|
Post by Wendy & Kado on Feb 23, 2014 15:43:49 GMT -7
My son ( who has a developmental disability) phoned on Wednesday in a panic that his dog could no longer walk, we raced to his town to pick up him and his dog to bring Lola to a vet. on the X-ray it appears she has a disc pressing into her spine, or , degenerative disc disease. She had no response in her right foot, none through her back and very little in her left foot, no tail wagging. She was put on prednisone and crate rest. Our son attempted her care but phoned Thursday morning saying carrying her down the flight of stairs of his building was too difficult for him and he requested we take over her care. She came to our house on Thursday afternoon. We returned her to the vet on Friday and the dog was doing a little better, tail wagging, sensation in left foot and back, and, sensation with caliper in her right foot. The vet placed her on tramadol and do robaxin. Each day she is getting a little better, her feet are mostly flat when being sling walked ( altogether will still knuckle under) for her elimination, she whines when she needs to eliminate her bowel and bladder. She is bearing some weight on her legs and they are both moving as we sling walk her for her elimination. Your website has so much helpful information, I am wondering if there is anything else we can do for Lola, or expect with her recovery? The vet was a little disappointed on Friday that she was not recovering a little better..I feel a little gain is better than nothing?
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
|
Post by PaulaM on Feb 23, 2014 19:23:35 GMT -7
Wendy, welcom to Dodgerlist. I'm so sorry your son's dog is having this problem. I'm also glad that you will be able to care for Lola as carrying such a heavy dog down stairs could be dangerous not just for Lola but your son. With our small dogs we can more easily prevent movement by carrying them to and from the potty place. With Lola you'll need to see how you can limit footsteps to the very fewest to get the job done. It is the 100% STRICT crate rest that allows the disc to heal.. no meds do that. Maybe you can toss some snow on the deck and only a few footsteps would be needed to potty? Lola is making a good turn around already walking and not knuckling so much! The focus during conservative treatment is on healing the disc. Full nerve healing may or may not come during the 8 weeks...better to thinks in terms of month as nerves are the slowest part of the body to heal. -- Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy? During the time on the anti-inflammatory the pain meds may need to be adjusted so that there is no pain surfacing dose to dose of pain relief medications. Pain deters healing. -- How much does Lola weigh? Can you list all meds, their doses in mg's and frequencies? Is there a scheduled date for the Pred taper? Often it takes being at the anti-inflammatory dose of prednisone 2x/day for 7-30 days before all the swelling is gone. When the vet guesses swelling might be gone he'll call for a taper. The dose is lowered to less than the anti-flammatory dose your job at home would be to assess just how well reduction of swelling is going by observing for any hint of pain. To have a clear picture on a taper, pain meds are also stopped or backed off too. Rule of thumb is: pain = swelling = more time on Pred, pain meds and Pepcid AC is needed. If there is no pain on the taper then it goes to completion. Then no meds at all are needed. Disc healing will continue for the remainder of the 8 weeks. Nerves can continue to self heal…think in terms of months. --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 Pepcid AC (famotidine) 30 minutes before the anti-inflammatory and thereafter every 12 hours.This directory very good for learning about each of your dog's meds: www.marvistavet.com/html/pharmacy_center.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?
|
|
|
Post by Wendy & Kado on Feb 23, 2014 20:33:54 GMT -7
Hi Paula ,
Thankyou for your reply and great information! I replied quick reply and cannot see where it is..I will re do my reply, Lola has not been shivering or trembling since she started the pain meds on Friday, she does some panting, I am not sure if this is pain, or adjusting to being in the crate in a strange home with children and other dogs around when she is used to my sons home with just him in the home and an older cat. lola weighs about 60 lbs. her meds are as follows prednisone 25 mg every 12 hrs for 3 days 25 mg every 24 hrs for 3 days 25 mg every 48 hrs for 3 doses tramadol 100mg every 8 hrs for 10 days Robaxin 500 mg every 8 hrs we were just told to give her the prednisone with food, perhaps her panting is from a sore stomach? we were also told she would need crate rest for 2 weeks. I am pleased to have this new information on resting her for 8 weeks as it does make more sense.
