Caroline's Louie 8/13 surgery UK

Hi Maureen, my name is Caroline, we live in Portsmouth in the UK. 
Thank you for replying so promptly   Today Louie has passed urine twice but no stool. I have just attempted to lift him from the crate now and he is refusing to move at all so he is not feeling good ? The vets we are registered is a large vets with several vets ( and they are often changing) so it can be tricky to get the same vets for consistency  And the vet that got us through Piggy's episode and surgery has left   I guess part of my nervousness is how to tell the vet that he should not have lifted the dachshund up under his front legs for that neuro test, but I have no confidence in him now  How is the way that particular test should have been carried out on the back paws / legs ?

Best wishes
Caroline


    

Hi Marjorie I am Caroline. The medication prescribed is Meloxidyl  [meloxicam] 1.5mh/ml for dog , once a day as required and a 5kg dose for Louie who weighs 5.8kg [12.8 lbs]. I have read the leaflet carefully as I am familiar with this med (I use it a great deal for the pigeons I rescue) and on the leaflet it is described as anti-inflamatory / pain relief combined. I remember we asked for stomach protector when Piggy was prescribed the same drug and were told no we would not need one as it is given on his food in liquid form and that protects the stomach ?

Because the prescription was vague and he seemed to be a bit lively on Saturday I with-held the medication but in hindsight that was an error. I have administered about 2 hours ago and he has just allowed me to lift him out and has passed urine again with slightly stiff stance but no problems. No leaking when in crate. But not keen on moving at all. I was just looking for a way to make a false ceiling in the cage and your message came through so I will find a cardboard box now and get cracking. One of the vets at our practice has a dachshund cross so I will insist on seeing him instead I think ?
He is eating and drinking fine .
Thanks again for your help x

Hi Caroline, welcome back to Dodgerslist! So glad you have joined us here once again.. 

Very glad to hear you are going to request a different vet because what he did lifting Louie up that way was extremely wrong and could have injured Louie further. That is NOT a necessary test and was completely wrong of him to do..  If he shows up for your appt walk out with dear Louie and insist on a vet that is familiar with  Dachshunds and IVDD.   

It's important to give him his medications on schedule and never withhold doses. It is important for the Metacam to work on his swelling which will help work on the source of his pain, relieving the inflammation so the disc can begin to heal.  Being in pain is detrimental to healing..

Good for you putting him on crate rest for 8 weeks and also carrying him out to potty. That is the best thing to do as you are aware!    in case you haven't seen this  here is a video that shows how to lift and carry Louie! 

My Tyler was prescribed Metacam.. It seemed to help get his swelling down quickly and does have some pain relief with it but a general pain reliever such as Tramadol is also needed to get him out of pain.. Please read this about the pain meds normally used to deal with disc pain.  www.dodgerslist.com/literature/healingpain.htm
Here is info about anti inflammatories:  www.dodgerslist.com/literature/healingsweling.htm

 Maureen, Marjorie and Paula have given you excelllent advice and you are also very familiar with IVDD with Stanley and Piggy.. So I know Louie is in great hands.. Please let us know when pain meds are on board as well as Pepcid AC to protect his tummy..

I thought I would post an update as things have changed, but first I must express my thanks to Paula, Paulinia and Jen for posting more support and advice. Paula I knew you would remember Stanley as you were such a support when we lost him. Devastated to hear Lewis was lost to Myelomalacia too  so my thoughts and love go out to you. 

We rang the vet having read the posts that he needed more pain relief, instead of seeing us for pain relief they referred us to Fitzpatrick referrals, but when the call came through from Fitz it was for an appointment on Thursday as was not assessed as an emergency case. By this time our vets was shut so we kept Louie comfortable all night (I think it may be a cervical disc as he needs the support of a rolled towel under neck and holds his head very stiff and high?) and rang our vet when they opened at 9am and said we must be seen this morning for more pain meds! In the meantime we have observed that Louie held off passing stool for over 24 hours , and when he did he could not quite complete evacuation. He is also developing a slight drunken back end when standing to pee and the back legs are too far behind and wide apart now. In other words I feel their is a slow decline in function 
We had to see the same vet  for continuity apparently as he had done the phone referral last night and saw us last week. i was already to stop him if he lifted Louie up by his arms but he did not. However, at first he said no more pain relief as it would mask the pain for the 10 days !!!!! crate rest and that we were to stick to the Thursday appoint as not an emergency as stills standing ! So I got a bit tearful as I was stressed and told him it was an emergency as from our experience a disc is quite likely leaking material and this is causing loss of function and time is of the essence. He reminds me today of how Piggy was on the Sunday night and by the monday Piggy's back legs were down. It felt like I had way more knowledge than him on the progress of IVDD ? But to be fair he is new, and is Spanish so language could be a slight barrier. Anyways , the upshot, despite his reluctance he was as good as his word and has got an emergency referral for us at Fitzpatrick for today at 12:30  Now I know that this is not giving crate rest a fair go, and Fitx may just MRI scan and then say he is not a candidate for surgery. But to watch him gradually deteriorate and just sit by is making us more and more anxious... I do hope people feel we have done the right thing and not over-reacted ? But please do give us your honest thoughts as it will be good learning experience whatever his outcome ? I will post the update post Fitzpatrick appointment today , and as for the vet fiasco, when we have louie sorted we will be writing to the practice and will be changing vets too I suspect ?
Thanks for all your help and support thusfar, I do hope we have not rushed ahead by getting Louie in to Fitzpatrick today ? xxxxx

The best information to read before going to your 12:30 appt today is this article: www.dodgerslist.com/literature/healingsurgery.htm  This way you are fully informed, not pushed into making a quick decision and no matter the outcome you know you made the best decision at the time.

