Lauren's Bailey 12/9 Conservative 3rd episode

Hi Lauren,
I am not a moderator, but I know one will be here shortly. It will help them to help you better if you give a bit more information. 

Prayers and thoughts to Bailey!  ....and you

Here goes:

With answers to these questions we will be better able to help you.
-- What is your dog's name? 
-- How much does your dog weigh?
--What breed is your dog and did you specifically get a diagnosis of IVDD?
-- What was the date you saw the vet and started 100% STRICT crate rest 24/7? 

NOTE: 100% STRICT rest 24/7 only out for a very few footsteps at potty time means: no laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no chiro (aka VOM). In other words do everything you can to limit the vertebrae in the back from moving and putting pressure on the bad disc. There are no meds to heal a disc... just time of 8 weeks and limited movement.

-- Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy?
-- What are the exact names of meds currently given, their doses in mgs and frequencies? 
-- Currently can your dog wobbly walk? move the legs at all? or wag the tail when you do some happy talk?
-- Do you find wet bedding or leaks on you when lifted up?
-- Eating and drinking OK?
-- Poops OK - normal color no dark or bright red blood?

Be sure to order one of our DVDs. Only $3 and that includes shipping. www.dodgerslist.com/literature/IVDDcourse/index.html While, there order some of our literature to pass out.

Welcome to Dodgerslist, Lauren! Please let Bailey know with your utmost confidence that things are going to be ok…because they will. With this disease self education is critical not just so you make sure the right things are being done for the best recovery but for your own emotions. The unknown is simply a scary place. Get ready to fight this disease now and in the future by knowing all things IVDD. There is no better place to start than on our main web page with "Overview: the essentials" and then read all you can as soon as possible. Here's the link www.dodgerslist.com/healingindex.htm

Do you have Pepcid AC (famotidine) now on board to protect the stomach from the steroid? If not ask your vet in this particular way: Is there any medical or health reason why Bailey can't take Pepcid AC. If there is no reason it's important that he takes it 30 minutes prior to the steroid to protect his stomach.

What are the names of the pain meds?  The dose in mg's and I see you listed the frequencies given. The more detail information you share the better we can support you.  Pain medications such as Tramadol work better given every 8 hours. Twice a day is not general enough to get the pain under control.  Bailey likely doesn't want to move around much because of the pain, so it is important to speak with the vet about giving the pain meds every 8 hours. Bailey can't heal until his pain is under control from dose to dose. Once that happens he will improve and feel much better.. www.dodgerslist.com/literature/healingpain.htm

It sounds like Bailey may be constipated from the medications.. Pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation that some IVDD meds can cause. The amount of water in the diet makes all the difference. To loosen the stool, add equal parts water to each kibble meal along with a teaspoon of plain canned pureed pumpkin 1x a day. To firm up the stool add 1 teaspoon pumpkin to kibble and no extra water 1x a day. Note alternatives: really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potato.

Yes Bailey can't have a great quality of life even in a cart.. Please read this:  www.dodgerslist.com/index/SDUNCANquality.htm   and watch this: 

Prayers and soothing thoughts to Bailey and for you..

Lauren, there should be no signs of pain at all from one dose of the pain meds to the next. When you see him shivering and looking uncomfortable before the next dose, that means that the pain meds are not lasting long enough. Tramadol has a short shelf life and needs to be given every 8 hours. As Paula said, both Tramadol and the Methocarbomol can be given every 8 hours. Also, Gabapentin can be added. Please contact your vet this morning to let him know of the pain that Bailey still has so his meds can be adjusted.

Good job on getting the Pepcid AC on board.

Bailey was very fortunate to heal so quickly the first two disc episodes. Nerves can sometimes take a long time to heal. The fact that he hasn't improved yet in such a short time does not indicate that he won't improve - just that it's taking longer this time. This disc may have torn more than the others did. The 8 weeks of crate rest is to heal the disc and allow it time to form scar tissue to protect it. The nerve damage that you're seeing, wobbly walking, may improve soon or may take longer. Wobbly walking is a mild symptom of IVDD and there is every reason to believe that he will be fine with crate rest. And you're very fortunate that Bailey is so content in the crate. So try not to look too far into the future and tell him every day that he's getting better - and believe it yourself, too!

