|
Post by Dawn1976 on Aug 31, 2020 22:36:29 GMT -7
[Original subject line: Ollie 8.5 year old dachshund loss of back leg movement ]
This story is kind of crazy. Came home Saturday evening around 7pm after being gone 2 hours ,found my standard male dachshund Ollie yelping and acting like he was in pain. Rushed him to the emergency vet . She was a horrible awful human with zero compassion, claimed he was paralyzed in his back legs and would need surgery. But there was nobody to do ct scan and surgery till monday . She said it would be too late by then and sent us home with 3 meds gabapentin, tramadol and rovera. [Moderator's Note. Please do not edit 29lbs Rovera® (carprofen) as of 8/31 ER: ?mg ?x/day for 7 days STOP test 9/6 gabapentin ?mg per 1 mL liquid: ?mg 2x/day tramadol ?mg ?x/day needs GI tract protector, Pepcid AC, on board w/Rovera®! ]He came home in a great deal of discomfort and originally was holding his neck in an upward motion and seemed unable to lower head. Didn't or could not drink water so i syringed in little bits of water. By afternoon early evening sunday his neck holding had relaxed greatly and he was laying in crate seemingly ok other than not being able to move hind legs.he started to drink water and ate chicken breast . He still had sensation when you touched his pads and toes of his feet . And full use of front legs ,head etc. So Monday morning ,today i take him in for second opinion by a much nicer vet and a surgical consult. They agreed he did indeed still have some feeling in toes and that we would proceed with surgery to the tune of 6 grand . First stop ct scan. I get a call from surgeon saying uhh we just did ct scan and i don't see the site of injury. I cant see what disc it is to even proceed with surgery. There are 5 areas i see some shadows and areas of possible inflamation etc but no clear disc injury. What the heck? So the decision was made to wake oOlie up and not do surgery because we had no clear thing to do surgery on. He still cant pee or poo on his own and that has me stressed to the max. Still no use of back legs. He is staying at vet hospital for 2 days where they will observe to see if any improvements. meanwhile they will teach me how to express his bladder as i tried over 20 times with no sucess. I can handle if he is paralyzed but the not being able to urinate has me scared to death. Do you think he has any chance of recovery since it seems its not a clear cut slipped disc? Also what the heck is then causing the loss of hind leg movement. He otherwise seems like he is improving and meds working as far as less pain neck doing better etc. Any insight as to if he may regain bladder function even if paralyzed or if so when do you see bladder function usually return ?
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Sept 1, 2020 5:30:51 GMT -7
Welcome to Dodgerslist, Dawn. 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. Know more about us and how we team up with veterinarians: dodgerslist.com/about-team-dodgerslist/**Disc disease is not a death sentence! Struggling with quality of life questions? Re-think things: dodgerslist.com/2020/04/18/hope-quality-life/Have you been given a diagnosis other than IVDD? To be honest, in all of my years here on Dodgerslist, I don't recall ever seeing a situation like this, where a scan was done on a dog with no leg movement but no damage was seen. Something is certainly pressing on the nerves of the spine which caused nerve damage. Any time IVDD is suspected, the dog should be treated for IVDD to protect the spine from further damage. If surgery is not possible, then conservative care (8 weeks of strict crate rest) certainly is an option. You need to be very, very strict about limiting movement of Ollie's spine when he comes home, more on that below. And yes, Ollie's nerve damage can heal with conservative care, but think more in terms of months, even a year or more, rather than days or weeks. As for bladder control, that can come back in time but no one can give you a time frame for that return or any guarantee that it will return. However, please don't be intimidated by expressing. It can take some practice to learn but it is something that becomes very routine. Review this page before your demonstration by the vet: dodgerslist.com/2020/05/05/bladder-bowel-careWhen Ollie comes home, we'll need the following information. Meanwhile, read down to #4 for tips on how to set up his recovery suite for his return home. ❖1 Is there still currently pain? ☐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 dose to dose. If not in control your vet needs to know asap to adjust meds. Neuropathic pain is not common but you should be aware of it. 