Thursday, January 17, 2013

The (long) story of the Corbin Ouchies

A post by the momma:

Well, settle in and get comfy, because this will be a long post. 

To say we were devastated and disappointed on Friday when Corbin's pain returned would be a complete understatement.  With the lack of occurrences, we were hopeful that the pain was being managed by the 5mg of Prednisone every other day and would no longer be an issue.  The thing that makes diagnosing him so difficult, is he doesn't show a single symptom while he's at the vets office.  So, this past weekend I started videoing him at home and sending clips to Dr. Mike.  It was torture watching him move around in pain, but we're pretty close to being out of options if our vets can't see this going on.  However, I do think his condition can't be something terribly awful if his adrenaline is enough to override the pain during a vet visit... but we still need to get to the bottom of it, because seeing him in pain like that, I don't care how infrequent, just isn't okay.

Momma, you're making me snooze already.

We've had a lot of new readers since the pain began last year and instead of tagging every single post we did on it, I decided to consolidate and post the time line that I've been keeping to document Corbin's pain, medications, treatments and diagnostic testings.  Plus, even for those who do read regularly and have been with us for the whole thing, it's hard to remember it all.  So, I'm going to get it out there, post it and pray that someone reading has experienced or has known someone who has experienced a pain similar to Corbin's.  We're pretty sure it's somewhere in his middle back, but with near perfect spinal MRI images and spinal fluid, we're left pretty baffled. Anywho, here's our time line if you want to read it, if you don't, there's a summary at the bottom!

