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Post by Wendy & Tripp on Mar 16, 2019 18:41:42 GMT -7
My name is Wendy and my pups name is Tripp. Tripp’s history: Tripp is a 10 year old Chihuahua who currently weighs 10.6 lbs. He had a previous C3 disc injury that was resolved through surgery 5 years ago. He made a full recovery and has had absolutely no problems in the last 5 years.
Sunday, March 10th... We returned from vacation and picked the pups up from our regular Boarding facility. Tripp was fine in the car, but when got home I immediately noticed something was wrong. He was walking slow, holding his head down, arching his back, and scrunching his shoulders. I immediately crated him and planned to call the vet in the morning. 2 hours later he was up in the crate acting completely nomal with normal posture. I let him out thinking he just pulled a muscle or something. He was fine all day. Crated him at night like usual. In the morning he was back to exhibiting pain and arching his back. Within an hour the episode had passed again, and he was back to normal. Brought him in to the vet where he seemed to be in a little pain from the car ride. He was showing signs of guarding his neck and was slow to flip his feet over on the right side. Both the front and the back foot. He was put on Prednisolone (5mg tablet once a day) and Gabapentin (0.5 mls every 8 hours.. 250mg/5ml solution). And crate rest.
[Moderator's Note. Please do not edit 10.6 lbs prednisolone as of 3/11: 5mgs 1x/day for 5 days, then a test for pain taper gabapentin 250mg/5mL: 0.5mL 3x/day methocarbamol 125mgs 3x/day no Pepcid AC on board with pred]
So far this week he has been doing pretty good. The majority of the day he seems completley fine. No pain. No neuro signs. Eating and drinking normally. ( I have a camera amd monitor him from work). But then once a day he has a pain episode. I think I have it figured out. It always happens within 30 mins of us getting home in the evening. He gets excited to see us and is moving around a lot in his pen. On Friday, March 15th I called the vet to discuss these events and not tappering down the prednisolone this weekend as planned. She added Methlycarbone(spelling?) a muscle relaxer for every 8 hours (1/4 pill) and said if still in pain to continue current meds.
Here are my concerns. I have thoroughly read all recommendations on the site and completley understand the importance of strict crate rest. The problem... me and my husband commute to work, so we are gone 10-11 hours a day. We have no one that can take him on potty breaks. I currently have him in a small pen with a small puppy pad down and his elevated food and water bowl. I think this is giving him too much room to get excited in when we get home. So my new plan is to stop on my way home and decrease his pen to just allow enough room for him in his bed and maybe adding a blanket over top to discourage standing up on his hind legs. Just for when we all get home at night. Any other suggestions to keep him calm? Even when his pain meds lapse he does not seem to be in pain at other times throughout the day. I think its just the excitement in the evening. We have 2 small children, and although I do my best to try to keep it calm when we get home... its like herding cats. I could also use some encourgement. His last disc episode was very tramatic. I’m terrified of surgery becoming our only option again. He was so much worse last time... no neuro problems, but in extreme pain. We were never able to get his pain under control. He would scream all night. It was horrific. Im really hoping since he seems completely fine except the one episode a day that crate rest will work this time. How long does it usually take to see results from the steroids? And no... he is not on a stomach protector. I do plan on asking the vet on Monday if there are any reasons why he shouldnt be on one.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Mar 16, 2019 21:12:40 GMT -7
Wendy, welcome to Dodgerslist. Sounds like you have been reading and absorbing info about disc episodes. Good for you!! Let us know when you have the Pepcid Ac on board: dose in mgs and that you are giving it 2x/day Let us know if we have the correct understanding about pred: prednisolone as of 3/11: 5mgs 1x/day for ? days, then a test for pain taper -- Pred started on 3/11?l -- The original dose was 5mgs once a day? What is the taper dose in mgs/frequency? -- What is the new date the taper will start? It is possible to bring Tripp to work where he could stay under your desk or in the work room? Or possible to see about modifying work schedule so one of you leaves later or earlier leaving less time when Tripp is alone. While on pred dogs will need to drink more and pee more. Check these two links for ideas that might fit your circumstance. - www.dodgerslist.com/literature/CrateRRP.htm - www.dodgerslist.com/literature/cratesupplies.htmBest is a mattress that is no high. You don't want Tripp having to take a hop up or down off the mattress to get to the pee pad. Limit the pee pad space to a small an area as possible.Keeping neck/back movement to the minimal is the goal in the disc being able to heal.When the meds are correct and movement is very, very minimal there should be no pain surfacing dose to dose, round the clock.
