Susi's Hans 6/5 conservative

Hi Paula,
Hans is back on crate rest and pred as of last night. The vet prescribed

[20lbs]
Prednisone [as of 6/5] 5 mg twice a day for two days, once a day for two days then one a day a day apart.
[1 50 mg of trazodone]


The only signs of pain that I've seen were once when I slipped my hand under his bottom to pick him up, that was earlier in the week, then the two times when I touched him near his shoulders happened a couple of days later. Both times I gave him pain meds. Other than those times I didn't see much difference until yesterday when I noticed that his walking had changed, and he seemed "depressed", he wasn't his playful self. That's when I called and got him into the vet. I'm not sure about the small burst of prednisone, but she said that he is still walking and is not knuckling or dragging his legs that this might be enough. We'll see.
So, to so recap his meds, he will take two 5 mg of prednisone today and tomorrow, one a day Monday and Tuesday, then one on Thursday, and one more on Saturday. He did have one last night too. I gave him 1 50 mg of trazodone this morning and one vetridisc. He's sleeping comfortably right now.
I hope I've given you enough info so that you know what's happening now. If you need to know anything else I know that you'll let me know.
Susi
PS: This week there have been some incidents that may have caused this...

Hi Paula,
I haven't been checking in like I usually do, so I am just reading your post right now.

I had forgotten the famotidine, I'd better go get some!

Hans started the taper down to every other day yesterday (he didn't have any prednisone at all), and today I am again seeing a marked regression in his walking. He's been walking wobbly since this new crate rest started, but it seemed to be getting better when he was on the 2 preds a day. Tonight he's walking very stiffly, and he is definitely reluctant to walk. When we went out tonight, he went potty, and just sat down. I had the other dogs out and as soon as I called for them to come, Hans got up and headed straight to the door. That's a big sign there, he never wants to come inside!
As usual, I am having a hard time telling whether he's having pain or not. He's not yelping at all, but he's panting a lot (I know, that could be side effect of pred), but the stiffness and reluctance to walk are signs, right? Anyway, I've called the vet, and left a message for her to call me, to see if maybe we need to back to 2 a day for a while and see how he does like we did the last time.Luckily, she prescribed 30 tablets so I have plenty on hand.

So, you want to know the reasons why this may have happened? To be br truthful, it was probably a combination of too much activity and rough housing. I don't remember the day, but I got the pool out to get him in to start some water therapy; there was not too much activity there at all, since he didn't want to move at all in the water. Finally I took him out and dried him off, but I failed to think about making sure his little feet were dry, and when he got inside, he started running around like crazy like doxies do after a bath. He slipped and fell all sprawled out several times before I could catch him to hold him in my lap and dry him off more. He didn't cry out or yelp at all, so I just assumed that he was okay, although I was worried that he could have re-injured himself. Another thing that might have caused a re-injury is that twice my girl Ghia jumped on him, knocking him down; which of course started a fight between the two. He did yelp those times, and after I got Ghia away from him, he'd be trembling a lot, but not crying. Both times I gave him pain meds. The only other thing that I can think of is that we took a walk that was a bit too much for him. Any or all of these things could have contributed to him being sore, and possibly re-injuring the bad discs.

The vet (not his regular vet, but one who has seen him previously) just called me back, she wants me to give him 2 a day for 4 days this time, then start the taper again. She said that I should go ahead and start up the pain meds again. Back to square one, sigh....but better for Hansie, I know.

I'm off to the store to get some Pepcid AC now, so he doesn't get a sick tummy on top of everything else! I'll keep you posted on his progress the next couple of days.

Susi, so we can follow along with his meds, please check we have a correct understanding of " she wants me to give him 2 a day for 4 days this time" ..that was for pred right?

What are the pain meds, the dose, the frequency?

What about Pepcid AC are you giving 5mgs 2x/day and giving Pred with a meal?

Hans Med list
[20lbs]
Prednisone as of 6/5: 5 mg 2x/day for two days; as of 6/11 5mgs 2x/day for four days
trazodone 50 mg 

Susi, I did not see that you had listed Pepcid AC, did you accidently forget to write it down? If you are not giving it then you need to get this on board immediately. Any time you give an anti-inflammatory there needs to be a proper stomach medication on board. Let us know if you are not giving it and we can send you information on how to ask your vet nicely for this medication.

Susi it would best to not go back an edit any previous posts with information as it is very confusing for us.

