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Post by Erin Klinghammer on Sept 20, 2022 7:40:01 GMT -7
[Original subject line:IVDD help! ] Erin has registered: dodgerslist.boards.net/user/9092i.postimg.cc/HndzvQRF/dox.jpg i.postimg.cc/BnqHfBN0/Conser-Rest.pngHi... I am looking for some advice and support for my mini dapple dachshund. I am getting mixed information and I'm not sure what my next steps would or should be. Ella go up yesterday morning
(Sept 19) and seemed weak in the hind end. She’s 12. She went down the steps to pee and went and peed with no issues but only made it back up two steps. Then when she came in she slipped on the floor … didn’t seem right to me so I crated her immediately and went to the vet. while at the vet, I took her out to pee again and she went to trot toward me drug her hind leg. we finally got in to see the vet and honestly I feel like they weren’t that concerned. They said it was either arthritis or IVDD I couldn’t tell unless they took an x-ray and the treatment would be the same anyway. They said if she did have IVDD that it was stage one.. I had to bring up the crate rest question and also the acupuncture question. When they put her down to walk yesterday in the clinic she was not wobbling a lot at all. If I hadn’t of known about these things I feel like I would not have been told and they didn’t really seem that concerned that she should be on crate rest but I am giving her crate rest anyway.. If a I left with Metacam and Gabapentin for the pain. Both for 10 days. [MED LIST/HISTORY- Moderator's Note. Please do not edit ]
weight? 12.5 y.o.
9/19 dragging back leg
Metacam as of 9/20: 5mL 1x/day for 10 days, then 9/30 STOP test _pain/neuro
gabapentin 50mg 2x/day ; Script runs out on 9/30
Doxie needs GI tract protector, Pepcid AC, on board for duration of Metacam! ] Is there anything else I should be doing? Now, her front legs seem weak [9/20] this morning when she went out to pee but they also said the Gaba might make her more wobbly...so it's hard to tell if she is getting worse or it is the meds. She has been in her crate. should I get another vet to check her ? What would you recommend? Maybe I'm just being impatient. Her front paws seem to want to tuck under when she is laying down... I have an appointment with my regular vet on Friday (Sept 23)...No one seems concerned and maybe I just need to give her time... I am having a hard time getting any vet clinic to help me... my regular vet says no appointment until Friday, the emergency vet yesterday didn't seen concerned (although I should call them back and tell them about her front legs) and I tried a few others that were recommended and they just keep telling me to go back to my regular vet. She is not yelping and doesn't seem to be in pain. Just very wobbly and awkward when she tries to move in her crate.QUESTIONS ☆ 1 Is there still currently pain? X can’t find a comfortable position, appears restlessX Not their normal perky selves?2 How much does your dog weigh? Age? Gabapentin 50 mg every 12 hours for 10 daysMetacam dosage for 5kg of body weight (5 ml?) every 24 hours for 10 days ☆ 3 -- So far, she is still eating and drinking.
☆ 4 Mini Dachshund 12.5 yrs. old Your dog’s name? Ella Your name? Erin ☆ 5 they said it could be Stage 1 IVDD or Arthritis - they did not specify -- Is the vet a general DVM? General vet ☆ 6 What was the date you saw the vet for CONSERVATIVE treatment? Sept 19
☆ 7 sniff and squat bladder control? YES☆ 8 Currently wobbly walk? YES
move the legs at all? YES wag the tail w/happy talk? YES
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 20, 2022 10:05:55 GMT -7
Erin, welcome to the Forum. When there are neuro issues along with pain, that would seem to make the diagnosis lean more in the nature of a current disc episode going on. We are not vets and we do not diagnose. Our job is to aid you in the key thing about a disc episode...that is to arm you with knowledge to ask good questions, understand what the vet may be saying and to give good home care. It sounds as though you have been doing some reading to know the importance with a disc episode of limited back movement in a recovery suite to allow the disc to begin healing....that is #1 care. Re-review "Potty Time" essentials in your above initial post w/questions, if you need to. Let us know that you are carrying Ella to and from the potty place. Then you allow only the very fewest minimal of footsteps to take care of business.
What is Ella's weight?
PAIN Pain meds are effective for about 8 hrs. And normally there are 3 sources pain each needing a different med to address. Advocate for 3x/day dosing and all three meds if signs of pain are not fully in control round the clock with one pain med (gabapentin 2x/day): traMADol-general analgesic,
methocarbamol- muscle spasm pain
gabapentin-nerve pain
Pepcid AC (famotidine) suppresses acids anti-inflammatory Metacam causes
Adjusting meds by phone avoids a risky-to-the disc car transport. Describe the signs that you're seeing especially when having to move or nearing next dose of gabapentin. There should be no sign of pain from one dose of meds to the next. Have no patience with pain as it does hinder healing. Look for your dog to be acting their normal, perky self when pain is fully under control round the clock.
