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Post by Campbell & Chloe on Jan 3, 2021 9:24:40 GMT -7
Chloe - Pomeranian - Dx 12/30
My 6yo 20-lb. Pomeranian mix on Wednesday jumped off the bed [12/30] and started turning in circles before her back half collapsed and she lost continence. We called the vet immediately and made an appointment [vet 12/30] for that day. She was already walking around and wagging her tail and did not seem in distress, aside from a minor tremor in the lower half.
While we waited for the appointment I Internet diagnosed her with IVDD and the vet pretty much confirmed [IVDD]. He said he could tell her thoracic spine was causing her some pain. She is pretty feisty at the vet so he said the adrenaline might be masking it. He said surgery is an option but based on the mild case he observed he said conservative treatment with medicine and keeping her “under wraps” for a few weeks would be fine. We brought her home with Gabapentin, Methocarbomal, and a liquid anti-inflammatory and stopped at the pet store for doggie stairs for the couch.
Since then we have been restricting movement to the doggie stairs on and off the couch; the downstairs rooms; and the three back stairs down to the backyard to go out. We assumed some movement would not make it worse. She seemed to be doing OK
until tonight [1/2] (Saturday) when after coming inside she was panting very badly and her lower half was shaking a lot. I called a 24-hour vet to see if I could give her any more of the medicine for the pain; he said no and told me ultimately she will lose all leg function unless she has the surgery. She finally calmed down and went to sleep on our bed but woke up screaming in pain and lost continence again [1/2].
We brought her downstairs and Jan 2 set up our old crate. I placed her inside; she was able to walk and has turned around inside the crate but she continued to pant until we all fell asleep.
She took a dose of medicine this morning [1/3] and seems comfortable in the crate but is not moving much. She does get up and walk to the water bowl (inside the crate) and then laid back down. Back legs seem wobbly but she can stand. Is it too late to continue the conservative treatment route?
I am so ashamed of how lax I have been and I am devastated at the thought that my beautiful girl was in more pain because I didn’t research or ask more questions. Thank you so much for your advice.
Medicine, three times a day:
Methocarbomal, 500 mg (quarter tablet)
Gabapentin, 100 mg
Once a day:
Meloxicam, 10 ml
[Moderator's Note. Please do not edit
20 lbs 6y.o.
Meloxicam as o f 12/30: 10mL 1x/day for 5 days, relapse restart
1/3 relapse: 10mL 1x/day for bal of 9 days 1/13 test stop for: _pain/_neuro
gabapentin 100mg 3x/day
methocarbamol 125mg 3x/day
needs GI tract protector, Pepcid AC, on board w/ anti-inflammatory! ]
Update: strict crate rest has resulted in no more painful episodes. She has been peeing in her crate but the vet said that may be the result of the Gabapentin. He said if she does not poop or pee on her own outside he would set up a neuro consult. Today she pooped and peed outside on her own in the mini-pen we set up in the backyard. She walks tentatively and weakly but not “drunkenly” and she uses all four legs. She was able to support herself while squatting and stand while eating. The doctor said we could reduce the Gabapentin to twice a day, to see if she is a little more herself in terms of bathroom. (We obviously don’t care if she goes in the crate but she whined last night when it happened so I think it makes her uncomfortable.)
She has the Meloxicam for 14 days. I will try to answer your other questions. I’m sorry, I just saw the responses.
Thanks for your thoughts and advice.
Campbell
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Post by Ann Brittain on Jan 3, 2021 10:18:06 GMT -7
Hi, Welcome To Dodgerslist. I'm sorry to hear that your Chloe is having pain issues. Can you give us your name and more information?
How much does she weigh?
Is the vet you talked to a general DVM or a specialist (ACVIM neurology or ACVS ortho)? Was Chloe tested for deep pain sensation (DPS)?
Is her appetite normal? Is she able to pee and poop on her own?
How is her pain displayed? tense tummy? Unable to get comfortable? Moving slowly or not at all? Holding her leg flamingo style and not wanting to bear weight?
If Chloe has DPS, surgery may not be the only option. Before making any decision you should consult with a veterinary neurologist. Please talk to your vet about scheduling a neuro exam as soon as possible.
For the time being you need to put her on100% STRICT crate rest 24/7. If conservative treatment, not surgery, is recommended, STRICT crate rest should continue for 8 weeks. STRICT means no laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no chiro (aka VOM)
Other Forum advocates will be posting addditional information and medication recommendations. Starting crate rest now, is the most important thing you can do right now to help your girl begin to recover. IVDD can be treated and in many cases dogs are able to completely heal and return to their normal routine. It's up to you now to take the first steps to help Chloe recover.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Jan 3, 2021 15:20:56 GMT -7
Hi and welcome! Hi, my name is Paula, what's yours? Please let us know for how many days is she to take Meloxicam?
