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Post by Heather & Murray on Jul 17, 2023 9:52:18 GMT -7
[Original subject line: Yellow Lab IVDD]
Male, neutered, yellow labrador retriever, 9 yrs old, approx. 83lbs
Initial onset of injury/first signs of discomfort May 18,2023. He came in from being outdoors and immediately laid down right inside the door which was odd and then didn't get up when my husband was making lunch in the kitchen which again was very odd. My husband knew something was wrong and brough him in to our Vet. He presented with vocalization (whining, loud yelps), reluctance to move. When he did move his movements were very guarded, carrying head low, would not move head to the left. Some limb weakness and ataxia, but never any paralysis or urination/bowel issues. With his presenting signs/symptoms our Vet was pretty certain that it was a cervical disk problem. No imaging was done to confirm the disk issue at this time, but we started meds and crate rest. Initial meds were gabapentin, prednisone, and methocarbamol. He responded well to the treatment regimen. He did have a couple of bad days in the first week and a half. His issue seemed very positional, almost like a light switch would turn on and off. By week 5 he was weaned down on most meds and our Vet allowed us to add very short leash walks back in to his daily activity.
At the week 6 mark he woke up one morning and he was back to how he was on May 18th (can't pinpoint what might have caused the setback). At this point we restarted all of his meds and made an appointment with the neurologist to see what we were dealing with.
We were able to get an appointment for the next day (June 30th).
Again, he responded well to the meds. He wasn't 100% at the neurologist appt, but he was doing pretty good. MRI showed mild disk disease at C5/C6. We decided to go forward with surgery [7/30] that same day as opposed to trying the conservative route again with different meds. A ventral slot was performed. The surgeon removed a small amount of gelatinous-like degenerative disk material and a large strand of annulus from the canal. The cord appeared well decompressed with the ventral dura being flush with the dorsal aspect of the slot.
Post surgery exercise restrictions: Confinement to an area no larger than 10 ft x 6 ft for the next 4-6 weeks, no running or jumping during that time and no "off leash" activity when not in the area of confinement. Leash walk under direct 4 ft leash control 3-5 times a day for 10-15 minutes to allow for controlled exercise and bathroom duties.
Post surgery meds: 300mg gabapentin every 8 hours, 10mg diazepam every 8 hours, 300mg acetaminophen/30mg codeine, every 6-12 hours as needed for pain
The first week post surgery went really well. He seemed very comfortable. We even started to drop his meds to every 12 hours.
Then, on Saturday night (July 8th) he got up to adjust himself and let out a yelp. His movements became a little guarded and the following morning he was carrying his head low, but this "stiffness" seemed to improve as we got out the door for him to do his business. Since he was showing some discomfort we started the acetaminophen/codeine at every 8 hours again. Even though he was somewhat uncomfortable he never hesitated to get up to do his business or for a meal, so that was good. The increase in meds did make him more comfortable, but he was still "stiff" in the mornings. His suture removal was on July 11th, and of course, he looked perfect at that appointment. The surgeon was so pleased with his appearance, strength, willingness to move around. I did tell him that he was still showing some discomfort first thing in the morning so he advised us to bring all of his meds back to every 8 hours for another week since we had that little setback that started Sat night and then we could start to decrease them again if all was good. All post surgery restrictions stayed the same, but we could increase his leash activity by 10-15% if no pain and neurologic function was normal.
So, July 11th he had a full day of meds at every 8 hours, but he still woke up with that "stiffness" in the morning. I gave this update to our surgeon and he started him on ✙meloxicam (1/4 of a 7.5mg tablet once a day). He has responded very well to this additional anti-inflammatory med. Yesterday morning he got right up with no signs of discomfort.
We currently stand at 17 days post surgery and all is going well.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
83 lbs 9 y.o.
✙meloxicam as of 7/11 1.875mgs 1x/day
gabapentin300mg 3x/day
diazepam 10mg 3x/day
acetaminophen300mg-codeine30mg 2-4x/day as needed]
Thanks for taking the time to read about our boys experience with IVDD so far. I would love to hear from others that had pups with mild cervical disease that opted for surgery. I'm especially interested to hear what others were advised for leash walking immediately after surgery if their dogs had no paralysis before surgery. I have to admit that I was a little shocked that we could start leashing walking right away, but maybe that is common with a dog that didn't have paralysis before surgery.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 17, 2023 12:00:32 GMT -7
Welcome! We are a small group just going by first names. Mine is Paula. What's your name and your dog's?
