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Post by gksmom on Sept 25, 2013 14:34:21 GMT -7
Grace Kelly
7yr old miniature dachshund, 13.2lbs
IVDD - disc mineralization but exhibited deep pain & withdrawal response; she showed weakness in hind limbs particularly the left side but was able to generate a gait
9/25 4:00AM
Strict crate rest started immediately
PAIN - she stiffens her neck awkwardly; whimpering that may likely be from kenneling (she's not a fan!)
MEDS - Vet administered a
Buprenorphine .5mg shot this morning
Prednisone 5mg tab, Give 1 tab twice daily for 7 days, then 1 tab once a day for 5 days, then 1 tablet by mouth every other day until finished
Robaxin 500mg, Give 1/4 tab every 8hrs for muscle spasms
Tramadol 50mg tab, Give 1/2 tablet every 8 hours for pain
PHYSICAL- at the vet this morning she was able to stand but her hind legs were weak & she was afraid to walk. She has been in her kennel all day except once to potty on her tinkle pad. She would not stand but just sat on her pad. She did poop in her kennel earlier (she has anxiety troubles & it is typical for her to poop in kennel when she gets upset) & while at vet's office. One symptom she has that I haven't seen anyone mention is a fairly heavy nose drip.
EATING - she refuses water or food of any kind. I've placed a water dish in her kennel but she has yet to touch it.
I can't thank you all enough for the information found in this blog. Today started with a very frightening time for my family when we discovered there was a problem with our little buddy. Armed with the knowledge gained from our Vet I've spent the day researching and gathering information to create the best treatment plan possible for her.
We are a military family & recently relocated so we do not have a "regular vet" yet locally. It was such an early hour when we discovered her in pain that we immediately took her to the Emergency Animal Hospital. The ER Vet advised to take her to our "regular vet" if we feel like she's getting worse or the medication needs adjustment. I certainly want to establish a relationship with a local veterinarian to check on her during rehabilitation but after a $600 ER bill this morning I certainly don't want to rack up any unnecessary bills. Given there are no backslides in her condition, how soon would you suggest taking her in for a check-up?
Also, I've read that Tramadol is not an adequate pain medication. Anyone have thoughts about it?
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,598
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Post by PaulaM on Sept 25, 2013 16:39:39 GMT -7
Robin, welcome to Dodgerslist and thanks for your service to our country! I'm so pleased you have seen the important of reading up on your dog's disease and the treatments. Your self education is what will make battling the IVDD enemy with an eye to winning a reality. Have you been to our main Dodgerslist web page…that is where the treasure trove of all things IVDD reside from setting up the recovery suite to learning about meds and all the phases of healing: www.dodgerslist.com/literature.htmBecause it sounds like Grace has a problematic neck disc please make this the first of those articles to read. www.dodgerslist.com/literature/cervical.htm Great tips on the extra things you can be doing to help. Your question about Tramadol is answered there… it is a staple used in conjunction with other pain meds to fully control pain. Is that the case at this hour….no signs of pain? No trembles, no yelps, no holding head in an unusual position high or low? Neck discs require really aggressive pain med approach. Discuss: 1. Tramadol going to 50 mgs 3x a day 2. Gabapentin Make sure her stomach is protected right away tonight and keep the vet in the loop asap in the morning…she is already showing signs of GI tract problems due to pred. Cortisteroids (Prednisone, Prednisolone, Dexamethasone, etc.) are involved with stimulating gastric acid secretion causing GI upset to the more threatening bleeding ulcers or holes in the stomach or intestine. Phrase the question to your vet in this particular way: "is there any medical reason my dog may not take Pepcid AC?" If there is no reason, we follow vets who are proactive in protecting the stomach by giving doxies 5MG Pepcid AC (generic name is Famotidine) 30 mins prior to steroid. This directory is in alpha order and what we use to learn about our dog's meds. www.marvistavet.com/html/pharmacy_center.htmlI would be a very good idea to get in with a local vet. Pred is one drug that needs to be used under the guidance of a vet. In fact if Pepcid tonight does not get her eating in the morning, I would ask for an Rx for Sucralfate. Do read about this med at the above Marvista link so you are prepared for productive discussions with the new vet. I'm not sure what the nose drip is…. what did the vet say? Hang in there, this is a bump in the road of life, but you and Grace will make it through to the other side. |
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Post by gksmom on Sept 26, 2013 8:25:41 GMT -7
Paula- Thank you so much! Well what a day yesterday & last night turned out to be but around 3AM I heard the little sound of water being lapped up in her kennel. Whew. She still has no interest in food but I'm thrilled to see her drink a a little. However, she didn't tinkle at all yesterday and as of this morning around 8AM she still has not. Since bladder function is a concern with IVDD, is there anything I should or shouldn't do to help her? Starting her on the Pepcid this morning & left a little chicken in her kennel. Hopefully there's some missing when I run home to check on her.