There is not one of us whose mind is not heavy that we contributed somehow to our dog's pain. When we know more we can do a lot better! So very glad you are taking the fork in the road to learn what you can about IVDD. Your knowledge will be instrumental in protecting Chloe now and in the many happy days ahead. In general, surgeons will not operate but want to try the least invasive treatment of conservative first. Especially when a dog can still walk! A dog who can walk by definition would have to have deep pain sensation (DPS). Chloe has an excellent chance to self heal her disc and self heal the neuro diminishment of wobbly legs with conservative treatment. There is no need yet to consult with a Neuro surgeon. Understanding what STRICT rest is allows you to commit to the single most important part of conservative treatment. A dog can recover and heal with time if given the gift of 100% strict crate rest 24/7 only out at potty times for 8 weeks. --- You will appreciate having all this information and a lot of tips laid out for you in this valuable article: dodgerslist.com/2020/05/14/strict-rest-recovery-process/--- tape to the Fridge the "Roadmap" so you are taking any more dangerous detours off the Conservative treatment road.VIEW, DOWNLOAD and print a copy for your fridge from here: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf Not all vets can know all the details for every disease known to dog, cat, fish, reptiles and the other species they treat daily. But you can know a whole lot about just one disease very important to you! Know when a surgery might be a consideration. Learn the about all the pros and cons between conservative and surgery. Again I highly recommend having this information in the back of your mind: dodgerslist.com/2020/02/10/surgery-vs-conservative/The Forum is a branch of Dodgerslist so we can speak directly to you and give specific comments about your dog. However, our treasure trove of IVDD info is what we point you to over at the Dodgerslist website. There is much more you can learn there. Use the orange search bar at the top of every page to learn more. Anything you read and are curious about, let's talk about it here! |
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Post by Campbell & Chloe on Jan 4, 2021 15:25:43 GMT -7
20 lbs
Chloe was prescribed 14 days of Meloxicam.
Thank you so, so much. My name is Campbell. You all are angels to help people through this.
General DVM
appetite normal? Yes
pee and poop on her own? Yes
pain displayed? She pants heavily and her back half tremors, I believe as a result of holding her tummy tense.
Thank you so much for this. I hope I answered the questions. The vet today said that it’s worrisome if she is not able to pee on her own and he wanted to set up a neuro consult if she did not by the end of the day, but today I took her out and she pooped and peed on her own. We are finally abiding by STRICT crate rest and she seems comfortable. My concern about a vet consult is it would be about an hour and a half drive to Cornell. We will do whatever is necessary but the crate rest seems to make her comfortable and quiet and I don’t want a long car drive to jar her.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Jan 4, 2021 19:01:45 GMT -7
Campbell, did you report those signs of pain (heavy panting and tremors)? What did the Vet Rx to get that pain fully in control round the clock?
ADVOCATE for tramadol to be added to the gabapentin and methocarbamol mox. Tramadol will act as the general analgesic in typically providing dose to dose of all 3 pain meds full comfort from pain. Let us know what the vet Rx's for Chloe over the phone (mgs and frequency).
A dog who still has ability to walk, even if wobbly, is still a good candidate to heal under conservative treatment. Now that you are on board with how STRICT rest must be to heal a disc in 8 weeks, things are looking good for Chloe already.
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Post by Campbell & Chloe on Jan 4, 2021 21:53:00 GMT -7
I’m going to call him in the morning and say she is still exhibiting some pain even with the strict crating and ask for Tramadol. She is in the crate and whining right now, which is very upsetting.
Is there a sling option you all recommend to lift her out of her crate? I want to put as little pressure on her spine as possible.
Thank you.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Jan 4, 2021 22:38:57 GMT -7
Campbell, whining sound more like wanting attention than a sign of pain. Which if any do you currently observe? When speaking to us and, of course, to your vet always describe what you observe, rather than giving a diagnosis.
◻︎ shivering-trembling ◻︎ yelping when picked up or moved
◻︎ slow to move ◻︎ tight tense tummy ◻︎ arched back, ears pinned back ◻︎ head held high or nose to the ground. ◻︎ restless, can't find a comfortable position ◻︎ slow or reluctant to move much in crate such as shift positions ◻︎ looks up with just eyes and does not move head and neck easily. ◻︎ not eating due to painful chewing or in too much overall pain ◻︎ holds front or back leg flamingo style not wanting to bear weight ◻︎ not their normal perky selves ANXIETY? Calmers! Using any oral calmer in combination with a Pheromone diffuser seems to work best. It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives (ACE, alprazolam or trazodone). Of course always keep your vet in the loop on all things you give your dog. Place a DAP pheromone diffusor at floor level where the recovery suite is: --DOG Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/Use diffusor with one oral calmer from below: Oral calmers: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed www.virbacvet.com/products/detail/anxitane-l-theanine-chewable-tablets/behavioral-health 2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. www.vetriscience.com/composure-soft-dogs-MD-LD.php UNWANTED BEHAVIOR ISSUES? Be aware you might be inadvertently training for unwanted behavior. To dogs rewards are: food, looking at them, talking to them, eye contact, approaching the crate, petting. So anytime you see unwanted behavior try speaking in your dog's language so he understands to calm down. Turn your body sideways, avoid eye contact until he calms and settles down. Preferable is to start teaching what you do want before there is too much practice in doing the unwanted behavior. Anytime your dog is sitting or lying down quietly, give a reward of a calm loving "good sit/lie." Soon your dog will see they get rewards by quietly sitting, etc. POTTY TIME Encourage Chloe to take 1-2 steps out of the recovery suite to where you can easily lift and carry her out to potty. Another idea is to have a sheet on top of her bedding where you can pull on the sheet and she will be brought closer to the suite door. Yet another idea for a DIY suite conversion to a top opening suite: dodgerslist.com/wp-content/uploads/2020/05/crate-top-conversion.pdfSLINGS and harness at potty time Carry to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog’s back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to a minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on! ** Pottytime sling/harness/leash  The Forum is best viewed on a mobile phone via the "desk top view" of your browser app (Safari, Chrome, Foxfire) As shown in picture below, you would scroll down to the bottom of the screen to click on "Desktop". click image below to view full graphic
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Post by Campbell & Chloe on Jan 5, 2021 17:19:47 GMT -7
Using a laptop is much better -- thank you.