It takes 8 weeks of little movement to allow the disc to heal with conservative treatment. Sorry to hear the disc relapse happened likely due to begining short walks.
After surgery it can take about 14 days before all of the surgical caused swelling subsides. So not unusual to need full complement of pain meds plus an anti-inflammatory drug on board.
The amount of PT a dog may do after a surgery is dependent on what the surgeon saw. So your vet wants 4-6 weeks before being re-introduced to a slow and incremental amount of physical activity. It is normal to for there to be allowed a short walk to and from the potty place and then back to rest to let all of the surgical areas to heal. Regarding the "official" graduation day to begin re-introduction back to family life and more activity, looks like that may be on July 28th? What is your understanding?
Once we know for sure what graduation day, we'll have lots of information to share with you in safely getting your dog back to family life and enjoying many hapys years ahead.
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Post by Heather & Murray on Jul 17, 2023 17:13:47 GMT -7
Hi Paula, My name is Heather and our dog is Murray. Here is what our surgeon outlined for post-surgery restrictions. This may be adjusted because we will check back in with him around the 4 week (7/28) and 6 week (8/11) time points and he already gave us the ok to do the 10-15% increase if Murray is pain free and has normal neurologic function. Immediate exercise restrictions: *0-4 weeks: Confinement to an area no larger than 10 ft x 6 ft for the next 4-6 weeks, no running or jumping during that time and no "off leash" activity when not in the area of confinement. Leash walk under direct 4 ft leash control 3-5 times a day for 10-15 minutes to allow for controlled exercise and bathroom duties. *4-6 weeks: 10-15% increase in activity/distance during walks if your pet is pain free and neurologic function has returned to normal. *6+ weeks: Slow return to normal activity, with continued adherence to life- long exercise restrictionsoutlined below. *No direct interaction with other dogs for at least 3 months. Life-long exercise restrictions: Limit leaping/jumping down sorts of behaviors Hello again. It seems like most dogs that are discussed on this forum are small breeds. Some things that apply to/work for small breeds just aren't applicable/possible with my 85lb lab. I was also wondering, since Murray is a larger dog, is getting on and off a couch as "risky" for him as it is for a smaller breed. Prior to the disc injury Murray would easily step up onto the couch or with just a little hop. And he didn't really jump off of the couch. It was more like a step off or he would slink his way off while stretching his back legs out on the couch  We are just trying to navigate what his new normal is going to be like and we need to prepare our home to make it as safe as possible for him, while still having him enjoy life. Another big obstacle at our home is that we live on a sloped lot. We have very little level land. Since his injury we have been leash walking him in our front yard which has some flat areas. There are only 4 steps from our front porch and we currently have a ramp over them. For him to get into our fenced backyard he would have to go up and down 15-18 stairs, either inside the house or from the deck. Unlike a small breed, carrying him up and down the stairs is not possible and a ramp is not an option on that many stairs. Is this something that he'll be able to do eventually? Are hills and slopes going to be safe for him. |
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Post by Romy & Frankie on Jul 18, 2023 13:41:10 GMT -7
The need to protect the backs of IVDD dogs is the same for both large and small breeds. We protect the backs by making sure there is little pressure on the discs in between the vertebrae of the spine. How best to do this may differ depending on the size of the dog.
Jumping up on furniture puts a lot of stress on the spine, so we often use ramps to avoid this stress. If Murray can simply step on the couch, a ramp may not be necessary. Although he can get off easily without jumping, does he ever simply jump off? Jumping would be risky for his back if he was enthusiastic about it.
What worked for my larger dog, Frankie, when crate rest was over, was a simple stair, sort of like a step stool. It was about 8 inches high, wide and stable with a non-slip surface. My husband made it. It was one easy step down, and he would get off and on using this. We had to teach him how to use this, and it was only available when we were already on the couch to supervise. When we were not there, the couch was blocked off. Our goal was always to keep stress off his spine.
