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Post by Jennifer & Copper - Doxy on Feb 5, 2020 12:37:56 GMT -7
Good Morning! I am full of emotions so please bare with me... The worst happened Monday night 2/3/20 Copper was excited for dinner and tried jumping on a sofa chair. His chest hit the cushion and he fell back on the floor screaming in pain. I could tell it was his back and he could not walk. I instantly crated him and gave him Tramadol. I took him to the emergency vet and they wanted to kept him in the hospital for 12 hours they t ook Radiographs which showed nothing obvious. They give him Injections of Solumedrol 125 mg., Buprenorph 0.6 mg/ml/Ace <20 #, Mannitol 200 mg., and Solumerdrol CRI. While there he was so stressed that he urinated and deficated on the staff. It was the hardest thing ever leaving him but what they advised. [Moderator's Note. Please do not edit
10lbs
2/4 xray
Mannitol, a diuretic
Solumendrol injection on 2/4
Solumedgrol constant-rate infusion 2/4
Prednisone 5mg Tabs as of 2/5: 2.5mgs 2x/day for 7 days then 2/12 test taper for: _pain / _neuro
Gabapentin 100 mg 3x/day
Tramadol 25mgs 3x/day
Pepcid AC 5mgs 2x/day]I left with a diagnosis of slippped disc / IVDD. They could not confirm anything without an MRI though. When I picked him up he was drugged but not in obvious pain. He is home in his crate and is resting. He is not his normal perky self but he is medicated so Im guessing that is normal. Copper weighs just under 10 lbsPrednisone Tablets 5 mg. 1/2 tab orally every 12 h ours for next 7 days, then once every 24 hours for 7 days, then once every other day for 7 days Gabapentin 100 mg. One tablet orally every 8 hours Tramadol Tablets 50 mg. Give 1/2 tablet orally every 8 hours. Pepcid AC 10 mg. 1/2 pill every 12 hours while on Prednisone *3 Since coming home I have not been able to get him to eat or drink anything except for the cheese that I put his meds in. I tried several things to put his meds in and he would just smell it and turn away. Has not pooped since bringing him home last night 2/4/20 at 9:00 pm.*4 Names My dog is an 8 year old mini Doxy and his name is Copper. My name is Jennifer *5 Diagnosis I was told by the emergency vet I took him to it was a slipped disc / IVDD but it could not be confirmed unless I had an MRI *6 Date saw vet for conservative treatment o n Tueseday February, 4th*7 I find wet bedding. So far it has just been small amouts of urine. each time I check on him. When I try to take him outside he just stands there while I hold his back end. *8 He seems to have some function of his right leg. I have not really tried to see what he could do. He can spin around in his kennel to get comfortable using his good leg. He can not walk unassisted. I am scared, overwhelmed, but want to do everything I can do to help Copper! Thank you! |
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Post by Romy & Frankie on Feb 5, 2020 14:38:24 GMT -7
Welcome to Dodgerslist, Jennifer. We are 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! It is very scary when our dogs are diagnosed with IVDD but the more we learn about the disease the less scary it becomes. Everyone here has had dogs with IVDD so we know what you are going through. It is important to know that disc disease is not a death sentence! Struggling with quality of life questions for your dog? Re-think things:
Not eating or drinking can be a sign of stomach damage caused by excess stomach acids which are a side effect of all anti-inflammatories. Usually Pepcid AC is used to help protect the stomach from this kind of damage but sometimes it is not enough. In these cases a second med can be added to double protect the stomach. This med is Sucralfate. Sucralfate works differently than Pepcid AC which is an acid controller. Sucralfate not only “bandages” the damaged area but accumulates healing tissue factors in its bandage; it not only protects the ulcer but actively assists in the healing process. Please call the vet, let them know that Copper is not eating and drinking and advocate for the addition of Sucralfate. Sucralfate will require timing with other meds. You can read more about that here.
