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Post by Emily & Zeus on Jan 30, 2020 16:59:24 GMT -7
I know Zeus is almost 14. I know every dog is different. I know healing takes time. But should I be concerned that we are nearing our second week of the injury and he’s not using his hind legs much? He’s not able to use them to try to stand nor to walk. I don’t know when I should fear that he has reinjured himself or not healed properly.
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PaulaM
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Post by PaulaM on Jan 30, 2020 18:52:00 GMT -7
Emily, no one will be able to give you a time table about nerve healing. The focus of conservative treatment is to get the disc to heal in 8 weeks of limited movement. You may or may not see evidence of nerve healing in that short of time. Best to think in terms of months rather than days/weeks. for this slowest part of the body to heal (nerves). There is a predictable order in nerve healing, the reverse of of damage to the cord. With bladder control then the next expected nerve repair will be: 4. __Leg Movement, and then ___ability to move up into a stand position, and then __wobbly walking. 5. Being able to walk with more steadiness and properly place the feet. 6. Ability to walk unassisted and perhaps even run. Dr. Isaacs, ACVIM (Neurology) explains: "I also advise that at 2-4 weeks we are not seeing the end result of the healing process - this typically does not occur for 6-12 months and in some cases even longer."
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Post by Emily & Zeus on Feb 1, 2020 14:07:53 GMT -7
In the event that he will need to be on pain meds again after 2/3 - will he be on them for another 2 weeks? and how soon will I know he needs them once he is off of them?
[Moderator's Note. Please do not edit 14lbs Novox as of 1/20: 37.5mgs 1x/day for 14 days, then 2/3 test stop to reveal any: _pain / _neuro gabapentin 100mgs 3x/day Robaxin 125mgs 3x/day tramadol 50mgs 3x/day famotidine 5mgs 2x/day Amoxycillin 100mg 2x/day for possible UTI ACEpromazine 2.5mgs as needed]
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Feb 1, 2020 14:33:56 GMT -7
Emily, you might see with the stop of the first Novox dose if any hint pain would surface or it may take the usual 5-7 days for Novox to be fully metabolized and out of his body.
How long to stay on Novox is a guess each time another course is prescribed. Since the first course was for 14 days, maybe the resolution of inflammation is getting near and perhaps a 5-7 days course would do it. The length of the next course, should one be needed, is something you and your vet will need to discuss and come up with the best idea.
I can't remember if you posted on this. On the test stop of Novox Mon 2/3 to find out if there would be still and remaining pain, which does you vet call for: -- the backing off of all pain meds to reveal if any pain? OR.... -- the full stop of all pain meds?
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Post by Emily & Zeus on Feb 1, 2020 15:54:12 GMT -7
From what I understand - he’s having us stop Novox completely on 2/3 but if I want to slowly get him off the other meds for pain, I have enough to do that slowly rather than abruptly. He’s giving me that choice. I was going to stop them all at once but Zeus has been having a difficult time getting comfortable today and I’ve felt his belly tighten a couple times today. However - I’ve seen this over the course of the past two weeks so it could be that it’s normal for him. I felt my other dogs belly and hers felt tight so I don’t know if I know what “tightness” is when talking about pain.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Feb 2, 2020 8:26:37 GMT -7
Emily, what will be the backing off schedule for the pain meds tomorrow— move down to 2x/day for each of the pain meds for example or ......?
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Post by Emily & Zeus on Feb 2, 2020 8:45:49 GMT -7
If that’s what you all recommend then that’s what I can do. We still have plenty Gaba, Tram, and Robox to last us several days.
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Marjorie
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Post by Marjorie on Feb 2, 2020 12:53:01 GMT -7
The stopping or tapering of meds is something that you and your vet need to work out. Did the vet seem to lean one way or the other? If your vet has left that decision completely up to you, then consider the fact that the quicker you determine whether there is still swelling/pain, the quicker you'll be able to get Zeus back on the anti-inflammatory if he still needs it. Pain = swelling = more time on the original dosages of all meds. You may or may not see pain immediately return with the stopping of the Novox as that can remain in the system for a few days. Having any pain meds on board may mask the signs of pain that you need to observe. That may drag out determining whether swelling has resolved for days and during those days, no anti-inflammatory will be working on the swelling.
