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Post by Sara & Maylee on Apr 29, 2024 15:19:43 GMT -7
[Original subject line:Maylee - 6yr old long- hair dachshund ] Hello - Sadly I am returning to this feed after 7 years with a new case. Maylee is a 6 1/2 year old long hair dachshund, fixed. Last nite, 4/28 around 8:30pm we realized Maylee want in the living room with us and found her on my daughters bedroom floor - she wasn’t crying or whimpering - just not moving - but seemed to walk fine with we came into the room but we knew something was up, but didn’t think IVDD at first. She sleeps in her crate and did last nite but when we woke up this am [4/29] she barely followed me into the bathroom and was clearly not right (I’ve been thru this before). I called the local vet the minute they opened and was able to get her in today 4/29 at 10am - they did xrays, even tho they don’t show what a MRI would (we live 2 hrs from the nearest surgery/pet hospital) She can still walk, still feels pain in both rear legs, although one is weaker and she doesn’t correct a knuckle roll on the left rear leg, she is not wobbly, but walks with an arched back. She can still pee and has bladder control. She got an injection of prednisone and pain meds and we left with the following, all to start this evening: Prednisone 10mg - 5 mg / 2x day - 5 days then 5 mg / 1x day - 5 days then 2.5 mg / 1x day - 5 days then 2.5 mg every other day for 3 doses
Gabapentin 100mg -50mg / 8hrs - 14 days Diazepam 5mg - 2.5 mg / 2x day - 5 days Robaxin 500mg - 125 mg / 2x day - 5 days [MED LIST/HISTORY- Moderator's Note. Please do not edit
11.9 lbs 6 y.o.
4/29 left rear knuckles
Pred inject 4/29
pred 10mg tab as of 4/29: 5mgs 2x/ay for 5 days, then 5/4 TEST TAPER for _pain _neuro
gabapentin 100mgs capsule: 50 mgs 3x/day for 14? days?
diazepam 2.5mgs 2x/day for 5 days
robaxin 125mgs 2x/day for 5 days
Pepcid AC (famotidine) 5mgs 2x/day]
They did not recommend Pepcid unless she shows signs of needing it - but I’m going to do it anyway - I trust this feed more than the vet at this point. Davis is 2+hrs away and the cost of surgery is 8-15k quoted this am - we cannot do that - so conservative care is our only option, yet I feel good about it as her symptoms seem mild at this time. Please confirm the meds are ok and will help. I am scared and can’t believe this is happening again to a new pup. Daisy died in June 2017 post surgery, having developed M. Thank you in advance, Sara
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PaulaM
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Post by PaulaM on Apr 29, 2024 15:58:00 GMT -7
Sara, it is very possible with STRICT crate rest and prednisone being on board, that not only will the disc heal at the end of eight week. But also nerves will heal. The crate rest is for disc healing. Nerve healing may or may not happen in the short 8 weeks it takes the disc to heal. Best to think more in terms of months rather than days/weeks. Let us know Maylee's weight and the mg dose of Pepcid AC (famotidine) you will be giving 2x/day. 5/4 will be the 5-day pred course TEST TAPER date for see if you observe any pain or new neuro diminishment. Looks like one pain med is to be on board (gabapentin) when the test for pain taper starts. See if you can get that one also stopped on 5/4. Otherwise you will blindfolded as to the existence of pain or not. Do you know why there are two muscle relaxers (Roboxin and diazepam) prescribed? If you need a review of crate rest tips....this is a good page to look at for how to handle potty times and much more dodgerslist.com/2020/05/14/strict-rest-recovery-process/Maylee will be moved over to the Conservative Board. Watch for a notification of the new link for your browser. Please keep us posted on how Maylee is doing. |
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Post by Sara & Maylee on Apr 29, 2024 16:10:21 GMT -7
Maylee weighs 11.9 lbs as of this morning.
i asked for Tramadol as that is listed on your website and was also given to Daisy, but they gave me Diazepam saying it works well - should I request something different? Push for Tramadol?
As far as Pepcid, I was just going to use the dosage suggested on this website, of .44 mg per pound, and I was going to buy it over the counter 🤷🏼♀️ - so I am a little nervous about it.
My vet office is not the most knowledgeable about IVDD - with Daisy, they never told me to crate her or give her meds - I learned what I learned to fight for with this website. I wish I could afford surgery this go round, but we can’t - and the fear of paying all that money and losing Maylee anyway is just not an option.