Unless the slope is very steep, walking on hills after crate rest is over should be okay. Climbing stairs should be permanently avoided. The only way to use a ramp to the backyard would be to sort of zig-zag the ramp, otherwise it would be too long. My vet has this type of ramp for patients that need to avoid stairs. |
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Post by Heather & Murray on Jul 20, 2023 9:38:23 GMT -7
[Yesterday,7/19, at 7:14am Post by Heather & Murray:]
Thank you for this information Romy. Yeah, we have a step setup that he used to get on and off of our bed prior to the injury. I'll have to share a picture of it to see if any improvements should be made to it. Maybe we will have to do something similar for the couch just to be safe.
Do you happen to have a picture of this zig zag ramp that your Vet uses?
-----------------
Hi,
Just wanted to give a quick update on Murray's recovery.
[Redundant info noted in previous Med list /History]
As a brief reminder, his medications as of 7/11 were:
gabapentin, 300mg, 3x day
diazepam, 10mg, 3x day
acetaminophen (300mg)/codeine (30mg), 3x day
meloxicam, 1.875mg, 1x day was started around 7/12 or 7/13 because in the mornings he would wake up a little stiff, slightly guarded movements, and low
head carriage. For PT he can do 10-15min controlled leash walks 3-5x day.
If all was going well on 7/18 we were to decrease the meds. His current medication regimen (as of 7/18) is:
▼gabapentin, 300mg, 2x day
▼diazepam, 10mg, 2x day
▼acetaminophen (300mg)/codeine (30mg), 2x day
meloxicam, 1.875mg, 1x day
[MED LIST/HISTORY- Moderator's Note. Please do not edit
83 lbs 9 y.o.
meloxicam as of 7/11 1.875mgs 1x/day
gabapentin 300mg ▼2x/day
diazepam 10mg ▼2x/day
acetaminophen 300mg-codeine30mg ▼2x/day]
One thing to note is when his meds are decreased, Murray is less loopy/sedated, so he feels much better and starts to behave more like himself. For example, during his night PT walk on 7/18 he did a quick lunge and bark at something in the neighbor's yard and also attempted to run after doing his business even though he was on a short leash.
On the morning of 7/19, he woke up with that slight stiffness and low head carriage again. The closest thing I can relate it to in human terms is if you wake up with a kink in your neck. Usually he will shake his head, do a full body shake or do a few play bow stretches and by the time we are out the door for him to do business the stiffness and low head carriage has resolved itself. Other than that, he is good. Pops right up for meals, does not hesitate to get up, gait is normal etc.
This morning, 7/20, he woke up the same way. We are thinking about bringing the dose of gabapentin or acetaminophen/codeine back to 3x day to see if this helps him in the mornings. But, if it's inflammation causing the discomfort in the morning then the increase in gabapentin and acet/cod really won't help. Correct?
Is this stiffness normal and something that we should expect during recovery? He is only at 3 weeks post surgery. We will definitely bring this up to his neurologist, but I wanted to see if others experienced anything similar during their dogs recovery.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 20, 2023 11:06:09 GMT -7
Heather, it sounds as if Murray is overdoing exercise. Surgeon directed slow, controlled, gentle walking does not include lunges, making an attempt to run off. Pain meds should be used for pain. If you feel his pain (low head, stiffness) is due to overdoing things, discuss with vet about traZODone or other calmer to use prior to an outing.
Can you walk him where there are no dogs to distract him?
Are you using a harness to attach the leash to? A collar from now on is to attach tags to.
If there has been some sort of set back to the surgical tissues from healing and the cause of inflammation, then pain meds and the anti-inflammatory Meloxicam would be useful
Let us know what your vet determines is the correct approach for Murray.
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Post by Heather & Murray on Jul 20, 2023 11:22:42 GMT -7
Thanks Paula.
I hesitate to get another sedative/calmer on board. He is so groggy as it is. Yes, we've always walked him using and easy walk harness. He doesn't even wear his neck collar any more.
I'm honestly not even sure what Murray reacted to. I didn't see anything. We are very aware of all of the surroundings when we have him outdoors. My husband usually goes out first to make sure the coast is clear.
I'll keep you posted on what the Vet says.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 20, 2023 11:30:30 GMT -7
You noted since the pain meds have now been decreased he is more himself.
