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Post by Madeline & Wolfie on Jan 29, 2020 15:46:44 GMT -7
Spoke to the new local vet [ Dr Walker, while visiting in St. Louis], she could not give us an accurate prediction of what his fully recovered state was going to be, and cautioned us that nerves take months to heal. She was pleased to note that Wolfie has recovered Deep Pain Sensation. Wolfie has been prescribed a month's worth of meloxicam and gabapentin (same amount as before), and wants to see him again in two weeks. She discussed other possible spinal issues, but agreed that based on his symptoms and his DPS recovery that he has IVDD. She told us that he may never be 100% again when walking (i.e., he may have a limp or one leg may even drag a little bit), and highly recommended hydrotherapy after his crate rest. I spoke to her about the Dodgerslist forum and the recommended strict 8 weeks crate rest. I asked if that's what she would recommend and she said "Yes, he needs 6 weeks at least." So I feel confident that Wolfie's in good hands, and understands his condition at least on a basic level. We are going to cancel our Feb 14th appointment with the ortho surgeon. Instead, we set up an appointment with this local vet on the 12th of February to see how he's doing. She said she can perform the bloodwork panel if it's something we want, but that she did not feel it was necessary. She does not expect Wolfie to be on medication long term. In terms of traveling, given how much he hates the crate and that he feels safe and calm enough in the bag to sleep during car rides, she said it would be okay to keep him in his travel bag when we return to Chicago. (I'm planning to switch to a hard-sided airline carrier type bag, to make sure it's sturdy enough. Thoughts?) I talked about getting him adaptil, and she recommended the adaptil collars. Overall it's been an interesting day. Wolfie hates going to the vet but he was feeling well enough to bark every time he heard another dog somewhere else in the clinic. He is now home and resting. I gave him his meloxicam. Romy & Frankie thank you for the checklist. We are done with the ER vet, and have a regular local vet for as long as we are still in St Louis.
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Post by Romy & Frankie on Jan 29, 2020 16:17:51 GMT -7
Good news that Wolfie is resting comfortably at home. I am very glad that you found a vet you are comfortable with. She is absolutely right that his ultimate recovery cannot be determined because nerves take a long time to heal.
During his IVDD episode my dog Frankie became paralyzed. He eventually recovered his ability to walk but his gait was never normal. People would smile when they saw him walking and one time someone asked me why he was dancing. So even if Wolfie's gait permanently changes it shouldn't change him or what he can do.
Thirty straight days on the meloxicam is longer than we usually see. Consider asking the vet about a stop for
pain test in about a week.
When Wolfie travels he needs something that will keep his back straight and stable. I am not sure if the travel bag would do that.
At the end of the two weeks, she if you can update the vet by phone rather than transporting Wolfie.
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Post by Madeline & Wolfie on Jan 29, 2020 16:41:05 GMT -7
I will speak to the vet about an update by phone, and a stop for pain test in about a week. [Moderator's Note. Please do not edit 7.8 lbs Meloxicam as of 1/24: 0.23mL 1x/day for 5 days new DVM as of 1/29: 0.23mL 1x/day for 7 days, then 2/5 test stop for _pain/_neuro Gabapentin 50mgs/1mL:50mg (1mL dose) 3x/day Pepcid AC (famotidine) 5mgs 2x/day ]
I'm so glad Frankie was able to walk again! Wolfie's always had a bit of a funny waddle because of his horrendous luxating patellas, so if he gets even goofier, I won't complain. As long as he is his happy, pain-free self. Going to look into those hard sided airline carriers, because his travel bag is so soft. With how much he dislikes his crate, and the fact that it's a 6 hour drive to get home once we leave St Louis, I have to weigh the chances of him hurting himself and stressing himself out in the crate for hours, or him settling down in the airline bag in the backseat between us. Sounds like it's going to be risky to move him either way, but I think I know which option is going to keep him the calmest. We used towels inside his current soft sided travel bag to keep him secure, but that was just a temporary thing for today's vet visit.