These are the signs of pain we look for; ☐shivering, trembling ☐yelping when picked up or moved ☐reluctant to move much in crate such as shift positions or slow to move ☐tight tense tummy ☐can’t find a comfortable position ☐Arched back ☐ Holding front or back leg flamingo style not wanting to bear weight ☐head held high or nose to the ground ☐Not their normal perky selves? Full pain relief is expected in 1 hour and stays that way between doses. If pain is not in control your vet needs to know asap to adjust med
Finding wet bedding is a sign that bladder control is lost. There are two ways that urine can be released. One is where the brain sends a message to the bladder down the spinal cord and which allows the dog to choose when to release urine….that is bladder control. The other way is when the spinal cord is damaged and no messages can be sent, the body will use reflexes. Similar to your pulling back your hand without thinking when touching a hot stove. Reflexes for a dog can kick in when the bladder is overstretched and full of urine. This is called overflowing…not a good thing. Overflowing will invite bladder infection and all the overstretching can permanently ruin bladder tone. Overflowing means the dog's bladder needs to be manually expressed so the dog stays dry. Learning to express will require a hands-on lesson from the vet. Expressing is a skill that must be practiced and learned. We have some info on expressing here: www.dodgerslist.com/literature/Expressing.htm#bladderexpress
The "Sniff and Pee" test verifies when bladder function has returned: Let Copper sniff a previous pee spot in the grass. If he urinates right after, that shows a message has been able to travel from the brain to the bladder! To try this carry Copper 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!
Good job immediately crating Copper. 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. Those 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. www.dodgerslist.com/literature/CrateRRP.htmSTRICT means:
◼︎no laps
◼︎no couches
◼︎no baths
◼︎no sleeping with you
◼︎no dragging or meandering at potty times.
◼︎no PT for conservative dogs during 8 weeks to heal disc
◼︎At home laser or acupuncture for severe neuro damage is best. Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment.
Most disc episodes are diagnosed by a hands on exam, the breed often prone to disc disease and how the dog appears at the vet visit. X-rays cannot be used to diagnose IVDD. Xrays are usually to rule out other disease that mimic IVDD such as tumor, infections, etc. An MRI can prove a disc episode and also see if some other disease is going on where the treatment would be different than for IVDD. It is mostly used before surgery so the doctor knows where to operate. If you are planning to treat Copper conservatively no imaging is needed because conservative treatment treats all the disc at the same time.
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 as soon as 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 There is an excellent video series here: PRINT OUT this link and tape to your fridge:
--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:
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Post by Jennifer & Copper - Doxy on Feb 14, 2020 12:24:20 GMT -7
Thank you for the help and all the info. I have been reading every opportunity I have. Copper is making progress. He is able to sniff and pee as well as have successful bowel movements. He is also able to wag is tail! I am concerned that when I take him out for potty breaks he shakes from head to tail. He is on a soft harness and leash and his back end is supported. We do very limited movement at potty breaks but I don't know if he is hurting himself when he shakes. There is no yelps or whimpers. Any help is much appreciated!!!
NOTE moved to the Forum: Copper has had bladder/bowel success all on his own for the last 5 days & his appetite is normal!
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Feb 14, 2020 12:36:32 GMT -7
Jennifer, glad to hear you are reading to get up to speed on all things IVDD...doing from our treasure trove of informaition here: www.dodgerslist.com/healingindex.htmLooking over Copper's med list, can you confirm that the test for pain pred taper did start on Feb 12? Were the meds that mask pain and hinder you from a clear picture about pain either stopped on Feb 12 or are slowly being reduced via the mgs dose and/or giving less often? Do update us on the med list, so we best understand the cause of the shaking.
oh and where you live, what is the temperature outdoors. Does Copper wear anything if cold when he goes outdoors?