I told the vet I would like an additional pain med because she seemed to be in discomfort toward the end of the dose and I also asked about the Pepcid AC. He prescribe Tramadol and added ✙Famotidine. I am picking it up tomorrow (he called me back after hours, sigh) so I don't know the dosage yet but I will update.
[Moderator's Note. Please do not edit
20 lbs 6y.o.
Meloxicam as of 12/30: 10mL 1x/day for 5 days, relapse restart
1/3 relapse: 10mL 1x/day for bal of 9 days 1/13 test stop for: _pain/_neuro
gabapentin 100mg 3x/day
methocarbamol 125mg 3x/day
✙Famotidine 10 mgs 2x/day
Chloe seems comfortable, too comfortable unfortunately -- she is getting very restless in the crate and starting to stand up to be taken out. I am not rewarding that behavior and we have started covering the crate in blankets so she cannot see us. It's going to be a long eight weeks but I am encouraged by what looks like a lack of pain and continued progress going outside. I just don't want her to be depressed; I know keeping her spirits up will be really important. Luckily my husband and I can WFH so we can really "be" with her all day, just not in the way she wants, which is up on the couch next to us. Would some time on the floor outside the crate be OK, if she is not allowed to jump, only lay or sit next to us? I do not want another setback and I am committed to seeing the eight weeks through as strictly as necessary. I am going to order the pheromone diffuser as well as an oral calmer you recommended.
Again, thank you all so much. I feel 1000% better than I did on Sunday and it's because of you.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Jan 5, 2021 18:55:48 GMT -7
Campbell, good job in advocating for another pain med to be added. Try putting the covering blanket just down to Choe's eye height when she sits on her butt. That what see will not feel isolated. BUT if she tries to stand up on her back legs with paws against side of suite, she will see nothing but dark. That ought to quickly extinguish rising up high on the back legs. If she is doing a normal stand with all four paws on the ground that is OK. Consider giving command to sit when you approach crate. Practice it several times a day and give lavish praise and small piece of apple or carrot as reward. Then at times she is actually going to be taken out of the suite, you will begin to she listens to your command "sit" as you reach to lift her up. Let us know how that goes. PET STROLLER recovery suite Keep her by your side as you do things around the house. Have the stroller right up against your recliner or couch while you guys watch TV or while you prepare meals. Many dogs do like being up at the height of a stroller to best see all round their home. Don't need anything expensive with big wheels. You are only going to use it in the house when you are there next to her. Maybe if weather in your area is not cold, you can take a daily trip to your deck for fresh air and observing nature. Features and other considerations for a pet strollers during a disc episode: dodgerslist.com/2020/05/17/pet-stroller-conservatve-treatment/Forum discussion on stroller brands: dodgerslist.boards.net/thread/3017/dog-stroller-recovery-suites?page=1&scrollTo=33094Any time out of the suite is a risky situation for the early healing disc. Critical to the disc's ability to heal is limited movement of the spine the recovery suite provides. Failure to provide a safe place to heal is not an option! We see reports all too often that go something like this…..was doing amazing until I let her lay with me on the carpet to watch a movie! I got up to "fill in the blank: close the front door, go to the bathroom, the fridge and within a second she tried to go up the doggie stairs to the couch! She screamed in pain! I feel so responsible for her going backwards in the healing process when I was warned. Just didn’t believe my little girl could/would do this! How about a nice comfy yoga pad for you to lie down beside her suite. There you can get close, rub noses, do some happy talk, touch her through the wires. Her disc wil be safe from any sudden/unexpected ideas to dart off at the sound of the TV doorbell. Every 4-6 hours when you take her out to potty, give her kisses and sweet talk and feel the warmth of her lovely body. She'll feel very loved! You make our day at the keyboard to hear your spirits are lifted and therefore positive energy is available for Chloe to sense. And what a good job you are doing advocating with the vet on behalf of Chloe. |
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