Karen's Diggy 8/31 Conservative GRAD 10/28

Welcome to Dodgerslist. Is your name Bonnie? 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.

**Disc disease is not a death sentence! ** Struggling with quality of life questions? Re-think things: www.dodgerslist.com/index/SDUNCANquality.htm

You should let the vet know ASAP this morning that Diggy is refusing water.  If your vet is not open today, then you'll need to contact an emergency room vet.  Changes to drinking could be a serious side effect of Rimadyl. If in fact the vet wants to stop Rimadyl, do know that a switch to a steriod such as Prednisone can be made with the addition of TWO stomach protectors - Pepcid AC and Sucralfate.

Diggy is also showing red flag signs of GI distress with not wanting to eat more than the food that his meds are given in. It's imperative that you get Pepcid AC on board today. Ask the 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 
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

If Diggy cannot pass a sniff and pee test (carry him to a spot where he or another dog has peed before, support his hind end but not under the belly, let him sniff and see if he can release urine on his own), then he most likely lost bladder control and will need to have his bladder manually expressed. Finding wet bedding could very well be due to an overflowing bladder and not that he's made a brain-connected decision to release urine on his own. Overflowing bladders are not healthy as urine lying for too long in the bladder can lead to urinary tract infections. You should bring Diggy into the vet's office for a hands-on-your-hands demonstration on how to express the bladder. Secure his crate in the car and pad it well with rolled up towels/blankets so he would be jostled around too much in the car and carry him in and out of the office. More info on expressing here: www.dodgerslist.com/literature/Expressing.htm Don't despair - bladder control can come back!

Please keep Diggy in the crate 24/7. Think of the crate as a cast for the spine. Too much movement and the damaged disc can tear more, resulting in more nerve damage, even permanent paralysis. It's very, very important to limit the movement of the spine as much as possible. The crate should only be large enough for Diggy to stand up, turn around and lie down with legs comfortably extended.

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:

❖1 Is there still currently 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.

❖2 …A How often are you giving Tramadol - how many times a day?
…B For how many days has Rimadyl been prescribed for?

❖3 GI Tract problems? You already let us know that eating and drinking is not currently normal. No vomit? —Poops OK? Normal firmness & color -no dark black or bright red blood indicating bleeding ulcers? No diarrhea?

❖4 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.
Super tried and true tips for setting up the recovery suite, the mattress and more! —> 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.

❖5 Is the vet a general DVM or a specialist surgeon: ACVIM neurology or ACVS ortho?

If there is great pain or severe neuro diminishment, acupuncture or laser light therapy can be be started right away as an adjunct to pain meds and to kick start nerve cell energy production. Options: Acupuncture vet who does home visits to avoid back moving during transports. For transport to necessary visits, pad out the recovery suite extra space with a rolled up towel/blanket to prevent body shifts during braking or cornering.
CAUTIONS: ~~ Laser light therapy is contra-indicated with tumors which are detected via x-ray.
~~ During conservative treatment, anytime out of the recovery suite is a dangerous time for the healing disc. Movement of the back can increase a disc tear and escape of disc material into the spinal cord . For an animal with very mild neuro deficits, the risk of transporting to therapy has to be carefully weighed against what benefit is to be gained. www.ahvma.org/find-a-holistic-veterinarian/
~~ Why Chiropractic is not recommended for IVDD dogs: www.dodgerslist.com/literature/chiropractic.htm

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

Please let us know what the vet says after speaking to them this morning. Healing prayers for Diggy.

Bonnie would you complete the med list for us:
Pepcid AC ?mgs 2?x/day

If surgery is not an option for your family, conservative treatment is a valid treatment.

Key is for the owner to understand limited movement of the spine. No tickling paws, limit vet vists to ones of utmost importance, get med adjustments over the phone.

Does he leak on you when lifted, that would be a sign of utmost important to go to the vet with Diggy to get a  hands on top of your hands expressing lesson.

He may not be purposely peeing due to not taking in enough liquid or that is hurts to move, to go potty.  Does he reposition himself in the recovery suite time to time showing he is not in pain.

As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order.
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. Diggy: 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 when you SPECIFICALLY do some happy talk or show a treat
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. So if surgery is an option for your family get to a neuro or ortho asap.
A quick overview of conservative treatment vs. a surgery: www.dodgerslist.com/literature/healingsurgery.htm#surgeryVSconservative

Hi,

Here are the doses for :Pepcid AC 5mgs 2x/day

Apoquel 5.4mg 1/2 tab twice a day

Does NOT leak when lifted, but has not sniff and peed outside either
He DOES reposition himself in the recovery suite time to time showing he is not in pain
He DOES wag his tail when happy talk and visit from friend

Hi,

We have had a very busy 2 weeks. We continue with the strict crate rest (only 5 weeks and 6 days to go!!). We took Dodgerslist recommendations and made a cushion for the crate from the egg crate foam mattress (from another dog bed) wrapped it in a garbage bag and then a pillow case.  We attached a rolling plant stand to the bottom of the crate for ease of moving. Thank goodness the crate fits in the back of our car for the doctor trips.

On 9/4/19 we took Digg back to the vet. They took him off the Rimadyl and gave him a Prednisone shot to avoid going through his intestinal track. At that time he was completely down in the back end with NO use of his back legs, but still had feeling. We saw a lot of improvement the very next morning 9/5/19. He started eating and drinking on his own, and eliminating by himself. 

Yesterday 9/14/19 we gave him his last dose of Methocarbamol. Currently on Prednisone and Pepsid. He can walk, but still real wobbly.

[Moderator's note: please do not edit
14 lbs.
Rimadyl as of 8/31: 18.75 mg 2x/day for 4 days then 9/4 stopped
Prednisone shot as of 9/4
 
no 4-7 days washout, no double GI protection for oral Pred pills!!
Prednisone pills as of 9/5: 5mgs 2x/day for 14 days, then 9/19 a test taper for: _pain / _neuro 
tramadol 25mg 2x/day    STOPPED 9/14
Pepcid AC 5mgs 2x/day]

He had a recheck 9/14/19 at the vet and they were pleased with his progress. They said it was really rare that people actually adhere to the strict crate plan and he thought Diggy will continue to improve over the next 6 weeks. 

He is really anxious about being in the crate. I talked to the vet and they can prescribe something if needed.

Karen, glad to hear that while Diggy had not lost bladder control, he was for some reason not going potty outside and now he is.

Is he still on tramadol?
For how many days did he take prednisone pills at the initial twice a day?  What was the twice a day dose in mgs?   What was the date of the first pred taper doses?

The taper days are too low to be working on swelling. Taper days are a test to find out if all painfulswelling is truly gone. Sounds like you are not observing any hint of pain surfacing on the pred taper?  No signs of pain during the taper test, means the taper goes to conclusion and all that remains is to finish out the balance of the 8 weeks for the disc to heal.


SIGNS OF PAIN:
◻︎ not their normal perky selves