PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Sept 29, 2013 11:10:49 GMT -7
If she is doing well on the current meds (that is swelling is being worked on and she is not experiencing pain, stomach is protected), then the meds are right. For me and my dog, I always want to understand how everything works and why. So I always ask the thinking behind everything. If you are also curious, just ask at the next vet visit. If things are not working, then getting on the phone is the right thing to do to get things corrected.
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StevieLuv
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Conservative Treatment 3x. It really does work!
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Post by StevieLuv on Sept 29, 2013 11:13:01 GMT -7
No you are not going to screw her up - learning about IVDD is an ongoing process, and it okay to call the Vet as often as you need to - that is what they are there for! It is great that your Vets will confer with each other, and you can add in all of the information that you learn here to help them learn about IVDD too. Just keep in mind that the Pepcid is to protect her stomach from the steroid - so she needs it 30 minutes prior to giving the Dex just to be safe. It could be that she is on the Dex 3 times a day for a short duration and that is why they are not concerned - best to clarify this with your Vet for your own peace of mind, and to help you understand what each medication is doing for your girl. Thank you also for taking the time to encourage other members - we are all in this together
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Post by Jean & Mimi on Sept 29, 2013 11:14:01 GMT -7
Thanks Paula. I will ask the reasoning. She is in no pain at all today and after the last pee (just minutes ago) she officially has bladder control back. The standing has also gotten better. She is doing a good job of resting today as well and have the back door open so she can look outside.
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StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
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Post by StevieLuv on Sept 29, 2013 11:16:11 GMT -7
That is wonderful news!!! We love hearing about successful peeing on this site
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Post by Jean & Mimi on Sept 30, 2013 13:52:49 GMT -7
Brief update today. Still is pain free (no shivering, whimpering, clenching). Still tries to take sloppy wobbly steps when pottying, although today when hubs got home from work he gently put her on the grass to pee and she proceeded to gently roll over onto her back for belly rubs (please note this is very flat grass that we take her too and she does this fast so we cannot stop her). She is eating and drinking and continues to have full bladder control. However, she seems kind of...sedate - maybe depressed? (I know this is a good thing when on crate rest). The vet did mention that the Gabapentin has a sedative like effect and I have noticed this since she started on it. So I am guessing that is what is doing it to her (along with the Tramadol).
So progress I guess? I don't know. I feel discouraged because before the setback on Friday night/Saturday she had more balance/leg motion than she has now. I feel like more damage happened during that episode causing that left rear leg to have not much of anything right now.
Also, do I start at 8 weeks rest from a week ago or did it restart on Saturday? Just so devestated by this whole thing.
Ps...left leg knuckles really rasily. She can get it under her and wobbly balance.
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Sabrina
Helpful Member
My Charley-dog, a Dodger'sList grad enjoying life!
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Post by Sabrina on Sept 30, 2013 17:28:49 GMT -7
Hi Jean! I know how hard this IVDD roller coaster ride is. It was so hard on me when Charley's first taper didn't work, boy do I remember. But the taper was just a "test" if the medicine had done it's job - it wasn't a test of Mimi's ability to recover. Focus on the great news that Mimi's pain is controlled and that you are giving her the rest she needs for her body to recover! The 8 weeks of crate rest doesn't get "reset" just because the test taper didn't work yet - if she's in her recovery suite except to be carried out to potty (and vet appts when needed) then you are doing it right and Mimi will still have the same graduation day. "Sedation" is a side-effect of Tramadol, and Gabapentin "may potentiate the sedative influence of other medications" (pages 4 and 5 here: www.vasg.org/pdfs/NEWER%20OPTIONS%20FOR%20CHRONIC%20PAIN%20MANAGEMENT.pdf ), so I would suspect that to be the cause of her "sedate-ness". So hang in there! Keep up the excellent job you are doing with observing Mimi - and teach yourself to note the encouraging observations, too (boy, do I know that that takes a conscious effort!)! ))Hugs!(( - Sabrina
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Post by Jean & Mimi on Oct 1, 2013 16:27:42 GMT -7
Ok tonite's update....
Spoke with our vet today and asked a million questions. I specifically asked why they do the Dex 3x per day. He said that in their experience, they feel having a lower, more constant dosing is better and has a more therapeutic benefit. He also said they use Dex from the get go because it is a more aggressive treatment to get the swelling down.
Beginning on Thursday - after 5 full additional days on dex 3x per day, we will begin to reduce the Dex to twice a day for five days, then once a day for five days, then once every other day for about 10 days then off. I asked if he would reduce her pain meds and he said not at this time (still continue with Tramadol 3x per day and the Gabapentin 2x per day) I asked him how he would know about the swelling if she was still on pain meds. He really felt that at this time her swelling will be down.
