Navneet's Nikku 6/30 conservative- India GRAD 8/25

Naveneet, sorry to hear about your doxie's disc episode.

We'll need from you exact names of meds, the dose in mgs and how often you give each and always using dates rather than things like yesterday, fortnight, etc.

Prednisone--- we'll need extra info.
--- What was the orig dose in mgs on what date?
--- What was the date there was a taper (reduction) in mgs and/or frequency?

ADDED QUESTIONS:
What is the name of the stomach protector used when Prednisone is on board? Nikku still have unknown cause of allergy with use of Famotidine? Aciloc (ranitidine)? Lansoprazol?   Then use sucralfate

What is his current weight? 29.1 lbs

Let us know you are being VERY STRICT with rest:
--- what date did get him into the crate to start conservative treatment?
--- you carry him to and from the potty place and allow a very, very few foot steps?
--- he eats and drinks inside the recovery suite?
--- no meandering at potty time? 
--- if wobbly you use a sling as back up to catch in case his back legs give out and his butt falls down?

Is he fully out of pain dose to dose of medications for as long as it takes prednsione to get all the swelling resolved (in the range of 7-30 days----  pred taper days are excluded) ?  If in pain AND in a pred taper, then clearly it is not time to taper pred but get another RX course of pred (5-day, 7-day are common length of a course).

    Please contact your vet ASAP to advise if you are seeing painAdvocate that any of the pain meds be given 3x/day (every 8 hours). 

—Methocarbamol works on the pain of muscle spasms. 

— Tramadol is the general pain reliever. 

— Gabapentin works on nerve pain. 

     There should be no sign of pain from one dose of meds to the next. Have no patience with pain as it does hinder healing. Look for your dog to be  acting their normal, perky self when pain is fully under control round the clock.

SIGNS OF PAIN:

◻︎ shivering-trembling                 ◻︎ yelping when picked up or moved 

◻︎ slow to move                          ◻︎ tight tense tummy 

◻︎ arched back, ears pinned back ◻︎ head held high or nose to the ground. 

◻︎ restless, can't find a comfortable position 

◻︎ slow or reluctant to move much in crate such as shift positions

◻︎ looks up with just eyes and does not move head and neck easily. 

◻︎ not eating due to painful chewing or in too much overall pain

◻︎ holds front or back leg flamingo style not wanting to bear weight 

◻︎ not their normal perky selves  

Thank you for the additional information, Navneet. Nikku is having a mild disc episode this time and if you keep his movement very limited, he should recover well. Please always carry him out to potty, only allow a very few steps at potty time and carry him back in to his crate. A sling is not to be used to help Nikku walk to potty, he should always be carried. Once he is outside, a sling should be used to stabilize him so he doesn't fall from side to side. Also a harness and leash should be used to limit his steps to only a very few.

It would be best not to massage his back at all and no passive exercise should be done during the 8 weeks of strict crate rest.  Nikku is able to move to reposition himself in the crate and that is enough to help tone his muscles.  Any muscle loss from the 8 weeks of crate rest will quickly return once movement is gradually reintroduced.  The less movement of the spine, the better. Too much movement and the not-yet-healed disc could tear more or even rupture, possibly causing more nerve damage.

Please confirm the date that strict crate rest started so we can keep track of the 8 weeks along with you.

Some information for future use: Nikku was given a very dangerous course of meds at the beginning as it appears there was no washout period between the NSAID (Carodyl) and the steroid (Prednisone). A 4-7 day washout is necessary. However, should a vet feel that a switch is medically necessary, such a switch can be made with the addition of TWO stomach protectors. We usually recommend Famotidine and Sucralfate. I'm glad that Nikku did not have any adverse effects from this. It's best not to give any meds if Nikku should show signs of a disc problem, but rather immediately crate him to protect his spine from further damage and have him seen ASAP on an emergency basis for the vet to determine what meds are needed.

Also, increase in thirst and urination is a very common side effect of Prednisone and that should not be a reason to stop it. It's very important that an anti-inflammatory be on board long enough to work on resolving the swelling pressing on the nerves of the spine. It's that pressure on the spine that causes the nerves to be damaged or even die.  Nikku was given a very high dosage of Prednisone at the beginning.  For his weight (still 29 lbs.?), 10mg 2x/day would be the anti-inflammatory dosage.  So a taper from the anti-inflammatory dosage didn't actually start until 7/16.  Again, Nikku was very lucky not to have had GI distress from the lack of a washout period, the very high dosage of Prednisone and not having two stomach protectors on board.

The more you learn about how to treat IVDD, the better you'll be able to know when dangerous treatment is being recommended.  Lots of information to read here:  dodgerslist.com/healingindex.htm

Please continue to update us on how Nikku is doing.

Navneet,  there is no problem if he wants to raise up to stand on all four legs in his recovery suite. 

Can you clarify about the actual amount of space in his blocked off recovery suite area?  Should be only room enough for him to turn around in and when he lies down to fully stretch out his legs?  More than that amount of space needs to be tightened up. An ex-pen can be used to surround a suitable size of dog mattress and allow you to have his suite in the midst of where the family spends time.  

Hello! It has been four weeks since we started Nikku's rest period and I am glad to inform that he is much better. He can stand for longer periods and also when he goes out to potty, he can walk without stumbling. He was almost about to chase a squirrel yesterday but he had a leash on and we restrained him and carried him indoors. He is eating well and since stopping the steroids, he does not need to pee often and can sleep for longer periods of time. We shall continue resting him this entire month of August. Thank you very much for your help and support.

Hi, Paula
I shall keep you updated from time to time. He has been sleeping in his favourite ,"all fours in the air" pose for the past few days.

So very glad to hear how well Nikku is doing! Please continue to keep Nikku's steps to a very, very few at potty time. He's almost to the safe point in time when movement can once again be gradually introduced but not quite yet. The damaged disc not only needs to heal but needs to form secure scar tissue before movement is gradually reintroduced.

If Nikku is jumping up in the crate, you can try to drape a towel or blanket over the top of the crate to discourage him from that. Lower the blanket down to his eye level when standing so when he jumps up, he won't be able to see.

Tips on calming Nikku during final days of crate rest:

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.
Dogs: Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/us/Products/ADAPTIL-Calm-Home-Diffuser with dog pheromones

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
2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine.
3) Bach's Rescue Remedy is a liquid 5-herb combo to help with relaxation (Star of Bethlehem – Orithogalum umbellatum, Rock Rose – Helianthemum, Cherry Plum – Prunus cerasifera, Impatiens – Impatiens gladulifera, Clematis – Clematis vitalba)

You can start getting your house ready for graduation day. Tips on how to do that here:
www.dodgerslist.com/literature/protectback.htm

Once August 25th is here, movement can once again be gradually reintroduced. Please do keep it very slow and easy. Should there be any sign of pain and too much movement has been done, it would be difficult to determine whether pain is due to sore muscles or another disc problem. Slow and easy does it! I found the schedule on the following page to be very helpful after my Jeremy's conservative care: www.dodgerslist.com/literature/AfterCrateRest.htm

Please do stop by on graduation day so we can celebrate with you!

Navneet, good that that potty time is still quite limited to no walking....just the very fewest of footsteps to take care of business.

Graduation day is just around the corner, please do stop in and let us know what plan you have worked out to ease him into family life gradually over a couple of weeks after graduation. Don't want your little couch potatoe to over do things!