Wanda's Porschia 9/18 Conservative - B. Terrier GRAD 11/13

Wanda, welcome to Dodgerslist! So glad you’ve joined us all. We’ve got valuable information we’ve gleaned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you!

I understand what you and Porschia are going through since I went through it with my Shih Tzu Tyler.. He was diagnosed in 2013.. He had surgery when he woke up paralyzed and recovered walking.  He has had several milder episodes since and has been treated with crate rest and medications in other words conservative treatment. He has recovered each and every time..  Here on Dodgerslist many, many member dogs go on to recover walking with Conservative treatment..Some do need surgery to heal..  This article explains how to decide which treatment is the best for your dog.   dodgerslist.com/literature/healingsurgery.htm#surgeryVSconservative

It's too soon to think about a wheel cart, she needs time to heal..  Has anyone spoken to you about crate rest? That is how the disc heals, lack of movement.. Sort of like a broken arm heals in a cast to protect the healing bone..  It sounds to me the disc hasn't been given the rest it needs to heal.  Too much movement can disrupt the scar tissue forming over the early healing disc..and lead to more pain and more damage to the spinal cord..Lots to learn about IVDD and how to have many happy years in the future with Porschia..

STRICT rest means:

◼︎ no laps ◼︎ no couches

◼︎ no baths ◼︎ no sleeping with you

◼︎ no chiro therapy "whys" -- www.dodgerslist.com/literature/chiropractic.htm

◼︎ no dragging or meandering at potty times.

1) CONSERVATIVE: The hallmark component of conservative treatment is the crate rest part. With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. Those 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 back movement to allow good strong disc scar tissue to form. PT waits til graduation day. LASER or ACUPUNCTURE for severe neuro damage is best at home via a mobile vet. Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment during conservative treatment.

Disc disease is not a death sentence!

Struggling with quality of life questions?

Re-think things: www.dodgerslist.com/index/more.htm

Super tried and true tips for setting up the recovery suite:

www.dodgerslist.com/literature/CrateRRP.htm

It will help us work together with you and avoid offering ideas that could cause harm or lead the discussion in the wrong direction delaying help for your dog — please share the details with us:

✦1 Is there still currently pain?

☐ shivering, trembling ☐ Arched back
☐ yelping when picked up or moved ☐ can’t find a comfortable position
☐ reluctant or slow to move much in crate such as shift positions
☐ tight tense tummy
☐ Holding front or back leg flamingo style not wanting to bear weight
☐ Nose to the ground or head held high, uses eyes only to look
☐ Not their normal perky selves?

Full pain relief is expected in 1 hour and stays that way dose to dose, round the clock. If not in control your vet needs to know asap to adjust meds.

How much does your dog weigh?

Prednisone....what was the start date & dose?
What was the date Dex was started?
Date of Dexmethasone taper?

C. Please include the all important stomach protector such as Pepcid AC (famotidine) when taking any anti-inflammatory med (steroid or NSAID). We follow vets who are proactive against not eating, vomit, diarrhea, bleeding ulcers by giving doxie weight dogs 5mg Pepcid (famotidine) 30 minutes before the anti-inflammatory.

canigivemydog.com/wp-content/uploads/2011/10/can-i-give-my-dog-pepcid-ac-300x300.jpg

✦3 GI track damage?

—Eating and drinking OK? No nausea/not eating, no vomit?

—Poops OK? Normal firmness & color -no dark black blood of bleeding ulcers nor bright red blood ? No diarrhea?
-- Is the vet a general DVM or a specialist surgeon (ACVIM neurology or ACVS ortho)?

✦6 What was the date you saw the vet for conservative treatment for this episode?? 

✦7 Tell us about current neuro functions:

A. Can Porschia move the legs at all? or wag her tail when you specifically do some happy talk?


If there is no bladder control, you would be expressing every 2-3 hours depending on which meds he is on. Do not hesitate to express in the vet’s clinic and have the vet tech check your work, give you additional pointers. It may take a weeks worth of expressing to reach “pro level.” Doesn’t hurt to re-review the tips and video on expressing to keep your dog dry session to expressing session: www.dodgerslist.com/literature/Expressing.htm Express for poop, not the health issue urine is but to prevent anxiety of your dog finding poop where he sleeps.

