Kim & Baxter
New Member
MALE - Chihuahua — Heart & Kidney
Posts: 35 
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Post by Kim & Baxter on Jun 17, 2020 9:15:44 GMT -7
[Original subject line: Kim's Baxter-Surgery years ago, conservative now - chihuahua]
ADVICE PLEASE!
Hello. A few years ago my dog Baxter was completely paralyzed in the front limbs. Had surgery and regained everything and had a great recovery.
Recently he has hurt his neck again and he's in pain. Still can walk etc, a little bit wobbly. I want to do conservative rest and not move him around, but i want him to get pain medication for this so for that i need to go to the vet, do an exam, etc. I can take him to his neurologist today, but ideally he could stay resting. Anyone have advice on what to do? I think the only way to get pain meds for him is to take him in, but I'm afraid the exam will make it worse. Please advise asap if anyone has any ideas. Thank you.
Age - 15 yrs old
[Moderator's Note. Please do not edit
weight?
vetmedin for CHF]
Medication - he's on vetmedin and an inhaler for heart problems and chronic bronchitis. This morning I have him 12 mg of tramadol that i had leftover from his surgery years ago. .
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Post by Julie & Perry on Jun 17, 2020 11:55:56 GMT -7
Unfortunately, if Baxter hasn't seen them in a year they most likely won't give pain meds without taking him in. I'd get him in ASAP. You can put rolled towels around the inside of the crate to minimize movement. He needs a nsaid or anti-inflammatory, tramadol for general pain, gabapentin for nerve pain, methocarbomal for muscle spasms, and pepcid AC or the generic famotidine to protect his stomach. Conservative crate rest is much stricter than after surgery. Go to the main website at www.dodgerslist.com and read up about it. Sending you both healing thoughts and prayers. |
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Post by Romy & Frankie on Jun 17, 2020 13:32:22 GMT -7
Welcome back to Dodgerslist, Kim. I am sorry that Baxter is having another episode.
Julie has given you good advice. Baxter needs to be seen by the vet. This transport is necessary so do all you can to minimize movement. At the vet, let everyone that sees Baxter know how important it is for his back and neck to be kept stable as it is suspected IVDD.
As Julie mentioned, crate rest for a dog on conservative treatment is much stricter than post-surgery crate rest. In fact, 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 dragging or meandering at potty times.
◼︎no PT for conservative dogs during 8 weeks to heal disc
◼︎At home laser or acupuncture for severe neuro damage is best. Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment. Carry Baxter to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog’s back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to a minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on!
If, as expected, the vet puts Baxter on an anti-inflammatory he must take a stomach protector. This is because all anti-inflammatories cause excess stomach acids which can sometimes cause serious stomach damage. We usually see Pepcid AC used to minimize the chance of damage but because of Baxter's heart issues the vet may want to suggest another stomach protector or Pepcid AC in a non-typical dose. Please ask the vet what he recommends for stomach protection. Knowledge is the power to fight the IVDD enemy and win!! The very best thing you can do for YOU, the caregiver, and for Baxter is to get back up to speed on IVDDas soon as possible. Begin absorbing the must-have overall sense of meds, care and how the conservative 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:
--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 website
Please let us know what the vet recommends for Baxter. We will be wanting to hear. |
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Kim & Baxter
New Member
MALE - Chihuahua — Heart & Kidney
Posts: 35
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Post by Kim & Baxter on Jun 18, 2020 21:35:07 GMT -7
Thank you both so much. I did take him yesterday [6/17] to vca as an emergency visit (the neurologists are booked until 2 weeks). The vet examined him and prescribed gabapentin and tramadol. I will call in the morning and ask about pepcid dosage. They told me to see his normal vet about getting nsaids because due to his heart condition and age they'll want to do blood work first.
[Moderator's Note. Please do not edit
weight? 15 y.o.
gabapentin ?mg ?x/day
tramadol ?mg ?x/day
vetmedin for enlarged heart ]
By the way, he is on vetmedin to prevent chf but he doesn't have heart failure yet, just an enlarged heart.