SIGNS OF PAIN: ⚙︎ shivering-trembling ⚙︎ yelping when picked up or moved ⚙︎ tight tense tummy ⚙︎ arched back, ears pinned bac ⚙︎ restless, can't find a comfortable position ⚙︎ slow or reluctant to move in suite such as shift positions ⚙︎ not their normal perky interested in life selves ➕if a neck disc: ◻︎ head held high/ nose to the ground ◻︎ 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 up flamingo style not wanting to bear weight METACAM (anti-inflammatory)  *-- Learn about Metacam. An informed owner is a dog's best defense when taking an anti-inflammatory: dodgerslist.com/2020/04/18/steroids-vs-nsaids/ Let us know what you and your vet have worked out on the 9/30 Metacam STOP. -- Be clear what your job is on the 9/30 stop of Metacam
-- Which does your vet want on the STOP re: pain meds—full stop or reduce in mgs/frequency? NOTE: it appears you would full STOP gabapentin on the 11th day. -- how to arrange for a Plan B with your vet. -- Why Pepcid AC: dodgerslist.com/2020/05/06/stomach-protection/ MONITOR NEURO DIMINISHMENT Did your vet think the disc was in the back or the neck? A neck disc can affect both the front legs and the back legs. A back disc only affects the back legs. As damage to the spinal cord increases, there is a predictable orderly step by step deterioration of functions. 1. 9/19 Pain caused by the intial disc tear & inflammation in the spinal cord 2. 9/19 back wobbly legs 9/20 front weak/wobbly? __ back __ front legs cross 3. __ back __ Nails/toes scuffing floor 4. __ back __ Paws knuckle under, dog can right paw or is slow to right it 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/Erin, is is very prudent to take the action you have to assume you may be dealing with a disc episode until you have a firm diagnosis of another disease which may have a different treatment. FYI: -- X-rays can't show soft tissue of muscles, discs and spinal cord. Thus an X-ray is used to rule out other disease that may mimic IVDD, when there is a high suspicion not IVDD. THANK YOU for registering. Please do first login and then post as a member rather than as a "GUEST" As a member you would be able to receive an email alert when a reply is waiting for you if you have logged in. Timely interaction is important when helping your dog. |
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Post by Erin & Ella on Sept 20, 2022 16:54:08 GMT -7
Thank you for all the information.... Ella is around 5.4 kg (about 12 lbs. ) That is what the vet said, but I think she is closer to 14 lbs. It was difficult to get her weight. I was just ( Sept 20)at the emergency vet again and they did not give me much hope because it had ▲ progressed to her front legs today. But I remain hopeful. I can't give up on her. Still on the same dose of Metacam and Gabapentin and crate rest. I feel so helpless! [MED LIST/HISTORY- Moderator's Note. Please do not edit ] about 11.9 pounds 12.5 y.o. NECK DISC 9/19 dragging back leg ▲9/20 weak front legs Metacam as of 9/20: 5mL 1x/day for 10 days, then 9/30 STOP test _pain/neuro gabapentin 50mg 2x/day ; Script runs out on 9/30 Ella needs GI tract protector, Pepcid AC, on board for duration of Metacam! ] I am afraid of making things worse when I take her out to pee, but how do I handle her when both her front and back legs are weak? I tried to support her today but it made it worse and made her more off balance. she ended up wobbly walking on her own about 6 feet then stopped and peed. Can you offer any more guidance on this? The vet thought the disc was in her neck just because her front legs were not working properly BUT she is still moving her head normally, flapping her ears (head shake) and moving her head up and down and side to side. I am nervous that tomorrow she will be worse... I see your progression steps and it scares me to no end. I have an appoinment at my own vet on Friday (Sept 23rd) |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 20, 2022 19:37:26 GMT -7
Erin, do you live in the USA? if not which country, Canada?Not all vets can know in depth every disease for all the species they treat (birds, cats, dogs, reptiles, farm animals). But you CAN KNOW just one very important to you disease. If at some point their would be an indication a surgery might help, would that be an option for your family? If for whatever reason (health, finances, etc) a surgery is not an option, conservative treatment is the best option. As one IVDD researcher Dodgerslist is currently in contact with said the literature shows that many dogs can and do self-heal their nerves without a surgery. All nerve healing takes time for this slowest department of the body. #1 is to make sure you are limiting potty time to minimal footsteps only. -- set up a physical fence in the grass to limit visually and physical how many footsteps can be taken in a 6' diameter area' -- Do not walk with her with leash and harness. You stand in one spot. She may only take a few limited footsteps the 6' leash allows -- support both wobbly/weak ends with a harness and/or a sling. If your dog's legs are paralyzed or wobbly and has bladder control then the type of sling with holes for the back legs will give needed rear and for front leg support at potty time. Always try to keep the back horizontal to the ground as much as possible. 1) DIY sweatshirt sling...can be used for front or the back legs. Use same concept with cut out leg holes in a long strip of old bath towel: www.lyonpuffpetsit.com/htmlslp/sling.html 2) DIY figure-8 sling: dodgerslist.com/wp-content/uploads/2020/05/Figure8.jpg ** #2 STOMACH PROTECTION Is Pepcid AC (famoditine) on board now to suppress the acids stress, nerve damage AND Metacam cause? 5mgs every 12 hours. #3 POTTY TIME OPTION --Try a pee pad right outside and adjacent to the recovery suite to limit footsteps. Place an old urine stained paper towel on pee pad as incentive to let Ella know it is OK to pee on the pee pad. Save more urine stained paper towel in zip lock back for next time. As you see she start to think about peeing, tell her "go potty". When she does praise her. Soon she will be able to go on command to please you. #4 Ella will take her cues from you. It is important that you think everything is gonna be ok and that you are NOT HELPLESS. Actually it IS gonna be ok. With time your heart and brain will learn why as you educate yourself. Ella needs to be around positive energy...so be lighthearted in your body language and voice. You know how to monitor for neuro diminishment and YOU did the right thing getting to a vet.
**  Most vets would have switched to the more powerful of anti-inflammatory the steroid class soonest possible... hours matter! Getting your own vet to help in 3 days delay on 9/23 is not fast enough!
Can you call and tell ER you would like to get prednisone steroid on board tonight. PLUS not just the one stomach protector Pepcid AC we've asked you about BUT ALSO no2 (SUCRALFATE). Normally a 5-7 day washout is for stomach safety. In an emergency of neuro loss sucralfate is added to enable switching same day neuro decline is in evidence. Sucralfate bandaids any damaged areas of the stomach lining and provides a good healing environment. |
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Post by Erin & Ella on Sept 22, 2022 11:17:45 GMT -7
Yes, I'm in Canada (New Brunswick)
We are sticking to conservative treatment...surgery will be $10,000 + and Ella is already 12.5 yrs old
Thank you for these pics for a sling... I have tried and tried to get her to go outside and she is not comfortable with the sling around her and will not go. So has instead been peeing/pooping in her kennel and I clean her up right away. I'm just thankful she is still peeing and pooping on her own. She is also wagging her tail when she sees me in the morning.