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Post by Jennifer & Copper - Doxy on Feb 14, 2020 16:24:14 GMT -7
Paula, to clarify when he shakes, it is just an all over body shake and he does it once we get outside and it does not continue. He starts at his head and goes down his body all my doxies do it. I am just concerned as he shakes all the way to his tail. I don't know if it could hinder any of the healing process??? It is not a continuous shake. Its just a one and done think when we go outside. I hope that makes sense.
We are in Southern California. The daytime weather is in the 70s but evening and mornings can get to the 30s-40s. Copper has always disliked the cold weather. He is not currently wearing anything when going outside. I do have a jacket though that he could wear.
His meds have been continuous and I have continued them since bringing him home from the emergency vet. He has not showed any signs of pain.
He is currently taking:
Prednisone 5mg Tabs as of 2/5: 2.5mgs 2x/day Have not started taper. Waiting to see vet 2/15.
Gabapentin 100 mg 3x/day
Tramadol 25mgs 3x/daym - I was told I can taper to 25mgs 2x/day if he is not in pain
Pepcid AC 5mgs 2x/day
[Moderator's Note. Please do not edit
10lbs
2/4 xray
Mannitol, a diuretic
Solumendrol injection on 2/4
Solumedgrol constant-rate infusion 2/4
Prednisone 5mg Tabs as of 2/5: 2.5mgs 2x/day for 11 days then 2/15? test taper for: _pain / _neuro
Gabapentin 100 mg 3x/day
Tramadol 25mgs 3x/day
Pepcid AC 5mgs 2x/day]
Is it normal to taper the Prednisone so soon? I have not got a definite answer about tapering the prednisone from my regular vet. My Dr. said we will discuss on 2/15 at my next appointment. I was told I will need to find what keeps him comfortable. Over the phone I was told that, that may be 2xs a week or more. I'm not sure as of yet how we will taper or if he should keep taking the current dose. We will see...
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Feb 14, 2020 18:06:48 GMT -7
Jennifer, owners are not in an optimal position to protect their dogs when how the treatment works is kinda fuzzy. I believe reading up on the roll an anti-inflammatory such as the steroid prednisone plays during a disc episode will be helpful to you. The full story is here: www.dodgerslist.com/literature/healingsweling.htmSummary points about prednisone and the test for pain taper No one knows how long it might take to get all inflammation gone— just that it is in the range of 7-30 days. So a vet must guess if to Rx a 7-day course as you indicated in your first post OR .... a maybe a 14-day course. Everyone (you and the vet) is blindfolded about pain until the pred taper starts and the pain meds are backed off or full stopped on the date of taper. All vet visits are risky to the healings disc. Only the most beneficial vet visits override the risk to the disc of too much movement. -- Vets who understand the risk to the healing disc regarding vehicle transports possibly being too much movement for the disc, take phone calls about updates on the dog and adjust meds. -- There are no meds that will heal nerves. It is just the dog's body which self heals nerves and with time nerve functions can return. -- There are no meds which will heal the disc. The dog's body self heals the disc by forming scar tiissue as long as the back can be kept with minimal movement. --The only job of prednisone is to resolve swollen tissue around the cord possibly taking 1 of 2 course of pred. --- What do you see as a very important benefit of a vet visit when all pain masking pain meds are still on board and prednisone was not tapered on the 12th as you had indicated? -- Is updating the vet via a phone call about any positive changes to nerve functions? Asking for a pred taper to begin 2/15. Who knows perhaps all the swelling is really gone now and it just that no one can know due to lack of the test for pain prednisone taper. It just may htat getting started on the taper, you will have proof of no pain. Thus no need to take a risky trip into a vet. Clarification, please: ER Rx'd a 7-day course of pred. No instructions for tapering were on the Pred bottle? Your vet was the one that extended the pred Rx past the original 7-day course? Thank you for the specifics about shaking. It is often a notable sign of pain during a disc episode. But in Copper's case you are referring to the thing dogs often do when wet. The shake starts at the head and travels to the tail. So Copper is not in pain. While not the best thing for him to do, see if you are able to maybe prevent it or stop the full shake thing. Maybe having a jacket on would stop the body shaking, worth a try. |
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Post by Jennifer & Copper - Doxy on Mar 5, 2020 12:37:16 GMT -7
Update on Copper 3/5/20 - 4 Weeks and 3 days since injury
I decided to wait on Coppers vet visit that was scheduled for 2/25/20 and spoke with the vet over the phone about his condition. Vet advised I continue strict crate rest but that he wanted to see him before his taper of Prednisone was over. He saw the vet yesterday 3/4/20. Copper continues to have use of urination and bowels. He is doing great on crate rest. He still continues to do the full body shake when on potty break. I try to limit with holding his back end up and wearing a jacket when chilly. Of an evening when I get in bed (his crate is next to my side of the bed) he whines in his crate but it does not seem to be pain, but rather wanting my attention. After about 5 min he lies down and goes to sleep. Keeping a close eye on that.
