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Post by Frankie & Crispley on Apr 1, 2024 18:56:03 GMT -7
★1 10.5 lb, male
Prednisone, 2.5 mg tablet, 3/27 start 2x/day for four days, 1x/day 4 days, 1x/EOD Date of steroid taper? 3/31 start of 1x/day; 4/7 end.
Gabapentin 50 mg mini tabs 2-3x/day
Pepcid (famotidine) 5mg 1x/day while on steroid
[MED LIST/HISTORY- Moderator's Note. Please do not edit
10.5lbs 10y.o.
prednisone as of 3/27: 2.5mgs 2x/day for 4 days, 3/31 test taper for: _pain / _neuro; final taper 4/7
gabapentin 50 mgs 3x/day
Pepcid AC (famotdine) 5mgs 1x/day ]
★2 Dachshund / 10 y/o / Crispley. Frankie
★3 Suspect concussive disco or cervical disc herniation left side / ACVIM Neurology / MRI recommended and not done due to finances and vet tech recommendation of conservative approach
★4 vet for conservative treatment vet on 3/27
★5 - some shivering / trembling while laying after potty (being moved)
- yelping sometimes when picked up from left side or when upright and turns neck hard to the left
- frequently moves in crate such to shift positions using right front and fore paws
- nose to the ground when trying to stand, cannot hold self up, back paws mobile, front right mobile, verbally responds to pinching of ALL paw webs
- bright and alert, frequent tail wagging, anxious to get up but cannot hold self up entirely due to the paralysis left
★6 - full appetite
- normal urination and defecation, cannot hold self up to urine or defecate
★7 - frequently moves in crate such to shift positions using right front and fore paws
- nose to the ground when trying to stand, cannot hold self up, back paws mobile, front right mobile, verbally responds to pinching of ALL paw webs
- bright and alert, frequent tail wagging to happy talk or owner entrance or food, anxious to get up but cannot hold self up entirely due to the paralysis of left limbs primarily left front with some lameness of left back
★8 - cannot hold self up to urine or defecate, using a pad to contain defecation and immediately changing linens and using unscented baby wipes to clean fur / skin
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,561
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Post by PaulaM on Apr 1, 2024 20:34:57 GMT -7
Frankie, welcome to the Forum. First thing is that Crispley is being under medicated for pain! The neuro or any vet who can help at this time of night needs to know. Neck discs are pretty painful and normally need three different pain meds to control pain. All pain meds last about 8 hrs and should be dosed 3x/day (every 8 hrs). How often are you dosing gabapentin?Resolution of spinal cord inflammation/swelling provides the relief from pain. It can take an anti-inflammatory prednisone a range of 7 to 30 days before all swelling is gone. Taper days do not work on swelling. With the pred taper having started 3/31, you got the answer, Pred still has work to do. Pain means another course of pred perhaps longer than the VERY short 4-day course started on 3/27. Often the pred course will be a 7-day or even a 14-day course.
The best pain medications control is using more than one approach to address pain from multiple fronts. Advocate for all three pain meds to be on board each working on a different source of pain along with another course of pred. It often can take a couple of pred courses adding up to 7-30 days before all swelling is gone.
__traMADol-general analgesic
__methocarbamol- muscle spasm pain
√gabapentin-nerve pain.
All three pain meds need to be prescribed three times a day.
Adjusting meds by phone avoids a risky-to-the disc car transport. Describe the pain that you're seeing.
Advocate for adjusting pain meds over the phone tonight. Pepcid AC is 2x/day til the last dose of pred is given.
There should be no sign of pain from one dose of meds to the next. Have no patience with pain as it does hinder healing. Look for your dog to be acting their normal, perky self when pain is fully under control round the clock.
-- Learn about Prednisone. 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.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,561
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Post by PaulaM on Apr 1, 2024 20:48:41 GMT -7
Help us to understand if your dog has bladder control or not and why you are using diapers.