She is not worse today... wobbly of all four legs, can stand on all four legs, but cannot take any steps. no control of her legs, she falls down. She can prop herself up on her front legs, but cannot get up on her back legs by herself. If I set her up, she can stand on all fours for a few minutes.
asked the vet about this [Pepcid AC] yesterday (09/21) and she said that in the short term Metacam would not hurt her stomach (?) ... I am seeing my regular vet tmr and will ask this question again.
As mentioned above, for now, she pottying in her kennel.
I am trying my best to stay positive, but wake up each morning feeling hopeless and scared that she will be worse.
I did call the emergency vet again re: the steroids and they said that steroids are not used as much anymore and have more side effects and that the Metacam would do the same thing ...(?).... I will ask my regular vet this question tmr.
I am also going to ask about cold laser therapy and acupuncture.. What is your opinion on these and when should each be started? Right away? After the 10 days of Metacam? Again, thank you for all this information. It is very very helpful and I am grateful.
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Post by Romy & Frankie on Sept 22, 2022 13:52:03 GMT -7
All meds have side effects. This includes both types of anti-inflammatories; NSAIDS like Metacam and steroids like prednisone. Some vets prefer one type of medication over the other, but steroid type medications are the more powerful type of anti-inflammatory. Vets that use steroids in the treatment of IVDD usually feel that they work well in reducing inflammation, which causes the pain and neuro issues.
Alan Schulman, DVM, DACVS, The Animal Medical Center of Southern California and the Veterinary Surgical Referral Service reflects those vets on this Forum who use steroids at the anti-inflammatory dose: "... While some may consider corticosteroid therapy controversial in treating intervertebral disk disease, my personal opinion, based on over 20 years of experience as a board certified surgeon, is to give steroids. Used intelligently and judiciously, my experience is that steroids have absolutely had a positive effect on a substantial number of our spinal patients." Dr. Alan Schulman, DVM, ACVS of Animal Medical Center of Southern California. animalmedcenter.com/intervertebral-disc-disease/There are several reasons that excess stomach acid is common during an IVDD episode. 1- Stress can increase stomach acids. Dogs are creatures of routine. Change of needing to be in a recovery suite, suffering with pain until pain meds can be Rx’d are stressful to a dog. 2- The use of any anti-inflammatory drug (steroid) or a non-steroidal (NSAID) can increase stomach acids. 3- Spinal cord damage can inhibit the autonomic function that normally protects the stomach lining.
Dogs can not speak up at the first sign of stomach distress like a person would. This is why Dodgerslist supports vets who are proactive in safeguarding the GI tract by using a stomach protector like Pepcid AC, choosing not to wait until signs of stomach damage appear.
I know that Ella does not like to go outside with her sling to potty. In general, dogs do not like to potty where they sleep, so she might be more comfortable using a pee pad right outside the crate. You can support her with your hands while she goes. I did this for a while during my dog's crate rest time.
Laser and acupuncture can be userful in recovery. These therapies can be started right away. Since transports can be risky during the IVDD episode, see if you can find a vet that will make house calls.
It is very scary when our dogs are diagnosed with IVDD. I remember so well feeling like this when my dog had an IVDD episode. Learning everything you can about the disease makes it less scary. Learn what to expect during the phases of healing here: www.dodgerslist.com/in-the-right-place |
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Post by Erin & Ella on Sept 24, 2022 17:18:16 GMT -7
These are the results from my vet visit on 09/23:
They took xrays and couldn't see any major issues. No visibly bulging discs or anything like that. She had no calcification between her vertebrae which could also be a cause of pressure on her spinal cord. The vertebrae when her back is hunched looked closer together but she feels that they have probably always been this way because she has always had a bit of a hunched back... The vet was very knowledgeable...the best one I have had yet. She used to assist on the surgeries for IVDD dogs at Atlantic Veterinary College when she was there, so she has seen a lot of this...She says that Ella's back end is definitely worse than her front but she is wagging her tail and will also withdrawn her leg when you pinch her toes on the hind end.
Front end is not as bad as rear end, but she said we need to watch closely to make sure the front end doesn't get worse. Ella is refusing her pain meds because they are in pill form, so they gave my ✙gabapentin in liquid form (which I think would be better anyway)...staying on the metacam ...she said that it generally works as well as steroids and has less side effects..She said that we would only try steroids as a last ditch effort...
[MED LIST/HISTORY- Moderator's Note. Please do not edit ]
about 11.9 pounds 12.5 y.o. NECK DISC
9/19 dragging back leg
▲9/20 weak front legs
9/23 wags tail, back legs weaker than front
Metacam as of 9/20: 5mL 1x/day for 10 days, then 9/30 STOP test _pain/neuro
gabapentin 50mg 2x/day ; Script runs out on 9/30
+gabapentin 100mg/mL: 50mgs (0.5 mL dose) 2x/day
Ella needs GI tract protector, Pepcid AC, on board for duration of Metacam! ]
we are hoping that she regains function in her rear legs so that she can at least support herself and walk, even if she's a bit wobbly.
Strict crate rest still...she said no exercises to be done with her yet at this stage... She got me into another clinic for acupuncture next week (09/29)....She said the vet there was very knowledgeable about acupuncture and IVDD dogs. She said as long as she keeps peeing on her own and her front legs don't get any worse, then it's just a waiting game and we will also treat her with acupuncture. She wants to see me for a recheck on 09/28 before the acupuncture treatment on 09/29. I think that's it... I left there feeling better and hoping for a recovery...I don't think all is lost.
The vet felt all along her spine and Ella did not cry out or wince...and she had no pain medicine in her at that time, so the vet feels that she is either a very tough cookies or she is not experiencing a lot of pain. That was yesterday (09/23) as for
today (09/24) Ella had diarhea in the night last night in her kennel...no poops so far today (09/24). She is not wanting to eat today and I had to try several things... I finally got her to eat a fair amount of chicken at 2pm but she has not eaten since and it is 9 pm. She drank about 300 ml of water yesterday (09/23), but only 125ml today (09/24), at the most. She peed at 9am, 4pm and 8pm.