You mentioned that you were going to stop all meds at once but you're not sure if there is still pain. Seeing signs of pain would not be an indication that you should taper off of pain meds rather than stop pain meds abruptly but rather not taper off or stop any meds at all. Are you still observing Zeus having a difficult time getting comfortable or possibly is he getting restless in his crate due to feeling better? You know your dog best. You mentioned that you've been seeing this over the last two weeks and yet felt that his pain was under control so it's a bit confusing. Try not to overthink things but just observe him and see if he appears to be a dog in pain, taking into consideration the signs of pain that you've learned here.
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Post by Emily & Zeus on Feb 2, 2020 13:24:25 GMT -7
My vet is allowing me to decide - he is following my lead with this because he recognizes he doesn’t know everything about IVDD.
I don’t know whether to continue the pain meds or not. I don’t want to mask the fact he needs more anti-inflam. He seems to take extra time finding a comfortable place to lay in his kennel but that’s been the case since day 1. I don’t know if that’s pain. He’s had a tense tummy and every once in a while I feel the same with my other two dogs so I don’t know if that’s pain or not. I’m not seeing anything else on the list for pain that he has symptoms of besides finding a comfy place to lay and tense belly. So I’m not sure what to do tomorrow with meds. I’m just as confused too, I guess.
Also - if I got Zeus a larger crate and put his bed in the back and a potty pad in the front, would that be ok? An IVDD group I follow was suggesting getting him a larger pen to help him during the day since he hates crates but I’m afraid he will move around too much in it and hurt himself again.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,544
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Post by PaulaM on Feb 2, 2020 16:18:45 GMT -7
Confirm with your vet if the idea of backing off of the pain meds down to 2x/day is appropriate for Zeus. If, a yes, then ask for how many days to go to 1x/day and then be fully stopped. Your vet knows about dealing with pain and pain meds, he should be able to guide you in backing off of them. Backing off should quickly help you to identify with confidence IF, if, you would see signs of pain.
The danger in a crate larger than enough room to lie down, fully stretch out the legs is a dog can then pace, and other things that would jeopardize the early healing disc. Is there anyone who can check on him during the day for a potty break?
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Post by Emily & Zeus on Feb 2, 2020 16:24:25 GMT -7
Unfortunately not - everyone works like we do :/ he hasn’t been having messes except in his kennel while we are at work. My theory is that he either A) gets mad he’s in there and pees which he has always been the kind of dog to do or B) wakes up and remembers he’s in the kennel and upsets himself enough to pee. That’s why I was trying to get a puppy pad in there separate but if you think we should just keep him in his small kennel, we can do that too.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Feb 2, 2020 17:15:57 GMT -7
Emily, use same size crate. Just a mattress maybe 2" high (enclosed in trash bag and fleece tucked in all around. Place potty pad in the area remaining.. Fold up potty pad if need be, he won't need the whole area to pee on. The idea with matress vs. not a bed is he would not be having to step up or step down as with those dog beds. The mattress only is more like just one level.
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Post by Emily & Zeus on Feb 2, 2020 17:24:25 GMT -7
Paula, are you saying to use the bigger crate but just use a bigger mattress so it covers more than the puppy pad would?
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Feb 2, 2020 18:16:56 GMT -7
Emily, it appears from the avatar you can use the same crate (not a larger one). Can't tell much more from that picure. YOu want the area inside the crate to be all one level as much as possitble. YOu do not wnat Zeus having to deal with different levels cause his back more movement. The dog below is long. When he lies down he is able to fully stretch out his legs. Note there would still be enough room to expose the pee pad by folding back the tucked in fleece blanket a bit more. Note that the the area he has is all one level. Put some incentive old urine on the pee pad so Zeus knows that's where he should pee. Note the top picture of an expen tightly surrounding a typical dog bed (has a red blanket draped across the top). See how high the dog bed mattress is? To expand the expen area would then have too high a level from the dog bed mattress down to the level of a pee pad on the floor. Too much movement for a dog's back.
