Susan's Stella 9/12 conserv-Cckr Sp Maine; GRAD 12/19

Quick reply would NOT work for whatever reason... sorry, hope this gets found with just reply!

At vet visit 8.22 she said to crate her, but that she felt Stella would be OK with some walk within the house, she has always been quite calm and lays down, and now not inclined to follow me as much as per usual. I do NOT let her do any stairs, jumping etc. Also, I use 6’ leash to walk her to potty, no sling seems to be needed. Our routine: I do carry her all the way out in the AM as I already have her in my arms from coming downstairs. She potty’s quite quickly and back in we go... sometimes a little walk around me, maybe 50’, is needed to get her to BM in the first morning outing. I feel it is better to get it out then, than to need to go through the whole process after her AM meal? Other times she is on leash but walks out on her own and always pees, sometimes both, it’s prob a 50’ walk from door to potty area and back to house, in that case too. I take her out about every 2 hrs which seems like a lot, she does pee. She can wait all night for about 7 hours.

I have tried crating full-time, but she has such a hard time... barking, trying to jump (though the crate height stops that), will sideways lunge on back legs, and just general protest w/lots of panting etc. She has a water bowl in 24” crate, but I do feed her out of it 2x daily. I do now see you say much more crating than I do. I will have to try to get her to be happier in there; it is right where we sit most of the time when inside. Suggestions? She will often just sit in there staring at me and panting, waiting to be let out. Also, I do have work to do and it’s not always possible. When I leave the house, she barks n stresses if she is in the crate. Music doesn’t seem to help.

Prednisone from 8.8 - 8.21 was 10mgs, then

8.22 upped to 10mgs AM & 5mgs PM as Stella would not correct her paws when vet folded then back, she did in previous visit.

Then 9.15 [Sep 15th??] to start of taper @ 10mgs. Vet will decide what next date/cut will be...

Of Gabapentin 100mg from 8.8 2-3x daily, hard to fit in 3 but maybe half the time she was given 3. Vet said that was fine... she sleeps all night as well as ever.

9.1 vet visit [Gabapentin]1-2 daily as needed. I had cut back to mostly just 1... didn’t seem like she was in pain. She does pant quite a bit at times though... is that pain, stress of just not wanting to be in crate, she does not usually pant when not in kennel... some days it’s kinda hot and other dog will pant too so IDK. She is not a dog to cry out or complain...

I pay a lot of attention to her gait to try to help with understanding the pain issue. What to look for? Do you suggest I always give her 3 daily no matter what?

So will go get some Pepcid AC. Also, 3 meds multiple fronts... do you think I still need to add traMADol-general analgesic, methocarbamol- muscle spasm pain when reading all this? Not sure, but . Her gait is a bit wonky but is improving, is that pain? Those 3 meds 3x daily and are just needed while on Prednisone/anti-inflammatory right? I don't think I am seeing much pain. I can call for those after I hear back from you at it...

Of the pain signs you mentioned at the end of that last post, not really seeing any of those.

Last date talking to vet was 9.4 but that was for eye. Last for disc issues was 9.1 mentioned above. She does improve daily, but perhaps could be even better w/some changes.

An added issue is in the past week the whites of her eyes are quite red by night time... they do look much better again the next morning... thinking is this from stress? She has not had this in the past, just started... with this may just take her in for this and adding other pain meds. Also, I am wondering if the meds she is on cause panting too?

BTW her disc prob is the disc just above her last rib.

Sorry so many questions... thanks for all the help! Susan

Try to keep a happy voice and face around your dog. Dogs are very sensitive and pick up on our feelings very easily. Tell her everything's OK and that she's getting better every day. And you believe it, too!

Here are some tips to help calm your dog in the crate. If these do not help, it may be necessary to have the vet prescribe a mild sedative.

To calm your dog in the crate, it would be a good idea to cover the top with a towel. That should mellow him/her. It also creates a den like feeling that dogs love.

Using any oral calmer in combination with a Pheromone diffuser seems to work best. It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives such as Acepromazine, Trazodone, etc. Of course always keep your vet in the loop on all things you give your dog. Other product brands may be available in your area or on-line… just shop by the active ingredient(s) on the label and the quantity for best price.