I'm doing crate rest currently. He is still in pain so I'm going to try and get to his other vet tomorrow to get the difference medication. When he went potty tonight the [6/18] walking seemed worse :-(
During his last episode he was fully paralyzed in the front limbs and we did strict crate rest for two months and he had no improvement and that's when I did the surgery. So I'm very worried this time. I don't think he can handle another surgery at his age.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jun 19, 2020 4:06:27 GMT -7
It's very important that you get Baxter in to see his regular vet ASAP today. The sooner he can get on an anti-inflammatory, the better. Swelling presses on the nerves and causes pain and also causes the nerves to be damaged or even die. That may well be why his walking has worsened. Do all that you can this morning to get the proper meds on board - the anti-inflammatory to get the swelling down, pain meds to completely mask the pain until the swelling resolves and a stomach protector to protect against the side effects of the anti-inflammatory. Pepcid AC may not be the best stomach protector since Baxter has a heart problem so do check with the vet before starting. Methocarbamol should be added for the pain of muscle spasms which often accompany neck injuries. What date did conservative care start? Conservative care can work but you have to be very committed to keeping the movement of the spine to a very minimal and get the right meds on board. The worsening of his walking is an indication of nerve damage and could be due to the lack of an anti-inflammatory on board and/or too much movement. Please keep Baxter's steps to a very, very few at potty time. With conservative care, the less movement of the spine, the better. When going to the vet today, secure his crate in the car and pad it well with rolled up towels/blankets to prevent too much jostling around in the car and carry him in and out of the vet's office. You may not be able to go inside the vet's office so be sure that the vet tech is aware of the restriction of the spine limits. There are also several other things you should be doing to help the neck heal, such as softening hard kibble, raising food/water dishes. More info here: www.dodgerslist.com/literature/cervical.htmPlease let us know the exact dosage in mgs and frequency given of both Gabapentin and Tramadol and any new meds that are added today. How much does Baxter weigh? Weight?Tramadol ??mg ??x/dayGabapentin ??mg ??xdayHealing prayers for Baxter.
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Kim & Baxter
New Member
MALE - Chihuahua — Heart & Kidney
Posts: 35
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Post by Kim & Baxter on Jun 19, 2020 9:17:23 GMT -7
Thank you. I already carry Baxter everywhere because since his last episode he can't walk well on hard floors. I'm very committed to strict crate rest. As of last night he 6/18 could hardly walk. Right now he's on 25 mg of tramadol every 12 hrs, 1 mil of gabapentin every 8 hours.
[Moderator's Note. Please do not edit
11 lbs
tramadol 25mgs 2x/day
gabapentin mgs gaba in one mL? ?mgs (1mL) 3x/day
vetmedin for heart]
Conservative treatment started June 17. He is 11 lbs. Calling the vet now. However once again I'm very scared for him to go there, especially since I cannot go inside with him. I'm going to try talking to a mobile vet to see if they can come out and if not I'll take him.
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Post by Romy & Frankie on Jun 19, 2020 13:44:45 GMT -7
I know that it is scary to take our dogs to the vet these days. In some places it is just bring the dog in and then wait outside. Ordinarily this is something many of us would never do, but times are different now and it is very hard to tell when things will get back to normal.
It is important that Baxter be seen by a vet and prescribed an anti-inflammatory. The swelling that is pressing on the nerves can make things worse. Pain meds do not address this.
Please have Baxter seen by either a mobile vet or your regular vet. Once he has been prescribed an anti-inflammatory, Baxter will be able to heal in comfort.
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Kim & Baxter
New Member
MALE - Chihuahua — Heart & Kidney
Posts: 35
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Post by Kim & Baxter on Jun 20, 2020 13:58:03 GMT -7
Got Nsaids from the 2nd vet ✙(vetprofen 12.5 mg once a day) and am increasing ▲tramadol frequency to every 8 hours. Baxter has mild kidney issues but vet thought the risk is worth the benefit due to his pain level. Vet said he didn't want to give Baxter the antacid because of his age etc and says there's been no scientific evidence of it helping. I'm ok with this as Baxter wasn't on it throughout his last disc episode and steroids and didn't have any stomach issues. Baxter continues strict crate rest. Vet says if his pain doesn't subside soon I should take him for an MRI / surgery which would be great except I don't have the money. The last surgery was $13,000. So I'm hoping he can start to feel better soon.
