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Post by Tiffani & Cooper on Apr 15, 2020 13:31:11 GMT -7
Original Subject Cooper went Down 5 days ago [April 10 or 11?]
QUESTIONS ☆ 1 Is there still currently pain? Extreme pain, paralyzed waste down, has pain sensation, pain uncontrolled, shaking, panting, screams when you pick him up, unable to go to bathroom on his own. Arched back, depressed. Came on suddenly on Saturday [4/11?] ☆ 2 How much does your dog weigh? 21 pounds and is a Chug pix (obese)
Prednisone, Tramadol, Fentenyol Patch, Gabapentin, Trazadone for sleep, IV fluids, catheter, Cold laser therapy x 2 a day. Exact doses unknown[Moderator's Note. Please do not edit 21 lbs -obese Prednisone as of 4/13: ?mgs ?x/day at home 4/13 pain meds inadequate boarded 4/15 for pain control tramadol ?mg ?x/day Fentanyl patch gabapentin ?mg ?x/day needs GI tract protector, Pepcid AC, not reported ]☆ 3 -- Eating and drinking OK? No nausea/not eating, no vomit? Not eating or drinking - cannot urinate on his own ☆ 4 What breed? What is your dog’s name? Your name, too? Chug mix, Dog's name is cooper, my name is tiffani ☆ 5 Did you specifically get a diagnosis of IVDD, aka: a disc problem, a disc herniation, a bulging disc, slipped disc? IVDD slipped or ruptured disc. Saw a special surgeon and vet. ☆ 6 04/13: Surgery recommend at $12000.00, I declined and chose conservative treatment. ☆ 8 he cannot use his back legs at all or wag his tail. I took coop home after declining surgery . I tried to crate rest him for 3 days, where he screamed for 3 days straight, I could not master expressing his bladder, everytime I lifted him, he screamed. I ended up boarding him with his vet for medication pain control management. He had to be cathed as he cannot urinate on his own. He's 9 years old and this came on suddenly, and im heartbroken, ridden with guilt that I could not afford the surgery. He has a 50/50 chance to recovery. Today is 3rd he has been crated at vet. vet just called and he is still not eating, hes on iv for fluids and shes uping his meds to get pain under control. She wants to up the prednisone for inflammation. I want to go see him so badly and try to get him to eat but I know this is his time to heal and rest. I'm seeking any hope, inspiration, strength that can be shared by anyone. I'm literally lost without my best friend tagging me along. The thought of putting him to sleep is not an option and im trying to harness strength and hope where I can get it. Thank you to anyone who takes the time to read this.
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Post by Romy & Frankie on Apr 15, 2020 14:15:02 GMT -7
Welcome to Dodgerslist! 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 important to know that disc disease is not a death sentence! Struggling with quality of life questions for your dog? Re-think things:
Surgery is not the only option for dogs with IVDD. Surgery is not possible for many people and many dogs have recovered with conservative treatment. There is no reason to feel guilty.
With IVDD, disc material is pushed out of place and presses on the nerves of the spine which become inflamed. It is the pressure on the spinal cord nerves that causes the pain and the neuro diminishment like
not being able to walk.
It is very important that Cooper's pain is under control. The vet should be giving meds that will keep him pain free. Vets have many ways to control pain. Pain will only slow the healing process.
Anti-inflammatories, like pred, work on the inflamed nerves and treat the swelling which causes the pain. Cooper is being treated with pred, which will treat the inflammation. It can take a while for the pred to work and the swelling to go down, until it does pain meds are used.
Cooper may not be eating because of the pain, but there may be another reason. All anti-inflammatories like pred cause excess stomach acid which can cause stomach damage. Not eating can be a sign of this damage. A stomach protector is used to reduce the likelihood of stomach damage when pred is used. I do not see a stomach protector on the list of meds. Please ask your vet what stomach protector is being used. We most often see Pepcid AC being used for this.
You may be able to see Cooper at the vets. It would only be a good idea if he does not get too excited to see you and move too much.
Dogs can usually leave the hospital when IV pain meds are no longer needed. At this point, the dog is usually given an anti-inflammatory like pred in pill form as well as pain meds like tramadol and gabapentin. Dogs can even be given a fentanyl patch to wear at home along with the othr pain meds. Fentanyl patches usually give relief for only about three days. When the dog's pain meds are right there should be no pain.
When Cooper comes home, he will need to have his bladder expressed. Learning to express is tricky, but it can be practiced and learned. Before you take Cooper home, have the vet give you a hands-on lesson in expressing and then practice. When his pain meds are right, he will not scream when lifted and you will be able to work on expressing him.
