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Post by amyjrn on Oct 13, 2013 10:24:29 GMT -7
-- What is your dog's name? Shadow
-- How much does your dog weigh?14 lbs
--What breed is your dog and did you specifically get a diagnosis of IVDD? Dachshund and yes
-- What was the date you saw the vet and started 100% STRICT crate rest 24/7? 10/12 started crate rest that day
-- Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy? Yes with any movement, better after injection of pain med
-- What are the exact names of meds currently given, their doses in mgs and frequencies?
Tramadol 12.5mg q 8 hers
robaxin 250 mg 2-3 x/day
prednisone 5 mg bid with total of 9 days tapered
pepcid 5 mg bid
-- Currently can your dog wobbly walk? move the legs at all? or wag the tail when you do some happy talk? Yes, but significantly decreased function over the last 24 Hrs
-- Do you find wet bedding or leaks on you when lifted up? No
-- Eating and drinking OK? Not eating or drinking. I am forcing fluids with a syringe
-- Poops OK - normal color no dark or bright red blood. Stooling, won't pee, but did dribble when at vets last night.
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Post by amyjrn on Oct 13, 2013 10:32:34 GMT -7
My first question is what is the best way to get him to at least drink. The vet says he will most likely need surgery, but waiting to hopefully get through the weekend so I don't need to have all the extra cost of emergency care. I will make some chicken and rice but he has snubbed his nose at everything. Second, what are the normal radiology scans needed for surgery, do you actually need a MRI? My older dog had the dachshund back surgery almost 10years ago, and they just did a mylogram. Shadow is just 3 yrs old, young for IVDD issues, and very slim, not a stitch of fat on him, not sure how this got so bad so quick.
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Post by Jean & Mimi on Oct 13, 2013 10:45:33 GMT -7
I am not a moderator just a "mom" going through the same thing. Some of the moderators have suggeated low sodium broth for them to drink. I have let Mimi have some warmed up and ahe seems to like it. Hope your sweetie recovers quickly.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,603
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Post by PaulaM on Oct 13, 2013 11:01:42 GMT -7
Amy, welcome to Dodgerlist. I'm sorry to hear Shadow is having a disc episode. Pain can't wait til Monday. For a 14 pound dog there is PLENTY of room to move the Tramadol dose up. So get on the phone, go to ER but get his pain meds where they need to be to control pain. Just to give you an idea my 13lbs dog was prescribed 50mg 3x a day. Make sure you are giving Roboxin at the max frequency of 3 times a day. How often had you been giving it? There is till another med that could be added to the pain med mix…gabapentin. The first order of business is 100% pain control dose to dose of the pain meds. That will happen in 1 hour and thereafter IF the meds have been properly tweaked for Shadow. You and your vet are a team to keep each other in the loop about everything, pain, neuro diminishment. Pepcid alone is often enough stomach protection for most dogs. When it is not for other, a 2nd protector is necessary on top of Pepcid AC….that med is an Rx item, sucralfate. This article bears reading to under stand how it works, timing with meds and meals. Do look up all your dog's meds here: www.marvistavet.com/html/pharmacy_center.html When the stomach is protected then Shadow will want to eat/drink. So the two can't-wait things to address today are:
1. Getting pain meds adjusted to fully control pain
2. Getting the GI tract protected.Know your neuro functions, know about conservative vs. surgery. THis is a must read: www.dodgerslist.com/literature/healingsurgery.htmAs long as Shadow can wag his tail he is a candidate for conservative treatment. The big IF on that is if you are educated on IVDD by reading our core IVDD readings www.dodgerslist.com/literature.htm and you commit to 100% STRICT crate rest 24/7, only out for a very few footsteps at potty time. Dogs who were born with this disease typcially show signs at 3-7 years old. This is a disease, a progressive disease of prematurely aging discs. You can learn much more at the "Shortcut through IVDD" presentation, you will be glad you saw it: www.dodgerslist.com/literature/IVDDcourse/index.htmlWe anxiously await hearing pain meds have been adjusted and sucralfate is on board. |
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Post by amyjrn on Oct 13, 2013 15:20:51 GMT -7
Went back to vets, gave SQ fluids, and iv buprinex for pain? (sp). They are calling the specialist in the morning as the vet feels his Neurological status has declined more. He can still walk though, so no trips tonight. He is still refusing all food and drink, made chicken, rice and broth, he didn't even sniff at it.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,603
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Post by PaulaM on Oct 13, 2013 18:07:05 GMT -7
Did Sucralfate get added to protect his stomach. Not eating and drinking is a beginning red flag sign of Pred damage. Please do not wait, strongly advocate for this med.
Why were there no modification to his pain meds? It really would be best if you get that consult with a specialist who is more knowledgeable about pain control.
Is his pain now fully under control dose to dose of his pain meds?