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Post by Madeline & Wolfie on Jan 30, 2020 11:20:08 GMT -7
Sorta settling into a routine! When we bring him to the pads in the morning, he poops right away (tail starts flexing and moving), but he's still very reluctant to pee. I think he's waiting until he gets uncomfortable and can't avoid it, then we have to hurry to get him to his pads before he ends up peeing where he's laying.
He does not like being unable to crouch. How can I make this easier for him? I'm lowering the sling a little to give him the impression of crouching, but he's a stubborn little guy.
It's a game of Will He Won't He. I don't like moving him, and he gets crabby if I try to move him when he'd rather nap (NOT new, he's always preferred his beauty sleep lol).
How often should I try to bring him to his pads?
This is Wolfie's current medication schedule. (is it alright, or is there something I should be doing differently? How much wiggle room is allowed when it comes to giving doses? as in, is it okay if I give a dose 30 minutes late or early?)
3:30AM - Gabapentin (administered every eight hours) 11:30AM - Gabapentin, pepcid ac (given every 12 hours?)
Bathroom break
12PM - breakfast, meloxicam (once per day) 7:30PM - gabapentin, dinner 11:30PM - pepcid ac Cycle repeats.
Either before or after dinner, we schedule in another bathroom break. (he's up to pooping twice per day, which is regular for him. Stool quality is normal, btw)
Does this schedule look alright?
And could I get the link to the medication log? I know it was mentioned in a previous reply but I'm having trouble finding it.
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Post by Romy & Frankie on Jan 30, 2020 14:22:59 GMT -7
Glad you have gotten into a routine. It does make things easier.
Has Wolfie been tested for a UTI recently? A reluctance to urinate may be because it hurts him to pee. Pain on urinating is a common symptom of a UTI. There aren't always symptoms like dark or foul smelling urine with a UTI. A urine sample can usually be dropped off at the vet's office for testing.
When my dog was just recovering his ability to stand and walk he could not squat to poop. If he tried, he would fall down, his legs just weren't strong enough. I learned to watch him very, very carefully and at the first sign he was even thinking about trying to squat, I would kneel down and support his upper body while he pooped. One day I wasn't watching closely enough and he fell right into the poop. It was heartbreaking. Maybe you could try to support Wolfie in that way when he wants to crouch.
The medication schedule seems fine. It shouldn't matter if you are giving it to him 30 minutes earlier or later than scheduled. Sometimes life just won't let you stick to a strict schedule.
Here's the link to the medication log: www.dodgerslist.com/literature/crateRRP/medchart.pdf
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Post by Madeline & Wolfie on Jan 30, 2020 15:20:49 GMT -7
Thank you for the reply! How do I go about getting a urine sample from Wolfie?
If he DOES have a UTI, would he need more medication? Would I need to start expressing his bladder?
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Post by Julie & Perry on Jan 30, 2020 15:33:52 GMT -7
When Wolfie needs to pee have a clean container ready to catch some urine.
Or I found a soup ladle handy.
If it's a UTI the vet will prescribe antibiotics.
You could check after Wolfie pees to see if he's completely empty.
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Post by Madeline & Wolfie on Jan 30, 2020 16:57:12 GMT -7
That's gonna be a little tricky, holding up his body with the sling and also trying to catch the urine. I spoke to his vet clinic for costs ($35 is way less than I expected), I talked about possibly bringing in a soiled towel in a ziplock baggy, and was told that would be alright as long as it's fresh. I am going to keep trying to get him to pee on the pads throughout the evening and night. If I have no success, I'll see about bringing in a urine sample somehow to the vet clinic and we'll go from there. I have a few more questions, if anyone can answer them. Wolfie keeps repeatedly trying to stand? Is this okay? Should I let him keep trying? Or should he just not be allowed to move at all? When he hears the doorbell, he sits up and barks. He's using his front legs to brace himself, is that alright? I'm worried about him sitting up and shifting around in the night while I'm asleep. I know I can't watch him 24/7. Update: Wolfie looked a little uncomfortable, so I brought him to his pads. He peed so much. I can't tell if it's worth it to do the UTI check or not. I'll see what tomorrow brings.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,805
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Post by PaulaM on Jan 30, 2020 19:13:10 GMT -7
Madeline, a clean catch used to be acceptable for doing a UTI. Hope was there would not be bacterial contamination and possibly inaccurate urinalysis results (bacteria from contaminated container, etc. VS. bacteria actually growing in the bladder) Now many vets are moving to doing a cystocentesis to provide a contamination free specimen in the clinic. I was wondering why when you had the appt, the vet did not offer collecting a urine specimen that way. It it is going to be clean catch, then this Mar Vista Veterinary article explains how to do it: www.marvistavet.com/urinary-tract-infection.pml It would be easier if you have a partner to help you get the urine specimen. STANDING, Sitting on the butt Standing or sitting as long as it is not include being rambuction is ok. Place a note on the doorbell outside, to no ring it baby sleeping or such. At times you are in the house, add to call your cell phone instead of ringing the bell.
