Whitney's Henry- Surgery 9/10 - was conservative 8/30

Welcome to Dodgerslist, Whitney! Sorry to hear that Henry is having a disc episode but I am glad you came here to share his story with us.   Here you will get a chance to get up to speed on the disease Henry was born with to not just care for him now but to live with this disease for the rest of his life. We hope he is one who only has one disc episode his entire life! So do start your reading journey here so you are a well informed owner who can talk and discuss everything with the vet: www.dodgerslist.com/healingindex.htm

In order to help you and Henry can you let us know what medications he was sent home with, the dosages and frequencies given? I hope after his vet visits that his pain is under control with the correct medications.  Please include the all important stomach protector such as Pepcid AC. Ask your vet in this particular way "Is there any medical reason why Henry can't take Pepcid AC?" If there is no reason you can buy it over the counter. We give Doxie's and other small dogs, 5mg 30 minutes before NSAIDS or Steroids to protect their stomachs, every 12 hours.

The focus with conservative treatment is 100% STRICT crate rest 24/7 only out at potty times for 8 weeks. No laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no chiro (aka VOM). In other words do everything you can to limit the vertebrae in the back from moving and putting pressure on the bad disc.

The crate is the only surface that is firm, supportive for the spine, not inclining, always horizontal and keeps a dog from darting off at a TV doorbell and safe from other pets and kids from bothering them. The rest of the details of doing crate rest to ensure the best recovery in this excellent document: www.dodgerslist.com/literature/CrateRRP.htm

The purpose of crate rest is to act as a cast of sorts to let the disc heal… only limited movement of STRICT crate rest allows that to happen…there are no meds to heal a disc. Immediate neuro improvement may or may not come during the 8 weeks of crate rest… as nerves may take more than 8 weeks to heal.

-- Can your dog move the legs at all or wag the tail due when you do some happy talk? The very, very lightest least aggressive range of motion and leg massage is necessary for paralyzed legs during conservative treatment. The information highlighted in PINK pertains to a dog who can't walk.
www.dodgerslist.com/literature/massagepassiveexercises.htm

-- Can your dog sniff and squat and then release urine or do you find wet bedding or leaks on you when lifted up? Helpful videos with tips on expressing both urine and poop: www.dodgerslist.com/literature/Expressing.htm

-- Eating and drinking OK?

-- Poops OK - normal color and firmness no dark or bright red blood?

Here is a link that describes the Laser Disc Ablation procedure. Most of the dogs here on Dodgers have surgery or go through conservative crate rest. I am very intrigued with the LDA though, so I will be very interested in hearing how it goes with Henry.  veterinarysurgerycenter.com/services/surgeries/percutaneous-laser-disc-ablation.html

Here is a link to our success stories on Dodgerslist, I hope you find some hope and encouragement in these stories.  www.dodgerslist.com/monthstory.htm

Add this comprehensive "must-have" $3 DVD on IVDD to your arsenal of educational resources. Friends, family and those who will be caring for your dog should also watch this DVD; plus don't forget to order one DVD for your vet www.dodgerslist.com/store/DVDorder.htm

Hi, Whitney. I'm glad you're going to check with your vet today about the sign of pain that you're seeing. Usually Tramadol is prescribed for pain. Here's some info about IVDD meds: www.dodgerslist.com/literature/drugs.htm#intestinaldrugs Please let us know what the vet says. And good job on getting the Pepcid AC on board.

I know how scary this all is. Great job on convincing your husband that Henry does not need to be euthanized.

From what I've read about LDAs, they need to be pain free and off all medication for at least two weeks. And they shouldn't have the surgery until a month has passed from the disc incident. So it sounds like your neurosurgeon is on the right track.

Prayers that all goes well for Henry. Please keep us updated.

He has had wet food before today and I was worried without him drinking the dry food would make him constipated with being confined. Gave him Pepcid tonight...realized it was maximum strength after the fact.

Any tips on the scarf technique during excretion? He tends to fall back when pooping.

The vet said the Rimadyl was a pain reliever as well. I'm not sure I'm convinced, though my husband said he has not been shivering today.

Dustin has been wonderful. He has been taking fabulous care of Henry and checking on him frequently. How do you handle the crating with your other dogs? My big dog, Bruce, seems confused and out of sorts.

I'm hoping that he is laying by Henry during the day. I am also worried about Henry's emotional health. He is used to a lot of physical contact, I don't want him to become dejected.

Right now we are still in the information gathering stages and hoping to care the best we can for Henry. The other stories on the board are so inspiring and helpful.

Pauliana,

This is Whitney's husband Dustin. I have a few moments to post before work and I want to express my appreciation for this site and what you guys do.

I grew up a "farm boy" and historically (my dad and grandparents) could not afford to see a dog (or any animal) "suffer". I guess you could say our culture dictates a hard outer shell when it comes to things like this. This is probably why when I first saw Henry in this condition my first thought was about "putting him out of his misery". Unfortunately, I am sure there are others like me.