When Cooper comes home, he will need 8 weeks of strict crate rest. 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.htm STRICT means: - no laps - no couches - no baths - no sleeping with you - no chiro therapy
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 - excellent video series here: PRINT OUT this link and tape to your fridge: www.dodgerslist.com/literature/healingpage.htm
--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 website:
Healing thought for Cooper.
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Post by Tiffani & Cooper on Apr 15, 2020 16:01:51 GMT -7
Thank you very much Romy and Frankie! Comforting finding this site, and your words of wisdom are extremely helpful.
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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 15, 2020 17:26:31 GMT -7
Tiffani, there is a possiblity that when the surgeon and the vet sent Cooper home, the pain meds were under medicated. That could be the reason you could not care for him (expressing). IVDD does require an aggressive pain med approach. We'd like to be prepared to comment by knowing all the important facts. IF you know 'em, please fill us in. Otherwise when Cooper is discharged to home, you can tell us then. ** - When Cooper went down 5 days ago on 4/10, were you able to crate him at once at home until you could take him into the vet on Saturday 4/11 - Which anti-inflammatory did the 4/11 vet prescribe? How many mgs and how often given? - What is the name of the anti-inflammatory the 4/13 surgeon and the DVM vet sent Cooper home on? Was it prednisone pills? ?mg ?x/day Not eating can be due to pain and can be a red flag sign due to prednisone. Do inquire if Pepcid AC (famtodine) is on board during the length of prednisone use to help suppress all the extra acids pred causes. Also dogs in stress with pain, strange surrounding are in stress and producing more stomach acids. When you get an update from the boarding vet, please keep us posted. Hope to hear pain will be under control with adjusting his meds.
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Post by Tiffani & Cooper on Apr 16, 2020 13:14:39 GMT -7
Good Day Paula,
Thank you for your extremely helpful comments.
The emergency animal hospital sent me home on Saturday [4/11] with the following: 1) They put a fentanyl patch on his back (50cg) 2) Gabapentin 100mg 1 tab every 8 hours 3) Prednisone: 5mg tablets: 1/2 tab every 12 hours.
His pain was not under control based. He screamed and cried for 3 days. I had to bring him to his local vet to board him and get his pain under control.
As of today [4/16], this is what he is on at his current vet:
1) Gabapentin 100mg: 1 capsule twice daily 2) Prednisone: 5mg: 1/2 tablet twice daily 3) Tramadol: 50mg: 1/2 tablet 3 x daily 4) ✙Trazodone: 50mg- 1 tabled 3 times a day (cooper has SEVERE separation anxiety every since I rescued him from shelter) He cries when I leave the house and is very stressed out 4 years later. 5) ✙Mirtazapine: 15mg- 1/4 tabled once daily.
[Moderator's Note. Please do not edit 21 lbs/ 9.53 kg -obese Prednisone 5mg tab as of 4/11: ER Rx TAPER DOSE!!!: 2.5mg 2x/day dog in pain! boarded 4/15 for pain control as of 4/16: vet Rx ?mgs ?x/day as of 4/16: Vet Rx TAPER DOSE!!!: 2.5mgs 2x/day dog in pain! tramadol 25mg 3x/day gabapentin 100mg 2x/day ✙Mirtazapine antidepressant ✙Trazodone: 50mg 3x/day needs GI tract protector, Pepcid AC, not reported ]
The vet called me at 8pm last night [4/15] . Cooper had not eaten in 3 days. Dr asked me to bring some chicken and come and try to feed him. I went and fed him chicken and he gobbled it up. He has a catheter and was clearly in pain when he wobbled to get close to me.
I closed the kennel door and he then he lost it, he screamed out of control when I left, I could hear him in my car outside the building. I will be dropping off chicken but will not go visit him personally, to not upset his anxiety.
Vet called this morning [4/16]and he did eat breakfast this morning, she is reducing his ▼sedative a little. Hes now resting but still cries out when lifted and during manipulation. Today is 4 days since he was admitted.
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Post by Romy & Frankie on Apr 16, 2020 14:07:45 GMT -7
Cooper is not on any meds to protect his stomach from excess stomach acid caused by all anti_inflammatories including pred. Mirtazapine does not reduce excess stomach acid. Mirtazapine is usually used for appetite stimulation and for nausea. If Cooper is starting to suffer stomach damage because of excess stomach acid Mirtazapine may cover up the symptoms but it will not treat the cause. Please ask your vet about putting Cooper on an acid controlling medicine like Pepcid AC. This is very important.
Cooper's dose of pred at 2.5 2x a day is lower than the usual anti-inflammatory dose. When the dose of pred is below the anti-inflammatory dose there is really nothing working on the spinal cord inflammation. A more typical dose would be the whole 5mg tablet 2x/day.