lola has not had any leaking or wetting in her bed, she recognizes the need to go and will wen to be taken outside, the same with her bowel movement. Her stool is well formed and normal volume and colour. lolas appetite is a bit of a concern, she drinks a lot, will on occasion eat on her own though some times she needs a lot of coaxing, or, I take the food and place it in her mouth to get her to eat. She is on the canned recovery food from the vet and we are giving her at least 2 small cans each day , she sometimes will nibble on her kibble in her crate. her crate is 3 feet from our side door and there is only 2 steps down to the yard, it is currently icy but she only takes maybe 8 steps supported with her sling to eliminate, maybe a few more for her bowel movement. When she is in her sling, both legs are moving and her tail is wagging. Carrying her out takes a bit of work as she is heavy and large, but, it is do able. She only goes out 3 or 4 times daily so she is not moved too much. i can suggest the Pepcid to the vet tomorrow, should I also ask her to remain on the prednisone for a longer period of time? The vet was quite nice, but, admittedly did not have a lot of experience with this disorder. My sons regular vet is in his town and I could also contact them for their recommendations
|
|
|
Post by Pauliana on Feb 23, 2014 22:26:03 GMT -7
Hi Wendy,
So glad you joined us here on Dodgerslist!
Panting can be a side effect of the Prednisone as is drinking a lot of water. Also Lola may need to urinate every 2 to 3 hours due to Prednisone and her drinking.
By now she has started on the taper of the Prednisone to one every 24 hours.. Have you also backed off the pain medications? If not discuss with your Vet. It's the only way to tell if the swelling is gone.. If she has symptoms of pain,as mentioned in Paula's post, contact the Vet immediately and ask to return to the twice a day dose of the Prednisone and go back on the pain medications.. If there is no sign of pain, it means the swelling is gone.. and no further medications would be needed. 3 days isn't normally enough on the twice a day anti inflammatory dose, but a taper just gives a clearer picture of what is going on regarding the swelling.
It would be best to carry her down the stairs. Stairs are the worst thing for disc disease. I know she is heavy.. if that can't be done, try the idea Paula gave you about putting a layer of snow or dirt on the deck and let her go there..
If your son's Vet is more experienced with IVDD perhaps a consulatation would be in order.. Maybe your Vet and his Vet can communicate since your son's Vet has his prior history..
Sending soothing thoughts and prayers...
|
|
|
Post by Wendy & Kado on Feb 24, 2014 9:18:43 GMT -7
Thankyou Pauliana,
i am pleased to to hear that the panting is due to the prednisone and not discomfort. Will the Pepcid ( if added) help with the panting at all? Should we ask for the Pepcid, given the taper, or, should we ask she remain on the prednisone twice daily for a little longer? She had a wet bed this morning, the first one, but, I am assuming she perhaps whined to go out and I was in a deep sleep last night. is her walking some steps with the sling outside a big problem? She is wanting to wander a little further now and it is hard to stop her this morning, but, I do want to do what is best for her. also, is it better to carry her under her trunk, or, to get a harness and hold her harness and the sling. Which is more stabilizing for her back being a large dog? thankyou so much for all this info. wendy
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
|
Post by PaulaM on Feb 24, 2014 11:08:18 GMT -7
Wendy, fully understanding this disease makes it far easier to assess whether an activity, a treatment, etc is harmful. Conservative treatment is all about allowing the disc to heal. That only happens with limited movement. Each footstep means the back, the neck, etc is moving. Whatever you can do to limit the number of footsteps to the very, very fewest of footsteps is necessary. As the vertebrae move they push on discs. Healthy discs are flexible and it is their job to cushion the vertebral bones. A torn disc, on the other hand can't heal when it continually is pushed on. 100% STRICT rest is to allow time for the torn disc to for a scab, then the scab to turn to weak scar tissue and finally contract to form a more secure scar. Same process you've seen hundreds of time with a cut to yourself. Only the skin heals at a much faster rate than avascular (without blood) discs. Move too much and that cut on your knuckle will tear the hard scab, it bleeds and the need to start all over again. With a disc it is not bleeding it is more disc material spewed out into the spinal canal and the potential for severe nerve damage. SOLUTION: use an expen as pictured in a previous post at potty time to visually and physically let Lola know there is not going to be any sniff festing going on! If by steps you mean stairs, then use a ramp on the outdoor steps to do as much as possible to limit movement of the vertebrae. Shortcut through IVDD is a very good overview of this disease: www.dodgerslist.com/literature/IVDDcourse/index.htmlHOW to know when to taper off of Prednisone