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Post by Wendy & Tripp on Mar 16, 2019 22:03:09 GMT -7
Yes.. Pred was started on 3/11 at 1 5mg tablet a day for 5 days. Then taper to 1/2 a tablet a day for 5 days. Then 1/2 a tab every other day. She did not mention when the new taper would start. Am I correct in holding off the taper today since he was still having pain? He had an episode before it was time for his pred dose, so I didnt think I should taper. [Moderator's Note. Please do not edit 10.6 lbs prednisolone as of 3/11: 5mgs 1x/day for 5+? days due to pain on 3/15; 3/18 phone consult with vet gabapentin 250mg/5mL: 25mgs (0.5mL) 3x/day methocarbamol 125mgs 3x/day no Pepcid AC on board with pred] It is not possible to bring Tripp to work with either of us, and also not possible to adjust our schedules. Unfortunately, we are just coming from a week off for vacation, and another week off due to the Flu hitting our household So also no available time off. I figured since I’m allowing a little more movement for the potty pad during the day, I would not take him outside. Just let him exclusively use the pad to minimize movement. Currently, he has a small pet bed with a bolstered back and sides. I find he likes to rest his neck on these when having an episode. It is not high. An egg crate topper mattress does sound like it would be more comfy for him though. I will look for one tomorrow. I also ordered the calming plug in. Thank you so much for all the advice!! I wish I would have had this much information the first time
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Mar 17, 2019 5:52:28 GMT -7
Yes, you are absolutely right that a taper should not be done when there is still pain. Pain means there's still swelling pressing on the nerves of the spine and still a need for the anti-inflammatory dosage of the Prednisone for a bit longer. Good job on speaking to the vet about extending the anti-inflammatory dosage. When you speak to her on Monday about Pepcid AC, do find out when the next taper will be. And also ask her what she wants done about the pain meds during the next taper? Does she want to stop the pain meds or to taper the pain meds when the Prednisone tapers. Having pain meds on board during a taper makes it difficult to determine whether there is still pain/swelling and still a need to stay on the anti-inflammatory dosage of the Prednisone. Would a neighbor, friend or family member be willing to stop by to take Tripp out for potty breaks and to give meds? Or maybe a vet tech or IVDD experienced dog walker could be hired? The Gabapentin and Methocarbamol should be given every 8 hours to keep pain completely under control. Allowing pain to arise between doses make it harder to get it back under control. Have no patience with pain as it does hinder healing. Hopefully the calmer plug-in will help keep Tripp calm when you come home. Good idea to cover the top of the crate with a towel or blanket and bringing it down on the sides. Hopefully that will encourage him not to stand on his hind legs. It also creates a calming den-like feeling that dogs like. You can also lower the ceiling of the wire crate. Take a piece of cardboard the size of the top of the crate, punch holes in the corners and tie it down in the crate to the level where Tripp is when standing. Other tips on calming can be found here: www.dodgerslist.com/literature/EmergencyCrate%20Training.htmHealing prayers for Tripp. Try to take it one day at a time. It doesn't sound as though this episode is as severe as Tripp's first episode and hopefully he can relax enough in his crate that his neck will heal fine with conservative care.
