Meredith's Henry 1/3 rlpse Conservative GRAD 2/28

Welcome to Dodgerslist, Meredith. 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.

You have a pain emergency that must be addressed ASAP today as Henry is still showing signs of pain. Pain hinders healing so have no patience with it. As Julie mentioned, advocate strongly for Gabapentin 3x/day as it has a short half life and works best when given every 8 hours. From what you said, it would appear that Tramadol was stopped when Methocarbamol was added. Please advocate for Tramadol to be re-added. It often takes all three pain meds to get the pain of IVDD completely under control. Tramadol is a general pain med, Gabapentin works on nerve pain and Methocarbamol works on muscle spasms which often accompany IVDD. Pain needs to be brought completely under control within one hour of giving new meds and should remain completely under control from one dose of pain meds to the next.

Also as Julie mentioned, do get Pepcid AC on board today. 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

For how many days as Prednisolone been prescribed for before tapering?

Neuropathic pain is not common but you should be aware of it. This kind of pain is abnormal, phantom pain sensations with severe spinal cord damage. Signs are obsessive licking of paw, leg, genitals, tail. Escalates to biting, life-threatening chewing off parts. Immediately put on an e-collar (or lengthwise folded towel around neck and duct taped closed) to prevent access to lower body. Contact vet immediately for Gabapentin or stronger Lyrica (pregabalin) for neuropathic pain. More info: www.dodgerslist.com/literature/neuropathy.pdf

I'm sorry you were given incorrect advice concerning crate rest. 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  

IF your current vet can get Henry's pain completely under control (and it may take several adjustments of pain meds to do that) and if you're not considering surgery, then there should not be a need to consult with a neurologist unless Henry should worsen.  IVDD is usually diagnosed based on breed and symptoms.  MRIs are usually only done just prior to surgery.  

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 about adjusting pain meds and adding Pepcid AC.  We're here for you and Henry and will help you through his recovery.  Healing prayers for Henry.

I agree that you don't want Henry to be in pain. If Henry were my dog, I would give him pain meds if he shows signs of pain today. If he is uncomfortable and fidgety, it will hamper the healing process and add to his (and your distress). But I would be sure to get him to the vet tomorrow to discuss continuing pain meds and Henry's progress.

For prednisone- Henry was given 2tabs/day for 7days (started 12/30, ends 1/6), then instructed to reduce to 1tab/day for the next 7 days, then reduce to 1tab every other day with the remaining 2 pills. This was before Henry’s symptoms got worse. Will consult the vet to see if this is still what she wants. Thanks, that had not crossed my mind.
We will be seeing our vet tomorrow.
I was thinking the only reason to keep the neuro appt would be to see if they had other ideas for pain/inflammation management.
Thank y’all for so much help- it takes a village!
Photo below of Henry living the suite life. 

Yes, thank you. He is handling it better than I thought he would. And, he's already showing signs of progress, standing on his own to turn in his crate and with much improved happy tail wag! 

Had a phone consult with our vet today. She agrees we should continue the ✙prednisone x2/day for now. She urged us to keep the neurologist appt as they may have a better understanding of this disease and be able to better assist with medication management. So, we’ll see what they have to say on 1/9.

Henry seems to be pain free, definitely has more energy and wants out of the crate. Our vet ok’d ✙Benadryl 12.5 mg x2/day to make him rest.
He is wagging his tail at full speed, stands up on all fours but is still very wobbly. When taking steps during potty breaks he tends to drag legs behind, I am supporting him to prevent this.

I’m really happy that he is getting closer to his usual self. Thank you for helping me advocate for my dog.

[Moderator's note: please do not edit
20 lbs
Lack of rest rest Rx on 12/30; neuro decline on 1/2
Crate rest started on 1/3
Prednisolone as of 12/30: 5mg 2x/day for 7 days; 1/6 taper;
                                        leg paralyzed/pain 1/2 due to lack of crate rest
                     as of 1/6: 5mg 2x/day for how many days till taper?
Gabapentin 100 mg 2x/day
methocarbamol 250mg 3x/day
Pepcid AC ? mgs ?x/day  on Jan 3
✙Benadryl 12.5mg 2x/day]

I'm glad to hear that Henry is pain free, Meredith, and that the vet agreed to extend the course of Prednisone to be sure that swelling is gone before tapering again. For how many days did she extend the Prednisone before the next taper?

Our visit to the neurology specialist went well today. We were given the option of mri and surgery but have decided to continue with conservative treatment as we are already seeing positive results.

The vet noted that Henry is ▲ambulating with rear limb weakness and incoordination. Proprioceptive responses are absent in rear legs but otherwise the neuro exam was normal. No pain with spinal palpation, normal segmental spinal reflexes, bilateral cutaneous trunci reflex.

Medications were changed slightly. Henry will continue with Pepcid 20mg 1/2 tablet x2/day. Prednisolone 5mg x2/day through 1/13, taper to x1/day through 1/20 taper to 1/2 per day through 1/27. He is on Gabapentin 100mg 2-3 times per day. And ✙Tramadol 50mg 1/2 tablet as needed.

[Moderator's note: please do not edit
20 lbs
Lack of rest rest Rx on 12/30; neuro decline on 1/2
Crate rest started on 1/3
Prednisolone as of 12/30: 5mg 2x/day for 7 days; 1/6 taper;
                         leg paralyzed/pain 1/2 due to lack of crate rest
                         as of 1/6: 5mg 2x/day for 8  days  , 1/14 test taper for _pain/_neuro
Gabapentin 100 mg 2x/day
✙tramadol 12.5 mgs ?x/day
methocarbamol 250mg 3x/day STOPPED
Pepcid AC 10 mgs 2x/day on Jan 3
Benadryl 12.5mg 2x/day]

The neuro specialist vet, Carley Giovanella, specifically Recommended we consult dodgerslist.com for support and was happy to hear that we were already using the site.

We have been giving ▲Gabapentin x3/day and have not given Tramadol as we have not seen signs of pain.
Henry is getting used to life in his crate and is not back to normal but continues to show improved strength and coordination in his back legs.


[Moderator's note: please do not edit
20 lbs
Lack of rest rest Rx on 12/30; neuro decline on 1/2
Crate rest started on 1/3
Prednisolone as of 12/30: 5mg 2x/day for 7 days; 1/6 taper;
                                      leg paralyzed/pain 1/2 due to lack of crate rest
                   as of 1/6: 5mg 2x/day for 8 days , 1/14 test taper for _pain/_neuro
Gabapentin 100 mg ▲3x/day
tramadol 12.5 mgs ?x/day  NEVER GIVEN
Pepcid AC 10 mgs 2x/day on Jan 3
Benadryl 12.5mg 2x/day]

Yes the neuro vet we saw 1/9 told us to give “if needed”. We have a handful of Tramadol pills left and have been watching closely to make sure Henry is comfortable.

Henry finished his 8weeks of crate rest last Friday! He is doing really well and loved getting some supervised time out of his crate over the weekend! He has an occasional clumsy moment but has recovered a lot of his strength and coordination. We are slowly easing back into things as so far all is going well. I made him a ramp to get onto the sofa safely and we are starting with training to prevent him from jumping up to the bed. Thanks for all of the support and resources on here. We would have been lost without it!