The very best thing you can do for YOU, the caregiver, and for your Porschia is to get up to speed on IVDD soonest possible. Begin absorbing the must-have overall sense of meds, care and how the treatment works.

➤ PRINT OUT the yellow button pictured below on CONSERVATIVE treatment and tape to your fridge as a road map for the next 8 weeks: www.dodgerslist.com/literature/healingpage.htm

image.ibb.co/dBfFbo/conserv_button5.jpg

➤Follow all the other colored buttons in the next days to become the IVDD savvy pet parent you dog will need. All Things IVDD: www.dodgerslist.com/healingindex.htm

➤ Use the “search box” to easily locate topics over at our Main www.dodgerslist.com website:

www.dodgerslist.com/index/searchBOX.jpg

Healing thoughts and prayers for you and Porschia..We'll help you learn to care for her as she heals!

Please contact the vet ASAP this morning and advise of the signs of pain that you're still seeing so the pain meds can be adjusted. Tramadol can be added as a general pain med and Gabapentin can be added for nerve pain. Have no patience with pain as it does hinder healing and there's just no reason for it as the vet has other options. There should be no sign of pain arising from one dose of pain meds to the next.

Also speak to the vet this morning about getting Pepcid AC on board. Ask if Proschia has any health issues that would prevent her from taking Pepcid AC and if not, start her on it ASAP. Dexamethasone is a very powerful anti-inflammatory and side effects are GI distress - vomiting, diarrhea, ulcers, bleeding. So it's very important to get a stomach protector on board. How much does Porschia weight? We usually see 5 mg of Pepcid AC given 30 mins before the Dexamethasone and then every 12 hours thereafter for as long as she's on Dex. Please check with the vet on dosage.

Please fill in the following med list:

Weight: ?? lbs.
Prednisone 5mg 2x/day started date?? for 7 days - stopped
Dexamethasone .5 mg 2x/day started date??
for how many days then taper to test for pain/neuro loss
Pepcid AC ?? mg 2x/day started??

It may seem that Porschia is emptying her bladder on her own but if she cannot hold it until she's carried outside, then she may have lost bladder control and the bladder is just over flowing due to reflex. The only way to tell is to do a sniff and pee test. Carry her outside, put her near a spot where she or another dog has peed, support her hind end but not under her belly, let her sniff and see if she can release urine on her own. If she can, then do take her out every 2-3 hours to pee as Dex can cause increased thirst and therefore she would need to urinate more often. Finding wet bedding or leaking when lifted indicates loss of bladder control.

If she has lost bladder control, she will need to have her bladder manually expressed by you. Urine lying in the bladder for too long can lead to urinary tract infections and/or the bladder can stretch out of shape. You would need to get a hands-on-your-hands demonstration on how to express the bladder from your vet. Here's our page on expressing for your review prior to your lesson from the vet: www.dodgerslist.com/literature/Expressing.htm

To prevent Porschia from dragging her legs during potty time, you'll need to use a sling to support her hind end. Carry her to the potty spot, use a 6' leash to prevent her from trying to take more than a few steps to potty, support her hind end with a sling and then carry her back to her crate.

www.dodgerslist.com/literature/slingwalk.jpg

Physical therapy, such as swaying her hind end from side to side, needs to wait until the full 8 weeks of strict crate rest are finished. Once Porschia is off of all meds, we will let you know of some gentle massage that you can do but nothing right now. There is still swelling pressing on the nerves of the spine which is causing the pain and the less movement of the spine, the better.

Good for you that you're checking on renting a laser to do at home to prevent the risky transport to the vet. If that doesn't work out for you, possibly you can find a vet who will make home visits to do the laser treatments.

We're here for you and Porschia and will help you through this.  Healing prayers for Porschia.

Wanda, thanks for the further information on the two anti-inflammatory drugs. The time that she is on the "anti-inflammatory" level are the important days. The taper days do not work on swelling. The taper has an important function for a disc episode as it lets you and the vet know if another course is needed.