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Post by Emily & Zeus on Feb 3, 2020 4:27:22 GMT -7
Zeus slept through the night and this morning, my husband took him out. He said Zeus pushed off without warning and fell over and let out a yelp (could have been startled or hurt) and after he finally got him in his sling, he walked him around. My husband observed what he thinks is a hunch in Zeus’ back. However, I’m not feeling tummy tightness, Zeus isn’t struggling to get comfortable in his kennel this morning, and I’m not seeing any signs of pain.
My husband is really sick to his stomach and swears he couldn’t have done anything to prevent Zeus from taking off. But now we are fearing reinjury based on the yelp and the hunch. Help 😭
Update: 30 min after this incident, Zeus attempted to stand up in his kennel. I took him out and he’s still trying to use his legs. No sign of pain. His back doesn’t look any different to me than it did yesterday.
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Marjorie
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Post by Marjorie on Feb 3, 2020 6:03:00 GMT -7
Hopefully Zeus was just startled when he fell and hasn't sustained a re-injury. It's good that he's showing no signs of pain now. I would let the vet know what happened so he can determine whether the meds should start to taper or stop today. It might be best to hold off on that for a day or two while you observe him because if the taper starts today and he's just had a fall, should pain start to appear again, it would be difficult to determine whether it's because of a re-injury or because of the taper off of meds. You need to know what the cause of any pain is because if it's a re-injury, the 8 weeks of strict crate rest would have to start from the beginning.
Whenever we see words such as "he walked him around", it always makes us concerned. Please be sure that you and your husband keep Zeus' steps to a very, very few at potty time. I understand that you wanted to test his neuro function but that can be seen with just a few steps. The less movement of the spine during conservative care, the better. Too much movement of the spine can also cause a re-injury as the not-yet-healed disc can tear more or even rupture and you'd be back to square one.
Prayers that Zeus has not sustained a re-injury. Please let us know what the vet says after speaking to him this morning.
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Post by Emily & Zeus on Feb 3, 2020 7:22:53 GMT -7
Vet wants to do another weeks work of pain meds and anti-inflammatory
[Moderator's Note. Please do not edit 14lbs Novox as of 1/20: 37.5mgs 1x/day for 14 days, Zeus slipped on 2/3 and yelped as of 2/3: 37.5mgs 1x/day for 7 days, then 2/10 stop test for pain gabapentin 100mgs 3x/day Robaxin 125mgs 3x/day tramadol 50mgs 3x/day famotidine 5mgs 2x/day Amoxycillin 100mg 2x/day for possible UTI ACEpromazine 2.5mgs as needed]
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Post by Emily & Zeus on Feb 3, 2020 8:49:32 GMT -7
I still can’t get a for sure answer on whether or not we are tapering or stopping all together. I asked twice.
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Post by Emily & Zeus on Feb 3, 2020 15:00:22 GMT -7
I asked The vet a third time, in person, whether we are tapering or fully stopping all meds after this next week (he is doing another weeks worth of anti-inflam and pain meds) and he responded “we can continue these meds for longer if need be”. Still no set answer. He’s learned about IVDD from me so I feel like he is following my lead. But i don’t know the best course of action.
Today was the first work day since the injury that Zeus’ kennel was mess free! Granted, my husband got lucky and checked him during his break which we can’t always do but it’s progress. At lunch time. My husband reported that Zeus was using his legs better than we’ve seen him use them so far! (He took him potty and got to see)
My husband got home from work later on, earlier than I did. He said he took Zeus out and he was still trying to use his legs but not like he was. He also observed a hunch in his back and Zeus apparently looked like he was sucking his stomach in. Zeus didn’t potty so my husband brought him in and tried again after 30 min. When he took him out the second time, there was no hunch and Zeus was using his legs better.
