Chris' Fritz 2/7 conservative; relapse grad: May 18

Welcome to Dodgerslist. My name is Paula what is yours?

Can you confirm for us that Fritz does have bladder control. That mean carry him to and from the potty place. Put him on an old pee spot and then he sniffs and chooses to release urine? The only way for us humans to know if there is bladder control is with the sniff and pee test. Make sure the sling or your hands are not on the tummy area as that can press on the bladder. If urine comes out after sniffing, bladder control is returning. If you find urine leaks in bedding or he leaks on you when lifted he likely has lost bladder control would need you to manually express his bladder. www.dodgerslist.com/literature/Expressing.htm Let us know what you observe.

We'd love to know a bit more about Fritz, can you fill us in on these important details:

--Did you specifically get a diagnosis of IVDD?

-- What was the date you saw the vet and 100% STRICT crate rest 24/7 for this current disc episode?

-- Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy?

-- How much does Fritz weigh? What are the exact names of meds currently given, their doses in mg's and frequencies?
Anti-inflammatories can increase GI tract damage. Phrase the question to your vet this particular way:" Is there a medical/health reason my dog may not take Pepcid?" If there is no reason, we follow vets who are proactive in stomach protection by giving doxies 5mg Pepcid (famotidine) 30 minutes before the anti-inflammatory and thereafter every 12 hours. Pepcid is generally considered a safe-over-the-counter suppressor of stomach acid production for a healthy dog and good insurance. Dogs don't speak up at first signs of trouble like a person would.  This directory very good for learning about each of your dog's meds:
www.marvistavet.com/html/pharmacy_center.htm

-- Currently can your dog wobbly walk? move the legs at all? or wag the tail when you do some happy talk? The very, very lightest least aggressive range of motion and leg massage is necessary for paralyzed legs during conservative treatment. The information highlighted in PINK pertains to a dog who can't walk once off all pain meds and no more signs of pain.
www.dodgerslist.com/literature/massagepassiveexercises.htm

-- Do you find wet bedding or leaks on you when lifted up?

-- Eating and drinking OK?

- How are poops today- normal color and firmness, no dark or bright red blood?

-- If there is pain or neuro diminishment, dogs can benefit greatly with acupuncture or laser light therapy. These therapies can be be started right away to help relieve pain and to also to kick start energy production in nerve cells to sprout. So if this therapy is in your budget, seek out a holistic vet.
ahvma.org/Widgets/FindVet.html
www.serenityvetacupuncture.com/index.php/faq_/ [one vet's overview/prices] Chiropractic is not recommended for IVDD dogs.

We look forward to reading your answers to the above questions.

Hi Chris, I'm Sabrina. I'm so sorry you and Fritz have to go through this, but I'm so glad that you have found Dodger'sList!

A once a day dose of Tramadol doesn't provide full-day pain relief. Tramadol has a very short half-life (1.7hrs), and for full pain relief dose to dose it may need to be prescribed at a minimum of ever 8hrs (3x/day). As Fritz is a very stoic little guy, it would be good to speak with his vet and see if the Tramadol can be prescribed more frequently to be sure he isn't in pain, as pain hinders the body's healing process. Watch out for signs of pain such as: holding the head in an unusual position...head held high or nose to the ground, shivering/trembling, not wanting to move much or moving gingerly, yelping, tight/tense stomach muscles, holding leg up flamingo style...not wanting to bear weight on the leg, just not their usual perky-interested-in-life self.
www.dodgerslist.com/literature/healingpain.htm
www.dodgerslist.com/literature/healingpage.htm

What sort of sling are you using at potty time? Often times male dogs are more comfortable with a "figure 8" style sling:


Potty time was a huge adjustment when my dog was first on crate rest! What really helped us was making a "potty spot" - a 6ft diameter area blocked off from the rest of the yard with that push in the ground garden fencing. With it being winter now, it would probably work better to make a potty spot out of an ex-pen or something that you don't have to try to drive into frozen ground! For my dog, knowing that he wasn't going to be allowed to wander all over the and find his own spot made potty times so much easier!

If you haven't already seen this, here's a good, secure way to lift Fritz:


Have you seen these pages about setting up the recovery suite?
www.dodgerslist.com/literature/cratesupplies.htm
www.dodgerslist.com/literature/cratesupplies/preppingcrate.pdf
Fritz's crate should be large enough for him to lay fully stretched out and turn around comfortably, but not so big that it encourages too much movement. A good size is: as wide as Fritz is long, and 1.5x as long as he is. If Fritz's crate is a bit too large, the extra room can be padded out with blankets.

I'm so glad to hear that Fritz's stomach is being protected! As Paula said, when there are no other health reasons Dodger'sList follows vets who use PepcidAC 30min before the steroid, and then every twelve hours afterwards (2x/day). I'm so glad to hear Fritz's blood work and heart are healthy! When you are checking about Fritz's Tramadol also ask his vet if there is any reason he couldn't take the PepcidAC 5mg 2x/day. As he's cleared to take it there shouldn't be any reason, but it's always wise to consult with/keep your vet in the loop about everything!