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Post by Wendy & Tripp on Mar 17, 2019 13:00:38 GMT -7
Unfortunatley, no we dont have anyone that I trust to take him on multiple potty breaks during the day. My mom and dad can come at lunch to give meds, but I dont think they could keep him calm or limit his movement outside. I also dont think hiring someone would be a good idea either. All of my dogs get riled up when someone new comes in the house....Especially Tripp. I forsee that causing way more excitement than when we get home. While we are gone, He has only been leaving his bed to pee and go to the food/water bowl. Otherwise he resting comfortably. I really think allowing a potty pad during the day and taking away that space when we get home will help. He’s been doing really well today and seems to be getting frustrated with being locked up. He even tried to break out a few times. I will update tomorrow on how it goes and what the vet says about the new med schedule. Good point about tapering the pain meds. I will ask about that as well. Thank you so much for the support and advice!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Mar 17, 2019 13:20:12 GMT -7
Wendy an egg crate or piece of memory foam would be a good mattress as it would be lower and not necessitate his short little legs go up and down from the mattress to the pee pad. You can make a bolster for his neck by rolling up a fleece blanket or a towel. Having your parent give meds to make sure they are given every 8 hrs would be a good approach. The pee pad in a tiny space inside his recovery suite would work so he does not have to be taken outdoors. The food and water bowls should not require leaving his mattress to access. Do you have them attached to the side of the recovery suite at head height? Are you continuing on the orig pred dose until you can contact the vet on Monday. Or did you begin the lower taper doses on Mar 16?
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Post by Wendy & Tripp on Mar 17, 2019 15:49:55 GMT -7
No, I did not taper pred. on March 16th. He is currently on all originally prescribed dosages. I will ask the vet tomorrow about the new taper date. I have replaced his bed with foam mattress topper type bed yall suggested. It’s flatter than his bed which seems to be working out better for him. I have his f ood/water bowl in an elevated holder that Ive been using for him since his surgery. He does not need to leave his bed to access it. He just needs to stand up and move to the end of the mattress. It’s head height. He’s doing really well today
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Post by Wendy & Tripp on Mar 18, 2019 19:49:27 GMT -7
Update... Tripp had no pain episodes yesterday (Sunday March 17th). Spoke to the vet this morning, I was advised to taper the pred to 1/2 a pill once a day starting today March 18th. So this puts him at getting 2.5mgs a day for the next 5 days. Then move to every other day until gone. I asked about giving Pepcid to protect his stomach and also noted that he had looser stools on Sunday. Not diarrhea yet, just looser and different than normal. He didnt agree with adding Pepcid to help. Said it was a side effect of the pred and to taper down for now because his dose was pretty high. He never answered my question if there was any reaon why he couldnt be on it. I checked on Tripp all day through the camera... he did fine all day. He seemed to be getting very frustrated this morning and tried escaping his pen multiple times. Which I took as a good sign he was feeling good. Minimized his crate area immediately upon arriving home. He was good with this. Gave the tapered dose of pred. at 7:30pm....By 8:15pm he was in pain.
[Moderator's Note. Please do not edit 10.6 lbs prednisolone as of 3/11: 5mgs 1x/day for 7 days pain on 3/15; 3/18 tapered √ PaIN! gabapentin 250mg/5mL: 25mgs (0.5mL) 3x/day methocarbamol 125mgs 3x/day no Pepcid AC on board with pred]
Not as bad as before, but holding his head straight up and shivering. Just looking uncomfortable in general. Immediately gave pain med and muscle relaxer as it was time for another dose. Just checked on him at 9:30 and he’s back to himself and looking ok. He ate normally today but no poop yet.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Mar 18, 2019 20:16:19 GMT -7
Wendy, clearly it is NOT time to do the taper. The taper tests to see if there is still pain existing, you have th answer. The vet needs to know asap in the morning to Rx another course of pred and then another test for pain taper. With Pepcid AC on board he stomach would be protected! You are seeing red flag signs of loose stool because of no protection! To continue pred there now needs to be TWO protectors on board. Do you best job of advocating for sucralfate which works differently to bandaid the damaged areas of the stomach lininng. Pepcid Ac work to suppress the extra acids that cause the problem. Read about both so you can be prepared to do your best job of getting what Tripp needs. Sucralfate marvistavet.com/sucralfate.pmlPepcid AC: marvistavet.com/famotidine.pml Do you have some extra pred pills to give til you can phone the vet tomorrow a.m to get another course back up at the 2x/day anti-inflammatory dose? Pepcid AC shold be on board whenever pred is on board, as well.
