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Post by Karen & Maddie on Mar 29, 2023 11:55:26 GMT -7
Hi- my 13yo black and tan dachshund, Maddie had her first IVDD incident 3/9. Vet recommended steroids and crate rest, and follow up with surgeon if no improvement or things worsened. We saw the neurologist/surgeon last week and she aid she feels confident she could “fix” Maddie with surgery ($10-12K), but doesn’t necessarily recommend it, as the likelihood of her blowing another disc in 3-6 mos is fairly high.
She also said that she would have liked to see more improvement than we’ve already seen with crate rest. Given what we’ve observed, our primary vet’s assessment, her overall age & health, the neurologist is also not confident in Maddie faring well as a “down” dog.
I was surprised that she strongly recommended we consider euthanasia, and it breaks my heart to even consider it. That being said, Maddie is clearly still in pain, she’s miserable (barking day and night - she has never been one to bark). She’s completely incontinent, and non-ambulatory. She does still love to snuggle. I’d like to finish out crate rest and add in acupuncture etc to see if things improve, but I worry I’m grasping at straws.
Has anyone been here before? Has anyone’s dog rallied after very little improvement in the first few weeks of crate rest? Maddie is, by nature, an extremely anxious dog already and her anxiety is through the roof now. She slams herself against the crate.
No medications seem to keep her sedated. (She’s on Steroids, Prozac, Gabapentin, a benzodiazepine, and trazadone, as well as PRN Sileo. None of these are calming her down.). Per the neurologist, I’ve given up on the crate and have her in the floor next to me instead, where she is calm and still not trying to move away.
Thanks for any assistance you can offer!
[7.3kg/16 lbs 13 y.o.
3/29 reports neuro status: no bladder control, non-ambulatory
Deracoxib stopped? 3/8 no 4-7 days washout provided! no double GI tract protection
prednisolone as of 3/9: 10mgs 2x/day for 14 days, 3/24 test taper for: √3/29 pain / √3/28 neuro
Gabapentin 150mg 3x/day
fluoxetine SSRI: 10mg 1xday
Ativan (Lorazepam) 0.5mg 3x/day muscle relaxer + anti-anxiety
Trazadone 50-100mg 3x/day as a sedative
Sileo (dexmedetomidine oromucosal gel) 1x/day pm for sedation
famotidine 10mg 1x/day]
Current weight 7.3kg
Medications: Prednisolone taper (currently 5mg/day); fluoxetine 10mg/day; Ativan 0.5mg PRN; Trazadone 50-100mg PRN; Sileo PRN; Gabapentin 150mg/day; famotidine 10mg/day.
Date dx by vet: 3/9
Date saw neurologist: 3/27
No CT or MRI; only x-ray and clinical assessment.
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Post by Romy & Frankie on Mar 29, 2023 13:56:34 GMT -7
Welcome to Dodgerslist. We are glad you’ve joined us all. We’ve got valuable information we’ve learned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you. Learn more about us and how we team up with veterinarians: dodgerslist.com/about-team-dodgerslist/Disc disease is not a death sentence! Struggling with quality of life questions? Re-think things: dodgerslist.com/2020/04/18/hope-quality-life/
Dodgerslist work's with vets: dodgerslist.com/2020/04/20/education-team-ivddIs your name Karen? I am Romy.
Maddie is in pain. Vets have many ways to address pain. What we have seen work best for pain relief in IVDD dogs is a combination of three meds each attacking pain differently:
Methocarbamol for painful muscle contractions 3x/day Tramadol Rx'd 3x/day as the general pain reliever Gabapentin for nerve pain also Rx'd 3x/day.
The only pain med you mention is gabapentin. Gabapentin is primarily for nerve pain and does not really address the other sources of IVDD pain. These three pain meds do not last long in the body and must often be taken 3x a day to provide full relief. When methocarbamol, tramadol and gabapentin are on board, you would expect full pain control in 1 hour and for it to stay that way dose to dose. Please speak to your vet right away and let them know that Maddie is in pain and discuss the pain meds mentioned above. Advocate strongly for an adjustment in medication. Maddie is relying on you to speak for her.
