Maryanne's Tobi 4/12 Conservative GRAD: 6/8

Maryanne welcome to Dodgerslist we are glad you found us. Thank you for your service to our country and for giving your two precious doxies a forever home!

Sounds like Tobi is on the right meds as already you are seeing return of neuro functions that were recently diminishing. Turn around can happen fast when there has been quick vet help and good crate rest.

When you can, do fill us in on the med details of how many mgs for each dose and how often you give.

Does the prednisone bottle indicate when the vet wants to try a taper?

During the time on prednisone we follow the vets who are proactive in protecting the stomach from the extra acids prednisone causes.  Just like people get stressed and get ulcers from stomach acids..dogs do too.  So with those two culprits (stress and prednisone) please get the ok from your vet to give 5mg Pepcid AC (famotidine) 2x/day.  Ask your vet in this particular way:  Does my dog have any health issues of heart, kidney or liver that he may not use Pepcid AC?  Pepcid AC has been made over the counter because it is generally safe and good insurance for a dog during an episode.  More detail on Pepcid AC: www.1800petmeds.com/Famotidine-prod11171.html


Are you observing that there are no signs of pain between doses of the pain meds (Tramadol, Gabapentin and Robaxin)? pain is: shivering, trembling, yelping when picked up or moved, reluctant to move much in crate such as shift positions or slow to move, tight tense tummy, can't find a comfortable position, Arched back. Holding leg flamingo style not wanting to bear weight, head held high or nose to the ground. Not their normal perky selves.

Are you letting her out for potty in this way: Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep Tobi's back aligned and butt from tipping over. A harness and 6 foot leash will control speed and keep footsteps to minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on!

Maryanne, I'm concerned that Tobi is needlessly in pain because the pain meds are not yet right. The vet needs to know this am via phone:
--- your observations of pain when eating
--- your red flag observations of stomach issues of not wanting to eat turning head away. Not eating can be pain, can be stomach issues from pred. Assume GI tract needs protection by getting Pepcid AC on board asap this am. Also may need to discuss adding a 2nd protector as for some dogs Pepcid AC alone is not enought. Sucralfate is the 2nd protector.  As always we encourage owners knowing about each med their dog takes.  I keep the Mar Vista Vet page bookmarked for my dog's meds.  You can read more about sucralfate here: www.marvistavet.com/html/pharmacy_center.html

Feeding should be inside of the recovery suite.  You may like to consider a homemade bowl attachment that takes up no space inside the suite


Our supplies list www.dodgerslist.com/literature/cratesupplies/cratetopconvert.pdf has many very good tips including Michelle's. You can adapt your own crate to a top opening one  www.dodgerslist.com/literature/cratesupplies/cratetopconvert.pdf 

Did the vet indicate where he suspicioned the disc episode? Was it the neck?  If yes, these are all the extra things you can do at home to help with a neck disc:  www.dodgerslist.com/literature/cervical.htm

With the details on weight and med mgs and frequency, we'll be better able to give more helpful comments.  Let us know what adjustments the vet makes to ensure Tobi is not suffering with pain.

I'm beat. Have been redoing Tobi's setup. It's 8:45 and I just started cooking dinner. Larger bed, water and food bowl in crates. She can stretch out now. She's been dozing and wagging her tail.

Her meds:
[14.3 lbs]
Tramadol 50mg 1/4 tab.  11pm & lunchtime
Gabapentin 100mg 7am & 7pm ,
Prednisone 5mg, [for ten days]
Robaxin 500mg 1/4 tab.  7am & 7pm

She is very happy with the new set up. More room to stretch out. Oh and I can open the top of the cage. I also have a cage set up downstairs.

Tobi weighs 14.3. Robaxin & Prednisone 7am & 7pm.

Hello Maryanne, my name is Debbie. Crate rest just began for Tobi on 4-12. It is way, way to early for anyone to predict the outcome of Tobi's future health. You need to reread a little on nerves and their re growth and functions: When nerves are initially pressured they can loose function. If the NSAID or a more powerful steroid can turn about the swelling in the spinal cord, then that nerve loss can be temporary and come back in days. HOWEVER, if the swelling continues on too long, the nerve cells will die. Then in order for nerve function to come back the body has to regrow nerves. That can take a long time...think in terms of months.