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Post by Madeline & Wolfie on Jan 30, 2020 20:13:26 GMT -7
So as long as he's calm about it, I can let him stand and walk a little on the sling during potty time?
I can't do anything about the door bell, it's more of a motion sensor triggered noise in the doorway for security purposes. We are staying with family and my uncle is hard of hearing, given that it is his house, I don't think he's going to disable it during our stay.
Our new local vet does house visits, so I'm sure we can work something out with the cystocentesis if needed, just gotta check pricing.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jan 31, 2020 6:28:57 GMT -7
Hi, Madeline. Standing and turning to re-position himself in the crate is fine and will help keep his muscles and joints toned and blood circulating. Sitting up, supporting himself by his front legs is fine. Taking a very, very few sling-supported steps at potty time to get the job done is fine; however, do keep those steps to a very, very few, only enough to do potty, then pick him up and carry him to the crate. If you can avoid steps at all by lifting him to a pee pad placed right outside of his crate and supporting his hind end as you've been doing, that would be best. The less movement of the spine, the better. If you think Wolfie will do better going potty if he's taken outside to a favorite pee spot (if he's not going to get too excited), there are ways to limit his steps. 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! www.dodgerslist.com/literature/slingwalk.jpg
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Post by Madeline & Wolfie on Jan 31, 2020 18:54:50 GMT -7
Well we made it through Wolfie's first week of recovery. With a vet nearby and the help of this forum (not to mention Wolfie being his same old self sans walking), this no longer feels so impossible or frightening. Just to recap to keep everything straight in my head. Wolfie is on pepcid ac for stomach protection, he is getting 1ml of gabapentin 3 times a day, and 0.23ml of meloxicam once a day. I think we've finally mastered a bathroom routine for him. Before this started, he typically had a bowel movement two times a day (though it wasn't unusual to have it be just one a day). How often he urinated is harder to keep track of, because he would pee on his pads just to get a food reward if he saw us eating something he really wanted.Typically he went in the morning and in the evening, sometimes late at night depending on whether he'd rather have a nap before bed. LOL. He pooped this afternoon after breakfast, and a few hours ago he peed another lake. He didn't seem uncomfortable in any way. Is it worth it to pay for a urinalysis at this point? It's $35. Wolfie's next appointment with Dr Walker is the 12th of February at 3PM. His crate is arriving tomorrow. Wish me luck, he's never been a fan of crates but I feel better knowing he'll be safe and contained. He's definitely getting impatient, and typically tries to walk around the rest of the living room after I set him down on the puppy pads. I see his back legs trying to work (the right more than the left), and I also see them heavily crossing when he tries to stand. He flexes and shifts his tail both during a bowel movement and when he's trying to get his balance. I'm looking forward to what this upcoming week will bring. Hopefully it will be more improvement for this little guy. Last Friday was hands down one of the scariest moments of my life. I'm 27 years old, and Wolfie is my first dog. I've never experienced anything like this before. So very grateful to have this resource so close at hand. Your help has been invaluable. If anyone has any advice or tips for these next few weeks, I'm all ears. One last thing, I will call the vet on Monday to ask about a test-stop of the meloxicam and gabapentin on Friday. He's been doing well, I'm not sure he needs the gabapentin as much. He fidgets to get himself settled, but not as much as before. He even managed to get one of his legs under his body, to shift positions to lay on his right side instead of his left.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,805
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Post by PaulaM on Jan 31, 2020 20:15:31 GMT -7
Madeline, we all are glad being on the Forum has helped you cope with so many new things which can, indeed, be scary. Thanks, for letting us know.
