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Post by Jackie & Auggie on Mar 18, 2024 16:43:54 GMT -7
Jackie's Auggie 3/15/24 conservative Frenchie- GRAD 5/13 Crate rest was cut down to only 3 weeks, ending on 4/4
Hi there, I am writing because Auggie is experiencing acute symptoms, and I need advice. In general, he had made a nearly full recovery since his IVDD surgery last February. He has been walking and even running. On Thursday, we put him on a leash for the first time without wheels and he walked up a big hill to the park. We were thrilled. He didn't exhibit any signs of pain. In fact, when he got home, he continued to walk around and wanted to play with his toys. The next day he was also fine in the morning. Around noon the UPS person came and he snuck out the front door and [3/15] went down a 1-2 ft step. Shortly after he was shaking and clearly in pain. I could feel his heartbeat in his back near his spine (this happened back in August and we went to conservative treatment and he made a full recovery).
[MED LIST/HISTORY- Moderator's Note. Please do not edit ] 36 lbs 4 y.o. gabapentin 100mgs 3x/day]
I immediately gave him a 100 mg gapabentin and called the emergency vet to request anti-inflammatory meds. They would not prescribe any without him being seen. He absolutely hates the vet, and so I wanted to avoid bringing him in as I knew he would flail around and it could possibly do more harm. I then called his regular vet who comes to the house. By this point, it was after 5 pm on a Friday and the on-call vet also refused to give him anti-inflammatory meds without being seen. We were able to get him an appointment at 11 AM on Tuesday 3/19 with a neurologist and so I figured it was better to go that route and keep him comfortable at home over the weekend then possibly hurt himself more by going into the ER. We were able to manage his pain during the weekend and limited mobility by keeping him in the crate and carrying him outside to pee.
When I woke up this morning (Monday, 3/18), he was in good spirits and ate. I gave him the 100 mg gabapentin at 6:30 am. At noon my husband fed him lunch but forgot to give him his pain meds. Around 1:45 pm he started shaking and was clearly in pain. My husband realized that he had not given Auggie his pain meds. Auggie then appeared to be in acute pain, and cried out in severe pain (I have near heard him make this sound before) and he was really shaking. I could feel his heart beat quite strongly near his spine. I gave him a 300 mg gabapentin and called the on-call neurologist. She said I could bring him into the ER, but again, there isn't anything they can really do from a diagnostic standpoint, and I would prefer for him to see an expert who understands how to treat IVDD. In fact, before he had his emergency surgery last year, he walked into the emergency vet, they admitted him, and by the time he was able to see a neurologist the next day, he was paralyzed. Given this, I am reluctant to have him seen by a non-specialist or wait for long periods at the ER when he could absolutely hurt himself more. I am just so frustrated that none of these docs will prescribe an anti-inflammatory without him being seen! The doc today told me that there are legal and medical restrictions that prevent them from doing so.
In any case, he is now (3/18, 7:30 EST) comfortable, and I will keep him comfortable until his appointment tomorrow with the neurologist at 11 am. I am just worried that he may have ruptured another disc. He is still able to stand and walk, although I am preventing him from doing so.
Did I make the right call by waiting 4 days to get him to the neurologist and on anti-inflammatories?
Other than doing an MRI, is there any way for them to tell if he has a disc rupture or if it is just a serious flare-up?
The neurologist who did his surgery is out on medical leave for another month. At this point, I feel I am more of an expert on his condition and care than most of the doctors who have seen him over the 12 months. Based on past guidance from Dodger's list, I know we need to do conservative treatment for up to 4 weeks. In the past, we have done 10-day crate rest protocols with carprofen and gabapentin, but this one seems worse - maybe because we haven't had the right drugs for him. But how would you determine whether he should follow a 10, 20, or 30-day conservative treatment? Are there specific symptoms we should look out for?
Also, are there questions I should ask the neurologist tomorrow?
Thanks so much for your guidance. I am sincerely hoping we can get this managed because I don't think surgery will be an option for my sweet boy again.
With much appreciation.