Please let us know what the vet says about the pain meds and getting Bailey's pain completely under control.

All the best to you both.

Is that both the Tramadol and the Methocarbamol that is now being given every 8 hours? Good job on advocating for more pain meds for Bailey. It sounds like your vet is on top of things with him asking you to contact him tomorrow if you don't notice changes. That's great.

Acupuncture and laser light therapy can help give the nerves a kick start to regenerate if that's within your budget. Also, after the 8 weeks of crate rest, physical therapy and water therapy can help if he still is having difficulty at that point, but only after conservative care is over.

Hang in there. It's very early days and he hasn't had much time for healing yet. You're doing a good job in making sure his pain is under control. Once that is accomplished, he can heal in comfort.

Lauren, kudos to you on the feedback to your vet and to your vet for wanting feedback again just in case pain meds might need more tweaking.  Do you give Pepcid AC 2x a day and give the Metacam with a meal?

8 lbs
Pepcid
metacam liquid once daily
tramodol 50mg 1/4 twice daily, as of 12/11 3x/day
methocarbomol 500mg 1/4 twice daily, as of 12/11 3x/day

At potty time you might find as I did, setting up an fenced area of about 6 feet in diameter (it is small!) will help Bailey know he is not going to be able to do sniff fests at potty time.  Use an ex-pen set up in the grass or if snowing there, you can set up on your deck with a layer of snow to pee and poop on.

Sling can be a long winter scarf or as most males prefer a figure 8 sling.

Hi Lauren, I'm Sabrina. So happy to hear that Bailey's pain is under control!

Metacam, Bailey's anti-inflammatory drug, is an NSAID (non-steroidal anti-inflammatory drug). Prednisone is a steroid. FDA and manufacturer package inserts warn against use of a NSAID with a steroid or with another NSAID without a washout period of 4 to 7 days before starting the new medication. Vets that practice safe medicine require a 4- to 7-day washout period between the medications. It is also a good idea in that situation to add in a 2nd stomach protector, Sucralfate (vet has to Rx), in addition to Pepcid AC (famotidine).
www.dodgerslist.com/literature/healingsweling.htm

Did your vet say in what situation he would want to switch Bailey from the NSAID (metacam) to the steroid (pred)?

Are Bailey's neuro symptoms getting worse?
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 scuffing floor
4. Paws knuckle
5. Legs do not work (paralysis, dog is down)
6. Bladder control is lost
7. Tail wagging with joy is lost
8. Deep pain sensation is lost
www.dodgerslist.com/literature/healingnerves.htm

I hope the figure-8 sling is more comfortable for Bailey!

))Hugs!((
- Sabrina

You would not necessarily expect all the neuro functions (knuckling) to be back during the 8 weeks of crate rest. Crate rest focuses on allowing the disc to heal. Nerve healing can be a slow thing and may take more than 8 weeks

What you expect is that there is not worsening of neuro functions… which you confirm…that is good!

You would expect all pain to be fully under control and never showing nearing next dose of meds, which you also confirm..that is also good!!

When there is an emergency of severe loss of neuro function a vet has to make a very serious consideration to switch classes from the non-steroid to the steroid class. That means a washout where no inflammatory is on board for 4-7 days OR skipping the washout with quite serious implications for the GI tract, the need for double protection. It really does not sound like anything like that is going on with Bailey from what you are writing.

Hi Lauren,

Glad to hear that Bailey had no complications from the switch to Prednisone from Metacam.  Glad your Vet did the washout of at least 4 days and that Pepcid AC was on board twice a day.  Very glad to hear of his improvements..  If he does show any signs of GI distress such as not eating or diarrhea be sure to ask his Vet to prescribe Sucralfate, it would form a gel coating over the problem areas in his stomach.. So far it doesn't sound like he will need it but do keep it in mind if he shows any signs..

Thank you for the update and we look forward to the next one..

Usually vets taper down the pains meds also or completely stop them during a taper of the steroid. That gives a more accurate test for pain. Please speak to your vet to see what they want to do about also tapering or stopping the pain meds.

If Bailey's constipation has cleared up and he's going normally now, you can stop giving the pumpkin.

Please let us know what the vet says after speaking to them.