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Post by Tamara on Jan 22, 2023 9:52:28 GMT -7
[Original subject line:Floyd--elderly spaniel/shih tzu mix ] Hi everyone, Really a relief to find this site. My elderly guy Floyd is experiencing back leg paralysis for the second time since I adopted him six years ago. He recovered with a conservative approach a few years ago, though this time it's more severe. He can still tell me when he needs to go out and use the bathroom, but cannot walk or stand at all. I got some pressure from the [date?]emergency vet for surgery, but I can't put him through it if it might not work (I also can't afford it, but that's my secondary concern). It's hard to know what the right thing to do is and we're both struggling. I have a follow up with his vet [date?] in a few days where I want to have a candid conversation about his chances and quality of life and how long to wait. I want to do right by him, whatever that looks like. ☆ 1 Is there still currently pain? ☐ shivering, trembling ☐yelping when picked up or moved S ome shivering occasionally, growling when I first pick him up--though he hates to be picked up and growled at me when he was healthy too. X Not their normal perky selves? 2 How much does your dog weigh? 27 lbs Age? at least 11 Unknown--he was a middle aged rescue- -.A.. Rimadyl, 25 mg, twice a day (was on this before disc problems); Methacarbanol, 250 mg, every 8 hours; gabapentin, 100-150 mg, every 8 hours. Tylenol, 5 ml, every 12 hours.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
27lbs ±11 y.o.
legs paralized, has bladder control
Rimadyl as of 1/21: 25 mg, 2x/day, for ? days, then STOP to test for _pain/_neuro_
Methacarbanol, 250 mg 3x/day
gabapentin, 150 mg 2x/day (doesn't wake up for a middle ofnight dose)
Tylenol, 5 ml, every 12 hours.
Floyd needs GI tract protector, Pepcid AC, on board for duration of Rimadyl! ] C.. PEPCID AC: Doesn't need it
Pepcid AC (famotidine) for dogs is 0.44mg per pound 30 mins before the anti-inflammary for the duration of the disc episode while on Rimadyl ☆ 3 -- List any red flag signs of stomach damage.  ? Not eating, vomit, loose stool, bleeding ulcers, red or black blood in diarrhea. ☆ 4 Cocker spaniel/shih tzu mix, Floyd. Tamara☆ 5 likely disc problem based on prior IVDD diagnosis DVM? Yes--Emergency vet--follow up with regular vet next week☆ 6 date you saw the vet for CONSERVATIVE treatment? 1-21-23☆ 7 He can't squat but he can sniff and release.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 22, 2023 13:19:29 GMT -7
Tamara, welcome! Do make it a point to register and login when you can. If you need details see my note and link to "guests" at bottom of this post. Points to know: -- With still maintaining bladder control there is REAL potential for nerves to self repair with time. Think in terms of months rather than days/weeks for this slow healing part of the body. -- Key component to conservative care is the STRICT rest to allow the disc to heal and no longer impact the spinal cord with nerve function loss. -- Unfortunatley your own vet will require a risky to the disc transport in for an exam in order to Rx or adjust meds, that is the law. All other future vet visits would be for only the most urgent of health issues that can't be done via a phone call (med adjustment, updates, etc.) -- Concerned if picking him up is related to dosing time of pain meds when they wear off. Observe for a pattern -- Tylenol What is the formula on the bottle—how many mgs in one mL of liquid? Tylenol is VERY UNTYPICAL for a disc episode. Plumbs is the veterinary bible on drugs: -- traMADol, methocarbamol and gabapentin 3x/day are typical pain meds during a disc episodel: Gabapentin WHICH do you actually give 100 or 150 mg 3x/day?-- Short story: Pepcid AC suppresses extra acids caused by 1. change in routine to crate rest 2. meds that cause extra acids: Rimadyl, Tylenol 3. Nerve damage that can affect stomach acids 4. READ so you know why you want to discuss grocery store Pepcid AC for your dog: dodgerslist.com/2020/05/06/stomach-protectionEducate yourself 🚩shortcut thru IVDD: dodgerslist.com/2020/06/26/time-and-ivdd/🚩 when surgery, when conservative: Dr. Isaacs answered alot of questions we've had about surgery: "Surgery needs to be a decision an owner enters into recognizing the risk, but also recognizes the benefit. This way if something unforeseen occurs an owner can be comforted and at peace with the fact that surgery was the right decision and they did all they could for their dog." You will find it worthwhile to read the rest of his answers about surgery: dodgerslist.com/2020/05/12/dr-isaacs-surgery-answers/ More excellent info to help with conservative vs. surgery decisions: dodgerslist.com/2020/02/10/surgery-vs-conservative/ |
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Post by Tamara & Floyd on Jan 23, 2023 13:04:45 GMT -7
Thanks so much, this is very helpful. I will ask my vet about the Tylenol and Pepcid.