Place a DAP pheromone diffuser at floor level where the recovery suite is.
Dogs: Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/us/Products/ADAPTIL-Calm-Home-Diffuser with dog pheromones

Use a diffuser with one oral calmer from below:
1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed
2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine.
3) Bach's Rescue Remedy is a liquid 5-herb combo to help with relaxation (Star of Bethlehem – Orithogalum umbellatum, Rock Rose – Helianthemum, Cherry Plum – Prunus cerasifera, Impatiens – Impatiens gladulifera, Clematis – Clematis vitalba)

Be aware you might be inadvertently training for unwanted behavior. To dogs rewards are: food, looking at them, talking to them, eye contact, approaching the crate, petting. So anytime you see unwanted behavior ignore it, turn your back, leave the room if you have to. Preferable is to start teaching what you do want before there is too much practice in doing the unwanted behavior. Anytime your dog is sitting or lying down quietly, give a reward. Soon your dog will see they get rewards for four feet on the floor, quietly sitting, etc.

Consider some of these ideas:

-- Many members have found a pet stroller to solve the whining problem because the stroller can be wheeled from room to room as you go about your activities. Pet strollers, however, should only be used when you are directly supervising and only inside during conservative care. More details on strollers: www.dodgerslist.com/literature/strollers.htm

--Caster wheels can be added to a wire crate so the crate can be wheeled from one room to the next so your dog can stay with you.

-- Put a garment you have been wearing and have not washed in the crate.

-- Nan Arthur, CDBC, CPDT, KPACTP writes:
"According to the book, Stress in Dogs, by Martina Scholz & Clarissa von Reinhardt, the most well-behaved dogs get 17 or more hours of rest and sleep per day.
Teaching self-calming exercises can also help your dog to relax more. You can make something as simple as eye contact a very rewarding behavior that also acts as a way for your dog to “ask permission” when he wants something. When dogs have a focus and an understanding about how to behave to get what they want, they are much calmer overall. To do this, each time your dog looks at you, say, something like, “Yes!” or use a clicker to mark the second he looks at you, and then give your dog a high-value food reward. Wait for your dog to look up at you again, say, “Yes,” and reward again. Do this exercise 10 or so times and then say, “All done,” and put the treats away. Come back later and do it again until you can see that your dog is really starting to make automatic eye contact in hopes you will say, “Yes,” again and give him his reward. " [NOTE: treats should be subtracted from the normal daily kibble ration so as not to gain weight during crate rest.]

-- If your dog won’t get too excited seeing what’s happening outside, during the day try putting the crate on the coffee table or the dining room table so there will be a view out a window and a better perspective on what is going on in the house from on high.

-- Play classical music or one of the wildlife TV shows.

-- Fill a Kong with soft dog food and freeze. Put part of the dog's total daily dinner kibble in the Kong to lengthen time to consume dinner. Good low cal snacks are carrots, apples, or frozen green beans, licking a frozen low sodium broth ice cube. Good thick low salt/no fat chicken broth is full of cartilage-building proteins and amino acids. Freeze it up into cubes for easy access as you need it. Fun and keeps the body hydrated: place cubes in a bowl for licking.

If a dog is jumping up at the sides of the crate, you can lower the ceiling of the crate. Cut a piece of cardboard the size of the top of the crate, punch holes in the corners and tie the cardboard down into the crate to the level of the top of the dog's head when standing. Or cover the top of the crate with a blanket or towel, bringing the blanket/towel down to the level of the dog's eyes so when he/she jumps up, he won't be able to see anything. That may discourage him/her from jumping up.

dodgerslist.com/2020/05/14/strict-rest-recovery-process/

dodgerslist.com/2020/02/24/tips-to-help-with-recovery-suite/

Susan, if "sat up" means she sat on her butt, that is fine for her to do. She does not have to be in the lying down position all the time. As long as she is not being rambunctious and moving her back way too much, it is fine for her to sit on her butt as she wishes.

She might enjoy some cooling licking of frozen ice cubes or better yet frozen no salt/no fat meat broth.  Simmer up a hamburger patty (in no salt, no onion water). When cool remove the fat disc at the top.  Save the meat to crumble a teaspoon on each meal. Freeze the broth in cubes.