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: dodgerslist.com/2020/06/10/neuropathy/?highlight=neuropathic❖2 How much does your dog weigh? …A Please provide a list of the exact names of meds currently given, their doses in mgs and times per day given. …B If on a steroid….what was the start date & dose? Date of steroid taper? If on a NSAID, for how many days has it been prescribed for? …C PEPCID AC: Anytime a dog is taking an anti-inflammatory, stomach protection must be added. Ask if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health” issues answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine). i.ibb.co/DCN9611/91x-Aj-s00z-L-SY355.jpgDoxie weight dogs: 5mg Pepcid AC (famotidine) every 12 hours. NOTE: Pepcid AC (famotidine) for dogs is 0.44mg per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory. www.1800petmeds.com/Famotidine-prod11171.html❖3 GI Tract problems? —Eating and drinking OK? No nausea/not eating, no vomit? —Poops OK? Normal firmness & color -no dark black or bright red blood indicating bleeding ulcers? No diarrhea? ❖4 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. Super tried and true tips for setting up the recovery suite, the mattress and more! —> dodgerslist.com/2020/05/14/strict-rest-recovery-process/STRICT means: ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy whys: dodgerslist.com/2020/04/22/chiropractic/?highlight=chiropractic◼︎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. ❖5 Overflowing bladders need to be expressed to avoid UTIs. Review video then get a hands-on-top-of-your-hands expressing lesson. dodgerslist.com/2020/05/05/bladder-bowel-care❖6 Currently can your dog move the legs at all? or wag the tail when you specifically do some happy talk? ❖7 Did you specifically get a diagnosis of IVDD, aka: a disc problem, a disc herniation, a bulging disc, slipped disc? — Is the vet a general DVM or a specialist surgeon: ACVIM neurology or ACVS ortho? 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. ~~ During conservative treatment, anytime out of the recovery suite is a dangerous time for the healing disc. Movement of the back can increase a disc tear and escape of disc material into the spinal cord . For an animal with very mild neuro deficits, the risk of transporting to therapy has to be carefully weighed against what benefit is to be gained. www.ahvma.org/find-a-holistic-veterinarian/~~ Why Chiropractic is not recommended for IVDD dogs: dodgerslist.com/2020/04/22/chiropractic/?highlight=chiropracticKnowledge 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 soonest 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. ﹆1 Remove yourself from the dark scary unknown. Be in command of the 4 phases of healing, what to expect with pain, with swelling, disc and nerve healing. Get up to speed: dodgerslist.com/healing-the-disc/** dodgerslist.com/wp-content/uploads/2020/07/Fridge-Flyer-promo.jpg﹆2 Two FRIDGE FLYERs to print out a) Help all of your family recognize emergency signs and action to take. dodgerslist.com/wp-content/uploads/2020/07/emergency-fridge-flyer2.pdf b) Avoid dangerous detours with the Conservative Roadmap for your fridge: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf﹆3 Excellent IVDD video playlist: www.youtube.com/playlist?list=PLGTcmjenJIkUNy9ke7IvPlFIMKFfjBSen ﹆4 At the MAIN WEBSITE, use the orange SEARCH bar feature to easily access the treasure trove of more IVDD information. You will feel so very empowered to help your dog! dodgerslist.com/The guest board is a temporary Guest courtesy to get immediate help until you can register. I encourage you to register and login. That way all the features of the Forum are available to you, making it faster to reply and get an email alert about replies. It also makes is far easier for us to track your dog and give the best assistance. Illustrated what to expect during registration: www.dodgerslist.com/forumads/RegisterFORUM/register.htmPlease keep us updated on Ollie's status. Healing prayers for Ollie.
|
|
|
Post by Dawn1976 on Sept 1, 2020 7:27:21 GMT -7
My surgeon said in all the years of doing this surgery which is his specialty by the way and a surgery he actually loves doing because it has a high success rate he has never seen this. He even brought in the lead radiologist to look and they both agreed they did not know what they were looking at . But with his injury it seems like IVDD but the evidence is not there to do surgery as such . They talked of shooting dye into the spine to try to get a little better picture of which areas were more affected but he said if more than one of those spots lights up that still doesn't zero in on which one it may be and we would be stuck in the same spot we are now. Again theres certain things that show a telltale slipped or pressing disc and they dont see it. So i declined and said just wake him up and lets moniter him. The agreement was we leave him at pet hospital for 2 days and they will moniter and also hopefully be able to show me how to express. Ollie is a big dachshund about 29 pounds and his shape and size are making finding his bladder difficult . Im willing to help him as long as i can learn how to express and his pain is manageable . I dont want him to suffer. Im so mentally exhausted and so confused as to what it could be. I agree something is putting stress to the spine or his back legs wouldnt be lame . Im hoping that his ability to urinate will come back . Does anyone have any stories about how long it too for that to return for your dog if they were paralyzed in the back legs? Im planning on strict rest and little movement with the exception of expressing him. Some say to stand him up and try to make his feet touch the ground and get his brain to reconnect with his legs . Is this good advice? I will ask about pepcid ac , As of right now they cant give me a clear diagnosis.
