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Post by Ben & Gracie on Feb 28, 2023 2:35:57 GMT -7
[Original subject line: Benjamin’s Gracie - mini dachshund - calcification c3/c4]
Trying to figure out if conservative or surgery option is better for Gracie and our situation.
My wife is pregnant and due in June. We want to try the conservative approach but we will opt for surgery if things do not get progressively better and closer to 100%. If we crate rest for 6-8 weeks and she is not returning to her normal self, we would be looking at surgery and another 4-8 weeks post op crate rest and recovery which would coincide with our first baby being born. We want to avoid this scenario and we are leaning towards surgery now to avoid further issues/damage and to get Gracie back to herself in time to meet her new baby human.
We are also concerned because we certainly don’t want to spend $6,000-$8,000 if her calcifications are minor or can easily be mended through conservative treatment. The mineral opacity in her neck on the x-rays is alarming especially when compared to other x-rays of dachshund cervical calcifications.
Gracie has had no neurological deficits but was taken to vet because of shrieking pain. She sits and lays down in very awkward and stiff positions. Front legs have been slightly wobbly a few times but never consistently or severe.
☆ 1 Is there still currently[?] pain? No[?] ☐ reluctant to move much in crate such as shift positions or slow, ginger movements - Yes ☐ shivering, trembling - No ☐yelping when picked up or moved - Yes ☐ tight tense tummy - No ☐can’t find a comfortable position, appears restless - No ☐ Arched back - Yes ☐head held high or nose to the ground - Yes, nose to ground ☐ Holding front or back leg flamingo style not wanting to bear weight - No ☐Not their normal perky selves? Definitely not herself
2 12 lbs 8.5 years Rimadyl 25 mg - 0.5 tablet every 12 hours. Attempted to stop after 4th day home from emergency vet (2/21/23) Pain and stiffness became much more noticeable. Started back on taking 0.5 tablet every 12 hours, 25 mg Rimadyl on 2/22/23 and is currently still on this medication Pepcid A/C - 5mg every 12 hours before Rimadyl Methocarbamol 500mg - 0.25/0.5[?] tablet every [?] 8-12 hours Gabapentin 100 mg - one capsule every [?]8-12 hours Phenobarbital 16.2 mg - one tablet every 12 hours for therapeutic dose to control seizures C.. PEPCID AC: yes [?mg ?x/day] [MED LIST/HISTORY- Moderator's Note. Please do not edit 12 lbs 8.5 years Rimadyl as of 2/17: 12.5mgs 2x/day for 4 days, 2/21 test STOP: √2/21 Pain/_neuro as of 2/22: 12.5mgs 2x/day for ? days methocarbmaol ?mg ?x/day gabapentin 100mgs ?mg ?x/day phenobarbital 16.2 mgs 2x/day Pepcid AC ?mg ?x/day ]
☆ 3 -- List any red flag signs of stomach damage. None ☆ 4 Dachshund Gracie. Benjamin ☆ 5 Yes, after x-rays were taken on 2/17/23, Calcification in neck was diagnosed -- Is the vet a general DVM? Yes -- Consultation with ACVIM neurology surgeon on 3/1/23
☆ 6 2/15/23 (no x-rays taken because of Gracie shrieking in pain) emergency vet 2/17/23 ☆ 7 bladder control? Yes ☆ 8 Currently can your dog wobbly walk? No neurological deficits Very ginger walking and moving with a few minor wobbles
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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 28, 2023 9:38:46 GMT -7
Ben, welcome to the Forum! We are glad you've joined us all. We could use extra info re: the reporting of current pain. YOU HAVE AN EMERGENCY to call the vet ASAP today, if Gracie is currently reluctant to move, yelps when having to move, holds head high or low. These signs of current pain mean her pain meds are not yet right. The vet needs your feedback to know to make pain med adjustments. In general pain meds are Rx'd promptly every 8 hrs. Pain meds are effective for 8 hrs. The single most important care is the limited movement of the spine (neck and back) to allow the disc to heal. Vets who know IVDD, understand the risk of too much movement for the healing disc with transports into a clinic for anything but the most urgent of health issues. They handle med adjustments, updates from you over the phone. MEDICATION LIST detail Gracie's med list is important data to base our comments on. Please correct or fill in the missing information. Wonderful to hear your vet gave you a range of mgs and frequency to give. However, we need to know what you actually give. What med(s) were given on 2/15 vet visit?
2/15 pain and neuro wobblinessRimadyl as of 2/17: 12.5mgs 2x/day for 4 days, 2/21 test STOP: √2/21 pain/_neuro as of 2/22: 12.5mgs 2x/day for ? days, then test stop: _ pain/_neuro methocarbmaol ?mg ?x/day gabapentin 100mgs ?mg ?x/day Pepcid AC ?mg ?x/day
MEDICATION CHART-
Useful tool for quality communications with your vet. Be able to see patterns, have dates and specific facts handy as you discuss things with the vet. D/l a sample and a blank form to use with your dog's meds dodgerslist.com/wp-content/uploads/2020/02/med-chart-printable.pdf
SURGERY vs CONSERVATIVE Gracie is an excellent candidate to heal her disc with 8 weeks of limited movement. The neuro damage of front leg wobbliness may or may not self repair in the short time the disc heals in. Think more in term of months rather than days/weeks for this slowest part of the body to heal in. Key component of conservative treatment working is owner education about 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/🚩 Be in the know how each phase of healing works, how long, which supportive care. AVOID jumping the gun with dangerous detours from STRICT rest. Follow the "Roadmap" View, d/l and print a copy for your fridge from here: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf 🚩 BROWSE through the tried and true ways to provide an effective healing environment for your Gracie. How to set up a “recovery suite” with room service. How to limit for minimal footsteps at potty times and more.... dodgerslist.com/2020/05/14/strict-rest-recovery-process/ 🚩 Understand the disease Gracie was born with. You can protect her now and in the many happy years ahead living with and IVDD dog: dodgerslist.com/2020/06/26/time-and-ivdd/🚩 IF conservative treatment is working • pain is controlled by using an aggressive pain med approach, • limited movement is allowing the disc to heal • 7-30 days of anti-inflammatory Rimadyl to resolve all swelling. Gracie has only had a 2/17 4-day course and a 2/22 ?-day course so far. then at this point in time a consult for surgery may be premature and expose the disc to too much movement in a transport. In general surgeons want to use the least invasive treatment first. All surgeries have a degree of risk to them. Know the two treatments and when used: dodgerslist.com/2020/02/10/surgery-vs-conservative/
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