My questions are:
-what is causing her not to eat? She does NOT seem to be in any pain, even if her pain meds are late, and she have never cried out or yelped, there is no shaking, and she is not holding her head low. I am thankful for that, but everything I have read says that she should be experiencing pain and I have not seen it yet, not once.
-I had to push her Metacam by 3 hours today because she would not eat and I didn't want to give it to her on an empty stomach. What are my options? Give it to her at her scheduled time even though she won't eat OR wait until I can get some food into her.
-is it ok to give the ✙Gabapentin (liquid) on an empty stomach. Her does is 0.5 ml every 12 hours now, instead of the pills which were 50 mg every 12 hours.
-it is possible that her front legs are a bit weaker today but I don't know if it is because she seems more lethargic today (not feeling well from diarrhea ?) or it's the gabapentin??? I can still prop her up on them and she will support herself for maybe 15 - 30 seconds, but that's it.
Perhaps I am expecting too much, too fast.... I keep reminding myself that it could take up to 8 weeks, but at what point should I see some tiny improvements?
Thank you for answering my questions.
Erin
[All quoted material has been removed. Moderators only want to read your words. Best way to reply is by using the QUICK REPLY area down at the bottom of the page. Avoid the "QuOTE" button.]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 24, 2022 17:42:26 GMT -7
Erin, it does not seem you are able to read Romy and my posts. We have been asking why Pepcid AC is not on board. As long as you believe your dog has no health issue to prevent Pepcid AC, give it now. Keep your vet in the loop as soon as you can. Then call your vet as soon as possible to to get #2 stomach protector an Rx item SUCRALFATE marvistavet.com/sucralfate.pml on board since you are now seeing ⚠️ RED FLAG⚠️ stomach damage of diarrhea PEPCID AC (famotidine) Proactive vets don't wait til there red flag signs of nausea, not eating, vomit, diarrhea leading to serious bleeding ulcers from the extra stomach acids Metacam causes. Pepcid AC (famotidine) supresses acid production. The usual dose of Pepcid AC (famotidine) with a disc episode for doxies is 5mgs 2x/day (0.44mg famotidine X dog's weight. Given every 12 hours.) Available at the grocery store. FIRST do ask your vet in this very, very particular way: Is there a medical/health reason my dog may not take Pepcid AC (famotidine) e.g heart murmur? Doesn’t need it, we wait til there is problem…are NOT answers to your question! dodgerslist.com/2020/04/18/steroids-vs-nsaids/** thumb.ibb.co/mEGRuy/91x_Aj_s00z_L_SY355.jpg |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 24, 2022 18:00:00 GMT -7
Erin, update us on the gabapentin.
What is the formula of gabapentin mgs to liquid mL? The bottle should contain the formula which might be written. 1mg/1mL or 5mgs/1mL, etc.
Did you discuss if a phone update rather than doing a risky to the healing disc transport for a vet visit?
Can you hire a mobile vet to do the acupuncture to also avoid risk of too much movement during a transport in for acupuncture?
It is best to GIVE PEPCID AC 30 mins before Metacam to help stomach suppress acids Metacam causes. IF you can also give a meal or a treat with the Metacam that also can be helpful.
Gabapentin can be given at the same time as Metacam. Gabapentin does not need to be given on an empty stomach.
PLEASE let us know when Ella's stomach has been protected with Pepcid AC (famotidine) from your grocery store or a pharmacy.
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Post by Erin & Ella on Sept 25, 2022 12:16:16 GMT -7
[Moderators only want to read your own words, Erin. Best to NOT quote from the post being replied to to avoid our being confused.
--- instead use only 1-2 word of reference with your reply
--- Use the QUICK REPLY area at bottom of page to write your reply in. QUICK REPLY allows scrolling up to post being replied to and then back down to continue your reply. Thanks for help us.]
Ok, I am going now (09/25 4:00 pm) to get [Pepcid AC] some... Ella does NOT have any other health issues. She has refused to eat thus far today. Can I still give her Metacam if she has not eaten IF I can get the Pepcid AC pill in her.... I think this will prove to be difficult without moving her neck too much.
I will call them tmr....it is Sunday (09/25) there in no one in office but I am going to drugtstore to get Pepcid AC anyway.
formula: Gabapentin 100mg/ml Give 0.5 ml every 12 hours
I will ask [about phone update] but she wanted to do another assessment before Ella starts acupuncture.
no mobile vet available in this area..... it is even difficult to get into any vet at the moment for anything...We are very very short on vets in this area of Canada.
If I cannot get any treats or food into her, do I still give her the Metacam???
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 25, 2022 13:24:54 GMT -7
Erin, do let us know you have the correct dose for the Pepcid AC with one single active ingredient of famotidine: Ella dose 5mgs famotidine twice a day. Use these ideas to ensure you get Metacam and Pepcid AC into her. 1) THREE TREAT METHOD Put the pill into the well of a small mashed banana ball, a cream cheese ball, liverwurst ball, Gerber Lil' meat sticks, or inside of a sticky small marshmallow and sealed completely so no taste is on the exterior. Use the three treat method. Prepare 2 treats with no meds inside PLUS the med ball. Give plain treat while holding med ball in front of eyes. The idea is your dog will be greedy after the first treat to get the 2nd. Immediately hold the 3rd plain treat so she will hurry to swallow the med ball to get to treat #3. 2) PILLING A DOG You know Ella has deep pain sensation because she CAN do a happy wag. Any one can correctly ID a happy tail wag (do some happy talk or show a yummy treat). But not every vet can correctly ID deep pain sensation. Could you give a phone update if Ella still can do a happy tail wag on 9/28 and perhaps save a trip in? HOWEVER the even any further neuro diminishment happens, update the vet asap...hours matter in getting steroid prednisone on board instead of less powerful Metacam The critical neuro function vets want to know about in order to take action is any further neuro diminishment. Especially the deep pain sensation (DPS). If DPS has been lost either a surgery could be considered OR immediate hours matter in switching to a steroid such as prednisone. Transport to and from the vet can be risky for a dog on conservative care with the potential for too much movement of the spine and pressure to the weak early healing disc. The benefits of any treatment (acupuncture, vet visits) need to be weighed against the risk of too much movement vs. what is an urgent care matter. You're doing the single most important part of conservative care - the 100% STRICT crate rest 24/7 to let the disc heal. In cases of an urgent care matter, roll up blanket or towel snug around Ella. This keeps her back from shifting as you take a corner or come to a stop.Erin, will be watching for your update on dosing Pepcid AC + the Metacam. Hopefully you will get pepcid AC into her asap you get home and then right away give the Metacam asap. Thereafter time it so ---pepcid is 30 mins before giving the Metacam. ---Give Metacam with a treat or meal. Helpful tip for you and to help us out, too.QUICK REPLY: Easy, fast and recommended!