Dr. Reuben's information on prednisone is in line with what we see many, many vets on this Forum using for a disc episode. So for Cooper, 0.3mg x 21= 6.5mg
Cooper is still in pain. We must have no patience with pain in our dogs. If the fentanyl patch was applied on 4/13, it is likely providing minimal pain relief now, four days later.
At a 25mg 3x daily dose of tramadol, Cooper is well below the dose we typically see for dogs of Coopers weight, 21 lbs. Veterinary pharmacologist Bruce KuKanich, DVM, PhD, DACVCP: "Tramadol is rapidly eliminated from dogs after oral administration. Recent studies are suggestive the bioavailability of tramadol in dogs is lower than originally determined and the dose of tramadol needs to be increased with dosages from 5 - 10 mg/kg PO q 8-12 hours in dogs to maintain similar plasma drug concentrations as those in humans." New developments in opioids: old drugs and some future directions (Proceedings)" DVM360. Nov 01, 2009 By Butch KuKanich, DVM, PhD, DACVCP veterinarycalendar.dvm360.com/new-developments-opioids-old-drugs-and-some-future-directions-proceedings Last accessed 3/18/16
Using this formula, at 21 lbs, which converts to 9.5kgs, 9.5x5mg = 47.5. This is at the low end of the scale. Please advocate with your vet for the tramadol to be increased to 50mg 3x day. Methocarbamol, which is a muscle relaxant that works on painful muscle spasms often seen with IVDD can be add 3x/day.
Cooper is still in pain and has been for some days. Based on what we usually see prescribed he continues to
be under medicated.
We are not vets and do not know the specifics of each dog's health. We are making this suggestion based on what we've seen qualified vets prescribe in the past and only as a basis for discussion with your vet..
Things to speak with your vet about as soon as you possibly can. Pepcid AC, because Cooper is already showing signs of stomach damage by his reluctance to eat. An increase in pred to an anti-inflammatory dose for a 21 lb dog, 5mg 2x day. An increase in tramadol to 50mg 3x day and the addition of Methocarbamol to get his pain under control.
Not all vets know IVDD. If you are unhappy with the care that Cooper is getting, consider seeking another vet more familiar with the disease. This article shows what to look for in a Vet that treats IVDD. www.dodgerslist.com/literature/VetchkList.htm
Healing thoughts for Cooper.
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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 16, 2020 21:24:00 GMT -7
Tiffani, I want you to know to read with care the excellent information Romy has explained why Cooper is still in pain — he is being way under medicated! With Romy's thorough information under your belt, you will want to advocate on behalf of Cooper. What harm is there in trying an aggressive, usual medication approach that is so very typical to a disc episode? There is no reason to suffer with pain when meds can be adjusted. Help Cooper by speaking up for him: 1. GABAPENTIN (for nerve pain) 100mgs promptly every 8 hrs. 2. TRAMADOL (general analgesic) is WAY way under medicated for a 21 lbs dog! Adovcate for the max analgesic dose promptly every 8 hours. Look for the vet to be Rxing tramadol: 10mgs tramadol x 9.53 kg dog weight = close to 100mgs 3x/day 3. METHOCARBAMOL (muscle contraction pain) Nothing is covering the pain of muscle contractions! Advocate for methocarbamol every 8 hrs. 4. PREDNISONE is complicated. Please use dates, the are incredibly important to us. We would hate be incorrect about something and get the wrong picture. For a 21 lbs dog the "anti-inflammatory" dose is Pred 6mgs every 12 hours. Taper doses do nothing for the inflammation! Taper doses are to determine if pain is seen to get back up to the anti-"inflammatory" dose ASAP. Taper doses do not work on inflammation. 5. Famotidine or other stomach acid reducer while on pred. I'm assuming w/o all the facts that Cooper never had any days yet on the "anti-inflammatory" level. He's had nothing to attack and resolve the swelling/inflammation. Please look over and let us know what is incorrect. Am a great deal of trouble correlating what you write with actual dates. Prednisone 5mg tab as of 4/11: ER Rx TAPER DOSE!!!: 2.5mg 2x/day dog in pain! ? boarded 3 days later on 4/13 or 4/15 for pain control? ? "Today is 4 days since he was admitted" on Sunday 4/12? as of 4/15: boarding vet Rx ?mgs ?x/day as of 4/16: brdngVet Rx TAPER DOSE!!!: 2.5mgs 2x/day dog in pain!
