Trent's Apollo Nov 2019 conservative- Fr. Bulldog

Theyre still bothering him as far as the neuropathic pain i think and then the toe nail that was ripped off a couple of weeks ago. He is finally off of his muscle relaxer and back to:
 
once a day tramadol and
twice a day gabapentin.

Hes still wearing his cone because every now and again he will get i guess pain in his legs and try to lick and chew on them again. Its not an all the time thing it is just randomly throughout the day or night i guess he gets that tingling sensation or something in his feet and he wants to get to them.

Hey just a quick update on Apollo. The soft stool has resolved itself. His poop is back to normal. He is still trying to stand and walk but he’s not there yet. He doesn’t just drag his legs anymore though. He more like crosses his legs when he moves around now.

He really enjoys being in his cart and I think it’s helping some. When he’s in his cart I can lightly touch or tickle his feet and he try’s to flip them over now!!! Not just slightly twitch them. It’s been such a long process but I have yet to see a plateau in his healing.

It’s very slow but I still see slight improvements. He is no longer on the tramadol just his gabapentin twice a day, and he doesn’t have those bouts of trying to get his feet unless he’s not in his cart and then it’s only rarely. I have no idea why that is though. I’m still hopeful for more healing and seeing how far he’s able to go and maybe the ability to walk again.

Apollo got his cone off somehow last night. I woke up to him have chewed off a toe some on his other foot. Just dropped him off at the vet to have it stitched up. I’ll let you guys know how everything goes Bc this is a new vet because ours was completely booked but they referred us over here. Its hard with them not letting anyone inside to explain everything with Apollo as well as his cleft in his mouth. He has been doing so well idk what I did wrong.

He did well and they removed the rest of the toe digit. I’m picking him up at 5:30. The vet prescribed him carprofen (nsaid) for 5 days and clavamox (antibiotic) for 5 days also. He will get his stitches out in 10-14 days. They did blood work and my mom said they said everything was normal. The vet said to also definitely keep Apollo on the gabapentin which I’m going to up to every 8 hours instead of 12, and then to also give him his tramadol again for 5 days then wean him off of it unless needed. I won’t be putting him back on his methocarbomal (Muscle relaxer) because it’s not needed. Like I said he’s still running and jumping around and trying to use his legs more and more each day and he loves being in his wheelchair during the day and only seems to go after his feet when he’s not in his wheelchair. I have no idea why they don’t bother him when he’s in it. I’m just really upset about him getting his cone off and chewing another toe off while I was sleeping, but I’m grateful he didn’t chew multiple toes or his whole foot off. He was just laying in bed asleep with his toe hanging off when I woke up this morning. He’s now 3 toed on each of his back feet. Hopefully the stitches can be taken out by our normal vet and I will ask her about switching to a stronger medication for nerve pain for him then.

Thank you. The cone I have is one I bought that has a soft velvet around the neck with 3 buttons and Velcro. Last night I didn’t do the Velcro just two of the buttons and he doesn’t try to take the cone off just more like get at his feet with it on. I’ll now make sure the Velcro is completely done as well as all three buttons. The vet cone had rubbed his neck raw and red bc he wears it all day unless he’s in his wheel chair so that’s why I had bought this other one which he hadn’t gotten out of before.

Okay Apollo is home and laying down now. He has
clavamox (62.5mg) and
novox (75mg) that he will start taking tomorrow morning. The vet also said to continue the gabapentin, [every 8 hours] and also
tramadol while his foot is healing and then as needed for any pain.

Also his blood work was good they said, and to change his bandage tomorrow.

Stitches will come out in 10-14 days and we can take him to his normal vet for that. He has come such a long way with barely twitches his feet to fully almost flipping them when tickled and like crossing legs when trying to walk instead of just dragging them and I’m not giving up. I’ll ask the vet to switch gabapentin to pregablin when he gets his stitches out. Until then I’ll up his dose to every 8 hours instead of every 12 hours.

This is what I was referring to. For the first like 2 months there was barely any movement when tickling or pinching his toes. Now he is at the point that a slight touch or tickle will make him move his legs. I don’t believe this is reflex because it has progressed more each day it seems he will move his legs more. Also the fact that he can feel his feet when I move them or touch them. I’ve done it while he was asleep gently moving his foot up and he woke up and looked at me.

Apollo is doing fine. I hate having him confined again but I know he needs to be so his foot will heal and the stitches can come out. He wants to run around in his wheelchair so bad. He still has some bouts of trying to get at his feet. Maybe 3-5 times a day.

He’s on gabapentin 3 time a day. As well as tramadol twice a day while his foot heals. Also novox he takes his last one tomorrow, and clavamox twice a day until he’s out of it. So he really shouldn’t have any pain in his feet. I don’t know if it’s actual pain or the fact that it bothers him that he can’t walk with his feet only attempt to stand up and try to currently. He’s eating and drinking fine. Stool and urine is normal also. I want to let him in his wheelchair some in a few days. After about a week of his foot healing I think. He seems to do the best when he’s in it and enjoys running around in it and moving. Thoughts?