Once Maddie is no longer in pain, you will see that euthanasia is not necessary and not an appropriate treatment for IVDD.
Crate rest is very important for IVDD. This is because immobility allows the disc to heal. With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. Those weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form. dodgerslist.com/2020/05/14/strict-rest-recovery-process/
I understand that Maddie is non-ambulatory, but dogs can do the unexpected in a heartbeat and run to the window or jump off the couch. Even paralyzed dogs have done this. This would disrupt the healing disc and could lead to a worsening of the condition.
Maddie is very anxious in the crate and has been taking medication for that. You mention prozac, ativan, silio and trazadone being prescribed as anti-anxiety meds. Some sedatives work the opposite for some dogs...they get wired up rather than calmed. Is Maddie still taking all of these meds for anxiety? Consider backing off on some of them.
Maddie's anxiety is probably influenced by pain. Once her meds are right, and she is no longer in pain, she may feel calmer.
When was the prednisone prescribed and at what dose? When did the taper start?
It often takes 30 days at the full dose of a steroid before the swelling in the spinal cord is gone. Taper days do not count. Usually if a dog is still in pain, the vet will not start a taper. This is because the pain indicates that there is still swelling in the spinal cord and still work for the pred to do. It is not uncommon for a dog to try to taper more than once before all the swelling is gone.
We have more information on meds here:
Can Maddie move her legs at all, for example to reposition herself?
For dogs that are incontinent, expressing is used to help them empty the bladder and bowels. It is particularly important that the bladder is emptied regularly because stale urine in the bladder often leads to a UTI. Expressing is a matter of physics. This means the pressure is put on the bladder greater than the strength of the urinary sphincter to push the urine out.
Bowel expression keeps the dog from being anxious about poop in the bedding and makes cleanup much easier for the pet parent.
Information about expressing is here: dodgerslist.com/2020/05/05/bladder-bowel-care/
Dogs may not show improvement in neuro function during crate rest or for some time after. During crate rest the dog should be taking an anti-inflammatory and appropriate pain meds. The anti-inflammatory addresses the spinal cord inflammation and the pain meds are taken to provide immediate pain relief. The severely restricted movement of the spine is to encourage the body to reabsorb the bulging disc, so it's no longer pressing on the nerves of the spine which causes the pain.
All anti-inflammatories, like pred, cause excess stomach acid which can cause serious stomach problems. To reduce the chance of stomach problems a stomach protector like Pepcid AC is used. Please speak to your vet about stomach protection. Don't wait until there are signs like vomiting, diarrhea or not eating because once you see signs, stomach damage has already begun. Pepcid AC is an over the counter med in the US. In some countries, it is prescription only. What country are you in?
Please do not feel alone in fighting the terrible disease that is IVDD. Everyone here has or has had a dog that went through this. We know what you are going through because we have been there.
There is much more information at our main website: www.dodgerslist.com |
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Post by Karen & Maddie on Mar 29, 2023 14:40:59 GMT -7
[Quoted text has been removed. We only want to read your own words in your post. Thanks for helping us out] IF there is new information or a correction, please do so in a new post as this post is being marked and we may miss what you write]Hi Romy - yes, I’m Karen (I just hate my name for obvious reasons). You mention Pepcid - Maddie is on Famotidine, which is the same thing. The Ativan was being used as both an anxiolytic and a muscle relaxant (benzos work well as muscle relaxants), the trazadone, normally sedating for Maddie is a straight sedative, not an anxiolytic. Sileo is for loud noise anxiety but the vet said we could use it for sedation also since it’s the only thing helping. The Prednisolone isn’t just an anti inflammatory med, it also treats pain (similar to NSAIDs). She had been on deracoxib (an NSAID) but we stopped it to go on the prednisolone. The vet said when we’re done with the taper. She was on the full doses [mgs; x/day?] of prednisolone for two weeks and started the taper last Friday (3/24).
