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Post by Natalie & Radar on Apr 22, 2020 18:25:08 GMT -7
Hi, My name is Natalie and Radar my 5 year old Cardigan Welsh Corgi just had surgery on 4/20 on for a intervertebral disk extrusion/rupture. His surgery was performed by a DVM with a practice limited to Neurology. He got to come home this evening 4/22. We first saw our regular vet the am of 4/20 and he went right to the emergency vet and had his surgery that night. He is able to stand with the sling but no walking. He can feel pain on his right back paw but didn't really notice him pulling back for the left. When speaking to the vet they said they observed him wag his tail but we have not seen that yet. He is resting comfortably at home as of now. It is his first few hours home so we are watching him like a hawk but seem to be doing well. Vet said he will be on rest for the next4-6 weeks with a recheck at 2 weeks. We are to do PT at home now with Toe Pinches, Static Standing and Passive range of motion 2/3 times a day. He can also have 2 short walks 5 min at the most. Radar weighs about 47 pounds right (overweight)
2)Meds: Sucralfate tab 1gm: 1 tablet every 8 hours 60 min before food and other meds Gabapentin 100mg capsule:1 capsule every 8 hours for discomfort Prazosin 0.5mg tablet: 1 tablet every 8 hours for aid with urination Cerenia 24mg tablet: 2 tablets (48mg) once a day for nausea Prednisone 10mg tablet: 1 tablet twice a day for 7 day and then 1 tablet once daily for the next 7 days. (Radar has not started these yet we are waiting till he consistently is eating for 48 hours) Can the prazosin and gabapentin be given at the same time? No Pepcid AC was given. Should we add this?
[Moderator's note: please do not edit 47 lbs. Prednisone as of 4/24 : 10mg 2x/day for 7 day and then taper to test for pain/neuro Sucralfate 1gm 3x/day Gabapentin 100mg 3x/day Prazosin 0.5mg 3x/day Cerenia 48mg 1x/day needs GI tract protector, Pepcid AC, on board w/prednisone! ]
3) he is eating now that he is home and eating ice cubes. haven't seen him go for water just yet. He was having nausea at the vet today but haven't seen that since he has been home tonight. He did pee when we put him in the sling. No poop yet.
Thank you for taking the time to help us and if there is anything you recommend for us to be doing please let me know. I will update how he does overnight. Natalie and Radar
Update on first night home. Didn’t really sleep for more than an hour or two at a time. Yelped when he tried to move about 30 min before getting pain med and getting them after. He seem to pant when he needs to go pee pee. Not sure if there is something that could make him feel more settled so he can be resting more.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Apr 23, 2020 6:10:00 GMT -7
Welcome to Dodgerslist, Natalie. 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! **Disc disease is not a death sentence!**Struggling with quality of life questions? Re-think things: www.dodgerslist.com/index/SDUNCANquality.htmYou have a pain emergency that must be discussed with the vet ASAP this morning. Which med(s) are not to be started until Radar has eaten for 48 hours? Was it the Prednisone due to the nausea he showed at the vets' office? If the vet is concerned about GI distress, Prednisone can be started now with the addition of Famotidine (Pepcid AC) as a second stomach protector in addition to the Sucralfate. The typical dose of Famotidine we see for a dog of Radar's weight is 5mg 2x/day, given 30 mins before the Prednisone and then every 12 hours thereafter for as long as Radar is on Prednisone. Gabapentin addresses nerve pain. Tramadol can be added as a general pain med. Methocarbamol can be added for the pain of muscle spasms. Advocate strongly for an adjustment of pain meds. Pain hinders healing so have no patience with it. Pain should remain completely under control within one hour of new course of meds and should remain completely under control from one dose of pain meds to the next. 