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Post by Danielle & Otto on Feb 10, 2022 22:26:04 GMT -7
[Original subject line: Otto 13yo Pug Conservative Neck ] Hello. My dog is Otto. He had an IVDD (likely, maybe stroke?) episode three years ago dodgerslist.boards.net/thread/6868/danielles-otto-2019rlpsconserv-neck-grad and dodgerslist.boards.net/thread/7512/danielles-otto-2020-conservative-pug . But recovered. He is older and has hip dysplasia so he was still not super active but could walk again after crate rest. In early January ( 1/10/22?), he stopped walking again. I took him to the vet 2/11/22 today. She seemed a bit clueless and suggested I put him down. I was not happy with her. Here is what my dog is taking 1. Trazadone at night 12.5 mg 2. meloxicam - up to the 20 lb mark on the syringe 3. pepcid ac I think 5 mg. 4. glucosamine - half of a trader's joe tablet. 5. sometimes melatoninHe also takes some topical eye meds.Here is what the doctor gave him today: 1. gabapentin. The prescribed dose is 1.5 mg every 8 hours. I think, off the top of my head. I will just give him as needed. 2. Antibiotics - for foot abscess/eye issues
[MED LIST/HISTORY- Moderator's Note. Please do not edit
20 lbs 13 y.o.
1/10/22 stopped walking
Strict rest started 2/10
2/11/22 vet appt neck pain
Meloxicam since 2015 hip displays: 20lb dose
gabapentin 1.5 mgs 3x/day AS NEEDED
Amoxiclav 125mgs for foot abscess
cyclosporine drops for eye
Trazadone 12.5 mgs 1x/day p.m. stopped 2/12
Pepcid AC 5mgs 1x/day] I need some support after the vet suggested putting him down. Also, he twists in a weird way (this could be due to paralysis on his left side). Best, Danielle and Otto
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Feb 11, 2022 9:46:29 GMT -7
Danielle, so sorry to hear Otto having another problem. It is not clear when OR if STRICT rest was started. If you have not, then immediately put Otto in his recovery suite.
STRICT REST! WHY? If your dog moves around too much with a disc episode suspicion, the disc cannot heal. Too much movement could possibly cause permanent paralysis. With appropriate pain medication to mask pain, they will not suffer pain. So it is up to you as the pet parent to restrict your dog’s activity for them so they are not further damaging a weak healing disc. STRICT rest means: ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy WHYs: dodgerslist.com/2020/04/22/chiropractic/ ◼︎no dragging or meandering at potty times. ◼︎no PT for conservative dogs during 8 weeks to heal disc ◼︎ At-home laser or acupuncture for severe neuro damage is best. BLADDER CONTROLDoes Otto have the ability to sniff an old pee spot and the make a decision to release urine? That is proof of bladder control.OR....Does Otto leak on you when lifted? Do you find urine leaks in his bedding? That is a sign his bladder is overflowing due to reflexes. An overflowing bladder MUST be manually expressed by the owner. This in a very important health issue to prevent urinary tract infection (UTIs) and to maintain the health of bladder muscles. You will get more out of a hands-on-top-of-your-hands type of expressing lesson by first reading and viewing the video at this page: dodgerslist.com/2020/05/05/bladder-bowel-care/
We can make meaningful comments when we have all he facts. Avoiding incorrect assumptions keeps the conversation from going off in a false direction. -- Let us know the date you started strict rest for loss of walking 1/10.
-- Did your vet say the issue this time was in the neck?
-- What was the reason for waiting a month until a Feb 11 vet visit?
-- Where is the paralysis exactly?: in the front legs or the back legs. Or both front and back legs. Just the left side front or back legs? -- Can the paralyzed leg(s) still move a bit, such as when trying to reposition his body in the crate? -- Can his tail stump or his butt wriggle with happiness? -- Can you get in to see a specialist asap to verify which of several diseases this might be. Pugs can have diseases that mimic a disc episode but may have a totally different treatment. The actual disease must have the matching proper treatment.