Using traZODone should not make him sedated but instead just not care about things/relieves anxiety. You would be able to experiment which mg dose works best to just take the edge off so he can be calm at walk times.
Pain meds can have sedating/sleepy effects for some dogs. Let us know what your vet thinks would be the right approach.
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Post by Heather & Murray on Jul 21, 2023 8:01:20 GMT -7
Hello,
The Vet advised us to adjust the ▲gabapentin back to 300mg, 3x day and then reassess.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
83 lbs 9 y.o.
meloxicam as of 7/11: 1.875mgs 1x/day
gabapentin 300mg ▲3x/day
diazepam 10mg 2x/day
acetaminophen 300mg-codeine30mg 2x/day]
She wasn't sure if it was the exuberant activity Wednesday evening that caused the setback or if it was just something else. She said it's not uncommon to have these bad days during recovery.
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Post by Heather & Murray on Jul 28, 2023 7:56:22 GMT -7
Hello,
I wanted to give you all an update.
As of Thursday, 7/21, we significantly decreased Murray's activity. He was only going outdoors for the bathroom and then back inside to his xpen. By Friday, 7/22, his medications were back to:
gabapentin, 300mg, 3x day
diazepam, 10mg, 2x day
▲acetaminophen with codeine, 300mg/30mg, 3x day
meloxicam, 1.875mg, 1x day
[MED LIST/HISTORY- Moderator's Note. Please do not edit
83 lbs 9 y.o.
meloxicam as of 7/24: ▲ 3.75mg 1x/day
gabapentin 300mg 3x/day
diazepam 10mg 2x/day
acetaminophen 300mg-codeine30mg ▲3x/day
✙Pepcid AC (famotidine) 20mg 2x day]
He was still showing signs of discomfort throughout the weekend (more so on Sunday), but we were noticing that an hour or two after giving the meloxicam he would be more comfortable. We were giving the meloxicam at 6pm and by 8pm we would see improvements.
I took videos of Murray over the weekend and sent them to our neurologist/surgeon along with a list of other updates and questions. He was a bit considered with Murray's low head carriage in some of the videos. He thought there were two possibilities: either a flap of disk was causing the discomfort or the nerve root was inflamed from the original herniation. Murray got his 1st increased dose of ▲meloxicam Monday night (7/24).
He wanted us to consider a follow up MRI and also increased his ▲meloxicam to 3.75mg, 1x day and added 20mg ✙pepcid, 2x day. We decided to schedule the follow up MRI and they were able to get us in the next day (Tuesday, 7/25).
Monday night and Tuesday morning Murray was very comfortable (no vocalizing, normal gait, normal head carriage). When we arrived at the neurologist's office for the follow up MRI, he did an assessment of Murray and decided to hold off on the imaging because Murray had such a quick and positive response to the increased meloxicam. He is thinking that Murray's nerve root is inflamed vs there being a flap of disk material. If it is nerve root inflammation it could take months to resolve.
The plan was to keep everything the same (same meds, same activity restriction) until 8/1 Tuesday,when we will give our neurologist/surgeon an update. He will adjust the medications and activity level at that time based on how Murray has done during the week. I'm happy to report that Murray is doing really well.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 28, 2023 9:54:53 GMT -7
Heather, glad to hear Pepcid AC is on board. Fingers crossed the increase in meloxicam will be getting to work resolving the inflamed tissue. Thanks for the report and so happy to hear Murray is in comfort and doing well.