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PaulaM
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Post by PaulaM on Apr 29, 2024 16:46:40 GMT -7
Sara, most surgeons would not want to operate on a dog who could still walk even if wobbly. They'd want to try the least invasive treatment first..conservative. So be very strict on the rest part during conservative treatment. Conservative vs. Surgical crate rest If Maylee is displaying any signs of pain nearing the next dose of pain meds or when having to move to reposition in the recovery suite or the few permitted footsteps at potty time, then do advocate for traMADol as the general analgesic 3x/day. I'd ask why there are two muscle relaxants on board for Maylee. Read up on the "Why" of stomach protection such as Pepcid AC: dodgerslist.com/2020/05/06/stomach-protection/Pepcid AC (famotidine) 5mgs 2x/day thumb.ibb.co/mEGRuy/91x_Aj_s00z_L_SY355.jpg |
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Post by Sara & Maylee on Apr 29, 2024 17:09:10 GMT -7
Ok - I called to request the Tramadol - they will review the request - some doctors don’t appreciate being challenged 🤷🏼♀️ - I will fight for it - and we will have the Pepcid on board before her dosage this evening.
Can all these meds be given at the same time? She is due to start them all this evening…
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PaulaM
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Post by PaulaM on Apr 29, 2024 17:39:44 GMT -7
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Post by Sara & Maylee on Apr 30, 2024 6:45:49 GMT -7
4/29:My vet called and will not issue Tramadol - he likes the combo of Diazapam and Robaxin better - and I was reminded he’s been a vet for a very long time. So I will wait and see how it goes - her first nite of meds have been given, along with Pepcid and food - she has not had anything to drink today and has not peed since abt 7 am this morning - nor has she pooped at all. I fed her soft food tonite and watered it down quite a bit to get more fluid in her. I downloaded the med sheet and filled it out - I will set a timer for the Gab tonite - thank you for your help today - here’s to hoping for a good nite.
Sara
4/30: Maylee had an ok nite. She finally peed at 1am but when she finished, she hopped a little and ran from the spot - she was on a leash but still did it.
Then this am, when I went to feed her she bolted out the crate door as I opened it - it’s on casters so her jump down was about 6 inches - ugh! She seems more agitated to be in her crate than she was yesterday. This will not be an easy 8 weeks. She still has not had any water other than what I mix with her food to get her liquids. She’s peed twice in 24hrs and has not pooped. Today I will get an xpen for the yard and modify her crate to open from the top. She’s a bouncer - always tried to bounce up and down. I tried to occupy some extra space in her crate last nite with a rolled towel, but instead she used the rolled towel to stand up on.
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PaulaM
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Post by PaulaM on Apr 30, 2024 9:26:43 GMT -7
Sara, with the escapes last night and this am, do be watchful for any increased disc and spinal cord damage (more pain, new or increased loss of neuro function. Pred makes them feel good and attempt dangerous activity for the healing disc. Good job in securing an ex-pen for potty time or even some poke in the ground garden edging fencing at hardware, home Depot stores. And modifying crate to top opening one. You are doing a good job in being proactive!  To stop the behavior of jumping up (bouncing) in the crate when you approach or other times, drape a blanket down to his eye level when standing on all four legs. If he's to jump up on two back legs, then he'll be in the dark. Soon that behavior of jumping up should soon be extinguished.  What signs of pain did you observe that made you request traMADol?
Prednisone makes them thirsty. So be sure a bowl of water is attached to inside the recovery suite. Hopefully you will see her drinking on her own. Also remember the intake of water includes what is in the food itself PLUS the amt of liquid you might be adding. |
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Post by Sara & Maylee on Apr 30, 2024 10:30:37 GMT -7
Yes - I am watching - she seems so agitated today - constantly crying. She just drank water for the first time snd peed again - still no bowel movement. She doesn’t look like she’s in pain at all - and I get that the meds are probably the reason she feels so good.
Can I give her CBD coconut oil with the meds? We use it for the pups on the first day of a rv trip just to calm them a bit - but don’t know if ok to use under these meds. I also have noticed it can soften their stool and might help if Maylee gets constipated.
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Post by Romy & Frankie on Apr 30, 2024 13:26:03 GMT -7
Good to hear that Maylee drank some water.