Not all local DVM vets are up on the diseases pugs can have. Seeing a specialist is important! |
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Post by Danielle & Otto on Feb 12, 2022 7:50:58 GMT -7
Strict rest - Started 2.10.22. Kept pretty still before then but not on strict rest plan.
Does Otto have the ability to sniff an old pee spot yes sort of. If I take him outside, he knows it is time to pee. I am just using pee pads for now though.
Does Otto leak on you when lifted? Even when he was walking, he had trouble holding it due to old age, I think. We were using pee pads.
-- started strict rest for loss of walking 1/10 on 2.10.22.
-- This vet did not seem to know anything. The vets at this chain are usually pretty sophisticated, but she was not that good. When I mentioned cervical ivdd, she said that makes sense because he had some pain in his neck.
-- What was the reason for waiting a month until a Feb 11 vet visit? I think at first I wasn't sure if his loss of the ability to walk was neurological or general decline due to old/arthritis. I am actually kind of regretting that vet visit. She was a nightmare.
-- paralysis exactly?: Both front and back.
-- I am not sure if legs can still move a bit. He definitely still has feeling there. I wiped him with a pet wipe on the left side yesterday and he re-acted.
-- happiness wriggle? He could in January.
-- have a feeling it is another disc episode although I am not a vet, I know. I put him on strict rest. I have to go somewhere for a week due to family medical issue, but will go to neuro when I get back.
My family watching him are retired and know what to do.
My dog lost weight (we put him on strict diet). He is slightly less than 20 pounds now. Trying to maintain.
AmoxiClav (Clavamox) Chew 125mg Tab 14 chews. I am not going to eye medicine right now as they look clear (she said they looked okay/clear but I asked for antibiotic because they looked mucky a week ago). He usually gets 2 percent cyclosporine with castor oil 1 drop twice a day for his eyes. I will continue with that.
Trazadone 12.5 mgs 1x/day p.m. going to stop for now and try Gabapentin only.
Pepcid AC 5mgs 1 times a day before his meloxicam
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Feb 12, 2022 12:21:52 GMT -7
Danielle, until you have a diagnosis that says, Otto is suffering with a different disease that caused leg paralysis, then you are doing the prudent things to assume this is a disc episode. Strict rest until you have a different diagnosis is to protect the spinal cord from permanent nerve damage. The understanding for us now is that Otto is fully paralyzed on all four legs (can't walk or move any of his legs (front/back and left/right). When observing for neuro functions, watch for a head level involvement with paw, leg, or tail movements. Ignore any leg movement observations that happen during potty time. As they are very likely due to reflex. Examples of head level involvement 1. Hearing (head level) happy talk or seeing (head level) you, then the tail stump/butt wriggles. Let us know what you observe currently.
2. Sniffs (head level) an old pee spot, then brain (head level) sends a message down the spinal cord to bladder to release urine. Let us know what you observe currently.Monitoring Neuro Functions
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.0. ? Initial pain of the disc tear with loss of leg on 1/10?
1. 2/10 vet observed painful neck inflammation in the spinal cord
2. Wobbly walking, legs cross
3. Nails/toes scuffing floor
4. Paws knuckle under
5. ? Weak or little leg movement
? can't move up into a stand position
6. 1/10 4 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 an old urine spot outdoors.
8. Tail wagging with joy is lost
9. Deep pain sensation (DSP), the last neuro function, a critical indicator for nerves to be able to self heal with conservative treatment or after a surgery.
Trust only the word of a neuro (ACVIM) or ortho (ACVS) surgeon about DPS. Would your parents be able to login and update or ask questions during the week you are out of town? PEPCID ACIf vet says Otto has no health issue of liver, kidney, or heart, then the usual use of Pepcid AC (famotidine) is 0.44mgs X 20 lbs Otto = 8.8mg dose. ROUND UP to 10mgs tablet TWICE (2x/day) LEARN MORE that the vet may not have had time to go over with you
PAiN MEDAs long as the one single pain med Gabapentin which addresses only nerve pain is doing the job of giving Otto full comfort from pain, then he can heal in comfort with the strict rest. With neck discs often it takes 3 different pain meds. Pain meds are not given as needed, but promptly every 8 hrs. Gabapentin stays effective in the body for about 8 hours. (NOTE: Trazodone is for anxiety. Gabapentin can have some sedating effect.)
