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Post by Mark & Shorty on Apr 26, 2024 17:46:03 GMT -7
[Original subject line: My dog is getting worse by the day, I don't know what to do]
My 15lb Dachshund has had minor back issues over the years but very few problems and always healed by just not jumping. Last week he injured himself at boarding on 4/18. (at a place I don't normally use and I regret sending him to for 1 night)
[MED LIST/HISTORY- Moderator's Note. Please do not edit 15lbs 15 y.o. Pain 4/18; Strict crate rest started on 4/22 4/19 Wobbly walking 4/26 Paws knuckle under. Rimadyl as of 4/20: 12.5mgs 2x/day for ? days, then a TEST STOP for pain √4/26 knuckles neuro gabpentin 150mgs 3x/day methocarbamol 125mgs 3x/day Shorty needs GI tract protector, Pepcid AC, on board for duration of Rimadyl! ]
1. He's 15lbs and He's on 150mg of Gabapentin 3 times a day, 12.5mg of rimadyl twice a day and Methocarbomal 125mg 3 times a day. He's been on these for 7 days and has been getting worse everyday. 2. Dachshund. 15. Shorty. 3. The emergency and the vet both said IVDD, but I did not see a Neurologist. The vet thinks he slipped a disc but I realize that's just a guess since they did not do a MRI. 4. I've been in conservative treatment for a week but screwed up and let him move too much the first 2-3 days.
Since Monday 4/22 he's been in a recovery suite or crate 24x7.
Each day he has less ability to stand up and move. 5. He will shiver and cry but most of that is due to him hating the crate and having major separation anxiety. When he's out of the suite he's fine. While he can still stand he's clearly having trouble getting up on his own and it's worse since yesterday. He's able to pee on his own and take a few steps but if he's just standing there he'll eventually fall over. On Monday he was still able to stand and walk fine so it's gotten much worse this week. 6. Eats and drinks fine. 7. Wags tail and can stand. Able to take a few steps. Has a hard time getting up. 8. Can squat and pee.
I was going to take him to a neurologist. My breeder said they never recommend surgery, especially in older dogs, so I was committed to waiting it out, but it's hard to see him get worse everyday. I also realize he's 15 and the risk is high with surgery, he lost half his hearing after his dental surgery a year ago.
I want to get help to know if others have seen a similar path and had the dog heal up after months of crate rest and get back to some small amount of normal function? Or if it's clear he's slowly slipping into paralysis and surgery is my only option.
I'm really struggling to weigh my options. Right now I really trust the breeder who has taken care of him and he's been boarded there dozens of times. I don't want him to be paralyzed if he does not have to be. I don't care about the $ for surgery, it's only the risk for him I'm worried about.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Apr 26, 2024 18:31:06 GMT -7
Mark, I'm sorry to hear Shorty is having another disc episode. Your actually starting STRICT rest is going to play a good roll in his hopefully in time healing the damaged nerves. Need to make sure you are on the same page about protecting the spinal cord. STRICT REST MEANS: ◼︎ Avoid dangerous detours. Follow the "Roadmap." Tape it to your fridge. D/L and print out: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf ◼︎No laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎No chiro therapy whys: dodgerslist.com/2020/04/22/chiropractic/◼︎ Carry to and from the potty place. No dragging or meandering at potty times. Carry to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog’s back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on! ◼︎No PT for conservative dogs during 8 weeks to heal disc ◼︎At home laser or acupuncture for severe neuro damage is best. ◼︎ 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. Here are lots of tips and ideas to make the next weeks of disc healing rest go smoother: dodgerslist.com/2020/05/14/strict-rest-recovery-process/RIMADYL -- Is he still on the 12.5mgs 2x/day dose. What date will that end? Am trying to figure out how many days-course was prescribed. -- When increased neuro diminishment happens caused by too much movement, let the vet know you did not do strict rest. Advocate for Shorty to be moved to the most powerful class of anti-inflammatory drugs...a steroid. Usually it would be prednisone. Normally a 4-7 day washout