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 Currently can Radar move the legs at all? Neuropathic pain is not common but is something you should be aware of. This kind of pain is abnormal, phantom pain sensations with severe spinal cord damage. Signs are obsessive licking of paw, leg, genitals, tail. Escalates to biting, life-threatening chewing off parts. Immediately put on an e-collar (or lengthwise folded towel around neck and duct taped closed) to prevent access to lower body. Contact vet immediately for Gabapentin or stronger Lyrica (pregabalin) for neuropathic pain. More info: www.dodgerslist.com/literature/neuropathy.pdfPost-op crate rest is to allow the surgical sites to heal. Super tried and true tips for setting up the recovery suite, the mattress and more! —> www.dodgerslist.com/literature/CrateRRP.htmSTRICT for a post-op dog means: ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy whys: www.dodgerslist.com/literature/chiropractic.htm◼︎no dragging or meandering at potty times. Post-op dogs will follow surgeon's directives for PT during post-op rest as the offending disc material was surgically removed. If there is great pain or severe neuro diminishment, acupuncture or laser light therapy can be be started right away as an adjunct to pain meds and to kick start nerve cell energy production. Options: Acupuncture vet who does home visits to avoid back moving during transports. For transport to necessary visits, pad out the recovery suite extra space with a rolled up towel/blanket to prevent body shifts during braking or cornering. CAUTIONS: ~~ Laser light therapy is contra-indicated with tumors which are detected via x-ray. ~~ Why Chiropractic is not recommended for IVDD dogs: www.dodgerslist.com/literature/chiropractic.htmAlso water therapy can be performed after the stitches/sutures are removed. Some of these exercises can be done right in the bathtub. Many members have found underwater treadmills to be very helpful in regaining their dogs' use of their legs. Please check with the surgeon before starting any of these. www.dodgerslist.com/literature/watertherapy.htmKnowledge 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: www.dodgerslist.com/literature/theater.htm --- 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 Main www.dodgerslist.com website: www.dodgerslist.com/index/searchBOX.jpgPlease let us know what the vet says after speaking with them this morning. Healing prayers for Radar.
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Post by Natalie & Radar on Apr 23, 2020 8:15:54 GMT -7
Hello Marjorie, Radar is to start the Prednisone after he has eaten for 48 hours. I am going to as to start them [Predisone] tomorrow because now that he is home he is not having a issue eating. He is being given Cerenia for Anti-Nausea med and the Prazosin for Bladder med. Currently we have not seen any leg movement. He does have good deep pain feeling in his right hind paw and light pain feeling in the left hind paw. He also has still not gone #2 yet fingers crossed that happens today or tomorrow.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Apr 23, 2020 10:47:39 GMT -7
Have you spoken to the vet today about the signs of pain that you're seeing, Natalie? Radar cannot and should not be allowed to remain in pain until you can get the Prednisone on board tomorrow. His pain meds need to be adjusted today ASAP. Pain hinders healing so please have no patience with it.
Pain is a significant stressor, leading to all the deleterious consequences of stress, such as immunosuppression, slowing of the healing process and acceleration of disease processes. Thurman JC, Tranquilli WJ, Benson GJ. Perioperative pain and distress. In: Veterinary Anesthesia. Baltimore: Williams and Wilkins;1996. p 40–62.
Constipation is common following surgery. Pumpkin can help to loosen stools. Give one teaspoon of pumpkin for every 10 pounds of body weight per day. To loosen the stool, add equal parts water to each kibble meal along with plain canned pureed pumpkin 1x a day. Note alternatives for constipation: really ripe mashed fresh pear, just take off the peel; microwaved and mashed peeled sweet potato.
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Post by Natalie & Radar on Apr 23, 2020 13:39:08 GMT -7
yes just spoke with the vet they said to up his ▲Gabapentin to 200mg 3X daily and they also added ✙TRAZODONE 50mg every 2x daily. He seems to be pretty pain free today but still is not very settled so tonight I will start the 200mg Gabapentin and 50mg Trazodone.