NECK DISC HOME CARE
There are extra things you can do at home to help the neck heal, such as softening hard kibble, raising food/water dishes, etc. More info here: dodgerslist.com/2020/05/05/cervical-care-tips/
RECOMMENDED to not quote any of part of our posts. -- Instead use the QUICK REPLY typing area at the bottom of the page. -- QUICK REPLY area allows you to quickly scroll up to read a question, then scroll down to make your own full sentence reply, etc. -- Otherwise it becomes confusing when you quote our posts whether then those are your words or ours. -- In your post we only want to read your words. Thanks bunches for helping us! 5 QUESTIONS (please do not quote the questions in your " QUICK REPLY" answer.) 1. Let us know what you observe currently if you do some happy talk or if Otto sees you coming home.2. Currently have you observed any movement of front or back legs? Such as an trying to reposition his body, makes attempts to use back or front legs?3. A. Can you take him outdoors to see if he will sniff an old pee spot and then observe if urine comes out. Make sure your hands nor a sling are not pressing on the tummy area. or... B. Can you make sure your hands on not pressing on tummy when he is put on a pee pad. Seeing (head level) the pee pad may trigger the brain to send a message to the bladder to release urine.4. Would your parents be able to login and update or ask questions while you are gone?5. Let us know more about gabapentin. Liquid or capsule or tablet? 1.5 mgs gabapentin dose does not make sense for a 20 lbs dog. (If liquid what is the formula on the bottle: ?mgs gaba in one mL liquid?) |
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Post by Danielle & Otto on Feb 20, 2022 19:21:17 GMT -7
Movement - I think my dog has function on his [front?] right side but not his left. Even in back legs he seems to control them on the right. This is what the neuro said before (three years ago). He was worse on his left. Working on getting appt with neuro. She is out next week but may be able to see us the week after. I think Otto has a uti. His urine is a bit brown. I need to go to primary tomorrow. Will try not to get the terrible vet I saw a on 2.10.22 again. 5 Questions 1. Looks happy does not move much. 2. He can move on his right side not his left. 3. I should [take him outside for Sniff/pee test] do this. I have just been keeping him very still indoors. 4. [Would your parents be able to login and update]Sorry, I was so wrapped up in a human medical emergency I did not have much time except to ask how he is doing to my family. 5. [Liquid or capsule or tablet? Formula ?mgs in on mL?] Maybe it is 1.5 ml. Otto has not improved but it has only been a week. Same condition. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Feb 20, 2022 22:07:44 GMT -7
Danielle, pretty much Otto is non-functional on his the left side of his body?
--- Has pretty good control of front and back RIGHT legs only?
--- Not much or any control of front and back LEFT legs?
If you do some happy talk, will Otto wag his tail?
Color brown in urine may well mean blood in his urine. Good thing you are taking him in tomorrow, as he may have a bad UTI if there is blood in the urine. A urinalysis is the in-house test done while you are there. The result will if there is infection needing an antibiotic Rx.
Take the bottle of gabapentin in with you to the appt. Ask the vet for clarification about gabapentin dose.
TABLET? Have the vet tell you how many mgs in one dose.
LIQUID? Have the vet tell you the forumula. How many mgs of gabapentin are one mL of the liquid.
You can then tell us how many mL's you give for each dose.
Look forward to hearing if Otto has a UTI and name of antibiotic Rx'd + (mgs and frequency).
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Post by Danielle & Otto on Feb 24, 2022 19:17:26 GMT -7
Otto has a uti. ✙Cefpodoxime 50 mg a day.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
20 lbs 13 y.o.
