Erin's Ella 9/19 conservative NECK Canada; GRAD 11/15

I thought I posted a reply but now it's not showing...

When I look at the steps, Ella is up to #6

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. 9/28 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.


As for the peeing in her kennel, she has done that before...even before she was sick. Or she would pee in her own bed. So it's not that unsual for her to pee in her kennel.

Yes, It is the same peeing situation that I reported on 9/22

She has not pooped since 09/24 but she has eaten very little since then.

Yes, she is 🙁still doing happy tail wag [has DPS!] when I've been out and come back into the room or when I talk to her.

She seems to have some belly breathing, which is odd. I wish I could send you a video.

She seems to not want to swallow or is not comfortable swallowing. She has been drinking all along but I just gave her a drink and she seemed thirsty, like the water and then seemed confused and didn't take anymore. She has drop [drunk?] about 275 ml already today so I think she is ok that way for now.

For DPS, the vet used her fingernail and pressed really hard between Ella's toes and she withdrew all four legs slightly and you could see her muscles contract ..

Thoughts?

1) DOWN DOGS – DISK DISEASE, THE STEROID CONTROVERSY AND BEYOND

Deep pain perception, assessed by squeezing on the bone of one of the digits of an affected limb with hemostats or pliers, is a crucial part of the examination, as it impacts the prognosis and potential time to recovery of the patient. The appropriate response is cerebral recognition of the pain, characterized by crying out, turning to look at the limb or trying to bite the examiner. Withdrawal of the limb is a reflex only, and does not indicate pain perception. (Dr. Christopher Mariani, DVM, PhD, DACVIM University of Florida. CanWest Veterinary Conference 2007
www.canwestconference.ca/proceedings/Chris-Mariani/Down-dogs–disk-disease-the-steroid-controversy-and-beyond.pdf last accessed 1/5/2009)

The very last neuro function to go is DPS.
The neuro function before DPS is happy tail wag.
Ella would not be able to do a happy tail wag if she had lost DPS.  Ellis is doing a happy wag therefore she HAS DPS !!! YEA!!!!

Happy tail wag indicates by definition, of course, she would have to have DPS (the last to go).
Please review again at the orderly, step by step nerves are lost in list.

Today, 9/28, Ella can make no movement at all even a weak leg movement with all four of her legs?  That is... she is fully paralyzed in all four legs?  You do not see her attempt even a weak leg movement to reposition her body?

Have you/ did you seek getting sucralfate from the vet in light of Dex injection and Metacam only being stopped 2 days ago? If no 5-7 days washout from Metacam, then Ella's body deserve protection:
Pepcid AC (famotidine) to suppress acids) PLUS sucralfate to provide a gel coat over any areas of damage that are very likely to occur.

YES!!! Happy tail wag! so good to hear. I guess she was NOT happy tail wagging at the vet. she is actually doing the happy tail wag EVERY TIME I talk to her tonight..usually, it was just in the morning when I first saw her or when I was out of the house and came back.
She may do a very slight leg movement sometimes, but I do NOT see her trying to reposition herself. I don't think she is completely paralyzed but I will pay closer attention.
I emailed the vet and she actually emailed me back after hours..I'm surprised..this is what she said.

Hi Erin,

I totally agree with the gastro protection….however, I will say that with my experience, the dex injection is not going to cause the same stomach irritation as the prednisone tablets. If we are able to start her on the pred tomorrow then of course. This is an emergency situation and we would never have jumped and given her steroids if not. I totally understand your worry, but in practice we have to consider all things….how affected she may be by giving her many meds in the short term while we’re trying to get her eating (even if they are protective in the long run). We will also switch her from just pepsid to omeorazole which is a stronger stomach acid medication. I assure you I’ve been thinking of Ella’s best interest. ♥️

Let us know how she makes out tomorrow at acupuncture and we will see how we can help from there.

Thinking of you and Ella,
Kristi

Thank you for all of this ...all the notes and information! I will definitely be speaking with the vet again in the morning...

Erin good job either on your part to get sucralfate on board or kudos to the vet who Rx'd on their own!

"know if it is making a difference"  That statement is so general doesn't really tell you anything in particular.  As an IVDD savvy pet parent you want clarity in your mind.  Do you have the Conservative Roadmap taped to the fridge for easy reference on what heals what, what the time line is for each phase of healing?
VIEW, DOWNLOAD and print for your fridge: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf


1. The job of any anti-inflammatory (Metacam, Dex or prednisone) is to get painful swelling down in a range of 7-30 days.
 --- The dex 9/28 plus 7 days of pred (total of 8 days), as noted may or may not have gotten all swelling down.
---- The test about swelling will be on Thurs Oct 6 when the pred taper starts.  To get rid of the blindfold on your eyes, gabapentin which masks pain should also be stopped. You would want clarity in quick ability to monitor if pain would surface or is there is any new/increased neuro diminishment.  Let us know if the vet is calling for a stop of gabapentin on 10/6.
2. Job of nerve healing happens with the body's ability to self heal neuro functions. It may take thinking more in terms of months rather than days weeks.

3. The body self heals the disc over the course of 8 weeks

Erin, what do you think was meant by" acupuncture making a difference or not" in 7 days on 10/5?

It is normal for them to be extra lethargic after starting the steroid treatment? I noticed this afternoon and tonight (09/30) that Ella will barely raise her head anymore and she seems to struggle to even keep it up enough to drink her water... in other words, she seems weaker today. She has drank about 2/3 cup of water today and usually she drink 1 to 1 1/4 cups lately.
she did poop this afternoon. It was very soft but I didn't notice any blood, but it was dark in color and very very foul smelling.

I fed her about 1/3 cup of soft food today with a syringe. She is still swallowing it, but seeming like she doesn't want to. I feel like she is doing downhill or maybe she is just very very tired ?

I just wanted to let you know that we lost Ella yesterday. On Saturday (10/01) she seemed more lethargic... no wanting to drink as much and certainly not willing to eat unless I gave her the soft food in a syringe and then she didn't seem to want to swallow it. On Sunday, she only drank 1/3 cup of water and was holding the food in her mouth and not swallowing very much of it. On Monday, I took her to acupuncture again they said she was responding/reacting to the needling, but I was increasinghly worried because she had not peed in the night at all. She refused to drink any water on Monday and I could tell she was going downhill fast. I had been updating my vet all weekend and she was honestly at a lost as to what was going on and what to do. By mid morning on Monday (10/03) she peed and at the end of the pee there was a lot of blood clots and there was blood all over her urethra opening. Then she pooped and it was the worst yet... all black, diarhea and smelled like the worst thing ever... she burped at one point when I was holding her and her breathe smelt the same. The vet said this was not typical with IVDD and she even called a surgeon at the Atlantic Veterinary College to ask his opinion and he was also at a loss... I'm thinking she had a bleeding ulcer. I made the extremely painful and hard decision to put her to sleep... it was the hardest thing ever but she was so so sick and she had so many things wrong with her... the bloody urine, black stool, not eating, not drinking (she would not even swallow the food I was syringing into her mouth anymore. ) I know it won't bring her back, but I am still wondering what happened to her? Have you heard of this before? I miss her terribly..the house is too quiet.. I am devastated.

Erin, it is always a hard thing to loose those we love. Especially when we are not sure why and may never know the exact cause. The depth of your love = depth of grief. One of our member's addressed handling grief that may provide you comfort: dodgerslist.com/2020/07/28/tears-heal-grief/ My sincerest condolences to you and your family.