Her pain HAD seemed fairly controlled until we started the taper, but her anxiety went nuts with the pred also. I’m told this is common. I’ll ask about tramadol in the morning. I’m sure I have some here - if I can find it, I’ll just call for dosing. (Two vets AND the surgeon said there was limited benefit to extending the pred- I’ll ask again!) She is gated into a small area of the floor which she objects to less than the crate, even though it’s close to the same size (slightly larger, but she hasn’t tried to move). She still has deep pain in her feet, but she does not move her legs/feet at all, no. If there’s a knock on the door, she lifts her head up but doesn’t even try to scurry toward the door like she did before. I hate seeing her struggle, but she’s my *baby* so obviously I’ll do whatever she needs. I went to the surgeon fully expecting to sign forms for surgery right then and there, but I was NOT expecting to hear they didn’t recommend it. I especially wasn’t expecting to hear the E word. I was completely blindsided. 
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 29, 2023 15:31:48 GMT -7
Karen, I'm so sorry you did not get a vet supportive of helping rather than upsetting euthanasia that is NOT a treatment for IVDD! As many of us have learned not all vets know IVDD especially at home care tips. Some are not as familiar with the disease itself. Romy has pointed you to things to help you learn the disease Maddie was born with. I'll add a 10 min Shortcut thru IVDD to give you the big overall picture, for the now and to know you can live many happy years ahead with your IVDD dog. dodgerslist.com/2020/06/26/time-and-ivdd/Fill us in on a few points so we have all the info to give useful comments for you and Maddie. Deracoxib started on what date? date stopped?
prednisolone as of 3/9: ?mgs ?x/day for 14 days With meds you listed as giving "as needed", what is the usual frequency currently? TRAMADOL traMADol inhibits inhibits the reuptake of serotonin fluoxetine (SSRI) also affects seratonin traZODone also affect saratonin ⚠️Make sure you have a vet RX to start traMADol
Barking is not a sign of pain. Could you list what you observe that relate to pain: Where did the Neuro think the bad disc was: in the neck or the back? 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
Resolution of spinal cord inflammation/swelling provides the relief from pain. It can take an anti-inflammatory (steroid or a non-steriodal NSAID) a range of 7 to 30 days before all swelling is gone. So steroid prednisone or NSAOID Deracoxib are not pain relievers as it can take 7-30 days to finally resolve the painful swelling around the cord. Pain relievers act in a matter of an hour.
-- Learn about Prednisone as used during a disc episode. An informed owner is a dog's best defense when taking an anti-inflammatory. What your job is, how to arrange for a Plan B with your vet. dodgerslist.com/2020/04/18/steroids-vs-nsaids/ Did the neuro on 3/27 say that Maddie had the ability to sense deep pain (DPS)?What are the specifics of neuro diminishment currently: -- Can she push up with rear legs to attempt to stand?
-- Does she use rear legs to attempt to reposition her body?
-- When you put her in a stand position, do the rear paws knuckle under? Is she slow to corret? Or cannot place her paw correctly al all?
-- Have you seen her give you a happy tail wag if you specifically do happy talk with her?-- How often do you express the bladder?
-- Does she stay dry between expressing sessions?Crating is to protect from unexpected movement to the spine which could further damage the disc and the spinal cord functions. Do you work from home? When you are at home to supervise, many owners have found the use of a pet stroller to help keep there dog calm Dogs often like being up high to see around the home. And of course, like being beside you as you move from room to room. Features and other considerations about strollers during conservative treatment: dodgerslist.com/2020/05/17/pet-stroller-conservatve-treatment/ |
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Post by Karen & Maddie on Mar 29, 2023 16:40:31 GMT -7
Do not edit, this post is being marked. If there is updated info, please make a new post. Thanks!]
Thank you - Maddie has been on Deroxacib/Deramax for years (we rescued her two years ago - she was already on it for a subluxated shoulder and a floating kneecap - her previous owner had this dog weighing in at 24 pounds. We’ve gotten her down to 16. She’s still a few pounds overweight.). The
Previous dose was 25mg/day [date Deroxacib stopped?]
The prednisolone started 3/9 at 10mg [2x/day] BID. Two weeks later it tapered to 5mg/daily. Next week it’s supposed to taper further to 2.5mg every other day. After the taper, they plan to put her back on the Deramax but said we could use carprofen if we prefer.
