|
Post by austinj on Oct 18, 2013 12:36:40 GMT -7
Paula: we were giving her 75mg tram 3x daily and now were up to 100mg 3x daily. We did go a couple of days at 50mg every 6hrs but saw no change. He is hesitant about upping the pred. bc of her size(20lb). Right now we administer the pred 10mg 2x daily. The swelling in her back seems to have gone down but like I said her nuero symptoms keep declining.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
|
Post by PaulaM on Oct 18, 2013 16:42:28 GMT -7
Just wanted to make sure you did touch base today with the vet to update him, he definately needs to have your observations when things change. You need a plan B in mind coming into the weekend when vets can be closed. So it is good to know your med options by having had a medication discussion with the vet.
I'm sorry the neuro functions are diminishing....do know that nerves can come back. The main thing is to have the pain fully under control.
Are you seeing pain control now with upping to 100mg Tramadol 3x a day?
|
|
|
Post by austinj on Oct 18, 2013 18:19:50 GMT -7
We did call the vet this afternoon to discuss if we could give tramadol at 100mg/6hrs. He said that was fine and there was still room to move around. He did try to encourage us however that he had faith in what we are doing.
That being said when I arrived home I gave her the pilld and carried her out to potty and noticed even more trouble standing. I tried using the sling but she refuses to "go" while it's under her. She still went potty once I removed the sling but she went all over her legs and basically sat in it. I took her inside to clean her up and to rest.
Now it's 8:00pm and she seems to have lost the ability to move her back legs all together. I tried pinching both of her toes very hard to which she gave no reaction. Im afraid surgery is becoming more of the route the vet is going to want to take which we can't afford.
I don't know.....
And Paula nothing we have tried has been able to manage the pain from dose to dose.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
|
Post by PaulaM on Oct 19, 2013 10:23:55 GMT -7
Austin, how is Lacee this am with leg neuro function and is pain at bay fully? How much room to move on meds, i.e. what range of doses, did the vet give you for each? Please do update the med list.
20lb tramadol 100mg 3x daily Robaxin-v 250mg twice daily Gabapentin 100mg 3x daily pred 10mg 2x daily Pepcid AC is this 5mg 2x a day?
|
|
|
Post by austinj on Oct 19, 2013 12:56:15 GMT -7
Paula that is the correct amount of each except that the Robaxin is 3x as well.
We took her in this morning so the vet could witness her symptoms. He is worried as we are about her loss of motor function. His idea was to give her a blast of steroid injections through an IV there in the office. He gave her 125mg of Solu-Medrol through IV and plans on doing that every 3hrs for the next 9hrs. He also put on a trans-dermal Fentanyl patch of 25mcg/hr. We will pick her up this evening and watch how she reacts to this plan of action.
Right now it's a waiting game and our options are running out.
|
|
StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
Posts: 1,335
|
Post by StevieLuv on Oct 19, 2013 21:03:43 GMT -7
Prayers that the steriod blasting gives her the edge that she needs to get this pain under control. I was hoping that your Vet would add some high powered opioids to her meds to get that pain under control. Good for you for keeping at him to help Lacee. I hope that she feels better soon (((hugs)))
|
|
|
Post by austinj on Oct 20, 2013 6:57:14 GMT -7
Well we picked her up from the vet at around 8p. She looked very groggy and tired. The vet did inform us that she was trying to move around a little though.
When we returned home we carried her out to potty where she stood on her own and took steps!!! Granted they were very shaky but we'll take it! Kept her very quiet all night. And now were giving her sucrolfate instead of pepcid and continuing our other meds as normal. She definately seemed in less/no pain. I checked on her this am. and she was passed out kike a rock which is the first I've seen in 2 wks.
