Diana's Bentley 5/14 conservative - UK - GRAD 7/9

I am so sorry that Bentley might be having another disk episode. Assuming it is another disk episode until told otherwise and crating Bentley is the best thing to do.


Outside of using medical imaging, a disk episode is usually diagnosed by the symptoms with reference to the breed. Medical imaging is not necessary unless you are considering another surgery for Bentley. It requires general anesthetic which can be risky for IVDD dogs. With the conservative treatment all disks are treated with the immobility of crate rest and the anti-inflammatory.


Bentley's symptoms are very mild and since you crated him immediately his odds of recovery are high. In fact, the neuro may tell you he doesn't think it is a disk episode.


What medications is Bentley taking now? Please include the dosage and frequency.


Is Bentley showing any signs of pain now? When you take him to potty is he wobbly or knuckling even after he has rested?


You may want to read up on the conservative treatment as Bentley had surgery last time. That and other information is here:

www.dodgerslist.com/literature.htm

The knuckled back paw, was that a new neuro diminishment you just saw or something he has done since surgery?

There are 26 other discs in a dog's back. When born with disc disease, that means any of those discs could have the potential to also prematurely age and have a problem one day.  Some dogs have only one episode while others can have multiple. 

Let us know what your Neuro says.   And what is the name of the pain killer, mgs, and how many times per day do you  give it.

If you see any sign of pain today, you shouldn't wait until Monday to get pain meds for Bentley. You said he's not his usual self and is resigned to the crate rest. Not being his usual perky self is a sign of pain. He may be resigning himself to crate rest as he's reluctant to move which causes pain. Possibly your surgeon or regular vet might have an emergency contact number or you may have an ER facility that can prescribe pain meds. Have no patience with pain as pain hinders healing and Bentley shouldn't be subjected to pain for another day.

Please get your vet's permission to give 5 mg of Pepcid AC (generic is famotidine) 30 minutes before the dose of the anti-inflammatory and thereafter every 12 hours. Phrase the question to your vet in this particular way: "Is there any medical reason my dog may not take Pepcid AC?" If your vet says your dog has no health issues such as liver, heart, etc to keep him from taking Pepcid AC, then do get it on board.

Seeing his back paw knuckle, which is something that you haven't seen in a long time, indicates that there could be some new nerve damage. Be sure to let the surgeon know that you saw this, even if he's no longer doing it.

To answer one of your previous questions, yes, whenever a disc is damaged/torn, it will take a full 8 weeks of strict 100% 24/7 crate rest with limitation of movement of the spine to heal the disc and allow it time to form scar tissue. The crate rest is stricter while on conservative care than it is post-op. STRICT means:
- no laps - no couches
- no baths - no sleeping with you
- no chiro therapy - no dragging or meandering at potty times.
Carry to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog's back aligned and butt from tipping over. A harness and 6 foot leash is to 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! www.dodgerslist.com/literature/slingwalk.jpg

Healing prayers for Bentley.

Metacam is a NSAID, which is an anti-inflammatory. It works on getting down the swelling that's pressing on the nerves of the spine. It's that swelling pressing on the nerves that causes the pain. But it can take 7-30 days for that swelling to resolve so meanwhile pain meds are needed to mask the pain. Usually we see Tramadol, Gabapentin and/or Methocarbamol prescribed as pain meds.

Are you seeing any signs of pain today, such as shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, nose held to the ground, head held up high, tight hard tummy, arched back, not usual perky self?

We've spoken to Bentley's surgeon so thought I'd update you.

She said for now no need to bring him in (as it's around a three hour drive) due to his condition greatly improving since Saturday. Even if we took him in now, as she would only physically examine him, she said whether she could see any neurological changes or not, she would still prescribe the conservative treatment for the time being.
She said to keep him on the metacam (she also said this acts as a painkiller? Like ibuprofen for dogs so I am a little confused whether this is or isn't giving him pain relief) until the bottle is finished and to keep him restricted as we are for a month. 

If anything changes then we will take him in immediately. Therefore we are none the wiser as to what's really going on and he's totally back to his usual self, but we are keeping him rested for the time being.

Thanks so much again for your support, knowing dodgerslist is there is such a great comfort... I shall keep you posted on Bentley's condition.

Thank you so much Marjorie, you are so kind

There are some few disc episodes that are not painful. Once on pain meds and an anti-inflammatory that could take up to 30+days to get painful swelling down, then of course you would expect that all pain is in control and a dog might roll on their back because they are out of pain.

The diagnosis of a mild disc episode is a challenge and is basically the knowledge of the dog having the disease IVDD, the way the dog acts at the visit, and what the vet can determine through the hands on neuro exam. Any worsening neuro function would be a clear indicator of nerve damage rather than having eaten something or over exercised muscle pain.

You mentioned Bently is improving. Can you give us specific information on what you see "improving"... less knuckling, feeling more his perky self, etc.

If this is suspicioned as a disc episode then the prudent thing is to allow the disc to heal. Disc healing can only happen with limited movement of the back and the time it takes for the disc to heal.  With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. That 6 weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form.

Try a calmer to help Bently to be able to relax in his recovery suite

Using any oral calmer in combination with a Pheromone diffuser seems to work best.  It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives such as Acepromazine, Trazodone, etc. Of course always keep your vet in the loop on all things you give your dog. Other product brands may be available in your area or on-line… just shop by the active ingredient(s) on the label and the quantity for best price.