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Sept 1, 2020 7:58:40 GMT -7
I wish I could give you some idea if or when bladder control will return but no one can do that. Comparisons with other dogs is not helpful either since no two dogs are alike. You can certainly read through the posts in our forum and members can share their experiences with you. But that really won't tell you how Ollie will do. Some dogs regain bladder control during the 8 weeks of strict crate rest, some very quickly, while others never regain it. The fact that Ollie still has deep pain sensation is a good sign that there will be healing ahead but it's impossible to say how much or when. While there is no time frame for return of function, it is known that neurological function usually returns in the reverse order of the damage. The first big sign you want to look for is that wonderful tail wag! 1. Deep Pain Sensation (Only correctly identified by a specialist.) 2. Tail wagging with joy at seeing you, getting a treat or due to your happy talk. 3. Bladder and bowel control proved by passing the "sniff and pee" test. Take your dog out to an old pee spot in the grass. Let him sniff and then observe for release of urine. 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 placed paws. 6. Ability to walk unassisted and perhaps even run. Not being able to walk or having to be expressed does not mean that Ollie will suffer. The pain that he now has will be masked by pain meds and once the anti-inflammatory does its job of getting the swelling down, the pain will be gone. That can take 7-30 days. He will rest in his crate with very limited movement of his spine for 8 weeks and then can gradually be reintroduced to movement so his strength and stamina can be gradually built up. At that point, if he still has neuro loss in his legs, there is PT that can be done, either at a facility or at home, to help with that. Also acupuncture and/or laser can help. Sometimes it just takes time for the nerves to heal. My own dog, Jeremy, a Cocker Spaniel, did walk again after being paralyzed but he was not as fortunate with bladder control (though many, many others have been). I've been expressing Jeremy for 9 years and it's no problem whatsoever. I no longer have to take him out in the dark or the snow or rain. I just take him into the bathroom and express him. It's become so very routine for both of us. One day my daughter asked me to let her dogs out to do their business and I actually leaned down to express them! That's what's normal for me and Jeremy and I don't think twice about it. The first few weeks were challenging but then it was fine. Standing Ollie up and trying to get his feet to touch or feel the ground is a form of physical therapy and cannot be done during the 8 weeks of strict crate rest. The less movement of the spine the better. Too much movement and the damaged disc can tear more, causing more harm to the spine. You're on the right track with little movement except when expressing. I know the shock of IVDD can be overwhelming. The best thing you can do for Ollie right now while he's in the hospital is to prepare his recovery suite for his return and to read, read, read all that you can to learn how to fight this disease. Knowledge takes the fear away. Here's the best place to start your reading: dodgerslist.com/in-the-right-place/Try to take it one day at a time. No one knows what their future holds but you're learning what you can do for Ollie today. I've learned so much from Jeremy about how to live in the moment. And he and the other dogs on this forum show us how quickly they can adapt to their situations, much better than we humans can! We're here for you and Ollie and will help you through his recovery. Stay strong, stay positive and never give up hope! Healing prayers for Ollie. Here's a link to our page of success stories to give you hope and encouragement, Dawn.
|
|
|
Post by Dawn1976 on Sept 1, 2020 12:13:12 GMT -7
I went to the pet hospital today and was able to express a little from Ollie. He seems to be in good spirits today and is clearly feeling much better pain wise . He still has no use of back legs nor can he urinate on his own BUT the vet tech said early this morning they found a good puddle of pee in his cage which could possibly be an encouraging sign. I thank you for your detailed replies and although overwhelmed i am committed to providing ollie with the best care i can no matter what . He has brought so much joy and love to our family over the years ill never give up trying to help him. Im praying for continued improvement and that i will in fact be able to do expressing at home with confidence .
|
|
|
Post by Romy & Frankie on Sept 1, 2020 13:04:16 GMT -7
Good job on starting to express, even if only a little. For me, learning to express was very difficult. I had to have several hands-on lessons from the vet and vet tech. Even then I struggled. My dog Frankie was about 60 lbs and I had to figure out how to support him while expressing. I was afraid I would never get it right. But I practiced and I learned, and I was able to express my dog for as long as he needed it. You will learn too. Once you do, taking care of Ollie will be much, much easier.
|
|
Mary & Mila
Helpful Member
FEMALE— DACHSHUND
Posts: 218
|
Post by Mary & Mila on Sept 2, 2020 4:04:52 GMT -7
Hi Dawn, I'd also like to add my welcome to Dodgerslist to you and Ollie. Great that you're getting on with the expressing and I know that Marjorie posted you a link yesterday, I'm going to repost it in case you missed it, as there was a lot of other info to take in as well. It's a great link to reference and there's a very easy to follow video there too, should you need it. dodgerslist.com/2020/05/05/bladder-bowel-care/Kind regards Mary
|
|
|
Post by Dawn1976! on Sept 3, 2020 22:22:24 GMT -7
So today [9/3] we agreed to bring Ollie home as his pain level is low and I have been able to express some . We agreed upon a charge for simply expressing if I should need to bring him back in for help and he will have a follow up on Tuesday [9/8] to see what kind of progress he makes . When I brought him home he was overjoyed to be here . He still could not walk or use bathroom . Tonight I took him outside and he smelled where one of my other dogs peed and he actually peed some! I had to help with the rest but he did pretty good . About 25 minutes later settling down for bed he involuntarily peed in his crate. I guess good news is the pee is not trapped in him but being let out lol. I also bought a sling to use on his rear when he is feeling a bit better and more stable. But I am pleased so far with where we are at . He seems to accept the crate fate lol I think he needs lots of rest . I thank you again for everything .