The full details on how Dex, an anti-inflammatory works with a disc episode. Good reading to be in the know about Porchia's treatment, to ask pertinent questions and understand what the vet is thinking.:
www.dodgerslist.com/literature/healingsweling.htm

QUESTION: for how many days is dex to remain at 0.5mgs 2x/day?  Day one of the dex taper is for you to monitor for pain any increased neuro diminishment and if there is alert your vet asap and expect another course, another test for pain/neuro issues.

Let us know that only Porchia is in the recovery suite...alone.  Your Chi can keep her company by lying adjacent to the suite but not inside of it.

I sounds as though Porchia may still have bladder control if she will hold her urine til outside and then squat to release.  It is a tough one to know for sure since she has not had good bladder control since you got her.
--- why was metronadazole Rx'd--- for a bladder infection?
--- signs of bladder loss typically are:  1) leaks on you when lifted  )finding urine leaks in bedding.
--- Not expressing a dog who does not have bladder control to fully empty their bladder will in days develop a urinary tract infection (UTI).  Discuss with your vet DOES Porchia have bladder control? OR Do you need to do an express check after urine is released by reflex to make sure the bladder is pretty empty?

Let us know you NOW understand the importance of crate rest and know to just say "no thanks" to anyone who  may be giving you well intentioned but very harmful advice.
STRICT crate rest means:
◼︎no laps   ◼︎no couches
◼︎no baths ◼︎no sleeping with you
◼︎no chiro therapy "whys": __ www.dodgerslist.com/literature/chiropractic.htm
◼︎no dragging  at potty times.
◼︎no PT for conservative dogs during 8 weeks to heal disc
◼︎laser or acupuncture for severe neuro damage is best at home via a mobile vet. Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment.

Best to provide water access inside the recovery suite. Here is a DIY idea with containers you may already have in your kitchen.
www.dodgerslist.com/literature/cratesupplies/bowlHLDR.jpg

Pepcid AC will help protect Porschia from GI tract damage. Dex, like all anti-inflammatories cause excess stomach acid so the sooner you start the Pepcid AC the better.

Are there any signs of pain now? I am listing the signs of pain again here for your easy reference; 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. If there a signs of pain let the vet know right away.

I think that she does not yet have full bladder control. This is common as dogs recover. Sometimes she can wait until outside and sometimes not. It might be a good idea to express check after she pees to be sure her bladder is empty. This might cut down on accidents.

Does Porschia wiggle her little butt when she is happy as she has no tail? I have seen some dogs do that. If she does, watch for that instead of tail wagging.
Porschia is really cute with that little dot in the middle of her head

Unscented baby wipes are good and I'd also use some decaffeinated green tea to help clean Porschia.

It helps keep the urine from burning the skin and causing diaper rash.

Also has a nice fresh scent.

If you see a rash starting you can also apply Aquaphor baby healing ointment with petroleum.

Not the kind with zinc. That's toxic to dogs.

August 23rd the vet did hot laser on Aug 31st she wanted to do another hot laser and I said I want xrays. So on the 31st of August just xrays were done. No MRI and no blood has been taken. The vet said suspicious are L6 L7 T 16, T17 suspect trauma probably at some point in her life. The prednisone was until complete however her first vet said there was nothing else she could do. So I decided to see my Holistic vet who is a licensed Vet who does the holistic side now. She changed Porschia medication which is the Dexamethasone .5 mg 1 tab x2 daily and Methocarbamol 750 mg 1/4 tablet 3 times a day. There has not been a day set to discontinue this medication yet. She started these two on Sept 7th plus the cold laser therapy (started on the 10th) and a Homeopathic Remedy she get one squirt 10 times a day. ✚IVDD homeopathic. 

[Moderator's note: please do not modify
20 lbs
no crate rest RX'd by vet 1 nor holistic vet !!!
prednisone  as of 8/23?? : 5mgs 2x/day for 3 days, then 8/26 taper
dex as of 9/7: 0.5mgs 2x/day for ? days, then taper to test for pain/neuro
methocarbamol 750 tab: 187.5mgs 2x/day
walking around at vet disc relapsed 9/12
Crate rest as of 9/18
✚IVDD homeopathic 1 squirt 10x/day
Pepcid AC 5mgs  2x/day]

Yes Paula both paws are knuckling. Her hind legs look like a flamingo crossed and if I touch they both go in the air, She doesn't stand with one up and one down, just crossed and under her. I have to catch her so she doesn't go over head first.  Porschia gets carried outside and when I sit her to the ground her hind legs cross and down she goes. I try to hold her back legs up in her standing position so she doesn't pee all over herself. This part just started this past weekend. The peeing all the time.