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Post by amyjrn on Oct 13, 2013 21:43:20 GMT -7
He is more comfortable after the iv med, they said I could give tramadol a little more often every 6-8 hrs. He is walking better when I take him out for potty time. I am hoping the specialist will have more ideas for pain control and getting him to eat. I am force feeding liquids, I used the rice water and chicken broth mix. His real mom was a very finicky eater and he is too, it does not take much for him to refuse food, but he usually will drink. I will update with specialist recommendations. I am an icu nurse, so I know all the meds very well, just don't know doses for dogs.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,603
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Post by PaulaM on Oct 14, 2013 9:12:10 GMT -7
"More comfortable" is not good enough… it should be full pain control dose to dose of pain meds. Are you giving Robaxin at the max frequency 3x a day? Can you tell us if you are giving 12.5mg Tramadol consistently every 6 hours? If yes, then it is clear the dose is not enough. The half life for Tramadol is pretty short at 1.7 hours plus the range of mgs is wide (Veterinary Anesthesia & Analgesia Support Group: vasg.org/t_drugs.htm ) So if you are still seeing any hint of pain ( shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy, not his usual perky self) then do strongly advocate for getting the Tramadol dose increased. What is the date that Pred will start the taper down from 5mg 2x a day? With a disc episode often it can take being at the anti-inflammatory dose of prednisone (5mg 2x/day) for 1-2 weeks or even for some dogs more like a month before all the swelling is gone. When the vet guesses swelling might be gone there will be a taper. The dose is lowered to less than the anti-flammatory dose your job at home would be to assess just how well reduction of swelling is going by observing for any hint of pain. To have a clear picture on a taper, pain meds are also stopped or backed off too. Rule of thumb is: pain = swelling = more time on Pred needed. Force feeding liquids is not solving the problem at hand…focus on getting his tummy protected asap by adding a 2nd stomach protector to the Pepcid AC….sucralfate is needed. Let us know what the vet does to modify pain meds to get it just right for Shadow and that sucralfate is on board. |
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Post by amyjrn on Oct 14, 2013 14:40:14 GMT -7
Specialist thinks he will need surgery, it is scheduled for Wednesday unless he loses motor function before. More SQ fluids, and they sent me home with the bag so I can dose 1-2 times/day depending on if he starts eating. They gave me sublingual buprinex to give every 6-8 hrs and I will then give something for pain every 3-4 hrs. Just starting the new regimen so don't know if it will work, just quiet and meds tonight. The vet said since Shadow had no vomiting, diarrhea, retching or other signs of GI issues, he felt it was the pain causing his lack of appetite. I will give the Pepcid q12 hrs, and they gave me some Hills AD wet food to dilute and syringe feed, hoping that getting food in with the meds will also help. Pray that he keeps movement during non business hrs, I can take him Tuesday if needed if there is decline in function. Really liked the Vet at Northlake Vet Surgery, in Atlanta, really listened to my concerns and spent over 30 mins examining and discussing Shadows care.
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Deborah & Angel
Helpful Member 
No current back issues... Living Life.. <3
Posts: 294 
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Post by Deborah & Angel on Oct 14, 2013 14:50:40 GMT -7
Hang in there Sweetie, we are here, prayers for you and your FurKid, and many (((hugs))) going your way. If you need to.... give meds with Cream cheese to make sure he is getting them...that was the ONLY thing that worked with mine...also a "picky eater".. :/
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,603
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Post by PaulaM on Oct 14, 2013 16:04:20 GMT -7
Is this the new regime? 14 pounds buprinex .3ml sublingual; to give every 6-8 hrs tramadol 12.5mg, now 25mg; a little more often than every 6-8 hrs Pepcid q12 hrs Robaxin 250 mg 3x a day Curious how you get sublingual to work with a dog, will your dog allow that? We've heard of transdermal gel working very well and oral Buprenorphine being ineffectively absorbed by dogs. Surgery would be a consideration if aggressive pain meds will not cover pain while Pred needs time to work on swelling in the spinal cord. Pros and cons including a good article by Dr. Isaacs, ACVIM (neurology): www.dodgerslist.com/literature/healingsurgery.htmWas there any reason tramadol was not increased? Was there any reason gabapentin was not used as it works synergistically with Tramadol and vets are finding very good success with pain control? I hope you find sublinqual burpinex/tramadol/Robaxin combo will do the trick. If not advocate for trying Tramadol/Robaxin/Gabapentin mix. Can you bring us up to date on his neuro functions. Can he move his legs at all, wobbly walk, does he knuckle his paws? |
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Post by amyjrn on Oct 14, 2013 16:54:48 GMT -7
He can move legs, but just sits when I take him out to potty, he wagged his tail when I can in the kitchen from taking my very senior doxie outside (15 yrs). The above meds are correct, I try to space so not to many at one time. I have increased the tramadol to 25 mg. He HATES the crate, whines the entire time he is in it, he is most comfortable with my hand on his head on the sofa. I know 100% crate rest, but it was making him more ill, and making his pain worse. In the pediatric world, you do what works for the patient, so he is with me on the sofa, NEVER left alone, but he rests, and sleeps so until his surgery, I will have my hand on him if that is what makes him rest/sleep. There his has normal respirations, and is not panting or whining. Even with me and the other doggies all around him, he still is whining and very anxious.
