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Post by ? & Charlie on Sept 12, 2021 9:28:10 GMT -7
[Original subject line:?'s Charlie - IVDD Stage 4/5 ]  Our beloved 60lb 4yr old labradoodle, Charlie was diagnosed with IVDD [9/10] Friday afternoon. We came home from work on Thursday where Charlie normally jumps, wags, and barks in excitment, but instead he whimpered and lay on his side. We didn't know the source of the pain, so we took him to the ER, where they misdiagnosed him as having "gas." His movement got worse Thursday evening, and even worse Friday morning, so I took him in to see his normal vet where she immediately suggested IVDD, but we needed a MRI to confirm. At that point Charlie could hobble around and still wag his tail, but by Friday evening/Sat morning, he was fully paralyzed in his back legs. We took him back in to learn how to express his bladder, and the vet suggested surgery was really the only option, but being Saturday afternoon, we couldn't find anyone open. Charlie is currenlty on 3 different meds - 1 for pain, 1 for inflamation, and 1 for muscle relaxation. The vet said he was not currently in pain, but was likely in stage 5 IVDD. I can get his leg to slightly twitch when pressing on his paw pads, but he's been in this paralyzed state since Friday evening. This is breaking my heart and I've been a complete wreck since Thursday night and I really don't know what to do. While the vet said surgery is the only real option, I have several issues. My wife and I are broke public school teachers, so we hate to say it, but cost is an issue. I'm willing to put this all on my credit card and I suppose I can figure out the money later, but this is a big financial hit for us. Also, from what I'm reading surgery needed to be done Thurs or Fri, and his chances of walking again are minimal since we still don't have anything scheduled. I am on a waitlist with one local specialist, but no one can provide any answers on the weekend. I plan on calling everyone I can Monday. I also have the problem of proving proper care as he's paralyzed and potentially post-op, which I understand can take up to a year. My wife and I are gone from 6am-4pm M-F and we don't really have anyone who can help. Right now I'm carrying him everywhere, which I can do, but I'm close to throwing out my back.As I look at Charlie laying on the floor next to me, he looks somewhat content, but it breaks my heart knowing that he can't walk, chase squirrels, or do the things we loved. Sorry if this was a bit scatterbrained, but I'm just looking for some advice on what to do and maybe some hope on Charlie's future. Please advise. Thanks, Charlie's Dad |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Sept 12, 2021 12:07:58 GMT -7
Hi and welcome to the Dodgerslist Forum. We are very glad you have joined us. Keep in mind house finances need to be sound enough to provide for yourselves and to take care of Charlie now and in the future. However if a surgery does turn out to be a financial option for your family, then you need to know the real timeline for it. Paralyzed legs are deemed an emergency and surgeons have emergency hours. Find a board certified surgeon (neuro or ortho specialist) whether at a University or a Hospital: find.vetspecialists.com Call them and tell them you are coming now. Dodgerslist members have a directory also to check: dodgerslist.boards.net/board/13/member-reported-surgery-costs-recommendationsAs 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. Pain caused by the tearing disc & inflammation in the spinal cord2. Wobbly walking, legs cross3. Nails/toes scuffing floor4. Paws knuckle under5. Weak/little leg movement, can't move up into a stand6. 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. CAN Charlie give a happy wag if you specifically do some happy talk or show him a yummy treat? If YES, then you know he still has to have deep pain sensation.
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/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. Post continued...... |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Sept 12, 2021 12:36:14 GMT -7
Post continuation.... The single most important care is the STRICT rest inside of a recovery suite.
Care education is the key to soothing your mind and looking out for your dog. That's right, your dog has a serious disease. It can have a good outcome or a different one. 1) Emergency FAQ will fill you in on the big picture. It helps to plant a seed in your mind: dodgerslist.com/2020/02/24/emergency-faq/ 2) Be in the know how each phase of healing works. Be able to have meaningful conversation about the specific expectations of healing for your dog with your vet: dodgerslist.com/in-the-right-place 3) Nursing Care Tips— No need to reinvent the wheel with at-home nursing care during a disc episode: dodgerslist.com/2021/01/19/nursing-care-at-home-tips/A large dog does have more challenge weight wise in home care. VET HELP during work hours. Brain storm with your vet: --- about bringing Charlie for day care at the vet clinic during your work hours. -- about hiring one of the vet techs if possible to stop by your home during lunch ? ? --- NOTE: transporting Charlie a lot is not the best option concerning too much back movement during conservative care. But sometimes the optimal is not always possible. RECOVERY SUITE An expen is easier than a wire crate in accessing to give care.