I know many of you believe that you need to reduce the pain meds in order to determine if the swelling is down, but quite frankly I don't want to see her in pain. I will be watching her very carefully during the reduction process to see what is going on. Quite frankly I am scared to death to see how this goes, but I know we need to let her body begin to heal itself a bit.
Regarding her, she is now being very whiney if we leave the room where her crate is- specifically me. She wants love and attention and we shower her as much as we can. I felt maybe her step was slightly better tonite once or twice (again in her crate and just out to potty).
Fingers crossed the reduction will go ok.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Oct 1, 2013 16:55:55 GMT -7
Thanks for relaying the Dex 3x a day thinking. It sounds like you had a good discussion of things with the vet and are statisfied with the taper plan. I'm glad you will be watching for any tiny hint of pain on the taper and gettng back to the vet right away on your observation. We have our fingers crossed too for a smooth taper! Do keep us in the loop of what you observe on Friday.
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Post by Jean & Mimi on Oct 1, 2013 17:04:51 GMT -7
Paula I am so scared you have no idea. Last Thursday is when we began the first taper. All I know is that I will be watching her like a hawk.
Honestly I don't know hiw I would have gotten through this without this site and all of the moderators. You have really helped me become my dogs advocate and have given me hope. Thank you frim the bottom of my heart.
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Post by Jean & Mimi on Oct 2, 2013 5:57:05 GMT -7
Good morning,
I have decided to start thinking ahead a bit so I do not panick about Mimi starting her taper tomorrow. I am just going to be positive in my mind that it will go ok (while watching her like a hawk for signs of anything).
I am curious about supplements that others may give their dogs after these types of episodes. Mimi will be six in March and up until now, she hasn't had any supplements, just her dog food, her checkups and visits to the vet, appropriate vaccinations and her heartworm and flea/tick prevention.
Are there any supplements that may be helpful for her after this? What about glucosamine? I don't really know what it is but have heard it is good for joints so maybe it is good for the spine? Really just curious.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Oct 2, 2013 9:04:36 GMT -7
Good questions!! We have an article that addresses supplements for the IVDD dog and one that deals with nutrition and diet. Check out our treasure trove of IVDD information here: www.dodgerslist.com/literature.htm#afterrest
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Post by Jean & Mimi on Oct 3, 2013 11:40:33 GMT -7
Today's update...
So today is day one of the taper off dexamethosone. Let's see how it goes. The last time day1 was fine, day two was a disaster. I am watching VERY closely.
We have feisty girl today. She was desperately trying to climb up her crate today to get to me. No, I did not let her. At first I climbed into her crate to sit next to her and pet her (keeping her calm and horizontal). She is desperately looking for attention and that calmed her a bit. When I got out she tried it again. I immediately turned my back on her (I could hear she had stopped trying to climb) and would not look at her until she calmed. I then gave her "good dogs" and attention again.
She is currently in her crate in our living room, whining for me. And this is with my husband sitting in the chair right next to the crate. Ugh!
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Oct 3, 2013 13:21:49 GMT -7
Hi, Jean. It sounds like Mimi is feeling a bit better, getting so frisky! You can take a piece of cardboard, punch some holes in the corners and tie it with some string to shorten the height of the crate so Mimi can't jump up. Good job on turning your back on her when she was trying to get your attention. Here are some other tips on calming her during crate rest: www.dodgerslist.com/literature/EmergencyCrate%20Training.htm
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Post by Jean & Mimi on Oct 4, 2013 5:18:11 GMT -7
Good morning,
Today is day two of the taper off the dexamethosone (she is now getting dex at .125 2x per day). I want to see how things go today to ensure there is no loss of function (which is what happened the last time).
Although it was not what my vet directed, I am thinking about reducing her Tramadol to see if there is pain associated with this taper (Vet said to keep the Tramadol and Gabapentin on board for now). She is currently getting 25mg of Tramadol 3x per day. How do I taper off the pain meds? Could I do 25 mg in the am and 25 mg in the pm and then drop the mid-day dose to 12.5 for a day or two to see how it goes? Then perhaps drop the mid-day dosage all together? She is still getting her gabapentin 2x per day and I don't want to touch that.
What do you think? You guys know how scared I am of this. Let me know what you think.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Oct 4, 2013 14:22:38 GMT -7
How's the taper continuing to go? I would ask your vet if it is ok to give tramadol 2x a day, to kind of back of a bit to give a clearer picture on how swelling is going.