RULE OF THUMB Pain= +course of Pred at anti-inflammatory level & all pain meds, famotidine back on board. No Pain= complete the pred taper... finish out the 8 weeks of crate rest for the disc to heal. The full details on how prednisone, an anti-inflammatory works with a disc episode. Good reading to be able to ask the right questions and discuss treatment AND to be a strong advocate for getting Cooper the meds he needs: www.dodgerslist.com/literature/healingsweling.htmLet us know when:- Famotidine for stomach protection during Prednisone is on board - Methocarbamol for muscle contraction pain is on board 3x/day - Tramadol is increased to max analgesic dose 3x/day - Gabapentin is increased to 3x/day - Prednisone is up at the "anti-inflammatory" level of about 5mgs 2x/day I'm keeping my fingers crossed you will be successful in speaking up on behalf of Cooper. Polite but assertive. He deserves to be able to heal in comfort.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Apr 17, 2020 5:47:26 GMT -7
Tiffani, you mentioned that Cooper had pain upon manipulation. Please make sure that no chiropractic treatments or manipulation is being done at the vet's office. The less movement of the spine, the better. Here is why chiro is not recommended: www.dodgerslist.com/literature/chiropractic.htm Prayers that Cooper's pain can be brought under control today and that he will soon be home with you. Dogs heal better in a home environment. If this vet cannot get Cooper's pain completely under control, get a second opinion emergency exam ASAP, today, preferably by a Board-certified neurologist. Not all vets understand how to treat IVDD.
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Post by Tiffani & Cooper on Apr 17, 2020 11:55:17 GMT -7
Hi, Thank you all for taking the time for Cooper and myself. As of today 4/17, here are his daily meds: gapapentin: 100mg every 8 hours trazadone: 1 tablet x2 a day: 50mg ▲ pred: 5mg 1 tablet twice a day ▼ tramadol: 50mg 1/2 x twice a day appetite suppressant [name of med?] removed today [Moderator's Note. Please do not edit 21 lbs/ 9.53 kg -obese Prednisone 5mg tab as of 4/11: ER Rx TAPER DOSE!!!: 2.5mg 2x/day dog in pain! ? boarded 3 days later on 4/13 or 4/15 for pain control? ? "Today is 4 days since he was admitted" on Sunday 4/12? as of 4/15: boarding vet Rx ?mgs ?x/day as of 4/16: brdngVet Rx TAPER DOSE!!!: 2.5mgs 2x/day dog in pain! as of 4/17: ▲5mgs 2x/day tramadol 25mg 2x/day? gabapentin 100mg 2x/day Mirtazapine antidepressant stopped ? Trazodone: 50mg 3x/day needs GI tract protector, Pepcid AC]Cooper is now eating. they called me today and cooper stood today on his hind legs for two minutes, but I was told "he still cannot walk". Tomorrow is one week since we went down so because he cannot walk yet, I don't feel hope should be lost? I take him standing for the first time even for a few seconds as a victory. I feel its not a race and Coop will decide when he's ready. They also stated he yelps when they go to pick him up. I know his behavior and he's always done that, preimptively yelp for something he doesn't like without even touching him. They spoke about getting him into rehab when he comes home, I expressed I don't want to start rehab until after the strict 8 weeks crating to allow him time to heal. They're still doing the cold light therapy now twice a day. I'm so lost without him. I wake up and look for him and forget he's not here. 5:00pm I go to feed him, he's not here. I'm trying to stay hopeful and positive. any words of positively are most welcome today. thank you for your kindness and care. I'm new to this forum and learning curve on responding to each post. ill get the hang of it
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Post by Romy & Frankie on Apr 17, 2020 13:42:36 GMT -7
Standing by himself is a victory for Cooper. There is absolutely no reason to lose hope. It is very, very early in Cooper's recovery. So much healing can still take place.
Good work getting the pred increased to 5mg twice a day. I notice the pain meds have not been increased. Is Cooper showing any signs of pain besides yelping when picked up? If he commonly yelps when picked up, I don't believe it is a pain indicator it is just Cooper. I am putting the signs of pain here for your easy reference:
-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 he is showing any of these signs of pain, besides yelping, his pain is not in control. If his pain is not in control please talk to the vet about tweaking his pain meds. In previous posts we talked about some meds and their typical doses that we have seen successfully prescribed by knowledgeable IVDD vets.
Cooper should be able to come home very, very soon. At home, you will be able to monitor him in a way that the vet simply can't because of the need to care for other dogs.
When Cooper comes home he must be on 8 weeks of strict crate rest. This is critical to his recovery. It is the immobility enforced by crate rest that will heal the disc. The crate rest must be very, very strict. Any time out of the crate can be dangerous. There should be no rehab until the 8 weeks of crate rest is over. There are different types of enclosures used for recovery suites. Some people use ex-pens, some people like pack and plays. I started out using a traditional wire crate during my dog's recovery but also used an ex-pen during the recovery period. The recovery suite must be only large enough for Cooper to stand up, turn around and fully stretch out the legs when lying down. If the crate you choose is larger than this, the extra room can be padded with rolled up towels or blankets. I am not sure if you have yet seen the info here:
When he comes home, he may not yet have bladder control although being able to stand by himself is an indicator that he might, possibly have control. The way we determine if a dog has bladder control is to bring them to a previous pee spot and let them sniff. If the dog then releases urine there is bladder control. If he does not yet have control, he must be expressed. A good first step in learning to express is read and watch the video here: www.dodgerslist.com/literature/Expressing.htm#bladderexpress Then, before you bring Cooper home ask the vet for a hands-on lesson in expressing. Expressing is a skill that must be practiced and learned but if you practice you will learn. By learning to express his bladder, if needed, you are keeping his bladder healthy and lowering the chances of a urinary tract infection.