What have you learned about Stella's health to be able to take an acid suppresser Pepcid AC (famotidine) for the duration of prednisone:Would you verify if the 9/15 date is correct?  "wants me to taper back on 8.15 [?] to orig dose 1/2 AM"

Hello Paula, Thanks so much for all the help n verification of what I am doing.
Stella is back to the Gabapentin as per the original amount of 100mg 2-3x daily. Obviously 3x means every 8 hrs... 6am, 2pm, and 10pm... but once n a while I am gone at 2pm, so give another w/6pm meal, only 2x. That 3x was the usual daily was the schedule from 8.8-9.1 vet visit. At that 9.1 visit she said I could just give them as needed up to 3... most days I gave 2 but some just 1. On 9.12 back to 3x and she was so much calmer in the crate too... perhaps she was in some pain in previous days and I just didn't realize it... not good. Today 9.13 she just had 2 as I was not home until after when I did give her the 2nd for today... she was still fine in the crate etc all day. Since it's hard to determine her pain, especially with 1-3, I should do as you say above just to give them to her x3 daily (if possible, anyway). I thought maybe they were causing the anxiety, but it seems not now after trying less for a bit that doesn't seem likely... or even her eye redness (which was worse again w/the 3x)... sighs. Perhaps it's the Predisone is causing the anxiousness.
I am glad to see you say no need to add the others, but will keep them in mind if need be.
This site and you all are so helpful, and supportive... TY!

HA... yes, sat up=sits up! I worried me she wasn't sleeping more is all. Anyway, yesterday 9.12 n today 9.13 her crate experience was amazinly much better! Will also try some of the goodies you suggested... need to buy an ice tray... giggles.

So, I didn't get a call back from vets office, but did buy some Pepcid today and hope to get her going on that. How much should I give Stella, she is 18#? Also, I read that it was best to give on empty stomach and 2hrs away from the Gabapentin pill? Will have to figure that out with-in her routine.

The Prednisone 10mg taper back starts [date?], but called vet today to see what follows. I did call today to try and find out a date for next change, but they have not gotten back to me yet. She has appt this coming Tuesday the 19th for her eye, though I call each 7 AM daily to see if some time sooner is available... I will keep up those efforts and questions... or maybe they can check all that same day...

Thanks for all the support!

OK, I was using the quote to answer the first message when there were two... sorry, will use this to answer all at once now.
Glad to know about the 'no worries' w/Pepcid, makes things much easier! I too had read that it would reduce the Gabapentin by 20% as above when 1st looking into it days ago, prob wouldn't bother much even if that were true in reality in our case. Just me stressing...

Paula, Glad that it is fine to give right in her meals with the Gabapentin & Predinsone.
Also, tomorrow 9.15 she will be starting a taper back of Predinsone to 10mg AM. Stellas next vet appt is 9.28.
Susan

Paula, IDK... my next visit w/vet is 9.28. Should have asked more about what's next when calling for that appt. yesterday. I really just talked to the desk person who scheduled it after talking to vet. Typically they do call a couple days after a change to see how things are going, like w/this first taper, hopefully. Was assuming vet will decide more at 9.28 appointment when she has more feedback from me and hands/eyes on. Vet did say at previous visit that steroids would be cut back even further, maybe every other day or some other way. Does that seem like typical timing for 2nd cutback?

Also, Stella was a little off her food [9/16] this AM. Maybe that 3rd time of Pepcid in the mix was off putting. I will give it by itself next time before, or after meal as things are kind of hurried in the AM to get Stella out and dogs feed... they are very ready! or maybe cut the amount down a bit?
Thanks for all the help, Susan

Hello there Roma & Frankie,
Thanks for the response! "It is fairly common for dogs to taper more than once before all the spinal cord swelling is gone."... good to know!
    Stella, again [9/16]  this AM, left a bit of food in bottom of bowl same as yesterday. I am giving Pepcid about a 1/2 hour after eating. Should I try hold off on food and give her Pepcid 1st, then feed... reversing that order? Or cut dosage? She has no diarrhrea or vomiting, will do as you suggest n call vet if that happens. She did not miss food before the Pepcid. Seems weird? Maybe Pepcid just started working on the GI concerns she was just starting to have?

Paula... Yes, I had been giving all meds in her bowl w/food, which is why I questioned earlier the need for Pepcid wait period. The last 2 days when she didn't finish, I picked up bowl and she finishes it off 30 or so mins later. So I am sure she gets the meds.