For constipation, try adding pumpkin to her food. To loosen Maylee's stool, add equal parts water to each kibble meal and soak overnight. At mealtime add one teaspoon of plain canned pureed pumpkin for every 10 pounds of body weight 1x a day. I did this for my dog during his disc episode. I didn't think he would like it, but he did. For crate calming, you can try using an oral calmer in combination with a Pheromone diffuser. It takes several days for these to start working, but they are natural methods.
Place a DAP pheromone diffuser at floor level where the recovery suite is.
Adaptil (DAP) wall plug in diffuser with dog pheromones
Use the diffuser with an oral calmer similar to the ones listed below us.virbac.com/anxitane or www.vetriscience.com/composure-153-calming-supplement-for-dogs.htmlIf Maylee is still agitated in the crate the vet can prescribe a sedative like Trazodone
You can read more about calming here: |
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Post by Sara & Maylee on Apr 30, 2024 20:57:30 GMT -7
Should I be concerned about how much Maylee moves in her crate? She tries to dig and adjust at the blankets, constantly moves around to find a good spot…all normal things that I don’t know if I need to stop her. Last nite I tried to take extra space up with a rolled towel but she just used it to stand on. How do I know if she needs a sedative? I’m just not sure how still I can make her be - she is so hyper naturally.
She still seems to be pain free and I have not noticed any additional wobble or neuro signs. She is now drinking and peeing regularly- the expen was the way to go for potty time.
Also - I’m beginning to be concerned that she was only issued 5 days of diazepam and robaxin. Should I ask for more just to keep her calm?
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PaulaM
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Post by PaulaM on May 1, 2024 12:31:00 GMT -7
Sara, good to hear the ex-pen works better for Maylee at potty time. It is ok if she repositions herself in the crate. Digging at blankets is a doxie thing for sure. About all you can do is distract her and maybe she'll stop that time particular time. Pain meds ( diazepam and roboxin block pain). Naturally it makes sense they only be used prior to the PRED TEST TAPER FOR PAIN. The PRED TAPER TEST happenson 5/4. Pain meds stopping then allow you to correctly and accurately observe if any hint of pain would be surfacing. If behavior is a problem then a calmer or sedative is used (NOT prescription PAIN MEDS) when pred goes to the taper test for pain. Romy in above post provided a link to ADJUSTING to the recovery suite and when the use of calmers or a prescription sedative. Not a bad idea to re-review how prednisone AND its taper work during a disc episode. Have a Plan B worked out in advance with your vet should pain or neuro diminishment occur when vet is close: ==> dodgerslist.com/2020/04/18/steroids-vs-nsaids/ |
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Post by Sara & Maylee on May 1, 2024 12:51:14 GMT -7
Thank you for the response. It just feels too soon for all of it - even the pred taper - not that I sense anything further is damaged, but I’m scared. Having lost one post surgery before, I just don’t want to do anything too soon.
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Post by Romy & Frankie on May 1, 2024 13:31:22 GMT -7
I can understand that having lost a dog to M, you are very anxious about this IVDD episode, but a pred taper now can tell you a lot about Maylee's condition. If, when you start the taper, you also stop or cut back the pain meds and pain emerges there is still swelling of the spinal cord. This will require more time on the full dose of pred and pain meds. Only the full dose of pred works on swelling. If no pain is seen, the pred has completed its task and no more meds are needed, only the rest of the 8 weeks of crate rest.
It is important to stop or cut back the pain meds during a taper because they may mask the pain that indicates more time on the original dose of pred is needed.
It is not uncommon for dogs to need to taper more than once.
Paula's suggestion to have a Plan B set up is a good one. Even if you cannot reach your vet right away, you will know what to do during the taper if pain is seen. Planning ahead like this may help to reduce your anxiety. |
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Post by Sara & Maylee on May 1, 2024 13:38:18 GMT -7
How will I know if she is in pain? She has never cried or yelped in pain from the beginning? Will she just go back to not moving? Or acting herself? I guess all the signs she gave to determine she was hurt in the first place? The doctors did give her an14 day script for Gab, with no taper of that on the label - But I should taper her from that as well? Sorry, I know you are not her vets but I trust your input so greatly.
My anxiety level for this not working is off the charts. I did request a referral to UC Davis for a consult but havnt heard anything and don’t know how beneficial that would be if we can’t do surgery.