The twinkle in her eyes isn't completely back but this morning the blank/frozen look of fear was no longer. Perhaps Mommy needs to chill a little and let the healing process happen? Ha!
One more question....Accupuncture therapy. We've found a holistic doctor with excellent references but I'm not sure how soon to have Grace treated. What do you recommend?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,598
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Post by PaulaM on Sept 26, 2013 9:27:00 GMT -7
Did the ER vet say this was a neck disc…it sound like it to me from what your wrote about the stiff neck.
If she can still move her back legs then she has bladder control. If when lifted she leaks on you or you are finding leaks in her bedding when you have given her chances to go out, that would be loss of bladder control….. and the need to go in for a lesson on manually expressing the bladder.
IF her pain is fully under control dose to dose of the Tramadol & methocarbamol, then things are going properly. Pain control is a must to allow her to heal her disc in comfort for the next 8 weeks. Full pain control would also have her back to her perky self. Let us know what you are observing this morning and if she ate the chicken.
Acupuncture. if in your budget, could start right away. This therapy helps not only with pain but to stimulate nerve endings to regenerate.
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Post by gksmom on Sept 26, 2013 11:56:20 GMT -7
The ER vet did not use the word "neck" just the vertebrae numbers. I believe the calcification was between N12 & N13(?). He reviewed the xrays with me & the injury is along her back but the upper portion of her back, near her shoulder blades. She is no longer stiffening her neck so I believe that was a reaction to either pain or the medication. When I checked on her she showed interest in the food when I offered it to her but wouldn't take it. She was however much more like herself, wanting to snuggle & have me love on her.
The ER doctor noted she was able to stand when examining her but she certainly wasn't attempting to stand on her own nor has she tried since being home. I saw a slight tail wiggle this morning though! She's tried to scooch a little but isn't able to do much more than rotate.
I'm also wondering if the muscle relaxer has an affect on her ability to stand?
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Sept 26, 2013 16:56:44 GMT -7
Dear Robin, I'm very concerned that Grace Kelly hasn't eaten yet. Please contact your vet immediately and discuss adding Sucralfate along with the Pepcid AC as Paula recommended yesterday. Sucralfate works in a different way to bandaid the damaged mucus lining of the stomach and also promotes a healing environment. Sucralfate should be given on an empty stomach, one hour before food and Prednisone so the gel coating action can begin. Pepcid should be given 30 minutes after the Sucralfate. GI tract problems resulting from the steroid can be very serious so please don't delay in contacting the vet about her refusal to eat. If the vet mentioned vertebrae 12 & 13, it would have been T12 and T13, which, as he explained, is at the upper back at the shoulders. The stiffening of her neck is due to pain. She may be reluctant to stand or move due to pain. Please also discuss this reluctance to move with the vet so he can adjust the pain medications. There should be no signs of pain between one dose of pain medication and the next. Pain inhibits healing. As Paula recommended, the Tramadol can be increased to 50 mgs 3 times a day and Gabapentin can also be added. As for the wiggle of the tail, what you want to look for is wagging the tail when she hears a happy voice or a loved one walks into the room. Then you'll know that the brain is sending proper signals to the tail. How is she doing urinating? Is she going on her own? Or is she leaking or are you finding wet bedding? If she isn't urinating, you will need to express her bladder. The vet should give you a hands on your hands demonstration. Here is the info on expressing: www.dodgerslist.com/literature/Expressing.htm Please give us an update after you have spoken to your vet. Blessings to you both. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,598
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Post by PaulaM on Sept 27, 2013 10:51:31 GMT -7