Jackie
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PaulaM
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Post by PaulaM on Mar 18, 2024 20:44:39 GMT -7
Jackie, it does sound very much like a disc episode from a previous bad disc or yet another new disc. Only expensive advanced MRI imaging would be able to tell which disc. With conservative treatment all discs are treated the same so no need of an MRI. Strict rest to allow the disc to form good secure scar tissue. That takes 8 weeks for a disc to heal. With surgery, an MRI is necessary to plan on which specific disc to treat. Also if the neuro has quite a high suspicion this is not a disc episode, but rather another disease that mimics IVDD, he'd want to rule it out with and MRI. Good job on immediately crating him and carrying to and from the potty place. That is the NUMBER 1 most important thing. Too bad the vet situation did not allow an anti-inflammatory to get started. But at least you are able to fully contain pain by giving gabapentin every 8 hrs. Maintain strict resting. MED CHART How about a med chart to help when two people dose meds to make sure nothing gets skipped? The info you keep on the chart makes it a useful tool for quality communications with your vet. Helps you to have accurate dates to go with the patterns you observe. D/l here: dodgerslist.com/wp-content/uploads/2020/02/med-chart-printable.pdfCONSERVATIVE ROADMAP You will find the "Conservative Roadmap" helpful in keeping your mind clear on what is healing, when it heals and what it takes to heal each of the 4 phases of healing. Also it may bring questions to your mind you'd want to discuss at the neuro appointment. VIEW, DOWNLOAD and print: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf Here is what the RoadMap will look like taped to your fridge for handy reference during the next 8 weeks. Conservative vs. Surgical crate rest Do let us know if the neuro is able to confirm this is a disc episode. If not, then what other disease did he diagnose?
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Post by Jackie & Auggie on Mar 19, 2024 9:31:15 GMT -7
Hi Paula, Thanks so much for the guidance. Auggie saw the neurosurgeon today. The did an exam and believe he is having a disc episode in his neck. He is able to use his front and back legs and he has full reflexes. They prescribed him 200 mg ▲gabapentin 3 times a day, 25 mg +Carprofen, and +AMANtadine 100 mg twice a day for 14 days. They did his bloodwork. Assuming there are no liver or kidney issues, they will refill all prescriptions. They want me to call back in 10 days with an update.
[MED LIST/HISTORY- Moderator's Note. Please do not edit ] 36 lbs 4 y.o. + Carprofen as of 3/19: 25mg 1x/day for 14 days, test STOP 4/2: _ pain? ?neuro Gabapentin ▲200mgs 3x/day +Amantadine 100 mg 2x/day No stomach protector on board ]
He is comfortable and we will stick to the plan as far as the 8 week crate rest. Just glad we finally have the right meds to help with the inflammation. I will keep you all posted on how he does with the treatment plan. Thanks! Jackie
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Post by Romy & Frankie on Mar 19, 2024 13:19:27 GMT -7
I am glad that you were able to get a diagnosis from the neuro. A neck disc episode can be more painful and take longer to resolve because almost all movement will involve moving the neck and head. We have some info on things you can do at home to help your dog's neck disc here: www.dodgerslist.com/2020/05/05/cervical-care-tips
Although Auggie is being kept comfortable with the meds he is on now, painful muscle spasms often accompany neck disc problems. If he shows any signs of pain going forward, you can speak with the vet about adding methocarbamol to his pain meds. You can read more about methocarbamol here:
All anti-inflammatories, like Carprofen, cause excess stomach acid, which can sometimes cause serious stomach issues. To guard against this, a stomach protector like Pepcid AC is used. Ask the vet if your dog has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health” issues answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine).
The usual dose of Pepcid AC (famotidine) for dogs is 0.44mg per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory.
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Post by Jackie & Auggie on Mar 19, 2024 18:28:11 GMT -7
Thank you! The neck injury is new to us so we are reading up to ensure he is able to heal as best as possible. He loves his recovery suite and as long as he is next to me while I work, he is perfectly content.
I brought up the muscle relaxer today but the neurologist redirected me to the Amantadine. I can see if she would still prescribe the muscle relaxer. Is there something I should look out for to see if he needs it?
We are bummed we are here again but it’s just a reminder that he has a chronic condition and we need to ensure he doesn’t overdo it once he recovers.
Thanks so much!
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PaulaM
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Post by PaulaM on Mar 19, 2024 21:15:23 GMT -7
Jackie, glad you got an exact diagnosis specifying it is a neck disc. Any hint of pain surfacing before the next dose of pain meds or when he has to move would indicate the need to move to an aggressive use of pain meds. 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
Fingers crossed the Rx for meds will keep Auggie out of pain round the clock. If not, do not have any patience with pain. Neck discs more often than not need all three sources of pain to be addressed. It is the resolution of spinal cord inflammation/swelling that provides the relief from pain. It can take carprofen a range of 7 to 30 days before all swelling is gone. While carprofen is at work, the pain meds do the job of giving Auggie full comfort from pain if Rx'd correctly for his needs.