1/10/22 stopped walking
Strict rest started 2/10
2/11/22 vet appt neck pain
Meloxicam since 2015 hip displays: 20lb dose
gabapentin 50 mg/mL: 75mgs (1.5mL dose) 3x/day AS NEEDED
Amoxiclav 125mgs for foot abscess
✙Cefpodoxime 50 mg a day as of 2/21 for UTI
cyclosporine drops for eye
Trazadone 12.5 mgs 1x/day p.m. stopped 2/12
Pepcid AC 5mgs 1x/day]
I think his gaba compound has 75mg in a dose. Does not walk but does pee and poo in old pee spot. Curled in a ball.
Have appt with neuro. Checking to see if i can get appt sooner with ivdd expert surgeon.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Feb 24, 2022 20:12:33 GMT -7
Danielle, so that Otto does not need to lie down curled in a ball when peeing, would you be able to support him in an upright position with the use of both a front end sling and a rear end sling? A DIY figure-8 sling works especially well for the male dog anatomy at potty times. DIY sweatshirt sling...can be used for front leg support. Also you could use the same concept with cut out leg holes in a long strip of sheet or bath towel: www.lyonpuffpetsit.com/htmlslp/sling.html4 questions: 1) When he pees in a lying down position, is there a clean up issue from getting urine on his fur, his skin and on his penis?2) We would need to have the formula for the liquid Gabapentin compound. The formula should be on the bottle itself. Can you take a picture of the bottle for us to see. The formula would be in a format similar to this: 5mgs/5mL or 1mg/1mL
If he started the Cefpodoxime on 2/20, by now Otto should be feeling much better. The dark color of the urine should be getting back to normal.
3) Could you give us an update on the UTI, let us know how things are going.
Glad to hear you do now have an appt with a neuro to confirm a diagnosis.
4) What date is the neuro appt? |
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Post by Danielle & Otto on Feb 25, 2022 19:51:08 GMT -7
Thank you for your help and support, Paula!
1. yes, I have Pet wipes. I try to use them.
2. [gabapentin] 50 mg/ml/ml
3. Getting better. No blood in urine.
4. [neuro appt] March 8th.
I am not a vet but I think he has cervical ivdd affecting his left side. His head is constantly tilted to the right.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Feb 26, 2022 9:55:18 GMT -7
Danielle, very glad to hear in 10 days Otto will be seen by a neuro on March 8!
Constant tilting of head to the right is something the neuro will be able to comment on.
Most Important will be learning the neuro's diagnosis which includes the name of the disease he determines Otto has. With the confirmation of a named disease, then you can be assured Otto gets the matching correct treatment. That is whether to continue with the treatment for IVDD or a different treatment plan for a different disease. The written report the neuro gives you will have loads of valuable information!
Otto must feel much better with the antibiotic killing off the bladder bacteria. Does he act more perky with the infection declining or now gone?
Can you now take him outdoors for the sniff and pee test? See if he still has bladder control. Leaking on you when lifted would be a sign of no bladder control. Dogs who have lost bladder control can get UTI's in a matter of days if not expressed. So that is why it is important for you to know about bladder control. Dogs with lost bladder control need to have their bladders manually expressed.
We look forward to updates that all pain remains in control.
Let us know if you observe any purposeful movement with his paralyzed LEFT side.
What do you observe with the LEFT front and/or LEFT back legs?
--- When he tries to reposition his body with his RIGHT legs...
what do you observe the LEFT front leg doing?
What about the LEFT hind leg?
Do the left legs (back or front) attempt to move to help reposition his body?
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Post by Danielle & Otto on Mar 8, 2022 22:44:05 GMT -7
Went to neuro [3/9] today. MRI machine is broken. Waiting for them to get it fixed, as we opted for MRI. Neuro says he is in much worse shape than the last time she saw him three years ago.
Went through his antibiotics treatment [completed] and neuro tested him to check if he has any infection left. Waiting for results. We also discussed ways to prevent uti. She suggested I take him outside to pee to empty his bladder. So I started doing that but still use a pee pad outside so he doesn't get too messy. I have this whole process where I use pet wipes to wipe him down.
Still has bladder control.