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Sept 4, 2020 4:31:54 GMT -7
So glad to hear that Ollie is home, Dawn. And it does sound as though he has some bladder control since he smelled where the other dog had peed and was able to release urine on his own! That's truly wonderful news. Since he involuntarily peed in his crate shortly after, that indicates that he is unable to completely empty his bladder on his own so you did exactly right by trying to express him after he went on his own. You two make a great team! Try taking him out every 2-3 hours until you become proficient at expressing him or he can completely empty his bladder on his own. The bladder will get smaller as he goes on his own so it may be a bit difficult to find the bladder to express. Sometimes it hides back by the pelvic area and you need to push it forward a bit to express. Involuntarily peeing in his crate means that his bladder is overflowing and there is still urine in his bladder, it's just the overflow that you're seeing. That isn't healthy for his bladder as urine lying for too long leads to urinary tract infections. The goal with expressing is that Ollie stays dry between expressing. But you'll get there! The sling can be used now to support Ollie when he goes out to potty. A harness and 6 foot leash is to control speed and keep footsteps to a minimum as you stand in one spot. With a sling supporting his hind end, he should be able to take a few steps with his front legs but do keep those steps to a very, very few. Carrying him out without a leash and harness may be fine but if he should start to feel better, there's a chance that he might try to take off and damage his spine more. Here's a photo that will help show you: When you say that Ollie's pain level is low, does that mean he's still showing signs of pain? Pain should be completely under control with no sign of pain appearing from one does of pain meds to the next. Have no patience with pain as it does hinder healing. Should you see any sign of pain, do contact the vet to advise so pain meds can be adjusted. Please let us know what meds Ollie has been sent home with with the name of the meds, their doses in mgs and times per day given.Transport to a vet involves risk of too much movement of the spine and should be kept to only vitally necessary visits. Vets who understand the importance of strict crate rest will agree to getting updates by phone to avoid the risk of transport. Please speak to them about phone updates rather than taking Ollie in for an exam. There is no reason at this point for him to be examined. If there are improvements, though it's still very early days to expect improvement, you can observe them. Keep practicing expressing and taking Ollie out often to avoid the necessity of bringing him in to the vet to be expressed. The less movement of the spine during conservative care, the better. Too much movement and the damaged disc could tear more, causing more or permanent damage to the spine. Please do register so you have full use of the forum. www.dodgerslist.com/forumads/RegisterFORUM/register.htmPlease continue to keep us updated.
|
|
|
Post by Dawn & Ollie on Sept 4, 2020 13:25:43 GMT -7
So Ollie was sent home on 1ml of gabapentin every 8-12 hours as needed for pain and carprofen 100mg tabs 1/2 a tab by mouth every 24 hours till gone. [Moderator's Note. Please do not edit 29lbs Rovera® (carprofen) as of 8/31 ER: 50mg 1x/day for ? days gabapentin 50mg/mL: 50mgs (1mL) which: 2x or3x/day? needs GI tract protector, Pepcid AC, on board w/Rovera®! ]
I am doing my best to express him and so far it seems touch and go like sometimes after a good bit of water he goes much easier but today he seems indifferent about drinking . When I say low pain he is not showing any outward signs of pain but that could be because the meds he is in are providing enough relief he was originally also taking tramadol and that was discontinued because he was doing so well .
His recovery suite is set up he isn’t to happy he is in there but he seems to accept it . His recovery suite is a soft sided octogon pen I got on amazon with food water a blanket and pee pads down in case of accident . I will continue to offer him outdoor potty time . I know he probably urinated in his crate last night because we didn’t get it all when expressing but we are trying hard I hope he regains gradually the ability to fully let go . As of now he seems to only be able to go a little on his own I help him with the rest .
|
|
|
Post by Romy & Frankie on Sept 4, 2020 13:50:24 GMT -7
Good news that Ollie is not showing any signs of pain. If he can remain pain free without the tramadol than no need to take it.
As long as the recovery suite is large enough to only allow Ollie to stand up, turn around and stretch out when lying down it is fine. It is also important that the crate can keep him confined even after he feels better. If the pen you got from Amazon is this size it is fine.
Ollie is just beginning to regain bladder control. Sometimes control doesn't all come at once. As you continue expressing Ollie you will get better at it. The fact that you are able to get urine, even if not all of it, shows you are learning. Many, many of our members have struggled with this but by persevering they succeeded.
Until you no longer find wet bedding continue to express after he goes outside to keep his bladder healthy.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
|
Post by PaulaM on Sept 4, 2020 19:07:27 GMT -7
Dawn, very good points Romy makes above. Don't hesitate to get another hands-on-top-of-your-hands type of expressing lesson if you need one. It is a health issue to prevent permanent damage to the bladder with overflowing. And to prevent bacterial bladder infection can move to a life threatening kidney infection.
Would you fill us in about his med list so we are prepared to comment correctly.
