and avoid offering ideas that could cause harm or lead the discussion in the wrong direction delaying help for your dog — please share a bit more detail with us: ❖1 Is there still currently pain? ☐ shivering, trembling ☐yelping when picked up or moved ☐ tight tense tummy ☐can’t find a comfortable position, appears restless ☐ Arched back ☐Not their normal perky selves? ☐ reluctant to move much in crate such as shift positions or slow, ginger movements ☐ Holding front or back leg flamingo style not wanting to bear weight ☐head held high or nose to the ground Full pain relief is expected in 1 hour and stays that way dose to dose. If not in control your vet needs to know asap to adjust meds. ❖2 How much does your dog weigh? A.. Please list the exact names of meds currently given, their doses in mg’s and times per day given. B.. If on a steroid….what was the start date & dose? Date of steroid taper? or date of NSAID stop? C.. PEPCID AC: Phrase a simple question that you expect a simple "yes "or "no" to it. Does my dog have 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). (NOTE: Pepcid AC (famotidine) for dogs is 0.44mg per pound 30 mins before the anti-inflammatory and thereafter every 12 hours. www.1800petmeds.com/Famotidine-prod11171.html ) ❖3 -- Eating and drinking OK? No nausea/not eating, no vomit? mgs ?x/day -- Poops OK - normal firmness & color -no dark black or bright red blood indicating bleeding ulcers? No diarrhea? ❖5 Did you specifically get a diagnosis of IVDD, aka: a disc problem, a disc herniation, a bulging disc, slipped disc? -- Is the vet a general DVM or a specialist surgeon: ACVIM neurology or ACVS ortho? ❖6 What was the date you saw the vet for CONSERVATIVE treatment or date of SURGERY? The hallmark component of conservative treatment is the very STRICT crate rest part (no PT, little movement). With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. That 6 weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form. Super tried and true tips for setting up the recovery suite, the mattress and more! —> www.dodgerslist.com/literature/CrateRRP.htmSTRICT means: - no laps - no couches - no baths - no sleeping with you - no chiro therapy - no dragging or meandering at potty times. - no PT ❖7 Can your dog specifically sniff and squat and then release urine which is bladder control - OR- do you find wet bedding or leaks on you when lifted which are indication of an overflowing bladder and loss of bladder control? Overflowing bladders need to be expressed to avoid UTIs. Review video then get a hands-on-top-of-your-hands expressing lesson. www.dodgerslist.com/literature/Expressing.htmDOGs with BLADDER CONTROL: Carry to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog’s back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on! ❖8 Currently can your dog wobbly walk? move the legs at all? or wag the tail when you specifically do some happy talk?
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Post by Laura & Gizmo on Dec 7, 2019 13:12:38 GMT -7
Gizmo is her name. She is a Maltese
And it says " date of current episode" She is not having an episode, at the moment. She is having a new thing.. leg locking.
I was thinking of surgery if it's less than $$2,500 or less. More, is too much.
is your dog currently experience a disc episode? No.
Slipped a disk. Happened twice. Been treated with steroids and Meloxicam. No surgery because where I am, it was over $5,000 + $700 for mri (which they would not do, at the time, unless you were getting surgery)
Not currently painful. Not sure what flamingo style is. She was treated twice for slipped disk. And eventually could walk. Right now, she has one leg starting to lock up and that is making her having difficulty walking. The vet wasn’t sure how to treat the leg locking.
❖2 7lbs A.. Currently: Meloxican 1mg/ml which is done is a few days. There is no end date. He gave me enough for a week and a half-ish. She takes it until she's done
[Moderator's Note. Please do not edit 7lbs Meloxicam as 11/19: for about 9ish??? days needs GI tract protector, Pepcid AC, on board w/Meloxicam!]
❖3 -- Eating and drinking OK? No nausea/not eating, no vomit? All OK
❖5 slipped disk by and ER DVM ❖6 A few yrs ago and last yr.
Yes, she had off of that when originally treated with steroid and & Meloxicam
❖7 She can sniff, squat, release No. 1 & 2. Harder to hold herself up so she gets a dirty bum.
❖8 She could walk until recently when her leg started to lock up. Not sure how to treat that and not sure the vet knows.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Dec 7, 2019 13:47:35 GMT -7
Laura, twice you mentioned Gizmo being treated in a highly dangerous way of using both classes of anti-inflammatory drugs (steroids and a non-steroid NSAIDs). IF that truly was the case, you will want to bone up on why this is so very dangerous and be prepared to advocate for Gizmo in the future. I see that with Meloxcam again the stomach is not being protected with Pepcid AC. Another thing to stand up for Gizmo on even right now. What trusting eyes our dogs have! Vets choose an anti-inflammatory during a disc episode to get painful swelling down in about 7-30 days. These powerhouse meds do wonders OR they can be dangerous. Vets who practice safe medicine and owners up to speed on medications make all the difference. Did you get all four questions right? Answers here: www.dodgerslist.com/literature/healingswelingANSWERS.htmDoes Gizmo bend her leg not wanting to place it down on the ground. YOu know hold it up like a flamingo bird does? That would be a sign of pain.
