Amber's Lily 3/5 Surgery NECK - 4 wks

Weight 12 lb
Meds For 6 days, and before her admission on 2/29, were Methocarbamol 125 mg every 8 to 12 hrs; Truprofen (rimadyl) 12.5 mg every 12 hrs w/food; gabapentin ??
I don’t know what her med regimen has been in the hospital or what it will be when she comes home - will find out tomorrow
Famotidine was not recommended
What is loss of deep pain sensation and how can I know if she’s at that stage?
Do you suggest I insist on MRI?

Thank you

Rimadyl: She had only two doses left, so on the second to last day of the RX, I gave her one does instead of two. First couple days of starting her meds, she seemed to be improving with gabapentin and methocarbamol and Rimadyl every 12 hrs, but then she had one episode of crying out while I was repositioning her, and after that her pain increased, so I increased ▲gabapentin and▲methocarbamol to every 8 hours, but also decreased ▼Rimadyl to once a day. I suspect she re-tweaked her neck and was allowed too much time outside her crate (she had laptime).

[Moderator's Note. Please do not edit
12 lbs
Truprofen (rimadyl) as of 2/23: 12.5 mg 2x/day for 5 days;
                             as of 2/27:  12.5 mg ▼1x/day 
                             as of 2/29:  ?mgs  ?x/day   for ? days
2/29 relapsed disc- admited to hospital 2/29 for pain
gabapentin ?mgs ▲3x/day
methocarbamol 125mgs ▲3x/day
stomach protection? Pepcid AC??]

She had improved pain with oral and injectable meds; yesterday was her trial off the injectable; vet will let me know if pain control was good with just oral (I don’t know what oral meds)

On initial eval in the ER, the internal med resident identified Lily’s pain at the cervical and thoracolumbar spine, so I want to be sure the neuro vet considers this as she develops the treatment plan. IMPORTANTLY: The precipitating event was that Lily fell off the 1-1/2-foot porch: she was obviously dazed and unable to get off her side; I had to lift her on to her feet. She then was just not herself - dazed, unwilling to walk. She could stand and take a couple steps but then would freeze. I am concerned about possible INJURY on top of the ‘presumed IVDD’.

When she went to hospital this past Saturday, just before her next dose of meds, she dropped food from her mouth, was trembling, was only able to sit up for about 30 seconds, could stand, frozen (wouldn’t take steps or pee). After her meds kicked in and we were at the vet, she was able to stand and walk a few steps, NO tail wagging. Yesterday, vet reported she is able to go potty when carried outside; a pain med had been causing nausea and was affecting her appetite, so they stopped/changed that; she is wagging her tail. Vet said she did not see any clinical neurological signs on exam.

Thank you.

The MRI was performed and revealed C2-C3 herniation; we were offered surgery with 90% chance of recovery and medical management with 70% chance of recovery. What does recovery mean? Are there others in the forum whose dogs have had C2-C3 herniation? We need to decide on treatment. The location of the herniation can affect breathing ... Can you please advise? Thank you.

We had the MRI done, which showed IVDD throughout her spine and a glaring, huge C2-C3 disc herniation. Lily underwent ventral slot surgery yesterday without complication. Thank God! Vet said she ate well last night and will be discharged tomorrow. I asked about starting Pepcid because she is on Rimadyl, but the vet said she didn’t think it’s necessary and wouldn’t prescribe it. Thank you.

Do you recommend a specific type and brand of harness for Dachshund recovering from neck surgery?

I'm glad to hear that the surgery went well, Amber.

I completely agree with Julie about starting Pepcid AC if Lily comes home with an oral prescription of Rimadyl. We follow vets who are proactive and protect against side effects, such as bleeding, ulceration, and perforation, which can occur at any time while on an anti-inflammatory, with or without warning symptoms. Please get your vet's permission to give 5 mg of Pepcid AC (generic is famotidine) 30 minutes before the dose of the Rimadyl and thereafter every 12 hours. Phrase the question to your vet in this particular way: "Is there any medical reason my dog may not take Pepcid AC?" If your vet says your dog has no health issues such as liver, heart, etc to keep her from taking Pepcid AC, then do get it on board.

Here's Dodgerslist page about what to expect discharge day. www.dodgerslist.com/literature/surgery.htm#discharge

Here is a list of questions to ask on discharge day, too. www.dodgerslist.com/literature/dischargequestions.htm

Please let us know what meds Lily comes home with and the dosages of each and frequency taken.

Please also let us know what, if any, PT is prescribed and for how many weeks crate rest is prescribed for.

As for a harness, you should check with the surgeon as to when and if a harness can be used during the healing process or needs to wait until stitches come out, according to how large the incision is. Once a harness is OK'd, from now on and for forever, not just during the healing process, you'll want a harness where the neck part of the harness sits on the boney structure of the shoulders not the weaker soft tissue of the throat. Any pulling should be against the strong upper chest/shoulder area. Here is a picture showing how a harness should sit on the shoulders and chest.

i.ibb.co/7167f4G/harness1.jpg

Healing prayers for Lily.