Yes I’m going to ask the vet to switch from gabapentin to pregablin when I take him to get his stitches removed in 7-10 days.

Trent, how's Apollo doing with his neuropathy?

Hi, Trent. It may very well be that Apollo can't reach his feet while in his wheelchair but when you take him out of it, he knows he can then reach them and so does. They must still be bothering him and that nerve pain can be very annoying or even painful to him all of the time. Do speak to the vet about that today and let us know what he thinks.

I'm so glad to hear that he's enjoying the freedom of movement that the cart gives him! Do keep in mind that a cart is not for all day use, but rather a couple of hours at a time. Constant use can cause chafing and a cart is usually used only outside to go for walks. Inside he can scoot around and drag himself. There are garments you can use to prevent his skin from abrasions from scooting. More info on that here: www.dodgerslist.com/literature/IncontinentDown.htm

Thanks so much for the update. We'll be awaiting word as to what your vet wants to do to help him more with the neuropathy.

I am happy to hear that Apollo had his stitches taken out. That should make him more comfortable.

Pregabalin is a sort of next generation gabapentin. If your vet is not familiar with Pregabalin, it is best that she research it to determine appropriate doses and be aware of possible side effects. Just follow-up with her in a few days.

Trent, thank you for stopping by with an update. Dogs adjust to things more easily than we do sometimes. Glad to hear you've become accustomed to a new normal in caring for Apollo. As long as Apollo can be in your company the world is right by him.

Gabapentin does not cure neuropathic pain. Just takes away the phantom abnormal pain. The hope is at some point the phantom nerve signals will go away on their own. So no cone during the day and he shows no unusual interest to lick, bite or chew at rear limbs?

I'm glad you will now be on a regular expressing schedule. That is what will prevent UTIs. An overflowing bladder (leaking bladder) invites bacteria to grow in the bladder. Overflowing can release some urine by reflex but not all of it. The part that remains becomes a breeding ground for bacteria.

Take care and do pop in when you can. We always love to hear from you and about Apollo.

Trent reoccurring UTIs can be for several reasons.

It may be the antibiotic used did not target the specific bacteria in the bladder.  In that case a urine culture is sent out to a lab to learn the name of the problematic bacteria and select the correct antibiotic.  I encourage you to read the article a reoccurring UTIs so you are informed to grasp what your vet may be telling you or that you have the ability to ask the right questions.

I hope getting the right match antibiotic will clear up the infection.

"UTI’s That Keep Returning"  dodgerslist.com/2020/06/09/recurrent-uti       Article includes: things you can discuss with your vet and things you can do at home and the reason why supplements are not very likely to keep a UTI away.

Please updates on which approach you and your vet tried that helped Apollo.

When a dog has a urinary tract infection, it can be very painful when they're expressed. So that explains why he growls when expressing him now.

Is this growling when being moved something new, Trent? Reluctance to move is a sign of pain. Do you see any other sign of pain, such as in the following list?
◻︎ restless, pacing, can’t find a comfortable position
◻︎reluctant to move much in crate such as shift positions
◻︎shivering-trembling ◻︎yelping when picked up or moved
◻︎slow to move ◻︎tight tense tummy
◻︎arched back, ears pinned back ◻︎ head held high or nose to the ground.
◻︎looks up with just eyes and does not move head and neck easily.
◻︎ not eating due to pain of moving jaw with a neck disc or pain of back disc
◻︎ holds front or back leg flamingo style not wanting to bear weight
◻︎not their normal perky selves

If you're seeing more than this one possible sign of pain (growling when you move or touch him), you need to immediately crate Apollo and get him to a vet ASAP as he may be having another disc episode. Regardless, I would mention this change in temperament to the vet when you see them tomorrow and have them check out his spine and determine whether he has any back or neck pain.

If the growling is not due to actual pain or has been going on since Apollo first had a disc problem, it may be due to what is known as anticipatory pain. When a dog has experienced pain when moved or touched before, they anticipate that they will again experience pain when moved or touched. If that's the case, hopefully he will grow out of it.

My Jeremy's temperament changed after his first major disc episode. He was a rescue dog and had experienced some bad times before I adopted him. He had some aggression issues when I first got him but during the two years before he was paralyzed, I had gotten him to a trusting place. He was very loving to people and other dogs. But after his surgery and paralysis, some of his aggression came back. He was fine with me but he started barking aggressively at strangers and other dogs and would yipe frantically if anyone leaned down to touch him, even on his head. Now, 9 years after his surgery, he does allow some strangers to pet him, others he still barks at. He's OK with little dogs but not big ones. I think his barking is to show that he can handle himself, even if he's paralyzed or maybe he feels other dogs will sense his weakness.

Please let us know what the vet says tomorrow about the UTI and the aggression/possible pain.