is advised from the stop of Rimadyl to the begin of Prednisone. It is an emergency when there is neuro diminishment to stop the spinal cord damage! THEREFORE if two stomach protectors (Pepcid AC®-famotdine) and Sucralfate are on board there can be a switch right away, dispensing with washout days. To avoid more risk to the disc, see if you can call ER tonight where he has been seen and has a file. Any vet working ER can read the file and prescribe. Otherwise you have to wait til Sat morning and CALL/PHONE your vet to advocate for: Prednisone (steroid) Adding traMADol as the general analgesic 3x/day if there is any pain displaying when having to move or nearing the next dose of the other two pain meds.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Apr 26, 2024 18:36:32 GMT -7
MONITORING NEURO FUNCTIONS As damage to the spinal cord increases, there can be a predictable stepwise deterioration of functions if excessive back/neck movement for example. Nerves do heal in the exact opposite order nerve damage occured. 1. 4/18 Pain with initial tear of disc and ensuing swelling 2. 4/19 Wobbly walking _?_legs cross 3. _?_Nails/toes scuffing floor 4. 4/26 Paws knuckle under. Dog is slow to correct or can't right the paw(s) at all5. _?_Weak/little leg movement, __can't move up into a stand 6. Legs do not work at all (paralysis, dog is down) 7. Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors. 8. Tail wagging with joy is lost 9. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. If surgery is not an option (for whatever reason) then the best option is conservative therapy. Surgery can still be successful in the window of 12-24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance. Precious hours can be lost with a general vet who gets DPS wrong. Trust only the word of a neuro (ACVIM) or ortho (ACVS) surgeon about DPS. 🚩A quick overview of conservative treatment vs. a surgery: dodgerslist.com/2020/02/10/surgery-vs-conservative/ 🚩Dr. Isaacs indepth Interview on surgery and conservative treatment: dodgerslist.com/2020/05/12/dr-isaacs-surgery-answers
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Post by Mark & Shorty on Apr 26, 2024 18:41:32 GMT -7
Thanks for the other questions. I do everything other than a sling when he potty's.
For the rimadyl they just said 25mg broken up to twice a day, the vet did not give an end date.
He was supposed to go in for Acupuncture Monday but with him getting worse I'm debating if I should do that or not. My vet already told me a few days ago he did not want to put him on prednisone and it was too much of a risk. I will consider what to do and either call the emergency tonight or first thing tomorrow morning.
Thanks for the help!
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Post by Mark & Shorty on Apr 26, 2024 18:43:39 GMT -7
1. 4/18 Pain with initial tear of disc and ensuing swelling - 4/18 2. 4/24 Wobbly walking - 4/19 _?_legs cross
3. _?_Nails/toes scuffing floor 4/24 4. 4/26 paws knuckle under. Dog is slow to correct or can't right the paw(s) at all - He's sorta here now. 5. _?_Weak/little leg movement,
__can't move up into a stand - He can still move around in the crate but is struggling to stand.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Apr 26, 2024 18:51:12 GMT -7
Let the vet understand the reason for neuro diminishment (lack of strict rest until 4/22). Adovcate for prednisone. Hours matter when there is loss of neuro function. Prednsone, I have seen in my own dogs, can turn the diminishment around in a matter of hours if started early in the diminishment. Hire a mobile vet if you want acupuncture. At home crate rest is the safest for his healing disc. All anti-inflammatories have dangers including Rimadyl. He should already be on Pepcid AC (famotdine). Going to a steroid like pred can be done if both kinds of stomach protectors are on board. Anti-inflammatories remedy pain by reducing inflammation. Vets choose an anti-inflammatory during a disc episode to get painful swelling down in about 7-30 days. These powerhouse meds do wonders OR they can be dangerous. Vets who practice safe medicine and owners up to speed on medications make all the difference. Did you get all four questions right?
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Post by Mark & Shorty on Apr 26, 2024 19:06:10 GMT -7
I call the emergency and they refused to put him on prednisone. I will have to wait to call my vet tomorrow morning.
