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Post by Máira & Axl on Jun 19, 2023 12:04:34 GMT -7
[Original subject line: Axl fall injury, unable to diagnose, conservative 6/19] Responding to intro message: Hello I'm Máira and I recently joined this group for my dog Axl.
Axl is a 15 yo Pomeranian. We've been managing several health issues. He's diabetic, and has chronic kidney disease. We've been able to get these conditions under control and he's been experiencing a relatively normal and good quality of life despite everything.
Last weekend, June 11th, he fell down the stairs from the 2nd floor. And while not immediately affected, after 2 days started getting wobbly and unable to stand without falling over. He's seen a neurologist (DVM, DIPLOMATE ACVIM (NEUROLOGY)) for seizures from diabetes, but given his kidney disease any procedure that includes anesthesia is not an option, so we are unable to diagnose any disk issues. When we saw our Neuro, Axl was being bed rest but still going potty with a little too much freedom. Up until today he was able to sit up in his bed be moved without wincing and pain, but
today [6/19] he's much worse. He's very delicate; and in pain. Whenever we attempt to pick him up by holding his body he is visible pain. However, now we are handling him with much more care and heeding the advise on this website for strict bed/crate rest.
Axl weighs 13 pounds, and is considered normal weight for his size; he's a larger Pom.
Since he fell down the stairs we started him on Gabapentin (2x day, 100mg), Galliprant (1x day, 10mg), Omeprazol (10mg, 2x day, but we stopped. and give him gastro elm instead), dramamine, and keppra for as needed basis. Our we currently have a 20 day supply but I assume we'll need to refill to match the conservative time frame to heal any potential disk problems.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
13 lbs 15 y.o.
Galliprant as of 6/29 relapse: 10mgs 1x/day for ? days, then test STOP: _pain/ _neuro
gabapentin 100mgs 2x/day
dramamine as needed
keppra antiepileptic as needed
gastro elm. Stopped omeprasol 10mgs 2x/day]
He's eating and peeing well, but pooping less often, which we are thinking is related his back pain. When we take him out to potty we do so with the assistance of a full body harness with straps that can help offset the weight of his body in both the back and front of his body, otherwise he would wouldnt be able to hold his body up. To be clear, he has feeling in his limbs and can put weight on them, but will fall over from a lack of strength and balance. Up until today he was mostly happy, but today he seems pretty somber.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jun 19, 2023 13:27:26 GMT -7
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jun 19, 2023 14:22:24 GMT -7
Máira welcome to the Forum. So sorry to hear that too much movement maybe the cause of a relapse of the healing disc and starting at square one in re-healing. With the new pain, it means typically the meds need adjusting. Call your vet and report pain. Discuss in light of Axl's health issues how to cover each of the usual 3 sources of pain. Pain meds last for 8 hrs and the reason they are Rx'd for every 8 hrs dosing (3x/day). 1. Gabapentin (excreted by kidney) for nerve pain 3x/day 2. Other pain typical to a disc episode is covered by: Methocarbarbamol processed by liver (muscle contraction pain) 3x/day traMADol processed by liver (as the over all analgesic) 3x/day STRICT rest for disc healing. 🚩How to implement the #1 care of STRICT rest with a current disc episode including how to handle potty time safely==> dodgerslist.com/2020/05/14/strict-rest-recovery-process 🚩 The most asked question "What is the length of time for my dog to improve?" Answer: ==> dodgerslist.com/most-asked-disc-disease-ivdd-questions 🚩 Support both ends when lifting and carrying What was the reason to move from acid suppressor Omeprazole to GastroElm?Learn about the acid suppressers typcially used with a disc episode and why. Discuss Pepcid AC (famotidine) excreted by the liver would better suit use wity Axl's health issues: ==> dodgerslist.com/2020/05/06/stomach-protection/Galliprant as an anti-inflammatory is used only until all painfully inflammed tissue around the cord is gone. The test is to stop Galliprant, stop pain meds and you observe at home. Vets must guess as to how long a Galliprant course should be. Often the guess is a 5-7 day course or even a 14 day course. Let us know for how long Galiprant since the 6/19 relapse will be taken, then a STOP test to observe for pain. It can take in a range of up to 30 days for the anti-inflammatory to get rid of inflammation. No one wants a dog taking meds they don't need. That is the reason to try a course and test if all pain is gone. If not Rx another course. Learn more about the use of an anti-inflammatory during a disc episode. Good background info for you to be able to discuss things and ask good questions. ==> dodgerslist.com/2020/04/18/steroids-vs-nsaids/Will be watching for your update to learn the details of how meds were adjusted for full round the clock relief from pain for Axl. Pain deters the healing process. 1. Also Pepcid AC possible?... 2. and how many days will Galliprant be on board since 6/19 relapse? 3. Are the front legs also wobbly, weak indicating this is a neck disc? |
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