[Moderator's Note. Please do not edit 29lbs Rovera® (carprofen) as of 8/31 ER: 50mg 1x/day for ? days Let us know when the last date to dose will be
gabapentin ?mgs in one mL?: ?mg (1mL) which: 2x or3x/day? 1. Look on the gabapentin bottle for the formula. How many mgs of gabapentin are in one mL of liquid? 2. Which do you actually give gabapentin- every 8 or every12 hours?
needs GI tract protector, Pepcid AC, on board w/Rovera®! Ollie needs Pepcid AC (famotidine) during the use of Carprofen as Marjorie explained in her Sep 1 post above. Is there a health reason Ollie is not taking Pepcid AC?
|
|
|
Post by Dawn1976! on Sept 4, 2020 22:58:03 GMT -7
I’m only giving the 1ml of gabapentin every 12 hours . There’s CB no medical reason he can’t take Pepcid ac and I asked the vet and the surgeon both said there was no need since he would only be on it for about 6 days . Not sure why they did not seem keen on it as I pushed it a bit asking about it . I’m perplexed by his bladder situation. I have been monitoring his water intake pretty closely, this evening we expressed quite a bit and he did again a few small streams on his own . He also let loose when I used the band to help support his back end I guess it pressed on the right spot . What was crazy was again after getting him set up in bed for the night within 15 minutes his bladder released in his bed crate . Kind of crazy as he really didn’t drink much and we had already let so much go earlier in the evening . I also might be wrong but I notice he seems to have more accidental release after a dose of the gabapentin. He will be rechecked on Tuesday morning which I feel is good as it gives us a few days of home time to see how things are going .
[Moderator's Note. Please do not edit 29lbs Rovera® (carprofen) as of 8/31 ER: 50mg 1x/day for 7 days STOP test 9/6 Gabapentin 50mg/mL: 50mg(1ml) 1x/day No stomach protection on board!]
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Sept 5, 2020 4:39:27 GMT -7
GI issues can come up very quickly with very little use of the Carprofen and can worsen quickly. Ollie doesn't need anything else to deal with. Plus the vet doesn't know if Ollie will only be on the Carprofen for 6 days since there may still be pain/swelling when stopped and Ollie may need Carprofen for a bit longer. It can take 7-30 days for the swelling to resolve and until then, the anti-inflammatory is needed. If there are no health issues, such as heart or liver, then do get Pepcid AC on board. 10 mg of Pepcid AC (Famotidine) 30 min. before the Carprofen and then every 12 hours thereafter for as long as Ollie is on Carprofen.
Carprofen was started on August 31, which is already 6 days. On what date will the Carprofen stop?
It's very important for us to have a complete medical list so we can advise you properly. Please check the Gabapentin bottle and let us know how many mgs are in one ml.
How often are you taking Ollie out to potty? Without complete control of his bladder and until you learn to completely empty his bladder, he'll need to be taken out quite often, every 2-3 hours. Be sure to take him out right before bed as that's the longest period of time he'll have without a potty break. As the bladder empties, it becomes smaller and can often slip away from our hands so you'll need to find out (often back by the pelvic area) and keep pressing until the bladder feels flat, almost like your fingers are touching.
Please do reconsider taking him in for an exam on Tuesday. Transport really does pose risk of too much movement of the spine and then there's the exam where he will be moved. The safest place for Ollie is in his crate except for necessary potty breaks. Any updates can be given by phone to the vet. You're already doing what's best for him with the strict crate rest so there's really no need for an exam unless Ollie's condition were to worsen. If there is an absolute need to take him in, be sure to secure his crate in the car and pad it well with rolled up towels/blankets to prevent him from jostling around too much when you brake or turn corners. It really would be best to leave Ollie safe in his crate for his spine to heal.
|
|
|
Post by Dawn & Ollie on Sept 5, 2020 7:51:27 GMT -7
On the bottle it says 50 mg [?] for the gabapentin and to distribute 1ml of that every 8-12 hours which I am doing every 12 as that seems sufficient.
I will get the Pepcid ac he only has enough caprofen through tomorrow [9/6] morning . There enough gabapentin till Tuesday morning.
I believe the reason for recheck is 1. To see if I am expressing his bladder properly and 2. To visually see if they notate any change with their own eyes. I mentioned to the vet I saw his tail seemingly move a few times but it’s random he wants to check that as he says some movements are involuntary. 3. He won’t give further meds than what we already have until he is seen.
Originally they were going to keep him several more days due to his bladder But as I mentioned we agreed upon a plan by where I am able to bring him home and work with him from here and I have the option for $34 to bring him back to the pet hospital for expressing only should we need it . If I had left him it was $130 a day for medical boarding . I am in California where nothing is cheap.
Ollie seems very resistant to drinking water for some reason which makes expressing him difficult because at times there just isn’t much in there . After the episode in his crate where his bladder released that last time he stayed dry all night and I was not able to express any this morning. But again he didn’t drink anything after 8 pm so I don’t know if he is empty or not . I am expressing often though . It’s frustrating because I don’t want him ending up with a uti.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
|
Post by PaulaM on Sept 5, 2020 16:35:28 GMT -7
Dawn, Things you must report via a phone call asap to the surgeon or vet at that hospital!--- red flag sign of stomach damage or other toxicity. Not wanting to drink while on carprofen! Discuss adding right now, today, to the Pepcid AC (famotidine) PLUS an Rx for Sucralfate you can get filled today/asap Sunday. ----Or it may be to immediately STOP the carprofen! Let us know which the vet wants re: NSAID. READ UP on NSAIDs: please: www.fda.gov/AnimalVeterinary/ResourcesforYou/AnimalHealthLiteracy/ucm196295.htm
GABAPENTIN formula. The formula may be printed such as: 50mgs/1mL OR 50mgs/5mL OR ??? -- please take a picture of the bottle and up load or write out exactly as it reads on the bottle.