My lovely wife found your site and now I am convinced that Henry can live out a wonderful life even if we have to get him a little cart with wheels. I never thought that was even possible or an option. I do not believe it will come to that for our little guy, but it is inspiring to see the stories about other little pups that were worse off then Henry and are doing fine because of diligent/loving owners.

As far as the medicine, he has stopped shivering the same day he was put on Rimadyl and he seems pain free to me. If he starts acting like he is in pain we will certainly revisit his pain management plan. To be fair to our first Vet that prescribed the drug, I agreed to start with a lower medicinal baseline to see if it worked for Henry and he said if the drug schedule needs to be readdressed that he could and would do that at any time. The vet also called in a referral to the specialist at the Dallas Veterinary Surgical Center for us.

After taking Henry to the DVSC Whit and I were amazed with the facility, doctors, and the Percutaneous Laser Disc Ablation (PLDA) procedure. It will be a long 4-5 weeks but we feel confident that Henry can make it to the procedure date and beyond. Hopefully Henry can be one of the 97% success stories with PLDA.

Henry seems much better this morning...much more steady for the 45 seconds he was outside to potty.

Hopefully my upbringing didn't paint me in too bad of a light with some of you. My wife evens me out in that regard. It is just one of the reasons that I love her.

Paula we received the video today. It was informative for us. Thank you!

Henry threw up sometime this afternoon. He is eating well this evening and drinking. Though, he does seem to be in more pain in the evening.

Can you settle a debate between Dustin and I? On the video, it said a baby crib was a suitable place? We have a 10 month old daughter and I could easily move Henry into her portable crib. Dustin thinks we should keep him in his small pen - it is 25 inches long and 18 inches wide. Henry is a muscular 18 pounds.

Whitney, throwing up is a concern that Pepcid AC may not be enough. How many mg's of famotidine (the active ingredient in Pepcid AC Maximum) are you giving? Henry needs 5mg of famotidine 2x a day.

I would get on the phone and let the vet know of the vomit and ask for a 2nd stomach protector called sucralfate. You wlll need to know the timing with Pepcid AC and with food. Here is where you can learn about sucralfate. www.marvistavet.com/html/sucralfate.html

It is very clear that Henry is not being medicated for pain. It can take Rimadyl days, weeks or longer to get all the swelling down. So it makes no sense healthwise or morally to have him in pain, Pain releivers are what give comfort while the anti-inflammatory is busy at work on swelling. So you can STRONGLY advocate for getting pain meds on board you will first need to read up on the traditional pain meds used with a disc episode: www.dodgerslist.com/literature/healingpain.htm

A baby crib will be fine when you are there at home. Just pad out any extra room with a cardboard box or rolled up blanket. He needs enough room to turn around and when lying down to fully stretch out his legs. Can he turn around easily enough and stretch out his legs fully in a 25 x18 inch crate? Do observe how he reacts in the portable crib, is it a pak N play? If you leave the house and are not with him the crate may be the safest place as he can't chew out of mesh sides, etc.

Glad to hear you found the DVD helpful viewing!

Whitney, it's not a good idea to just give pain medication when you see signs of pain. You need to consistently give the Tramadol to Henry so his pain is completely under control. You shouldn't see any sign of pain from one dose to the next dose. If it gets near the time for a dose and he starts to show signs of pain, it means that the dose needs to be adjusted. So please don't withhold the Tramadol. What mgs of Tramadol did the vet prescribe and how often is it to be given?

Good job on getting the Tramadol and the Sucralfate on board. Sucralfate should be given on an empty stomach, one hour before food and Prednisone so the gell coating action can begin. Pepcid should be given 30 minutes after the Sucralfate.

Here's a link where Dodgerslist discusses pain control. It also discusses tapering off of the anti-inflammatory.
www.dodgerslist.com/literature/healingpain.htm

An anti-inflammatory can take 1-2 weeks or longer to resolve all pain. It's really guesswork on the part of a vet as to when the stopping of the Rimadyl will take place. At that point, you'll also taper down or stop the pain medication and will be on the lookout for any signs of pain. If there are still signs of pain, Henry will need more of the Rimadyl and Tramadol. If there are no signs of pain at that time, that means the swelling in the disc is down and the medication can be stopped.

It's hard when our dogs have to miss things that they previously loved and that we loved seeing them do. Tomorrow is the Ocean Grove Flea Market and Jeremy so loved to go there with me. But he's just recovering from his second disc episode and graduated from crate rest less than three weeks ago and he's just not up to walking that much yet. I don't want to go without him. Luckily, Jeremy and Henry won't know what they're missing tomorrow.

All the best to you all.

Glad to hear you are now promptly giving pain meds…that's the way to keep pain at bay! What is the dose in mg's for tramadol and how often was the Rx for every 8 or every 12 hours?

Please do read up on sucralfate so you will know all the options for timing of this med. I was able to give 1/2 gram sucralfate tablet by hiding it in a treat with no problems. So you may not need to go the extra steps of making that slurry. Be sure and keep the vet in the loop about the sucralfate.