Starting [9/17] towmorrow I will do as you suggest in 1,2,3 order. For my own pills I prefer to eat 1st, so just assumed (incorrectly to do the same w/her). Guess we can still learn things at age 74!
    I can do the down the hatch/video method, but will these pills both of us perfer the 'hide' method, or as previously w/meals. I do make use of banannas or liverwurst when giving separate from meals... she loves them! Luckily cocker/Stella loves most everything. I have also used pill pockets and always have cream cheese about to try... but never tried mashmellows, ha!

I had read that Pepcid page before and again recently to stay on top of it. She has NOT had any potty issues, dark stools, or nausea etc. Will also continue Pepcid until completely off Prednisone... plus a couple days for good measure. Thanks for that note too. Sure hope all goes well w/taper. She seems to be same so far but early days.

The other page w/chart, I had seen but couldn't find again. I did make up one quite similar with all that info of meds X daily, med changes, and also notes... VERY helpful as compared to a running diary.

Again, thanks for all the help with all my questions, I know I can come up with a lot of them! Much appreciated!!! Susan & Stella

Very happy to hear this good report!

With the additional cut back in pred as well as the decrease in gabapentin, be on the lookout for any signs of pain emerging. Pet parents are in the best position to notice pain and can report it to the vet right away.

Stay the course with crate rest as much as possible until Stella's graduation day. It is coming up soon and would be just terrible if too much movement caused any type of setback. Especially since she is doing so well.

Hello again,
It's been a while, my life has been getting a little hectic getting ready for our Maine winter!!! This is what has been happening since our last talks and her 9/28 vet visit followed by...
9.29 Pred 5mg AM, and Gabapentin still 2X daily as above...
10.4 Gabapentin cut to 1X daily
10.12 Pred 5mg every-other day
10.19 I called and took Stella to vet, a slight curve to her back appeared today and was concerned. Vet (different vet in same practice) felt she was having a set back and changed meds to...
10.19 Pred back to 10mg 1X AM, Gab 3X daily
10.20 Stella was doing much better already. Then looking back a few days later wished I had not prompted this change to meds... perhaps just over-reacting.
10.26 Called vet and reported Stella has leaked a couple times while asleep, she had never done this previously. Re-adjusted her meds to...
Gab to 2X daily vet felt that was the issue, but also Pred 5mg 2X daily (same amt just split into 2X).
That resolved the potty problem as it has not happened again. Since then all seems to be well. Though Stella has had a slight curve to her back a couple staggered days since... only for a few hours or so, not all day... then goes away.

[MED LIST/HISTORY- Moderator's Note. Please do not edit
18 lbs 10 y.o
had not been providing strict crate rest 8/8 to 9/11
STRICT rest as of 9/12, should have graduated Nov 7.
prednisone as of 8/8: 10mgs 1x/day for 14 days, 8/22 test taper for: pain / √8/22 new knuckling neuro
                as of 8/22: 10mgs am; 5mg pm for 28 days ; 9/28 test taper for _pain  _neuro
                as of 10/19 : 10 mgs 1x/day for 27 days, then taper TBA
gabapentin 100mgs 3x/day  as of 10/5, pred tapers on 9/28!
Pepcid AC (famotidine) 10mgs 2x/day] 

So tomorrow 11.14 morning she is to visit vet again, I'm expecting to cut back further on Prednisone, maybe the Gab too.
I am wondering what are the next steps to expect once we figure out about the drugs... I do want to get her completely off the Prednisone eventually (if possible), though I do predict vet will say 5mg every other day as she had before. Gabapentin? IDK AND what for backup if another slight set back happens? Will be asking vet this too. Also, was wondering about trying acupuncture, when might that be an appropriate time? 
Anyway, how to proceed with the re-into her to a more normal day/life.
Thanks so much for all you do! Susan

