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Post by Alex & Loki on Jan 25, 2021 8:17:47 GMT -7
[Original subject line: Loki relapse, multiple episodes] Loki is a 10 year old mini daschund. This is his 4th episode. I wrote here about one of his episodes back in 2019: dodgerslist.boards.net/thread/7014/alex-loki-rlpse-conservative-neckAfter he recovered from that episode, he was fine for about a year, and then went down with another slipped disk in his neck this fall. He was on strict crate rest for over two months and the same medication (prednisone/tramadol/gabapentin/ metacarbamol). He appeared to recover and we let him out of the crate just a few days ago. Unfortunately, he immediately got another slipped disk, now it appears to be in his lower back. In just a matter of 3 or 4 days he lost use of his back legs. He is obviously back in the crate and i started giving him prednisone and pain medication again (we had it left over from the previous episode). Unfortunately, we know the drill now, so we'll just contact the vet for more meds once we run out of what we have. He still feels pain in his back legs (i did the pinch test) but hasn't urinated since yesterday, likely because he cannot stand on his hind legs. I know that it is impossible to express him, so did the vet we tried before. So I just hope he is somehow able to do it either when i take him out or even in his bed. My question is this. It is clear that the discs in his spine have degenerated to the point that he can't even walk a little bit without injuring himself. At what point do we say enough? Has anyone had a dog with multiple successive episodes who recovered and was able to walk for ay least some time - a year, a few years? I am even open to the wheelchair option if he is unable to regain the use of his hind legs this time, but that won't protect him from the awful pain that comes with slipped neck disks. I cannot even think of euthanasia at this point, but I'm afraid his condition is such that he is beyond repair. I will appreciate any advise. Thank you.
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PaulaM
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Post by PaulaM on Jan 25, 2021 9:28:36 GMT -7
Alex, in a new post, please list the date this disc episode in the back started. Also give the med list with
Pred, what date started? mg/ and frequency given. For how many days THEN the date of the taper test begins.
All pain meds, mgs/frequency
Pepcid AC one board
Weight?
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Post by Alex & Loki on Jan 25, 2021 9:36:19 GMT -7
Not sure of his weight. The episode started, I'd say, 4 days ago [Jan 21?] with a couple of yelps and progressed to him being unable to stand on hind legs by this morning.
I started giving him prednisone [1/25] today, will be giving 2.5 mg twice a day. Gave him gabapentin this morning, but when i saw that he was still tense and shivering an hour later, also gave tramadol 30 mg. Ill continue with pain meds every 8 hrs (will also add metacarbamol) and will see how he's going before deciding to taper (at least after a week).
[Moderator's Note. Please do not edit
Weight unknown (mini doxie 8-10 lbs??)
1/2 football field walks up graduation!
prednisone as of 1/25: 2.5mgs 2x/day for 7 days, then Feb 1 test taper
gabapentin ?mg 3x/day
tramadol 30 mgs 3x/day
methocarbamol ?mg 3x/day
Pepcid AC ?mg 2x/day ]
Sorry, forgot to mention. I do give him pepsid half an hour prior to prednisone.
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PaulaM
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Post by PaulaM on Jan 25, 2021 9:41:11 GMT -7
I'm sorry to hear Loki is having such a time with IVDD. Additional questions so we have a full understanding to give our best comment. Upon graduation from Nov 2020 episode a few days ago, was there a very gradual slow introduction back to being allowed physical activity? Does Loki leak on you when lifted ( a sign of loss of bladder control and need to be expressed or use of catheter)? Can he move his back legs at all?-- move back legs to reposition in his recovery suite -- move back legs to attempt to scratch an ear? -- Can he give a happy wag IF you specifically do some happy talk?
-- most general vet can not correctly identify neuro pinch test. Likely you will not and just cause pain/discomfort to Loki.Better for you to watch for neuro diminishment signs. As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order. Where is Loki on this list as of today?1. Still in any pain 1/25 ? Pain caused by the tearing disc & inflammation in the spinal cord
2. ? Wobbly walking, legs cross
3. ?Nails/toes scuffing floor
4. ? Paws knuckle under
5. √ Weak/little leg movement, √ can't move up into a stand
6. ? Legs do not work at all (paralysis, dog is down)
7. ? Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors.
8. ? Tail wagging with joy is lost
9. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. If surgery is not an option (for whatever reason) then the best option is conservative therapy.
Surgery can still be successful in the window of 12-24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance. Precious hours can be lost with a vet that gets DPS wrong. Trust only the word of a neuro (ACVIM) or ortho (ACVS) surgeon about DPS. So if surgery is an option for your family get to a neuro or ortho asap. A quick overview of conservative treatment vs. a surgery: dodgerslist.com/2020/02/10/surgery-vs-conservative/ IS a surgery a option for your family if it were to be something to consider?Let us know you have contacted the vet today to let him know of another disc episode. Prednisone is one med that really needs to be used under supervision of a vet. |
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Post by Alex & Loki on Jan 25, 2021 9:52:07 GMT -7
He is at stage 5 I believe, his back legs are weak and he cannot stand up. He hasn't leaked urine yet.