It looks like the Pepcid AC is not enough due to not eating, please do get with the new vet and strongly advocate for getting sucralfate on board. This is an Rx item and you will need to know how to give it in relation to feeding and Pepcid AC. Here is where you find out more about sucralfate: www.marvistavet.com/html/pharmacy_center.htmlStiffening her neck is a sign of pain which seems to be in control with the current dose of pain meds (Robaxin & Tramdol) So that is good! Not being able to raise up to stand is due to nerve damage. During crate rest the focus is letting the disc heal and not so much on the body self repairing nerves as they can continue to heal well past 8 weeks…think in terms of months for nerve healing. A tail wiggle due to happiness is a good sign of nerve function. Do let us know the specifics of the wiggle…she saw you or it was at potty time? Do let us know about bladder control. If you are finding leaks on you when lifted or urine leaks in the bedding this is an real health issue. You will need to get a hands on expressing lesson as Marjorie indicated. Let us know what you are observing regarding bladder control. Are you stationed abroad? Below is the letters and numbering system used in the states.  |
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Post by gksmom on Sept 28, 2013 12:43:14 GMT -7
Lots to update! Visited vet (who praised all of the information you ladies have passed along, so thank you again!) and found out that her tummy doesn't appear to be irritated however she was extremely bloated because she was not urinating on her own. I was given a lesson in expressing her bladder & she streamed almost 1/2 a pint of urine in the office. She reacted when the doc pressed scissors between her toes so he says there is a good chance she will regain bladder control but in the meantime we will need to help her out. I went back this morning to review my technique & got a thumbs up! I just need to be patient & make sure I give her time to release it all. Since she hasn't eaten much there hasn't been much to poop but if she has not pooped by Sunday evening he wants to see her again Monday morning. He also said the pain medication can constipate some dogs. Last night & today she's eaten small amounts of chicken & salmon so here's to hoping we see some action tonight! He did not advise taking the sucralfate but did say to keep taking the Pepcid AC. If she's not eating her typical consumption by Monday he will add the sucralfate. He did increase her pain medicine to a whole▲ Tramadol tablet every 8 hrs. Overall she's acting much more like herself today. She's sleeping more but then again...that's more normal for her  The doorbell rang earlier & she barked. My bedroom vanity has now become her nurse's station & we're getting accustomed to the changes. One day at a time! |
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Sept 28, 2013 18:22:18 GMT -7
OK, good job in getting a thumbs up on expressing!
Pumpkin can help firm up stools OR it can help to loosen stools. The amount of water in the diet makes all the difference. To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day. To firm up the stool, add 1 teaspoon pumpkin to kibble and no extra water 1x a day. Note alternatives for constipation: really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potato.
Glad she's feeling better. Please keep us updated on her progress.
All the best to you.
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Post by gksmom on Oct 11, 2013 6:56:34 GMT -7
Hi Everyone!
It's been awhile since I've written an update and quite frankly I was becoming an obsessed nut about her condition. Guilty of being an over anxious wiener dog mom I suppose :-) But I'm happy to report that she's doing MUCH better! Slowly she regained her appetite and it seems like a switch flipped and all of a sudden her little attitude was back to normal too.
The entire family is being strict about the crate rest and she's actually much more tolerant of it than I anticipated. She attempts to walk but is wobbly & cannot stabilize. We started tapering off the▼ Prednisone last Monday to every other day and tomorrow is her last dose. She has a vet appointment this afternoon so we will see what the doc says but hopefully tomorrow is her last dose!
I will update after our vet appointment. Thank you all so much for the support & help getting through this!
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Post by Linda Stowe on Oct 11, 2013 9:18:00 GMT -7
Good news and anxious to hear what your vet thinks. IVDD is really a disease of time and patience. We can never stress that enough. OH, and Crate Rest Crate Rest Crate Rest
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The doorbell rang earlier & she barked. My bedroom vanity has now become her nurse's station & we're getting accustomed to the changes. One day at a time! 