Go to the "Quick reply" typing area at bottom of your dog's thread to write a reply. No need to quote from another post. Use your own words and maybe 1-2 words of reference if needed to make the sentence clearer. Quick reply allows you to scroll up and down to a previous post and then back down to the "Quick Reply" typing area to continue your own post. |
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Post by Erin & Ella on Sept 25, 2022 13:34:29 GMT -7
Hi...Just got back... it is coated ✙Pepcid AC Famotidine Tablets 10 mg (one single active ingredient)... I can cut them in half. Do you know if I can dissolved them or crush them and put them in a bit of water and then in a syringe to get it into her.
[MED LIST/HISTORY- Moderator's Note. Please do not edit ]
about 11.9 pounds 12.5 y.o. NECK DISC
9/19 dragging back leg
▲9/20 weak front legs
9/23 wags tail, back legs weaker than front
Metacam as of 9/20: 5mL 1x/day for 10 days, then 9/30 STOP test _pain/neuro
gabapentin 50mg 2x/day ; Script runs out on 9/30
gabapentin 100mg/mL: 50mgs (0.5 mL dose) 2x/day
✙Pepcid AC 5mgs 2x/day for duration of Metacam! ]
At this point, she is refusing all treats....even bacon. Just before I went to store, I did manage to get about 1/4 cup of ground beef (cooked) into her.
Does Pepcid AC interact at all with the Gabapentin? Is there any time period where I have to wait between giving the Pepcid Ac and the Gabapentin?
So there was stool in her kennel this morning (09/25) and it was completely back to normal.
She is drinking ..so far today about 125 ml of water.
I also have a question about the liquid gabapentin.... she wants to shake her head several times (not good) when I give it to her and I have to hold her head so that she doesn't...I think it's the taste... Can I mix the liquid gabapentin with a bit of liquid sugar or something in the syringe so that it will taste better?
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 25, 2022 18:49:45 GMT -7
You can try crushing Pepcid AC to dissolve in a bit of beef broth. Gabapentin is very bitter. The liquid is supposed to have a flavor added to make it tasty for dogs. Do not add any xylitol sweetener (toxic to dogs) to gabapentin liquid you have. You could try a bit of regular sugar but I have no idea how much it would take to mask the bitterness. Another option is beef broth to mask bitterness.. Have owners reporting their med list that neuros prescribe Pepcid AC gabapentin, and other IVDD Meds. There may be a technicality about some anti acids and giving space. Mostly the vets Rx'ing gabapentin do not seem to be calling for time space with Pepcid AC. Pepcid AC contains no aluminum or magnesium. We are not vets, we don't know your dog's complete health history. If you have a concern call ER and get their take. Dosing liquid medsPlace the tip of the Syrine in the mouth, just behind one of the canine teeth. Angle the syringe slightly to the side and deposit the medications onto the tongue. This avoids a dog aspirating liquids into their lungs. Encourages them to swallow properly. Stroke neck to encourage swallowing liquid meds.  * source: vcahospitals.com/ |
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Post by Erin & Ella on Sept 26, 2022 5:41:38 GMT -7
I did get the pepcid AC tablet into her...she swallowed it without too much fuss...
For the Gabapentin, it is supposed to be honey flavored, but she hates it and wants to shake her head when I give it to her, but I try to keep her from doing that. I did mix it with some real sugar solution this morning...I will get some beef broth later today. She still have very little appetite, whatever she will eat, she won't eat the second time. Like the hamburger, now she won't touch it. I'm going to pet store to see if I can get some sort of gravy or something more appetizing for her. She seems to be drinking lots... 250 ml [1 cup] yesterday (09/25). I am keeping her in her kennel 24/7. Just moving her in and out gently when I need to change her bedding. She was wagging her tail happily this morning when I seen her.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Sept 26, 2022 7:34:11 GMT -7
Erin, hope to hear today will go better for Ella as Pepcid AC is used 2x/day and where you can get all her meds down the hatch on time. Goal is to have no tummy issues and any painful discomfort is fully in control.
Sounds like her spirits were good with that happy tail wag greeting this morning!
You can look for no or low salt/no onion beef broth at the grocery store.
However, best nutrition is to make your own broth. On stovetop simmer a hamburger patty in a cup of water or so (no salt added). Cool. Discard the fat disc at the top which can cause diarrhea.
Save the cooked hamburger to crumble over her balanced vitamins/minerals/protein-kibble food. You could also make larger quantity broth to be able to soak her dry kibble in meat broth to make it more yummy tasting.
Reduce the hamburger broth by simmering until thicker and more intense flavor. This thick broth can be used to flavor gabapentin, etc.
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Post by Erin & Ella on Sept 26, 2022 10:56:20 GMT -7
I emailed the vet and she is mixing me up an ✙anti nausea medication today (09/26) that I am picking up shortly that she says may help with her appetite and she told me to stop the Metacam right away because it is hard on her stomach (which we know). When I get there, I will tell her I am giving Ella the Pepcid AC and maybe she will suggest contiuing with the Metacam. ... What are the consequence of stopping the Metacam at this point? Maybe just until Ella starts eating again?