Often it takes being at the anti-inflammatory dose of prednisone 2x/day) for 7-30 days. When the vet guesses swelling might be gone there will be a taper. Usually the first course will be 5 or 7 days and then a test taper. The dose is lowered to less than the anti-flammatory dose your job at home would be to assess just how well reduction of swelling is going by observing for any hint of pain. To have a clear picture on a taper, pain meds are also stopped or backed off too. Do not be dismayed if a three day course of Pred is not enough. Prompt feedback of any pain is necessary to get back up on the original dose for a bit longer. IVDD meds carry side effects so no one want to use them any longer past when the job has been done of getting all painful swelling down. Rule of thumb is: pain = swelling = more time on Pred, pain meds and Pepcid AC is needed. Why give Pepcid AC? Just as people get stress with job changes, routine changes same with dogs. Stress produces extra acids which may lead to ulcers. Now add a med that on top which stimulate gastric acid secretion it is much more likely to be 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 take Pepcid AC?" If there is no reason, we follow vets who are proactive in protecting the stomach by giving Pepcid AC (generic name is Famotidine) 30 mins prior to steroid and thereafter every 12 hours.
|
|
|
Post by Wendy & Kado on Feb 25, 2014 9:53:56 GMT -7
Lola continues to make small gains each day. The vet is wanting me to continue with the prednisone taper, and, let her know if I notice any discomfort ,regression , or stop in her gains she is making. She said we may need to do another round if the prednisone if this happens. She is not wanting me to stop the pain meds as she is concerned we may see change from that and did not want to muddy the waters. I am hoping that I will be able to see if she is not responding well to the prednisone taper. Should we buy her a harness to wear, to assist with carrying, and, later on with her walking? Is it safer to lift her by her harness and a sling as opposed to carry her under her belly as far as pressure on the spine goes? I see this with the dacshunds and am wondering if it is a good idea with a large dog as well?
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
|
Post by PaulaM on Feb 25, 2014 12:54:13 GMT -7
Wendy, pain meds masking pain when on a taper muddies the water about existing pain, it may take longer into the taper with below anti-iflammatory doses to reveal if pain exists. No pain meds on a taper gives a perfectly clear picture if pain is still existing, where pred can be promptly brought back up to the anti-inflammaory dose level.
I think it would be too tricky to be of any saftey in transport to potty lifting by a front harness and a rear sling for a large dog such as Lola. The better idea is to figure out a way that eliminates all but the very fewest of footsteps to get to the potty place and once in the potty place allows only a very, very few footsteps. Do you have a deck off a sliding glass door? Crate could be rolled to the door. Then Lola would only need to take a few footsteps to some snow or dirt placed on the deck.
|
|
|
Post by Wendy & Kado on Feb 26, 2014 7:09:14 GMT -7
Thanks Paula,
what a great idea to either move the crate to the door, or, level the steps. I have now placed a dog bed down the one step to the landing, eliminating that step, then I can open the door and just lift her down the one step to yard level. With all the snow hardened right now, I can't make a ramp right now, but, am thinking how this can be done safely. I am stopping the pain meds to see how she tolerates the taper, she only has 2 doses left, one tomorrow morning and then again Saturday morning. She is still panting, but, is not showing the other signs of pain. Once the prednisone is stopped, hopefully we will only need to have her go out of the crate 3 x daily which will allow more rest as well. Fingers crossed and prayers that she will be okay with this taper and continue healing nicely. When in the sling to eliminate, she is 98% of the time flat pawed instead of knuckling both legs are moving and taking some weigh but still wobbly. She is also sitting and laying in different positions looking more comfortable in her crate now too. Although, she keeps looking at me wondering why I have her confined while all the other dogs and cat are allowed to roam the house.
