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Post by Maureen & Biscuit on Mar 7, 2014 22:32:28 GMT -7
My dog Bryce is almost 11 years old. He's a dachshund and weighs 15 pounds. He began showing signs of a back or neck problem and I took him to the vet right away, last Monday. He is on strict crate rest (at my insisting...his vet said he didn't need it (?!), but I know better), Tramadol, methocarbamol, Prednisone (a dose that is tappered off) and I give him Pepcid before his Prednisone. In the past, I had a doxie with a cervical problem so this problem is familiar to me. I know that even if he seems to be feeling better, I should continue the crate rest. I plan on 8 weeks of crate rest for him.
His vet found his most painful area to be his abdomen. She could not pinpoint a specific spot where the pain was coming from in regards to his neck and back. I suspected neck because Bryce did not want to bend over to eat or drink water. (I now raise his water & food dishes to a level where he doesn't have to bend.) His vet suspects the problem is with his back, not his neck. She did a blood test to rule out pancreatitis. We are on day 5 of this IVDD episode.
Two things I am considering right now are taking him to a neurology speciality vet and laser therapy. My questions are - With regards to the neurology specialist, should I try crate rest first or should I be taking him right away? Is there anything the neurology specialist can help with in terms of conservative treatment that I might not be doing already? Also, with regards to laser therapy, I'd like to try this because I've heard good things about it and did find a vet in my area who does it. My concern is the amount of picking up and jostling around that I'd have to do to take him to this other vet for laser therapy. Picking him up and him riding in the car, even in a small crate, just seems like it will do more damage than good. I'm afraid to pick him up too much, so I let him go potty just outside his crate on potty pads. He still trembles because of pain. I can tell when his pain pill (Tramadol) is working and when it has worn off. I'm just wondering if any of you have any advice about whether I should immeditately take him to a neurology specialist or just continue with his regular vet and the conservative treatment... and if I should take him for laser therapy - is that amount of being moved around okay? Has anyone had laser therapy done on their dogs? If so, did it help?
Thank you!
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Mar 8, 2014 6:15:27 GMT -7
Welcome to Dodgerslist. My name's Marjorie - what's yours? First of all, due to the pain that you're seeing during the taper of the Prednisone, Bryce still has swelling that the Prednisone hasn't resolved yet. Therefore, the vet needs to return Bryce to the original dosage of all meds for a bit longer. Pain = swelling = more time on meds. You should speak to her today and get him back on the original dosage. The swelling presses on the nerves of the spine and is what causes nerve damage so it's vitally important that he return to the anti-inflammatory dose of the Prednisone ASAP. Neck issues can be more painful and take longer to resolve than back issues. Good job on being observant about that and raising his dishes. Here are some more tips on dealing with a cervical issue: www.dodgerslist.com/literature/cervical.htmAlso, good job on committing to a strict 8 weeks of crate rest. 100% STRICT crate rest 24/7 only out to potty for a full 8 weeks is the SINGLE most important thing you can do to help your dog-- it is the hallmark component of conservative treatment. Carried in and out to potty. 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. www.dodgerslist.com/literature/CrateRRP.htmDid your vet let you know that you should be on the lookout for pain during the taper, is she aware of the pain that Bryce still has? If she knows of the pain but has not returned Bryce to the anti-inflammatory level of the Prednisone, she may not be familiar with treating IVDD. Was the pain ever completely under control or did it reappear during the taper? If your vet was able to get Bryce's pain under control and if she is just now becoming aware of the pain during taper and will put Bryce back on the original meds, then she is doing what needs to be done (other than not being informed about crate rest). Otherwise, you should look for a neurologist. A neurologist should be Board certified (ACVIM). There's a search engine on this page: www.acvim.org [neuros] You can make it clear to the neurologist that you only need help with getting the meds correct and not looking into surgery, if that is the case. Laser and acupuncture can be very helpful but yes, it will require moving Bryce. We need to know more about his neuro symptoms before giving advice on that since you have only mentioned pain and not neuro deficits. First thing is getting his pain under complete control. 1. What are the exact names, dose in mgs and frequency of all meds? Please include the original dosage of the Prednisone and the taper schedule. It's important that you be knowledgeable about each medication being given and all cautions concerning them. www.dodgerslist.com/literature/drugs.htmmarvistavet.com/html/pharmacy_center.html2. Currently can your dog wobbly walk? move the legs at all? or wag the tail when you do some happy talk? 3. Can your dog sniff and squat and then release urine or do you find wet bedding or leaks on you when lifted up? 4. Eating and drinking OK? 5. Poops OK - normal color, firmness, no dark or bright red blood? 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.htmWe're here for you and will help you and Bryce through this episode. Healing prayers for Bryce. |
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Post by Maureen & Biscuit on Mar 8, 2014 10:27:00 GMT -7
Hello - I'm Maureen. Thanks so much for replying to me. Last Monday, Bryce [3/3] began
1/2 tablet of Tramadol (50mg tablets) every 8 - 12 hours for pain...I gave them to him every 8 hours. Same day, last Monday (5 days ago)he also began
1/4 tablet of Methocarbamol
[ (500mg tablets) every 8 hours. His vet did not start him on Prednisone right away, wanting to see if the other meds would help first because she hoped to avoid the side effects of Prednisone if possible. But by Thursday Bryce was doing worse instead of better. When I set him down to go potty on Thursday, he walked a little and tripped himself and I think in the process he hurt his left front leg because now he holds it out like he's afraid to step down on it - he can walk on it without limping and yet when he's in his kennel, he holds that leg up. So Thursday I called and insisted that he go on Prednisone and they agreed. He started
[3/6] Prednisone (5mg tablets) 1 every 12 hours for 3 days, then 1 every 24 hours for 3 days, then 1 every 2 days til gone. Since he only started Prednisone Thursday afternoon, he has basically only 2 full days of time on it now, so we have not started to taper the dose yet.