When the leg is locked, how is it locked. Straight out, will not bend and the knee. Or is it locked in a bent positiion at the knee and can not be straightened out?
Do Gizmo's paw's knuckle under..that is she can't place them correctly on the ground? Are her legs not able to bend at the knee, but instead stick out like in the picture below? We have costs of surgery for a disc episode. If you are looking for another kind of surgery then the prices will not very likely be the same for a totally different kind of procedure. Here is our member's comments on their dog's IVDD surgery: www.dodgerslist.com/literature/surgerycosts.htm
What date did Meloxicam start? What date will Meloxicam end?
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Post by Laura & Gizmo on Dec 7, 2019 15:29:42 GMT -7
Does Gizmo bend her leg not wanting to place it down on the ground. No. When the leg is locked, how is it locked. Straight out, will not bend and the knee. Or is it locked in a bent positiion at the knee and can not be straightened out? Up and down. And when Straight.Do Gizmo's paw's knuckle under..that is she can't place them correctly on the ground? Are her legs not able to bend at the knee, but instead stick out like in the picture below? No. I think she had a bit of knuckling [on what date, please?] but it got better [what date?]. Yes, she needs that. Thanks for the list. You don’t have anything for Guelph Animal Hospital? Toronto is too much.
She has seen a few vets. Not one has mention Pepcid AC. I will look into it. Thanks
Meloxicam Started Nov. 19. There is no end date. When it is complete and looks like enough for half of this week.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Dec 7, 2019 16:11:23 GMT -7
Laura, the first thing is to get a diagnosis of what the disease is by going for a consultation with a specialist. This Forum deals exclusively with IVDD (disc episodes) I hope you can understand that we just can't comment on possiblities of other disease..we just do not know those things. Once you have a diagnosis for a current disc episode, then we know lots about giving you support and help The member directory is only what members contribute about their dog's medical care, costs, etc. If no one contibuted about Guelph then that is why we have no data to share. Being on Meloxicam since Nov 19 thru to approx Dec 11 (about 23 days) is a long time to be on the NSAID and you don't even know what the reason is (what the diagnsosis is). It would be immensively helpful to give dates . when you mentioned knuckling, but it got better, we have no idea if you are speaking in current days or talking about something that happend a year ago. We are all about what is happening now. If your dog is knuckling in recent days, then that is neuro damage. It could be a disc episode, it could be another disease. Untll you know you are not dealing with a current disc episode, the best course is to emply STRICT crate rest to prevent the suspicion of a bad disc currently doing harm to the spinal cord. CRATE REST if any suspicion of a disc episode: The centerpiece of "DISC disease" treatment is the healing of the disc via limited movement of the back via a recovery suite. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong disc scar tissue to form. Super tried and true tips for setting up the recovery suite: www.dodgerslist.com/literature/CrateRRP.htm PLUS further guidance on conservative treatment on our "All Things IVDD page: www.dodgerslist.com/literature/healingpage.htm www.dodgerslist.com/healingindex.htmSTRICT means: - no laps - no couches - no baths - no sleeping with you - no chiro therapy - no dragging or meandering at potty times. Carry your dog to and from the recovery suite to the potty place and then allow a very, very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog's back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on!
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Post by Laura & Gizmo on Dec 7, 2019 18:48:50 GMT -7
Sorry. My dog has been diagnosed. I actually did not expect these questions. I just looking for a forum of info.. where you can ask questions and was hoping to find someone from my general location. She has had a disk herniation, twice. Both times treated with out surgery. Originally treated with steroids & Meloxicam. Second time, I believe either just Meloxicam or steroids & Meloxican. She's been through the create rest things. Surgery was over $5,000 plus $7++. for MRI. (I know the MRI is about $250 across the boarder. U.S. is cheaper.. I need a "Dr. Jeff" from Rocky Mountain Vets from TV. I wish I could go there.) She's been to acupuncture, dog swimming, & chiropractor. Right now, her leg is locking up. Not 100% sure the Vet knows is is doing that. So she is not on Meloxicam to see if helps, because her spine could be pinching it. You think it's a long but she doesn't have many options. So she is getting that and going to and accredited chiropractor (next week). I hope it helps but probably not. Not 100% sure why the leg is locking up. And I don't know how to treat it. However, I was going online to see about possibly surgery. But seems it's still about $5,000. I just can't do that much. I see you have a post about not doing chiropractor. However, that person who work on her stayed away from the bad parts of her spine (using the dogs x-rays to guide her) and was actually able to loosen up the front of my dogs legs. My dog uses her front legs much more because the back ones don't work that well. It actually was good for her.