[MED LIST/HISTORY- Moderator's Note. Please do not edit ]
about 11.9 pounds 12.5 y.o. NECK DISC
9/19 dragging back leg
▲9/20 weak front legs
9/23 wags tail, back legs weaker than front
Metacam as of 9/20: 5mL 1x/day for 10 days, then 9/26 STOP test _pain/neuro
gabapentin 100mg/mL: 50mgs (0.5 mL dose) 2x/day
✙cerenia 12mg 1xday
Pepcid AC 5mgs 2x/day for duration of Metacam! ]
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 26, 2022 14:10:52 GMT -7
The consequences of stopping Metacam is there will be no longer anything working on resolving the painfully inflamed tissue. Thus it may well be... ---- there is a need to increase pain meds to compensate til Metacam is back on board. ----- The test stop of metacam was to be 9/30. So it also may be if pain meds are stopped as well you just may not see any pain at all IF metacam has already been able to rid the body completely of painful swelling. No pain means no meds at all are needed! ---- Of course if you've been observing any hint of discomfort it would not be time to stop Metacam unless Pepcid AC and even maybe a 2nd protector SUCRALFATE can be prescribed in order to continue on with Metacam. So many variables, as you see. Discuss the pros and cons of each with the vet to come to a treatment that makes sense. Do let us know what the treatment will be. |
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Post by Erin & Ella on Sept 27, 2022 9:11:59 GMT -7
Ok thanks... I gave Ella the anti-nausea medication (Cerenia 12mg once per day) yesterday (09/26) at 5:30 pm and at 7:30 pm, Ella did eat 2 Tablespoons of chicken breast/cheese but that was all. so far not eating today.
I still gave her the liquid Gabapentin this morning at 7:30 am and the Pepcid AC but honesty, she isn't exhibiting any signs of pain and she never has, from the start... is this unusual?
No shaking, no whimpering, no crying, nothing, even when I move her in and out of her crate. She is drinking lots when offered to her. I am just worried about her not eating... I haven't heard back from the vet today to discuss the eating and I have a call in to her.
Is it unusual for them to stop eating even if they are not exhibiting any signs of pain or discomfort?
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 27, 2022 10:03:13 GMT -7
Erin, to be clear, did you stop metacam yesterday 9/26?
It seems to be a rather rare thing that a dog would not suffer from any signs of pain during a disc episode. But it can happen.
So then you would be monitoring the stop of metacam for worsening neuro function or pain surfacing. Those would be indicators to resume Metacam with not just Pepcid AC alone, but also a stomach protector that works in a different way: prescription SUCRALFATE.
She is not eating for a reason.
-- pain to open the jaw to eat (neck disc)?
-- upset stomach still? Indication 2nd protector (prescription SUCRALFATE) should be added?
Stopping all pain meds (gabapentin) eliminates masking of pain to let you accurately assess if Metacam has done its job:
--- reduction of aggravating/painful swelling over 7 to 30 days so the cord won't be aggravated and pain will be gone.
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Post by Erin & Ella on Sept 27, 2022 10:21:43 GMT -7
Yes... I did stop the metacam yesterday (09/26). so she has missed one dose thus far.
I am waiting to hear back from the vet and I will mention the sucralfate.
I honestly think her stomach is bothering her... she is moving her head and neck around with no issues at all..It's very strange.
I will keep an eye on her for worsening neuro functions, but she is very lethargic from the gabapentin, I believe. She is still wagging her tail when I talk to her and rub her belly.
Her vet appointment is (09/28) tomorrow at 12 noon. She is getting the gabapentin at 8am and 8pm. Perhaps I should NOT give it to her tmr morning before her appnt ? I will ask the vet if and when she calls me back.
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Post by Erin & Ella on Sept 27, 2022 12:45:42 GMT -7
Yes... I did stop the metacam(09/26) yesterday. so she has missed one dose thus far.
I am waiting to hear back from the vet and I will mention the sucralfate.
I honestly think her stomach is bothering her... she is moving her head and neck around with no issues at all..It's very strange.
I will keep an eye on her for worsening neuro functions, but she is very lethargic from the gabapentin, I believe. She is still wagging her tail when I talk to her and rub her belly.
Her vet appointment is (09/28) tomorrow at 12 noon. She is getting the gabapentin at 8am and 8pm. Perhaps I should NOT give it to her tmr morning before her appnt ? I will ask the vet if and when she calls me back.
The vet was not in today (09/27), I will talk to her tomorrow. I have been trying to not move Ella too much but I did try to prop her up on her front legs just now and she cannot support herself like she was on 09/23 at our last vet visit. Her front legs will not support her. On 09/23 I could put her front legs under her and she could hold her front end up but now she cannot. Maybe it is time I discuss steroids again with the vet...
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 27, 2022 14:03:45 GMT -7
Erin, once propped up being able to maintain the upright is not a neuro function. Dogs can support their weight by reflex.
In order to monitor for neuro function loss due to lack of Metacam (anti-inflammatory drug) since stopping 9/26, observe for these diminishments:
1. 9/19 Pain caused by the intial disc tear & inflammation in the spinal cord
2. 9/19 back wobbly legs 9/20 front weak/wobbly?
__ back __ front legs cross
3. __ back __ Nails/toes scuffing floor
4. __ back __ Paws knuckle under, dog can right paw or is slow to right it
5. __ little leg movement (can reposition in crate with legs
__ 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.
Ask to speak with another vet in the clinic if you believe there has been more neuro diminishment since 9/26. That vet has access to Ella's file and can prescribe meds.
--- hours matter in getting the lessor class (Metacam) or moving to the more powerful class (prednisone)
-- Restarting Metacam might require sucralfate added to the Pepcid AC if you are observing that she has a stomach issue still.( lip licking, nausea, not eating, loose/diarrhea stool, bleeding ulcer, red or black blood in diarrhea, dangerous perforated stomach lining.
-- Switching today to Prednisone a different class DEFINATELY requires Pepcid AC + prescription SUCRALFATE. This kind of switch is an emergency measure to protect the spinal cord. Hours matter in getting an anti-inflammatory on board to stop damage (diminishment) to nerves.
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Post by Erin & Ella on Sept 28, 2022 9:48:29 GMT -7
Also, she ate 2 Tablespoons of chicken [9/25] yesterday.. that was it..nothing [9/26]today.