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Feb 26, 2014 8:00:33 GMT -7
Hi, Wendy
As for the panting, a fan near but not pointed at the crate will help. Also a rice sock from the refrigerator can help them cool by laying their tummy along side of it. Fill a sock with 1-2 cups of rice and tie the end of the sock closed. Try a frozen broth ice cube to lick on.
As Paula mentioned, with a short round of three days of the Prednisone before tapering, there may still be swelling. Any signs of pain (shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, nose held to the ground, head held up high, tight hard tummy, arched back) requires an immediate call to the vet so Lola can be returned to the original dose of all meds.
Prayers for a pain free taper for Lola
|
|
|
Post by Wendy & Kado on Feb 26, 2014 13:12:22 GMT -7
Lola is on her ▼prednisone taper, had one half tablet Yesterday morning, none today. She is not moving her legs as well as she did yesterday, she is knuckling more often and she seems to be panting more than she was before. I did not give her the tramadol or robaxin this morning. Should I call the vet to ask for another course of prednisone?..wait this out? I am concerned with the seeming regression and that is what the vet wanted me to watch for.
|
|
|
Post by Jean & Mimi on Feb 26, 2014 13:27:51 GMT -7
Wendy, the knuckling more often, not walking as well are signs of neurodeficiencies and that the swelling has not gone down. Please contact the vet immediately to report what you see and ask that Lola be put back on the anti-inflammatory dose of Prednisone today. Some dogs need longer on the anti-inflammatory dose of the medication for up to two weeks, some need it for even up to a month, before the swelling goes down. My Mimi was on for over a month.
Please let us know what the vet says (((HUGS))) to you both.
|
|
|
Post by Wendy & Kado on Feb 26, 2014 14:20:51 GMT -7
Thanks Jean,
i started her back on the robaxin and tramadol, I have 2 half tablets left of the prednisone, I will give her a dose this evening and hopefully by then I will have heard from the vet. She did say to let her know immediately if I see Lola either not making any more gains, or losing any of her abilities she has gained, so, I am thinking she will not have a problem with our re starting the treatment dose of the prednisone. I think I will pick up some Pepcid as well now that she is no longer tapering and requiring prednisone for longer. It certainly is scary to see her regress like this...she was doing so well.
|
|
|
Post by Jean & Mimi on Feb 26, 2014 14:33:14 GMT -7
Ok, glad you called the vet and are given her the pain meds right away and that you will get the Pepcid onboard. Do not worry about a regression right now. This can happen during a taper and hopefully when the prednisone is back at the anti-inflammatory level the regression will heal again.
I can tell you that my Mimi regressed a bit with two tapers, and is now doing really well. One leg is still weaker than the other, but at one point that leg was completely useless to her. Now she runs and plays and has a great time. Deep breath, and I hope the vet calls you back soon.
|
|
|
Post by Wendy & Kado on Feb 26, 2014 17:50:01 GMT -7
I have not heard back from the vet, she may not have been in today, I just left a message on the voicemail. I started back on the pain meds, and gave a dose of the prednisone tonight, I have another dose for the morning and I will make sure to get some more tomorrow , the vet did suggest this May be necessary if Lola did not respond well to the taper so it should not be a problem. I have some Pepcid ac now, and, am not sure on the dose for a 60lb dog, should I give it by her weight, or just a small dose to help her stomach since this is preventive?
|
|
|
Post by Pauliana on Feb 26, 2014 23:38:35 GMT -7
Hi Wendy,
Hope the Vet calls you first thing tomorrow. If not, I would call back.. When you are talking to them ask the dose for Pepcid for a 60 pound dog. We use 1/2 of a 10 mg tablet= 5mg for 15 pound dogs or under. Pepcid also comes in Extra strength 20mg tablets..