We'll just keep plugging along!
|
|
|
Post by Jean & Mimi on Oct 20, 2013 7:23:03 GMT -7
So glad she is sleeping and resting and is in less pain. Sleep is healing and what her body needs to repair. Praying for continued recovery.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
|
Post by PaulaM on Oct 20, 2013 9:56:44 GMT -7
So glad to hear Lacee is resting comfortably AND neuro diminishments have been reversed!!! You know I would most definately advocate strongly for keeping Pepcid AC on board. It works to inhibit acid production, where as sucralfate works by forming a gel like coating over damaged areas of the tummy. Lacee needs both kinds of protection since there was a very high use of steroids (steroid blasting). Your little girl does not need another problem of bleeding ulcers on top of dealing with this disc episode. Do advocate strongly for Pepcid AC 5mg 2x a day. The order of meds would then be: Sucralfate 1 hour before meals Pepcid AC 30 mins after sucralfate Pred given with a meal. There are other options for timing with sucralfate…do read up on them here as well as all of Lacee's other meds: www.marvistavet.com/html/pharmacy_center.htmlDid the vet make any other changes to her med list? 20lb tramadol 100mg 3x daily Robaxin-v 250mg 3x daily Gabapentin 100mg 3x daily pred 10mg 2x daily Pepcid AC stopped Sucralfate10/19: Steroid blasting Fentanyl patch of 25mcg/hr effective for 3 days
|
|
|
Post by austinj on Oct 20, 2013 13:19:40 GMT -7
Well our joy was short lived. Today she shows no signs of trying to use her legs anymore. When we do take her out she just tries to drag them. She doesn't seem to be in hardly any pain but it's just dis-heartening to see her regress again. I really think the addition of the Fentanyl patch is what's helping the pain the most.
Does anyone have a good idea of what a wheelchair costs just in case?
|
|
|
Post by Jean & Mimi on Oct 20, 2013 13:27:36 GMT -7
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Oct 20, 2013 15:35:51 GMT -7
I'm so sorry to hear that Austin. Yes, that is disheartening, but nerve damage can heal. Right now, the most important thing is getting the pain under control. Hopefully, the steroids are getting the swelling down in Lacee's back so the pain will diminish. The 8 weeks of crate rest is to heal the disc. Nerves can take weeks, months, even a year or more to heal. Yes, it is too early to be looking at carts. You should assess her condition at the end of the 8 weeks. Quite possibly, you might want to spend the money on physical therapy to help her walk rather than on a cart. Carts can cost anywhere from $100 to $500 or more. Eddie's Wheels has a good cart. You can also get a cart from www.dogstogo.net/ for about $100. I do hope, as Paula advised, that you will be contacting your vet in the morning to strongly advocate for Pepcid AC and Sucralfate and, of course, to let him know of the loss of neuro functions. Hang in there. I know what a roller coaster ride you've been on. But you've seen that it can turn around and hopefully her condition will improve.
|
|
|
Post by austinj on Oct 21, 2013 19:53:48 GMT -7
Lacee's pain seems to be much better but tonight at potty time I noticed her inside leg seemed red and upon further visuslization we noticed a SEVERE rash. I looked up urine scald pictures but I'm just not sure thats what it is. We have been using a wet wash cloth to clean her up after every outing but this seems really bad. It looks really inflamed and sore. Any insight? Could it just be sores from not being active?
|
|
|
Post by Pauliana on Oct 21, 2013 21:11:13 GMT -7
Hi Austin,
Being the inner leg, I would tend to think it's a urine scald. Not sure if she is putting pressure on that inner leg while sleeping.. It could also be a reaction from drugs or ?? I would take her in to the Vet and let them determine what caused it and get the right ointment or medication for it.
Make sure after using the wet washcloth on her to dry her and don't use a diaper rash cream that has Zinc in it as it is toxic to dogs to lick it..
Sending healing thoughts and prayers to Lacee and comforting thoughts to you and family..