She just turns her head away at everything that I offer her...Still drinking...
---------------
Just back from the vet...[ 9/28] she confirmed that Ella's
front legs are worse but she can still move them a tiny bit...
Back legs will still withdraw when pinched, but one leg is worse than when I was there Friday (09/23).
The vet feels that maybe myelomalacia is occurring because her back legs were wobbly and then it gradually went to her front legs and now all her legs are getting worse.
She said that we could try steroids as a last-ditch effort but felt that Ella would never regain mobility. She gave her an ✙injection of Dexamethazone 0.17 ml (0.15mg/kg - dex 5mg/ml)
[MED LIST/HISTORY- Moderator's Note. Please do not edit ]
about 11.9 pounds 12.5 y.o. NECK DISC
9/19 dragging back leg
9/20 weak front legs
9/23 wags tail, back legs weaker than front
9/28 increase front leg weakness; one back leg increased decline
Metacam as of 9/20: 5mL 1x/day for 10 days, 9/26 STOPPED
Dex injection 9/28
gabapentin 100mg/mL: 50mgs (0.5 mL dose) 2x/day
cerenia 12mg 1xday
Pepcid AC 5mgs 2x/day for duration of any anti-inflammatory drug! ]
and some soft food to whip it and feed Ella with a syringe since she is not eating. I just gave her some and she took it with the syringe.
The vet said we would know within 24 hours if the steroids would work and at that time we could discuss continuing them or if euthanasia is what we need to do. I am devastated. Ella is still peeing on her own but is noticeably lethargic for the past 3 days... the vet was concerned with the difference that she saw in her since last Friday (09/23)
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 28, 2022 11:32:06 GMT -7
Erin, did the vet give a prescription to sucralfate? She is using one of the more powerful classes and one of the more powerful in the steroid class called Dexamethasone. It is notorious among veterinarians for causing GI tract damage. I can not say this more clearly and strongly:
MAKE SURE Ella has both Pepcid AC and Sucralfate on board now, today!Myelomalacia ("M") Erin, I don't want to compound your fears in any way. The idea is for you to be educated to know when to act when there is actually something to take action on. Make sure you question and discuss to fully understand the signs of "M" before taking action that can't be reversed.
Not all vets know "M"
Should there be a reason to let Ella go, you want clear confirmation she has the signs. Sadly one of my dogs had "M". The ER vet over the phone didn't really know "M." He quickly did his homework and by time I arrived, he could confirm to my satisfaction each of the signs I believed I was seeing at 2am in the morning. It hurt to let her go, but my heart felt calm it was the right time and for the right reason.
---So far what you have posted, Ella is not suffering any pain as just one single pain med gabapentin is keeping her in comfort. Typically dogs need 3 different pain meds to get the pain control with any disc episode that Ella has with just one med.
--- While there is a decline in leg function, she has not lost DPS proved by bladder control still and hopefully still a happy tail wag. Hope to hear the action of steroid Dex can turn things around or prevent further loss.
When a steroid is used in a matter of a few hours from the decline, I have seen with my own dog, leg neuro improvement in a matter of a couple of hours. My vet confirmed this can, indeed be the case.
HOWEVER, when steroid has been delayed too many hours, once neuro damage has occurred, expect that it can take months for the body to self heal nerves. No one can give you a time line for nerve healing...by the same token no one can rightly say a dog will never walk again.
--- STEROID expectation is not to prevent "M". Vets do not understand the cause of it nor how to stop "M". The expectation with any anti-inflammatory (Metacam NSAID or Dex steroid) is to get the swelling down round the spinal cord.
It is important that owners are familiar with "M" symptoms in order to promptly get their vet's help at any hour of the night or day.
Deep pain sensation or leg function not returning right away alone are not symptoms of myelomalacia.
With "M", what happens basically is that the spinal cord starts to die and turn soft from the point of the spinal cord trauma moving forward toward the head. It can happen fast, within hours. It is a very painful ending.. making a dog unable to breathe.
Should a dog be developing myelomalacia, before difficulty in breathing as the lungs shut down, you would want to help to cross to the rainbow bridge to spare a very painful death.Signs of Myelomalacia neuro surgeons use to suspect and monitor
* about 3-4 days into recovery, they become painful. Within the first week, they are in a LOT of pain. * acute disc extrusion with no deep pain sensation * development of excruciating pain (more than just pain from the original disc herniation) • hyper-esthesia (over-reaction to any touch sensation on body) • even the strongest pain meds do not help * loss of anal tone, the anus hangs open, (anal flaccidity) and areflexia (below normal or no reflexes) * neurologic deficits that localize to more than one neuroanatomical section of spinal cord (e.g. T3-L3 myelopathy and an L4-S3 myelopathy) * loss of cutaneous trunci reflex at a level more cranial to a previous evaluation over a period of hours to days with or w/o surgery * development of fever (normal rectal temperature is 100.5 to 102.5 degrees Fahrenheit) * sudden twitching or jerking of the neck and/or head * loss of voice, horse bark * Front legs can't hold body up, can't hold head up * increased respiration/ labored breathing (short, open-mouthed, belly breaths (not chest breathing) as the nerves to the lungs begin to shutdown • On an MRI, extensive high T2 signal (brightness) within the spinal cord (>6 vertebral lengths) has been associated with myelomalacia in the setting of a disk extrusion. More information: dodgerslist.com/2020/05/08/myelomalacia/ |
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Post by Erin & Ella on Sept 28, 2022 14:17:56 GMT -7
She did not give me a prescription for Sucralfate ... do they only need this for orally taking steroids? Will a steroid injection cause GI tract damage? Ella has just had an injection thus far and will continue with steroids if we see an improvement in 24 hours BUT I don't know what I am looking for! How much improvement? she is very lethargic. The vet said that if I don't notice an improvement in 24 hours, then the steroids are not working either and there is nothing left to try. I am trying to figure this all out...the vet actually said it was odd that Ella was not exhibiting any signs of pain. The vet is very puzzled by this. I am calling the vet tomorrow to give her an update. I am still continuing with the gabapention, Pepcid AC, and cerenia. What does this mean in your previous post ?loss of cutaneous trunci reflex at a level more cranial to a previous evaluation over a period of hours to days with or w/o surgery ? Sometimes I feel like she has a hard time swallowing and other times she is fine... she keeps swallowing repeatedly but mostly after I give her medication, so maybe she just doesn't like the taste? She just had another big pee on her own in her kennel. I also got her to swallow 2 tablespoons of soft dog food (Royal Canine Recovery) from a syringe... I don't want to overwhelm her belly, so I just gave her a bit with a syringe. I am really struggling with a decision to keep her lying in her kennel (for how long?) and considering letting her go...how long do I let this go on?  ? I am devastated. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 28, 2022 15:10:48 GMT -7
Erin, do not delay on getting sucralfate on board today!