Nerves heal slowly. As IVDD pet parents we must think of recovery in terms of weeks or months not days. Nerves are slow to heal but heal they can.
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Post by Tiffani & Cooper on Apr 17, 2020 13:58:36 GMT -7
Thank you very much Romy and Frankie! Pain: Yes, Cooper's pain is now controlled. And his personality has always been that he yelps before anyone pics him up (anyone but me. ) Vet office said he's eating and resting well now. I dropped off his favorite bones and he's loving them like usual. Meds: was able to get the prednisone increased. I forgot to mention the muscle relaxer add on, but was told he is no longer trembling. www.amazon.com/Portable-Playard-Comfortable-Mattress-Changing/dp/B07RZQC1T1/ref=sr_1_13?dchild=1&keywords=pack+and+play&qid=1587156729&sr=8-13I'm thinking a pack and play (one like above) without all the baby stuff, might be best for me as I can move it easier than the wire crate I bought him next to my bed at night. THANK YOU!
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Post by Romy & Frankie on Apr 17, 2020 14:04:43 GMT -7
That pack and play looks just fine. Put rolled up blankets or towels around the sides to shrink it to Cooper's size.
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Post by Romy & Frankie on Apr 17, 2020 14:20:16 GMT -7
Was the tramadol reduced from 3x/day to 2x/day? We have it at 3x/day in our earlier notes.
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Post by Tiffani & Cooper on Apr 17, 2020 15:11:26 GMT -7
That is correct. They reduced the tramadol from 3x a day to 2x a day. When the vet calls again, I will ask for the reasoning. I had spoken to a tech this morning.
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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 17, 2020 15:45:01 GMT -7
Tiffani, so wonderful to hear Cooper can move himself up into a stand all by himself!!! That is the important part, not the how long he can remain standing.
when the test for pain prednisone taper begins, than that is the time to be reducing pain meds. Until then one ought to assume a painful disease is, indeed, painful and make sure the dog is not in pain by reducing pain meds.
At the begin of the pred taper then the pain meds will be backed off or full stopped to provide a quick and clear assessment about pain. If pain, then right way back up to the anti-inflammatory level of pred (5mgs 2x/day) for more days and then retest. And all pain meds and stomach protector on board too.
FAMOTIDINE
QUESTIONS: -- For how many days will he be on Pred 5mgs 2x/day? -- What is the reason no stomach protection is on board for the duration of Prednisone?
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Post by Tiffani & Cooper on Apr 17, 2020 19:40:23 GMT -7
Apologies, I misquoted. The vet helped him stand, and then he was able to stand on his own for two minutes. I was informed. He wasn't able to get to a standing position on his own.
I am unsure of these questions, and will inquire tomorrow. Thank you all and have a lovely evening.
Question: Cooper went down a week ago tomorrow [Sat 4/11] . He was medically boarded on Monday [4/13]. He will stay there two weeks total [til 4/27].
When he comes home does the 8 weeks strict crate risk begin then? or does the 2 weeks in a kennel count as the 8 weeks?
thank you kindly Coop's mom
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Apr 18, 2020 5:16:41 GMT -7
If you are absolutely sure that strict crate rest has been implemented at the vet's office and that Cooper was kept strictly in a kennel that was only large enough for him to lie down comfortably with his legs extended, that he didn't have too much of an area where he could drag himself around, then you can count the days he has been at the vet's office as part of the full 8 weeks of strict crate rest. We have the date that you personally started strict crate rest as April 11th. Is that correct? Why would Cooper need to stay at the vet's office for two weeks? As mentioned previously, dogs heal so much better when in their familiar, loving home environment. Now that Cooper's pain is under control, he can be given the same meds in oral form to be taken at home. I know you had problems expressing him but now that his pain is under control, it should be much easier for you to learn how to do this. Unless Cooper's bladder control returns soon, expressing is something you're going to need to learn how to do. Here's our page on expressing for your review: www.dodgerslist.com/literature/Expressing.htmNow that Cooper's pain is under control, there is no reason that I can see from what you've told us as to why Cooper shouldn't be allowed to come home today.