HARNESS to aid your back in lifting, etc. Help 'em up harness: rear end and front helpemup.com/features/helpemup.comWalkabout rear harness www.walkaboutharnesses.com www.walkaboutharnesses.com/products/airlift-one-back-harnesscompare: www.walkaboutharnesses.com/pages/product-comparison?type=harnessesQUESTIONs Help us to understand all the important details by giving a full med list: ☆ 1 Is there still currently pain today? Any pain nearing next dose? ☐ reluctant to move much in crate such as shift positions or slow, ginger movements
☐ shivering, trembling ☐yelping when picked up or moved
☐ tight tense tummy ☐can’t find a comfortable position, restless
☐ Arched back ☐head held high or nose to the ground
☐ Holding front or back leg flamingo style not wanting to bear weight
☐ Not their normal perky selves? If not in control your vet needs to know asap to adjust meds. ☆ 2 A.. List the exact names of all meds currently given, doses in mg’s and times per day given. B.. 🔘 -- IF a steroid (prednisone, dex, etc)….what was the start date & dose? -- Date of steroid taper? 🔘 -- IF a non-steroidal NSAID (Rimadyl, carprofen, Deramaxx, etc), what are the start & stop dates? C.. PEPCID AC: Phrase a simple question that you expect a simple "yes "or "no" to it. Does my dog have any health issues to prevent use of Pepcid AC (famotidine)? (doesn't need it, we wait til there is problem…are NOT answers to your question!) If you get a "no health" issues answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine). (NOTE: Pepcid AC (famotidine) for dogs is 0.44mg per pound 30 mins before the anti-inflammatory and thereafter every 12 hours. www.1800petmeds.com/Famotidine-prod11171.html ) We are anxious to learn more about Charlie and help you find the best solution for care. |
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Post by ? & Charlie on Sept 12, 2021 13:19:44 GMT -7
Thanks for the response. We are still considering surgery, but everywhere we called does not deem this an immediate emergency. One place told us that he'd be hospitalized until they could do the MRI tomorrow. We are on a priority review list with one of the 3 area surgeons and we are awaiting their call. Does anyone have experience waiting more than 48 hours for the surgery?
As for the meds, Charlie is on:
1.5 tablets of Methocarbamol 500mg every 12hrs
1 capsule of Gabapentim 300mg every 12hrs
1/2 tab of Carprofen 100mg every 12hrs
We have never given him Pepcid AC
As for signs of pain, no, he seems pretty relaxed, but he does get anxious at times when I leave the room or our other dog runs outside. He sometimes tries to sit up and is able to awkardly prop himself on his front two legs.
He has not lost bladder control yet, we were told to express his bladder twice a day
The last time he wagged his tail was Friday afternoon, he has been unable to since, and he's normally a big tail wagger.
Charlie still has an appetite and we were able to induce a bowel movement this morning.
Thanks again for taking the time to respond and for the information.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Sept 12, 2021 15:52:03 GMT -7
Hi, my name is Paula, what's yours? The neuro function thing can be confusing. The hour timeline only relates to deep pain sensation (DPS) ability. A neuro tests for DPS in their office. An MRI is taken for the purposes of planning the surgical procedure, not for identifying DPS. Surgeons know that a surgery can still have a good outcome when the surgery has been done in a window of 12-24 hours AFTER the neuro function of deep pain sensation (DPS) ability has been lost. The problem is we lay people and many family vets are not qualified to correctly identify what they see about DPS. Precious hours can be lost with incorrect identification. While in the hospital and being monitored for DPS, those folks WiLL GET IT RIGHT and call in the surgeon in a timely manner. You give conflicting neuro information because you are not used to this neuro stuff. --- A dog that must be expressed does not have bladder control. That neuro function has been lost. --- Many a person has seen urine come out and feels that is the act of peeing directed by the brain. When a dog has lost bladder control, reflex takes over at the point the bladder is over stretched/full of urine. However, reflex does not allow all the urine to escape. --- Tell tale signs of lost bladder control are dog leaks on you when lifted, finding urine leaks in bedding. --- Proof there is still bladder control, means the dog can hold urine in til outside or smelling a pee pad "incentivevised" with some other dog's urine or the dog's own old urine on a bit of paper towel. IF they can sniff an old pee spot and then make the decision to release urine that is bladder control. Any one can correctly identify a happy wag if you do some happy talk. If your dog truly can no longer do a happy tail wag, then only a specialist can correctly identify if at this point he has or does not have DPS (the critical indicator for best out come for a surgery to decompress the cord.) I'm glad to hear the pain meds are providing relief from any pain. That is how it should be. Carprofen is the anti-inflammatory that can take 7-30 days to rid the body of painful inflamed tissue around the spinal cord during conservative treatment. There are several reasons why the body makes extra acids (such as stress). Please read up on Pepcid AC. IF you know Charlie has no health issues, I'd give the Pepcid AC and keep your vet in the loop when he reopens. Good reading on Pepcid AC: dodgerslist.com/2020/05/06/stomach-protection/We anxiously await your next update to learn which avenue of treatment you take and how we can support you and Charlie. |
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