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Oct 22, 2013 15:44:33 GMT -7
Urine can really cause quite a scald on the tender inside of the legs. If you find that it's urine that is causing the rash, wiping her clean with green tea will help. Green tea neutralizes the acidity in the urine and it smells nice and clean, too. Just make a pot of green tea, let it cool down and wash with a sponge or cloth. I hope she's still doing better with the pain.
|
|
StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
Posts: 1,335
|
Post by StevieLuv on Oct 23, 2013 19:15:33 GMT -7
Good to hear that Lacee's pain control is working much better. Keep in mind that the pain patch (fentanyl) can make her a bit "stoned" and affect her ability to stand up. Stevie was put on an opiod for pain and it actually knocked her flat - at first I panicked, thinking that she had taken a turn for the worse because she was unable to stand anymore. Turns out that she needed to sleep that one off (17 hours!) Her medication was oral and the dose could be adjusted. If Lacee is wearing a patch and her pain is controlled, then her lack of mobility may be a blessing, rest=healing time, check with your Vet if you have any concerns - that's what they are there for Hoping she continues to feel better!
|
|
|
Post by austinj on Oct 24, 2013 7:43:28 GMT -7
Well it seems that Lacee's pain is really in control now due to our rx schedule. However, the urine scald is what is making her uncomfortable now. She had a pretty severe rash from it. We've been cleaning her up after every outing and applying Desitin to her soresto help heal them.
Last night we noticed that she peed in her bed and that she didn't give us any indication that she needed to go. Later that night we took herout to go which she did but then again thismorning I took her out which she went and placed her back in her crate. Not 30 min later her bed was completely wet again. Is this sign of incontinence telling us we need to express her? She still poops on her own and she still pee's on her own when we take her out??? I'm lost.
Still not walking or showing any signs of it.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
|
Post by PaulaM on Oct 24, 2013 7:57:49 GMT -7
It is hard for humans to know if a dog is peeing by choice or if urine is being released by reflexes. So the "sniff and pee" test is necessary. Plut her down on an old pee spot to sniff, does she then release urine, maybe tries to lower herself? If yes, she has bladder control. So finding urine in her bedding may because you are not taking her out often enough (every 3-4 hours) Finding poop or pee in bedding or leaking on you when lifted are evidence of lack of bladder control. This means you need to get a hands on top of your hands type of expressing less at the vet. You will get more out of the less if you review this first: www.dodgerslist.com/literature/Expressing.htm Let us know what you are observing. Excellent news that pain is being fully controlled now….healing can progress!
|
|
|
Post by austinj on Oct 24, 2013 9:33:59 GMT -7
Paula: When we take her out she doesn't really sniff and pee but she does wiggle exactly to where she wants and raises her tail to release herself as if she was going on her own. I have noticed though in the last couple of outings she will pee while she is inching along sometimes. Do you think that would be reflexes?
|
|
|
Post by Pauliana on Oct 24, 2013 20:20:45 GMT -7
Hi Austin, Peeing while inching along sounds like overflowing when her bladder has gotten too full. Prednisone makes them very thirsty and makes them drink more which makes them have to urinate more often. Try Taking her out every 2-3 hours and see if that helps.. I do think it would be a good idea to get an expressing lesson just in case.. www.dodgerslist.com/literature/Expressing.htm Marjorie's tip about using green tea on her urine scald rash would be a good idea. It is very soothing. "Urine can really cause quite a scald on the tender inside of the legs. If you find that it's urine that is causing the rash, wiping her clean with green tea will help. Green tea neutralizes the acidity in the urine and it smells nice and clean, too. Just make a pot of green tea, let it cool down and wash with a sponge or cloth. "
|
|
|
Post by Jean & Mimi on Oct 25, 2013 6:30:43 GMT -7
I give Mimi green tea "baths" at least once a week (more if she gets caught up in her submissive pee when we get home. It works wonders
|
|
|
Post by austinj on Oct 30, 2013 19:03:45 GMT -7
Well here's an update on Lacee.
We have gotten the pain pretty much in control. The main thing we are struggling with right now is her potty times. She did aquire some urine scald which led to a pretty severe rash. We managed to get that under control with diligent cleaning and green tea as many of you suggested. Last night we noticed that at potty time she was bleeding a little. Took her in today and found out she has a bladder infection. The vet gave her a shot of anti-biotics and gave us a rx for that.
