Debbie & Roxy
New Member
1/18 conservative; relapsed 2/22
Posts: 9 
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Post by Debbie & Roxy on Mar 18, 2015 20:17:28 GMT -7
Hello! I love this site. Thank you to everyone that takes the time and effort to make this the great resource that it is! I learned so much over the last few months from everybody. I will give you an idea regarding her current situation and then give history. I feel she should be better and not still have the yelping episodes. I don't think she is ready to come off crate rest. Everything I have read says 8 weeks but she isn't ready to come out. Now what?  . Are there other dogs that have to stay longer than 8 weeks She is not 100% better. I don't know what else to do. I feel like she should start to taper her meds but she relapses. Help! CURRENT - Strict crate rest (I take her out every other night and allow her to lay on the a soft, folded blanket while I gently massage her back, neck and legs. She LOVES this. Her eyes roll back in her head!) - It has been a little over 8 weeks. Still has a few episodes of yelping. Not every day but some days are better than others. - Carried to and from the potty area. - 19 lbs. - No X-rays, diagnosed via examination. MEDICATIONS 19 lbs 1. 5 mg prednisone @ 2x a day 2. 5 mg Pepcid @ 2x a day 3. 100 mg gabapentin @ 3x a day 4. 50 mg tramadol @ 3x a day 5. 5 mg diazepam @ 3x a day HISTORY My 5 yr old female beagle has been down since 1/18. She was down back in October for a few weeks and "recovered" so quickly that we regretfully didn't stick with the full 8 weeks of strict crate rest. We only did 2-3.  She was great for almost 2 months. Then when she went down again on 1/18 it was bad. The yelping was awful! She was in so much pain. My husband took her to the vet on 1/21 and the vet prescribed gabapentin, tramadol and diazepam. No prednisone. I waited to take her to the vet because I didn't know any better. I honestly thought if she felt better she would do too much and keep hurting herself. She got better once she started her meds but was still in so much pain! She would claw to get out of her cage when meds kicked in and then cry in pain when wore off. I asked my husband why the vet didn't prescribe prednisone and he said he didn't know. I called the vet and she said they don't do that for dogs that might have surgery. Well, surgery was out of the question because it is too much money right now. She said she was a more recent grad from vet school and steroids were not recommended treatment these days especially for dogs that might have surgery due to excessive bleeding. I said, surgery is not in the stars so she gave it to her. Gabapentin was every 12 hrs, diazepam and tramadol were every 8 hours. We go back and forth with a different vet (same practice) over the next 6 weeks. Roxy is better, then relapses. We increase her pred, she gets better and we cut it back. Then she is miserable again. Several times we were told they might not be able to do any more for her and the only option may be to euthanize. Lots of tears over this and thankfully our vet loved Roxy too and said she wanted to keep trying. The vet would adjust her meds and Roxy would have some relief but eventually relapse. I have only slept in my bed a handful of times since this happened because I want to be there if she cries in addition to giving her the middle of the night meds. We live near Chicago and it was bitter cold for several weeks. I thought the cold was aggravating her issue because she would feel great before a meal. She would wag her tail and bark. She would eat and we would take her potty. Then when she came in from the cold and yelp like crazy. We started warming a towel in the dryer on the really cold (-25 windchill) days to warm her up. She is slowly getting better but like I said, it has been 8 weeks. She never lost mobility. Never had an accident in the house . There were two days (not in a row) she would not want to move for 24 hours! There was only one time where she didnt want to eat her dinner. This really scared us because there were many times where she would eat her meals even if it meant yelping the entire time. We soaked her kibble in warm water to soften it. We were so worried because she wouldn't even get up to go to the bathroom or drink water on the 2 days previously mentioned. She would feel well enough to eat because the timing of her meds had her feeling well at meal times. I knew she was thirsty so I would dribble water by her mouth with my hand and she eventually licked it off my fingers. She always took her medicine wrapped in a tiny piece of bread even if it meant only laying on her side and yelping while swallowing.
