Lorie's Oscar 3/19 conservative

Is Oscar on strict crate rest?
Please tell us what medications Oscar is on. What has the vet told you?

My name is Paula what is yours?  We do have lots of good information to share with you. The most important of the information is the IVDD self education program all owners need to embark on.  What makes IVDD scary is the not knowing or understanding how treatment works, verifying if even our own vet is well versed in this particular disease. Most all of us have had to take it upon our selves to be outspoken advocates for our dogs.

Take advantage of all of the information we have for you at www.dodgerslist.com/literature/healingpage.htm on the "Disc Disease IVDD 101" page.  The more YOU know, the better informed decisions you'll be able to make concerning treatment, care and protection.

I highly recommend you start with the article entitled "Hows and Whys of conservative treatment" which will be your road map for the next 8 weeks.  www.dodgerslist.com/literature/conservative.htm
 
Add this comprehensive "must-have" $3 DVD on IVDD to your arsenal of educational resources. Friends, family and those who will be caring for your dog should also watch this DVD; plus don't forget to order one DVD for your vet www.dodgerslist.com/store/DVDorder.htm

Medications are how pain is controlled in an hour and over weeks swelling in the spinal cord is reduced. We can better provide support if you will give us the meds, their dose in mg and how often you give them.  You did not mention a stomach protector while on Pred.  Cortisteroids (Prednisone, Prednisolone, Dexamethasone, etc.)  are involved with stimulating gastric acid secretion causing GI upset to the more threatening bleeding ulcers or holes in the stomach or intestine.  Phrase the question to your vet in this particular way:  "is there any medical reason my dog may not to take Pepcid AC?"  If there is no reason, we follow vets who are proactive in protecting the stomach by giving doxies 5MG Pepcid AC (generic name is Famotidine) 30 mins prior to steroid.  We ask that all members read about each med their dog is on or may take as a safety measure. This directory is in alpha order and the one I use all the time:
www.marvistavet.com/html/pharmacy_center.html

Is his pain under control? pain-- Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy, holding leg flamingo style not wanting to bear weight?  Have no patience with pain at all.  Because we do not yet know the dose in mg or how often you give meds, we don't know if there are plenty of options with mg and frequency should you be seeing pain.  Many vets do add gabapentin to the Trmadol/methocarbamol mix for hard to control pain.  Let us know how Oscar is feeling.

I do not believe that Oscar has bladder control. Dogs can feel poop coming and will move, get agitated, but if paralyzed can't keep it from escaping their bodies.  Urine, is different, when the bladder is filled to over stretching reflexes just release some of the urine. Max may already have a UTI it happens very fast.  Another reason to learn to express is to preserve the tone of the bladder.  You will need a hands on top of your hands lesson tomorrow asap. This is a wonderful video to help you get more out of the lesson. www.dodgerslist.com/literature/Expressing.htm   How to set up his recovery suite tips you will want to read about:   www.dodgerslist.com/literature.htm#recoverysuite

Oscar should have a urinalysis to verify no infection has started in his bladder. Infections can  move up to the kidneys to become life threatening.

To be truthful, many vets do not correctly interpret what they see with the deep pain sensation test and likely you will not either.  It can cause undo movement to Oscar's back.  Far better is something you can make no mistake about....tail wagging with joy.  If a dog can wag the tail then naturally they still have deep pain sensation.

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 (happy talking, seeing a treat) is lost
8. Deep pain sensation, the last neuro function, a critical indicator for successful surgery.Trust only a board certified neuro or ortho specialist to correctly identify deep pain sensation. Surgery can still be successful in the window of 12/24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance. Precious hours can be lost with a vet that gets DPS wrong.

--What breed is your dog?

-- Currently can your dog wobbly walk? move the legs at all? move up into a standing position  or wag the tail when you do some happy talk?

-- Do you find wet bedding or leaks on you when lifted up? This is a sign of loss of bladder control and the need to express

-- Eating and drinking OK?  Poops normal firmness?

-- Poops OK - normal color no dark or bright red blood?