Please let us know if this is now the correct med list for Hans.

20lbs
Prednisone as of 6/5: 5 mg 2x/day for two days;  as of 6/11: 5 mgs 2x/day for four days then taper
Trazodone: 50 mg, 3x/day
Pepcid AC: 5 mg 2x/day
Tramadol: 25mgs only if hurting
Gabapentin: 1 100 mg capsule only if hurting
Methocarbomol: 125mgs  only if hurting

The time to back off of pain meds is when the test taper of prednisone starts.   Waiting to give pain meds when you see pain is too late.... the ugly head of pain has risen and it takes longer to get pain back under control.

The test taper of prednisone is then scheduled to begin on June 15. At that time pain meds would also be backed off or stopped to have a clear assessment about pain.

Hi Susi,

Give the pain meds as directed until the taper starts.  The test taper of prednisone is  scheduled to begin on June 15. At that time pain meds would also be backed off or stopped to have a clear assessment about pain.


When the taper starts that's the time to back off the pain meds, so you would have a true test of whether the swelling is gone or not. If you see pain (shivering, yelping, reluctance to move, slow to move, not his perky self) that means the swelling is not gone and you should contact the Vet and ask to go back to the anti inflammatory twice a day dose of the Prednisone..Have a plan in place with the vet should that happen to avoid an expensive ER visit. Below that twice a day dose it is no longer anti inflammatory. If you see no signs of pain, continue the taper until it ends and then afterwards no further medications are necessary, just the continuation of the remainder of the 8 weeks of crate rest.  

Susi, I agree with the comment Pauli made about pain. Trembling IS pain. A disc episode is a painful thing. So one would expect to give pain meds for a painful disc episode.. The pain meds would be stopped when the vet believes all the painful swelling might be gone.

A test taper is called for when the vet want to confirm if the swelling is gone. Then at that time, the pain meds will be stopped or backed off as the pred dose is being tapered (lowered).

The hope is on the pred taper and the stop of pain meds one would not see any pain. No pain means the swelling has been resolved.

Pain showing on the taper and stop of pain meds, lets the vet know there is still more work for pred to do. So pain meds would be back on board and pred would be back in use for a bit longer.

Yes, just as Pauli mentioned, on the taper of pred the pain meds should be stopped. You and your vet need a clear picture of what is going regarding painful spinal cord swelling during a pred taper.

Let us know as the day proceeds that there is no more trembling. How many times a day are you giving the 25mgs of tramadol?

20lbs
Prednisone as of 6/5: 5 mg 2x/day for two days; as of 6/11: 5 mgs 2x/day for four days then taper
Trazodone: 50 mg, 3x/day
Pepcid AC: 5 mg 2x/day
Tramadol: 25mgs ?x/day 
Gabapentin: 1 100 mg capsule ?x/day 
Methocarbomol: 125mgs ?x/day 

I gave give the pain meds yesterday like you said. I think I told you that I gave him 1/2 tramadol and 1/2 trazodone with the 1/4 methocarbomol, and gabapentin. I also gave him the prednisone and the Pepcid AC as well as the vetridisc.
Today I gave him a whole tramadol and 1/2 a trazodone with the rest, because he was panting heavily all night long, I thought that maybe he was hurting, that's why I gave the whole (50 mg) of tramadol. He seemed fine this morning (other than the panting) when I took him out to potty which was before I fed him and gave him his meds.
When I took the other dogs out a couple of hours later, he just slept thru us opening the door and going out; when he usually lifts up his head if he's resting and wants to go out to. So I let him sleep about 1/2 more. When I went to get him to take him out, I discovered that he had peed in his crate. He hasn't done that in months! I took him out and he didn't pee, I guess because he already had. BUT, he's walking worse now than he has been the past few days. Again I don't know if it was because he was so dopey from the medicine, or he's getting worse; but I am really worried now. When he was taking just the trazodone, he was much more alert and was walking "better" than this morning. This afternoon I am going to give him a trazadone only, and see if there is any change in how he walks. This can't be because of the taper, since that is only starting today. Something is not right here. Maybe I did the wrong thing in giving him the whole tramadol with the rest of his meds, but I've done it before and there was never a reaction like this.
I've called the vets office, and left a message for her to call me so I can fill her in with what has been going on, and see what she says. He has an appointment for Thursday evening, then she can see for herself how he's doing. I am so worried that he's got more nerve damage this time than before. I am going to tell her that i haven't seen the typical signs of pain, other than the trembly hind legs since he started the prednisone; that I' only seen that he is walking worse and worse, even though he's been on crate rest and taking the prednisone. Like I said, something is not right. I'm hoping that all of this that has happened this morning is because he was too dopey from the meds.