The reason a UTI was recommended was your reporting that Wolfie was reluctant. to pee, holding the urine in for long periods of time. Not all UTI's have signs we can observe and other UTIs may give a hint with change in color, smell, frequency, dribbling etc. Also if he was under medicated for pain, that would be a reason why he was reluctant to have to move for potty time. So is sure is hard to know which way you should go on the urinalysis.
HOpe you all are taking care that Wolfie is not walking around, but always taking the very fewest of footstep to take care of business on the pee pad. The phrase "walking around" sends up red flags for us about the safety of the healing disc.
Any movement of the legs or tail at potty time are very likely related to reflex movements. So monitor those neuro functions when he is not at potty.
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Post by Madeline & Wolfie on Jan 31, 2020 21:54:22 GMT -7
We've admittedly been a little lax with allowing him only a few steps. I'll correct this. I don't want to jeopardize his healing, but I'd be lying if I said I wasn't a little bit desperate to see improvement (or a little of the 'old' Wolfie).
Hope is a hard thing to nurture with only a maybe. I am trying to stay positive, though! Hard not to look back on the past 5 years with Wolfie and wonder if I could have done something to prevent him going through this.
I'll keep an eye on his potty habits going forward, and keep a urinalysis in mind.
I have a question about crate rest. It's strict 24/7 rest. How do we keep him from being bored and miserable? Are there any safe games I can play with him? Is there any way I can get him some fresh air?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,805
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Post by PaulaM on Feb 1, 2020 9:24:21 GMT -7
Madeline, one thing this Forum gives access to is see what vets world wide prescribe, what works and doesn't work. Seing how a large number of dogs go through the nerve healing process including owners kind enough to come back and give us periodic longer term updates. With the 4mos, 6mo and even a year out from disc episode we see it is indeed true that having deep pain sensation (DPS) bodes quite well for more nerve healing to take place. Wolfie has ALREADY confirmed he likley always retained DPS. Now predictably he is following the stepwise order nerve function come back in. He is ALREADY using his back legs for purposeful movement: dreams and paws move, and now attempting to use back legs to reposition himself in his recovery suite! Wolfie's body is on a roll in the nerve healing department! Take a note from Wolfie. He lives in the moment not thinking of what used to be nor what he wants to happen in the future. For us humans, that means sure plan for the future, then set those plans aside to live in the now. Notice all the good things you observe: Wolfie's crate is coming, the sun is shining, Wolfie is getting good healing sleep, he is out of pain. So many points happen during the day to take note of. The past is the past and the future is not yet here. Live in the now. A Calming tip for YOU: Wolfie will pick up on your stresses and internalize them...not good for your recovering patient! A simple breathing technique can also help YOU help your Wolfie. Belly breathing will relax you, slow you down, quiet your mind. Through regular belly breathing you can learn to focus on the now. You DESERVE it as a care giver!!! Do anytime during the day, whether you are sitting at your desk, driving in your car, or walking down the street!