As for gabapentin, I give him 150 mg two to three times a day (every eight hours, but he sleeps through the night fine and I don't wake him up for a dose). I'm in the U.S. (California)
Today I noticed the first slight improvement---a bigger tail wag. Hopeful but trying to manage my expectations and take it day by day.
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Post by Romy & Frankie on Jan 24, 2023 14:05:28 GMT -7
A bigger tail wag is definitely an improvement. That is good news.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 26, 2023 9:59:23 GMT -7
Tamara, if you are still observing signs of pain when lifting, may be a prudent thing to assume it is pain. Gabapentin lasts for 8 hrs. If you observe signs of pain when awakening in the morning, then moving to every 8 hrs (3x/day) would be necessary. Let us know the details of time when you observe pain in relation to the last time gabapentin was dosed. If the gabapentin dosing schedule has one of the doses falling in the middle of the night, then: 1. either set up an alarm to give the dose #3 at the 8 hr point 2. Or you can gradually move the gabapentin dose up or back gradually over a couple of days so that eventually the 3rd every 8 hr dose will land at a reasonable maybe 10pm or 11 pm? Do keep us updated on Pepcid AC (famotidine) getting on board. And what the formula for Tylenonl is (?mgs tylenol in one mL of liquid)
Thank you so much for registering! ➡️ EMAIL ALERTS With registration, now you can receive email alerts when someone has posted. Timely interaction/communications is needed when helping your dog. Bookmark your dog's thread to receive an email alert when someone has replied. Go to the CONSERVATIVE board: dodgerslist.boards.net/board/6/conservative 1. Look for your dog's thread and checkmark it. 2. Look for the white ACTIONS button towards top. 3. Select “Notification Options" from the pull down menu — check mark “NEW POST” change from never to INSTANT email — press the SAVE button. Click the “x” to close the window 4. Next choose the “Bookmark” See the tiny book symbol now! |
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Post by Tamara & Floyd on Jan 26, 2023 20:11:32 GMT -7
We went to the vet [1/26] today. She didn't seem super hopeful about his prognosis, but didn't make it seem like it was hopeless either. She recommended I stop with the tylenol since it can damage his liver.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
27lbs ±11 y.o.
legs paralized, has bladder control
Rimadyl as of 1/21: 25 mg, 2x/day, for ? days, then STOP to test for _pain/_neuro_
Methacarbanol, 250 mg 3x/day
gabapentin, 150 mg 2x/day (doesn't wake up for a middle ofnight dose)
Tylenol, 5 ml, every 12 hours. STOPPED 1/26
Floyd needs GI tract protector, Pepcid AC, on board for duration of Rimadyl! ]
She said that Pepcid is pretty ineffective as a stomach protector, but that it does make some dogs and owners feel better, so I might as well give it a try. She also recommended the "help em up" harness to save our own backs when lifting him, and suggested I get a consult at a dog rehab place.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jan 27, 2023 8:50:07 GMT -7
Tamara, of course, there is hope for Floyd! Nerves can and do heal where neuro functions (legs) with time can return. Nerves are slow to heal. Best to think in terms of months rather than days/weeks. Conservative treament is all about focus on the disc healing in 8 weeks. Nerve healing may or may not some back in that short of time. With the stop of tylenol, watch for any pain surfacing as there is now one less pain med on board. The two pain med meds may no longer be enough to mask all pain. Suffering with pain hinders the healing process. YOu are the eyes and ears at home for your vet. Alert your vet by phone if you would see pain surfacing to get meds adjusted/added. YOu are currently giving gabapentin 150mgs TWICE a day. As suggested you could inch by an hour the doses over a couple of days to allow a 3x/day schedule where you don't awake for middle of the night dosing. There is good potential for leg function to return as long as you do right by FLoyd by maintaining limited movement of his back. Rehab PT will ONLY be safe at the end of 8 weeks when the disc has healed. Mark your calendar for GRADUATiON DAY on March 18. ---Also when we learn you have proof all of the painful swelling is actually gone, we have have information for you. This info will be how to do some very light safe movement for Floyd's legs at home. -- PROOF procedure: 1. tell us for how many more days of Rimadyl. It MUST stop in order to know. Usually Rimadyl would be Rx'd for 5-7 days (sometimes also could be a 14-day) course and then a stop to see whether more days are needed or not. 2. All meds that keep pain at bay need to be stopped or backed down( methocarbamol, gabapentin) Try to avoid risky to Floyd's disc healing car transports. Try to attend to things with a phone call...such as to further adjust meds now that your own (new) vet has examined Floyd. Let us know when you have Pepcid AC (famtodine) on board. It IS important as explained HERE to suppress sotmach acids. Invitiing bleeding ulcers due to an increased stomach acid situation is nothing to fool around with! Pepcid AC® (famotidine) 0.44mg per pound 30 mins before the anti-inflammary for the duration of Rimadyl Care tips for the large dog: dodgerslist.com/2022/02/10/large-dog-care-tips-ivdd/ |
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? Not eating, vomit, loose stool, bleeding ulcers, red or black blood in diarrhea.
