Kaitlyn's Bear 10/16 Conservative

Welcome to Dodgerslist, Kaitlyn. 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

At this point, Bear is a very good candidate for conservative care. The crate rest must be very strict (see more on that below) for a full 8 weeks, carried in and out to potty with only a very few steps to potty.  The recovery suite should only be large enough for Bear to stand up, turn around and lie down with legs comfortably extended.  Any additional space should be filled in with rolled up towels/blankets.  Nerves can take a long time to heal, think in terms of months.  At this time, the priority is to protect the spine from further damage.

On what date did strict crate rest start?  10/15 or 10/16?

Information on when surgery should be a consideration:
www.dodgerslist.com/literature/healingsurgery.htm

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 Check these signs of pain to see if Bear is showing any sign 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.  Gabapentin works most efficiently when given 3x/day.  Also Tramadol and/or Methocarbamol can be added if there is any sign of pain.

❖2 
…A How many days has the Carprofen been prescribed for?
…C PEPCID AC: Anytime a dog is taking an anti-inflammatory, stomach protection must be added. Ask 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

❖3 GI Tract problems? — No nausea/not eating, 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.

Carry 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  LARGE DOGS: If your dog is too big 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. Add caster wheels to a wire crate and wheel down ramp over steps to outside.

❖6 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.jpg

Healing prayers for Bear.  We're here for you and Bear and will help you through his recovery.  Should you have any questions or concerns at all, please don't hesitate to ask.

At this time there isn’t enough research on back braces for Dodgerslist to support their use with an IVDD dog. What we do know is that strict crate rest is what works to heal a disc – it’s proven and crate rest is safe. 
You can read the discussion on back braces to learn in more detail why they are not recommended here:
www.dodgerslist.boards.net/thread/826/back-braces

Any time a disc tears, even a slight tear, a full 8 weeks of strict crate rest is needed to heal the damaged disc. So yes, even if there is improvement, the full 8 weeks of crate rest need to be done. With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. That 6 weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. Crate rest does not heal nerve damage - only time heals nerve damage. The crate rest and limitation of movement of the spine is to heal the disc.

Conservative care seeks to relieve swelling/compression of the spinal cord with an anti-inflammatory. Over time the hope is that disc material where it should not be will shrink back enough so that pain resolves and nerves can start to self repair. Too much movement and the damaged disc can tear more, even rupture, causing more pain and possibly more nerve damage, even paralysis.
More info here: www.dodgerslist.com/literature/healingdisc.htm

When a dog has IVDD, any disc can degenerate to the point where it tears or ruptures at any time. Neither surgery nor conservative care will prevent a disc from tearing again. The only thing that can be done to help prevent a future problem, for both Bear and your other dachshund, is to prevent jumping up and down on furniture, etc. or up on their hind legs and prevent going up and down steps/stairs. Hydrotherapy is used to help a dog regain use of his hind legs (though not during conservative care) but not as a preventative of a future disc problem.

With a dog on conservative care, transport to a vet can be risky as it could involve too much movement of the spine. The benefit of any treatment such as laser needs to be weighed against the risk of transport. At this point, Bear is having a mild disc episode and should do well with conservative care. If you could find a vet who will come to your home to do laser and if Bear will not get too excited or move too much during the treatment, that would be an option. But you're already doing the most important part of his treatment - the strict crate rest.

As for transport to a vet, I see that your vet has requested a follow-up exam after two weeks on the Carprofen. Most vets who understand the importance of strict crate rest will agree to get status updates via phone updates. Please speak to the vet about doing that instead of bringing Bear in for a follow-up visit. Once the Carprofen is stopped, that would be the time to also stop the Gabapentin so a true test for pain can be made. If any sign of pain returns with the stopping of meds, that would mean there is still swelling pressing on the spine and still a need for the meds for a bit longer. If no pain returns, then no further need for meds. That is something that you can observe from home and no need for a physical exam by the vet.

Please don't be concerned about loss of muscle tone. Muscle tone comes back quickly after the 8 weeks of strict crate rest. The primary goal right now is to protect the spine from further damage. If after the 8 weeks of strict crate rest Bear is still wobbly walking, then a very gradual increase in his walking would be a great therapy for him to regain use of his legs and to gradually build back muscle tone.

Please confirm that Pepcid AC is now on board.

Update on Bear - 

He is one week into his conservative treatment. We moved him from a child's pack and play to a crate to ease my mind that he wasn't making any jumping movements. He has adjusted well. He is in no pain, is eating and drinking normal, and his back legs have lost their wobbliness. *knock on wood* he seems to be back to normal. We will continue on until his 8 weeks are up. He will have a followup with the vet next week when his medicine runs out. I am going to push to do the exam over the phone as you have suggested. Is there anything I should know going into it? Should they be administering more medicine even though he isn't in any more pain? Very thankful that I found this group and for the support we have received. 

Kaitlyn