She still doesn't have any movement in her legs which is the most difficult thing about going potty. We did get a sling that goes aroung her legs to help her move and not drag/cut her legs up while moving.
Right now we're just trucking through the 8wks of rest but I do think a cart is in our future. Does anyone know the wait time on ordering one?
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
|
Post by PaulaM on Oct 30, 2013 19:38:10 GMT -7
It is way to early to think about a cart…do wait until all 8 weeks of crate rest have been completed. At that time you can best assess whether to spend $$ on PT at a rehab clinic or a cart.
At potty time, how to you express her? Can you express her on a pee pad on the floor, so you do not have to contend with sling/harness/leash outdoors? How many hours apart is each session? Is she now staying dry or are you finding urine leaks in her bedding?
So are you not seeing any hint of pain dose to dose of her medications? No shivers, no yelps, no tight tense tummy, no reluctance to be moved or move herself some in the crate to shift sides, etc.? Can you update her med list:
20lb tramadol 100mg 3x daily Robaxin-v 250mg 3x daily Gabapentin 100mg 3x daily pred 10mg 2x daily Pepcid AC stopped Sucralfate
10/19: Steroid blasting Fentanyl patch of 25mcg/hr effective for 3 days
|
|
|
Post by austinj on Nov 12, 2013 19:48:16 GMT -7
Lacee update:
Well were done with our 6th week of crate rest. Lacee isn't in any pain at all. Our rx schedule is now
10mg ▼prednisone 1x daily but switching to 1 every other day tomorrow for one week and we'll be done.
We give her a [Tramadol] 50mg in the evening just to help through the nights sleep.
She still has control of both bladder and bowels. We did invest in some doggy diapers just to help in the instances that she doesnt get it all out at potty time.
She still shows no function in her back legs but we do try and massage them and do a little PT in the evenings. When I pinch her toes really hard she does try and pull her foot away as in "Hey! That hurts!" So I'm holding out hope that her neuro functions may return.
We'll just keep taking it one day at a time and hope for some results soon!
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Nov 12, 2013 20:26:22 GMT -7
Hi, Austin That's very good news that there are no signs of pain during the taper of the Prednisone. Continue to keep a lookout for pain as the taper continues. Is it Tramadol that you're giving 50 mg in the evening? There would be no need to give Tramadol if there are no signs of pain. Please let us know what is being given at night and the reason it's being given. Why was the Pepcid AC stopped? Lacee is still on Prednisone and her system still needs to be protected from the side effects of the steroid. While on crate rest, you want to limit Lacee's movements as much as possible so you shouldn't be pinching her toes and making her pull her foot away. The only PT you should be doing while on crate rest are the massage and exercises #1-4 (highlighted in pink) on this page: www.dodgerslist.com/literature/massagepassiveexercises.htmYou said that she has bladder control but it sounds as though she's still peeing in her crate. How often do you take her outside? Is she releasing urine on her own when you do take her out? Take her to a spot where she has peed before, let her sniff and see if she can release urine. If she can release urine but is still peeing in her crate, she may not have complete control and may not be emptying her bladder completely. Or if not taken out often enough, her bladder may be overflowing. In reading back in the messages, it appears as though this has been an ongoing problem. Have you tried expressing her?
|
|
|
Post by austinj on Nov 12, 2013 21:59:59 GMT -7
We have tried expressing her but you can tell she tenses up and doesnt enjoy it and will not release. The only reason I pinched was to check for sensation. As far as the pepcid we are still administering it 30 min before her pred rx.
|
|
|
Post by Pauliana on Nov 12, 2013 22:18:51 GMT -7
Hi Austin,
You might ask the vet for a drug to help her release when you are expressing her. Expressing until she is empty would eliminate accidents and prevent overflowing which can damage her bladder tone and ability to hold until the right time to pee if she should get bladder control back.. Has she been tested for a Urinary tract infection? If not it would be a good idea to have a sterile urine sample tested just in case..