Thinking of Lola and hoping she feels better by now. Don't worry, most dogs don't have the swelling down in 3 days and it's not at all unusual to have to taper more than once. It usually takes from 7 days to two weeks on the Prednisone to get the swelling down and some dogs more like a month as Jean said..
|
|
|
Post by Wendy & Kado on Feb 27, 2014 7:19:38 GMT -7
This morning Lola woke up wet, I just took her outside again and there is blood in her urine, I have a call in to the vet again, she is whining asking to go out continually...I started her on the Pepcid last night and gave her a dose this morning, could the blood be from he Pepcid? Her stools are still normal and she ate well this morning and had a bowel movement.
|
|
|
Post by Jean & Mimi on Feb 27, 2014 7:34:05 GMT -7
Wendy, it sounds like Lola has a UTI. She needs to see the vet asap. Please call again if you do not hear back. Antibiotics will help.
|
|
|
Post by Wendy & Kado on Feb 27, 2014 7:58:39 GMT -7
Does this mean she cannot remain on the prednisone? The taper did not go well for her, I am concerned if we have to stop the prednisone.
|
|
Deborah & Angel
Helpful Member
No current back issues... Living Life.. <3
Posts: 294
|
Post by Deborah & Angel on Feb 27, 2014 8:05:54 GMT -7
Hi Wendy my name is Debbie, have you heard from the vet? I agree with Jean and think Lola may have a UTI and in need of a antibiotic. Boy...when it rains it pours... Waiting to hear from you.. HUGS...
|
|
|
Post by Wendy & Kado on Feb 27, 2014 8:13:25 GMT -7
I do have a call in to the vets office, the receptionist is contacting the vet, the vet is due in to the clinic in 2 hours. Waiting to hear what to do. I know....this certainly is becoming an interesting journey, I feel badly for poor Lola, staying in a strange home, locked in a crate and feeling uncomfortable and in pain at times. Originally we thought she'd be with us for the 2 weeks as told by the vet....she has to settle in for at least 8 now and depending on her abilities after that time, we will have to see what happens. This is not an easy journey for someone who likes to fix things.
|
|
|
Post by Jean & Mimi on Feb 27, 2014 8:25:51 GMT -7
Wendy, she can stay on the prednisone. UTI's are very common in dogs suffering from disk disease. As long as her GI symptoms are ok, she can stay on the steriod (with stomach protectors). THe antibiotics will work to kill the bacteria if she does have a UTI. She wants to go out a lot because pain and always feeling like you have to pee are common symptoms of a UTI. Hang in there, I know there is so much going on...you are doing such a great job for Lola.
Trust me, once she starts to mend and has no more pain, this will be easier on all of you.
|
|
|
Post by Wendy & Kado on Feb 27, 2014 13:52:59 GMT -7
Back from vet, I brought a urine sample, Lola had a uti, vet also liked how Lola was responding to the prednisone before her taper so she now has her in more than originally ▲ prednisone . 50mg tablets, 1 tablet every 12 hrs for 5 days, then 1 tablet every 24 hours for 10 days, then 1/2 tablet every 24 hours for 10 days. I asked her about the Pepcid, she said it was a good idea Pepcid and continuing with the tramadol and robaxin. For the UTI, she is on clavaseptin 250mg, 1 tablet every 12 hours for 12 days.
the clavaseptin and prednisone are to be taken with food
lola is whining and asking to go out a lot with this uti, I am concerned that I cannot be continually taking her out as she is to be on crate rest, but, she is leaking in her bed as well. I am assuming that the spine healing trumps the need to pee continually?