Very unusual circumstances of the CT showing no signs of disc damage but yet there is spinal cord damage. Plus issues of expressing the bladder fully, making the surgeon want to examine Ollie to get a better handle on the diagnosis and what the correct treatment should be. Things to add to your list of questions for the 9/8 surgeon appt:-- What is your top diagnosis causing leg paralysis, what other diseases might be the cause? -- Discuss where Ollie is neurologically -- Make sure YOU express right there in the clinic. Have the vet tech or the surgeon then check your work if all the urine has been removed. Give you extra pointers and expressing tips. -- Discuss with the surgeon any medications to help relax the sprinter muscle that might help you to more easily express. -- Ollie was Rx'd by the ER vet for a 7-day course of Carprofen. Normally at the stop on 9/7, pain meds are also stopped so you can clearly observe if there is any hint of pain still being observed. Pain = another carprofen course. Discuss what approach your surgeon recommends. TRANSPORT in the safest manner possible to protect the suspicion of a damaged disc. -- Keep his back horizontal to the ground -- Support both ends when lifting and carrying. -- Pad out the crate in the car with rolled up blankets snugged up to Ollie's body. This prevents his disc from getting jarred with a stop or taking a corner. -- Make arrangements ahead of team with the clinic, to have someone help you negotiate bringing him in if you need that assistance to be safe with Ollie's back.
|
|
|
Post by Dawn & Ollie on Sept 5, 2020 19:05:03 GMT -7
I didn’t mean to cause alarm buy the not drinking part . To be honest he was never a dog who drank a whole lot . He IS drinking just not as much as I would like .
The bottle says Gabapentin (gen) 50mg/ml/ml DISPMED Give 1ml by mouth every 8-12 hours as needed for pain or discomfort .
He really appears to be in zero pain so I don’t even know if I will give him his dose tonight .I got the Pepcid AC .
Because the ct scan did not show disc damage they donot have a diagnosis. It could be some of the jelly like substance is seeping out between the discs , it could be swelling , or it could be a disc that is slightly pushing but not actually out . There was no mineralization to be seen anywhere on the scan. The radiologist also agreed they don’t see anywhere to perform surgery . Believe me I know how crazy this sounds .
The bladder issue is the most concerning . Again at times I see him sniff a pee spot and out squirts some urine but it isn’t a lot and I’m not sure why he still can’t let go . We have expressed many times today each time yielding small but steady amounts but no flood so to speak .
He is on crate rest and has not had an accident in his crate yet today .
We are using the sling to assist his hind legs .
He still has sensation in his toes and will jerk his leg if you mess with them to much . I take that as a positive that that has not changed .
I use an ice cube on his rear to get him to poop and it works really quick and also when I put the ice cube there his tail wags back and forth as if he is reacting to the cold but he doesn’t seem to be able to wag out of excitement or happiness.h But he does seem content and his demeanor seems generally happy.
I’m not sure what will continue to be prescribed but will keep you up to date come Tuesday . He also eats very normally which is good . He is annoyed at being in the crate but I make him do it anyways .
|
|
|
Post by Dawn & Ollie on Sept 6, 2020 9:32:22 GMT -7
I feel like a broken record about ollies bladder but i dont know what else to do. I have had 3 seperate people at the vets office show me how to express ollie . All three of them had alot of trouble themselves and so did the surgeon .
He said ollies shape and size are making it difficult to express him. He would not go last night nor did he go this morning. He has drank water , At no point not now not ever have i felt his bladder. The vet tech admitted to me she doesnt really feel it either and that she has had alot of troube finding it . Great .
Im literally just winging it and am in tears . the very first day he came home from the pet hospital i was hopeful as he seemed to go a little on his own and also when i pressed him i was able to get a bit out. Now it seems i cant get anything . He is acting perfectly fine he isnt whining crying or uncomfortable. I have tried several different ways and none produce results. Im starting to see the only time he goes [OVERFLOWS] is when his bladder is very very full and even then it is almost by accident. Like yesterday he was full but would not express it was crazy i tried and tried then we put the sling under him and walked him around the yard a bit and nothing . the minute we came inside his bladder just let go but i could tell it was not intentional. If i cant get him to go by noon ill have no choice but to transport him to the pet hospital to have them do it . I am over the top stressed and sad .
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
|
Post by PaulaM on Sept 6, 2020 10:00:35 GMT -7
Dawn, I can imagine how stressed you are about the expressing.
First. AVOID walking him around in the sling. At minimum he should ONLY be taking a very fewest of footsteps, not walking around. This is to protect the disc and avoid a permanent paralysis.
Can you phone the hospital and explain your concerns of no ability to express the bladder and concern to take more than a few footsteps to let him sniff?
