Allyssa's Zoey 7/23 Conservative-CANADA; Grad 9/17

Welcome to Dodgerslist. We are 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!

What is your name? I am Romy.

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 a bit more detail with us:

You have not mentioned an anti-inflammatory for Zoey. An anti-inflammatory works to bring down the swelling in the spinal cord and is almost aways prescribed for IVDD. It is this swelling that causes the pain and neuro deficits of IVDD. Please speak to your vet about adding an anti-inflammatory to Zoey's pain medications.

Is Zoey currently showing any signs of pain? ☐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 ☐can’t find a comfortable position ☐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? Full pain relief is expected in 1 hour and stays that way dose to dose. If not in control your vet needs to know asap to adjust meds.

IVDD commonly results in excess stomach acid which can lead to stomach damage. This is true for all IVDD dogs, especially those on anti-inflammatories. Pepcid AC is used to prevent excess stomach acid. Ask the vet if Zoey has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health” issues answer, then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine).

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



Doxie weight dogs: 5mg Pepcid AC (famotidine) every 12 hours. NOTE: Pepcid AC (famotidine) for dogs is 0.44mg per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory.
www.1800petmeds.com/Famotidine-prod11171.html

Is Zoey showing any signs of GI Tract problems now? —Eating and drinking OK? No nausea/not eating, no vomit? —Poops OK? Normal firmness & color -no dark black or bright red blood indicating bleeding ulcers? No diarrhea?

The hallmark component of conservative treatment is the very STRICT crate rest part (no PT, little movement). 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 movement to allow good strong scar tissue to form.
www.dodgerslist.com/literature/CrateRRP.htm

STRICT 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.
◼︎no PT for conservative dogs during 8 weeks to heal disc
◼︎At home laser or acupuncture for severe neuro damage is best. 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.

Carry Zoey 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


If Zoey is too heavy to carry it is still important that the amount of movement to the potty place be minimized. Try a pee pad right outside the crate.

Currently can Zoey wobbly walk?

Knowledge is the power to fight the IVDD enemy and win!! The very best thing you can do for YOU, the caregiver, and for your dog 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. Your dog will be depending on your ability to learn - excellent video series here:
www.dodgerslist.com/literature/theater.htm

--PRINT OUT this link and tape to your fridge: www.dodgerslist.com/literature/healingpage.htm

--use the printout as your roadmap to avoid dangerous detours in your dog’s care

--make notes/highlight to keep yourself on track

--follow all the links in the next days to become the IVDD savvy pet parent your dog needs. Use the “search box” to easily locate topics over at our Main www.Dodgerslist.com website:

www.dodgerslist.com/index/searchBOX.jpg

Allyssa, if there is any thought to this being a disc episode, then restrict movement rest inside of a recovery suite, pain meds to provide relief from pain AND an anti-inflammatory drug to get to work on the cause of the painful inflammation. No steroid or non-steroid NSAID have been prescribed. Do call your and see about getting an anti-inflammatory drug on board. Learn about the so you are in a knowledgeable position to discuss things with the vet. www.dodgerslist.com/literature/healingsweling.htm
     A handy reference card to print out and carry with you makes sense.  D/l here: www.dodgerslist.com/literature/MedCard.pdf

Allyssa , what any anti-inflammatory drug does is increase the acids the stomach produces. By using two different kinds of GI Tract protectors, Zoey may well be able to take an anti-inflammatory drug. These two protectors are very typically given together each working in a different way.
----Pepcid AC (famotidine) to suppress the production of stomach acids
--- Sucralfate to make a gel coating where ever there has been a disruption in the mucous stomach lining and provide a good healing environment.

If you were to see neuro loss/diminishment then saving the spinal cord vs treating intestinal gastritis has to be very carefully weighed by you and your vet.

At this point you are not reporting any sign of neuro diminishment?  

As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. 
1. Pain caused by the tearing disc & inflammation in the spinal cord
2. Wobbly walking, legs cross
3. Nails/toes scuffing floor
4. Paws knuckle under
5. Weak/little leg movement, can't move up into a stand
6. Legs do not work at all (paralysis, dog is down)
7. Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors.
8. Tail wagging with joy is lost
9. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. If surgery is not an option (for whatever reason) then the best option is conservative therapy.
Surgery can still be successful in the window of 12-24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance. Precious hours can be lost with a vet that gets DPS wrong. Trust only the word of a neuro (ACVIM) or ortho (ACVS) surgeon about DPS.  
       A quick overview of conservative treatment vs. a surgery: www.dodgerslist.com/literature/healingsurgery.htm#surgeryVSconservative


Who/what kind of vet (general, specialist?) do you have an appt booked with on 7/29?