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Post by Mark & Shorty on Apr 27, 2024 12:35:22 GMT -7
Update on Shorty. I've talked to 2 more vets since last night, both said absolutely do not put him on Prednisone and it's best to keep him on rimadyl. That's 4 total vets that would not make the move over.
Shorty is having more trouble standing (but he's also now on trazodone), both vets think he should get surgery which I am now seriously considering. That will have to wait until Monday at least since they would not schedule him since it's not an emergency yet and the Neurologists are not in on the weekends. I still have hope that he could stabilize here.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on Apr 27, 2024 13:04:04 GMT -7
Mark, keep up STRICT rest with little movement to back. Protecting the disc from more damage is the goal. What's done since yesterday damage is done. Likely with time that damage can self heal.
I hope you will not be reporting any increased neuro diminishment since yesterday. With no increased diminishment, Shorty's body does have a path to self repair the neuro damage. Think more in terms of months rather than days/weeks for this very slow to heal part of the body.
Not only has there been controversy in use of steroids for some time. Some vets know their power and others fear steroids. We also are not aware of Shorty's complete health history, that these vets may be aware of.
Only a neuro or ortho surgeon has the authority to tell you if a surgery is warranted and if at 15 y.o. what risks if any with anesthesia.
Dr. Isaacs, Neurology (ACVIM) says: Surgery needs to be a decision an owner enters into recognizing the risk, but also recognizes the benefit. This way if something unforeseen occurs an owner can be comforted and at peace with the fact that surgery was the right decision and they did all they could for their dog.
We are here to support you with either choice in treatment you make.
As you can, please do keep us updated on how Shorty is doing neuro- and pain-wise.
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Post by Romy & Frankie on Apr 27, 2024 13:29:37 GMT -7
Shorty's neuro functions are diminishing, which would indicate the move to a steroid, a stronger class of medication than Rimadyl, which is an NSAID.
Some vets consider steroids to be controversial. Steroids, like NSAIDs, or any other medication, can have side effects. To use them safely, the vet can request a blood test to verify the liver and kidneys are healthy prior to starting the steroids. This would be particularly important for a 15-year-old dog. But being 15 should not preclude the use of steroids if Shorty is otherwise healthy.
For now, continue on the Very strict crate rest. This will give Shorty's disc the best chance to heal. I am not sure if you have had the chance to look at this link Paula pointed you to. It may help you make your decision on surgery: dodgerslist.com/2020/02/10/surgery-vs-conservative/
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Post by Mark & Shorty on Apr 27, 2024 13:33:41 GMT -7
Thanks for all the help and support. I've read the surgery vs. conservative 10 times. I'll probably read it another 10 before Monday comes around.
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Post by Mark & Shorty on May 3, 2024 4:20:08 GMT -7
Quick update on Shorty. He's finally stabilized [?meaning]. 1 treatment of acupuncture really made a huge difference [?meaning]. I've got him on strict crate rest for the next 6-8 weeks, we'll see if he starts to improve.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,884
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Post by PaulaM on May 3, 2024 6:49:23 GMT -7
Mark, when you have time do fill us in on things since you last wrote 4/27 "Shorty's neuro functions are diminishing." We do like to be able to follow along giving us the ability to make informed comments.
1. What are his current neuro functions? 2. Does he still show signs of pain when moving or nearing next dose of pain meds. 3. What do you observe that explains the meaining of "stabilized" and "acupuncture really made a huge difference"? 4. For how many days was the 4/20 course of Rimdyl? Any additional courses of Rimadyl or another anti-inflammatory drug? 5. Have any changes to his med list been made? Med list reported as of 4/26 Rimadyl as of 4/20: 12.5mgs 2x/day for ? days, then a TEST STOP for pain √4/26 knuckles neuro gabpentin 150mgs 3x/day methocarbamol 125mgs 3x/day Shorty needs GI tract protector, Pepcid AC, on board for duration of Rimadyl!
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