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Post by Wendy & Tripp on Mar 31, 2019 21:42:03 GMT -7
Update: Tripp is doing great! He has not had any pain since March 18th and is completely off all pain meds and pred. He finnished the pred. taper 2 days ago and so far so good. The struggle now will be to continue the crate rest for another 5-6 weeks. I’m very commited to this as I really do not want to go the surgical route again. I can tell he’s getting restless from being locked up. Hopefully the weather will cooperate, and I will be able to bring him out in the yard in his pen for a bit this weekend. Thank ya’ll for all the advice!! This page is amazing, and I only wish I had this info 5 years ago with his first disc injury 🙂
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Apr 1, 2019 4:57:12 GMT -7
Wonderful to hear that Tripp was able to taper off of all meds, Wendy. The last time you spoke to us on 3/18, Tripp showed pain at the start of the taper and Paula recommended that you advocate for another round of Prednisone. It would appear that the taper did continue at that point. Possibly the signs of pain seen on 3/18 were misinterpreted? On what date were the pain meds stopped? Have the loose stools all cleared up now and back to normal poop?
Yes, when dogs start feeling better, crate rest can become a challenge. But hang in there. If Tripp begins to get too restless and starts to move around too much in his crate, please let us know so we can give you some tips on how to calm him.
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Post by Wendy & Tripp on May 6, 2019 12:58:33 GMT -7
Tripp update: Tripp has done great for his crate rest. No signs of pain since 3/18. I started introducing short walks outside his pen this weekend (5/3/19). Just outside to go potty and only once a day. He did fine..no jumping or crazy movements. I noticed yesterday (5/5/19) that he was stiff in the morning, and his posture was off. He seemed to be hunching his shoulders again and was shivering. No crying or whimpering... He ate and went the bathroom normally but just seemed off. My alarm bells were going off as soon as I saw him. I gave him a muscle relaxer in the evening, just in case, so he could rest well over night. He seemed back to normal this morning. Normal posture and no shivering or stiffness. My question... I read that I should crate rest again after signs of soreness or stiffness when returning to exercise. How long should I keep him crated after this episode before trying a little exercise again? And was I correct that his 8 week crate rest period ended 5/5 if we started on 3/10?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on May 6, 2019 16:00:35 GMT -7
Wendy, sounds as though your little couch potato maybe over did things more than you thought and was sore. At graduation definately want to make sure all introduction back to physical activity is a slow and gradual thing to avoid being confusing if merely muscle soreness or a new disc episode. Did you take a look at our information for that gradual plan to over about a month's time following the end of crate rest: www.dodgerslist.com/literature/AfterCrateRest.htm The plan starts with 1st week. Mon-Tues- 1 min up and down hallway 1x back in crate observe, no signs of soreness? then:... Wed 1 min up and down hallway 3x a dayNow is the perfect time if you haven't already to make those home modifications so that you can reduce the stress on the spine in the future. No more stairs, ramps up to furniture, or blocking furniture all together. All those ideas and more are in this link: www.dodgerslist.com/literature/protectback.htmPlease do let us know how things are going as you begin the gradual program.
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Post by Wendy & Tripp on May 7, 2019 8:43:13 GMT -7
How will I know the difference between soreness and a disc episode? He seemed a little stiff last night and again this morning. I noticed he seemed hesitant to shake his head.. like he would start to shake and then stop himself. I planned on keeping him strictly crated for the rest of the week just to be safe, but how long should I continue this? Should I call the vet back and re-start pred. if this doesn't resolve?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on May 7, 2019 10:31:28 GMT -7
That is the importance of slowly and gradually increasing acitvity. It is difficult to know which is which wil mild symptoms--- whether muscle soreness or disc problem.
If it were to be a disc episode, then without meds on board things would not improve. If it were muscle soreness, then without meds on board things would improve. You know yourself with sore muscles often time over night with a good rest, they feel alot better.
Very hard to know if he was pulling abit on the harness and made neck muscles still. You will need to speak with your vet as he has the ability to examine and diagnose and come up with a plan.
Would you please keep us posted...surely hope it is muscle soreness or maybe a bit of arthritis stiffness? Good idea to crate and observe as well as touch base with your vet.
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