Hi Sarah, Welcome to Dodgerslist. I am going to start a new thread for your Ralph on the Conservative board. This will allow us to keep better track of your postings.
At Dodgerslist 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 would like to ask a few questions about Ralph's meds. How often are you giving the pain meds? Neck discs are particularly painful. All of these pain meds (Gabapentin, Methocarbamol and Tramadol) have short half lives which means they do not last long in the body. These meds may need to be given three times a day in order to provide full relief. If you are already giving them 3x a day approximately every 8 hours, ask your vet if it is possible to increase the dosage. Methocarbamol is the medicine that will help the most with muscle spasms.
Initially, methocarbamol is dosed at 7 to 20 mg per pound (15 to 44 mg/kg) up to three times daily. In dogs and cats, doses of methocarbamol can be repeated and up to 110 mg per pound (220 mg/kg) for severe symptoms.
www.petplace.com/article/drug-library/drug-library/library/methocarbamol-robaxin-v-for-dogs-and-cats/This article by Dr Dawn Reuben mentions a higher dose of methocarabamol than Ralph is currently getting for severe symptoms. You can ask your vet about a higher dose of methocarbamol .
We also typically see vets prescribing higher doses of pred for a dog Ralph's weight.
Anti-inflammatory doses range from 0.1 to 0.3 mg per pound (0.2 to 0.6 mg/kg) up to twice daily.
Dr. Dawn Ruben "Prednisone / Prednisolone"
www.petplace.com/DrugLibrary/prednisone-prednisolone/page1.aspx last accessed 8/13/2014
Please call your vet right away, if Ralph is in pain. He should not have to suffer. Vets have many ways of addressing pain and if Ralph is in pain we know the pain meds are not yet right.
We are not vets and do not know the specifics of each dog's health. We are making this suggestion based on what we've seen qualified vets prescribe in the past and only as a basis for discussion with your vet.
This page gives fuller info on those pain relievers and also lists the things you can do at home to help Ralph's neck disc:
www.dodgerslist.com/literature/cervical.htmDid the pred start on 7/21? What is the date of the steroid taper?
All anti-inflammatories cause excess stomach acid that can cause stomach damage. To help prevent stomach damage a stomach protector like Pepcid AC is needed. Ask your vet if your dog 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 The usual dosage of 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.htmlIs Ralph showing any signs of GI Tract problems? —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.htmSTRICT 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.
Can your dog specifically sniff and squat and then release urine which is bladder control – OR- do you find wet bedding or leaks on you when lifted which are indication of an overflowing bladder and loss of bladder control?
If Ralph has bladder control carry him 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 Ralph 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 Ralph wobbly walk?
Did you specifically get a diagnosis of IVDD, aka: a disc problem, a disc herniation, a bulging disc, slipped disc? — Is the vet a general DVM or a specialist surgeon: ACVIM neurology or ACVS ortho?
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.jpgHealing thoughts for Ralph.