Vets who know their meds understand the dangers of DEX and protect the GI tract lining. Each dog can have a different rate of metabolism. Therefore it may take 5 to 7 days before METACAM washes out of the body. Til then there is the danger combo of Metacam still being in the body and NOW an injection of corticosteroid Dex in the body!!!!!l It takes about 5-7 days for the body to process and excrete Metacam.
Ella DOES NOT Need another problem to deal with on top of this disc episode!
Vets who practice safe medicine will look for a 5-7 day washout from a NSAID (i.e.metacam, etc) to a glucocorticoids (i.e. prednisone, etc) unless an emergency calls for a faster switch. If deemed an emergency to try and prevent further loss of neuro functions it is a high consideration to double protect the stomach with not just Pepcid AC, but adding sucralfate.
Reading references:
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Post by Erin & Ella on Sept 28, 2022 15:38:13 GMT -7
I put YES or NO beside the Signs of Myelomalacia neuro surgeons use to suspect and monitor
* about 3-4 days into recovery, they become painful. Within the first week, they are in a LOT of pain. NO
* acute disc extrusion with no deep pain sensation NO (she will withdraw all 4 legs when you pinch in between her toes)
* development of excruciating pain (more than just pain from the original disc herniation) NO
• hyper-esthesia (over-reaction to any touch sensation on body) NO
• even the strongest pain meds do not help NO [dog has no pain on single gabapentin med]
* loss of anal tone, the anus hangs open, (anal flaccidity) and areflexia (below normal or no reflexes) NO
* neurologic deficits that localize to more than one neuroanatomical section of spinal cord (e.g. T3-L3 myelopathy and an L4-S3 myelopathy) ??
* loss of cutaneous trunci reflex at a level more cranial to a previous evaluation over a period of hours to days with or w/o surgery ??
* development of fever (normal rectal temperature is 100.5 to 102.5 degrees Fahrenheit) NO
* sudden twitching or jerking of the neck and/or head NO
* loss of voice, horse bark NO (she's not a barker anyway)
* Front legs can't hold body up-YES to front legs, can't hold head up, she can hold her head up for maybe 5 seconds
* increased respiration/ labored breathing (short, open-mouthed, belly breaths (not chest breathing) as the nerves to the lungs begin to shutdown .. I think she is belly breathing
• On an MRI, extensive high T2 signal (brightness) within the spinal cord (>6 vertebral lengths) has been associated with myelomalacia in the setting of a disk extrusion. No MRI done
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 28, 2022 15:52:06 GMT -7
Erin, just like loss of neuro function goes in a predictable order...same way for "M"
Do not get the horse before the cart. Monitor for signs that follow in the predictable order.
It is not the typical that a dog does not have pain from a disc episode. It is not a common thing. HOWEVER, it appears Ella is one of those dogs.
The "cutaneous trunci reflex" are the spots on the spine that shows which reflexes correlate with what spinal cord segments. Surgeons mark the spot on the back with a marker and monitor closely for advancing signs of reflex loss. It can be "M" stops and goes no further, never reaches upwards towards the lung area.
Monitor neuro and monitor "M" in order so you do not make your brain jump to conclusions.
Do not randomly monitor things and jump the gun.
Does she have a temperature, then...
Any sudden twitch or jerking head/neck then....
loss of voice, or a horse bark, .... etc.
Peeing where she sleeps is a red flag sign to us. So if this is something new/different/a decline, you need to include that kind of info in your post. Is that the same kind of peeing situation you reported on 9/22: "peeing/pooping in her kennel" How often do you check her/express her to try and get to her before urine escapes in her bedding....every 3-4 hours or .....?
Can she still give a happy tail wag?
Stay strong, stay positive. Until you have concrete facts to do otherwise, then carry on with good at home care. Travis' owner overcame an unexpected journey with her doxie's 4 paralyzed legs.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 28, 2022 16:02:29 GMT -7
FIRST she must have loss deep pain sensation.
Most vets except surgeons simply do not have the training and the practiced eye to correctly identify what they see with the harsh pinch with a metal tool.
However, if Ella maintains any one the functions prior to the very last function to be lost (deep pain sensation DPS), then by definition if she has bladder control, if she can move a leg even if weakly, can do a happy tail wag, then she has DPS.
Please review the orderly, predictable step by step loss of neuro function. She would have DPS if she maintain anything before the last of DPS.
With Myelomalacia the dog has to first have lost DPS before the cord will start to dye and travel upwards.
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Post by Erin & Ella on Sept 28, 2022 16:06:48 GMT -7
Ella has peed in her kennel before this... I know dogs are not supposed to do this, but I would often find her sometimes laying in her bed over the years only to see that she had peed in it at some point.
So I don't consider her going in her kennel to be that odd.
She does NOT leak when I lift her.
I have tried to express her several times and she starts whining and will not let urinate.
When she does pee, it is a very large quantity. and yes, it is the same peeing situation as I reported on 09/22. she hasn't pooped since 09/24 but she has barely been eating anything.
😊 Yes, she still has a happy tail wag when I am out and come back and talk to her and rub her belly.
She does seem to be belly breathing though...laboring a bit. I wish I could send you a video.
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? I am devastated.