When you read about Reglan, you'll see its job is NOT protection of the stomach as Pepcid AC and Sucralfate do.

Mar Vista vet web page for looking up meds: www.marvistavet.com/html/pharmacy_center.html

Question for moderators. Why are vets so reluctant to give sucralfate. My neurologist wouldn't do it, either.

Polly, thanks for the advice about cleaning him. I appreciate it.

Today has been Henry's best day in over a week. No throwing up, no pain, walking almost normally at potty breaks. In general, he feels much better. He has been anxious to play and we've had to pull him from the pack-n-play to go in his cage because of his rambunctious nature.

I think we've finally figured out his medicines. He is on:

Rymadil 25 mg twice per day- 7 am & 7 pm
Tramadol 50mg- up to twice per day at the same time as Pepcid AC
Pepcid AC 5 mg twice per day- 30 minutes after Sulfulcrate, 30 minutes before Rymadil
Sulfulcrate (my mom's) 1/2 pill twice per day- 1 hour before Rymadil

My anxieties are are easing. It's a job to take care of him but I am so happy this is an option.

Invasive surgery seems more distant now and we are focusing now on the laser disc ablasion. Does anyone know of any success stories personally?

Also, Henry needs a toenail trim. He freaks out so much that we are thinking about waiting until the surgery. However, his nails grow very fast and need to be trimmed every 2 weeks. Any suggestions on that?

Henry has taken a turn for the worse. Panting, in lots of pain. I think he felt too good yesterday and over did it at pee breaks. 

He will not sit down. 

He has had 3 tramadol today. Any other suggestions for pain?

I'm very sorry to hear this, Whitney. My prayers are with you that his pain will be quickly brought under control with an adjustment of his medications. As Sabrina said, another pain medication can be added. Please let us know what is prescribed after you speak to a vet tonight.

Blessings to you all.

Hi Whitney,  Sorry to hear Henry is in pain. As Sabrina said it is important to call your vet and let him know right away.  Pain control is one of the most important things in a disc disease.. he just can't heal until his medications are right..

What to expect during pain healing

1. PAIN control happens in approximately an hour when a prescription is customized to your dog for the dose, the frequency and combination of pain meds. There is no one-size-fits-all pain relief.

Make sure the medications are fully controlling pain from dose to dose with no break through in pain. Continued feedback to your vet is vitally important until the pain medications have been properly adjusted for your Henry.

Signs of pain are holding the head in an unusual position...head held high or nose to the ground, shivering/trembling, not wanting to move much or moving gingerly, yelping, tight/tense stomach muscles, holding leg up flamingo style...not wanting to bear weight on the leg, just not their usual perky-interested-in-life self.

These are some of the more typical pain medications used to treat IVDD:

Tramadol as the general pain reliever. It has a short half life of 1.7 hours and may need to be prescribed at a minimum of every 8 hours. 
Methocarbamol treats muscle spasms stemming from aggravated muscles due to nerve trauma related to the spinal cord inflammation.
Gabapentin may be added to the mix for hard to control pain and nerve pain. Veterinarians are finding this medication works very well in combination with Tramadol.

Laser light therapy, acupuncture and electroacupuncture which sends a microcurrent of electricity to and from acupuncture points (which are really big nerve bundles), can be very beneficial at helping to re-establish the nerve connections in the body. Any one of these therapies can be started right away if in your budget... they not only help relieve pain and inflammation but will kick start nerves to begin regeneration. Find a holistic vet here: ahvma.org/Widgets/FindVet.html www.serenityvetacupuncture.com/index.php/faq_/ [one vet's overview/prices] NOTE: Chiropractic is NOT recommended for IVDD dogs.

I know how much work it is to take care of these little guys and I was anxious also in the early days with IVDD.  Sending you comforting thoughts and prayers..

If you believe Henry has had more neurological deficits and is now paralyzed, he should be immediately seen by a vet. A determination needs to be made if he still has deep pain sensation. If there is no deep pain sensation, there is a window of time when surgery can still be successful. That window of time is 12-24 hours from losing deep pain sensation (DPS). Even after that window of time, surgery is often successful. The spinal cord is very fragile, the more hours after the window, the less chance of a complete recovery.

He also needs to have his bladder expressed ASAP. Have the vet show you - hands on your hands - how to express the bladder. The bladder will overflow if it gets too full, which can stretch out the bladder. Also urine laying in the bladder can cause urinary tract infections. Here's info on expressing so you can try again before going to the vet.
www.dodgerslist.com/literature/Expressing.htm

It sounds like he's in quite a bit of pain and just can't get comfortable. Hopefully, once the medications are added, the pain will be under control again.

Here is the information you need to review to decide whether surgery is indicated:
www.dodgerslist.com/literature/healingsurgery.htm
www.dodgerslist.com/literature/surgery.htm

My prayers continue for you all. Please give us an update as soon as Henry's been seen by a vet.