During the balance of the 8 weeks the focus is all about limited movement of the spine so that early healing scar tissue forming on the disc does not retear. A tear would mean starting back at square one with meds, with crate rest. -- For when you return to Chicago this idea may be useful. Many members have found a pet stroller to solve a whining problem because the stroller can be wheeled from room to room as you go about your activities. Even out on your deck for a few moments of fresh air before getting too chilly. Pet strollers, however, should only be used when you are directly supervising. More details on strollers: www.dodgerslist.com/literature/strollers.htm-- Put a garment you have been wearing and have not washed in the crate. --- Most dogs need some 16-18 hours of sleep per day, people sleep 8-9 hours day. What are they doing in the crate? Laying around and sleeping! Don't give into the temptation to start a treat routine to combat non-existent boredom. Adding a bunch of treats as entertainment contributes to weight gain which isn't a good thin What you CAN do if Wolfie does not have a neck disc episode and he is not a ramrambunctiousbuctious chewer is soak his kibble in broth and freeze each of his normal kibble portions into a Kong so he has a job... working for his two daily meals ---Teach self-calming exercises can also help your dog to relax more. You can make something as simple as eye contact a very rewarding behavior that also acts as a way for your dog to “ask permission” when he wants something. When dogs have a focus and an understanding about how to behave to get what they want, they are much calmer overall. Learning and practicing behavior is a mental stimulation which can help to tire them out. To do this, each time your dog looks at you, say, something like, “Yes!” or use a clicker to mark the second he looks at you, and then give your dog a food reward. [NOTE: for crate resting dogs, shift your body a bit] .... wait for your dog to look up at you again, say, “Yes,” and reward again. Do this exercise 10 or so times and then say, “All done,” and put the treats away. Come back later and do it again until you can see that your dog is really starting to make automatic eye contact in hopes you will say, “Yes,” again and give him his reward. from Whole Dog Training. All Dogs are Trainable. [NOTE: treats should be subtracted from the normal daily kibble ration so as not to gain weight during crate rest. Lo-cal treats are small pieces of apple or carrot.]
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Post by Madeline & Wolfie on Feb 3, 2020 16:05:51 GMT -7
Thank you so much, Paula. These were the words I needed today. I am familiar with belly breathing techniques, but I'd forgotten to use them lately. I have an anxiety disorder, so keeping calm is always high on my list of priorities. We just put together Wolfie's crate and so far he doesn't seem to hate it. In fact, we put it on the coffee table and I think he loves being able to peer into the kitchen to see what my Dad's up to at dinner time. So far that's been a huge weight off my shoulders. Wolfie moves around in his recovery suite to get himself settled. It's a little hard watching him stumble, but I feel like I can relax now that I know he's not in any danger of falling or moving too much. Here's the happy boy in his new crate!
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Feb 3, 2020 17:33:26 GMT -7
Well, look at that little guy in his new crate! Nice to see you do safe and sound, Wolfie! It's hard to tell from the photo and since Wolfie has such pretty long fur but just to note: the crate should only be large enough for him to stand up, turn around and lie down with his legs comfortably extended. Any additional space should be filled in with rolled up towels/blankets. Try to take it one day at a time and enjoy each moment with your boy just the way he is. Your love for him shines through every post so he's a very lucky fellow indeed!
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Post by Madeline & Wolfie on Feb 3, 2020 19:42:34 GMT -7
We've filled up the crate with towels and blankets! I picked the smallest size a Pomeranian could comfortably be in. 24L x 20w x 18H. The crate came with a crate divider though if that allows him too much space to move around him. He's able to comfortably circle around and lay out with all his legs spread.I can try to get a top-down view tomorrow. He has a lot more room if he sits up. I misinterpreted his whining as more of his 'I want out of this crate NOW' whine and not a "I have to PEE" whine so we had to clean him and his bedding, but he's back in it and he's settled down again. (This was after I took him out of his crate to potty TWICE after dinner) Just when we get settled into one routine, it's time to change it up a little. Hoping for smoother days ahead. We're both in good spirits now, I think. Like Paula said, Wolfie lives in the now, and doesn't seem especially bothered by his temporary immobility.
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Post by Julie & Perry on Feb 3, 2020 20:24:00 GMT -7
Wolfie is adorable and looked quite happy in his crate.
You're doing a great job getting up to speed on conservative crate rest.
Take it one day at a time. It will get easier.
Sending healing thoughts and prayers.