We did take it very slow when he was out of the crate, just let him walk a bit around the house and took him for a super short walk (like 50 meters). [54 yards; 1/2 football field!!]
We are not considering surgery not only because it's just not possible financially, but also because we understand that at this point we can spend another $6,000 and get another slipped disk the day after. Hence my question. What are the chances that he would be able to have even a resemblance of normal life (even in a wheelchair) given that it appears that multiple disks in his spine have deteriorated and can herniate at any moment.
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PaulaM
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Post by PaulaM on Jan 25, 2021 9:59:51 GMT -7
Dogs do not think like people. We need to put things into perspective in their terms. Life is a journey. No matter where you are in the travels, live in the now. Dogs know to take life a moment at a time and enjoy it for all it has to offer. They move forward in life in the best way they can. We can learn a lot from them! Take a look at this page to see IVDD warriors living good quality of life.
What country are you in? |
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Post by Alex & Loki on Jan 25, 2021 10:08:24 GMT -7
We're in Canada.
I do understand that he will be able to enjoy life even in a wheelchair, but that's if he doesn't have other disks herniating at the same time.
I am pretty sure this episode is not connected to the one in November. That was clearly in his neck, caused him a great deal of pain, and affected the right side of his body, both front and back legs. This one is clearly in the lower back, and the symptoms are the same as his first episode when he had a surgery. I don't know, maybe his back muscles were too weak after two months in a crate and it was caused by starting to walk too early?
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PaulaM
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Post by PaulaM on Jan 25, 2021 10:15:48 GMT -7
Weight is an important fact to know as all meds depend on the weight of the dog. Is it possible to weigh him on your at home scale?Is all pain fully in control with the three meds you now give? Which do you still observe?SIGNS OF PAIN: ◻︎ 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 Would you fill us in on his med list: Weight unknown (guessing mini doxie 8-10 lbs??) prednisone as of 1/25: 2.5mgs 2x/day for 7 days, then Feb 1 test taper
gabapentin ?mg 3x/day tramadol 30 mgs 3x/day
methocarbamol ?mg 3x/day Pepcid AC ?mg 2x/day ] Refresh on the parts of a prednisone taper test and then fill us in: Will the three pain meds be backed off or full stopped on Feb 1? This is a vet's decision. Do you have a plan B worked out ahead of time with your vet?
 *Could be an emergency RX script you could fill at local 24 hr pharmacy or some extra pills at home til the vet opens again. An ER visit is very expensive, a "Plan B" is free! --- Learn why prednisone is not a pain reliever, how long it could take to rid the body of all painfully inflamed and swollen tissue around the spinal cord and how a pred taper test is carried out. dodgerslist.com/in-the-right-place/dodgerslist.com/2020/04/18/steroids-vs-nsaids/ |
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PaulaM
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Post by PaulaM on Jan 25, 2021 10:37:34 GMT -7
Alex, as you surmised there is some degree of muscle atrophy after 8 weeks of strict rest. Good strong, trunk muscles (core muscles) supports the spine. This is why a slow and gradual introduction back to physical activity over several months is the better idea to ensure core muscles are again strong and supportive of the spine. This disease is a challenge in that there can be multiple disc episodes for some dogs. Owner knowledge is "the" key to living with an IVDD dog. Knowledge is the power and the ability to recognize signs and be suspicious of a possible disc episode. Crate to restrict movement of the spine at once. Prevent the suspicioned bad disc from then impacting the spinal cord.  Then getting to a vet asap for a diagnosis. There are other diseases that mimic a disc episode, so a good idea to make sure it is not another mimicking disease. You want the dog on the right drugs to match the diagnosis. There is still good hope in the cards for Loki to enjoy many years ahead with his family. Do not give up on him--- he still has a lot of living to do! Where in Canada do you live? |
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Post by Alex & Loki on Jan 26, 2021 7:17:43 GMT -7
He is ▲walking today. Wobbly, but much better than yesterday. I'm glad we caught it early, before it escalated to full paralysis.
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Marjorie
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Post by Marjorie on Jan 26, 2021 7:40:54 GMT -7
How wonderful to see such progress in such a short time, Alex! Great news. Now that he's walking, he may try to take more steps at potty time than he should. Be sure to only allow a very few steps at potty time. Carry him outside, use a halter and a 6' leash and stand in one spot to limit his steps and carry back in. The less movement of the spine, the better, to prevent a relapse. Use a sling to keep his wobbly back steady.  You have a taper of the Prednisone coming up on Feb. 1st. That serves as a test for pain/swelling so you'll need to keep an eye out for any sign of pain returning. What directions has the vet given you about the pain meds - does he want you to taper off of them, too or stop them completely? If he has given you any directions about, do speak to them at some point this week about it. Keeping pain meds on board during the taper of the Prednisone will mask your ability to see whether there is still pain/swelling and still a need for the original dosage of Prednisone for a bit longer. Please let us know what the vet says about pain meds during taper of Prednisone and please continue to keep us updated. |
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