Unfortunately, the vet did not feel she should switch Pred to every other day, yet. Nor did she want to reduce the Gabapentin. When we did get to Pred every other day and one Gab daily, Stella then had a setback, but was fine after a full day of the change. I told the vet I was hoping to someday get her off Pred altogether. She feels that Stella may never be able to be off Pred. Sad. I had hoped that the Gab as needed would be enough at some point, but that may not happen.
In Stella’s daily life she shows no signs of neuro problems IMO. She places her back feet apart in a good stance and has a smooth walk with good foot placement, vet agrees. No wobbles anymore. When she squats n sits, she does put one leg under her belly kind of weirdly (is that a neuro thing?), the other is not quite straight under her but slightly out to the side... what I would call a lazy sit, not unusual. However, when the vet folds her paw back, she is just lazily slow (one second) [neuro] to correct either one or the other not usually both... it changes which paw from one visit to the next, weird. I wondered if this was her show dog foot placement training showing up.
I did ask if she thought acupuncture would help. She, herself, does not do that... she has another in-house vet that does acupuncture... who wanted to wait a bit last visit... and wasn’t there today to ask if now was a good time. I ended up getting an appointment for a session for 11.30.
Any thoughts and suggestions about all the above will be appreciated!!! Thanks... S

8.8 Pred 10mg 1X AM, Gabapentin 100mg 3X
8.22 Pred 10mg AM +5mg PM
9.13 Pepcid 10mg 2X before Pred
9.15 Pred 10mg 1X AM, Gab 2-3X
9.28 Taper Pred 5mg 2X daily, Gab 2X
10.4 Taper Gab 1X PM
10.12 Taper Pred 5mg every other day
10.17 Gab stopped, but was supposed to stop 10.19
10.19 +Pred 10mg 1X AM, Gab 2-3X as per setback
10.26 Pred 5mg 2X daily, Gab 2X ▼Gab changed as per urine leakage 2X when asleep, this stopped it
11.14 no change to meds at this vet visit

[MED LIST/HISTORY- Moderator's Note. Please do not edit
18 lbs 10 y.o
had not been providing strict crate rest 8/8 to 9/11
STRICT rest as of 9/12, should have graduated Nov 7.
prednisone as of 8/8: 10mgs 1x/day for 14 days, 8/22 test taper for: pain / √8/22 new knuckling neuro
                as of 8/22: 10mgs am; 5mg pm for 28 days ; 9/28 test taper for _pain _neuro
                as of 10/19 : 10 mgs 1x/day for 27 days, then taper TBA
gabapentin 100mgs ▼2x/day as of 10/26
Pepcid AC (famotidine) 10mgs 2x/day]

So you don't believe the acupuncture will do any good as per your previous response? I was trying to see what else might help her. I do think she is doing great knowing what others are experiencing, but once the meds are stopped it is questionable that she can actually get off them. The Prednisone brings on so much with it I would love to get her off it! Guess I need to keep being patient, but what are the chances at this point she might get off them??? Is it common that many dogs stay on steroids? I noticed in your response "The taper ALWAYS must conclude in an every other day dose to let the body know to again make its own steroid hormone." So it seems we MUST try the every other day taper AGAIN at some point... and keep trying all this.
Again, thanks to you and the group for all the help n insights.

Hi Romy & Frankie,

Thanks so much for the uplifting and helpful reply! and a little more clarification penetrating my brain. Glad to know that the repositioning of her paw is not a reason to keep her on Prednisone. At the vet is the only time that seems to be noticed. It doesn't seem to be a problem for Stella. With the meds she has on board now she seems great really, but now to get it to be great off them too! I would like to make sure I have a Plan B, in case Stella needs a little help now n then, what do you suggest? Gabapentin or?

It seems the only neuro prob would be Stella's arched back? And a reason to keep her on the Pred? Not sure if arch is pain or swelling.

The vet did not indicate when Stella's next taper would be.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
18 lbs 10 y.o
had not been providing strict crate rest 8/8 to 9/11
STRICT rest as of 9/12, should have graduated Nov 7.
prednisone as of 8/8: 10mgs 1x/day for 14 days, 8/22 test taper for: pain / √8/22 new knuckling neuro
                        as of 8/22: 10mgs am; 5mg pm for 28 days ; 9/28 test taper for _pain _neuro
                        as of 10/19: anti flam dose: 10 mgs 1x/day ⚠️for 30+? days, then taper TBA
gabapentin 100mgs ▼2x/day as of 10/26
Pepcid AC (famotidine) 10mgs 2x/day]
I had an appt. made for acupuncture but I just canceled it since neither you nor Paula think it will be of much help.

11.30 Vet visit to recheck and hopefully start another try at tapering Prednisone.

You, PaulaM, and Marjorie have been a lifeline for me! TY all... S