Post by Courtney & Charlie on Jul 12, 2021 13:55:29 GMT -7
[Original subject line: Post Surgery Paralysis] Hi there!
Our Charlie had surgery in November 2020. He had three compressions. He's been doing well in PT, getting stronger with each visit! He's been walking and doing his normal things. Until
last night [7/11/2021]. We heard a little yip and his back legs were weak. No signs of pain, but I gave him the meds we had given previously and thankfully had them on all hand. He is eating normally/going to the bathroom just fine. Last night I put in back into his recovery suite and gave him all meds. This morning [7/12]no movement in rear at all.
We called our neurologist and they can get us in tomorrow AM. We also have a message in with our PT. Is there anything else I should do to keep him comfy? Hubby and I discussed that we will try conservative tx first and if that does not work, will get him a wheelchair. He's 11 and surgery was tough. I don't want to put him thru that again.
Charlie, 12 pounddachshund Gabapentin, 100 mg (was twice a day, but directed that I can do three times a day) Rimadyl, 1/2 tab every 12 hours (25 mg) Methocarbamol 1/4 of a 500 mg tab 2 times a day Trazadone 1/2 tab 50 mg every 8-12 hours (had only been giving this to him when we left home for longer periods of time. Gave it last night/today to help keep him calm.) In the excitement, I forgot to give him a pepcid but have been instructed previously by both of our vets to give so will give that next go round.
[Moderator's Note. Please do not edit 12 lbs 11 y.o. 7/12 progressed from weak back legs to paraylysis Rimadyl as of 7/11: 25mgs 2x/day for ? days, then a STOP test for pain gabapentin 100mgs 3x/day methocarbamol 125mgs 2x/day trazodone 50 mgs for anxiety Pepcid AC (famotidine) ?mg ?x/day ]
We currently have two with IVDD and thanks you, we knew what to do. I recommend anyone with IVDD questions to your site. Thank you so much, Courtney
Courtney, sorry to hear the fast progression to back leg paralysis.
OPTION 1 ER Visit asap: Many vets would want the most powerful of steroids on board within hours of paralysis. Even though you gave the other class of anti-inflammatory drug (NSAID) Rimadyl, a switch without 5-7 days of washout is possible to a steroid such as prednisone. HOURS matter usually within 8 hrs of the increased damage. Time of back leg paralysis to the time you are reading this may be past the 8 hrs. However, if within 8 hrs, then use of TWO stomach protectors: Pepcid ADC + Sucralfate can greatly reduce an emergency switch asap now today to a steroid such as prednisone.
OPTION 2 more than 8 hrs after back leg paralysis: not a rush, any vet visit would be required to get needed refills for NSAID Rimadyl and any pain meds you are short on. Could be a neuro tomorrow a.m. if you feel your family vet is not good with IVDD meds and such.
QUESTIONs when things have settled for you and Charlie: Is all pain fully covered by your giving: Gabapentin 100mgs actually giving: 3x/day? Methocarbamol 125mgs 2x/day Pepcid AC (famotidine) ?mgs ? times per day? IF pain not fully round the clock controlled, then advocate for traMADol to be added and that all three pain meds be given every 8 hrs.
Neuro status? 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. 1. 7/11 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 6.7/12 a.m.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.
A disc episode compresses the spinal cord and causes a lot of bruising, swelling, and inflammation. -- Surgery immediately relieves the pressure with severe paralysis by removing offending disc material. -- Conservative treatment relieves pressure with an anti-inflammatory drug and takes 7-30 days.
Just as with any traumatic injury, the body can self heal nerves and the disc. -- The disc heals under Conservative treatment with very STRICT limited movement and time of 8 weeks. -- Damaged nerves in the spinal cord heal with time after a surgery or conservative treament. Best to think in terms of months rather than days/weeks for this slowest part of the body to heal.
NO PT for conservative dogs unless paralyzed and no pain when off all meds.
Remind us when off all meds and no pain for how to:
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