I started her today on 5 mg Pepcid every 12 hours 30 minutes before food and her evening medication. She will now get Pepcid every 12 hours until off the medication Now last week the 10th of Sept when Porschia had her first laser double treatment, then the 12th her second laser treatment she walked out of the office. Both feet on the ground visiting other dogs. Over the weekend laying in her wire kennel she couldn't walk again.  So she went down hill from Wednesday [9/12] of last week until 18th. I think the laser should be spaced out more so it isn't so far in between. That is my personal opinion. I will be glad when she is off the steroids  maybe then she wouldn't pee  every 30 minutes like a royal flood. She does have access to water at all times because I know the steroids make her thirsty.  I have printed out two cold lasers I found on the internet and when Porschia goes in tomorrow at 10 am and stays until 1 pm(makes a long day and she is tired) I am going to talk to the vet and ask if I should buy a cold laser and show her the two I have found or could she show me how to use them and me do it at home and bring it back to her whenever she wants to do the laser. I know it is to much on Porschia and I want to keep her calm and in a crate for the 8 weeks to give her back and muscles which the doctor said her muscles in her back are very tight time to relax and heal. I am fighting for Porschia I am her voice. I have to protect her and take care of her.  Porschia is in her recovery kennel alone. Everyone else is sitting and looking at her. she lays down and sleeps

Wanda, the correlation of getting worse seems to be associated with not doing 100% STRICT rest rather than laser causing her to walk. Nerves can heal on their own without aid of Laser.  Focus on the STRICT rest rather than laser visits.

Neither vet prescribed STRICT Rest at the get go on 8/23 vet visit and recent 9/12 walking around at the vet and sniffing other dogs was WAY too much movement for the early healing disc. Not doing 100% STRICT crate rest until 9/18 also may have contributed to a re-tear in the early still weak healing disc.  The relapse caused further damage to the disc. The disc in turn pushes more on the spinal cord.


The SINGLE most important care you can give Porchia is for her to remain in her recovery suite. Vet transports kept to only the most beneficial must have-to-do transports.  The body can heal nerves on their own, in time. Laser may NOT be the most beneficial thing to be doing IF it requires a transport.

Poor Porchia has not been receiving the ultimate in conservative principals and her disc has suffered. She still has great potential to heal her disc and with time heal nerves BUT only if it is YOU who understands that STRICT rest is a must. Not all vets understand this principal.That is why we owners have to be up to speed on IVDD to protect our furry friends from well-meaning but harmful advice.

What is the exact name of the "IVDD homeopathic" liquid. Is she still taking it?  
      As with any substance consumed (from food to pills), there is the potential for risk. Just because something is “natural” or a "herb" doesn’t mean it is automatically harmless.
      Chinese Herbs are composed of many herbs in one bottle, meaning you will need to Google each one to familiarize yourself on what your dog is taking.  There can be possible negative reactions between prescription meds and Chinese herbs.
         Very experienced holistic vets will be hesitant to prescribe Chinese herbs when conventional medication are already in use. The reason is there is no asurity there would not be any interactions with the other medications that could make your dog sick or worse.

Dex is one of the steroids that does not cause as much thirst as prednisone.  So it doesn't make sense that all of a sudden she is brain-directed peeing every 30 mins or is it reflex-overflowing release of urine without control flooding every 30 mins????  
-- Has she lost some degree of bladder control??
-- That is, have more nerve cells died and now the need for YOU to express her bladder?

I believe you need good vet help now. 
--- to determine if there is still bladder control OR if you need a hands-on-top-of-your-hands type of  expressing lesson.  www.dodgerslist.com/literature/Expressing.htm 
--- dogs who are not expressed will in days develop a UTI as bacteria begin to breed in the urine the dog can no longer fully void out.  A urinalysis will proove if an antibotic to kill bacteria is needed.