I just noticed that you don't have the amounts of gabapentin and methocarbomol I've been giving him.

Gabapentin 100 mg 2x a day (every 12 hours)
Methocarbomol 125 mg 3x a day

The rest you have correct already.

Spoke to vet last night, the taper was stopped, at least until she sees him tomorrow evening.

Hi everyone,
The vet put Hans on a
twice a day prednisone regimen for 7 days, yesterday he started the taper down to one a day. She has him taking the same pain meds as always,
1/2 of a 50 mg tab of tramadol,
1 100 mg gabapentin, and
1/4 tab of methacarbomol (125 mg) 2-3x a day, I've been giving it to him 2x a day, once in the morning, once in the late afternoon. I'm still giving him
trazodone, but only 1/2 a 50 mg tab in the morning, and at 2pm, then a whole one at bedtime.

You asked if his pain seems to be controlled between doses of pain meds; I guess it is, I still am not seeing any signs that he's hurting, only the trembly hind legs.
I'm extremely concerned about his behavior though. He had a doxie "melt down" earlier this week. I finally bought him a real orthopedic crate pad, and I had it double wrapped in garbage bags, covered it with a fleece blanket, then a pee pad, then another fleece blanket. The mat fits the crate nice and snug, so I am able to tuck the blankets underneath it. But on Monday morning he was so agitated that even after taking his pain meds and trazodone, he would not sleep; and he scratched and bit up all of those blankets and tore up the pee pads and even tore holes in the bags covering the mattress. He was standing up in the crate and circling around and whining, barking, howling... I gave him a bully braid to chew on thinking that would help burn up some of that energy, and he had that gone in less than 45 minutes, and he still wasn't going to sleep. You could see in his eyes that he was higher than a kite! When he finally collapsed from pure exhaustion, he only slept for about an hour, maybe two; then started up with the circling and biting at the blankets etc. he even growled at me. I was in tears and I think if he were human he'd have been in tears as well. He was like that for almost 24 hours. It was the worst I have ever seen him.
I called the vet about it, and she said that it's probably the prednisone that was causing the extreme behavior. She gave me two options to try, one is to take him out of the crate and if he stays quiet and rests better out of it, then let him stay out. So that's what I did, and believe me, he has calmed down so so much, and is now getting real rest. He's not walking around, he pretty much lies on a blanket on the floor. I still carry him out to go potty and limit his movement, and carry him back in. I can tell that he's starting to feel better because he's wanting to get get up and walk around, so tomorrow I'm going to try her other suggestion of putting up the expen, making it just a tad bigger in area than the crate and put him in there. Hopefully he won't feel quite as confined and will be able to handle it.
Dachshund World Charities is holding an auction right now to help me get some other kind of treatment for him such as cold laser and maybe some water therapy later.
That's all for now.
Susi

Hi y'all, I can't believe it's been just over a month since I've written to update you on Hans.
Because he was having such a difficult time I took him out of his crate before his taper finished; he was walking ok and wasn't showing signs of pain, so I just kept a close eye on him.
He finished the president taper on July 16, and has been doing well since then. His mood is slowly but surely going back to normal, but he's still fairly aggressive with the other dogs.
He went to his 1st physical therapy (rehabilitation?) session last Thursday and it went very well. The therapist gave me several things to do with I'm here at home, and has recommending a diet for him so he can start getting some of that extra weight off. I haven't been able to all of the exercises yet,as I still have some things I need to buy. He did do 10 minute of swimming today, which is a good start. We've started the diet too. I'm having some problems doing some of them, just because I'm Mom I think. He did really well getting his back massage from Jeff, but was not so cooperative with me. He's being a stinker!
Anyway, I wanted all of you to know that he's doing good now, and that we haven't forgotten you!
Lots of love from all of Ed, especially Hansie!
PS: i finally got harnesses for all of the dogs. They're the HugaDog brand.

Yes he's definitely going! I have a video that I'd like you to see. I know that you've given me the address many times, but I don't remember it for the life of me! I think you will enjoy it!

Yay! Hansie's a graduate again!