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Post by Romy & Frankie on May 1, 2024 14:19:20 GMT -7
These are the signs of pain we look for; ☐shivering, trembling ☐yelping when picked up or moved ☐ reluctant to move much in crate such as shift positions or slow to move ☐tight tense tummy ☐can’t find a comfortable position ☐Arched back ☐ Holding front or back leg flamingo style not wanting to bear weight ☐head held high or nose to the ground ☐ Not their normal perky selves?Not wanting to move and not acting like her normal self are signs of pain. It is likely that the signs of pain she would show would be similar to those shown at the time the IVDD episode started.
Gabapentin is a medicine used for nerve pain. Some vets prefer to taper the gabapentin, while some prefer to just stop it. Many of our members have just stopped it. I don't know which your vet prefers. Best to check with him.
Maylee is a good candidate for conservative treatment. Sometimes a consultation with a board certified neuro (ACVIM) or ortho (ACVS) is not for surgery if it is not time nor an option for the family. The consultation would be because you are not comfortable with the treatment plan prescribed by your vet. Specialists are very experienced with the medical management of IVDD as well as surgery.
The drawback to a consult with UC Davis is the need to transport Maylee there. Transports are risky during an IVDD episode. |
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Post by Sara & Maylee on May 1, 2024 19:56:11 GMT -7
If it’s not uncommon to go back on pred - why come off so soon? Why not stay on the meds a little longer to solidify the treatment ?
I placed a phone call to the vet requesting more Robaxin and Diazepam just in case coming off the pred shows pain while we enter a weekend. I hope they will comply.
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PaulaM
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Post by PaulaM on May 2, 2024 12:16:35 GMT -7
Sara, no one wants a dog on any anti-inflammatory drug any longer past the time it has done its job. All anti-inflammatory drugs carry with them dangerous side effects. Drugs can be a miracle when there is a job to be done. And they can be a danger when there is nothing for them to work on once their benefit has been achieved. Owner knowledge of each drug their dog takes is important part of protecting the dog. I use the Mar Vista Veterinary drug directory to learn about my dog's meds. Here is the link: www.marvistavet.com/libraries.pmlIt can take 7-30 days before the anti-inflammatory completes its job. All vets must take a guess on how long the course should be. A prudent vet offers a 7-day or maybe a 14-day course of an anti-inflammatory. Observes on the taper of the steroid anti-inflammatory if any hint of pain or new neuro diminishment occurs which would signal another course. IF no pain/neuro occurs, then go to the necessary completion of the pred taper doses. Complete crate rest to allow the disc to finish healing. |
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Post by Sara & Maylee on May 2, 2024 14:41:21 GMT -7
Thank you. The vet filled the Robaxin and Diazepam again for a couple days just in case the pain returns over the weekend. Maylee is sleeping a lot today. It is better than her constant whining to get out of the crate, but a little concerning as well - I suppose I can’t have it both ways. She still seems to have no pain, no additional wobble than before and responds when we ⚠️pinch her feet - I have not tried the knuckle placement today. She’s just quiet and sleeping and I don’t want to disturb her.
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Post by Romy & Frankie on May 2, 2024 14:58:36 GMT -7
I don't think her sleeping more than usual is a cause for concern. These meds often make our dogs sleepy.
I am glad that you got a refill of the pain meds just in case. When you stop these meds and start the pred taper it will quickly become apparent if there is pain and therefore still spinal cord swelling. If you see any signs of pain, you can start the pain meds again. Maylee will also need to go back to the full dose of pred for a while more. Only the full dose of pred will work on the swelling. Hopefully, the taper will be successful, and no more meds are needed.
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Post by Sara & Maylee on May 4, 2024 11:17:53 GMT -7
So this am 5/4 was Maylees last full dose of Pred…. She would normally get another dose this evening…. When do I give her next dose, which is supposed to be 1/2 tablet (5mg) once a day…. Do I wait until tomorrow morning (for 5 days) Or tonite for 5 days - my gut tells me give the pred in the am - before the day begins …. Also - the vet did give me the refil of Roboxin and Diazepam…. But never called back to tell me how to ween the Gab …. Right now she takes 3 pills a day ( every 8 hrs)…. How slowly should I pull her off Gab …. As of tonite she will not get the R and D……
This is very uncharted territory for me … and I did not get much guidance from the vet office.
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Post by Sara & Maylee on May 4, 2024 11:25:25 GMT -7
PS - not even a full week in and I am aching to hold my little baby girl and give her all the kisses and cuddles …
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Post by Romy & Frankie on May 4, 2024 13:14:34 GMT -7
I think giving her the next dose of pred tomorrow morning is a good plan.