This important info comes from a page you should read all of www.dodgerslist.com/literature/healingsurgery.htm As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions . When nerve healing begins, often it follows the reverse order.
1. Pain caused by the tearing disc & inflammation in the spinal cord
2. Wobbly walking, legs cross
3. Nails scuffing floor
4. Paws knuckle
5. Legs do not work (paralysis, dog is down). (Sounds like Tobi is here)
6. Bladder control is lost
7. Tail wagging with joy is lost
8. Deep pain sensation, the last neuro function

If Tobi just started the Prednisone on 4-12 then when did your vet tell you to start the taper?
Normally anti inflammatories are given for 7 days and for some dogs up to 30 days.. With NSAIDS or Steroids, as a test they are stopped and the pain meds are stopped as well.. If the dog shows that they are in pain, go back on the anti inflammatory immediately, for a while longer.. If the dog shows no pain, then no further medications are needed, the swelling is gone.. Pain=swelling=more time on anti inflammatory needed. Since all medications carry side effects especially anti inflammtories, it is best to only use them as long as they are needed and go off of them as soon as the swelling/ inflammation is gone.

Crate Rest:  It is imperative to keep the dog quiet 24/7 during the recovey period of 8 whyyhteeks if the dog is recuperating with conservative treatment (crate rest and medical management). One benefit of surgery is physical therapy uocan start soon after. Conservatively treated dogs, however, follow a plan of 8 weeks of quiet and rest to allow the disc to fully heal. Dogs on conservative treatment are limited only to a few minimal footsteps at potty time. Follow your surgeon's or veterinarian's instructions.

The crate actually acts like a cast for the spine. The less movement, the better. Carry her in and out to do potty with only a very few steps taken at potty time. The crate rest is vitally important to allow the disc to heal and form scar tissue. Too much movement and the disc could tear more and you'd be back to square one.

If Tobi can wag her tail and go to the bathroom then she has deep pain sensation, the LAST Neuro function to leave. The odds are fantastic that she will regain the ability to walk. Sounds like your vet does not see that many cases of IVDD and is very unsure of how to treat her.  Please double check everything when it comes to Tobi's treatment. You are Tobi's voice right now so read all you can about IVDD. 

By the way, thank you so much for your service to our great country. It is people like you that defends and keeps our freedom here in the U.S.  

Debbie

Maryanne, please keep us posted on the pred taper. You should not see any increase in neuro diminishment nor any pain surfacing. 

 Pepcid AC really, really needs to be on board to protect the stomach. What is the stumbling block that it is not yet on board?

When we know the details we are better able to understand & support you and Tobi
How many times a day were you giving a 5mg Prednisone dose at the start on 4/12?
How many times a day are you now giving a 5mg Prednisone dose at the start taper on 4/16?

During a taper so that there can be quick id of pain and knowledge to know to get back up on the original anti-inflammatory dose of pred, vets also back off or stop the pain meds.  Are the pain meds being backed off or stopped?  Do you and your vet have a plan "B" since the taper will go through the weekend to avoid an expensive ER visit should pain surface or neuro functions go backwards?  Let  us know what the plan B is.

It takes the disc 8 (eight) weeks to heal with 100% STRICT crate rest 24/7 only out at potty times.  So graduation day would be on June 7.
Canada West Vet Surgeons Dr. Nicholas Sharp, DVM, ACVIM (neurology) explain more:  It is necessary to continue rest for conservative treatment for this long period because a disc takes on average about twice as long as a broken bone to heal, as a disc has a very poor blood supply compared to most other tissues including bone.

Maryanne, the larger crate set up with a pee pad beside the mattress is OK. Make sure the bed it not high in that Tobi will have too much back movement in getting in and out of the bed.

Did you ask about pepcid AC in this simple manner: Does my dog have any health issue he may not take it. If Tobi has no health issues give the Pepcid AC.

We follow the vets who are proactive not waiting to see if there are GI tract problems with prednisone.
North Carolina U. recognizes the high incidence of GI irritation in dogs with disc problems. The reasons are that pain and body changes are stresses. Just as humans can experience ulcers when under stress. NCU and 11+ hospitals working with NCU prescribe a GI protectant. Dogs presented to NCU with IVDD often develop GI upset whether they are given steroid medications or not.
www.cvm.ncsu.edu/vhc/tc/clinical_services/neuro/acute_disc.html

The important part about prednisone is before the taper. The taper is not at the anti-inflammatory dose.  