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Post by Pauliana on Mar 18, 2015 21:12:21 GMT -7
Welcome to Dodgerslist, Debbie! First thing to know is that it IS in the cards for your dog to get back to enjoying life whether immediately walking or waiting on more nerve repair - IVDD is not a death sentence. Find out why that is true: www.dodgerslist.com/index/SDUNCANquality.htmIs the vet a general DVM or a specialist (ACVIM neurology or ACVS ortho)? You are right, she shouldn't come off crate rest until she is off all meds. First thing to do is to discuss with the vet that her pain med dosages are not right for her. She is showing pain in between doses and also continuing signs of pain such as yelping, reluctance to move, yelping when eating etc. When the pain med dosages are right, dogs are pain free from dose to dose. Pain slows down healing and her pain has never been under control from dose to dose since this episode started on January 18th. Discuss with her vet all the pain you are seeing and get an adjustment to her pain medications. Advocate for Roxy strongly as the captain of her health care team and her voice. Think of it this way. You hired her Vet and that makes you the boss. : ) dodgerslist.com/literature/healingpain.htmOnce her pain is under control that would free you to sleep in your own bed. You can't function in life without a good night sleep.. STRICT crate rest means No laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no chiro (aka VOM)? If there is pain or neuro diminishment, dogs can benefit greatly with acupuncture or laser light therapy. These therapies can be be started right away to help relieve pain and to also to kick start energy production in nerve cells to sprout. So if this therapy is in your budget, seek out a holistic vet. ahvma.org/Widgets/FindVet.html Chiropractic is not recommended for IVDD dogs. With this disease self education is critical not just so you make sure the right things are being done for the best recovery but for your own emotions. The goal of our Forum is to support you, to teach you how to look up things at the original source point (a credible and authoritative resource), question everything and read so you become the most important part of your dog's health care team. Good place to start your self education: www.dodgerslist.com/healingindex.htmLet us know about the changes to Roxy's medications after you speak with her vet. Healing thoughts and prayers! |
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Debbie & Roxy
New Member
1/18 conservative; relapsed 2/22
Posts: 9
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Post by Debbie & Roxy on Mar 19, 2015 4:26:50 GMT -7
Thank you so much! Our vet is a regular DVM. Roxy also saw a neurologist at VCA and that person also said surgery was her only option. Do you think she should be on methocarbamol instead of diazepam? I asked our DVM and age said she didn't really prescribe that because she is already on gabapentin.
Do you think her doses are correct? We are told she is at the maximum dose.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 19, 2015 5:18:01 GMT -7
We've seen Diazepam prescribed for muscle spasms, but mostly we see Methocarbamol prescribed. Methocarbamol works well on the pain caused by muscle spasms and can most certainly be prescribed along with Tramadol and Gabapentin. Since there is still pain, a switch to Methocarbamol should be considered as it may be the Diazepam that isn't working well on the muscle spasm pain.
Pain should be under control within one hour after giving if the combo of meds is correct. If the Methocarbamol doesn't get the pain completely under control, speak to the vet about giving the Tramadol dose every 6 hours.
Can you give us a better idea of what tapers of the Prednisone have been tried? When was the last taper and when did she once again start the full dosage of 5 mg 2x/day? When is the next taper called for?
Has anything been said about this being a neck injury? You mentioned that she had pain upon swallowing. Neck injuries can be much more painful than back injuries and can take longer to heal. If this is a neck injury, please take a look at this page for tips on how to help the neck heal, such as softening hard kibble and raising food/water dishes:
www.dodgerslist.com/literature/cervical.htm
Be very, very strict about crate rest. Think of the crate as a cast for the spine. No more taking her out of the crate for massages. There should be no massage of any type, no pressing on the neck or back. Use a 6' harness and leash at potty time and stand in one place to limit the steps she takes. Or use an ex-pen outside or make a 6' potty area with plastic push-in-the-ground fencing to limit her steps. She should only take a very few steps at potty time.
Does she lie quietly in her crate or is she active - barking - pushing at her blankets with her nose - moving around a lot? If she's too active in the crate, please take a look at this page on tips for calming a dog during crate rest - www.dodgerslist.com/literature/EmergencyCrate%20Training.htm No toys in the crate for her to chew on or shake. She needs to rest with limited movement, just getting up occasionally to turn around in her crate and lie down again.
At some point during the last 8 weeks, she may have re-injured the damaged disc, at which time the 8 weeks would have had to be started again. It's hard to tell since we haven't been following closely along. But if her pain has never been fully under control, that hinders healing, too. At this point, your main goal is to get her pain fully under control and continue with strict crate rest. At some point, if she still cannot taper off of the Pred without pain returning, it may be determined that she will have to remain on a low dose of the Pred. But certainly euthanasia is not to be considered!
Please let us know what the vet says after speaking to her today. Healing prayers for Roxy.
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Debbie & Roxy
New Member
1/18 conservative; relapsed 2/22
Posts: 9
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Post by Debbie & Roxy on Mar 19, 2015 21:39:13 GMT -7
Thank you, Marjorie for the info! I apologize for not responding sooner. I was at work and then running errands. I just finished gathering my info on the meds. 
Our vet did prescribe the methocarbamol 187.5 mg 3x a day. Yay! She said she can stay on diazepam, too. Thoughts?
I have thought that it is a neck injury but the vet didn't say. She did tell me that she didn't want to maneuver her too much because she was in excruciating pain when she examined her. We hold her food/water bowls up while she eats and drinks. Sometimes she cries when we give her a pill and she extends her head. I will read up in that.