As far as the buccal buprenex, many meds are actually better absorbed either through the gums, or other membranes, i.e. rectal valium. It is only .3ml, just place it in the buccal area, and it is absorbed. We give fentanyl/versed intranasal so we don't have to start an IV. a little higher dose than IV, but onset is actually fairly fast ~ 15-30 min. I will update tomorrow, hopefully he will sleep and rest. The many trips to the vet over the last 2 days have taken a big toll.
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Sabrina
Helpful Member
My Charley-dog, a Dodger'sList grad enjoying life!
Posts: 471
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Post by Sabrina on Oct 14, 2013 18:54:33 GMT -7
Hi Amy, I'm Sabrina. I'm so sorry to hear of Shadow's struggle with IVDD, but I'm glad you found Dodger'sList! Have you seen this page of strategies for "Emergency Crate Confinement"? www.dodgerslist.com/literature/EmergencyCrate%20Training.htm#EmergencyconfinementDo you have a sturdy coffee table that you could put Shadow's crate on so that he could be right next to you while you're on the couch? Being in the crate is import not only for rest/confinement but also because: "Your dog needs a flat, always horizontal and firm surface to support his back during recovery" (from - www.dodgerslist.com/literature/CrateRRP.htm ) - the floor of the crate underneath the bed/foam mattress acts as a sort of "cast" so that your dog has an always firm, always level surface under him. I hope that the strategies in the "Emergency Crate Confinement" article can help you help Shadow rest in his crate! Is Shadow currently showing any signs of pain dose to dose? ))Hugs!(( - Sabrina |
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Post by amyjrn on Oct 14, 2013 23:39:50 GMT -7
He can move, just still has pain. I still have to force feed, so treats have no effect for crate problems. He won't pee, not sure if it is pain, or if the back issues have his urinary sphincters closed, rather than the constant leak. I am giving SQ fluids also, so today he has had 340 ml in, and only one void early yesterday (10/15) at 9 am. Going back to the specialists in the morning. Probably time for surgery.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Oct 15, 2013 5:40:27 GMT -7
Hi, Amy It sounds as though Shadow could still be a good candidate for conservative care if his pain can be brought under control. He may just be reluctant to move due to pain. I think a switch to a Tramadol/Robaxin/Gabapentin mix would be well worth trying before making the decision to have surgery. Also Sucralfate is needed as his not eating is a red flag for GI tract problems from the medication. That can quickly lead to a very dangerous situation. He may not be eating due to pain but it's best to be proactive to protect his system from side effects of the medication. Have you been trying to express him? He may have lost bladder control and it's very important to empty his bladder. Any urine remaining in the bladder for any length of time can lead to urinary tract infections and it can stretch the bladder out of shape. www.dodgerslist.com/literature/Expressing.htm Please let us know what the specialists say today. Blessings to you both. |
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Post by amyjrn on Oct 15, 2013 20:36:49 GMT -7
Shadow has his surgery tomorrow, he stopped walking, but can still wag his tail. The surgeon felt that since he continued to decline, and the pain control issues, he would have relief with surgery. Shadow did take his first treats Tuesday morning, his first non forced food in 4 days. 3 of my doxies have had to have surgery, so the post op period is not new to me. In had tried to express his bladder, but his abdominal muscles were so tight, it was not possible. The only thing that gave him relief of the horrible pain was IV pain meds. I will update after surgery.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,603
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Post by PaulaM on Oct 16, 2013 8:12:04 GMT -7
We'll be here to support surgery also…. keep us posted on Shadow. Until surgery, hope the vet will get on board to use more aggressive pain meds so that Shadow is not needlessly suffering til surgery.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Oct 16, 2013 8:23:01 GMT -7
I'm sorry to hear that Shadow's neuro functions have continued to decline. My thoughts and prayers are with Shadow that all goes well. He has a good mom who is doing all she can for him so he's one lucky boy! Please keep us posted.
All the best to you both.
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Post by amyjrn on Oct 18, 2013 6:38:31 GMT -7
Surgery went well, herniated disk between L4 and L5, today (Friday), he walked into the examination room for my morning visit, wagged his tail. He is just getting his appetite back, and if it can be worked out, he will come home Sunday morning. God is good, he has brought Shadow back with all functions.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Oct 18, 2013 8:56:10 GMT -7
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Deborah & Angel
Helpful Member
No current back issues... Living Life.. <3
Posts: 294
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Post by Deborah & Angel on Oct 19, 2013 7:19:37 GMT -7
Hi Amy, I know Shadow didn't like the crate before, BUT he may welcome it and it is VERY important now. Mine was never crated until she went down, and it was like she knew THIS was the best for her...she gave me NO issues at all. I did find one that had a door in the top, and the front, it was easier to get her in and out of the top after surgery...Many prayers, and Hugs for you and Shadow...  |
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Post by Pam & Dobby on Oct 20, 2013 8:14:19 GMT -7
I've just read your story. I am in Atlanta, also. I hope Shadow will have a smooth recovery after coming home today.
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Post by Pauliana on Oct 20, 2013 20:01:18 GMT -7
Hi Amy,
I hope by now Shadow is home and resting comfortably.. What medications did they send him home with, the dosages and the frequencies given?
So happy to hear he walked out to greet you! My Tyler walked the day after surgery also! Fabulous news!
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