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Post by Heather & Murray on Aug 4, 2023 7:54:57 GMT -7
Hello, Well, things were going great as it relates to his recovery from the ventral slot surgery, but at night on 7/31 we noticed that his stool was much darker than normal (maybe a little bit of black, but mainly a very deep/dark brown color). We contacted the neurologist Tuesday morning (8/1) and he added in ✙sucralfate, 1g, 3x/day and he told us to continue the meloxicam, diazepam, gabapentin, pepcid, but stop the acetaminophen with codeine. On Wednesday ( 8/2) we noticed that Murray was showing some hesitation in eating his kibble. A couple of hours after giving his 3rd dose of sucralfate Murray started vomiting and had diarrhea (still dark, but not black). We reached out to our neurologist but he is out of the office until Monday and the individual that called us back wasn't much help  We decided that we would bring Murray to our primary vet first thing on 8/3 and for the rest of 8/2 we withheld food and all meds except for 1.875mg meloxicam and 20mg Pepcid at night. That night and early morning, he vomited 5 more times. Thankfully he was still drinking and interested in the very small amount of chicken and rice that we used to give the meloxicam and Pepcid. Overall the [8/3] appointment with our primary vet went well. His kidney function and liver function was all good, so that was reassuring. I was afraid that all of the meds were causing organ failure. His red blood cells were a little low, so they are going to watch that, and his monocytes were high (I think is what she said). They gave him a cerenia injection and some SQ fluids. They advised us to restart the gabapentin, diazepam, pepcid, and sucralfate but to STOP the meloxicam. [MED LIST/HISTORY- Moderator's Note. Please do not edit
83 lbs 9 y.o.
meloxicam as of 7/24: 3.75mg 1x/day STOPPED 8/3
gabapentin 300mg 3x/day
diazepam 10mg 2x/day
acetaminophen 300mg-codeine30mg 3x/day STOPPED 8/1
7/31 dark formed stool, 8/3 dark diarrhea, 8/4 ate & drank, stayed down
sucralfate as of 8/1: 1g 3x/day
Pepcid AC (famotidine) as of 7/28: 20mg 2x day] Murray was very comfortable throughout the day yesterday. He was bright, although a bit tired, drinking as we offered him water, and he ate 6-8 tablespoons of chicken and rice and all of that stayed down. By 8pm we had restarted all of the meds per our vet. At 10pm when we got him up for his last bathroom break he was out of it (groggy, slow/wobbly gait) and very different from how he was during the day. Is it possible that he is over medicated? Is the sucralfate or sucralfate/pepcid combo not agreeing with him? He had a comfortable nights rest, but this morning he is still very depressed. It is very hard to tell what is causing him to feel so bad (GI pain, nausea from the meds, neck pain). I hesitate to say it's pain from his neck because he isn't presenting how he typically does (low head carriage, hesitant to move neck, vocalizing). He [8/4] did eat about a 1/4 cup of chicken and rice and drank a little this morning and that has stayed down. I sent an update to our primary vet this morning to see if they want to make any changes. Have there been other dogs in this forum that couldn't tolerate meloxicam or other NSAIDs. Since Murray may have some residual nerve root inflammation, being off of the NSAID really makes us nervous because we don't want that pain to resurface. Our vet mentioned using prednisone if it's needed. Does this tend to be safer than the NSAIDs? Murray was on it when we tried conservative treatment and we didn't have any issues at the time (besides increased thirst and appetite). Are there other things that can resolve inflammation? |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Aug 4, 2023 8:46:48 GMT -7
Heather, hope to hear Murray will be able to continue to keep food and drink down from now on. The non-steroid Meloxicam and the steroid Prednisone can cause the same GI issues. There is also a period of days to stop one before starting the other....washout days. Another thing... there have been a small number of dogs on this Forum who had GI issues with Pepcid AC. So if the stop of meloxicam on 8/3 does not continue to allow him to keep food down, discuss if Pepcid AC could be stopped or exchanged for a PPI such as omeprazole. Also some dogs can tolerate better a different brand (different active generic ingredient) of a non-steroid (Washout days ARE definitely required when switching from one NSAID to different NSAID.) Meloxciam is a non-steorid anti-inflammatory (NSAID).
You can get a better handle on the two classes of anti-inflammatory drugs + stomach protectors in order to understand and discuss things with your vet: ==> dodgerslist.com/2020/04/18/steroids-vs-nsaids D/l to print a copy of this handy ref card: ==> www.dodgerslist.com/literature/MedCard.pdf  ** |
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Post by Heather & Murray on Aug 18, 2023 7:49:46 GMT -7
Hello, I'm happy to report that as of 8/12 Murray's GI issues had resolved. He is fully transitioned back to his normal kibble diet and all is going well. As of 8/4 we stopped the ➖ diazepam, as of 8/9 he was off of the ➖ sucralfate and ➖ cerenia and as of 8/12 he finished the ➖ pepcid (per our primary Vet). As of 8/11 the neurologist advised us to stop the ➖ gabapentin (he was only getting 300mg, once a day at that point) and start to increase Murray's activity. Since 8/11, Murray has gotten some more freedom in our house and we've been walking a 1/4 mi in the morning and 1/2 mi at night. He is loving his walks and is doing really well. [MED LIST/HISTORY- Moderator's Note. Please do not edit
83 lbs 9 y.o.