I am reluctant to put a harness on her because she gets so excited when she sees her leash and harness. Last week she saw us putting a harness on our older dog, Betty, to take her to the vet. Roxy was so excited that she ended up hurting herself because she spent the evening stiff and yelping a little. I tried to calm her down and pet her while my husband took our other dog out. Lesson learned: hide the leash and harness and out it on where Roxy can't see it.
I promise, no more massages for Rox.
When she feels good she does NOT lie quietly. She barks and barks and barks. Sometimes we sit next to the cage and pet her thru the wire but as soon as she walks away she barks again. I will definitely review the tips on calming her down. She is just a happy, spastic dog. We wrap her meds in pieces of bread. When she sees it coming she stands up and sticks out her neck like a giraffe and we can't move fast enough to prevent it.
I agree with you. I do think she hurt herself again. Probably around 2/22. Even my 16 yr old son said she is too active when she feels good. I asked the vet several times about giving her Benadryl to make her sleep. She didn't want to because of all the meds she is on. Today she said the methocarbamol may make her sedate. I said, "Good! I hope it knocks her out!"
I wasn't very good initially about keeping track of when we decreased or increased her meds. I had to go back through text messages and emails to friends to piece together the first few weeks. I just didn't expect that it would go on so long.
1/22/2015 5mg prednisone 2x a day
1/27/2015 start taper to 5 mg 1x a day, major mistake
1/30/2015 bring to vet; increased 5 mg pred back to 2x a day
2/9/2015 decrease pred to 2.5 mg 2x a day
2/9 - 2/21 doing pretty good
2/22 starting to go downhill with yelping again
2/24 increase pred to 5 mg 2x a day
2/24 -2/25 absolutely miserable; worst she has been; didn't finish her breakfast and this is first time ever; wouldn't get up to to go to the bathroom for almost 24 hours
2/25 went potty @ 10:40pm. At 11:30 pm she was in SEVERE pain
2/27 increased pred to 7.5 mg 2x a day
3/2 better but still in pain; increased gabapentin to 3x a day
3/11/2015 decreased pred back down to 5mg 2x a day
3/19 added methocarbamol 187.5 mg 3x a day (750 mg pill cut into quarters)
She was in a lot of pain tonight. I came home from work at 6:00 pm and she was scratching desperately to get out of her cage. It was like she was having a panic attack. I took her outside and she pooped right away. Wasted no time sniffing. I brought her back inside and she helped off and on for several hours. Thankfully she is resting quietly right now but I am afraid she hurt herself trying to get out. My husband just let her out an hour prior and she pooped then. He didn't know she was freaking out because he was upstairs in the bedroom and she is in the family room.
Thank you so much for the advice, time and prayers! ! It means the world to me.
PS - sorry for the long post!
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 20, 2015 6:04:50 GMT -7
Hi, Debbie. Good job on getting the Methocarbamol in place. Giving that along with the Diazepam may indeed sedate Roxy. Keep an eye out for over-sedation and let the vet know if she's too lethargic. Hopefully, the two meds will calm her down. It's very important that Roxy stay calm in the crate. Barking and moving too much will prevent her damaged disc from healing or cause even more damage. If the two muscle relaxers or any of the suggestions in the link I gave you don't help to calm her down, I would strongly advocate for a mild sedative.
From what you wrote above, it does appear that Roxy re-injured the disc on 2/22 so I have noted that in the subject line of the thread. Unfortunately, the 8 weeks of strict crate rest will have to start again from 2/22.
Roxy's pain should be completely under control within one hour of giving the new mix of meds. There should be no sign of pain from one dose of the meds to the next. If there are signs of pain, you'll need to once again let the vet know so the meds can be adjusted.
If you're reluctant to use a harness on Roxy, then it would be a good idea to use an ex-pen in the yard or make a 6' potty area with push-in-the-ground plastic fencing to limit her walking around during potty time or from running off.
Please let us know how Roxy is today and if her pain is now under control.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,606
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Post by PaulaM on Mar 20, 2015 13:23:00 GMT -7
Debbie, often diazepam does not work the intended way for some dogs it wires them up. So I would see about advocating for a different type of relaxer. All that barking and scratching to get out if this is a neck disc explains well why the pain is not being controlled... too much movement can retear the early healing disc cause pain again as it tears. Just to confirm what Marjorie pointed out: the meds are not yet right until you see in one hour of dosing the pain is in control and stays that way dose to dose. 19 lbs prednisone - as of 2/24 5mg 2x/day for 3 days - as of 2/27 7.5mgs 2x/day for 12 days - as of 3/11 5 mgs 2x/day as of today now 10 daysgabapentin 100 mg 3x a day tramadol 50 mg 3x a day diazepam 5 mg 3x a day to continue methocarbamol 750 mg tab: 187.5 mg 3x a day. Pepcid 5 mg @ 2x a day Here is information to advocate for with your vet, a relaxer Trazadone that may well do a better job of relaxing Roxy in her recovery suite than diazepam so that neck disc or any disc has a better chance at healing. www.cvm.ncsu.edu/conted/documents/Gruen_VetMedForum_May2012.pdfDo you see her holding either front leg or back leg flamingo style, not wanting to bear weight on a leg? |
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Debbie & Roxy
New Member
1/18 conservative; relapsed 2/22
Posts: 9
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Post by Debbie & Roxy on Mar 20, 2015 13:57:14 GMT -7
Thank you, Marjorie! Our vet is very sweet and loves my dogs. She is just super cautious.