At some point, if I ever get any info. about her doing surgery, I will send you the info. to add to your list. I see on Google it says it's about $1,500 to $4,000 (plus imaging techniques). I can't do $1,500 or $2,000. but not $5,000.
At the very least, I would like to find out about the leg locking up. It is preventing her from walking. It locks up in the middle of walking so she can't keep moving.
It's just terrible I can't do $5,000 and get her surgery.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Dec 7, 2019 21:11:50 GMT -7
Laura, I think I understand what you are saying. Gizmo has had a disc episode in the past...and thus he IS, indeed, diagnosed as having been born with disc diesease. However at this current time, there is no diagnosis for the leg locking. Going to a specialist since your vet can't pinpoint the cause of the leg locking seems like a reasonable approach. You may wish to learn just why it can be dangerous for any chiro to perform on a dog who is known to have been born with IVDD. Any of the discs could be degenerating to the last straw of tearing (a disc episode!). Only an MRI can see what is happening with discs. Xrays do not show the soft tissue of discs and spinal cord only hard tissue such as bones. Read what these two neuro surgeons say about chiro at this link: www.dodgerslist.com/literature/chiropractic.htmIf Gizmo is not having a disc episode, then no neuro surgeon would do a surgery at this point in time. The purpose of surgery is to immedately remove the disc material causing pressure on the cord. The purpose of conservative treatment is to reduces swelling which causes pressure around the cord. This page will show you how a surgery compares with what conservative treatment does. Very useful information for you to have when discussing things with a vet. Here's that link: www.dodgerslist.com/literature/healingsurgery.htmNone of us here are veterinarians. We do not diagnose— that is a vet's job. We wait til you have a diagnosis for what is going on with the leg lock. If a neuro says it is due to a disc episode, then we have tons of information to share with you in care, etc. The graphic you see below, are among the things a vet will be looking for during an examination to formulate his diagnosis. There are other diseases that can look like a disc episode but are a different disease. So it is complicated and the reason to have a specialist look at your dog to get the correct diagnosis.
Click to enlarge graphic below
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Post by Laura & Gizmo on Dec 8, 2019 16:49:02 GMT -7
Thanks for the info. about the chiro..
I know that immediately, when it first happens, is better to have ivdd surgery. However, I was under the impression, they can have ivdd surgery at any time, to clean out the disc material? If that is not true, I guess we will have to find someone to find out why the leg is locking up. It is the current cause of her not walking. If it didn’t lock, she could walk. She tires but it locks and she falls.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Dec 8, 2019 17:26:51 GMT -7
Laura, it is not necessarily better to have a surgery at first sign of a disc episode. Not at all! In fact many a dog heals their disc just fine under conservative treatment. If there would be some nerve damage then iit is just the same as if the dog had sugery— nerve healing is something the body does all on its own. Surgery for a disc episode is only done during the disc episode to remove disc material from where it should not be and provide relief from pressuring the spinal cord.
Getting to a specialist who can see and observe that leg locking up is important to ket Gizmo the help she needs and get her back to enjoying walking after complete the treatment that goes with which ever diagnosis the specialist gives. Falling can't be good for her body.
Is a trip to the specialist in the cards any time soon? The reason I ask is that we do not have the ability fro this side of the computer to fully understand what the leg locking is. If, IF, there is any hint of suspicion it may be related to a new disc going bad, then you would immedately want her crated. Again we just don't know and the reason to see a specialist soonest possible.
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Post by Laura & Gizmo on Dec 8, 2019 19:31:42 GMT -7
Yes, we were trying the Meloxicam to see if it would help. It helped a tiny bit but good enough. They thought it was possibly inflammatory causing it. So, I plan to get an appt.. My vet has to do a referral.
"it is not necessarily better to have a surgery "
I was surprised to see that you don't have to do surgery and that dogs can walk again, without it. And considering they can have more than one occurrence and on difference parts of the spine, even after surgery, it isn't always a do or die option to have surgery.
The leg locking started quite a few months ago. I didn't know it was locking, I just saw that not walk, when I tried to take her for a walk. Took us a while to learn it's because her leg was locking. She didn't always like walking anyway, so, at first, we did not notice it was because of a new problem.
At the point, she could walk around the house, and out back. It was just "on a walk" where she could not do it.
By the way, re: this image
I was able to put it at her height ... a bowl was not working but this worked great.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Dec 9, 2019 10:39:49 GMT -7
Laura, let us know what the referral specialst diagnoses.
Glad to hear Gizmo is one of the dogs who does like the water bottle. Some do and some don't.
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Post by Laura & Gizmo on Dec 11, 2019 4:32:29 GMT -7
Can we delete ours threads?
