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Post by Kim & Jackson on Jan 16, 2020 15:54:03 GMT -7
Hi everyone. I have an 11 year old, 13 pound, longhair doxie. He went to bed Saturday night just fine and when I woke up Sunday he could barely walk. By Sunday night, he had no mobility, so we went to the ER and spent the night there. They gave him heavy doses of prednisone, methocarbamol, and gabapentin, as well as Pepcid and sucralfate.
[Moderator's Note. Please do not edit
13lbs
Solumedrol at hospiital
prednisone 2.5mgs 2x/day for 4 days, then 1/18 test taper to reveal any: _pain / _neuro
methocarbamol 250mgs 3x/day
gabapentin 100 mgs 3x/day
Pepcid AC ? mgs 2x/day
sucralfate ? mgs 3x/day ]
He is on strict crate rest 24/7, only going out to potty and only getting there by me carrying him. We started laser therapy treatments on Tuesday and he just had his second one today. He does have bowel and bladder control and is wagging his tail at times but still can’t hold his rear end up for more than a few seconds. I have to hold him up while he poops, but he can squat to pee. I’m holding out hope that with 8 weeks of rest and meds, we can turn this around. I think the most frustrating thing for me right now is all of the unsolicited advice from others about how it might be more humane to put him down. It makes me not want to talk to anyone about it. This little guy is my world, and I’m ready to do what it takes for him as long as it remains beneficial to him.
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Post by Romy & Frankie on Jan 16, 2020 16:16:08 GMT -7
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! It is important to know that disc disease is not a death sentence. Anyone suggesting euthanasia as a treatment for IVDD is ill-informed. Struggling with quality of life questions for Jackson? Re-think things: www.dodgerslist.com/index/SDUNCANquality.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: Is there still currently pain or are the pain meds keeping it in control? These are the signs of pain we look for; ☐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 between doses. If not in control your vet needs to know asap to adjust meds.
Please list the exact names of meds currently given, their doses in mgs and times per day given. What was the start date & dose of the prednisone? Date of pred taper?
Any sign 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?
You are doing the very best thing for Jackson by starting Strict 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. www.dodgerslist.com/literature/CrateRRP.htmSTRICT means:
◼︎no laps
◼︎no couches
◼︎no baths
◼︎no sleeping with you
◼︎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.
The fact that Jackson has bladder and bowel control and can wag his tail bodes well for future recovery.
Once you have carried Jackson to the potty spot, 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!
Dogs on pred will have to urinate much more frequently than usual. Sometimes as often as every 2-3 hours, so you may have to take him out more than you usually do.
What is your name? I am Romy.
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 as soon as possible. Begin absorbing the must-have overall sense of meds, care and how the treatment works. Jackson 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:
--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:
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Post by Julie & Perry on Jan 16, 2020 17:05:18 GMT -7
What I say to people who say pts for a furry family member with IVDD, " So if a human family member has back problems you're going to euthanize them?"
Sounds like you are doing everything right.
There's always hope! Sending healing thoughts and prayers.
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Post by Kim & Jackson on Jan 18, 2020 17:42:48 GMT -7
Hi Romy, my name is Kim. Jackson seems to be feeling a little better every day. Wagging his tail much more, and has taken a few wobbly steps when out to potty. The emergency vet gave him solumedrol while there and he came home on 2.5 mg prednisone twice a day for four days. He started a taper today with 2.5 mg once daily for 7 days, then every other day for another week. He is also on Robaxin 250 mg 3 times per day and gabapentin 100 mg 3 times per day. Pepcid twice a day and sucralfate 3 times per day.
His bowels are moving regularly and he has maintained a good appetite, so I think we are on the right track. He had his third laser treatment today, also. His pain seems to be under control. His belly is tight when I pick him up but then he relaxes once he feels secure in my arms.
He has disc space narrowing at T6-T7, so we are going on him having IVDD. I did not get an MRI done, as it wouldn’t have changed the course of treatment for us since surgery was not an option. I think I have answered all of your questions. I appreciate what you all do for IVDD dogs.