Some vets just stop gabapentin but other vets taper it. Many of our members have just stopped it without issue. Best to try to get instructions from your vet.
I can understand how you miss cuddling your Maylee. You can sit next to the crate and talk to her and stroke her if she is okay with touch. My husband used to lie on the floor next to my dog Frankie's crate and talk to him and stroke his head. Once Frankie recovered, his bond with my husband was much stronger than prior to the IVDD episode.
Best wishes for a successful taper.
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Post by Sara & Maylee on May 4, 2024 17:00:49 GMT -7
Is it possible that she will injure herself more from being weened from Pred? Or she may just experience pain?
I can’t get my vet regarding the Gab … so I will give her the full dose tonite of Gab and
tomorrow a.m. [5/5/] I will give her the reduced Pred and 1/4 of a ▼Gab
[MED LIST/HISTORY- Moderator's Note. Please do not edit
11.9 lbs 6 y.o.
4/29 left rear knuckles
Pred inject 4/29
pred 10mg tab as of 4/30: 5mgs 2x/ay for 5 days, then 5/5 TEST TAPER for _pain _neuro
gabapentin 100mgs capsule: ▼25mgs 3x/day
diazepam 2.5mgs 2x/day
robaxin 125mgs 2x/day
Pepcid AC (famotidine) 5mgs 2x/day]
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PaulaM
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Post by PaulaM on May 4, 2024 19:29:38 GMT -7
Sara, the right way to see if Maylee needs another pred course is to do a valid test for any hint of surfacing pain on the pred taper. That means ALL pain meds (gabapentin, diazepam robaxin) block your ability to correctly assess for pain until the start of backing off all three or all three full stopped on 5/5. Backing off pain meds lengthens the time to get a quick and accurate read, naturally.
You will be monitoring for signs of pain that would indicate she would need another course of pred, back on all pain meds.
You would not be dilly dallying around seeing pain and not taking any action, right? You have all pain meds on hand, you have extra pred to go back up to the original anti-inflammatory dose (5mgs 2x/day) until you can report the pain to the vet.
The vet would likely Rx another course of pred. Maybe a 7-day course and then test again for pain.
It can for some dogs take several pred courses adding up to 7-30 days in all. Pred taper days are not high enough doses to be working on pain so they are not counted in the 7-30 day range.
Keep us posted as the taper goes into effect tomorrow and the days following.
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Post by Sara & Maylee on May 5, 2024 7:39:20 GMT -7
Ok - thank you. That makes sense for sure. I will cut the pain meds as she tapers Pred - I hope I will notice a return of pain - she never cried in pain at all thru this episode and she is confined to the crate so Im afraid I won’t notice a hunched back or tight tummy - I suppose my sign will be shivering - which she doesn’t usually do a lot of except before she eats (excited) ha.
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Post by Ann Brittain on May 5, 2024 8:28:49 GMT -7
Hi Sara, I'm surprised your vet didn't give you instructions on tapering the prednisone. It's been a while since our Buster had his IVDD episode, but I recall that the taper started the next day at approximately the same time as he'd been given the full dose each day. Others will chime in if I'm incorrect on this or, if possible, you could check with your vet.
It is difficult to be unable to cuddle with your dog during crate rest and recovery, but it is necessary to keep Maylee as calm as possible during this time.
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Post by Sara & Maylee on May 5, 2024 8:33:52 GMT -7
I have instructions on the taper of Pred….. he did not instruct on pain meds during the taper… or what to do if the pain comes back.
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Post by Ann Brittain on May 5, 2024 9:05:32 GMT -7
Paula addressed pain management in her prior comment.
"You will be monitoring for signs of pain that would indicate she would need another course of pred, back on all pain meds.
You would not be dilly dallying around seeing pain and not taking any action, right? You have all pain meds on hand, you have extra pred to go back up to the original anti-inflammatory dose (5mgs 2x/day) until you can report the pain to the vet.
The vet would likely Rx another course of pred. Maybe a 7-day course and then test again for pain."
Should Maylee shows signs of pain during the taper, giving her pain meds would be your best action. Call you vet, in advance, to get his/her recommendations so you're prepared if she shows signs of pain.
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Post by Sara & Maylee on May 5, 2024 15:26:09 GMT -7
Yes - I appreciated Paula’s response. So far she is doing well today. I’m see no signs of pain as of yet.
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