Brain controlled "peeing" or reflex "overflowing"? Can your dog: -- Specifically sniff an old pee spot and then release urine (bladder control!) -- Or do you find wet bedding or leaks on you when lifted? Indicator signs of an overflowing bladder (loss of control). Manual bladder expressing is necessary for health reasons. How to: ==> dodgerslist.com/2020/05/05/bladder-bowel-care/ After reviewing bring Crispley in for a hand on your hands demo tomorrow. SLINGsDo you carry him to and from the potty place. Do you use a sling at potty time to support the rear end? And even a sling for the front end if he is not strong enough to stand with front legs? A sling is used as back up to catch a wobbly dog's butt and prevent twisting the back. 1) A figure 8 DIY sling works especially well for the male dog anatomy at potty times. 2) DIY sweatshirt sling...can be used for front legs if he needs. Use same concept with cut out leg holes in a long strip of towel or sheets: www.lyonpuffpetsit.com/htmlslp/sling.html2) DIY figure-8 sling: dodgerslist.com/wp-content/uploads/2020/05/Figure8.jpg ** Do you have mattress set up for easier maintenance? Lots of tips to make crate rest go smoother here: dodgerslist.com/2020/05/14/strict-rest-recovery-process/There are extra things you can do at home to help the neck heal, such as softening hard kibble, raising food/water dishes, etc. More info here: ==> dodgerslist.com/2020/05/05/cervical-care-tips/ |
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Post by Frankie & Crispley on Apr 2, 2024 9:23:46 GMT -7
Paula,
I really appreciate all the resources and dialogue you provide for me and so many other owners. We are following up with our vet for prescription of additional pain management medicines.
To answer your questions:
- Crisp is taking his 50 mg gabapentin tablets 3x/day
Help us to understand if your dog has bladder control or not and why you are using diapers.
- Crisp does not release urine when picked up or appear to have loss of control of urination. We are using absorbent method for his urine because we have not had success in our attempts to express him. He typically will choose when to go to the bathroom and will yelp when he has defecated. His linens are then changed and he is wiped clean with unscented baby wipes and dried with a dry towel.
- Crisp does lift his head and cannot walk so I do not believe he can do the above.
- Crisp does not leak when lifted. However, Crisp will urinate in his crate.
- Thank you for the expressing tips. We will try again using this info.
- We have both the front and back slings. However, potty time outside has not been successful in potty or expressing attempts.
Do you have mattress set up for easier maintenance? - Yes.
One of the biggest concerns we have at this point is him frequently sitting up, turning his neck, rolling around in his crate attempting to get up, and handling / taking him out of his crate for potty breaks and putting on his harnesses. He additionally is primarily laying on his left side, should we be periodically laying him on the right?
I am so nervous all the movement or handling or allowing him to attempt to move around / stand up could be contributing additional damage and want to do the best to ensure he is healing and not being set back by all this movement.
If you can, I would appreciate any thing you can add regarding proper pick up if he is laying down on his side and / or ways to stop him from squirming around (if that is the appropriate course of action, ofc).
Thanks again so much, I can’t express how much your support has meant to me. All the graduates on here give me great hope. I will provide an update with any changes.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,561
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Post by PaulaM on Apr 2, 2024 12:36:36 GMT -7
Frankie, it sounds as though he does have bladder control. Try lifting him and placing right on an old pee spot to urinate. Take him out to potty every 3-4 hrs. If still finding he is releasing urine in diaper, then move up to giving him a chance to pee every 2-3 hrs. Hopefully you will be able to time potty time so that he is not needing to pee where he sleeps in the crate or in diapers. Try using a bolster pillow or rolled up towel/blanket that he can lean again it in more of an upright position. Giving him better ability to change his body position than from a harder complete lying down position. In any case, you are right to sense that staying in one position all day/night is not good for pressure on the skin. Helping him change position during the day is important to help prevent pressure sores. A dog that does have ability to control their bladder, can make it difficult for you to express. They can feel you pressing and they may not like that...tense up, try to resist what you are doing. You may want to try using an expen for easier access to picking him up. Just an idea here: Another way to more easily get him to the door of the crate is to have him on top of pillow case which can be pulled closer to the crate door where you can more easily reach his body. And last an easy DIY converting your wire crate to a top opening one, could be helpful too: dodgerslist.com/wp-content/uploads/2020/05/crate-top-conversion.pdfSince he can really walk you may not need a harness for the puposes of controlling his darting off, speed, etc. Just the front and the rear harness is all that is needed for potty time. Pick up Crispley so that both end are supported and the back remains horizontal to the ground. i2.wp.com/dodgerslist.com/wp-content/uploads/2020/03/lift-carry-horizontal.png More crate rest tips you might find useful: What did the vet do about the pain? About addressing getting all swelling resolved with another course of pred? |
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Post by Frankie & Crispley on Apr 2, 2024 14:50:35 GMT -7
Paula,
Thank you so much for these references.