When I got home, I checked Zeus for pain on his belly or tightness and didn’t feel anything abnormal. I also didn’t see this hunch. Could it be that this hunch is occurring every once in a while after he’s napped in the same place too long? Could it be arthritis or even stiffness from laying in one place?
We’ve got not further sign that he reinjured his back. I would assume he wouldn’t be able to walk and we would see regression in progress? It’s so difficult to tell. I want to be happy because of the progress but I’m of course still concerned after this morning when he yelped after falling. I wouldn’t think a hunch from injury would come and go like this.
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Marjorie
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Post by Marjorie on Feb 3, 2020 17:26:17 GMT -7
Good to hear that there has been no obvious sign of a re-injury, Emily. If there were a re-injury, according to how bad the re-injury was, you would most likely be seeing new signs of pain and/or loss of neuro function (not necessarily that he couldn't walk at all but a worsening of his condition). A hunch that comes and goes would not be a true sign of pain from a re-injury.
As for whether you should stop or taper meds on 2/10, Zeus will have been on an anti-inflammatory for 21 days at that point and there's a good chance, unless you see a worsening of his condition between now and then, that the inflammation may well be gone by then. Your vet may not be familiar with IVDD but as Paula previously mentioned, he should be familiar with controlling pain and should be able to give you an idea of what you should do. Some vets believe that the pain meds should be tapered while other vets stop all meds at once. We're not vets and we don't know all the facts of Zeus' medical history and really cannot advise you in this regard. It's this vet's prescription and he's the one who examined Zeus so it's difficult to understand why he can't give you more direction.
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Post by Emily & Zeus on Feb 3, 2020 17:29:37 GMT -7
My husband suggested calling the vet again next Monday to ask again. This is frustrating for sure, but I’d rather the vet be more willing to help than to be reluctant to listen to me.
Do you have any theories as to what this reoccurring hunch might be?
I’ve seen supplements for arthritis and disc health - could that be something I look into during or after crate rest to help Zeus?
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Feb 3, 2020 17:52:17 GMT -7
The occasional hunch is something else that should be discussed with the vet. A hunch during conservative care can be a sign of pain as they assume this position to minimize pain. But you're not always seeing a hunch. Your husband seems to see it more often than you do. A disc episode usually does not let up with the pain or without protective confinement may increase as the nerves continue to be damaged by the bad disc. Arthritis joint pain usually eases up with some exercise after getting going from a night of inactivity or a daytime nap where the body's joints have been in one position. Of course, while on conservative care, Zeus would not be able to work out stiff joints. How old is he again? You shouldn't start any type of med or supplement for arthritis or disc health while Zeus is on other meds. If he should show signs of GI distress, it would be difficult to determine whether it was the Novox or the new supplements causing it. More info on Dodgerslist's opinion on IVDD supplements: www.dodgerslist.com/literature/Supplements.htmHere's more info on a hunched or humped back with IVDD: www.dodgerslist.com/neurocorner2/hump.htm
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Post by Emily & Zeus on Feb 3, 2020 17:59:35 GMT -7
He’s 13 going on 14. My husband typically takes him out after long times without activity (i.e. sleeping overnight or sleeping while we are at work). That’s when we are consistently seeing this hunch - not every time of course, but that’s the pattern I’m seeing with it, at any rate. I’ll read up on those materials - heard about not starting supplements while he’s on current meds. I’m doing some research on spinal arthritis and how that could’ve potentially created this IVDD issue (and both could’ve occurred due to his age). It’s very likely he might be dealing with that as a comorbid issue. I’ll have to bring it up to the vet next time I speak with him. thebark.com/content/vet-advice-relieving-your-dogs-arthritis
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Post by Emily & Zeus on Feb 4, 2020 14:35:36 GMT -7
This is the hunch that is coming and going - seen after periods of inactivity like sleeping all day while we are gone and waking up in the morning after a night's rest. Within 5-10 minutes, it works itself out. He does not yelp when being picked up during this. Also, his manly area does this each time. This is what we are thinking might be arthritis. My sister went through the same thing with her dog after IVDD struck. She said that she noticed it after her dog was in the kennel, curled up and sleeping for long periods of time. It was like a stiffness and went away after moving.