Corbin’s Pain History:
  • 1/28/12 –Pain began, abdomen x-rays at Latham Emergency Clinic. X-rays clear. Physical exam, no apparent problems –weight @70lbs
  • 1/29/12 – Lethargic, pale gums, emergency visit w/BHV. Physical exam inconclusive. Blood test for pancreatitis, positive. Hospitalized for IV fluids and medications. High anxiety, so discharged to be treated at home, given fluids.
  • 1/30/12 – BHV for recheck & fluids
  • 1/31/12 – BHV for recheck, fluids, start Tramadol (50mg) 2 pills, twice a day for pain
  • 2/1/12 – BHV Tramadol for pain, Metacam
  • 2/2/12 – BHV for pain, retest pancreatitis (negative)
  • 2/3/12 – Prednisone for suspected pinched nerve in back, restricted activity, Acepromazine to tranquilize and keep calm. Stop Metacam
  • 2/5/12 –Start 1 Prednisone (20mg) twice a day, 2 Acepromazine (25mg) three times a day, 3 Tramadol (50mg) three times a day
  • 2/7/12 – Pain stopped
  • 2/9/12 – Decrease Prednisone to 1 (20mg) pill twice per day
  • 2/14/12 – Decrease Prednisone to 1 (20mg) pill once per day
  • 2/20/12 – Stopped Prednisone
  • 2/22/12 – Pain returned
  • 2/23/12 – Restart Prednisone, 1 (20mg) pill twice a day
  • 2/27/12 – Decrease Prednisone, 1 (20mg) pill per day
  • 2/29/12 – Stopped Tramadol
  • 3/5/12 – Decrease Prednisone 1 (20mg) pill every other day
  • 3/22/12 – Stopped Prednisone
  • 3/23/12 – Pain returned
  • 3/29/12 – Neurologist appt with Dr. Todd Bishop, MRI of back and neck, Spinal Tab, x-rays of hips and hind legs, thorough exam by Dr. Bishop –weight @68lbs. Physical exam inconclusive.
  • 3/30 - 4/1/12 – Severe pain, was up every 45 minutes throughout the night, could not get comfortable and yelped every time he got up from laying down, yelped going up stairs/ramp, yelped squatting to urinate, yelped reaching to the ground while sitting or standing, yelped getting on furniture, yelped reaching down to eat or drink.
  • 4/2/12 – Restarted Prednisone 1 (20mg) pill twice a day for 8 weeks.
  • 4/14/12 – Found bump on flank area near hind left leg
  • 4/19/12 – BHV for check on bump, aspiration analysis showed scar tissue –weight @65lbs
  • 4/19/12 – Yelp getting up from laying down
  • 4/24/12 – Yelp reaching down for treat from standing position
  • 4/28/12 – Notice severe weight loss
  • 4/30/12 – Pale gums, labored breathing, lethargic
  • 5/1/12 – Yelped getting up from laying down during the night
  • 5/1/12 – BHV, abdominal ultrasound clear, possible enlarged heart -weight @60lbs
  • 5/2/12 – BHV all day for testing, full heart ultrasound showing an enlarged heart, start on Vetmedin (5mg) 1.5 tablet twice a day, 1 Enacard (5mg) twice a day
  • 5/3/12 – Recheck bump, lyme test (negative), decrease Prednisone to ¾ pill, twice a day
  • 5/10/12 – Recheck bump
  • 5/11/12 – Yelped in crate –possibly bending down to nibble up treat crumbs.
  • 5/14/12 – Cytology for skin lesion, Mupirocin Ointment (22g) apply 3 times per day
  • 5/17/12 – Yelp free
  • 5/24/12 – Decrease Prednisone to ½ pill, twice a day
  • 6/7/12 – Recheck bump, add 6tbls Welnectin supplement per day
  • 6/14/12 – Decrease Prednisone to ¼ pill, twice a day
  • 6/26/12 – Decrease Prednisone to ¼ pill, once per day
  • 8/16/12 – Decrease Prednisone to ¼ pill, every other day
  • 8/21/12 – Yelping, getting up from laying down, attempt to get on bed.
  • 8/22/12 – Increase Prednisone ¼ pill every day.
  • 9/20/12 – Decreased Prednisone ¼ pill, every other day.
  • 10/11/12 – Stopped Prednisone
  • 10/16/12 – Yelping
  • 10/17/12 – Restarted prednisone, ¼ pill, every other day.
  • 11/7/12 – Decreased Prednisone to ¼ pill every 3 days.
  • 11/23/12 – Yelping, increased prednisone to ¼ pill every other day.
  • 12/6/12 – Yearly check up, found broken tooth on right side, infected molar on right side.
  • 12/10/12 – Follow up heart ultrasound. Heart stronger than it was in May, still slightly weaker than should be. Discussed decreasing heart medications to see if Corbin can be stable on a lower dose
  • 12/14/12 – Surgery to remove broken tooth and infected molar. Tail amputation. Heart remained stable during surgery. Infected tooth was severely infected, started Clindamycin: 2 (150mg) pills, twice a day for 28 days. Mushy food for 10 days, Tramadol as needed for tail pain.
  • 12/20/12 – Recheck exam for teeth and tail. Stitches removed from tail. Back molar healed, broken tooth still healing, mushy food for an additional week. Tail rewrapped. Decrease Vetmedin to 1 (5mg) pill, twice a day.
  • 12/22/12 – Emergency vet visit, Corbin got his neck brace off and reopened his tail incision. Stapled tail, started on Acepromazine (25mg) 2-3 pills when left alone.
  • 12/24/12 – Emergency vet visit, Corbin ripped out the staples.
  • 12/26/12 – Second tail amputation surgery. Started Gabapentin (100mg) 2 pills, 3 times a day. Continued 3 Acepromazine (25mg) when left alone. 3 Tramadol twice a day (additional if needed for pain).
  • 1/3/13 – Recheck exam for tail, half stitches removed, tail rewrapped. Continue with medications.
  • 1/10/13 – Recheck exam for tail and heart. Remaining stitches removed. Tail rewrapped, continue with pain medications. Heart sounds good, decrease Vetmedin ½ (5mg) pill, twice a day.
  • 1/11/13 – Yelping, pain returns. Yelping when getting up from lying down, yelping when walking, yelping going up/down stairs, yelping when squatting to urinate. Seems comfortable while laying down, pain gets worse as the night goes on.
  • 1/12/13 – Vet visit. Corbin acts crazy and shows no sign of pain until we return him to the car to go home. Dr. Knapp increases prednisone to 20mg twice a day. Took videos during yelping at home and sent to Dr. Mike. Seems tender on his middle back, at the bottom of his ribs. No stairs, no couch, limited activity.
  • 1/14/12 – Yelp free since 8am
Momma, you're boring my readers.

Told ya it would be long. 

So, to sum it all up...
Corbin is currently on 1 Prednisone (20mg) twice a day, 1/2 Vetmedin (5mg) twice a day 1 Enacard (5mg) twice a day, 2 Gabapentin (100mg) three times a day, 3 Tramadol (50mg) three times a day, 1 Glycoflex (600mg) twice a day and 3 Acepromazine as needed when left alone.

He has had an MRI, spinal tap, x-rays of his abdomen, hind legs and hips and a handful of blood tests testing for lyme and lupus. 