[Moderator's note: please do not edit 47 lbs. Prednisone as of 4/24: 10mg 2x/day for 7 days Gabapentin 100mg ▲3x/day Prazosin 0.5mg 3x/day Cerenia 48mg 1x/day; last dose 4/24 ✙trazodone 50mgs 2x/day Sucralfate 1gm 3x/day needs an acid suppressor, Pepcid AC, on board w/prednisone ]
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Post by Romy & Frankie on Apr 23, 2020 14:37:11 GMT -7
I hope that the increase in gabapentin will work and Radar will no longer be in pain. If not, please call the vet right away and describe the pain symptoms you are seeing. Sometimes more than one type of pain medication is needed. Trazadone is a medication that we see prescribed for anxiety and may help Radar settle.
Have you had a chance to get the Pepcid on board?
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Post by Natalie & Radar on Apr 23, 2020 16:32:09 GMT -7
No Pepcid yet he starts the Prednisone tomorrow. He will take his last of Cerenia. Curious to see how he feels with the need amount of 200mg of Gabapentin and 50mg of Trazodone. I’m worried to up his pain meds cause he has seemed comfortable all day. I’m just don’t want to over drug him or not give him enough.
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Post by Natalie & Radar on Apr 24, 2020 8:21:16 GMT -7
Happy to report that Radar was more comfortable last night with upping the Gabapentin to 200mg and adding in the Trazodone 50mg. He had his first 10mg Prednisone pill today, I asked the Vet about adding in the Pepcid and she said that the Sucralfate is his GI Protectant. Should I ask again? I do not want him to have any issues that can be avoided. Also he was only able to express his bladder yesterday 3 times and 2 for the times I needed to give him a little pressure to start. I was not able to simulate his bladder yet this am and I am pretty sure it is full. Any tips on how to express such a big guy. He is overweight so its hard to hit his bladder. Also no poop yet, I will be going out to get organic pumpkin today. Thank you, Natalie and Radar
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Apr 24, 2020 8:44:53 GMT -7
Natalie, good to hear the pain med adjustment by the surgeon helped to be pain free last night. Pepcid AC (famotidine) works to suppress (stop) acid production. Sucralfate works to deacidify the acids in the stomach. valuable know your meds links: Sucralfate • Pepcid ACSucralfate may do the job. If you see any hint of GI tract problem, don't delay get Pepcid AC on board along with the sucralfate. Pepcid AC stops acid production. Sucralfate is kind of a after the fact working on existing stomach acids to neutralize them. Red Flag progression of GI tract issues: nausea (lip licking), not wanting to eat, vomiting, loose stool, bleeding ulcer, red or black blood in diarrhea, perforated stomach lining. Fat surrounding the bladder, does make it difficult get a feel of the bladder, it's size, etc. So that does make manually expressing more of a challenge. This also means you don't know if with your express check after he's peed on his own if he was actually able to get all the urine out. Urine left can quickly become a breeding ground for bacteria (UTI). While some UTI's will not display any signs, other UTIs may have these signs: change in color with blood in the urine change in odor, dog leaks urine, doesn't want to pee because it hurts to pee. Any suspicions of a UTI, a urinalysis at the vet could proove an infection and get a board spectrum antibiotic on board. So just do the best you can and keep an eye on possible signs. If Radar will allow you, you can express for poop to see if you can get it started: video and tips here: www.dodgerslist.com/literature/Expressing.htm Dogs who do have bowel control may not like you expressing bowels. See if Radar will be ok, if not hopefully the pumpkin will soon help.
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Post by Natalie & Radar on Apr 24, 2020 14:58:18 GMT -7
Good news to report we saw some involuntary paw movement on the left side today and he lifted his tail when we went out to go potty, no #2 yet but I think tonight cause it seemed as though he was trying to go. Everything with meds seems to be working great and he is resting well.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Apr 24, 2020 20:49:30 GMT -7
Natalie, good to hear all pain in in control for Radar. It is still very early in the nerve healing department. Often we need to think in terms of months rather than days/weeks for the body to self heal nerves.