I'm glad to hear Lily's is recovering and doing well. If the vet has recommended no PT for 4 weeks, I would follow his/her advice. The last thing you want to do is cause Lily to have a setback. I know how hard it is to wait but nerves take time to heal. 

Hi! Lily is now 1 week postop and seems to be recovering well. Generally back to her perky self, her appetite is returning with a vengeance (we are being vigilant about her diet and weight). The raspy breathing noises are almost completely gone. She does a lot of lip smacking. She is licking the previous IV sites in her legs; she has numerous spots of sparse fur from licking, which predates her injury, and which her vet could not identify a cause. I’m wondering if this licking is an indicator of pain/discomfort. She took her last dose of carprofen this afternoon; she did not get Pepcid while taking this. She has about 2 more days of gabapentin.

We carry her up and down steps of porch to go potty. Crate rest for 4 weeks postop.

When we go outside for potty and when she notices I’m getting ready to leave the house, she trembles - seems anxious. This is new behavior.

Her surgical incision is healing well, clean and dry.
Thank you

[Jun 15, 2020: moved from profile to Forum-  Lily is now 3 months status post ventral slot procedure and is fantastic!]

Lily is 5 years old, 11 pounds, active, and happy 3 months after C2-C3 ventral slot for disc herniation. We are thankful to Dodgerslist for the invaluable work they do!

Briefly, Lily fell off the porch, about 3 feet. She seemed dazed and unable to stand. I got her upright and she seemed off balance. Over the next hour or so, she would freeze in her tracks if she took a step, had a dazed look in her eyes, and eventually could only lie down. At that point I took her to the emergency vet who did a neuro exam and said she was ok. He was very rough with her, especially when rotating her neck. I suspect the neck injury was at the least exacerbated by the exam he performed. He said she was walking normally; offered pain meds; suggested crate rest, did not recommend imaging. I took her home and overnight she continued to be painful and less and less willing to move, much less walk. Next day I took her to emergency services at our university vet hospital; interestingly, the neuro exam I saw them perform on her was unlike that performed by the first vet, and it was definitely much more gentle. The vet suspected cervical spine injury and recommended crate rest and pain med and anti-inflammatory. The vet said x-ray would be unrevealing, but she didn’t think MRI was necessary; thus, we went home with meds and a plan for crate rest. Over the next few days Lily continued To be painful and still not moving, needing to be carried and food brought to her. She could still pee and poop, thankfully. I took her back to the university vet, who agreed that she was definitely in a lot of pain and requiring intravenous pain medication and ICU monitoring; thus, Lily was admitted.

Lily’s condition obviously worsened with the recommendation for conservative management, and so my big question was “How/why could the vet make any kind of Appropriate treatment recommendAtion Without knowing what the actual (not suspected) issue was?” I spoke to our regular vet who agreed that x-ray would be unrevealing; she understood my question and suggested I speak again with the neuro vet at the university to consider MRI. When I spoke with the neuro vet (resident) again, she stressed that the MRI would be costly and most likely the findings would warrant the same treatment, rest and meds, despite Lily’s worsened condition. I posed my question to her, and she responded defensively, stating, “I can do the MRI if you want.” I said I did and thus it was scheduled for  the next day. While in the hospital and with IV meds, Lily’s pain was better controlled, but her appetite was lost.

The  resident vet called me after the MRI and described the ‘severe’ herniation, which would require surgical repair, with 70% chance of relief/recovery. Ventral slot surgery was scheduled for the next day, to be performed by the attending physician vet.

If I hadn’t pushed for the MRI, Lily would have suffered even longer and her chances for recovery would have severely diminished. I urge everyone to please, if at all possible, seriously consider getting an MRI, so you and the vet can ‘see’ what is going on and then make a plan for the appropriate treatment.

Lily’s surgery was a success: The surgeon vet reported her entire spine, cervical and thoracic, is degenerative; thus, Lily will always be at risk for additional spinal injury. During surgery, the vet ‘cleaned’ up her entire cervical spine In an attempt to mitigate Risk of future C-spine injury. Altogether, Lily was in the hospital 6 or 7 days, and total cost was $7000+. No, we didn’t have pet insurance. We put it on a credit card and then took out a loan to pay that off. 

Lily came home and was on crate rest for 8 weeks. By about Day 3 at home, though, she was already feeling better, moving around, wagging her little tail. It was tough trying to keep her quiet, from jumping and running when she went out to potty. We were so happy and so relieved. I slept in the living room for the first three weeks in order to be near her and keep her company, while she slept in her crate. This has been a big change for all of us: Lily still has to remain in her crate when we’re not home and to sleep at night. She can’t sleep on our bed with us anymore, for fear she’ll jump off while we’re sleeping or we might accidentally roll over her. Still working on training her to use the ramp to get up and down the couch. She is spunky as ever and we are so thankful!

No obvious neurological deficits. Yay!

She has been taking fish oil since just before her injury. I recently bought Vetriscience joint supplement and am wondering if anyone else has used this and if you’d noticed any positive results. The reviews of this on the internet are positive, but one of my vets said she doesn’t think it’ll do anything. I’d appreciate hearing about your experience on the issue of supplements and IVDD.

We wish you all the best, healing, and lots of love for many years with your babies.