Skeletally, he is perfect.   There isn't a part of his body that causes concern for any vet (which, by the way, he's seen 5 vets and 2 specialists: Neuro and Ortho).  If I didn't have such a great relationship with Dr. Mike and if he didn't trust me to know my dog so well, we'd totally be flying down a river with no paddle.

Thanks to everyone who has already offered up advice.  I won't post the videos on here because, well, they're heart wrenching to watch and I don't know that they'll do any good and my boyfriend will probably shoot me for posting them, like he wanted to shoot me for taking them.

Momma... this post megaly lacked Corbin pictures.
I made up that word, megaly, to make this post more interesting.

We have discussed going to Cornell or Tufts University.  They're each about 3 hours away and I'm not concerned about the drive as much as I'm concerned that we're going to get there and also get no where because Corbin will not show his issues for them to assess.  And, as far as I know, neither university will look at his history without seeing him in person.

Okay, this is long enough, so I'll leave it at that.  If anyone has any ideas or clues to help us, it's all very much appreciated!!!!  He is stable now and we'll hopefully decrease his Prednisone on Monday.  The increased dose causes concerns for his heart, so it makes me nervous...

36 comments:

  1. The videos will be a great help to your vet. I have no advice to offer but your detailed chronology should help the conversation with whomever. I have had good experiences with the vets at Tufts provided that you insist on discussing everything with them in as much detail as you require (I think it takes them a bit to learn that they are dealing with a well organized, analytical person). While it will cost a lot of money, I think at this point if you can manage a trip to either Cornell or Tufts that it is worth it.

    Insist on talking to the vets as much as possible prior to the visit so that you can get as much out of the trip as possible. I always ask lots of "and then what" questions to be clear on what each test is looking for and what would happen next depending on what they find.

    Let me know if you decide to go to Tufts. If at all possible, I will swing by the hospital to offer you moral support during those excruciating hours in the waiting room.

    Mango Momma

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  2. Oh, and put the videos on a cd t bring with you. You might even be able to get them to the specialists in advance of the visit for them to consider. When Mango tore his ACL, he too did not present well at the vet, but I had a video of him moving funny and she recognized the presentation immediately.

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  3. I wish we had some words of wisdom or an idea, but we don't. After reading your post, I'm feeling frustrated and have sympathy for how horrible this is for you.

    The idea of video is really smart. If you go to the university clinic be sure and show them too. Maybe somebody might see something.

    Our thoughts and prayers are with all of you.

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  4. It is certainly a dilemma. I have lupus myself and spent 3 years in pain agony and suffering until they finally figured out what it was so I understand how frustrating it must all be. Sometimes you need a new set of eyes and thoughts to figure it out. I agree with Dex - put the video on CD and take with you - I know with Reilly - we ended up having all his info sent to the University of Texas Veterinary School who finally helped sort out his allergies.

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  5. Oh Corbin, you have really been through it havent you? I feel so very sorry for you and your Momma, I have no ideas what poor corbin could be going through but I am so happy that you are doing all that you can to help him with his "ouchies" and that you have such a good Vet with such mutual trust! I send you my love, prayers and deepest hope that you find some sort of solution!
    All my love, your furiend Frank and Family xxxxxxxxxxxxxx

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  6. Poor Corbin has been through so much. God bless you for taking such good care of him....I don't have any advice....you are doing exactly what Beth would do for me....Corbin is in our thoughts and prayers....

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  7. I wish I had some insight as to what is ailing Corbin. I do agree with Mango Momma that it sounds like a trip to the vet school is your next step. Good luck in finding a solution for Corbin.

    Cindy

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  8. How wonderful that you have such a detailed list and as horrible as it is to do the videos, it seems like a good idea because they may hold clues. I pray that your diligence will result in Corbin getting help.

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  9. Gosh poor baby. How about water therapy.
    Benny & Lily

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  10. Hey my pal, we haz sent a linky to the blog to my pawsome docs and surgeons at North Downs Specialist Referrals. They did amazin work for me on my heart. Da family is poppin in to see em next week so we will lets you know if they haz any ideas. Woof

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  11. Because you're so close, give the Tufts clinic a try--lots of great minds working there (including my sister's!) Corbin's so lucky to have such diligent caretakers!

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  12. How horrible for dear Corbin and such an unpleasant mystery. We all are purring and praying for a solution for our sweet pal.