Rox was very "chill" today. She was scratching this morning at 6:00 am while we were getting her food. I pet her while my husband gets her food ready. It seems to keep her calm and she doesn't jump. I told him I think feeding is going to be a 2 person job. One to keep her calm and the other to get the food. Unfortunately, there will not always be 2 people at meal time.
It was great because last night she was alert and watching us but very calm. Yes - that's exactly what happens. She barks and scratches to get out. She has to rearrange her blanket to just the right spot. Unfortunately she doesn't understand to just settle down. This definitely seems to be the biggest problem here. I have read the advice on calming them down and will implement changes starting today. She seems to be calmer with the methocarbamol but I don't know how long this will last. If this doesn't work - what kind of sedative do you think she can have with all of her other meds?
We will restart the clock from 2/22. She is definitely not ready to come out.
I have not been home all day but I know she was feeling good this morning as of 11:00 am.
One of the problems we have is our schedules don't always allow somebody to be home when she needs her medicine. I am thinking about paying my neighbor to come and give her the medicine at the proper times.
We put up a chicken wire fence off the patio a few days ago because I felt she was wandering around too much. We had a lot of snow so we formed a natural barrier and she couldn't wander far. She was sniffing all over the yard when the snow melted. It is larger than 6' so we will make it smaller. I wondered how much room she should have. Being a beagle - she can't get enough of the yummy smells and will sniff her way to trouble. I am all for the smaller space!!
Hi Paula! Thanks for the response. Do you think I should wait to see how she does on this methocarbamol before requesting a relaxer? I stated many times that she was too hyper but a relaxer was never brought up. She was reluctant to add it.
She does not hold her legs flamingo style. When she is in pain she is usually leaning against the side of the cage for support but both feet are down. Is the flamingo style a sign of neuro issues?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,606
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Post by PaulaM on Mar 20, 2015 15:17:41 GMT -7
Debbie that is a wonderful idea to enlist a neighbor for some of the daytime dosing. A chart will be of great help in ensuring who gave what. Here is a sample idea you can set up for Roxy's meds: www.dodgerslist.com/literature/crateRRP/medchart.pdfMethocarbamol relaxes muscle. Trazadone works in a different way to take the edge off so Roxy can relax in her crate. We are seeing more use of Trazadone on this Forum by vets with good reported results. If Roxy can't relax she is not going to be able to heal her disc. If the disc doesn't heal, it has the potential to cause severe damage to the spinal cord. The worse being permanent loss of legs. All of life is the weighing of risk vs. benefit. Do you own reading on the risks/benefits of Trazadone. And call the vet today. Just was trying to see if there was possible nerve root signature pain involved as those can be tough types of pain: www.dodgerslist.com/neurocorner2/rootsignature.htm |
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Debbie & Roxy
New Member
1/18 conservative; relapsed 2/22
Posts: 9
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Post by Debbie & Roxy on Mar 21, 2015 16:55:19 GMT -7
Thank you, Paula! Ugh. She was doing soooo well yesterday but was a train wreck from about 5:00 - 6:00 pm tonight. too much barking and clawing. I tried to do some of the training techniques from the crate rest page earlier this afternoon when she was barking. In hindsight now was not the time to try and train her because it just really made her upset. So she barked more and I think she may have hurt herself. She is resting in her cage quietly. She has always been a "I do what I want" girl. From drinking my coffee to getting on the kitchen table (right in front of your face) just to see what is up there. She is a typical very naughty beagle which does not serve her well. Our older beagle is not like that at all. We have tried to train her. She is a good candidate for the dog whisperer. She is lucky she is very cute. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,606
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Post by PaulaM on Mar 21, 2015 17:15:43 GMT -7
Did you get a phone call in to the vet to discuss Trazadone? She has to be calm in the recovery suite in order for the disc to heal.
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Debbie & Roxy
New Member
1/18 conservative; relapsed 2/22
Posts: 9
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Post by Debbie & Roxy on Mar 21, 2015 17:25:11 GMT -7
I didn't but definitely will Monday. I hoped she would calm down with the methocarbamol.
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. Are there other dogs that have to stay longer than 8 weeks She is not 100% better. I don't know what else to do. I feel like she should start to taper her meds but she relapses. Help! 