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Post by Romy & Frankie on Feb 4, 2020 14:56:01 GMT -7
Coming and going in response to exercise just does not sound like IVDD. If it is arthritis, during the IVDD episode he is not moving very much to protect his disc and so the hunch.
If you stand him up and support him without the sling does the hump change? Perhaps the position of the sling is a factor.
The penis not retracting is something that is seen in IVDD dogs. My dog Frankie had this issue for a little while during his IVDD episode. The penis was out much further than your picture of Zeus is showing. My vet said to lubricate it (I used aquaphor) so it would not dry out. As Frankie recovered this stopped happening.
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Post by Emily & Zeus on Feb 4, 2020 16:31:10 GMT -7
These occurrences of the hunch is happening seldom so I will have to attempt to support him without the sling next time I see it happen. It’s startling to see and he won’t move around much to pee. So my husband will put him in his crate again and try again in 10 minutes - by that time, the issue has resolved itself and Zeus potties no issue.
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PaulaM
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Post by PaulaM on Feb 5, 2020 8:17:07 GMT -7
Emily, the arched back the way you describe it, is not consistent with the pain that would be due to a disc episode. With meds on board every 8 hrs and aggressive, pain would be under control round the clock.
The arched back resolving itself in a matter of minutes sounds like the pain/discomfort is due to something else. Please do show your vet the picture and describe when it comes and when it goes.
Getting off meds when the test taper will happen, will eliminate those variables and perhaps make it easier for your vet to pinpoint the cause and what the treatment should be.
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Post by Emily & Zeus on Feb 5, 2020 19:42:38 GMT -7
Zeus stopped his last dose of amoxicillin today. He’s not urinating in his kennel while we are at work (knock on wood) and he’s not urinating unreasonable amounts all hours of the day.
I was going to show that photo of the hunch when I pick up more gabapentin and Tramadol to last us until we run out of Novox (and to ask if we are tapering or quitting cold turkey). Zeus has had a pretty good last few days but today he was extra whiny and breathed heavy frequently (something he’s always done even when he’s healthy, when he’s annoyed or frustrated). We laid down for the night which he hasn’t been minding but tonight he started panting and whining even after all his needs were met. I made it to where it was impossible for him to be hot so I could rule that out but he was still trying to stand up and continued to be restless. I finally had to sedate him which is only the third time I’ve done so. I wish he could tell me what he needs or what’s wrong. It could be that he’s feeling so good that he’s stressed about the kennel but I just don’t know. We are doing everything to combat pain and that’s been under control so I’m confused as to why he’s so restless and whiny (besides the fact he wants out of the kennel).
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,544
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Post by PaulaM on Feb 5, 2020 21:29:06 GMT -7
Emily, it may well be Zeus is feeeling better. A UTI can feel very crummy. it is an infection after all. Hope you all will be getting a good night's sleep. Let us know how Zeus is acting in the morning.
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Post by Emily & Zeus on Feb 7, 2020 7:25:06 GMT -7
Called the vet for more Tramadol and gabapentin and to ask whether I’m tapering meds or stopping them. He said he wants to continue gabapentin and Novox (same dosages) ONLY and for two more weeks from today. At that point he wants me to call him again and we will figure out the next course of action.
[Moderator's Note. Please do not edit 14lbs Novox as of 1/20: 37.5mgs 1x/day for 14 days, Zeus slipped on 2/3 and yelped as of 2/3: 37.5mgs 1x/day for 5 days,
as of 2/7: 37.5mgs 1x/day for 14 days, then 2/21 stop test for pain gabapentin 100mgs 3x/day for 14 days Robaxin 125mgs 3x/day STOPPED 2/7 tramadol 50mgs 3x/day STOPPED 2/7 famotidine 5mgs 2x/day ACEpromazine 2.5mgs as needed]
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