Julie, yeah, her husband was down on his knees one day in the yard trying to pick up their dog’s poop, because he was in so much pain. I didn’t ask her if she thought it was humane keeping him around. 🙄 Again, unsolicited advice usually doesn’t sit well with me, especially when it comes to my babies
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Jan 18, 2020 20:15:43 GMT -7
Kim, the tapering of Prednisone serves as a test to prove if all the painful swelling is gone. Having pain meds on board during the taper of the Prednisone is counterproductive. The pain meds will hide signs of pain if they still exist. Pain meds will delay getting back up on the anti-inflammatory level of pred, IF, if there still would be painful swelling. Having pain meds on board is like wearing blinders…does that make sense to you? Let us know which your vet prefers as the pred taper starts today so that you can get a true read if there is still painful inflammation going on — the backing off of pain meds or — the full stop of pain medseds are either backed down or full stopped. With any taper, it is always good to have worked out in advance a "PLAN B" should pain re-surface at night or on the weekend when your vet is not open. Could be an emergency RX script you could fill at local 24 hr pharmacy or some extra pills at home til the vet opens again. An ER visit is very expensive, a "Plan B" is free! Rule of Thumb Pain= another course of prednisone + all pain meds, Pepcid AC back on board. No Pain= go to the taper conclusion..finish out the 8 weeks of crate rest for the disc to heal. |
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Post by Kim & Jackson on Jan 19, 2020 8:35:13 GMT -7
The vet is decreasing pain meds to only twice a day starting tomorrow. Should I ask if I can stop them altogether? Also, he will still be on Robaxin 3x day. Will this also mask pain?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Jan 19, 2020 8:47:30 GMT -7
Kim, it is the vet's preference on whether to stop ALL the pain meds that mask pain (Robaxin and gabapentin) at the begin of the pred taper or he may prefer to begin backing off of those two pain masking pain meds. So do ask about either the stop also of Robaxin (for the pain a muscle spasm pain) or also backing it off. The reason it is a preference is that depending how long pain meds have been used, there may be a question preventing rebound pain with an abrupt stop. Discuss the reasoning behind your vet's thinking so you are privy this kind of knowledge.
anti-inflammatory is prednisone ( it is not a pain reliever)
pain meds are Robaxin and gabapentin.
Please clarify for us with the name of each med and what the dose and frequency will be as of Jan 20.
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Post by Kim & Jackson on Jan 19, 2020 8:58:49 GMT -7
As of Jan 20, he will be on ▼Gabapentin 100mg 2x per day, Robaxin 250 mg 3x per day, pred 2.5 mg once per day, Pepcid 10mg twice per day, and sucralfate 3x per day. She also had me start him on glucosamine/chondroitin once per day. She wants so do a reassessment at the end of this week after he completes his 4th and 5th laser tx sessions.
[Moderator's Note. Please do not edit
13lbs
Solumedrol at hospital 1/12
prednisone taper dose: 2.5mgs 2x/day for 4 days, then further 1/18 test taper to reveal any: _pain / _neuro
Robaxin (methocarbamol) 250mgs 3x/day
gabapentin 100 mgs ▼2x/day as of Jan 20
Pepcid AC 10mgs 2x/day
sucralfate ? mgs 3x/day ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Jan 19, 2020 9:28:44 GMT -7
Kim, thanks for the details on the meds, now we fully understand the upcome Rx's
--- Ask why is Robaxin not being either stopped or backed off. Pain meds place a blindfold on your eye is pain still exists. Robaxin masks pain (blind folds). The pred taper is a test. If you get inaccurate observations because you are blind folded, then if pain were still to exist, there is a delay in getting back up to a pred dose that would actually work on swelling. Nothing to work on swelling if it were needed is a bad idea for nerves. Nerves do not like being pressed on....it can cause them to die. We see that death as loss of functions like walking.