Let us know what the vet says about the anti-inflammatory when you have a chance. Zoey's symptoms are minor now and and an anti-inflammatory (with double stomach protection) and Strict crate rest will help keep her symptoms minor.

The double stomach protection we most often see is Pepcid AC which is available at any supermarket and Sucralfate which is prescription only.  

There are two classes of anti-inflammatories; NSAIDs and steroids.  Steroid type medications are stronger 
Metacam is an NSAID type of medication. NSAIDs are often prescribed with minor symptoms. 

I am not sure if you had a chance to look at this this page:
www.dodgerslist.com/literature/healingswelingANSWERS.htm

We have a lot of information about the different types of anti-inflammatories  there.

Allyssa, proactive vets don't wait til there is lip licking of nausea, not eating, vomit, diarrhea leading to serious bleeding ulcers, red or black blood in stool due to the extra stomach acids anti-inflammatory drugs cause. marvistavet.com/famotidine.pml 

Reading references about GI tract protection when on an anti-inflammatory drugs:

1) From the Onsior manufacturer's package insert:
ONSIOR, like other drugs of its class, is not free from adverse reactions. Owners should be advised of the potential for adverse reactions and be informed of the clinical signs associated with drug intolerance. Adverse reactions may include vomiting, diarrhea, decreased appetite, dark or tarry stools, increased water consumption, increased urination, anemia, yellowing of gums, skin or whites of the eye due to jaundice, lethargy, incoordination, seizure, or behavioral changes. Serious adverse reactions associated with this drug class can occur without warning and in some cases result in death (see Warnings and Adverse Reactions). Owners should be advised to discontinue ONSIOR therapy and contact their veterinarian immediately if signs of intolerance are observed. The vast majority of patients with drug related adverse reactions have recovered when the signs are recognized, the drug is withdrawn, and veterinary care, if appropriate, is initiated. animaldrugsatfda.fda.gov/adafda/app/search/public/document/downloadLabeling/201

2) North Carolina U. recognizes the high incidence of GI irritation in dogs with disc problems. The reasons are that pain and change in routines are stresses. Just as humans can experience ulcers when under stress, dogs can also. NCU and 11+ hospitals working with NCU prescribe a GI protectant. Dogs presented to NCU with IVDD often develop GI upset whether they are given anti-inflammatory medications or not.
www.cvm.ncsu.edu/vhc/tc/clinical_services/neuro/acute_disc.html== The antiulcer effect of famotidine plus magnesium and aluminum hydroxides was greater than the sum of the effects of these drugs used separately.
www.merckfrosst.ca/assets/en/pdf/products/PEPCID-PM_E.pdf
MERCK CANADA INC.
Date of Revision: April 27, 2011

3) Pets More Susceptible to Side Effects of NSAIDs
Dr. Stuart Clark-Price, a veterinary anesthesiologist and internal medicine specialist 
"Cats and dogs are much more susceptible than people to the adverse effect of NSAIDs," explains Dr. Clark-Price. In short, dogs and cats are not simply smaller versions of people. They lack certain enzymes that we have, and also may process these drugs differently. In short, the use of NSAIDS in dogs and cats comes with a smaller safety margin. Because of this, it is critical that veterinary patients be accurately dosed and routinely monitored for side effects.
news.aces.illinois.edu/news/pets-more-susceptible-side-effects-nsaids

4)   "The use of a GI tract protectant in cases that are receiving NSAID's or steroids would definitely be warranted under the supervision of the patient's veterinarian." Dr. Andrew Isaacs, DVM Diplomate ACVIM (Neurology) Dogwood Veterinary Referral Center www.dodgerslist.com/neurocorner2/stomachProtection.htm

ONSIOR
For how many days is Zoey to stay on it?  The stop of Onsior becomes the test to verify if all painful inflammation is actually gone and to verify no setback in neuro functions.  Can you tell us which your vet prefers on the stop of Onsior:
--- backing off of all pain meds (robaxin and gabapentin) on the stop day for Onsiro OR....
--- the full stop of all pain meds to provide the quickest way to verify if a need for other course of Onsior or not.

Once Onsior is stopped and the pain meds and there are no signs of pain, all that remains is to allow the disc to heal. 
    The hallmark component of conservative treatment is the very STRICT crate rest part (no PT, little movement). 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 movement to allow good strong scar tissue to form. 
   Crate rest is free.  Shortcutting crate rest can be expensive.  Not just your pocketbook is affected with extra vet appts and meds of having to start from scratch but the mild symptoms could rise severe enough to a costly surgery. A re-damaged  relapsed early healing disc would be expensive pain wise for Zoey to endure.


Hope to hear you are on schedule for 8 weeks of disc healing and a GI tract protector to be proactive against the common adverse GI problems all anti-inflammatory drugs can cause.