--- Discuss a medication that will relax the neck of the bladder so that you are more easily able to manually express. Prazosin relaxes the muscle that surrounds the neck of the bladder.
--- Would an antibiotic on board be advisable, since urinary tract infections can begin in as little as a couple of days, when a dog is not being properly expressed?
--- Vocabulary: PEEING- means the dog has bladder control to choose where to release urine BLADDER OVERFLOWING- means dog has no bladder control. Reflexes release some urine when the bladder reaches the over stretched point full of urine. TWO Problems: 1) is the urine that remains invites bacteria to breed. 2) Continuous over stretching of bladder muscles can cause them to loose tone permanently. When the brain can again give directives about releasing urine the bladder will no longer function as it should with loss of bladder muscle tone.
Let us know if you get thru to the pet hospital today and what they advise.
|
|
|
Post by Dawn & Ollie on Sept 6, 2020 10:10:09 GMT -7
I have already been on the phone with them this morning. They don't really have any other advice except that if i cant get him to go by this evening to bring him in .
The last time his bladder released [OVERFLOWED] was about 8:45 last night , again i dont feel he dd that on purpose. They felt i should give him a little longer than just noon. Its also 122 degrees here in the desert today so standing outside trying to express a dog in this heat poses its own challenges .
I will ask them about the medication to help relax his bladder .
Thank you for the reply im just so worried about my baby and want to do right by him . I am just dumfounded at how so many on videos i see on the internet make expressing a bladder seem so easy yet even with my own eyes i see people who do this every day still struggling to express my dog. Also admitting they cant feel his bladder either. How can i express what i cannot feel if that makes sense.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
|
Post by PaulaM on Sept 6, 2020 10:12:15 GMT -7
The time to stop meds is the date Rovera stops. What date will Rovera stop?
On the stop of Rovera and all pain meds, then you observe for pain or any decline in neuro functions.
100% STRICT rest is how the disc heals. --- Avoid any tickling of the paws as that may cause too much movement for the spine. --- avoid sling walking if you are trying the sniff and pee test. Only minimal footsteps are allowed to protect the disc and the spinal cord. For me having an ex-pen in the grass or on the back deck was of great advantage. No harness leash needed as a form of control from darting off. The ex-pen gave visual notice there would be no darting off nor walking around to sniff. I only used the sling to help support the back legs. Is that something you could try? Maybe your deck is also shaded?
In Winter I used snow on the deck. In Fall you could just place a pee pad inside the 6 foot diameter ex-pen area for Ollie to sniff and pee if he can. Give him a minute or less, if nothing, then test is over bring him back inside where it is cooler to express. You could try another sniff and pee test later or another day.
Follow up with trying best you can to express. Some dogs just are very hard to express. ope the vet will offer to consider a med to help relax Ollie's bladder neck.
|
|
|
Post by Dawn & Ollie on Sept 6, 2020 10:24:18 GMT -7
His last does of meds was yesterday morning of rovera. I have not even given him the gabapentin as he appears to be in zero pain . He did get the pepcid ac yesterday . [Moderator's Note. Please do not edit 29lbs Rovera® (carprofen) as of 8/31 ER: 50mg 1x/day for 7 days STOP test 9/6 for: _pain/_neuro]Our backyard is only dirt as we live in the desert and have desert landscape. I worry about allowing him to drag in the dirt. The minute i put him down to pee all he wants to do is take off. When his bladder overflows inside he looks so sad even though we reassure him its ok and he isnt in trouble. Again with the exception of not being able to walk or urinate on his own he acts normal , happy, barks when he hears something outside and appears to be in zero pain. Its all so confusing. Again i do appreciate all your help im just exasperated . The picture is ollie on his way home the other day from the pet hospital .
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
|
Post by PaulaM on Sept 6, 2020 11:17:00 GMT -7
Dawn, glad to hear no meds and zero pain today. Fingers crossed as Rovera is leaving the body in 5-7 days you will continue to see no signs of pain! All that remains is 100% STRICT rest with the suspicion this is a disc episode. Do what you can to avoid any dragging around. Getting an ex-pen for your deck or for the backyard dirt will give Ollie physical indication he is not going to be dragging around. Your use of a sling prevents dragging the legs at times you perform the sniff and pee test. Sling needs to be removed at last minute during the test so it is not pressing on the bladder (as in expressing). At that point you can use your hands to support his thighs.When you express him, then you have your hands on his body to control him from darting off. Best is to express inside the house. My dog always tensed up outdoors smelling things, seeing things of interest. Made it so hard to express. You can express him inside adjacent to his recovery suite. Put a pee pad down next to the crate to express on. Option: if you have a shower with a non-slip mat for Ollie, then you can sit on a RubberMade stool or the like as you express in the shower stall. After Ollie is back in his suite, it's easy enough spray the stall clean again and spritz some white vinegar, also to leave a clean smell. Replace vinegar bottle cap with a hand sprayer. TRANSPORT safety tips - A crate is necessary for transporting a dog. - Paralyzed dogs can jump off the seat. Owners have to be one step ahead of our little furry creatures as they do the expected in a blink of an eye. Owners have been devastated their paralyzed dog would even think to go down a flight of stairs and then the need to start back at square one in conservative treatment. - A vehicle stop or turn can cause a dog to unexpectedly shift his body to cause too much movement to the back/neck. -- Pad out the crate with a rolled up towel or blanket snug up to Ollie's body. This prevents his body from shifting during the transport.
|
|
|
Post by Dawn & Ollie on Sept 7, 2020 13:40:52 GMT -7
Ok so last 24 hours have been a rollercoaster. Finally around 12:30 yesterday on one last desperate attempt i took ollie out and i hit the right spot and was able to express quite a bit ! I felt like i just won a marathon.