X-rays are good for helping to rule out other conditions that can mimic IVDD, but calcified discs may not be the area(s) where Fritz is currently having trouble. Here's a good article about understanding x-rays in a case of IVDD: www.dodgerslist.com/literature/CalcifiedDiscs.htm

Let us know if you are observing any signs of pain, and what the vet says about the Tramadol dose. We are here for you as you care for Fritz!
))Hugs!((

Hi Chris, my name is Maureen. Sounds like you are doing a great job with Fritz. Here is a bit of information on the braces and vests www.dodgerslist.com/neurocorner2/backbraces.htm
Don't worry about the curling up or asking for belly rubs. He wouldn't do it if it hurt. One of the happier moments in Stevie's initial recovery was the rolling over to ask for a belly rub

Yes, once they start feeling better, keeping them confined can be a real challenge! That's why we always tell members that any time out of the crate is a dangerous time. They always can do the unexpected. When did the running down the stairs occur? Recently? No sign of pain since then? Keep up with the strict 100% 24/7 confinement until April 4 to ensure that the disc has fully healed. Just to prepare you for that day, here is our page with a suggested schedule and tips on how to very gradually re-introduce movement:
www.dodgerslist.com/literature/AfterCrateRest.htm

Will the steroid be tapered once again at the end of the week or stopped? The Gabapentin most definitely should be stopped so a true test for pain can be made. I would speak to the vet about that today. Pain = swelling = more time on all meds. The Tramadol has been completely stopped? Continue to keep your eye out for signs of pain as the steroid is tapered. Should the steroid continue to be given past the graduation date of April 4, Fritz will need to continue to stay in the crate until all meds are finished. It's not safe to graduate from the crate while on meds as meds mask any pain/swelling that still might be present. Once all meds are stopped and there is no sign of pain/swelling, then Fritz will be able to graduate.

Please continue to give Pepcid AC every 12 hours (2x/day) for as long as Fritz is on the steroid. That's most important as Fritz has been on a very strong steroid for quite awhile.

I'm so glad to hear how well Fritz is doing!

Chris a couple of things to keep in mind.

Increased neuro diminishment such as crossed legs happens when the spinal cord nerves have been pressured. So the question is did the 3/23 escape cause the still healing disc to have a tear? A torn disc either bulges into the spinal canal or if a severe tear bits of disc material escape from the disc and spew into the spinal canal. Either way the nerves get pressured, swelling happens all contributing to the increased nerve loss (crossed legs) you identified.

There are no medications to heal a disc that has mild tiny little crack-like tears in the surface that cause bulging into the spinal canal OR a disc that actually tears allowing disc material to escape. What allows a disc to form secure scar tissue is rest (little movement) and time (8 weeks).

The steroid is what gets that swelling down. The body makes steroids itself, but the amount to get swelling down is greater -- the anti-inflammatory dose given as a pill (prednisone) It varies per dog as to how long it takes swelling to be resolved by pred (7-30 days) A taper of every other day is mainly to signal the body to make its own steroid again to run critical body functions. For IVDD dogs a taper is the perfect window to check on spinal cord swelling. The true test of a taper is for pain meds to be stopped with the taper so it can be promptly assessed of any hint of painful swelling and the need to get back to the higher anti-inflammatory dose asap.

With early attention to neuro deficits with an anti-inflammatory Pred dose often early nerve diminishment CAN be turned around quickly. I've seen knuckling go to correct placement in a matter of an hour after the anti-inflammatory pred dose with my own dog. Once the nerve cells are dead there is a cascading chemical release causing death to adjacent nerve cells. All those nerve cells have to regrow nerve endings and that takes a lot of time. Think in terms of weeks/months rather than days.

So if it is presumed crossed legs was increased nerve damage, it is very likely the disc was re-damaged on the jump. That nerve damage will take time to heal. The disc will now need time to heal again from the start, not a week, but 8 weeks of STRICT rest. I know this is not what you want to hear, but if Fritz were my dog, I'd start crate rest count from 3/23 with graduation day of May 18.

Hi Chris! So sorry to hear of Fritz's relapse, but so happy that you are giving him the crate rest he needs!

Are the dental chews and/or busy bones something Fritz normally gets? I don't know the calorie count on either of those, but if they aren't things Fritz normally gets I'd try a Kong to give him longer-lasting, lower calorie entertainment:
"Fill a kong with a slight slather of 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."
www.dodgerslist.com/literature/CrateRRP.htm

With using ramps after crate rest: the gentler the slope the better it is for the back. There's great info and a training video about ramps here: www.dodgerslist.com/literature/ramptrain.htm

))Hugs!((

Thanks Sabrina, Fritz usually get these once in awhile. He already eats carrots and kong frozen with kibble and soft pate dog food. This is part of his dietary requirement. I also have the frozen no sodium chicken broth which he gets once in awhile. I also put some coconut water in to make sure he is hydrated when I feel like he isn't drinking enough water. He likes apples and green beans too. I am going on line to check out the ramps. Thanks for the advise. Very much appreciated.