I asked for more pain meds but she said he does not seem to be in much pain.
She actually thinks he is more affected on his right front side this time, not left.
I still think it is cervical ivdd. It is a bit difficult to really sit down with her and talk due to covid restrictions.
I suggested that but she is not sure. She says it would be atypical presentation for ivdd.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 9, 2022 8:57:11 GMT -7
Danielle, front legs affected means, if a disc problem, then the disc is in the neck (cervical). There are other diseases which can affect the front legs. So sorry the MRI was down for your appt. Hopefully, it will be back up soon, so you can get answers on the name of the disease.
Did the neuro send off for a Urine Culture test to verify all bacteria dead and the name of the specific bacteria? Or did she do a urinalysis that just indicates no bacterial infection?
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Post by Danielle & Otto on Mar 9, 2022 19:33:51 GMT -7
No uti present anymore. However, they are doing further testing to check for kidney disease.
Trying to put him on better plan of going outside and not just doing pee pad all of the time so he wont get a uti.
His mri should be [3/16] next weds.
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Post by Danielle & Otto on Mar 17, 2022 21:25:59 GMT -7
Went to neuro today for [3/17] MRI. Not great news. But I feel better. At least not a tumor.
My dog does have cervical ivdd. 4 discs are affected.
2 very badly. Neuro says the worst herniations she had seen!
He also has doggy dementia (he barks at night).
So now everything is explained and I know his exact conditions.
She is very concerned that he won't walk again and recommends I put him down if he can't walk.
We discussed surgery. I am a little scared of it. He is already almost 14.
remove meloxicam for 5 days
then start prednisone 5 mg per day
[MED LIST/HISTORY- Moderator's Note. Please do not edit
20 lbs 13 y.o.
1/10/22 stopped walking
Strict rest started 2/10
2/11/22 vet appt neck pain
Dementia - barks at night
Meloxicam since 2015 hip displays: 20lb dose STOPPED 3/18?
prednisone switch 3/23???:
gabapentin 50 mg/mL: 75mgs (1.5mL dose) 3x/day AS NEEDED
✙Codeine 15mgs ?x/day
Amoxiclav 125mgs for foot abscess
Cefpodoxime 50 mg a day as of 2/21 for UTI
cyclosporine drops for eye
Trazadone 12.5 mgs 1x/day p.m. stopped 2/12
Pepcid AC 5mgs 1x/day]
can have 15 mg ✙codeine if needed
Re-check in 2 weeks Then we will discuss next steps such as surgery.
I have internal med appt for kidneys in a few weeks.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 18, 2022 8:49:11 GMT -7
Danelle, there is usual expectation about nerve healing timeline. The extent of nerve damage dictates how long it could take to regain function. It is better to think in terms of many months rather than days/weeks for this slowest part of the body to heal — nerve healing.
The key component for the begin of nerve function return is having deep pain sensation (DPS). When there is loss of DPS, even that could have the possibility self heal with time.
What did the neuro tell you about the current observation about DPS in front LEFT & RIGHT legs and back LEFT & RIGHT legs?
Did you get a written report from the neuro?
Did the neuro yesterday explain the thinking behind the stop of Meloxicam (non-steroidal) and a switch to Prednisone (steroid) 37 days after this neck disc happened on 2/10?
If there would still exist painfully inflammed tissue, the stop of Meloxicam for 5 days could well leave Otto with pain breaking thru with only gabapentin. Having another pain med (codeine). Should keep him in comfort. Do monitor carefully for any hint of pain surfacing these 5 days. Report pain have no patience...there are further med adjustments a Neuro could make.
Sorry to keep asking, but details are important so we can follow along.
What date is prednisone dosing to start?
How many times a day can you give codeine 15mgs?
How is Otto acting/feeling now a days?
-- Happy to see his meal being delivered to him?
-- Does he eat it all?
-- Is he happy when you come near to keep him company and sweet talk with him?
-- Is he able raise up to sit.. to look about his home to see what's going on? Or see out the sliding glass door?