I spoke with the vet who gave us feedback, that after a week from the initial suspected diagnosis, he would expect Crisp to be doing better than he is. The vet again stated an MRI and surgery is best, but again, not something we can afford. The vet stated in that case we could try a chiropractor and laser therapy. We have an appointment scheduled on Friday for a consultation, however, I am concerned this consultation could include a physical movement that may increase injury. Thoughts?
This morning Crisp spent a lot of time with his shoulders and neck erect, and attempting to posture himself upright using his back legs. He has still has a normal appetite and is wagging with happy talk. However, this afternoon crisp was passing a normal stool and was crying out in great pain, the worst we have heard thus far. Since that incident this afternoon, Crisp has been incredibly immobile and fearful to get up, consistent trembling / shivering in the chest area, laying on his left side. I am now incredibly nervous to even pick him up to clean out his cage once he urinates this morning. I thought we had been seeing great progress, but after the from the discouraging response from the vet and Crisp’s displays of significant pain I am having my hopefulness challenged. Any advice or supportive words are appreciated at this time.
The vet obliged and has prescribed codeine and methocarbamol. We are scheduled to pick up codeine for him this Friday as pharmacies in our area are short of this drug. He was administered his first methocarbamol dose this hour.
Best,
F
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Post by Frankie & Crispley on Apr 2, 2024 16:38:15 GMT -7
UPDATE:
Crisp is now on 125 mg ✙methocarbamol 2-3x/day.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
10.5lbs 10y.o.
prednisone as of 3/27: 2.5mgs 2x/day for 4 days, 3/31 test taper for: √4/1, 4/2pain / _neuro; final taper 4/7
as of 4/1 vet does not Rx another course of pred!
gabapentin 50 mgs 3x/day
✙methocarbamol 125mgs ?x/day
Pepcid AC (famotdine) 5mgs 1x/day ]
- after his 1st methocarbamol dose, his shivering/shaking/trembling in his chest is much less pronounced.
- about 1-2 hr after his first methocarbamol dose, he stood up on his own in the crate, he was unable to make the full stand due to the left front paw but it was truly a relief. He also has been perking his head up, wagging, and has a very full appetite.
- he also ate his dinner with the bowl raised with his front chest and limbs supported by us while he supported and stood with his legs erect on a soft floor surface!
- he did however again after the 1st methocarbamol, pass a normal solid stool with pain and was yelping. He appears to have urinated and passed the stool in an upright position. I was not there to witness it but he did not have any wetness on himself or indication that he had defecated while laying down.
While this afternoon was disheartening, the above have eclipsed the things we saw earlier today and we are feeling so hopeful.
Thank you for everything. I will follow up with any updates.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,561
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Post by PaulaM on Apr 2, 2024 16:43:34 GMT -7
Frankie, I'm so sorry to hear you are running into vets who do not know their IVDD.
When you know the pain med details, please share and update us with what you actually give: dose in mgs, and how often you are to dose (should be every 8 hrs for gabapentin, codeine and methocarbamol). It is fine to report the range you may give a med, but in order for us to follow and comment we need to know what you actually give.
What about getting the SINGLE most important med back on board to fight the painful inflammation?? Advocate for another course of prednisone. Say a 7-day or even a 14-day course at the anti-inflammatory level dose of 2.5mgs twice a day.
Codeine might work.
If codeine doesn't work for Crispley, advocate for trying traMADol. Have no patience with pain. If anti-inflammatory is back on board + pain meds in the right combo, then expect pain relief in an hour. And it would stay that way right up to the next dose of pain meds.
CHIROPRACTIC warnings
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