Diana's Sam 1/26/2018 conservative - NECK

Hi Diana,

I wanted to chime in because this is exactly what happened to my girl Clover.  When we went down to one 5mg  of prednisone per day, Clover also started to have short painful episodes that would stop within an hour of administering pain meds. Her whole body would shake, tremble, and would tighten up.  Unfortunately, these episodes continued to happen for a week on and off.  When I took Clover to the vet, they stated that she had a relapse.  I had to go back to the anti-inflammatory dose of two 5mg of pred per day and start my 8 weeks of crate rest over.

I was so disappointed...like you, I was worried about how long Clover had been on prednisone and I wanted her to graduate so badly.  These darn neck discs just take so long to heal and I was so eager for Clover to get better.  I thought the episodes were just small breakthru pain and part of healing but have learned that the inflammation was back and that the prednisone taper was over and it was time for the big guns again! Prednisone to be reinstated 2x/ day along with methocarbamol and gabapentin every 8 hours.

I hope Sam and Clover can get better this round.  It's so sad to see them in pain. 

Michelle

It seems the vet thinks that poor Sam has had a relapse. Am I correct in saying that? Unfortunately, this does sometimes happen.

Is the gabapentin and roboxin taking care of his pain? Just for your easy reference the signs of pain we look for are;- 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, restless, can't find a comfortable position. Ears pinned back, arched back. Holding front or back leg flamingo style not wanting to bear weight, head held high or nose to the ground. Not their normal perky selves.
If you are still seeing signs of pain, let the vet know right away so the pain meds can be adjusted.

A 3 day washout between the metacam and the pred is shorter than the 4-7 day washouts we usually see. Speak to your vet about using another stomach protector, Sucralfate, besides the Pepcid AC to double protect his stomach. Sucralfate gel coats like a bandaid any disruption to the stomach lining and starts the healing process while the Pepcid reduces stomach acid.

As Michelle mentioned, the 8 weeks of crate rest must restart from the point of the relapse.  I know this is difficult to hear when you were almost finished. But it is the best way to heal the disk and prevent further damage. 

Healing thoughts for Sam.

Diana, the reason vets usually switch to the most powerful of the anti-inflammatory classes, a steroid is due to neuro loss.    You are reporting pain only.  Does Sam show neuro loss:  drag his nails, knuckle front or back paws under?

With the stop of metacam, Sam has nothing to be working on the a painful swollen spinal cord.  Discuss with the vet about resuming Metacam tomorrow and your doing 100% STRICT rest 24/7 for the full 8 weeks, only out for a very, very few footsteps at potty time that you had not been doing. STRICT crate at first hint of a disc episode is to keep the disc from further damage and potential for severe damage to the spinal cord.

With no anti-inflammatory on board, is his pain fully in control dose to dose all day and nite long?  If not in addition to finding out about continuing on with Metacam so there is no need of a washout advocate for a more aggressive pain approach, three meds each working on a different kind of pain and Rx'd for every 8 hours (Tramaold, Gabapentin to go with the Robaxin every 8 hours.

How many times a day are you giving Gabapentin 50 mgs?
Are you continuing with Pepcid AC 5mgs 2x/day?

Since the Sept disc episode likely had that disc enough time to heal, then what you are seeing and the end of January could be the same disc or another disc.  During the 8 weeks it takes a disc to heal, if too much movement is alllowed, then the early healing disc is likely to have a relapse, a disruption of the formation of disc scar tissue.

Where does the vet believe this current disc episode is in the neck or the back?
If it is a neck disc again, these are the extra things you can do at home:  www.dodgerslist.com/literature/cervical.htm

Unfortunately some dogs, like Sam and my Nala, are prone to repeated episodes.

Surgery can help an acute disc episode but other discs can still rupture at a later date.

One thing I've noticed is that when I'm very strict with crate rest it seems to help with having fewer episodes.

Also, I went over my house with a fine tooth comb and tried to IVDD proof any potential hazards.

Keeping Sam at a healthy weight and regular walks (when not on crate rest) is good.

IVDD is a lifelong condition unfortunately.

God bless.

Happy New Year! I would like to apologize for not posting Sam’s status. I have been dealing with my own health issues. Sam is doingwonderful, no pain, walking, only thing that did not come back is his tail, which he can not wag. Thank you to all of you for your support, without it, Sam would not be where he is today.

Graduated Mar 2018