An overflowing bladder where urine is released by reflex is a bad thing
1)   Reflexes can't push out all the urine..what remains breeds bacteria!
2)   A bladder overflows when over stretched to the fill point where reflex kicks in to release some urine. All that overstretching of bladder muscles can ruin them so that the bladder will not ever work correctly when brain control comes back.
    From what you write we simply are not able to figure out if there is bladder control or not. YOU NEED good IVDD knowledgable VET HELP.

The use of Dex is merely a matter of guessing. No one wants a dog on Dex any bit longer than receiving the benefit as this steroid is notorious for its adverse side effects! Therefore all vets MUST MAKE A GUESS.  That guess is the number of days a dog will stay on the anti-inflammatory level.  The guess might be a 5-7 day course or maybe a 14-day course. After the course is finished a test for pain and new neuro issues begins..the dose/frequency of dex is tapered.
    The dex taper is for YOU to monitor for pain/neuro and report back to your vet by phone. Meds can be adjusted by phone IF, IF you were to see pain surface, neuro diminishment by prescribing another dex course.

If you are seeing signs of pain, then of course it would not be time to taper dex to see if there is pain. 
If you are seeing signs of pain, then that means her current pain meds are under medicated and need prompt adjusting.
--Methocarbamol (for muscle contraction pain)  would be at the proper dose in mgs for  every 8 hours
-- Tramadol (as the general analgesic)  would be added for every 8 hours
-- gabapentin (for nerve pain) would be added for every 8 hours

Again, you need to find a vet who is IVDD knowledgeable to get things straighening out. A new vew at a new clinic would require a risky transport. That risk may be worth the benefit of getting things straightened out. 

Preferable is to work with your current holistic vet so as to keep transports at the minimum for only the most important/beneficial of visits, taking care of those things like med adjustments which so very often can be done by phone.





 

today the vet said to keep going with all medication. She is on Dex  still I will not taper because she still needs it. The methocarbamol 750 tab: 187.5mgs 3x/day plus Pepcid 5mg  every 12 hours. She is relaxing in her crate very nicely. Pain well today she did have a laser and the vet said she is still very tense. I said I will call you Monday and let you know how she is however I want to keep her home and let her rest. Only taking her out to pee and poop. Medication is still going and I am hanging in there. She is still not walking but we will just let her rest and take each day as it comes. Surgery would be an option if I thought it would help her. However two vets [DVMs or specialists?]have told me that while on steroids no surgery can be done [] and if she can't walk it is past the time []. That she isn't a good candidate for it. []. The only thing Porschia has had is an xray and nobody seems to be able to really say for 100 percent what she has. NO blood and no MRI has been done.

This process is the strangest. Porschia was walking when all this started in Aug. She just drug her legs when she peed and pooped. So after the two vets now Porschia's back legs have gone from walking to not at all. She can hold her front legs up but nothing else. I bring her water even though it is in her crate.  Is this normal during the healing process or any process to loose  total control of your hind legs? Aug 23rd she walked into the first vet. Sept 7th she half walked and now nothing. I really don't understand and it just saddens me.

Today after reading what Paula wrote Porschia is now having an image done with dye to see what kind of damage she has in Gainesville At Bluepearl. She has a 50/50 change of healing. Last week would have been better before she went totally limp however now we have to hope for the best for her. He tested her feet to see if she felt anything and there was no movement, The doctor took in in the back to do other test and came in to talk to us. While we were sitting there he showed us she has no feeling in her back legs and that laser is not helping her now. Then we touched under her foot and she lifted her back foot up. So how can she not have any feeling yet you touch underneath and she feels it? All of her records were copied and sent to the vet in Gainesville Florida at the Specialty clinic. After they look at her images we will get a phone call of what they found and proceed with her surgery. Her in the hospital time is 1-3 days. 50/50 is better than none at all. Say a prayer for all of us.

