Dawn's Ollie 8/29 conservative GRAD 10/24

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-care

When 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.jpg
Doxie 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=chiropractic


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 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.htm

Please keep us updated on Ollie's status.  Healing prayers for Ollie.

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.

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.

  
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 .

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 .

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?

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.

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.

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 . 

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. 

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 . 

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 . 

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.