He can walk wobbly on his own for a few steps. Wags his tail and is his happy self. He is no longer knuckling rear legs. His right leg is quicker to react than the left. His anus will react when touched. The vet said that is a good sign. We are stopping the pain meds to see if he is good to continue Prednisone of every other day. He is having me stay at every other day for two weeks and then we will talk again. Sadly he did not seem nearly as excited as I was about Copper's progress. He just said it will be a very long road and we will see how it goes.
Current Medication:
Prednisone 5mg Tabs: He takes 1/2 tab = 2.5mgs ever other day
Gabapentin 100 mg 3x/day -Stopped - directed to give if signs of pain arise
Tramadol 25mgs 3x/daym - Stopped - directed to give if signs of pain arise
Pepcid AC 5mgs 2x/day
[Moderator's Note. Please do not edit
10lbs
2/4 xray
Solumendrol injection on 2/4 /Solumedgrol constant-rate infusion 2/4
Prednisone 5mg Tabs as of 2/5: 2.5mgs 2x/day for 11 days then 2/15 test taper for: _pain / _neuro
Pepcid AC 5mgs 2x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Mar 5, 2020 13:09:55 GMT -7
Jennifer, no matter how many times we see nerve healing happening in the predicted order, we find it to be an awsome thing. Since I have been on this Forum since 2007 I never ever tire of a happy report such as yours!!! Copper is on a roll in the nerve healilng department. Since the focus on the 8 weeks is for the disc to heal, we know that nerve healing may or may not happen in that short of time. But for Copper it has!! Wonderful!! Wonderfull! Keep up the good work of attention to the STRICT rest so his disc can finish healing by Mar 31 graduation day!
Please do keep us posted when you can. Copper is such very good inspiration for new members to see if one will follow strictly what is needed in STRICT crate rest for disc healing and full pain control til the anti-inflammatory can do its job somewhere in the range of 7-30 days, it is, indeed, in the cards for each dog to return to a happy pain free life.
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Post by Jennifer & Copper - Doxy on Apr 20, 2020 17:01:48 GMT -7
A quick update on Copper 4/20/20. He is doing great!!! Walking fine a bit wobbly at times but walking very steady for the most part. He is his normal happy self.
My vet recommends that he stay on Prednisone 5mg tablets 1/2 tab. every other day with Famitodine 5 mg. I can't believe we graduated from crate rest for almost a month already!!! Taking everything very slow and one day at a time.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Apr 20, 2020 20:59:14 GMT -7
Jennifer, glad to hear Copper is a happy boy and only a bit wobbly.
Am very concerned to hear he is still on prednisone. Can you tell us what benefit pred is supposed to give?
--- prednisone works on reducing inflammed tissue. Inflammaiton is painful. The final dose of pred should have given proof before being let out of the crate that all swelling was gone.
-- Prednisone does nothing else but work on inflammaton, except to stay on it when pred had no job to do, Copper is exposed to all its many bad side effects. Please check into why still on pred and let us know.
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