-- traMADol- general analgesic -- methocarbamol- muscle spasm pain -- gabapentin- nerve pain -- amantadine- Amantadine is something we are seeing neuros Rx as part of the pain med cocktail as it allows other analgesics to function more effectively. The Mar Vista vets explain the mysteries of amantadine www.marvistavet.com/amantadine.pml Basically when stressed as our dogs are with a disc episode they may be more susceptible to physical pain. Muscle spasms hurt worse, everything hurts more. Amantadine alone is not an effective analgesic but when combined with the other IVDD pain relievers (methocarbamol for muscle spasms, gabapentin for nerve pain and tramadol as the general analgesic), it adds an extra dimension of pain relief. April 2 stop of 14-day course of carprofen
A clear picture if carprofen has finished the job on Apr 2 is needed. On the stop, pain meds are also stopped or backed off too.
--- The full details on how non-steroidal anti-inflammatories work with a disc episode. Good reading to be able to ask the right questions and discuss treatment: dodgerslist.com/2020/04/18/steroids-vs-nsaids/ 1. Do you have a Plan B with your vet worked out should pain surface when vet is not open in the middle of the night. 2. How will pain meds be handled on the Apr 2 carprofen stop date? dodgerslist.com/2020/04/18/steroids-vs-nsaids/ IVDD, a diseaseIVDD is a disease a dog is born with. Often the first signs of prematurely aging discs for dogs born with IVDD, appear typically at 3-7 years old. Some dogs might have only one disc episode their entire life. While others might have several disc episodes. It is a great idea to understand this disease.... I can recommend: -- Shortcut thru IVDD dodgerslist.com/2020/06/26/time-and-ivdd/ -- and the Conservative Roadmap which you likely already have taped to your fridge. Please keep us posted how Auggie is doing.
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Post by Jackie & Auggie on Mar 21, 2024 19:32:42 GMT -7
Thank you so much, Paula. I thought my post went through yesterday, but I guess not. The surgeon said she would call me later this week. When she does I will request the muscle relaxer as well as Extra carprofen so I have it on hand at the end of the 14 days or should we need to manage his pain and are unable to get in touch with his vet.
So grateful for your guidance. Auggie is resting comfortably!
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PaulaM
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Post by PaulaM on Mar 21, 2024 20:27:45 GMT -7
Glad to hear Auggie continues be free of pain while carprofen is at work. I sure hope the 14-day course of carprofen will do the job. For the end of the 14-day course on 4/2, do find out when you next speak, what the vet's preference is on stopping pain meds or backing them down. Can you verify with a vet if there is any health reason Auggie can't take Pepcid AC (famotidine). Dogs don't speak up at first signs of trouble like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach. If you get a “no health issues” answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine). ** thumb.ibb.co/mEGRuy/91x_Aj_s00z_L_SY355.jpg
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Post by Jackie & Auggie on Jun 7, 2024 12:52:26 GMT -7
Jackie's Auggie 6/7/24 conservative Frenchie- GRAD 8/2/24Hi Paula and team,So I have some updates and questions. So after the March 16th disc issue, Auggie essentially made a full recovery after 2 weeks of carprofen and gabapentin and 3 weeks of crate rest. [Jackie's Auggie 3/15/24 conservative Frenchie- GRAD 5/13 Crate rest was cut down to only 3 weeks, ending on 4/4] Fast forward to mid-May. [MED LIST/HISTORY- Moderator's Note. Please do not edit ] 36 lbs 4 y.o. After a previous surgery left back leg has an unstable gait, never gain ability to scratch ears with back legs. 6/7 started STRICT crate rest Rimadyl® (Carprofen) as of date ?: 75mg • 2x/day • for 14 days, test STOP date?: _ pain? _neuro? Gabapentin 100mgs 3x/day Amanatadine ?mg ?x/day Pepcid AC ?mg ?x/day , on board for duration of carprofen! ]I was traveling for work and my husband watched Auggie. Auggie got together with his dog cousin on 5/12 while I was away and they ran around and he seemed happy. I arrived home on 5/14 and my husband wasn’t home. Auggie was not walking and clearly in pain again. My husband said he was perfectly fine 2 hours prior. We went right to the protocol of pain meds and crate rest. He seemed to be moving in the right direction. Then he started to have his seasonal allergies and was really shaking his head because his ears were bothering him and he is no longer able to scratch his ears with his back legs. We figured it would be bad for his neck to keep shaking his head and he was clearly uncomfortable, so we went to the vet yesterday, 6/6. They sedated him and treated his ears. Because they sedated him, he was very lethargic last night and wouldn’t take the gabapentin or eat dinner. He was also a bit nauseous from the sedation. By the morning he had gone 24 hours with no gabapentin or carprofen and 36 hours