For us humans to be able to distinguish between reflex (involuntary) and brain (voluntary) directed, we have to see some sort of head level involvement with the tail, with a limb or with release of urine so we know the movement was done with purposeful thinking. --- Sniff (head level nose) then release of urine would be brain directed. --- Hear (head level ear) you doing some happy talk and then tail wags is brain directed. Tail movement during potty time can often be a reflex --- Itchy sensation at at neck and then tries to scratch would be purposeful (voluntary) movement. Tickling paws, etc can cause reflex (involuntary) leg movements.
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Post by Natalie & Radar on Apr 25, 2020 4:15:06 GMT -7
Paula, thank you for that information all this is so new and scary for us. I can report that he just let us know he needed to potty and when outside he wanted to try and walk(with assistance) to his normal potty spot and then did smell and release urine and then wanted to go a little further to finally smell and go #2. Makes my heart happy to see these things happening for my boy. Thank you guys for all the information and support. We are very thankful.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Apr 25, 2020 4:32:05 GMT -7
Radar is doing very well so soon after surgery, Natalie. The more you learn about this disease, the less fearful you'll be. Hang in there, stay strong, stay positive and never give up hope! Please continue to keep us updated. Healing prayers for Radar.
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Post by Natalie & Radar on Apr 27, 2020 20:35:19 GMT -7
Just a little update on Radar. I will be adding 5mg ✙Pepcid tomorrow an hour before I give him his prednisone because his sucralfate last pill was tonight. At potty time we can really feel his legs trying to work, still do not really see any movement in either paw. He will have his 2 week recheck on the 6th and we will meet with the physical therapist after that visit. All meds seem to be working well for him, he is resting comfortably and eating well. Pumpkin has really helped at potty time too.
[Moderator's note: please do not edit 47 lbs. Prednisone as of 4/24: 10mg 2x/day for 7 days 5/1 tapering Gabapentin 100mg ▲3x/day Prazosin 0.5mg 3x/day Cerenia 48mg 1x/day; last dose 4/24 trazodone 50mgs 2x/day Sucralfate 1gm 3x/day ✙Pepcid AC 5mg 5x/day ]
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Post by Natalie & Radar on Apr 29, 2020 9:03:58 GMT -7
I am giving him 5mg of pepcid one hour before the Prednisone. He is also done with the Sucralfate as of the 27th. Yesterday we did notice that he was able to hold himself in a standing position once up for about a minute. He is getting stronger each day.
[Moderator's note: please do not edit 47 lbs. Prednisone as of 4/24: 10mg 2x/day for 7 days 5/1 tapering Gabapentin 100mg ▲3x/day Prazosin 0.5mg 3x/day Cerenia 48mg 1x/day; last dose 4/24 trazodone 50mgs 2x/day Pepcid AC 5mg 2x/day ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Apr 29, 2020 17:49:00 GMT -7
Good news Natalie. Pepcid AC 5mgs every 12 hrs til off of prednisone.