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Post by Danielle & Otto on Mar 21, 2022 19:19:23 GMT -7
Per [3/18] neuro report, still has pain sensation. all legs.
yes, I have the report.
my dog was on meloxicam long-term. I did not get to a competent vet right away. In January, he started to have symptoms. i wish I had crate rested him asap, but I did not know it would get so bad. Sometimes, he will just have a bad day so it was hard to tell.
Around Feb 1st, stopped walking completely. On the 10th, went to a primary (I hadn't seen her before. Urgent care situation). She was horrible. I told her I thought my dog had ivdd and demanded a treatment plan, but she could not help me.
I had a human family medical issue, so I concentrated on that for a week to see if Otto would get better through conservative rest.
On the 18th, I called the neuro but she was on medical leave. I could not see her (the closest neuro to me) until March 9th.
We did not get our mri until the 18th because the machine was down. It took him a while to get care.
Wash-out period now over. I will give him steroids starting tomorrow.
The usual primary I like gave me some stronger ▲gaba. 100 mg pills I can give him 1 or 2 every 8 hrs.
Steroids start tomorrow. He can have codeine every 6 to 8 hrs.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
20 lbs 13 y.o.
1/10/22 stopped walking
Strict rest started 2/10
2/11/22 vet appt neck pain
Dementia - barks at night
3/21 4 limbs w/DPS. Can't sit up with front legs. Back leg paralyzed
Meloxicam since 2015 hip displays: 20lb dose STOPPED 3/18?
✙prednisone as of 3/21: 5mgs 2x/day for 14 days, then 4/4 taper _pain / _neuro
gabapentin 100mg tab: ▲100mgs 3x/day
Codeine 15mgs 3x/day.
cyclosporine drops for eye
Pepcid AC ▲10mgs ▲2x/day]
💕Otto still loves food! He eats it all. 💕He loves attention.
He cannot sit up. His mobility has never been so bad.
Can I put a blanket or towel a couple inches thick (folded over) under his head to keep his neck comfortable?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 21, 2022 20:46:45 GMT -7
Danielle, let us know what you are actually promptly giving at this point in time for these meds: - gabapentin __ 100mgs or __200mgs 3x/day - codeine 15mgs __ every 6 hrs or ___ every 8 hrs - Pepcid AC (famotidine) the usual for a 20 lbs dog is 10mgs twice a day. Did the neuro say there was a health reason he should take only 5mgs once a day? What is your observation on the pain meds, keeping pain fully in control round the clock? For how many days will prednisone be at 5mgs dose once a day? Then it begins to taper. If you have the ability to scan or take a jpg of the Neuro report, it may reveal a better understanding of things for us. YES, do provide a rolled up blanket/towel, a pillow as kind of a bit of bolster (raised area) for Otto to rest his head on if he wishes. Observe what height is most comfy for him. |
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Post by Danielle & Otto on Mar 23, 2022 18:52:50 GMT -7
Amoxiclav 125mgs for foot abscess
Cefpodoxime 50 mg a day as of 2/21 for UTI
We discontinued the above.
gabapentin __ 100mgs 3x
- codeine 15mgs every 8 hrs
- Pepcid AC (famotidine) My pills are 10 mgs. I can up to ▲[Pepcid AC] 10 mgs twice a day.
Pain - I think he is ok. Pain meds help.
steroids - [Prednisone] 5mgs twice a day
Surgery. I think surgery could benefit Otto. However, I am afraid that he might not survive such a major surgery when he will be 14 in July. Do you see a lot of older dogs having spinal/ivdd surgery? Do they do ok?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 23, 2022 20:10:07 GMT -7
Danielle, glad to hear having both codeine and gabapentin on board every 8 hrs is providing full comfort from pain right up to the next 8 hr doses. Yes there have been a number of senior dogs such as 14 y.o. who have had a surgery. Age alone does not rule out surgery. Do read over the interview with Neuro Surgeon Dr. Isaacs, about surgery: dodgerslist.com/2020/05/12/dr-isaacs-surgery-answers/More excellent info to help with discussing conservative vs. surgery with your own neuro: dodgerslist.com/2020/02/10/surgery-vs-conservative/It is the consultation with the neuro who takes into consideration the over all history of Otto and what the neuro thinks can be achieved with a surgery who you need to have a discussion with. |
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Post by Danielle & Otto on Mar 29, 2022 23:37:02 GMT -7
Otto is improving and neuro agrees at recheck. Steroids helped. No surgery. He will get a wheelie cart. Still not walking but trying hard.