Jackson has just shown nerve repair in that he has regained the ability to take some wobby footsteps. He is going in the right direction. Don't let a delayed assessment about pain (caused by still existing swelling) off tract Jackson's progress
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Post by Kim & Jackson on Feb 16, 2020 19:27:27 GMT -7
A little update on Jackson...we are 5 weeks post IVDD diagnosis. We have weaned him off the prednisone completely now. We tried to taper the prednisone down at 2 1/2 weeks, but it quickly became apparent that he still needed it, so we went back to 2.5 mg daily for another 10 days, then 2.5 every other day for 3 doses. He has not had any since last Thursday and so far so good. He has graduated from his smaller crate to an ex pen where there is enough room for his bed, water, and puppy pads, as I had to return to work and have to leave him for extended periods. He is up on his feet again and deep pain sensation has returned to his right foot, but still nothing on the left. We still have him on Gabapentin once daily in the morning and Robaxin once daily in the morning. He is not showing any signs of pain at this point. We have completed 11 laser therapy sessions as well, with the final session scheduled for Tuesday. All in all, he is doing very well. He has a wobbly walk, but it’s a beautiful sight to me. I have hopes that he will continue to progress over the next few months. We will continue the crate/ex pen rest for at least 3 more weeks, and I think I will keep him in there from here on out while I’m at work, since he has adjusted to it so well. I hope all of the others on here are also seeing progress with their babies. Thanks for being here for all of us!
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Feb 17, 2020 6:10:28 GMT -7
Hi, Kim. So glad to hear how well Jackson is doing!
The fear with moving him to a larger recovery suite is that he will move around too much and re-tear the not-yet-healed disc. If that should happen, you would be back to square one or worse, with pain again and possibly more nerve damage. His recovery suite should only be large enough for him to stand up, turn around and lie down with his legs comfortably extended. Think of the crate as a cast for his spine. Can you possibly stop by during your lunch break or can a neighbor or family member stop by to take Jackson out? What arrangements did you have prior to this disc problem with regard to potty breaks while you were at work? It would be terrible if Jackson should have a relapse at this point in his recovery and the 8 weeks of strict crate rest having to be started all over again.
Since Jackson is still on some pain meds, you still have no proof that the swelling is gone since any pain is being masked by the pain meds. If there is still swelling, there would still be a need for an anti-inflammatory but there is no way to tell until all meds have stopped so it's important to determine that as quickly as possible. Usually by the time the weaning of the Prednisone has completed, the vet stops the pain meds, too. What are the plans for completely stopping the pain meds so a true test for pain/swelling can be made? If the pain meds are not going to be stopped completely soon, please speak to the vet ASAP about stopping them at this point.
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Post by Kim & Jackson on Feb 17, 2020 7:43:26 GMT -7
Hi Marjorie, I don’t live in an area that is easily accessible to others to come see him daily. Before this occurred, he was puppy pad trained and had free reign in the house. The problem with me leaving him in the crate while I’m at work is that I was coming home to him being urine soaked and having tried to hide his feces. I’m not willing to continue that, and I don’t work close enough to come home for him. He is not a very active dog as it is, he’s pretty mellow for the most part, so I’m confident that he’s not doing much moving around in his ex pen while I’m gone. I spoke to my vet about this and she’s fine with this arrangement. She is IVDD savvy, and is keeping a watchful eye on him. The plan is to stop the other meds the middle of this week to see how he does without anything on board. I will check back in and let you all know how it goes.
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Post by Kim & Jackson on Feb 17, 2020 8:16:20 GMT -7
Another side note regarding Jackson’s history...he came from a hoarding/puppy mill type situation where he was caged for over 5 years and was never socialized to humans, so the only two people in this world that he trusts to handle him are me and my mom, and this is after 5 years of owning him. This adds another degree of difficulty when it comes to having someone else come in and care for him while I’m at work. Trust me, he is my #1 in the entire universe and I’m doing everything I can to keep him safe and taking the best care of him that I can.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Feb 17, 2020 8:30:04 GMT -7
Kim, under your circumstances, make the crate work the best possible for Jackson’s healing disc. Not sure what the “bed” is exactly. If one of those beds that would be 3-4 inches or higher requiring a little hop to get up and out, then see if you can make a change. You would want the mattress that Jackson lies on to be as low as possible to the pee pad level. The less the back is moving the better for the healing disc. A piece of one inch egg crate or memory foam enclosed in a garbage bag. Then layered with a pee pad (this pad is to absorb should there be a urine accident), then fleece top sheet tucked securely all around will make a very good bed. Then in the extra floor space you’d lay down the pee pad for the potty place.
Do you let us know the details of Jackson’s bed. And of course how he continues to do on these days where you are at work. Fingers crossed as the conclusion for the prednisone test for pain and stop of all pain meds comes to conclusion...there Will be true proof that all pain is gone!
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