Place a DAP pheromone diffuser at floor level where the recovery suite is. Some brands to consider:
--Comfort Zone (DAP) wall plug-in diffuser 48ml www.drsfostersmith.com/product/prod_display.cfm?pcatid=13043
--Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/

Use a diffuser with one oral calmer from below:
1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed www.virbacvet.com/products/detail/anxitane-l-theanine-chewable-tablets/behavioral-health
2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine.
www.vetriscience.com/composure-soft-dogs-MD-LD.php

Be aware you might be inadvertently training for unwanted behavior.  To dogs rewards are: food, looking at them, talking to them, eye contact, approaching the crate, petting.  So anytime you see unwanted behavior ignore it, turn your back, leave the room if you have to. Preferable is to start teaching what you do want before there is too much practice in doing the unwanted behavior. Anytime your dog is sitting or lying down quietly, give a reward.  Soon your dog will see they get rewards for four feet on the floor, quietly sitting, etc.

From our supplies list www.dodgerslist.com/literature/cratesupplies.htm :
Tamara's homemade lowering of crate roof to prevent standing on hind legs: Cut a cardboard box to the length and width of the crate. Punch holes around the cardboard edges. Use string or plastic ties to attach the cardboard inside the crate at a height that only allows standing up, but not room to jump up or stand on hind legs.

Option 2 to keep dog from jumping in crate. Drape blanket to head height of standing dog, so he can't see if he jumps or stands on hind legs.

Diana, when you can please update the med list. Otherwise we are bit in the dark and makes it hard to comment.

13 lbs
Metacam as of 5/14: 5kg dose 1x/day for ? days
Name of pain killer  ?mgs  ?x/day

-- For how many more days has the vet prescribed to stay on Metacam?
-- What is the stumbling block to getting Pepcid AC (famotidine) or other stomach protector on board?
-- Does the right rear paw still knuckle?

With this disc episode there was some nerve damage evidenced by the knuckling you saw on the right rear paw.  What you describe of him trying to get at something bothering that leg sounds like maybe it could be neuropathic pain.

Everyone has experienced numbness or pins and needles tingling in your legs when sitting in a bad position for too long a time.  Bently can be feeling abnormal nerve sensations that are mild pins and needles to quite painful burning, on-fire feeling that makes them bite to stop the pain. These are abnormal nerve signals. 

You would need to stay on top of observing for any increased attention to that leg, such as nibbling, to chewing.  Immediately put a e-collar on or a lengthwise folded towel and secured closed with duct tape. Get to a vet for a medicine that can help to control these very painful sensations.  The name of the pain med is called gabapentin.  Gabapentin addresses nerve pain.  More about neuropathic pain.  www.dodgerslist.com/literature/neuropathy.pdf

Hello, a quick update on our Bentley!

We took him to see his neuro today. She said his neurological function was all absolutely fine and showed no signs of pain or discomfort when examining his back and stomach. He was totally fine!

We are obviously continuing the crate rest until 9th July. He will continue metacam for one more week and tramadol only if he show any signs of pain. Fingers crossed he'll continue to be OK whilst on his rest.

Thank you again for being there and helping with your advice and words. We'll keep you posted!

Hello everyone,

Bentley has been doing well on his crate rest but I'm now wondering if this episode is possibly a UTI, or maybe a UTI as a by product of a disc episode.

I noticed a couple of days ago he went to squat a couple of times, but he didn't pee. I thought it might have been just because he didn't need to go, he can be stubborn so it wouldn't have been a surprise! Just now he went for his last potty before bed and right at the end I think he made a little grunt.

He is still sometimes quickly turning around as if something is irritating him, which I thought may have been his rear right leg/back and I have noticed him occasionally licking near the genital area.

I will call the vet first thing in the morning but thought there might be some kind dodgerslist members that have had some experience with a UTI, I know it must be hard to recognise symptoms and every dog is different!

Thank you so very much!

Hi Pauliana, thanks so much for your response!

I'm wondering now if it's been a UTI all along, so hopefully when we see the vet in an hour we'll get some clarity on the situation. He urinated no problem this morning, but when I tried taking him a couple of hours ago, he had no interest and just wanted to come back inside.

I'll let you know! Thanks so much

I'm glad to hear there's no UTI, Diana. Is he urinating now when you take him out for potty?

As for the anal glands, I've never had a problem with them for my Jeremy so I'm not too familiar with them. It's my understanding, though, that they can become painful if they're impacted. In fact, I've seen dogs with pain from an IVDD episode whose vet thought they had full anal glands. You can express them yourself though I wouldn't try to do that while Bentley's on conservative care. There are how-to videos online but you may want to get a demonstration from your vet.

His glands may still be a bit irritated from being expressed. Do hold off on doing anything about that while on conservative care. As I mentioned, I'm not familiar with anal glands as my Jeremy has never had a problem with them. From what I know, if there is no problem with the glands, then no need to do anything. If they're bothersome, itchy or smelly, then they would need to be expressed by you or the vet.

Do continue to keep an eye on his attention to his behind area to be sure it doesn't progress to excessive licking or biting and do let the vet know ASAP if that occurs as Paula mentioned.