Recheck a few weeks.
Same meds. Taper off ▼codeine [?mgs ?x/day].
[MED LIST/HISTORY- Moderator's Note. Please do not edit
20 lbs 13 y.o.
1/10/22 stopped walking
Strict rest started 2/10
2/11/22 vet appt neck pain
Dementia - barks at night
3/21 4 limbs w/DPS. Can't sit up with front legs. Back leg paralyzed
Meloxicam since 2015 hip displays: 20lb dose STOPPED 3/18?
prednisone as of 3/21: 5mgs 2x/day for 14 days, then 4/4 taper _pain / _neuro
gabapentin 100mg tab: 100mgs 3x/day
Codeine ▼15?mgs ▼3?x/day.
cyclosporine drops for eye
Pepcid AC 10mgs 2x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 30, 2022 8:14:14 GMT -7
Danielle, sounds like the neuro and you observed some things you referred to as improvement! We are very curious. Could you share the details... What did you both observe in the way of nerve function improvement for front legs, for back legs?
What is the taper dose for codeine now: ?mg dose and/or ?x/day Is prednisone still on schedule to begin a taper on April 4th? The pred taper along with the reduction in pain meds (gabapentin and codeine) will give proof if all spinal cord swelling is finally gone or not.
WHEELCHAIRS
Use of a cart is most typically reserved until off of all meds to prove all swelling is gone AND at the end of the 8 weeks to allow the disc to heal. That 8 week mark would be approaching on April 7th.
A cart means a new beginning as mobility and independence is restored, renewed spirits! Better to save up for a quality cart with features an IVDD dog requires. A cart will be used every day, several times a day. Avoid buying one that sits in the closet because it's too difficult to get the dog in and out. Or one the dog just does not like too much weighty feel of.
With Otto, the cart can also be used as a PT device. Look for a brand cart that also allows the limbs to also move in a walking motion as the cart supports them.
When considering a wheelchair, these are the key important features that an IVDD dog would need in a cart: dodgerslist.com/2020/06/06/wheelchairs/
This discussion may be of help to jot down wheelchair features important to you and your dog when comparing the many brands on the market: eddieswheels.com/p/15/Wheelchair-Comparisons
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Post by Danielle & Otto on Apr 3, 2022 17:31:58 GMT -7
Well, my dog was curled in a ball and could not move at all.
As of today [4/3], he can almost get off his pee pad by himself. He is doing it right now. However, he cannot get up yet. He definitely went from facing me to facing away from me by himself through squirming [no leg use?].
codeine - neuro just said taper. I have been giving it to him sparingly. Yesterday, I skipped because he seemed really drowsy due to his gabapentin.
Neuro says that Otto will stay on steroids long-term.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
20 lbs 13 y.o.
1/10/22 stopped walking
Strict rest started 2/10
2/11/22 vet appt neck pain
Dementia - barks at night
3/21 4 limbs w/DPS. Can't sit up with front legs. Back leg paralyzed
Meloxicam since 2015 hip displays: 20lb dose STOPPED 3/18
prednisone as of 3/21: 5mgs 2x/day for long term use
gabapentin 100mg tab: 100mgs 3x/day
Codeine ▼15?mgs ▼3?x/day.
cyclosporine drops for eye
Pepcid AC 10mgs 2x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Apr 3, 2022 19:02:39 GMT -7
Today did you see any purposeful use of his back or front limbs? Or was it just the wriggling/squirming which allowed his body to change position?
Did the Neuro say what the reason behind staying long term on the steroid prednisone?