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Marjorie
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Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Dec 11, 2019 5:08:41 GMT -7
Threads can be deleted but I hope you'll allow our group to continue to offer you support. If this turns out not to have been a disc episode, we'd like to know. In the meantime, until you get a diagnosis other than IVDD, you should continue with the strict crate rest. If in fact this is due to a disc problem, the spine needs to be protected from further damage. Has something happened that has caused you to want to delete your thread?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Dec 11, 2019 8:31:43 GMT -7
Laura, you have always asked important questions. Questions that perhaps others didn't think to ask or were too shy to ask. This is a teaching page to provide support to owners. The answers that took some time at the keyboard to research and then compose for you and Gizmo also likely benefited a good number of our daily 200 visitors! We hope you will not delete but allow others to continue to learn what is written in Gizmo's thread.
We are very interested in learning what a specialist diagnoses for Gizmo. If it turns out to be a disc episode, then we will have learned something new thanks to you! Please keep us updated when you get your appointment scheduled.
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Post by Laura & Gizmo on Dec 22, 2019 0:11:45 GMT -7
Yes, I just didn't like my name there. I did make it with my name or call myself that. It just kind of shocked me. Anyway.. Previously, she has slipped a disc, twice. Treated without surgery. She was recently given Meloxicam, as mentioned, because of the leg lock. We mthought she maybe slipped another disk and wasn't getting information back to legs to make them walk. She did end up having another x-ray to see if there was another slipped disk. It wasn't very clear on x-ray, that she did. So we set her up to see a Neurology, and she hasn't had the appt., yet. They might suggest better medicine to and probably to an MRI? And we should know more about her spine, later. We finally got her into chiropractor (they don't push on her spine). The chiropractor did relieve a few spots ( using ribs and a few other spots) and they next day, she started walking .. a bit. They next day, she was almost back to normal. And now it is back to her normal. And even on a floor. So, it still makes me think something was not telling the legs to move. Previously, if she was having trouble, a short dose of Meloxicam and acupuncture or chiropractor seem to help. She is on steroids, at the moment. And when sedated for x-ray, they found an infection in her leg so an antibiotic pill and cream, which is almost done. My vet thought the chiropractor was acceptable and he gave me one to go to that is accredited (he would not suggested one that isn't accredited). I can't speak for other chiropractors, but I have seen what this one does and I am OK with it. She doesn't push on the spine and she does give my dog a lot of relief. Looks at x-rays to see how the spine is. And apparently, makes her walk again. To be honest, I was shocked when she started walking. So, again, messages seem to not be getting through to her legs.
For now, she's good. I almost cancelled the Neurology appt., but at least we might get better information from this or different medication like Gabapentin or maybe no medication? We'll see.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Dec 22, 2019 9:49:59 GMT -7
Laura, so glad to hear that Gizmo is now doing well and is back to normal. Questions concerning the switch to a steroid:1. Was there a 4-7 day washout period when switching from a NSAID to a steroid? 2. If no washout period, have TWO stomach protectors, such as Pepcid AC and Sucralfate been added to reduce risk of damage to GI tract? If not, please advocate strongly that TWO stomach protectors be given? 3. What is the name of the steroid and dosage in mgs and frequency given? 4. What date was the steroid started and what date is the taper scheduled for? 5. Is Pepcid AC now on board even if a washout period was done? 6. What was the reason for the switch to a steroid? An x-ray would not be conclusive about a damaged disc. Regular X-rays (radiographs) are good for evaluating bony abnormalities (fractures, infection of the bone, tumors of the bone). A healthy intervertebral disk and spinal cord are not visible on a radiograph because they are soft tissue and not bone. The only way to accurately determine whether there is spinal compression from a disc or anything else is with an MRI or CT scan. Diagnosis of IVDD is usually made based on breed of dog and symptoms. MRIs should only be done just prior to surgery so the surgeon knows where to operate. MRIs and sometimes x-rays require anesthesia which can be dangerous for a dog with a damaged disc as anesthesia relaxes all of the core muscles supporting the spine. It could be that the steroid has relieved any swelling that may have been causing the locking of Gizmo's leg. It may be that this was not a disc problem and the chiropractor was able to help, but please do be very cautious of chiropractic treatments. Any chiro who understands IVDD would never do adjustments on a dog with a possible current disc problem. The ribs are connected to the spine and any adjustment of the ribs could have an affect on a spinal problem. Looking at an x-ray would not tell a chiropractor anything about a possible compression of the spine and the need for limited movement of the spine. The only way a chiro could know exactly what was happening with Gizmo's spine would be to have any MRI done before each adjustment and that of course would be risky due to anesthesia. www.dodgerslist.com/literature/chiropractic.htmPlease do continue to keep us updated on Gizmo's status.
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