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Post by Tiffani & Cooper on Apr 18, 2020 10:10:16 GMT -7
Coop and I have an unusual situation where we lost our home in January to a severe septic flood, losing most of what we own. Since January 8th, our home has been under construction, total remodel and we do not have a home for 1 to two more weeks. hotel has strict rules and to respect fellow guests, its best coop is safely treated at vet. My hope is our home will be ready in one week, covid has delayed construction and new furniture deliveries.
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Post by Julie & Perry on Apr 18, 2020 10:19:14 GMT -7
Oh my goodness, Tiffani, you have a lot on your plate!
So sorry for all you are going through.
Sounds like Cooper is in the best place for now to rest and heal.
So glad he's feeling better and not in pain.
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Post by Romy & Frankie on Apr 18, 2020 13:08:03 GMT -7
I am very sorry that you had to leave your home and I hope that you soon be able to move back in. Something like that is doubly difficult when your dog is having an IVDD episode.
For now, boarding Cooper at the vet seems like a good choice.
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Post by Tiffani & Cooper on Apr 19, 2020 10:12:53 GMT -7
First off, thank you for all of your time, care and guidance. Cooper’s injury on top of everything else has me beside myself. Finding you all, has been a blessing - extreme gratitude.
I just spoke to the vet and he was given ✙Pepcid for acid, I kept forgetting to ask that question posed on earlier this week.
[Moderator's Note. Please do not edit 21 lbs/ 9.53 kg -obese Prednisone 5mg tab as of 4/11: ER Rx TAPER DOSE!!!: 2.5mg 2x/day dog in pain! ? boarded 3 days later on 4/13 or 4/15 for pain control? ? "Today is 4 days since he was admitted" on Sunday 4/12? as of 4/15: boarding vet Rx ?mgs ?x/day as of 4/16: brdngVet Rx TAPER DOSE!!!: 2.5mgs 2x/day dog in pain! as of 4/17: 5mgs 2x/day tramadol 25mg 2x/day? gabapentin 100mg 2x/day Mirtazapine antidepressant stopped ? Trazodone: 50mg 3x/day ✙Pepcid AC]
Dr stated that coop is not in pain and way more comfortable. They take him out 3 times a day and set his feet on the for him and he’s able to stand each time for a minute or two on his own. She stated she does not feel coop will be able to walk again. This gives me very conflicted hope. It’s been 8 days today he became paralyzed. He had deep pain sensation. She said in one more week they should be able to tell. I’ve read for hours and hours about his condition and it seems no dogs recovery is the same from what I’ve studied. Each dog can heal on very different timelines. I asked if maybe he can walk again in a few months, she responded with “no, that is very unlikely” I won’t want to lose hope and any experience with a full recovery months later I welcome your words of encouragement
I asked if his catheter can be removed so we can see what he is able to do on his own when they stand him. She agreed they will take it out later this afternoon.
Thank you
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Post by Ann Brittain on Apr 19, 2020 10:58:19 GMT -7
So sorry for all you troubles.
I know how hard it can be to begin to lose hope when you dog is having an IVDD episode.
Your vet is trying to give you information based on her experience and education. I'm sure she does not want to give you false hope. Did she explain why she believes Cooper will never walk?
We were told Buster wouldn't walk again after his surgery, but we didn't want to give up on him. After many months of physical therapy, swim therapy and acupuncture he gradually got stronger and started to walk again. It was never perfect, but he got around on his own. He regained bladder control but not bowel control.
You're right to think each dog is unique. My son's dachshund went down and was unable to walk for several months. Without any PT or other treatment, she started walking again and never had another IVDD episode. Many people have reported similar outcomes here on Dodgerslist.
In my opinion, now is not the time to give up hope. Cooper wants to get back to his normal life and, with your help, he may be able to. But even if he doesn't he can live a healthy and happy life.
It takes patience and time for nerves to heal. Please rely on all the people on Dodgerslist who are here to help and support you and Cooper.
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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 19, 2020 12:22:02 GMT -7
Tiffani, you know, not all vets see a ton of IVDD cases. Even neuros do not typically follow up after a surgery much more than the last check up visit 4-6 after the surgery. Here at Dodgerslist, we have a very unique vantage point. We hear back from folks a year out, months out. This is since 2002 and with over 15,000 members having passed through our doors. So we have a totally different sense about nerve healing time. Here are vets with a very similar outlook on nerve healing as we have here at Dodgerslist. Deep pain sensation (DPS) is the ability perceive tissue-damaging stimuli which activates nerve endings (i.e. mechanical -pressure, pinch) when applied to the tail or toes. DPS indicates there is still an intact nerve pathway to the brain.