He drank some but again he is kind of a butt about drinking and so i had to keep encouraging . Every time i would put water in his recovery suite he would either try to put a pee pad over it [bowl] or knock it over so now im offering him water every hour instead of leaving it in there . Besides his recovery suite i also have a large clear plastic tub that I use for him to both sleep in at night and as a place i put him into with a blanket and pee pads under him when i attempt to express inside . He finally has gone twice in the plastic tub onto the pee pad . Something about being put in there relaxes him and makes him feel its ok to go. When i tried pee pads on floor or table he would not cooperate and acted like he was tensing his muscles . He knows he isn't supposed to pee on the floor so i think he was having stress about that. But in the plastic tub he seems to feel that's an ok place . Fine by me .
Today [9/7] just a bit ago i decided we would do a sniff and pee test and sure enough he sniffed a spot his sister went earlier and hesitated a moment and out came pee very light stream and then quite a bit of a stream . Iwas both excited and shocked . He still cant walk but i sense he has a little bit of things stirring. Today as my daughter praised him for going potty i saw a slight tail wag . It was small but it was there . Fingers crossed that everyday brings some improvement no matter how small .
|
|
|
Post by Julie & Nala on Sept 7, 2020 14:42:04 GMT -7
Woohoo Dawn that's awesome!! Finding out how to express and where works best is a game changer!!!
Everyone has difficulty learning this skill. It's not just you.
And then a little tail wag too. I'm doing my Snoopy happy dance for you!
Ollie looks happy and is obviously well loved.
Congratulations!
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
|
Post by PaulaM on Sept 7, 2020 15:45:11 GMT -7
Dawn, happy, happy day indeed on so many counts!!! Since he CAN sniff and then release urine, he HAS BLADDER CONTROL. This means he likely will not like you manually expressing his bladder. Ollie is following the usual step by step order return of neuro functions 1. tail wag only prooved with happy talk like praise, etc. 2. Bladder control comes next. Continue to do a quick express check after Ollie pees (bladder control) on his own until you feel he is fully emptying his bladder. Try attaching a water bowl inside of the recovery suite at head height off the floor of the suite so that food and water bowls can not tipped over.3. The next neuro function to return is typically leg function. Look for attempts to scratch an ear. Using his rear legs to reposition himself in the suite and attempting to push up into a stand. No one can tell you when you might observe these things. We must patiently wait til enough nerve healing has taken place to all a connection to the brain. CAUTION At all times we must be one or more steps ahead in protecting our charges. Even paralyzed dogs can tip over a plastic tub they sleep in and for sure a dog whose back legs are beginning to heal. Tubs are never a safe recovery suite at any time. Can you use a wire crate, a Pak N Play near your bed at night as a safer option for Ollie's healing disc? The plastic tub is fine for a quick express check after Ollie has done all he can release on his own. UPDATE YOUR VET via phone vs. 9/8 visit Now more than ever you want no set backs to disc healing. A vet visit must be very carefully weighed for the benefit of risking the disc, the spinal cord from a setback to square one if the disc should be return with too much movement. With clear inflammation pain & nerve healing progress in a forward direction (no meds, no pain; can pee on his own) what benefit would there be that is worth the risk of a transport in. If things were deteriorating, and the vet was still unsure of the diagnosis, then a transport to exam, test could be a good thing worth a transport risk for better diagnosis and the related treatment. These are questions you need answers to....what is the benefit vs. risk for a vet visit tomorrow 9/8 vs. update over the phone.
|
|
|
Post by Dawn & Ollie on Sept 8, 2020 11:22:44 GMT -7
Here is the latest update on Ollie . It does indeed seem that Ollie is regaining the ability to go potty on his own, as far as twice now he has sniffed and peed and also this morning found a spot to poop on his own or at least that is how it appeared to me. The vet insisted i bring him for [9/8] recheck and declined phone visit.
Ollie is FOR SURE wagging his tale as of this morning . He even did it in front of the vet . This is a good sign
The vet also said that no meds will be continued at this time.
Im going to work on finding something else to put near my bed .
He also encouraged me to make sure he is drinking enough and if need be to put a little low sodium organic chicken broth into the water to encourage him to drink . Overall i would say improvement has been made and i hope maybe in the next few weeks to see more
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,567
|
Post by PaulaM on Sept 8, 2020 11:30:33 GMT -7
Which kind of vet (family DVM vet, or .....) saw Ollie this morning?
|
|