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Post by Jean & Mimi on Oct 4, 2013 14:35:27 GMT -7
So far so good. Mimi was a much different dog last week at this time. She has not lost function like she did last week and again gave me her belly as soon as I got home. Right now she is laying in her recovery suite wagging her tail at me and giving me the "pet me" mini happy barks.
I am going to drop the mid day tramadol on Sunday. I want to make sure I am home to see how it goes.
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Oct 4, 2013 16:20:00 GMT -7
Excellent, Jean! Very good to hear this. Sounds like those extra days have really made a difference. Good idea on waiting until you'll be home to taper the Tramadol. I hope it goes well and will be looking out for your update.
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Post by Jean & Mimi on Oct 5, 2013 6:53:19 GMT -7
Good morning...quick question....
Mimi just had a very large poop. All the stool was formed but there was a lot. Is this diarrhea? It was not bloddy or mucus-y althought sime had a greenish tint.
I have been giving her the pepcid 2x per day and she always had ger dex with food. She still has an appetite abd has not turned away food or water. In Thursday, she didn't poop a lot (just once and it was small). Could she just be cleaning out? Or do I need to call for sulcrafate today? Sorry if I am being paranoid.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,565
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Post by PaulaM on Oct 5, 2013 7:48:30 GMT -7
Red flag warnings are diarrhea, which is loose or runny stools. Poop that is formed and has a shape to it is good! Greenish tint can be due to what she has been eating. Good to hear she has an appetite.
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Post by Jean & Mimi on Oct 6, 2013 16:44:15 GMT -7
Sunday update.
Today was day four of the taper (3x perday dex to 2x per day). Today I also dropped her afternoon ▼Tamarol. No signs of pain. Stull doing full body doggy flaps, no regression in function and still has an appette.
Is this a good sign that the swelling is going down? I know tamarol has a short half life so I guess if there was going to be some pain I would see it since her last dose was 12 hours ago right? Sorry to be so nervous about this.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
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Post by Marjorie on Oct 6, 2013 16:51:26 GMT -7
Yes, this is a good sign, Jean! Please continue to keep us updated. We do certainly understand being nervous about tapering.
Prayers for a continuing pain-free taper.
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Post by Jean & Mimi on Oct 6, 2013 18:07:33 GMT -7
I think things are going diwnhill again. We just took her out to potty one more time for the night. She would not even stand. She was just sitting there making little grunting noises. She tried to poop sitting down. I din't know what to do. Day four of the taper and first day off pain meds and now loss if function?
I live her so much but do not want to see her suffer. I also do not have unlimited financial resources. What do I do next? She has had all of her meds for tonight. I am at a loss.
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Post by Nori&Pixie on Oct 6, 2013 18:55:52 GMT -7
Hi, Jean. I'm so sorry. I know how you feel. Seeing your baby suffer is so hard. I wish they cold speak .and tell you whats hurting sometimes. I'm praying for Mimi's recovery.
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Post by Pauliana on Oct 6, 2013 20:03:16 GMT -7
Hi Jean,
How is Mimi now that she had her meds for the night? Did you also give her a Tramadol as well as Dex? From what I gathered you just cut out the afternoon doses of Dex and Tramadol so far, right?
Was she able to poop when you had her outside? I was just wondering since she was grunting if she was having problems pooping or if she was having pain from her back..
I would call the Vet's after hours line and ask what to do next. If she is comfortable by now you can wait until morning but if she is in pain try the after hours line. They usually have an answering service that will contact the vet in an emergency or they will refer you to the ER.. Do you have enough meds to go back to the 3 times a day doses? She just may need more time at those doses. I know how hard this is but some dogs need more like a month in some cases..
Hugs and prayers..
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lupi
New Member
Doing better every day!
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Post by lupi on Oct 6, 2013 20:42:02 GMT -7
Hi Jean, I understand how frustrating and scary this whole experience is. Our dogs seem to do well, then regress. I just wanted you to know I'm thinking of you and Mimi. I hope she feels better tonight.
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Post by Jean & Mimi on Oct 7, 2013 2:48:09 GMT -7
A very early Monday update
First, thank you all who responded last night. She quickly fell asleep last night with no grunting (the grunting is hard to describe). She slept peacefully through the night and I heard a full body flap around 5 am.
Hubs took her out and she sat at first then tried to poop sitting so hubs gave her support and lifted her butt so she could get one turd out. She then took a few wobbly steps to pee. He brought her back and she was still making the light grunts but when he put her down she was not shaking.