She’s trembling a lot, though she had a tendency to do that as baseline (I suspect she was in pain long before we realized. Shes also extremely restless.
She does not push to stand, she does not correct her toes when I put in standing position - she mostly just knuckles. No tail wag at all. She still has tail and anal tone per neurologist. Neurologist also confirmed deep pain, but I’ve been checking every 8-12 hours under instructions from a good friend who is a vet (she is a regular vet with a holistic specialty - she recommended adding acupuncture, which we’re starting tomorrow) and we are a medical household so I had a hemostat on hand.
[Oddly, my vet (regular vet, not the neuro) seems intimately familiar with IVDD. She’s had two dogs with IVDD. One had surgery but blew another disc right after surgical recovery so they reverted to crate rest - she lived another year or two before contracting cancer; the other had complications wherein the paralysis affected her respiratory system, so had to be euthanized before they could try surgery. My regular vet has been open to trying any suggestion I bring her and she talks me through the pros and cons.]
It’s very hard to express her bladder - even the vet had a hard time. It was easier when the Pred was higher but it’s harder again. It couldn’t be expressed at all before the pred, so the vet suspects a midline disc is involved. She pees almost immediately after drinking water. I otherwise take her out to express her bladder about 6-8 times a day (she’s accustomed to being taken out every two hours prior to becoming injured). I am successful at expressing her bladder 3-4 times a day, but after I’m CERTAIN I’ve emptied it completely, she still is peeing all over an XL pee pad within 10-15 minutes of bringing her in. Pooping is more predictable.
She has started refusing meals again, though, which I’m taking as evidence that she’s back to being in more pain. I do have an appetite stimulant I can put in her ear (it’s an ointment but I’ll have to look up the name later).
I do have a stroller for her, which she *loves*. The bassinet converts to a car seat, which is helpful because I have some medical disabilities of my own and I can’t carry her in the crate out to my car. She loves taking walks outside in the stroller, being near me in the stroller, etc. in many ways, my prior life of having had premature triplets definitely prepared me for caring for a disabled dog. I can’t leave her for five minutes because if I do, like I said - even if I JUST expressed her bladder, I come back and find her in a puddle of pee. I actually think she CAN pee on her own because she barks at me when she’s about to pee. I take her outside and she often pees once I put her “in the position” and I just express to make sure she fully emptied her bladder. For this reason, I am FAIRLY certain I do know what her empty vs full bladder feels like.
She is also arching her back a lot now. This is new since starting to taper the pred. Sounds like I should definitely be asking the vet to go back up to the full dose of prednisolone.
The barking (and there’s a lot of panting even if she’s not thirsty- she’s drinking a LOT of water) is, I’m sure, primarily an anxiety sign more than anything, but nothing seems to calm it, not even the things that used to work (I think she has acclimated to the trazadone, for example. Our other dachshund, who does not have IVDD, used to take trazadone for anxiety flares got acclimated to it very quickly also, so we had to stop using it). Speaking of our other dachshund - our 4 year old is very distraught. She sits on the other side of the gate or crate or next to the stroller as if she’s taking care of Maddie. The weird thing is, even in an anxiety flare, she never really barked before her injury unless our other dachshund barked at the door. When we first got her, we thought she might be deaf because she never responds to her name and she never barked. Eventually she saw a squirrel on our deck and let out two sharp excited barks and we didn’t even know where it came from. So for her to be barking incessantly 24/7 is extremely unusual.
Maddie is, of course, calmest if I’m sitting right down next to her, especially scritching her ears, but even that only helps for short periods. Her eyes still light up when she sees me, so I know she is not completely lost. She smiles at me and moves her front paws as if she’s trying to get toward me, but she’s not even able to drag her hindquarters. (I’m not encouraging that she do so- but it’s clear she WANTS to.