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Post by Madeline & Wolfie on Feb 5, 2020 7:51:41 GMT -7
A little update on Wolfie! It seems like the more he rests, the better he gets. His left leg is no longer dragging so much, I am seeing an effort to hold his paw flat instead of letting it knuckle over when I put him on his pads this morning. Not only did he circle around to go, but I'm 95% sure he squatted down to pee! He spread his legs, which he couldn't do before (his legs would just sort of cross). I woke up everyone in the house to share the good news, and to hammer in a few rules - NO picking him up for cuddles, and he has to do the FULL eight weeks. He's a very cute fluffy guy, so the temptation is always there, haha. I also called the vet's office this morning, and I am expecting an email later on about a test-stop of medication this Friday. I will keep everyone up to speed. It's so heartening to see him using his left leg more. It's almost like it's been bent out of shape and all this rest is slowly ironing it out. Wolfie seems to actually like his crate. Of course, it's only week two, but I think he likes the height advantage of it being in the center of all the activity (living room coffee table), and we put a towel over it to give him a bit more privacy. So he's treating it like his new den. He has slightly less of a conniption when anyone leaves the house and comes back, I think the restrictive quality of the crate is keeping him from going bonkers. His appetite continues to be quite good, and my parents are being good about only giving him little bits of carrot for a snack. Just wanted to share the good news this morning. So happy to see him improving little by little.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,805
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Post by PaulaM on Feb 5, 2020 8:36:43 GMT -7
Madelilne, what a way to start the day with your most wonderful email about Wolfie. Clearly you guys are making sure to provide Wolfie the things he needs to heal his disc and allow Wolfie's body to self heal his nerves. It is so wonderful to read when owners take conservative treatment seriously... wonderful things can happen. Good job on making Wolfie's new "den" the way it likes it. A lot of dogs do like being up higher. Many dogs after crate rest is over still love their recovery suite to slip into for naps, to chew in private on their toy, etc. Could you let us know why Meloxicam seems to have been extended for more than 7 days rather than the test stop being today? I think I missed something you may have written. Meloxicam's only job is to get painful inflammation resolved. This can't be proved until Meloxicam is stopped as a test along with the pain masking med, gabapentin. Few drugs are without possible side effects. The potential side effects of veterinary NSAIDs are numerous. So no one wants a dog on Meloxicam (NSAID) any bit longer than having gotten the benefit of all swellilng gone. Otherwise staying on a NSAID when there is nothing to work on means the dog is just exposed to the side effects. FDA on NSAIDS: www.fda.gov/animal-veterinary/animal-health-literacy/treating-pain-your-dog7.8 lbs Meloxicam as of 1/24: 0.23mL 1x/day for 5 days new DVM as of 1/29: 0.23mL 1x/day for 7 days, then 2/5 test stop for _pain/_neuro
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Post by Madeline & Wolfie on Feb 5, 2020 10:32:30 GMT -7
Sorry for the confusion, I think I confused myself or got a little freaked out at the idea of him running out of medication. I asked for more gabapentin and meloxicam, and she gave me a month's worth of both.
We discussed so many things, I forgot to mention a test stop during our appointment, but the plan was to assess Wolfie's condition on the 12th (his next appointment with Dr Walker).
Based on the email I just received, Dr Walker wants him to stay on the meloxicam and taper off the gabapentin.
I am not sure how to respond to this email. Based on what you've told me, meloxicam is only to control inflammation, and the pain Wolfie may or may not be feeling is directly caused by inflammation?
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Post by Romy & Frankie on Feb 5, 2020 15:42:24 GMT -7
It does take 8 weeks for a spinal disk injury to heal. Conservative treatment uses anti-inflammatory drugs to reduce the swollen spinal cord which causes the pain and neuro damage. This is what the meloxicam is treating. With time the body can very often absorb/shrink back enough of the offending disc so that nerves are no longer aggravated. This is what takes 8 weeks of crate rest. After this, the signs of nerve damage may still be there but no medication can heal the damaged nerves. Time is what can do this.
No one can be really sure how long the anti-inflammatory, in Wolfie's case meloxicam, will take to reduce the spinal cord swelling. It can sometimes take a total of 30 days but it often takes much less time. The only way to tell if the anit-inflammatory has finished its work is to stop it and the pain masking meds like gabapentin. If when you do this, there is no pain the swelling is gone and no more meds are required. Just the remainder of the 8 weeks of crate rest is needed. If when meds are stopped, pain is seen more time on all meds is needed. Vets often stop the anti-inflammatory after 7 or so days to see if there is pain. This is because all meds have side effects and no one wants a dog on any meds longer than needed. Sometimes this test for pain must be done several times. This is why it is good to have extra meds on hand in case the vet cannot be reached quickly.