Thus the potential for nerves to heal and at some point in time nerve functions to come back. Trust only the word of a Neuor or Ortho for this very tricky to idenitfy function. There is no person who would be able to give you a timeline or date for nerves functions to come back. How fast nerve function comes back is due to many of variables (things like: each dog's body's ability, severity of nerve damage in that particular disc episode, the distance from brain to the nerve damage location and other complexities to numerous to mention.) The rate of axonal regeneration has been assumed to be constant. It is generally estimated to be 1 mm per day. So a 12 inch span of nerve damage would take 1 year or so to self repair to bring back a function. HOWEVER.... reported rates of regeneration vary broadly from 0.5 to 9 mm per day. See why it is impossible to predict the timeline of when things will happen with nerve repair? The only thing anyone can tell you is "in general" the typical order of return. NOTE: "in general" covers the fact that in some few cases bladder control may return but not tail wagging. Bladder control would return but not bowel (anal) control, etc. Please take to heart the nerve healing philosophy of veterinary surgeon Andy Torrington BVMS CertSAO MRCVS. Success stories give one perspective on nerve healing time: www.dodgerslist.com/monthstory.htm
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Post by Tiffani & Cooper on Apr 20, 2020 8:07:54 GMT -7
Forgive the reply sequence, the forum on mobile device lends to weird placements.
Paula, a neuro team evaluated Cooper 04/11/20 on the day he went down for surgery consult. I was informed that evening that Cooper has no motor function but deep pain sensation, which made him a illegible candidate for surgery I was advised.
I have spoken to two doctors at my local vet where Coop is boarded. One stated she see's this all the time where dogs make a full recovery. Coop's primary vet stated yesterday, if he doesn't walk within a week it is unlikely he will again. I'm trying to focus on staying positive and getting cooper and I back into our home that we haven't been in for 4 months due to the septic flood, and take it one day at a time. I'm taking the news that he is able to stand on his own for a 1 minute at a time if his feet are placed as an excellent sign.
Cooper has extreme EXTREME separation anxiety and is very stubborn. When I rescued him he screamed for 3 months straight and we got through that, I think if he's in his home with tender love and care and his mom, his odds will be remarkable.
curious if any mods offer telephone consults/guidance/comfort for fee for service. Might be a nice tool in my toolbox during the next two months of crating and covid-19 stay at home.
Sincere thanks, Tiffani
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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 13:26:45 GMT -7
Tiffani, I'm sorry to hear you get conflicting information about nerve healing time. Not surprised, cause it happens to many. These things are true. --- if a dog still has deep pain sensation (DPS), then a surgeon would do the surgery. Even loss of this very last neuro function (DPS) — IF lost within a window of 12-24 hrs the surgery can still be successful. Only take the word of a surgeon for this very tricky to identify neuro function. General vets do not do enough neuro exams to develop a practiced eye that surgeon have in correctly IDing DPS. -- There is no vet alive, who can give you a date for when walking must happen or all is lost. No vet alive knows anything about the number of days/weeks or months when nerve healing would take place. Mother nature and Cooper's body hold the answers. Kathleen E. Collins, ortho surgeon (ACVS) wrote in the Ocean State Veterinary Specialist 2002 Newsletter and confirms what we see all the time. It IS in the cards for your dog to get back to enjoying life after the necessary period of rest! Remember to put a big smile on your face and in your voice and carry it in your heart while your dog is recovering! Dogs CAN smell when you are happy, sad or scared because each emotion has a subtle change in your scent. Many times their behavior reflects our mood and they may even misinterpret our sadness and tears and believe they have done something wrong. Everyone heals better in a positive energy environment. SO, "put on a happy face!!" It will help you and your sweet one!! ** The entire purpose of the Forum is to educate. We are all volunteers passionate to educate and help dogs through the vehicle of this Forum. The history of the dog is on the Forum we often refer back to before we post. That history is also an educational resource for any other members to learn from as well. We hope you will continue to see the priceless value of this FREE resource accessed only here on-line.
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Post by Tiffani & Cooper on Apr 21, 2020 13:50:13 GMT -7
All of you that have helped guide me with your amazing information, kindness and care.
I have some good news to share. The vet called and they took out Cooper's catheter and he can pee on his OWN! He needs his butt propped up again, but he goes on his own and she did an ultrasound and it showed that his stretched out bladder was now in normal size, and that he's able to eliminate completely.
I will take this as an absolute win!
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Post by Romy & Frankie on Apr 21, 2020 14:08:06 GMT -7
This is very good news, Tiffani. Bladder control is a true advance in Cooper's healing.
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Post by Tiffani & Cooper on Apr 25, 2020 17:29:01 GMT -7
Vet let me take Cooper home for 5 hours today. I laid him in his pack and play I bought and he did very well. Two weeks ago today he went down and what a relief that he is no longer screaming when i pick him up or touch him. This was her first time in 4 months he’s actually been home since we lost our house to a flood- very special day.