I’ll do anything I can for her (short of surgery at this point as I think the surgeon had good cause not to recommend it), but I also need to know there’s light at the end of the tunnel. Every vet I’ve talked to plus the surgeon all think that light is when she’s done with the pred taper- but it sounds like what she actually needs is to go back UP on the pred. As it is, I’ve barely slept since the day of her injury because she either barks all night or she is in a puddle of pee if I accidentally fall asleep for 20 minutes. I ALWAYS make sure she has peed before bedtime.
If I just knew how long it would be like this with no sleep, I think I could do it. [that came out wrong - of course I can do this. I just think it would feel more bearable in the short term]. But I don’t know if she’s going to start sleeping again in 8 weeks or if this is our forever life. Fortunately, I’m not working right now and my husband works from home, so we never have to leave her alone.
Thanks for listening. I hope I remembered to answer all your questions.
(Having just read through your stroller guidelinesI realize now it says no stroller rides outside until after she’s off pain medications. This was contrary to the advice the neuro gave, but I’m realizing now that it is possible she has just written Maddie off as unlikely to get better. Our stroller ride typically involves going from the front door down a smooth driveway to the mailbox and then just once or twice back and forth in front of our house. I don’t venture further because the sidewalk in front of my house is new and very smooth, but a few houses in either direction and the sidewalk is uneven from tree root growth. If that still seems like more than I should be doing, I’ll certainly stop immediately!)
Sorry - the gabapentin is 3 times a day, not once.
The trazadone and Ativan have been also about three times a day.
The Sileo I use once a day in the evening to get her calm enough to snooze for a bit, but it doesn’t last long.
Deracoxib was stopped 3/8 - about 24 hours before starting prednisolone.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 29, 2023 18:29:33 GMT -7
Karen, getting a decent nights sleep for you as care giver is important. -- Would it help to have her stroller by your beside side at night so you can touch her and she can smell you. Only if the stroller is stable and sturdy. Another option a wire crate on a sturdy table pulled up to bedside. Put in one of your unwashed shirts for her to sleep with. Be aware of GI tract protection when using any anti-inflammatory. Famotidine dose is effective for 12 hours is supressing stomach acids. The usual is famotidine 5mgs (0.44mgs/lb) twice a day. 3 reasons for stomach protection: dodgerslist.com/2020/05/06/stomach-protectionWhen there is a switch without the usual 4-7 days of washout from a NSAID to a steroid, then double stomach protection is used. Sucralfate PLUS acid suppessor famotidine. Each works in a different way to protect. Dogs eliminate NSAID dependent on their rate of metabolism. Danger to have both steroid and NSAID in body. When deemed an emergency double stomach protection gives GI tract saftey to go without the 4-7 days of washout. Most local DVM vets are not trained to correctly identify what they observe about DPS. It is not likely you will learn anything by the harsh pinching with that hemostat every 8-12 hrs than tissue damage! Instead, watch for the sign that no one can get wrong. Do some happy talk to her or show Maddie a treat...do you get a happy tail wag? What field of medicine are you in?For acupuncture or laser light therapy seek out a mobile vet. Avoid risky to the disc transports into a clinic. The single most important care you can Maddie give is at home inside the recovery suite. Movement of the spine can disrupt the early healing disc, can then cause more damage to the spinal cord. Nerves can self heal. The focus right now is all about the disc healing. Nerve healing may or may not happen in the short 8 weeks it takes for the disc to heal. Nerves are the slowest part of the body to self heal. Think more in terms of months rather than days/weeks.  Some signs of pain can be cause by other than pain. Do some detective work to see what is actually pain what may be from something else. Such as --Trembling being chilled, wrap her in a warm blanket from the dryer. -- Restless could be anxiety, over dosed side effects of the many anxiety meds? Try reducing those meds slowly to see if that would be the case? Run that idea by your regular vet to get the pros and cons. -- Arching back is pretty clear she is in pain. -- Observing two or more signs of pain? That helps you to further confirm a dog IS IN PAIN. The vet needs to know about that asap. If you are suspicious she is in pain then she should not be in a pred taper.