Yes he is board specialist certified. Also Porschia was laying on her side asleep while we were talking. She was very relaxed and we touched her foot just below on her pad, left foot then right foot and she lifted her foot just slightly. The vet was not in there when it happened.  So I am waiting to hear from the specialist how her contrast test went and since she is under if she is getting her surgery. I will keep you posted. Then my work really begins.

Paula the test they were doing with the dye they couldn't get the needle in her spine. She was under for two hours. Two specialists tried. Ok it is six am Sept 21st and we are on our way to Gainesville to pick up Porschia and take her to Tampa a bigger facility to do a different 3D xray to locate the problem, so as of yet no surgery. No charge for yesterday except the over night stay. The doctor didn't feel it right to charge when they couldn't complete their mission. I couldn't sleep so we are off now. It will be 1 1/2 hours to Gainesville, then 2 hours to Tampa and then 2 hours back home. Should make for a long day. Say many prayers for Porschia. So yes it was reflex. She can't feel anything, so time is a hurry to help her if possible.

Thank you everyone for your prayers. When we got to the Bluepearl this morning Sept 21 we had some bad news, her 50/50 went down to less than 10 percent. They tried 25 times for the SX-Myelogram to put dye in her spine to see what was going on. That was never completed. She was under for over 2 1/2 hours. So the Hemilaminectomy was not performed either. They were referring us to University of Florida but the odds were still less than 10 % for her. We were given all info and I was shown how to help her with her bladder, how to hold her in a sling that was provided to me, ween her off the Dex and the Methocarbamol and pepcid. 1xday for 7 days Dex, 3xday Methocarbamol and 2x day 5 mg of Pepcid.

[Moderator's note: please do not modify
20 lbs
no crate rest RX'd by vet 1 nor holistic vet !!!
prednisone as of 8/23?? : 5mgs 2x/day for 3 days, then 8/26 taper
dex as of 9/7: 0.5mgs 2x/day for 15 days, then 9/21 taper to test for pain/neuro
methocarbamol 750 tab: 187.5mgs 2x/day
walking around at vet disc relapsed 9/12
Crate rest as of 9/18
✚ undivulged  IVDD homeopathic remedy  1 squirt 10x/day
Pepcid AC 5mgs  2x/day]

I was given a list to do range of motion and riding bicycle even though she has no DPS now probably since Sunday. Life deals us bad cards sometimes so we have to do something to pick things up. I am going to start Porschia's bucket list, riding in a cart behind my Mama's three wheel bike, eating a piece of steak, I know Ice Cream isn't good but she will go to DQ and have a few licks after she heals from the procedure. So now to go and do a bladder relief. Thank you for all your prayers. So now I will let her rest and only take her out of pee and poop but there is no healing this baby. I believe in Miracles and I desperately need one now

She is still on her medication you have listed.

[Moderator's note: please do not modify
20 lbs
no crate rest RX'd by vet 1 nor holistic vet !!!
prednisone as of 8/23?? : 5mgs 2x/day for 3 days, then 8/26 taper
dex as of 9/7: 0.5mgs 2x/day for 15 days, then 9/21 was to taper
       as of 11/14: 0.5mgs 2x/day continues  for undetermined days!!!!
methocarbamol 750 tab: 187.5mgs ▲3x/day is this correct?
walking around at vet disc relapsed 9/12
Crate rest as of 9/18
IVDD homeopathic 1 squirt 10x/day has this stopped? if not what is the exact names?
Pepcid AC 5mgs 2x/day]

She will stay home with us and I will help her bladder and let her poop with the sling I have, use unscented wipes and Crate rest until Nov 14th and let her nerves heal. Please Dear God heal my baby. Once I know she isn't in any pain then I will slowly decrease her medication. ▲Methocarbamol is 750 tab cut into 4th and given 3 x day Pepcid 5 mg 2x day,
Dex is .5 mg 2x day and decrease when ready to test for pain. Complete bed rest and homeopathic 1 squirt 10x the Holistic vet never would tell me what was in it. No name just IVDD medicine. I asked and she said it is a homeopathic remedy, Paula you have so much knowledge may I ask are you a vet because you sure have the knowledge of one. Thank you so complete bed rest in her crate by herself and only out to pee. so is a diaper ok for her? I wipe her and dry her and then put a diaper on her. Is that ok?