as of 8/11 slowly resume physical activity ] Now Murray is an older, large breed dog so I'm assuming that he's going to have some aches and pains as we increase his activity since he's been inactive since mid-May. There have been a couple of times when he gets up from resting for an extended period and he's a little stiff and he does a play bow stretch, rolls his face and body around on the carpet, or does a full body shake to "get all the kinks out". There are also some times when he just shakes his head. I'm not sure if these head shakes are in response to some residual "twinges" coming from the nerve root/spinal cord that is still healing. I plan to put all of this in my next update to our neurologist. I could also be overthinking all of these behaviors and it's just him being his new, normal self. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Aug 18, 2023 11:26:13 GMT -7
Heather, very happy to hear how well Murray is doing since being graduated to get back to family life. With arthritis, being active helps. GRADUATION, A SLOW RE-INTRODUCTION Determine how you are going to ease back into more normal activity at graduation from rest. The idea is to gradually give more freedom under controlled conditions. Not free rein of the house and yard immediately! LOL Your dog's muscles are soft and out of shape after the rest period. Gradually build up their muscles and their lungs as you have been doing. Check out other ideas things you can do to encourage back friendly activities: www.dodgerslist.com/2020/06/15/back-friendly/ DIY back PROTECTION around the house 1) Good ideas in making your home back friendly: dodgerslist.com/2020/07/09/home-protect-ivdd-backs/2) Ideas and products to provide improved traction if Murray needs: www.dodgerslist.com/2022/10/08/traction-solution-improvements/3) Teach your dog to be safe and not jumping up or down, but to use a ramp whether over steps leading outdoors or to furniture in the house or getting into your vehicle. Dogs are best at visual learning rather than verbal commands. Dog trainer Anna Jane Grossman says “Dogs learn in pictures. Inside your dog’s brain is a very simple algorithm – pleasant images in one place and unpleasant images in another."
HAPPY DAYS AHEAD Check out these general ideas and tips in living with an IVDD dog such as dentals, nail trims, safe ways to have fun together, and more: dodgerslist.com/living-with-ivdd-tips-2 PT THERAPY AT HOME -- Strengthening core muscles Core exercises don't require specialized equipment. Here are 5 exercises you can do at home: totofit.com/five-basic-exercises-essential-to-building-core-strength/May we turn the tables and ask YOU for help? Did you know there are less than a handful who volunteer daily to help dogs and their owners? We need helping hands from other Forum members in educating. Education about disc disease is our number one mission! We invite you to hop on to our educational bandwagon team. Too many dogs are put to sleep because owners lack education about IVDD treatment. STRICT crate rest and proper medication have helped many dogs recover. We depend on all members to pay it forward for the help they have received with their dog by helping us educate! Pick what suits you....