Also switching to the lessor of the two classes of anti-inflammatory drugs, NSAID) is not likely a good idea if you are currently seeing pain. See about the more usual " anti-inflammatory level dose" of pred for a 16 lbs dog: 16lbs x 0.3mgs= 4.8mg pred Often rounded up to pill size: 5mgs pred TWICE a day Steroid taper days no longer work on getting the painful swelling around cord resolved. Taper days do not count in the 7-30 day range it may take pred to complete its job. The expeditious way to test for pain on the taper is to stop all pain meds or back them off. Pain meds block your ability to correctly and quickly assess for pain. HOWEVER, if you are suspicious she is in pain now, then she should not be in a pred taper. Vet should likley Rx another course of prednisone (maybe a 7-day or even a 14-day course.) All pain meds for each source of pain should be on board every 8 hrs + famotidine: traMADol (inhibits seratonin uptake) or other as the general analgesic methocarbamol for muscle spasm pain gabapentin for nerve pain PROOF of bladder control 1) Overflowing bladder is what a dog who has no bladder control does. Reflexes are activated to open the sphincter when the bladder is over stretched with urine. Overflowing is not good for the dog health. Not all the urine is released. The part remaining can quickly become a UTI. A dog that has a bad UTI can feel pretty crudy and may not be interested in eating. When is the last time Maddie had a urinalysis?2) Peeing is what a dog who has bladder control does. The brain directs release of urine when the dog has found an appropriate spot usually by sniffing around. If necessary go back with Maddie to the vet to get another hands on top of your hands expressing lesson. The health benefit vs car transport risk is overweighed by health of preventing UTI. Tips on expressing, a good review: dodgerslist.com/2020/05/05/bladder-bowel-care/The "sniff and pee test" is the only way for humans to determine whether bladder control exists. You want to observe a head level activity (sniff) with the release of urine. Carry Maddie outdoors, set her down on an old pee spot for a sniff. Make sure that neither the sling nor your hands are on the stomach region as this could put pressure on the bladder similar to expressing. If urine comes out after sniffing, bladder control is returning. Until you are certain that full voiding is always occurring, you would continue to do a quick express check after she released urne (peed). Tell us what you observe.
POOP Have you tried expressing for poop? Expressing for poop is so that before mother nature would just let it plop out anywhere, you get there first to encourage poop to clear from the digestive tube to plop out where you desire. Most of us express on the toilet: upon awaking in the morning, maybe at 1-2 pm during the day and again before bedtime. First you should make a chart of eating, poop plopping times and try to figure out when you should be expressing. You really do not need anyone to demonstrate how to express for poop. This video shows how easy it is: For health reasons we really do not recommend a diaper. But only as a last resort thing til you get proficient in expressing. Choose a baby diaper to fit Maddie. Cut a hole for the tail. Use a non-toxic zinc product as a barrier cream (Aquaphor Baby, Aquaphor regular Healing Ointment contain same ingredients OR Bayer's A+D® Original Ointment ) . Change diaper promptly just as for a baby to avoid urine scalds, rashes, etc. With the diaper you may be able to get a better night sleep, til the puddle of pee is resolved? |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 30, 2023 10:35:11 GMT -7
[Mar 30, moved to Maddies thread on behalf of Karen]
Hi Paula,
I just wanted to thank you for all your helpful information. My Maddie seems much calmer [3/30] today and I have a call in to the vet (she’s booked solid today but usually returns messages around 1pm during her short “lunch” break-which is really just a 20 minute “return calls” break) to refill medications and to get permission to increase the prednisone again. I’m sure she’ll agree.
I increased the famotidine [5mgs 2x/day?] to twice a day (I had originally been doing twice a day but my pharmacist husband had dropped to once a day when we switched to prednisone and I assumed he knew what he was doing…never assume!!).
Maddie isn’t tail wagging at all, not for treats, not for anything. She *is* happy to see me, though! I do help her express poop, just to help keep things clean and consistent (she lets out a tiny little growl when she needs to poop, and then I help her express it so I don’t end up finding her sitting in poo. Before we tapered the pred, Maddie peed when she sniffed the pee spots in the grass about 50% of the time. The other 50% she needed expression, even if her bladder felt full. Since about four days after the taper, she stopped that. I think the swelling increased and she stopped being able to pee as well on her own, but even expression is harder - when she was first injured, even the vet couldn’t express her and she needed Prazosin to relax her urethra.