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  13. I follow a blog called http://avetsguidetolife.blogspot.com/. His email address is on the right side of the page and he does answer questions or give advice. He's done that for me on more than a few times. While he may not have all the answers - especially in Corbin's case - I have to hope that maybe he's seen or heard of symptoms similar to what Corbin has been experiencing and can offer some insight. I would even go so far as to say to attach the video for him if you do send him an email.

    I am sorry I do not have any personal experience with this (well, you know what I mean) - but I am praying that you find answers somewhere. Everyone here telling you to put the video on a CD or thumb drive if you end up going to one of those universities - excellent advice.

    Please keep us posted and don't worry - I wasn't bored at all. I am actually impressed with your excellent records and that will go a long way in helping Corbin!

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  14. We have nothing to add to this conversation, butt want to send hugs and kisses to the Corbin. Ouchies suck.

    -Bart and Ruby

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  15. I'm so sorry you've had to go through all this, Corbin. And your poor momma too! I hope that you're able to find out the reason for these ouchies soon and fix things!

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  16. I just can't believe that magnificent, kind, gentle Corbin has been going through this for a year. Praying for answers.

    Nubbin wiggles,
    Oskar

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  17. We are so sad to read about Corby. We thought the Corbin was going so well. We don't have any advice except maybe the videos and the university.

    We'll keep our paws crossed.

    XXXOOO daisy, Bella & roxy

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  18. Howdy Corbin's mum, sorry we haven't any advice either and we don't know anything about Tufts or Cornell but if you have a slim hope they may find something/anything, go for it. We're just so sorry poor Corbin has this mystery illness and we send you all hugs and love. Keep your spirits up mates. We are all thinking of you here in Oz. No worries, and LOVE, Carol (and Stella and Rory)

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  19. So sorry to hear about Corbin. I can't imagine how frustrating and heart-breaking it is for you. We're having trouble getting Bella's limp diagnosed and that's frustrating enough. I would be beside myself if she were in such pain as Corbin. :(

    We had to video tape Bella's injury as well because she won't show pain to the vets. Definitely keep a copy available with you every time you see a vet - that is the only reason they took us seriously when looking at Bella.

    I can vouch for the quality of care at Tufts but to be honest, they were our last ditch effort with Bella and we still don't have a diagnosis.

    We're taking her to a rehabilitator on Saturday affiliated with Angell Memorial on Saturday just to see if we can learn massage or some way of giving her comfort until we can figure out what's really going on. I really wish I had something more constructive to offer...

    Oh I feel so bad for you and Corbin. :( We'll hold you in our thoughts and hope that you can get resolution soon.

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  20. Gosh, Corbin is a tough case, isn't he? Poor buddy. How lucky he's got you when so many other people would have just given up. The vet schools are usually a good option -- they sure see a lot more than the average clinic! I hope you'll find the right vet to get this puzzle solved soon.

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  21. Seeing this all together makes me MEGALY GLAD for CORBIN... Not that he hurts... butt that he is with YOU who will move Heaven and Earth to make his life what it SHOULD BE. AND What I am SURE it WILL Be..

    I agree with the others... CD's... butt make MULTIPLE COPIES... so that you have one to keep and OTHERs to Hand out... both AHEAD of an appointment and to TAKE TO any Appointments... beclaws we have all experienced the... WE DON"T HAVE ANY CD... are you sure you sent it to US?? thingy..
    AND I would suggest that you pay CLOSE attention to our BELOVED and WISE and CARING... Mango Momma... she is offering you EXCELLENT ADVICE... and a Face to Face meet and Paw Holding.. if you go that THAT place. SHE is WONDERFUL ... take her up on it.
    Although we are HERE for you... she would be THERE for you.

    PRAYING FOR RELIEF for CORBIN.

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  22. You've been through so much, Corbin. We hope that someone has answers for you. We want you better, buddy!

    Love ya lots,
    Mitch and Molly

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  23. Corbin, you have been through way too much pain. You are such a cool dude and you don't deserve this. I wish that someone somewhere could figure something out!! Mommy thinks it is a great idea that you videotaped it. If you go somewhere else it will help to explain it, in case Corbin isn't having problems that day. I will keep crossing paws for Corbin and hope that relief is in site.

    Loveys Sasha

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  24. Woof! woof! Simply sending your Lots of Golden Thoughts n Prayers. Just toooo much. Golden LVOE to your Corbin. Lots of Golden Woofs, Sugar

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  25. Sorry,no ideas here, just sweet thought for you Corbin and hope that someone figures out the problem soon. You've gone through enough already. Please get better soon!!