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Post by Natalie & Radar on Apr 30, 2020 18:03:41 GMT -7
I have a question about the recovery I have noticed that he does have a lot of strength in his back legs and I can feel the muscles working during potty time and during the pt. My question is about the paws/feet I notice on his right he pulls back during the pinching in between the webbing and on the left it is hit or miss. He also drags his paws when trying to walk. I know it is very early in the recovery but is this normal for the paws to drag or does that mean that the nerve damage very extensive?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Apr 30, 2020 20:57:08 GMT -7
Natalie, it will be helpful to have perspective along with knowing that nerves are the slowest part of the body to heal. Sometimes it takes the body more like months to self heal rather than days/weeks. Also normally one side the spinal cord is were the damage is, thus one side (legs, paws) may be worse in neuro function. What have you observed in front and hind legs?Nerves heal typically in the reverse order of the damage to the spinal cord: FRONT LEGS? 1. Deep Pain Sensation (Only correctly identified by a specialist.) 2. Tail wagging with joy at seeing you or getting a treat or meal. 3. Bladder and bowel control verified with the "sniff and pee" test. 4. Leg Movement, and then ability to move up into a standing position, and then wobbly walking. 5. Being able to walk with more steadiness and properly place the feet .6. Ability to walk unassisted and perhaps even run. More info: www.dodgerslist.com/literature/healingnerves.htmBACK LEGS? 1. Deep Pain Sensation √ right hind paw
2. Tail wagging with joy at seeing you or getting a treat or meal. 3. no Bladder and bowel control verified with the "sniff and pee" test. 4. Yes Leg Movement, and then ability to move up into a standing position, and then yes wobbly walking. 5. Being able to walk with more steadiness and _no_properly place the feet.6. Ability to walk unassisted and perhaps even run. More info: www.dodgerslist.com/literature/healingnerves.htm
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Post by Natalie & Radar on May 15, 2020 18:05:17 GMT -7
Just wanted to give a little update on Radar, he is almost done with the Prednisone his last dose will be next Thursday he is getting one 10mg tablet every other day. He is still taking the 50mg Trazodone once a day to keep him calm. We have had his 2 week check-up and the doctor said everything looks to be healing just the way she had hoped.
He was cleared to start PT and he has gone twice now, yesterday was his second treatment and they said he was able to stand and use the water treadmill for a minute longer and faster than last week.
He is releasing urine and bowels with the smell test and his tail wags with excitement. We are still doing his daily PT at home and have added some new ones that the PT has asked us to. He isn't walking on his own but he is able to get up and stand on his own for about a minute. Also his feet placement is getting better.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on May 18, 2020 9:36:42 GMT -7
Natalie, sound like Radar is following the typical path of self healing his nerves. Good news! I won't be surprised to hear from you that with use of the underwater treadmill that you'll be reporting back legs attempting to move in a walking motion at some point.
Glad to hear knuckling is starting to go away. Another good sign of nerve repair.
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Post by Natalie & Radar on Jun 6, 2020 20:15:45 GMT -7
Another update on Radar he is off all of his meds and he is walking. He is able to go for 3/5 minute walks about 2 times a day. He can go potty on his own and he is getting stronger everyday. He still has a little wobble to his gate but he is able to stand on his own and correct himself. We do PT once every week for an hour and still do the PT exercises 2 times daily.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Jun 6, 2020 22:03:57 GMT -7
Wonderful to hear Radar is doing so well post op. Did the surgeon decide if 4 weeks of rest is needed OR 6 weeks?
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Post by Natalie & Radar on Jun 7, 2020 9:23:02 GMT -7
We did 4 weeks and now she said that he is fine to be out an about as long as we keep an eye on him.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Jun 7, 2020 13:24:24 GMT -7
Congratulations, then on completing the required post op rest! Now is a good time to be determining how you are going to ease back into more normal activity at graduation. The idea is to gradually give more freedom under controlled conditions. Not free rein of the house and yard immediately! LOL Take a look at our information and then come up with a plan to gradually increase activity over about a month's time following the end of crate rest. Also check out how to teach four paws on the floor! www.dodgerslist.com/literature/AfterCrateRest.htmNow is the perfect time if you haven't already to make those home modifications so that you can reduce the stress on the spine in the future. No more stairs, ramps up to furniture, or blocking furniture all together. All those ideas and more are in this link: www.dodgerslist.com/literature/protectback.htm** Learning what you can about your dog's disease, can help you to identify red flag signs of a disc episode. Taking quick action to do STRICT rest at once may help to prevent a surgery. Knowledge can help you live many happy years ahead with Radar too. Check out our treasure trove of information: www.dodgerslist.com/healingindex.htm
We love updates, so do continue to stop by and let us know how Radar is doing.
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