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Post by Madeline & Wolfie on Feb 6, 2020 12:28:50 GMT -7
I have begun tapering Wolfie off of the ▼gabapentin. Because he only gets it twice a day for now, I've been instructed to space it out to 1 dose every twelve hours.
[Moderator's Note. Please do not edit 7.8 lbs Meloxicam as of 1/24: 0.23mL 1x/day for 5 days new DVM as of 1/29: 0.23mL 1x/day for 7 days, then 2/5 test stop for _pain/_neuro as of 2/5: 0.23mL 1x/day for ✙8 days, then 2/12 test stop for _pain/_neuro Gabapentin 50mgs/1mL:50mg (1mL dose) ▼1x/day Pepcid AC (famotidine) 5mgs 2x/day ]
Here is our new tentative schedule!
11:30PM - pepcid ac 12AM - gabapentin 11AM - Breakfast and meloxicam 11:30AM - pepcid ac 6:30PM - dinner 12PM - gabapentin
(with potty breaks throughout. He is going more regularly now, and there is a LOT of feet movement when he tries to poop, almost like he wants to hunch up like he used to.)
Does any of this look off? I know the pepcid ac is supposed to be given 30 minutes before any of the other medication.
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Post by Romy & Frankie on Feb 6, 2020 14:47:52 GMT -7
The schedule shows that the Pepcid AC is being given at 11:30am while the meloxicam is given at 11:00. The Pepcid should be taken 30 minutes before the meloxicam and then every 12 hours.
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Post by Madeline & Wolfie on Feb 9, 2020 0:10:41 GMT -7
Okay, that's where I've been getting confused! Thank you!
Recovery Week Three Update
Wolfie definitely seems to be improving. He is using the knuckled leg more and more each day it seems like. The paw no longer knuckles over, but his 'toes' touch the floor, like the foot is trying to straighten out but it's not quite there yet.
We have begun the process of tapering him off gabapentin. I believe the 9th is the start of Wolfie getting only one dosage of gabapentin before bed.
So far so good! He was his alert self, being more active in the afternoons and evenings, which is the usual for him. He enjoys a long leisurely morning.
He is pottying quite well. I still support him, but he spreads his legs to squat as best he can. He takes care of business once in the morning before breakfast (normal firm stool, normal urine) and again after dinner closer to bedtime (all normal).
He's feeling stronger on his feet and he wants to wander went he poops now. While I'm taking that as a good sign, I definitely have to be more dilligent about not letting him just go willynilly. He'd always poop, take a few steps, poop more, take a few more steps and poop again, almost like he's fertilizing the ground LOL.
It's good to see his old behaviors coming back.
Wolfie does not have 24/hr access to water inside his crate, because when he stands up to shift positions, he wobbles and sometimes stumbles into the crate walls. I am home with him all day, so I regularly give him water the moment he looks thirsty and after his medicine. Is that alright?
I have been hyperaware of any signs of pain, and I'm so scared I'll miss something because he's just so fluffy it's hard to see certain things (like whether or not his stomach is clenched).
His next vet appointment is scheduled for the 12th of February. I am going to call and see if we can get a laser or acupuncture treatment done while we are there as well to make the most of the trip. It will be probably be the last time he sees Dr Walker before we go home to the Chicago area, which is a shame because I like her and trust her judgement.
BUT I found Dr Walker through calling the St Louis Veterinary Specialty Services, and they told me they can give me recommendations for vets in the Chicago area, as they are connected.
The future seems positive for my little wolf. Though I'm pretty much always in fear of a setback, I'm doing my best to keep looking forward. One last thing, what are your thoughts on passive PT? (things like gently moving his legs when he's laying down in the crate?)
Thank you again for all your support. This forum is a lifesaver.
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Post by Ann Brittain on Feb 9, 2020 7:21:14 GMT -7
I'm so glad to hear Wolfie is making such good progress.
Depending on how much water Wolfie drinks, you should get him out to pee more than twice a day. As far as access to water goes, he should be offered the opportunity to drink regularly. You know what his habits were prior to his IVDD episode. I would use that as a guide for how much water he needs now. Our Buster might drink water a couple of times a day, but we're had dogs that drink much more often.