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  26. I have nothing to add, but I want you to know that I'm purring for you all. What a horrible time you must be going thru, and not knowing what's wrong :( :(

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  27. Oh Corbin. You being in pain just makes my heart ache. Hopefully the videos your Mom tearfully took will help and perhaps the University vets will be able to figure something out.

    Have pinched nerves been ruled out?

    Hugs and Wags,
    Roo and Mom

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  28. Corbin we are sorry your ouchies are still hanging around. And we cannot offer any advice as we are stumped just like everyone else. One idea that we used with Cleo was chiropractor and accupunture and it helped her back issues and got her head screwed back on the right way. She was so out of whack I could figure out how she could even be standing and walking. Don't know if you have tried that but I would think with all your record keeping and videos someone would take a look at them and could possible offer some advice. We continue to keep you in our thoughts and prayers, paws crossed and drool flinging your way. Sniffs, The HoundDogs

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  29. Oh poor Corbin! Glad he has been pain free for a few days though

    Stop on by for a visit
    Kari
    http://dogisgodinreverse.com/

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  30. Oh Corbin, we are so sorry to hear about your owies. We hope they go away for good.

    Love,
    Teddy Bear & Sierra

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  31. Oh Corbin, that is truly heartbreakin'. Ma wishes she had some kind of answer for ya, butts like everyones else, it sounds like your Momma and your vettie have been on the ball. I thinks that MangoMamma's idea probally would be worth it. Like Frankie said, take lots of CD's so they can have a copy for files and for any docs that want to consult.
    I do think that the HoundDogs had a great idea,too. I have heard lots of good results from accupuncture. You should visit Sunshade's bloggie and facebook page, and contact her Moms.
    http://www.sunshadethesuperdale.com/
    https://www.facebook.com/SunshadeTheSuperdale
    She has lots of experience with alternative treatments for doggies, and even though she's in Vancouver, I think she knows peeps, or could point you in the right direction, to peeps here that could help.
    I'll be keepin' my paws crossed for ya Corbee! Sendin' you and your Moms some AireZens, too...
    Kisses,
    Ruby

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  32. Oh poor Corbin, dealing with something so mysterious must be so difficult. We are praying for you

    urban hounds

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  33. Once, when I was a puppy, I was limping around, whimpering, and wouldn't put weight on my leg. Lots of green papers later (X-rays, blood tests, etc.) the vet couldn't find out a reason. Turns out when Dawn was giving me a bath, a tiny thorn that was somehow stuck between my foot pads, washed out. I was fine that day! The point of the story is, don't rule out any little thing. Who knew my pancreas had stopped producing insulin? Doggies can get the same ouchies as humans. There are so many possibilities. You are doing your best to find the cause of this painful mystery. I pray you will succeed!

    ((((((((Big Hug))))))))

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  34. If you're willing to drive to Tufts, are you willing to drive to Amherst MA? Dr. Kevin Landau www.landauvet.com

    I have Delilah's story on my blog, the vet could never figure out what the issues were, Dr. Landau did. It wasn't exactly like Corbin's because we didn't have all the tests you've had, but she had clean and clear x-rays. He did a chiropractic adjustment, laser treatment and acupuncture on her along with a prescription for Chinese hers, that was almost two years ago. He also called my vet up and told her what he thought. Love that man, don't know where we would be without him.

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  35. I'd go for the Tufts or Cornell option. In my experience with a vet school (Colorado State), they were will to assess a history and any tests (perhaps the videos would fit in this category) without seeing the dog. However, in your case, I suspect that they'd insist on seeing Corbin... to see if they can find anything that your vets haven't yet found.

    I won't hazard any guesses about Corbin but I will say that we had a dog a long time ago who exhibited similar symptoms (including the yelping) and he recovered with the help of the vets at UC - Davis (on par with Tufts or Cornell vets).

    My heart goes out to you. I think that your incredible documentation will help immensely, and they'll eventually figure this out.

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  36. I'm so sorry to hear this, Jenn. Corbin is so lucky to have you; you are such a good momma! And I thought Zoe's medication schedule was a challenge! Wow.

    I know how hard it is to have an animal in pain and not be able to make it go away. I really hope you guys figure out what's going on soon. :( It sounds like you're doing all the right things and you will get to the bottom of this someone. If there's anything I can do (or you just want to talk), I'm here! xo

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