We depend on you. Here are some ways to help..  ** -- Please celebrate Murray's graduation! Add a graduation photo and a short caption to our Gallery to give other members inspiration about your IVDD Survivor! dodgerslist.boards.net/thread/2262/add-dog-dodgerslist-photo-gallery-- "Share" our FB posts www.facebook.com/Dodgerslist-- When in conversation at the grocery store line or wherever you may meet breeds most prone to IVDD (Dachshunds, Beagles, Poodles, Spaniels, Shih Tzus, Pekingese, and Chihuahuas, Frenchies and some large breed dogs) give out our free little wallet cards. Hand carry our literature and print out our letter of introduction for your vet. ► ORDER BROCHURES & cards, they're free!◀︎] for your vet and wallet cards for you  -- Would you consider helping another trying to make decisions about surgery? We have a directory where you can share surgical info. Here is where you can share your dog's info: dodgerslist.boards.net/board/13/member-reported-surgery-costs-recommendationsState: Hospital: Address: Cost: Date of surgery: What was included in cost (MRI?, days stay, ER? PT? meds for home, sling, etc.) Comments: And finally, don't be a stranger! Stop in periodically. We really do love to hear how Murray is doing. We'd love a short video clip to see him in action at home and living & loving life in spite of IVDD! if you see a new member in a tough spot, give them hope. A brief paragraph about your dog can be insanely supportive and inspiring in a time of need!  |
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Post by Heather & Murray on Sept 13, 2023 9:57:57 GMT -7
[Heather's Murray 9/10 conserv NECK- Lab] Hey everyone, Murray had been doing great since "graduation" on 8/11. We were walking him a total of 1 to 1.5 miles a day and he was no longer confined inside our house. We were still keeping him off of all furniture, not allowing him to go up or down stairs, and no off leash activity outdoors. He has tried to do the "zoomies" in the house a couple of times, but we stopped him in the act. He would have some occasional discomfort after our evening walks and our neurologist gave us the "ok" to give gabapentin as needed. We only had to give 300mg on three occasions. We also started him on CBD oil (24mg, once a day) on 9/6. On Sunday morning, stupid me, [9/10] left our front door open to get some fresh air in through the storm door. Someone walked by our house on the road and Murray ran from his dog bed to the front door alert barking (maybe 20ft). It wasn't long before I noticed that that explosive movement aggravated something in his neck. He shook his head and slowly walked back to our office to lay down. For the rest of the day he didn't want to move much, he had low head carriage, when he did get up he was extremely stiff at first and very slow movements. He didn't seem to have the weakness/ataxia that he had with his original injury in mid May and although he was hesitant to move during the day he did not hesitate to get up to eat or drink. He had no issues with urination or defecation. It wasn't until later at night (approx 9:30pm) that he spontaneously yelped in pain (3 times). He did sleep comfortably throughout the night. Here is what we did for meds on Sunday, 9/10: Sunday before incident: 24mg CBD oil, 1 dasaquin tablet Sunday 12pm: 300mg gabapentin (this didn't really help much during the day) Sunday 8pm: 20mg prednisone (pred was our go to anti inflammatory since he had the ⚠️ulcer issue with the NSAID) Sunday 9:45pm: 300mg gabapentin Monday morning (9/11) he woke up and we were very surprised to find that he was much more comfortable. Maybe the 8pm prednisone dose really helped him. He did a play bow and either a head or full body shake first thing after getting up. His gait was back to normal and he was his perky self. After eating he rolled around on his mat to clean his face. We gave another dose of 20mg pred and 300mg gabapentin in the morning. We put him back in his confined areas just to be safe, and we are limiting his walks to bathroom breaks. Monday evening he got another dose of gabapentin and 15mg pred. On Tuesday (9/12) we continued with the gabapentin twice a day and 15mg pred twice a day. [MED LIST/HISTORY- Moderator's Note. Please do not edit
83 lbs 9 y.o.
Sun 9/10 disc episode, pain only
Crated as of 9/10
Pred as of 9/10 8pm 20mg 2x/day for 1 day
as of 9/11 15mgs 2x/day for 2 days then 9/13 TEST taper for __ pain? / _neuro?
gabapentin 300mg 1x/day til 9/16-17
⚠️Murray needs GI tract protector, Pepcid AC, on board for duration of prednisone! ]We contacted the neurologist and he thinks that Murray likely has aggravated his previous surgical site. I have to get some clarification on what he means by aggravated. Does this just mean the area is inflamed or does it mean there might be another herniation? He wants us to decrease his prednisone to 10mg/day for the next 3 days and then stop discontinue it and see how he does. Also, continue the gabapentin, 300mg twice a day, for 3-5 days. As of this morning Murray is showing no signs of discomfort. We gave him 10mg of pred and 300mg of gabapentin this morning (9/13). What are the chances that the disc re-herniated? Would he respond so quickly to minimal medication if it was re-herniated? Heather |
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Post by Romy & Frankie on Sept 13, 2023 13:25:06 GMT -7
I am sorry to hear that Murray may have aggravated his previous surgical site. When surgery is done on an IVDD dog, only the disc material that is out of place is removed. So it is possible that there is now additional disc material pressing on the nerves. This is not very common. It is also possible that another disc in the same area is causing the issue.