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,571
|
Post by PaulaM on Nov 13, 2013 10:43:18 GMT -7
There are several reasons she could be difficult to express. Let us know what you determine to be true. 1. Could be in pain because of a UTI still going on because the correct antibiotic was not selected at the end of Oct. A urine sample brought in for the vet to run a urinalysis would rule out a UTI is still there? 2. Could be in pain because you are tapering Pred. Do you see any other signs of pain such as shivering when you move her to be expressed or any other time? A taper is to test the waters to see if all the pain of swelling is gone. Why do you give Tramadol, as a sedative or a pain reliever? Pain meds are normally either stopped or backed off to give a clear picture whether there is pain still exisiting. Pain meds mask pain. 3.Where you express can make a difference. Outdoors there is too much going on, smells, squirells, neighborhood sounds that distract a dog, make them tense up concentrating on what is going on outdoors. Do you express inside on a pee pad where there are no distractions? 4. When bladder control is returning to any degree, the dog will not like you expressing. LIfting a tail at potty time is not a sign that bladder control is coming back. We need to see perhaps an attempt to lower themselves, sniff an old pee spot in the grass or old piece of pee pad placed on a new indoor pee pad. Then look to see if Lacee chooses to then release urine to confirm bladder control. 5. As long as she is on Pred you need to get her out to potty every 2-3 hours if she does not have bladder control. Every 3-4 if she does have control. How often do you take her out? Please wait til she is off all meds and clearly not in pain before doing those very, very light range of motion and massage as highlighted in PINK. Pinching toes must be delayed until she has completed all 8 weeks of crate rest. Here is that article: www.dodgerslist.com/literature/massagepassiveexercises.htmMost general DVM vets get the pinching and sensation things wrong, so likely you will also not learn anything of value…take only the word of a board certified neuro about deep pain sensation. However, the sign that you can't get wrong is the happy tail wag. Nerves heal typically in the reverse order of the damage to the spinal cord: 1. Deep Pain Sensation (Only correctly identified by a specialist.) 2. Tail wagging with joy at seeing you or getting a treat or meal. 3. Bladder and bowel control verified with the "sniff and pee" test. 4. Leg Movement, and then ability to move up into a standing position, and then wobbly walking. 5. Being able to walk with more steadiness and properly place the feet. 6. Ability to walk unassisted and perhaps even run. Please do keep us updated on this issue. There are meds to help relax the sphincter muscle if you have ruled out other things above AND if Lacee really does not have full bladder control yet.
|
|
|
Post by austinj on Dec 17, 2013 18:46:19 GMT -7
I have to apologize for not updating sooner. Sunday was the end of our 8 weeks of crate rest for Lacee. She had not been on any pain medication for quite sometime now. She showed no signs of pain coming off any of the medication. A couple weeks ago we were begining to notice that Lacee was showing a slight tremor/movement in one of her legs as we were going through range of motion excercises. Well soon that progressed to very visual evidence that she was getting nuero function back in her legs. The next week I woke to go to work and get her out of the kennell and there she was standing up. She took about 2-5 (very wobbly) steps toward me and back down. I was so excited I woke the wife and we were both so happy! Over the next several days she became more and more steady. I'm happy to report that Lacee is completely healthy and trotting along now wherever she goes even if it is wobbly every now and then. We no longer allow her on furniture and have made things in the house much easier for her to use with her back!I have to thank all the moderators and members of this forum who helped out with every bit of information that was given during this time for us! I can't express how much it means to us that we found Dodgerslist and all of you wonderful folks! There's no way we could have gotten through this without ý'all THANK YOU SO MUCH!!!
|
|
|
Post by Pauliana on Dec 17, 2013 19:56:43 GMT -7
Austin, I am so excited to hear Lacee has improved so much and is WALKING!!!!! Happy crate rest graduation to Lacee and to you and your wife! She is in excellent hands as she goes into her new normal life...Sounds like you have everything set up for her safety and comfort.. We were all happy to help you and Lacee! You did a great job caring for her and putting our information into practice, as well! Hope you will stick around and encourage the newbies on this journey when you have time..
|
|