We look forward to learning more about Oscar.... Give him a big hug and kiss, let him know everything is going to be alright.... because it will be.  He will be back enjoying family life after his recovery period.

Lori, it appears that Prednisone is now being tapered down from the original dose at the anti-inflammatory rate in mg and frequency, is that correct?

It is on the taper of Pred that pain needs to be assesed. Pain = swelling = more time needed back at the original dose, the  anti-inflammatory dose of Pred. Please alert your vet to the signs of pain you are seeing, so he knows another course of pred is needed.  Often it can take 1-2 weeks at the dose level called anti-inflammatory to get all the swelling down in the spinal cord. Some days may even take more like a month on pred.  It is on the taper to less than an anti-inflammatory does that is necessary for health reasons, that is also provides you and the vet a peek into how swelling is doing.

Care and healing just can't proceed untill the #1 healing level has been achieved...full pain control dose to dose of the pain meds (Tramadol and Methocarbamol)  Do not skimp on pain meds give them promptly a the max dose you were prescribed.  Tramadol is  not likely to control pain unless given every 8 hours as it's half life is 1.7 hours.  Your vet has still more options to get pain under control, increasing mg of Tramadol to 50  mgs, prescribing methocarbamol 3x a day and even adding in gabapentin. Do get the full range you can give pain meds so that nights and weekends when he is not open you know all of your options.

This article on conservative treatment discusses when surgery would be an option..it is your guide for the next 8 weeks.  www.dodgerslist.com/literature/conservative.htm

Let us know that today you have Pepcid AC (famotidine) on board.  5mg 30 mins before Pred and there after every 12 hours, that Oscar is back on the anti-inflammatory dose as per your vet, and that his pain is fully under control dose to dose of the pain meds and what changed to the prescription your vet gave.

Lorie, that is good news on nerve healing to be able to move up into a standing position!

Dogs abhor having poop where they sleep and will try to get rid of it. Yuk!

- Do you have Pepcid AC (famotidine) on board?
- Do you currently yesterday or today see any signs of pain with the reduction/taper of Prednisone?

Still having signs of pain means his pain meds are not right Yet. This takes your advocating and reporting signs of pain, being as persistant as you would be for yourself if you were in in pain. If he is on the taper off of Pred, then you need to advise the vet and likely pred will go back to the origianal dose for a bit longer to make sure all the swelling is gone.

The active ingredient (the generic name) is what goes in brand names products or brand X products. Look on your bottle for the active ingredient: famotidine. How many mg is it? So for example if you bought a tablets containing 10 mg of famotidine, then you would need to split the pill into halves to get a 5mg dose. The question to ask must be stated in this particular way: "is there any medical reason my dog may not to take Pepcid AC?" If there is no reason, we follow vets who are proactive in protecting the stomach by giving doxies 5MG Pepcid AC (generic name is Famotidine) 30 mins prior to steroid. Of course as always do your own research on each med your dog takes. I like this veterinary web site for that:
www.marvistavet.com/html/pharmacy_center.html

Let us know what the vet says this morning with your phone call and what changes to prescriptions he has made. It all becomes so much easier once pain is fully under control...it IS heart wrenching to see them in pain and it is not necessary if you can get the meds right for Oscar.

Lori, how is Oscar tonight. Is he still in pain.

Wow! It's been a long 10 days! A couple of really tough days, scary days, and many moments of wondering what the heck I was doing to my poor baby boy. I hope I don't jinx anything by reporting that Oscar really started to perk up last night! He was standing, wagging his tail and " boofing" which is my word for a noise that he makes when he wants something. He always "boofs" when he wants up in the big bed.

He is still wobbly on his back legs but he is showing signs of getting back to himself. He is barking at noises again (not that I missed that) and enjoying his chewie. He is almost spunky today, in spite of a little lack of coordination. And, best of all, he does not seem to be experiencing any pain!

Believe me though, Oscar is not coming out of that crate for awhile yet. I'm supposed to have him at a lazer treatment and follow up appointment on Saturday but I'm thinking of rescheduling for the following week. I'm just hesitant to move him around yet. Thoughts?

Thank you Paula for being here for Oscar and me!