He had upper motor neuron bladder problems and is unable to empty his bladder all the way based on many ultrasounds. I had to bring him back just now because he requires being catheterd. Vet started him on 3 medications for that and is consulting a neurologist about that issue over the weekend
I took him outside in his old grass area and he sniffed the grass and started peeing on his own right away both times I took him out. I didn’t need to express him. I’m not sure what upper motor neuron bladder is ...
Was so nice to spend time with my little man and my new reality with him is setting in. Grieving my old dog a little too- I haven’t spent any time with him since his injury happened as he’s been boarded - he dribbled a lot in the pack n play and I cleaned him and it felt like I was having to pick him up too many times to clean him
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Apr 26, 2020 6:02:33 GMT -7
I'm sure it was wonderful for both you and Cooper for him to be home, even for a little while. And it's great news that you saw with your own eyes that Cooper does have some bladder control and that his pain is now under control.
If you now have a place you can bring him home to, then there is no reason he can't come home. I'll give you a detailed explanation as to why in case you do now have a place Cooper can come home to. He does not have to return to the vet to be catheterized. You would need to learn how to express his bladder. Complete bladder control may not come back for months or at all so you will eventually need to learn how to do this. Manual expression of the bladder is the healthiest way to empty the bladder. Catheters require sterilization and can lead to scarring of internal tissue. Cooper is able to release urine on his own and should be allowed to do so. After he goes on his own, you would do a quick expression of the bladder to be sure it's completely empty. You would do that quick express after he's gone on his own until you're sure he's able to completely empty his bladder on his own. With expression of the bladder, you'd be able to tell when full bladder control returns and expression is no longer needed.
The other option is for Cooper to be catheterized at home if there is a specific reason why he can't be manually expressed. It is something your vet can show you how to do. With care to catheterize and be sterile about it, that is totally a fine option. However, it would make it difficult to determine when Cooper's bladder control completely returns.
What are the three meds that the vet put Cooper on for the bladder issue? Meds can help relax a tight sphincter if the vet expects that to be the case but meds cannot help nerve damage that causes urinary incontinence. Only time and Cooper's body's own ability to heal with do that.
Dribbling could be due to not being fully able to empty his bladder yet or it could be due to a urinary tract infection, which is common with incontinent dogs, both those that are expressed and those with a catheter. Please ask the vet to check for a UTI today.
Why have there been many ultrasounds done? One should have been sufficient if the vet suspected something other than IVDD. As for the bladder, an ultrasound shouldn't have been required as it's common for IVDD dogs to become incontinent due to nerve damage. Was Cooper sedated each time an ultrasound was done? Anesthesia can be dangerous for a dog having a disc problem. A dog's main defense against further disc damage is dependent upon control over the core trunk muscles – this defense is eliminated with anesthesia.
To clean Cooper from any urine on him, lean down into the pack and play if possible and gently wipe Cooper's inner thighs, legs and belly with him lying on his side. Wipe him with cooled down green tea. Green tea neutralizes the acidity of urine so it helps prevent urine scald/burn and also leaves a nice fresh scent.
Continued healing prayers for Cooper.
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Post by Tiffani & Cooper on Apr 27, 2020 20:16:46 GMT -7
Happy to report Cooper is now home! I’m his crate screaming his head off.
He was evaluated by CARE today, his rehab team. Dr said he is an above average chance of walking. They gave me PT to do at home and he had acupuncture today and laser therapy before he came home. Strict crate rest and he will go to then once a week. Here are his current meds
Diazepam- 3 to 4 pills every 6 to 8 hours ✙ Prazison- every 12 hours ✙Z-urecholine 1/4 tab every 8 hours ▲Prednisone- 1 1/2 tab once daily ▼Trazedone- 1/2 fab every 8 hours ▲Gabapentin- 100 mg 3 x a day
[Moderator's Note. Please do not edit 21 lbs/ 9.53 kg -obese Prednisone 5mg tab as of 4/11: ER Rx TAPER DOSE!!!: 2.5mg 2x/day dog in pain! ? boarded 3 days later on 4/13 or 4/15 for pain control? ? "Today is 4 days since he was admitted" on Sunday 4/12? as of 4/15: boarding vet Rx ?mgs ?x/day as of 4/16: brdngVet Rx TAPER DOSE!!!: 2.5mgs 2x/day dog in pain! as of 4/17: 5mgs 2x/day as of 4/27:▲ 7.5mgs 1x/day ✙Diazepam ?mg ?x/day which ? every 6 or 8 hrs? gabapentin 100mg ▲2x/day ✙Urecholine (bethanechol). ?mgs 3x/day ✙Prazison ? mgs 2x/day Trazodone: ▼25mg 3x/day Pepcid AC ?mg ?x/day
Dr said he has an injured left knee- I didn’t know that I have not been able to express his bladder yet - hoping
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