If you vet has given the okay for including PT for Wolfie after his conservative treatment is complete, I would definitely start doing that. Anything you can do to help him get stronger will increase his chances of getting to full recovery.
It's hard not to be worried about setbacks or having another IVDD episode. They do happened and are discouraging, but many dogs recover without further problems. You just have to take it one day at a time, follow your vet's instructions, and rely on your instincts because you know Wolfie better than anyone.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Feb 9, 2020 7:25:53 GMT -7
Hi, Madeline, it certainly is wonderful hearing how well Wolfie is doing! The nerve healing that you've seen in the knuckling is a very good sign of more healing to come. No passive PT while on conservative care. Wolfie can move his legs and re-position himself in the crate and that will be enough to help keep his joints and muscles toned. The disc has not yet healed so the movement of the spine must be kept to an absolute minimum. Some members have found it helpful to use a sling, harness and 6' leash during potty time, stand in one spot to limit steps Wolfie takes. Or when you get home, use an ex-pen or push in the ground plastic fencing to make a 6' foot potty area so Wolfie won't go on a sniff fest. It's very important to keep the movement of the spine to an absolute minimum - too much movement and the not-yet-healed disc can re-tear and you'd be back to square one starting crate rest over with more pain and possibly more nerve damage. www.dodgerslist.com/literature/slingwalk.jpgWhile laser therapy and/or acupuncture can be helpful in healing, there's also the danger involved in transport to the vet's office. If possible, a vet who can come to the home to administer laser and/or acupuncture would be best. Vet visits should be kept to only those that are absolutely essential. That would include the 2/12th appointment. There should be no reason why you would need to transport Wolfie to the vet on 2/12 instead of giving a status update to the phone via phone. I understand that this will be the last time you see her and that Wolfie will be stopping the Meloxicam on that date but that should not mean a risky transport in to see her is necessary. Possibly a water dish attached to the side of the crate would allow Wolfie access to water more often. www.dodgerslist.com/literature/cratesupplies/bowlHLDR.jpgKeep up the good work, Madeline - you're doing a great job caring for Wolfie.
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Post by Madeline & Wolfie on Feb 12, 2020 15:32:09 GMT -7
Little update! We decided to cancel our February 12th appointment, and I have left a message with Dr Walker to give her a general update on Wolfie. She called earlier but I missed it. So far Wolfie is now on ONE dose of gabapentin [as of 2/9] before bedtime, and it seems to be suiting him well! He actually seems more alert and interactive on just the one dose compared to three. I've started hiding his half-tablets of famotidine inside of blueberries, so he isn't getting so much coconut oil anymore. We've been very good about not feeding him, even if he's been doing his best irresistable puppy eyes! About his potty behavior, I've been offering him water several times throughout the day, and also taking him out to potty 3 or 4 times a day, but he typically only goes 2 out of the four times (before/after breakfast and before/after dinner). We're nearing the end of week three. His lame leg is moving a lot, but he can't quite put his paw flat to the ground, just part of his toes. Is this normal in IVDD? Or could this be related to his knees (luxating patellas)? If I gently bend the leg while he's laying down, the rest of his body is relaxed but the muscles in that leg seem just a little tight. When we've finished the eight weeks of crate rest and the physical therapy, I think I want him to get an x-ray or an MRI, as he seems to have orthopedic issues with his knees and tail area before the IVDD started. Once we're home I will definitely try the x-pen, thank you for the suggestion.
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Post by Romy & Frankie on Feb 12, 2020 16:02:35 GMT -7
I am glad that you have been able to give Wolfie is gabapentin in blueberries. They are low-cal and nutritious. Also yummy.
IVDD dogs often have trouble positioning their feet correctly. This is likely to improve over time. I am not sure about the effect of luxating patellas.
Gabapentin does have sleepiness as a side effect, so he may seem more alert because you are giving it less frequently.
If you decide to do imaging after the crate rest period is over, let the vet and any personnel that will be working with Wolfie know that he has IVDD and his back must be kept supported at all times.
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