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Post by Angie & Jude on Oct 24, 2020 11:27:49 GMT -7
[Original subject line:Angie's Jude 10/24 conservative - dachshund]
My dog Jude went down with IVDD on Thursday night (10/22) around 10pm. He started to look uncomfortable and yelp suddenly. I took him to the emergency vet [10/22], they saw him and sent me home with gabapentin and meloxicam and told me has to rest. When they gave him back to me, he appeared much stiffer and had an a very pronounced arch in his back. He yelped and cried when I carried him from the car to my apartment. I started both medications [10/23] Friday morning at 4:30am. The medication seemed to make him sleep a little but he was generally in the same shape. Very stiff, his head held high, arch in his back. I decided to take him to banfield which is where I normally go for his vet. She saw him and said she notices some paralysis on his hind legs but the fact that he can bear weight on them and wag his tale is a good sign. So she told me to stop the meloxicam, continue gabapentin and also prescribed tramadol, muscle relaxer, and prednisolone to start this afternoon with pepcid. He has a history of elevated liver enzymes and was taking denamarin all last month to lower them. She suggested to also give him denamarin with these meds.
The medication seem to help him sleep and manage his pain but as [meds] it's wearing off, he begins to yelp again when carried. He is constantly whining and crying in his gated off bed and has not peed or pooped on his own since Thursday night before this started. I don't know if he's anxious because of all these changes or because of his pain or both. He was normally a little anxious dog. I am very worried about him not peeing and pooping. I have not started prednisolone with pepcid yet, the vet said I should do so this afternoon. What should I do about his lack of potty time? I have taken him outside and held him up with a sling and he seems to want to lift his leg up to pee but since he can't, he won't pee. And he is used to squatting and pooping and I think the last thing he can do now, is squat. Today I've tried to take him out twice but he cries when I take hin out of the stroller and onto the grass. I am so worried. I haven't slept since this happened and I don't know how to help him. My boyfriend tried expressing his bladder and it worked but Jude looked very uncomfortable and hunched over as I was helping him stand. I feel helpless. Surgery isn't an option now since it is very expensive. Even imaging is expensive.
☆ 1
He weighs 16 pounds.
- Gabapentin suspension (250mg/5ml give 1 to 1.5ml every 12hrs)
- Meloxicam (administered one dose, then stopped)
- Tramadol (50mg tablet. give 0.5 tablets every 12 hrs for 14 days)
- Methocarbamol (500mg tablet. Give 1/4th tablet every 8hrs)
- Denamarin advanced (no mg showed, give 0.5 tablets once a day.
- Prednisolone (5mg tablet. Give 1.5 tablets every 24 hrs for 7 days. Give 1.5 tablets every 48 hrs for 17 days.
- Pepcid (10mg every 12 hrs)
[Moderator's Note. Please do not edit
16 lbs 8yr 3mo old
crated 10/23
Meloxicam as of 10/23 Stopped 10/24
Prednisolone as of 10/24 5mg tab: 7.5 mgs 2x/day for 7 days, then 10/31 test taper _pain/_neuro; taper ends 11/18
Tramadol 25mgs 2x/day 12 hrs ends 11/7
Methocarbamol 125mgs 3x/day
Gabapentin 250mg/5mL: 50 mgs (1mL) 2x/day
Denamarin advanced 0.5 tablets 1x/day
Pepcid 10 mgs 2x/day]
☆ 2 My name is Angie and my dog's name is Jude, he is 8 years and 3 months old. We live in Buffalo, NY USA.
☆ 3 He received a diagnosis two years ago of bulging disc but it was mild. My vet is a DVM.
☆ 4 I saw her yesterday 10/23/20 and crate rest started then.
☆ 5 He seems to be able to rest in the medication but will often wake up and cry and try to shift around in his bed. Not sure if it's pain or anxiety. His tummy feels tense when he is on all fours and his back is still arched. When laying down and in medication, his body doesn't look as arched. His tail wags crazily when I approach him. When I try to pick him up he cries and yelps loudly sometimes. It's not every time but mostly a few hours into the pain medication. And moving him to the stroller to go outside and taking him out of the stroller and onto the grass he yelps and doesn't want to be touched. Last night we took him out with a sling and he took a few steps and seemed like he wanted to raise his leg up to pee but couldn't.
☆ 6 He can bear weight in his hind legs and take small but wobbly steps. He definitely can wag his tail pretty fast.
☆ 7 He was sniffing the grass last night and wanted to pee but could not raise his leg to do so and so he could not pee. He cannot seem to squat to poop and he hasn't pooped in almost 48 hours. My boyfriend expressed his bladder today and some pee came out. When I placed him back in his bed, I think he peed more because there was a wet spot on his blanket.
☆ 8 He eats and drinks when I fees him, he has good appetite but will not go up to his water or food bowl by himself. He has not pooped in almost two days.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Oct 24, 2020 12:31:17 GMT -7
Angie the pain meds tramaold, gabapentin and methocarbamol last in the body for about 8hours. Call the vet and report what you are seeing painwise. Advocate for going to the three pain meds going to an every 8 hrs dosing (3x/day)
During the washout of not taking any anti-inflammatory (no Meloxicam and not yet starting Pred) it would be expected a need to increase pain meds to cover that no painful swelling is being worked on .
Even after you start pred this afternoon, the three pain meds may well need to be at 3/day.
Please do let us know how the pain is once pred is in the body this afternoon. Expect no pain especially if the 3 pain meds had be re-Rx'd for 3/day.
A dog in pain can't really function properly, doesn't want to eat, lift leg, etc. when enduring pain and you can't care for them such as lifting to carrying out to potty. Let us know when pred is on board if lifting and if he feels he can pee without being so painful.