I just saw her do another full body shake, wag her tail and then take a few steps to find a comfy spot in her crate to lay down (she did use her back legs). Also when I went in the other room for a minute she did her howling bark which she did not do at all last night.
So I don't really know what is going on. Is it possible that all this is being caused by problems with poop? Is it regression? Hubs will call our vet today. Right now she is curled up in the crate under my bathrobe. No shaking, no shivering, no grunting, just resting.
One more update...hubs just said she had a big poop and she was able to do it standing on her own. Said she is still doing the grunting a bit.
So I guess my question is would loss of function just come from reducing pain meds? She was doing fine on the dex reduction for three days (no loss of function) then we take the pain meds away and then there is loss? Or is it that it hurts and that's why she doesn't want to move?
I feel like she has been on these meds for 2 weeks and is still having problems. When will she be better or will she not get better? I don't care how she wobbles or whatever but I cannot see her suffer.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
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Post by Marjorie on Oct 7, 2013 6:28:43 GMT -7
Was the poop that she did on the hard side or was it normal, Jean? It may just be that she's having some constipation and is grunting because she's having difficulty pooping. To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day.
If you're still concerned today, it might be best to bring her in for a consult or at least speak to the vet on the phone and explain what's happening. It may just be that she needs more time on an anti-inflammatory. Sometimes it takes a month to get all of the swelling down. Please don't be discouraged. She may just need more time on the Dex or she may just be constipated. Neither of those things means that she is not going to get better. Please let us know what the vet says today.
All the best to you and Mimi.
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Post by Jean & Mimi on Oct 7, 2013 7:23:48 GMT -7
We are calling our vet this afternoon. Right now she has had all of her morning meds (Dex, Tramadol, Gabapentin and Pepcid) so there wouldn't be anything we could do until this afternoon (hubs gets home by 3).
As for the poop, hubs said it was very formed, so I wonder if there may be a constipation component. I put water or broth in her kibble now (the only way she will eat it now, fine by me I will spoil my princess). I will try the canned pumpkin too to see if that will help.
Like I said, the only thing about all of this that bothers me is seeing her suffer in pain or have the prospect of not having the pain stop. I don't care if she is wibbly wobbly or a scooter or needs a wheelchair whatever.
Will update more this afternoon after we speak with vet.
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Post by Jean & Mimi on Oct 7, 2013 13:27:31 GMT -7
Just finished up with our vet.
Our vet felt a few things....she may have had some intestinal discomfort or a little pain, and that is why she was grunting. He wants us to continue to leave her on the Tramadol 3x per day, but wants to continue with the taper off of the dexamethosone. He told me before that he would like to move her onto an NSAID, but he doesn't like to leave dogs on the dex long term. He said based on the fact that she was moving around this am, full body shaking, using the hind legs and curling up to rest that yesterday was most likely an isolated incident (because it was almost exactly the same time difference between last night's dose and this morning as it was between yesterday mornings dose and last nights dose). Note she was moving around, shaking herself and doing ok this morning before her dose of Tramadol and Dex.
So we are going to continue. Vet said he wants to see her in two weeks, but to call immediately if we have any concerns or see any other issues going on. I asked hubs how she was this afternoon and he said she was back to her "new normal" self - wobbly walking but providing a belly to rub and urinating herself etc. And again, this is before any Tramadol was given. He also wants her to continue on the Gabapentin.
I do like this vet. He listens to me (I had my husband read him an email that I wrote this am detailing exactly what happened and my specific questions) and will spend 1/2 hour talking on the phone (he also would have seen her today if we felt strongly that we needed to). So I am going to continue on our path and see what happens. I will continue to watch like a hawk so that we can catch the slightest issue.
Stay tuned and fingers crossed.
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Post by Jean & Mimi on Oct 8, 2013 2:52:48 GMT -7
Tuesday update. We are going back to the vet today. Last night, even after having all of her medication, Mimi was in pain. She just lay there but would not relax. When we took her out last night again she just sat, not wanting to put any weight on her rear. She was also doing the soft grunting and her belly was tight. She had pooped with ease earlier in the evening so it was not constipation. She finally put her head down and slept through the night until five am.
This morning, she scratched the crate for potty time and did the grunting whimper when hubs picked her up. She did take a few steps and peed in her own. To me it is clear that the taper is not working. I do not want to harm her by keeping her on drugs that could have side effects but at the same time the swelling needs to go away and I cannot see her in pain. It's been over two weeks now and I am really gettung scared that her pain will never go away.
If I had the finances she would have had surgery already. But it will never be an option. I am losing hope.
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