[Moderator's Note. Please do not edit
11 lbs
✙ Vetprofen as of 6/20: 12.5 mgs 1x/day for ? days, then a test stop for: _pain / _neuro
tramadol 25mgs ▲3x/day
gabapentin ?mgs gaba in one mL?: ?mgs (1mL) 3x/day
vetmedin for heart]
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Post by Romy & Frankie on Jun 20, 2020 14:27:30 GMT -7
Good work getting the vetprofen for Baxter. Now he will have something working on the spinal cord swelling which causes the pain and neuro deficits like difficulty walking. How many days is the prescription for?
All anti-inflammatories cause excess stomach acid which sometimes lead to serious stomach damage. Stomach protectors help reduce stomach acid. Even dogs with other diseases can usually take a stomach protector although sometimes the dose or type of stomach protector is modified because of underlying condition. Consider speaking to your vet again about this. Since Baxter will not be taking a stomach protector at least for now, please monitor him very closely for any sign that stomach damage is starting. These signs would be not wanting to eat or drink, diarrhea and or vomiting. If you see any of these please call the vet right away.
If you are not planning surgery there is no need for an expensive MRI. A dog being treated conservatively will have all his discs treated at the same time. An MRI will show the location of the disc and are used to plan a surgical procedure or if conservative treatment is not working to diagnose another cause of spinal cord pain.
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Kim & Baxter
New Member
MALE - Chihuahua — Heart & Kidney
Posts: 35
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Post by Kim & Baxter on Jun 20, 2020 19:22:26 GMT -7
Thank you Romy & Frankie. What the vet meant was that if Baxter is still in pain he would need the MRI AND surgery. His last surgery was so successful but i dont have the money now.  I went to VCA west los angeles before. and it was 13k. I saw on the list of costs on this board some people were saying 5 or 6k! How is that possible. The MRI alone here is 5k. I can see my dog going down the same road as he was then. I know surgery will help him and this is really a nightmare not being able to afford something that will make him better. There's also the issue of him being 15 years old with a heart condition, but he recently underwent anesthesia for tooth extractions and did well. |
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,546
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Post by PaulaM on Jun 20, 2020 19:33:21 GMT -7
Kim, if Baxter is still in pain with those med adjustments, what that means is the meds are not yet right. It does not mean you need to proceed to a surgery. I may mean this vet is not IVDD knowledgeable and is pushing a surgery because he is not comfortable about IVDD. Surgery costs vary widely across the USA. Large cities where taxes are very high, insurance high contribute to high costs of surgeries. Please do not be swayed by vets who do not know IVDD. Instead have information under your belt so you know what to advocate for or even hired a new 2nd opinion IVDD vet if need be. Hopefully you will find you CAN advocate if need be and this vet will be willing to learn, willing to do a little homework himself. Excellent background knowledge to help with conservative vs. surgery: www.dodgerslist.com/literature/healingsurgery.htmPlease be detailed in reporting what you currently observe. What does this mean in terms of the now?: I can see my dog going down the same road as he was then. What is getting worse now? Please clarify. NOTE: Gabapentin is excreted by the kidneys. owner knowledge of meds is key: www.marvistavet.com/gabapentin.pml Tramadol is removed by the liver. The beauty of tramadol as a pain reliever is that it is compatible with Vetprofen, possibly even synergizing with them. The same is true with tramadol combined with gabapentin. owner knowledge: www.marvistavet.com/tramadol.pmlImportant QUESTIONS:
1) Vetprofen as of 6/20: for how many days?
2) Gabapentin how many mgs of gaba are in one mL of liquid. That info should be on the bottle. |
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I went to VCA west los angeles before. and it was 13k. I saw on the list of costs on this board some people were saying 5 or 6k! How is that possible. The MRI alone here is 5k. 