Dr. Andrew Isaacs DVM Diplomate ACVIM (Neurology) discusses this here:
As you don't have a definite diagnosis yet, the prudent thing to do is err on the side of caution and crate Murray for now. I know you are limiting his walks, but do your best to limit movement overall until you have the follow-up call with the neurologist. Pred often works quite quickly. If Murray shows signs of pain or any neuro deficits on the lower dose of pred, let the vet know right away. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 13, 2023 18:09:07 GMT -7
Heather, STRICT rest (limited footsteps, limited movement of the back) during conservative treatment is to prevent worsening a bad disc which in turn could affect neuro function. As Romy comments make sure you are doing stricter than what was for post op rest. Tips for ensuring limited footsteps with a large breed dog: dodgerslist.com/2022/02/10/large-dog-care-tips-ivdd/Conservative vs. Surgical crate rest Prednisone, like any anti-inflammatory drug (NSAID or steroid) ought to be accompanied by an acid suppressor. Already Murray has shown to be ulcer prone with Meloxicam. Read and understand: the why behind stomach protection and let us know when you have Pepcid AC on board (?mg twice a day) for the duration of Prednisone.9/13 is the taper day for prednisone. With conservative treatment this is kinda of a test to find out if all painful inflammation is really gone. With gabapentin for nerve pain still on board, it will really be when it stops a some days later that you will have a better idea. Anyway, to be on the look out for any signs of pain surfacing on when pred starts to taper on 9/13. Good idea to have a sense of how steroid prednisone is used during conservative treatment. Good reading for you: 👉🏼https://dodgerslist.com/2020/04/18/steroids-vs-nsaids/Finger crossed for Murray that a short 2-day prednisone course will do the job! Please keep us updated.
RULE OF THUMB on a prednisone taper
pain = swelling = another course of pred back at the original anti-inflammatory dose +pain meds and Pepcid AC
no pain = go to conclusion of pred taper. No pain meds, just Pepcid AC for duration of finish out the neuo Rx'd crate rest |
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Post by Heather & Murray on Sept 20, 2023 6:15:29 GMT -7
Hello,
Murray continued to be normal with no signs of pain all [as of week 9/11] of last week.
He was dropped down to 10mg prednisone, once a day by Wednesday (9/13). We continued that dose for 9/14 and 9/15 and then stopped it.
We also continued to give 300mg gabapentin twice a day from 9/13-9/15, then 300mg once a day on 9/16 and 9/17 and then stopped it. We did hear back from the neurologist and he doesn't think that Murray has a new compression, likely he bruised or caused a contusion to his prior site that has caused his discomfort.
We got the ok to increase his activity again with controlled leash walks.
Before the incident happened on 9/10 we had already had an appointment scheduled with our primary Vet for an issue unrelated to Murray's neck injury. That appointment was Wednesday evening (9/13). Our Vet was very happy with the way Murray looked and was acting as it related to his neck. The staff was careful with him but they did need to do some handling in order to investigate the other health issue. Murray showed no pain or discomfort during or after this appointment. We found out that he most likely has hypothyroidism and he was started on 0.8mg thyro-tabs, once a day.
Current meds/supplements:
0.8mg thyro-tabs (hypothyroidism), once a day
24mg CBD oil, once a day
Dasaquin, 1 tab, once a day
[MED LIST/HISTORY- Moderator's Note. Please do not edit
83 lbs 9 y.o.
Sun 9/10 disc episode, pain only
Crated as of 9/10
Neuro diagnosis ±9/17: likely he bruised or caused a contusion to a prior disc ]
Heather
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Sept 20, 2023 10:15:40 GMT -7
Heather, hope the thryo-tabs will provide needed relief from symptoms. Let us know how the increased physical activity goes. Fingers crossed no more issues with any disc for Murray!
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We decided that we would bring Murray to our primary vet first thing on 8/3 and for the rest of 8/2 we withheld food and all meds except for 1.875mg meloxicam and 20mg Pepcid at night. That night and early morning, he vomited 5 more times. Thankfully he was still drinking and interested in the very small amount of chicken and rice that we used to give the meloxicam and Pepcid.