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
|
Post by PaulaM on Feb 27, 2014 14:16:42 GMT -7
While on pred, you will need to take her outside to pee likely every 3-4 hours. So do what you can to make the footsteps to get to the potty place as minimal as possible and the footsteps at the potty place just the very fewest as possible.
|
|
|
Post by Wendy & Kado on Feb 27, 2014 19:14:20 GMT -7
Thankyou all so much for all this help with Lola, it is so nice to have this board with so much information while going through this situation that I had absolutely no information on prior to this episode. does the claviseptin have any side effects or could it compromise any of her other meds?
i am not clear on the dose of Pepcid Lola should have, the vet said Lola is 25kg and can have between 2.5 - 12mg every 12 -24 hours. I have the 10mg tablets, what dose would you recommend for her?
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Feb 28, 2014 6:52:56 GMT -7
Here is the drug manufacturer's label for Claviseptin: veto.naccvp.com/product/view/1234295?key=labelAs for the Pepcid AC, I would give Lola the higher end of the vet's recommendation - 10 mg of Pepcid AC given 30 mins before the Prednisone and then every 12 hours thereafter. You could give her 12 mg but I think it would be difficult to measure that dosage if it comes in a tablet like it does here. We encourage our members to research each drug their dog takes and how it interacts with another drug. A good place to start researching each of Lola's drugs is here: www.marvistavet.com/html/pharmacy_center.html
|
|
|
Post by Wendy & Kado on Feb 28, 2014 16:56:39 GMT -7
The vet had suggested that I try taking Lola off the pain meds after the weekend, she is on Robaxin and tramadol , is ts a good idea now that she is in higher doses of prednisone? Which med should I try her off first? Also, with Lola's UTI, she is having accidents in her bed at night and the odd leak through the day, she has a long thick coat like a collie that is becoming hard to keep clean. Is it too much for her if I have a groomer come and shave her coat off to make keeping her clean easier, or, is the clipping process too risky for her right now?
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,549
|
Post by PaulaM on Feb 28, 2014 17:58:32 GMT -7
Back on a Jan 24 post I discussed "How to know when to taper off of Prednisone". How do you feel about stopping pain meds before a test taper starts? What explanation was the thinking behind your vets idea to stop pain meds prior to the taper date of this current 5 day pred course vs. pain med stopping coinciding with the taper? Understanding your vets treatment is important…otherwise you can’t really commit to it OR you can’t discuss why you are concerned about it.
It depends on the groomer if that person understands the limited movement of the back concept, the shaving should be done in the crate or on the floor where no jumping could happen. It depends on how Lola acts during grooming…relaxed or anxious?? Personally I think you can do what is needed with a pair of scissors, trimming fur near genitals, etc. The idea is not beauty but practicality of cleaning and protecting the back.
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
|
Post by Marjorie on Mar 1, 2014 5:34:53 GMT -7
Just wanted to chime in with our tip about using green tea for cleaning urine, Wendy. Make up a pot of green tea, let it cool down and wash Lola with it. The green tea neutralizes the acidity of the urine so helps with urine burn and leaves a nice smell. You can keep any unused tea in the fridge to be warmed up for later use. Hope that helps with the clean-up issue.
Hugs to you both.
|
|
|
Post by Wendy & Kado on Mar 1, 2014 12:15:04 GMT -7
I asked the vet for more tramadol when she gave me the new prednisone meds, she said to give them through the weekend and then try her off me that she may not need them. Thinking now, I guess she will have enough tramadol to get her through the 5 days and then her new taper will start so I guess I could try stopping for the taper and get more if Lola is uncomfortable.
i will try the green tea wipe down for Lola, her coat is so thick and dense that I will likely spray her down and wipe her off to get the tea through the coat. lola is now back to the condition she was prior to the taper this week, walking and moving both legs while in the sling with hardly any knuckling. Lola has some leaking at night, and the odd time through the day, but, she still does ask to go outside to eliminate and does so very well. It is a mystery as to what function she will have after her spine heals, we are getting letters from our sons doctor and Lola's vet to have him moved the the main floor of his housing unit, this would allow them both to live comfortably with a sliding door to walk out to eliminate regardless what Lola's end functional ability is.
|
|