without food. He wasn’t shaking but when I took him out he tried to take a few steps and then sat down. He refused to eat and would not take any meds wrapped in cheese (his favorite). I was petting his neck and he snapped and growled at me. Clearly a disc in his neck is bothering him. Eventually he ate a 100mg of gabapentin wrapping in lunch meat and about an hour later he ate breakfast (I hand fed him) and he had the carprofen. He seems comfortable but won’t let me pet him - he is acting like I am the one who hurt him, which is really sad. He will let my husband touch him. I just don’t know what to do. I am very certain that it is a cervical disc issue. When he was seen by the on call neurosurgeon in March she said he should have an MRI if he doesn’t get better with the conservative treatment. If he has an MRI and he has a disc episode they would recommend surgery. My husband doesn’t want to do surgery again. I feel we should since he can still walk and the recovery would be easier than the last surgery when he was paralyzed going into it. However I don’t know if that is fair to Auggie. Do you think that conservative treatment is still an option? He wasn’t on carprofen for a full 30 days this past time and perhaps yesterday’s vet visit was more traumatic to his neck than we realized. As of right now, I put him back on the conservative treatment and meds. I would like to see how he is tomorrow once the meds kick in, the nausea is gone, and he has a full belly. Any advice is appreciated. I am just so bummed. He is only 4 and loves life. I just can’t wrap my head around saying goodbye to him. 💔
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PaulaM
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Post by PaulaM on Jun 7, 2024 13:40:10 GMT -7
Jackie we are coming in the middle of treatment. So we are at a loss to comment until you provide these details. Auggie was to have graduated STRICT crate rest on 5/13 (8 wks of STRICT rest) You are reporting Auggie ran around on May 12th and by May 14th he was in pain. -- What was the reason you shortcut the full 8 weeks of STRICT rest to allow the neck disc to fully heal re: the 3/15 neck episode and supposed May 13 graduation from crate rest? Please fill us in on the medication list details: -- carprofen started on what date? ?mgs each dose • how many times a day? • For how many days?
-- gabapentin 100 mgs is given promptly how many times a day (2x or 3x's?)-- What is the reason the stomach is not protected with Pepcid AC for the duration of carprofen?
Tell us more about the back legs neuro function: --- does he use the back legs to attempt to reposition in his crate even though he does not have the ability reach and scratch his ears?--- Can he walk at all on his own? Or does he need help with support of a rear leg sling?Specify if you are observing any of these when both gabapentin and carprofen are on board. ⚙︎ 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 Confirm you are on the same page as we are about the single most important part of conservative treatment... the STRICT crate rest part: STRICT REST compliance MEANS: ◼︎No laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎ Eats in the recovery suite. ◼︎No chiro therapy whys: dodgerslist.com/chiropractic/◼︎Carried to and from the potty place. No meandering at potty times. Only a bare minimal FOOTSTEPS to take care of business. On a leash and harness to control darting off/speed. ◼︎No PT for conservative dogs during 8 weeks of STRICT rest to heal disc ◼︎ Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment. ◼︎ Refresh your mind. Avoid dangerous detours. Follow the "Roadmap." Tape it to your fridge. D/L and print out: dodgerslist.com/wp-content/uploads/2023/12/Roadmap-for-Fridge.pdf
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Post by Jackie & Auggie on Jun 7, 2024 15:29:24 GMT -7
Hi Paula,
Yes we did not do the full 8 weeks of crate rest and that’s on us. He just seemed so much better and was crying in the crate. I suppose we were basing his recovery off of his past back injuries and he seemed like he was totally better. We weren’t letting him run around after 3 weeks but we were letting him out of the crate and walk around the yard at potty time to sniff around. Unfortunately my husband took him to a family gathering for Mother’s Day when I was away (5/12). He was excited and ran around, which clearly was an error in judgment.
So I guess we will start from scratch again [6/7] today. He was prescribed [Rx Date?] 75 mg of rimadyl this time twice a day for 14 days. He has 100-200 gabapentin every 8 hours. We bought the Pepcid AC today. He was only nauseous yesterday because of the sedation. They had prescribed anti nausea medicine Amantadine but unbeknownst to me Auggie wouldn’t not take it before the appointment when my husband tried to give it to him.
As far as mobility, after his surgery he regained his ability to walk although he has an unstable gate and his back left leg gives out after awhile. He never regained the ability to scratch his ears with his back legs, so that is not a new injury.