Advise WHICH you actually HAD been giving Gabapentin 1mL OR 1.5mL . And IF you are now today dosing at 1.5mL of gabapentin
EMAIL ALERTS
Please do let us know that you have been able to set up email alerts as timely interaction/communications is needed when helping your dog. How to set up: dodgerslist.boards.net/thread/7353/register-bookmark-dogs-post-thread
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Post by Angie & Jude on Oct 25, 2020 21:11:02 GMT -7
I was giving 1.5ml of the gabapentin but he seemed to be in terrible pain yesterday and I ran him back to the er vet [10/25]. She examined him again and raised the dose of ▲gabapentin to 3ml and every 8 hours instead of 12. She also advised to stop the prednisolone for three days because even though he took meloxicam once, she said it stays in the system and mixing them both can be bad. She also prescribed him ✙Amantidine (100mg give 1/4 tablet every 24 hours) and ✙pantoprazole (20mg, give half a tablet every 12 hours for 10 days).
[Moderator's Note. Please do not edit
16 lbs 8yr 3mo old
crated 10/23
Meloxicam as of 10/23 Stopped 10/24
Prednisolone as of 10/24: 7.5 mgs 2x/day for 1 day, STOPPED 10/25-10/27
as of 10/28: 7.5 mgs 2x/day for 6 days then 11/3 test taper _pain/_neuro; taper ends 11/20
Tramadol 25mgs 2x/day 12 hrs ends 11/7
Methocarbamol 125mgs 3x/day
Gabapentin 250mg/5mL: ▲150 mgs (3mL) ▲3x/day
✙Amantidine 25mgs 1x/day
Denamarin advanced 0.5 tablets 1x/day
Pepcid 10 mgs 2x/day
✙pantoprazole 10mgs 2x/day. STOP on 11/4 ]
Today (10/25) I made him a liver broth containing liver, squash, a bit of brocoli, peas and carrots and mixed a little of the soup with two teaspoons of canned pumpkin to help him poop. He began to pee outside on his own on the grass. He also pooped a small amount. He has had two pee accidents in his bed today. Is that normal? I took him out to pee around 4 times. I have been feeding him soup and mostly really wet food today. There has been no yelping or crying out in pain when I've picked him up today.
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Mary & Mila
Helpful Member 
FEMALE— DACHSHUND
Posts: 218 
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Post by Mary & Mila on Oct 26, 2020 3:58:29 GMT -7
Hi Angie, Sorry to read about Jude's back issues. Good call on getting the meds increased, the fact that he is not crying anymore is proof that the pain meds are working well together, covering 24hrs daily, which is great because pain can hinder healing. Very important to get it under control, well done. Try to call the vet in future if and when you need to discuss Jude. Reason for this is that during conservative treatment, anytime out of the recovery suite is a dangerous time for the early healing disc. Movement of the back/neck can increase a disc tear with escape of disc material into the spinal cord . Pain again and the need to start from square one. For an animal with very mild neuro deficits, the risk of transporting to therapy/vets has to be carefully weighed against what benefit would be gained. If Jude was able to pee and poop outside on his own yesterday then it sounds like he does have bladder and bowel control, usually dogs that have control don't like being expressed, which may be why he was so uncomfortable when your boyfriend was expressing him. Try taking him outside just a little more frequently as it sounds like that's the only reason he had those little accidents in his bed. About every two hours and see how that works out and check if his bedding stays dry. Be sure that you are supporting him correctly when you are taking him out.  Also take care not to let him take too many steps while he outside. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. Continue to use the sling for support if he is still a little wobbly on his hind legs. kind regards and wishing little Jude a speedy recovery. Mary |
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Oct 26, 2020 6:38:23 GMT -7
Jude now has no anti-inflammatory on board to work on the swelling that's pressing on the nerves of the spine. It's that swelling pressing on the nerves that causes the pain and can cause damage to the nerves so it's very important to get that swelling down quickly. When there's a medical need to switch from a NSAID (Meloxicam) to a steroid (Prednisolone), a 4-7 day washout period does not need to be made with the addition of Sucralfate in addition to Pepcid AC. Sucralfate works to help heal any damage to the GI tract. I see that the vet has added pantoprazole, which is a Proton-pump inhibitor, that works on decreasing the acid in the stomach. On the other hand, SUCRALFATE, works in a different way to bandaid the damaged mucus lining and also promotes a healing environment. Sucralfate will require timing with other meds…so do your homework so you can discuss things with the vet: www.marvistavet.com/sucralfate.pml With the addition of Sucralfate, Jude would be able to continue taking the Prednisolone without a wash-out period. Please speak to the vet about this today. Good news that Jude's pain is now under control. As the Prednisolone leaves his system, his pain may return and if it does, then there would be even more of a reason to add Sucralfate so Jude can continue taking Prednisolone. Should pain return, immediately alert the vet so either prednisolone can be re-started along with Sucralfate (preferably) or the pain meds adjusted again to cover the pain. And good news that there appears to be bladder control! As Mary mentioned, you may need to take Jude out more often, especially when on prednisolone. Prednisolone causes increased thirst and urination so you may need to take Jude out every 2-3 hours while on that med. I see that you mentioned that Jude will not go up to his food/water dishes by himself. Do you have those dishes in his crate? Food and water should be given inside the crate to prevent movement of the spine. The only time Jude should be out of the crate is at potty time, carried out to potty with only a very few steps allowed to do his business and then carried back to the crate. Here's how to make a bowl holder:  Healing prayers for Jude. |
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