Did pred start on Monday 4/13 at first vet visit at the anti-inflammtory dose of 5mg 2x/day for ? days then taper.  Tobi is now in the pred taper.  Tobi is in the taper and still on pain-masking pain meds?  How can you effectively watch for pain on a taper when there are pain-masking pain meds on board?  Did you discuss the stop or backing off of  tramadol/robaxin/gabapentin?

Just make sure the only active ingredient is famotidine - 5mg 2x/day. Give it 30 mins before the Prednisone. And give Prednisone with a meal.

Hey Maryanne, If you go home at lunch I would give the Pepcid AC then and I would give her a dose tonight also. The quicker it gets in the system the better. The recommended dose of Pepcid AC is:

The usual dose of Pepcid AC (famotidine) with a disc episode for doxies is 5mgs 2x/day (0.44mg mg per pound every 12 hours.) Know all about your pet's meds, reading IS important: www.1800petmeds.com/Famotidine-prod11171.html

So she does have bladder control? You just have a problem with being away at work and she goes in the crate because of the Prednisone, correct?

During the dark hours of the night the body naturally produces less urine...that may be why she can hold it overnight?

Be careful soup bones or any other of the weight-bearing bones as being too hard and causing tooth breakage. A carrot might just be the thing.

I guess it is just a matter of opinion but my vet told me NO BONES, period! After reading this article I know why he said that, my dogs have been diagnosed with Pancreatitis. I found the articles very interesting, here are the links:

healthypets.mercola.com/sites/healthypets/archive/2010/05/19/caution-bones-can-kill-your-dog-find-out-which-ones-are-safe.aspx

healthypets.mercola.com/sites/healthypets/archive/2012/05/09/bone-supplements-for-pets.aspx

Just remember, we are a site about IVDD and in no way are we vets or claim to be. The articles are not part of the Dodgerslist web-site, they are just what I found while searching the subject for you. Debbie

Maryanne, I know the urge to free Tobi is overwhelming. But out of the crate and into your lap for an hour is not safe at all. It is the limited movement that helps the disc to heal. It is movement that will tear an early healing disc. So 8 full weeks of 100% STRICT crate rest 24/7 means: No laps, no couch, no sleeping in bed with you, no meandering, around during potty times. No baths, no chiro (aka VOM). In other words do everything you can to limit the vertebrae in the back from moving and putting pressure on the bad disc. The crate rest is vitally important to allow the disc to heal and form scar tissue. Too much movement and the disc could tear more and you'd be back to square one. Dogs can always do the unexpected - a doorbell could ring or they could hear something outside. They have to get used to the crate and accept it.  If a retear were to happen then crate rest would have to be restarted again for 8 full weeks. 

Continue to talk to her as long as she is behaving in the crate and reward her for relaxing and if she whines ignore her and walk away, soon she will realize that being mellow in the crate gets rewarded.. Even on crate rest, we continued to include our baby in all we were doing.. If she feels included and not isolated, that keeps the whining down..

www.dodgerslist.com/literature/healingdisc.htm

Maryanne, it might help if you think of the crate as a cast for the spine. You wouldn't take off a cast that is helping to mend a broken bone. The crate is the only surface that is firm, supportive for the spine, not inclining, always horizontal and keeps a dog from darting off at a doorbell and is truly the safest place for them.

Since she's jumping up, try putting a blanket over the top of the crate down to the level of her height when standing. That should discourage her from jumping up as when she does jump up, she wouldn't be able to see anything. More tips on crate training here with tips on how to calm: www.dodgerslist.com/literature/EmergencyCrate%20Training.htm

Possibly a stroller would be a better option for Tobi. They need to be used with caution and restrictions - more here: www.dodgerslist.com/literature/strollers.htm

I haven't read back through all of the postings but if you haven't tried it yet, securely place her crate up on a table near you on the couch or wherever you are during the day so she can be part of it all. Or near a window so she can look out.

You can make a 6' potty area outside with either an ex-pen or push-in-the-ground plastic fencing to restrict her from trying to walk too much during potty time.

It sounds as though the taper from the anti-inflammatory is going well with no sign of pain returning so far. You'll have a much better idea of that when the Tramadol is stopped tonight.