There is a good possibility that Louie can still recover under conservative treatment.  As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. 

1. Pain caused by the tearing disc & inflammation in the spinal cord
2. Wobbly walking, legs cross   <---Louie is here?
3. Nails scuffing floor
4. Paws knuckle
5. Legs do not work (paralysis, dog is down)
6. Bladder control is lost
7. Tail wagging with joy is lost
8. Deep pain sensation, the last neuro function, a critical indicator for successful surgery.  After a dog is paralyzed, the existence of deep pain sensation is an indicator that surgery could STILL be successful. That window of time is 12-24 hours from losing deep pain sensation (DPS). Even after that window of time, surgery is often successful. The spinal cord is very fragile, the more hours after the window, the less chance of a complete recovery.

The Spanish vet's lifting very likely worsened the disc damage you are now seeing.  If there is to be an MRI, that would probably also signal they are going to want to do surgery. Most will not do surgery unless the dog is not walking.  MRIs are not done lightly as the dog needs to be sedated, meaning the trunk muscles that support the vertebrae and defend against further disc damage are out of commission.

My honest thought is I would continue to try with conservative treatment IF you can get proper pain meds on board and Pepcid AC. I would then be very alert in monitoring the signs listed above and be prepared for surgery if the pain simply could not be controlled with the most aggressive of pain meds or that neuro functions rapidly deteriorated.

Let us know how the vet visit goes today.

Our thoughts are with you as you wait for a call. We are here to support you!!

We will all be anxiously waiting news of the surgery.

We would LOVE to have a vet recommendation from you for our directory. People are always looking for IVDD knowledgeable vets and also information about surgery and surgical costs. When things settle down and you have time, please consider entering information in the Directory: dodgerslist.boards.net/board/10/guidelines-posting

Update from Padraig last night. Louie is walking , and is passing urine voluntarily when taken out to toilet   They are thrilled that he is doing so well, and stressed that time really was on his side because it would have been totally different if we had not been bringing him in until today !!

More tests today but there is a good chance that because we are so IVDD aware that he can come home tonight to start 6 weeks crate rest and I will be given a lesson with physio upon discharge so I can do his physio 3 times a day at home.

We feel like we have won the lottery times one million   and it feels very different to Stanley so I aam allowing myself to feel a bit excited , although I keep crying because I'm a sentimental sausage truthfully 
xxxxxxxxx

Will update when the bubby is home xxxxx

   

Louie is just past his 3rd week of crate rest following surgery. He is doing well , after a small setback in which he was prescribed Tramadol as a secondary pain relief due to breakthrough pain (with stomach protector). He is having 3 short gentle physio sessions a day and is permitted 3 minutes gentle exploration of the lawn whilst on his lead for toilet.  
those of you who supported and advised us when Louie was going down may remember we had a nightmare with the general medicine vet who examined Louie (see below from original post)

"We are insured and kind of hoped he would refer us to Fitzpatrick Referrals which is where Piggy our older dachshund had surgery for a ruptured disc (T9) and made a 98% recovery
However, because Louie was only showing signs of pain and very slight weakness the vet said a referral was not an option at this stage.

He only prescribed 10 days crate rest which we will ignore anyway as we know from our first dachshund Stanley that 8 weeks is the only way to heal the disc, but the other thing that troubled me was one of the neuro tests he did was to hold Louie under his arms and bring his back feet up to touch the edge of the counter and see how quickly he lifted them up . It was hideous for me to watch this as I know it puts terrific strain on the discs and I was terrified it was going to make him worse. Is this a necessary test for spinal trouble ? "

Once Louie was home safely following surgery, I composed a 7 page complaint letter in order to prevent anyone else going through this trauma . Today we have had the reply , which ignores the fact Louie  was only prescribed 10 days crate rest, ignores the fact that we were refused a second pain relief on crate rest when it became apparent the metacam was not enough (no such qualms from Fitzpatrick when he had breakthrough pain after surgery) , but worse than this, it seems to imply that Louie was handled properly at all times
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Obviously we are very upset as this implies that either we made the neuro examination test up, or that they feel this is a safe test to carry out ?  I am writing a response to this as this is the whole issue we wanted changed so that no one else should go through this. I would value any thoughts, information and supporting evidence anyone can offer for this letter? Or if anybody else has had cause to complain about the initail treatment they had for their IVDD dog ? The sad thing is, had they addressed our concerns properly we might have stayed with them (but not seen Roberto again). But now we feel we can no longer trust the practice at all. It feels like they are just avoiding saying anything that will avoid litigation ? They have offered us free flea treatment and wormer for both our dachshunds , which is not what we were after at all