She has a UTI check scheduled for [4/3] Monday. That being said, I have test strips here, and I haven’t seen signs of blood, leukocytes, protein, or ketones in her urine so fair. There’s also no drastic pH change.
I’ll try the stroller next to my bed tonight. It is a very sturdy stroller. Honestly, I may not have a choice but to sleep tonight - my health took a turn today . . . But I’m worried about caring for her while my own health is taking a downturn. . .
I feel like im expected yo become an overnight expert? I feel like poor Maddie doesn’t understand why she doesn’t feel well and why we aren’t making her better yet snd here’s her mama not making it all better and WHY NOT!? I wish I could just… make her feel better. Hopefully with some med changes I can make it bearable for her.
Thank you for listening.
Karen
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 30, 2023 11:00:00 GMT -7
Karen, I'm sorry to hear you are not feeling well. Hope to hear you will be on the mend AND be able to get those good nights of needed rest too.
So many of us including me felt the same as you. Needing to quickly become knowledgeable about the disease we just learned our dog was diagnosed with. Learning while caring for them thru a disc episode, Whew! Our goal is to help you learn while you are in the process of broadening your reading about IVDD on the main DodgersLIST.com web site.
What is the dose in famotidine mgs you are now giving twice a day?
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Will make a note during the taper not only saw increased pain but going from having some degree of sniff and pee tested bladder control before the pred taper AND then 4 days after starting taper she has stopped sniffing and releasing urine seemingly neuro diminishment!!! The vet needs to know all things with DATES that you observe. Dates and details, for us as well, are very important as are what your observe.
We look forward to what the vet' response will be to get Maddie back in comfort from pain and to be able to continue working on the swelling around the cord.(specify which Neuro or local vet?) Hoping your urine monitoring will mirror the urinalysis and if not an antibiotic can get on board pronto.
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Post by Karen & Maddie on Mar 30, 2023 13:58:13 GMT -7
10mg ▲famotidine BID
Thanks for the support and advice. I appreciate knowing I’m not alone. The vet agreed to return to 5mg ▲prednisolone BID, and also suggested adding in ✙CBD. She said the poly pharmacy is complicated and agreed that backing off some of the meds is a helpful idea. We are pulling the 🛑Ativan for now and will increase the steroid. We’ll reevaluate when we see her Monday but I can call her between now and then if needed.
[7.3kg/16 lbs 13 y.o.
3/28 reports on taper: new bladder control diminishment and pain
Deracoxib: stopped? 3/8 no 4-7 days washout provided! no double GI tract protection
prednisolone as of 3/9: 10mgs 2x/day for 14 days, 3/24 test taper for: √3/29 pain / √3/28 neuro
as of 3/30: 5mgs 2x/day for ? days, then test taper: _pain/ _neuro
Gabapentin 150mg 3x/day
fluoxetine SSRI: 10mg 1xday
Ativan (Lorazepam) 0.5mg 3x/ STOPPED 3/30
Trazadone 50-100mg 3x/day as a sedative
Sileo (dexmedetomidine oromucosal gel) 1x/day pm for sedation
CDB ?mg ?x/day
famotidine 10mg ▲2x/day ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Mar 30, 2023 17:21:15 GMT -7
When you are able, please fill us in. As you know, we LOVE the detail!
Prednisone 5mgs 2x/day for how many days?
CDB ?mg ?x/day
Do keep us posted on the difference in pain obervation with getting on an anti-inflammatory level 5mgs 2x/day prednisone dosing. Have no patience with pain at all. When the pain meds are correct for Maddie pain within the hour pain should be in control. And it stays in control round the clock, night day, dose to dose of pain meds. Prednisone may take days/weeks to fully resolve the painfulness of swelling around the cord.
Currently she is only on gabapentin for nerve pain. Nothing for muscle contraction pain NOR a general analgesic.
Which type of vet prescribed today? Neuro or local vet?
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