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Post by Danielle & Otto on Apr 17, 2022 16:35:53 GMT -7
My dog can move his limbs a little but is not strong enough to get up and walk. Neuro is tapering down steroids but Otto will stay in lowest effective dose long-term I think. We had an internal med appt, but no organ issues at this time. A bit mobile, but cannot walk. I am trying to make him a pt appt to help get him in a wheelchair but there is a long wait. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Apr 17, 2022 18:18:17 GMT -7
It appears, then that Otto has graduated! You could order a cart for Otto. Unless there is some discount involved via the PT place, then going direct can be a good option of cutting out the middle man. Determine what your budget is and which cart you want for Otto. Leslie at Eddie's Wheels, from my own personal experience, is very helpful over the phone. Other manufacturers may also provide good service. AT HOME PT to help Otto's front and back legs get/stay in shape til he can begin to walk and you can get him in for underwater treadmill. Sorry it is taking so long to get in with PT. With graduation from conservative treatment, the disc has healed. Now it the time to incorporate these at-home exercises to help to keep the joints flexible as well as maintain good circulation for his limbs. Do them for the front and for the back legs.
Let us know how you are doing and if Otto is accepting of your doing these exercises. |
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Post by Danielle & Otto on Apr 20, 2022 18:12:41 GMT -7
Hello.
Working on getting a cart. have an appt for pt at end of May, but someone else might be able to take us sooner.
I have a question. Could Otto benefit from a drag bag? He can scooch around more everyday.
He has all four limbs affected.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Apr 20, 2022 18:36:35 GMT -7
Danielle, while all four limbs are affected, can you be specific in what the front legs and what the back legs can do. If we where there, we'd know. But we are not, so we depend on you painting a picture of what Otto can do. With more clarification we may be able to offer more ideas in the way of at-home PT. What are you currently doing for at-home PT? GARMENTS to protect Anxious to learn more just how much Otto can "scooch" on hard floors and carpets. You will want to consider how you will prevent rug burns from scooting indoors. Here are some sew and no-sew options: dodgerslist.com/2020/06/13/garment-skin-uti-protection/ |
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Post by Danielle & Otto on May 15, 2022 8:20:25 GMT -7
Otto can move limbs a bit but not strong enough to get up or walk. He was able to drag him self around a bit but has seemed to have lost it. I still have not ordered a wheelchair. I am not sure if he is still strong enough for it anymore? I have pt in two weeks. Maybe the therapist can do the measurements for me.
He had trouble during steroid tapering and lost some of his mobility so he will be on more steroids for a week (1.5 mg) and then .5 mg twice a day after that for a couple weeks. Then go back down to .5 mg.
For current pt, I just do bicycle leg exercises.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 15, 2022 8:53:31 GMT -7
Did the neuro say Otto would need to be on prednisone long term?
If yes, what does the neuro expect prednisone to do for the long term. Is Otto experiencing painful discomfort that an anti-inflammatory such as prednisone could deal with?
Nerve healing is something the body self heals. There are no meds that heal nerves.
"Otto can move limbs a bit but not strong enough to get up or walk." Which legs is this in reference to--- the back legs or the front legs?
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Post by Danielle & Otto on Jul 5, 2022 20:22:36 GMT -7
yes, Otto is on pred long-term but she reduced it to 2.5 mg every other day. It is to reduce inflammation, I believe. All legs can move, but not strong enough to walk. We went to the pt, but she was not very helpful. We just did consultation. We got a wheelchair ourselves. He cannot walk on his on, but can pedal his legs if I push him. He loves it!For pt, I massage his leg, and do bicycles. Still struggling with uti. He finished a one-month course a week ago. I am going to get him a follow-up test at the vet on Saturday to see if we kicked it. My question is, is this product safe to give my dog? www.samsclub.com/p/mm-famotidine-2x100ct/prod17110185?xid=plp_product_1Is there anything I need to watch out for when giving him a generic pepcid product? Any ingredients to avoid? He is approved by both neuro and internal medicine to take pepcid/famotidine! |
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