Currently, he can still stand and take steps but obviously he is in pain and we are preventing that. I am not concerned about paralysis at the moment. I just want to minimize his movement and ensure he is not in pain. Now that he has taken the pain meds, he seems much more comfortable. He has eaten all of his meals and his treats.
I just had a serious talk with my husband that we have to be committed to the full 8 weeks of crate rest as it is a matter of life or death at this point. I know Auggie will be depressed but that is 💯 better than putting him down.
I am mad at ourselves for not doing what you had advised before with the full 8 weeks of crate rest but it is what it is. We just need to be strong and do what we know is best for Auggie! I will send an update tomorrow.
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PaulaM
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Post by PaulaM on Jun 7, 2024 19:16:58 GMT -7
Jackie, mark your calendar for graduation from STRICT rest for Aug 2. At that time we will be able to offer you a safe and gentle way to reintroduce Auggie back to family life and physical activity.
With all family on board attending to Auggie's care, it is likely he can heal the neck disc by end of 8 weeks rest on Aug 2!
I highly recommend using a med chart not just to make sure no meds are skipped. But also as a place to note events, see patterns....very handy when you discuss things with a vet to be accurate...same as we like, too!
We maintain a running medication list to have an understanding of how his treatment is working or not working for our comments to you. Report mentions of med changes or a new med fully. That means: _name of med _ mgs per dose _ x/day given It is fine to tell us if there is a range a med could be given, but we want to know what you actually give.
1. Please confirm and fill us in on the missing information in pink:
⭐️Rimadyl® (Carprofen) first dosed as of what date ? Gabapentin ?mgs do you ACTUALY dose? 3x/day Amanatadine ?mg ?x/day Pepcid AC ?mg ?x/day
2. Rimadyl (Carprofen) is "the" anti-inflammatory. It is only used until all pain is proved gone. The Rimadyl STOP is at the end of the 14-day course. -- Let us if your vet has Rx'd that all pain meds be stopped when Rimadyl stops. • Pain meds blind you to observing for pain. • Know that should pain surface AND you have been doing STRICT rest, the pain likley means that Rimadyl has not had enough time to resolve all swelling. • Expect your vet would Rx another course of Rimadyl and on the STOP you monitor for pain. • Typically it takes anywhere in the range of 7-30 days to get all swelling resolved. Meaning it may take more than one Rimadyl course.
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Post by Jackie & Auggie on Aug 29, 2024 16:51:08 GMT -7
Hi! I am writing to share the good news that we followed your advice and we did crate rest and the med schedule you suggested. We got a new vet who was willing to prescribe the meds he needed. **We stopped the carprofen after a month. He went off crate rest on the [Aug?] 5th. We eased him back into a more regular routine and he has done so so well. No pain, as happy as ever. He definitely gained some weight and isn’t as strong but we can address that. We are now more careful about not letting him overdo it when he gets excited. Not that we realize it can happen again, we are incredibly cautious about anything impact. Luckily, he is now fully trained not to go down steps. We are just so happy to have him back and that he didnt have to go through surgery. Thank you so much!
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PaulaM
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Post by PaulaM on Aug 30, 2024 11:50:22 GMT -7
Jackie, this is wonderful to hear from you and learn how well Auggie is doing post graduation day of Aug 2! You may find it useful to know some handy tips and ideas for living many happy years ahead with your IVDD Auggie. HAPPY DAYS AHEAD 1) You and your dog have survived a disc herniation! Learn what you can do from this point forward. Especially good to use with youngsters who may be around your dog to help them understand the disease, Illustrated IVDD Strip: dodgerslist.com/wp-content/uploads/2024/04/ivdd-6-Life-with-IVDD-Dodgerslist.pdf2) For the everyday living with an IVDD dog things. Lots more ideas and tips in living with an IVDD dog such as how to handle dentals and other anesthesia procedures, nail trims for health, and safe ways to have fun together plus more: 🚩https://dodgerslist.com/after-graduation-living-with-ivdd/ 3) Strengthening core muscles. This applies not just for humans, but REALLY applies to the IVDD dog: "...improve the strength and coordination of the muscles that surround the spine so they can act like the world's greatest back and neck brace. www.spineuniverse.com/conditions/spondylosis " Core exercises don't require specialized equipment. These are 4 exercises you can do at home: 1) Sit toStand, 2) Down to Stand, 3) Three Leg Stand, 4) Backing UP. The last exercise presented in the video,⚠️ HIP extension, exercise is NOT for dogs with IVDD back disease! 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.. -- "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) 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
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