This morning his pain level seems to be better. He's not trembling anyway. Perhaps the Prednisone is beginning to work? Bryce can walk (slowly) and move his legs. He walks slow and as I mentioned above, he has tripped himself just by walking. It didn't appear that his paw went under him, but more as if a back knee gave out and down he went, hurting a front left leg in the process. Right after he tripped, he started limping and now the limp has gone away, but he still holds his left front paw up like that leg hurts. The odd thing is that he holds his leg up sometimes just sitting in his crate, but he can walk on it now without limping. As far as his neuro symptoms go, when the vet tested him Monday, he could bring his paws forward if she moved them back behind him. She pressed on his neck and back and abdomen and found his most painful area was his abdomen, which she said indicated back issues. She could not pinpoint one spot where it hurt. Before I realized what was wrong, he yelped when I picked him up. That's when I knew right away, it wasn't just that he wasn't feeling good, but he hurt. I knew something was wrong because he wasn't himself and walked slow. His back end trembles when he's in pain, which seems like it would be his back, but I found it odd that he hesitated leaning over to eat or drink water. To me that sounds like a neck issue.  When I raised his food & water dish to his level, he eats and drinks just fine. As far as his tail goes, it works just great! He wags happily and when I give him scratchies, he still will roll over on a side or his back so I can give him tummy scratches. I haven't done this much tho' because I fear the pain meds mask the pain and he shouldn't be rolling over like that? I want to keep him as still as possible, but...he still needs his attention! He eats and drinks fine (drinks a lot now that he's on Prednisone). He squats to go potty, but I have only seen him poop twice. I worry that if it hurts him, he'll hold it in. Seems like he should have pooped more than that. But...it looked normal and he did not yelp. As long as his regular vet keeps his meds up (I'm sure they will if he's still in pain when they run out), there's no need for a neurology specialist at this time? I just don't know if there's anything else they could help me with right now. At the same time, I want to make sure I'm doing everything possible for Bryce and I feel like they deal with this issue all the time, whereas regular vets don't as much. As far as the laser therapy goes, if I can put Bryce in a small crate to carry him to a vet's office, would it be benefical? I hate to move Bryce more than I have to, but feel like maybe it would help him. His current vet does not offer laser therapy, but I found another one close by whose website says, "We now offer laser therapy!" So automatically, I think...are they new at this? How do I know they'll do it right?" I don't know if there's a website to find certified laser therapists or how to tell if they're properly trained. I have Bryce in a wire kennel right now, but I opened the door to the kennel so he could step just outside it to go potty. Right outside, I fashioned a small ex-pen into a triangle shape, just large enough for him to walk out of his crate, put a potty pad down so that he can go potty there. If he steps out of his kennel to go potty in the ex-pen area, it would be maybe 8 steps total that he'd have to take...it's right outside the kennel door, and the area is just big enough to hold the potty pad and for him to turn around. Does that sound okay? Think of it as a rectangular crate with an adjoining small triangle room. : ) I always worry that I'll hurt him picking him up, so this seemed like it might be easier on him. Thank you so much! |
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,595
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Post by PaulaM on Mar 8, 2014 14:14:27 GMT -7
Maureen, if his pain can be managed because your vet feels comfortable in using medications then with your knowledge about the importance of 100% STRICT crate rest for 8 weeks, you may not need a specialist consultation. The consultation would be to use his services and knowledge of medications a general vet may not be comfortable in using.One of the best things you can do is read and be the most informed you can about IVDD. Our IVDD Core readings are located here: www.dodgerslist.com/literature.htm
No one wants to use steroids one bit longer than necessary. But there are needed until the job is done. So here is how it works: During the time on the anti-inflammatory the pain meds may need adjustments so that there is no pain surfacing dose to dose of pain relief medications. Pain deters healing. So do let us know you do not see ANY signs of pain now. Not slow to move, not walking gingerly, his normal perky self, no yelps, no holding his head in a stiff or unusual position.Often it takes being at the anti-inflammatory dose of prednisone (5mg 2x/day) anywhere from 7-30 days before all the swelling is gone. When the vet guesses swelling might be gone there will be a taper. Your vet Rx'd a 3 day course of pred and then calls 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. Do not be dissapointed if that 3-day course of pred is not enough. In fact if you see any hint of pain before the taper, the vet needs to know as a it would not be time yet for a test taper. Whenever a taper is on the books, it is prudent for you to know what the plan is ahead of time should there be pain at night during a weekend when you can't get ahold of the vet quickly.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.
Tramadol can be constipating, keep this in mind should you see too firm poop. Pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation. 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 potoato. Laser therapy would be as an adjunct to control pain. If you feel he needs this, transport in a crate that is padded out so when taking curves or breaking his body will not shift. Sounds like you have a good potty time situation with the ex-pen to contain him coming out of the crate.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Mar 9, 2014 6:18:11 GMT -7
Maureen, just so we're all on the same page, could you clarify the crate set-up that you have? Am I understanding it correctly that you keep Bryce confined in the crate and just open the door to the crate when he has to go potty so he can walk out into the ex-pen to do his business? At all other times, the door to the crate is closed? Just want to make sure that's the way it's working. Otherwise, when Bryce starts feeling better, he may come out of the crate too often and have too much room to move around with the crate and ex-pen combo.
You mentioned being frightened of lifting him. Once his pain is under control, he can be lifted without hurting him. This video will show you the proper way to lift him that hopefully will calm your fears about that:
Continued healing prayers for Bryce.
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When I raised his food & water dish to his level, he eats and drinks just fine. 
