Amy's Rosie 5/2 Conservative

Welcome to Dodgerslist, Amy. Please let Rosie 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

Vets are finding that Gabapentin works very well when given along with Tramadol. They work synergistically together. Methocarbamol can also be added to the mix to address the pain from muscle spasms, which is common with neck injuries. All three can be given. Neck episodes can be much more painful than back problems and can take longer to resolve.  Pain needs to be brought completely under control as pain hinders healing.  There should be no sign of pain from one dose of meds to the next.

5 mg of Pepcid AC should be given 30 minutes before the dose of the anti-inflammatory and thereafter every 12 hours (twice a day).

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.htm

Here is our page with tips about dealing with a cervical issue, such as softening hard kibble, raising water/food dishes so she doesn't have to bend her neck, etc.: www.dodgerslist.com/literature/cervical.htm

You can give her some warmed no salt, no fat broth to encourage her to drink. Adding water or broth to her kibble to soften it will also help her to get more liquid.

Laser light therapy, acupuncture and electroacupuncture which sends a microcurrent of electricity to and from acupuncture points (which are really big nerve bundles), can be very beneficial at helping to re-establish the nerve connections in the body. Any one of these therapies can be started right away if in your budget... they not only help relieve pain and inflammation but will kick start nerves to begin regeneration. Find a holistic vet here: ahvma.org/Widgets/FindVet.html www.serenityvetacupuncture.com/index.php/faq_/ [one vet's overview/prices] NOTE: Chiropractic is not recommended for IVDD dogs.

Please let us know what the vet says after your visit. We're here for you and will help you and Rosie through this. Healing prayers for Rosie.

Hi Amy,

Is Rosie's pain under control from dose to dose now that Gabapentin has been added?  If not keep in touch with your vet to continue to adjust the medications until she is pain free..  Once that perfect "recipe" has been reached she can heal in comfort.  Pain deters healing and it is so hard on them as well as on you..

Here is a great video that shows how to lift and carry a dog with IVDD.  

Rosie is much better today- she hasn't whimpered all day! I've been giving her

25 mg of Gabapentin 2x a day, and
25 mg of Tramadol 3x a day, plus
Rimadyl 12.5 mg 2x a day and
1/4 Pepcid AC.

Plus her acupuncturist came to this house today and gave her a treatment- he found the two places on her back where her back was in spasm- her back was very tender to his touch in those spots, but he said her neurological signs were great. After a 10 minute treatment (she struggled and acted like she really wanted to bite him when he was putting in the needles), the muscle spasms were basically gone- he could palpate her spine pretty hard and she didn't flinch- pretty amazing.

The acupuncturist also gave me some Chinese herbs to clear her stagnation (on top of the other herbs she's already taking).

I gave my cousin, who's a veterinary neurologist (in a far-off state) an update on Rosie's meds, and my cousin told me I could up the Gabapentin as high as 50 mg, 3x a day without a problem, so we have a lot more pain meds we can give her, if needed. I think what's she's taking is controlling her pain well, though- she's back to giving me kisses, letting me pet her, and trying to get out of the crate. It seems like the Gabapentin combined with the Tramadol is a great combination for her.

Hi Marjorie,

I probably described that badly....thanks for the caution. The vet acupuncturist wasn't palpating her to determine the extent of her pain- he was palpating to determine the location of the pain. If he hadn't done that, he wouldn't have been able to needle her appropriately. Every neurologist we've been to has also palpated her, more to determine the location of the pain I think than the extent, but from my observation, palpation of the spine is a standard part of their initial exam. And don't worry, I would never let a chiropractor touch her.

I am not concerned about contraindications of the Chinese herbs (and I'm pretty paranoid)- the herbalist is a vet, and got a list of Rosie's meds before he prescribed the herbs, partly to make sure there were no contraindications. I couldn't give you a list of the herbs anyway, they're all compounded formulas.

Today was another seemingly pain-free day....I hope the trend continues! Our current challenge is that I can't spend one more night on the couch, and I don't think carrying her downstairs at bedtime is a great idea (she'd sleep in a crate in my room)- we have a lot of stairs and I have back issues myself. So I may try having her sleep upstairs while I'm downstairs, and see if we can tolerate the separation :-)

-Amy

Hi There,

Rosie continues to be pain free, and is still confined to her pen. She slept in her crate on the floor of my bedroom for one night, but the second night she cried unceasingly, and I finally put the crate on the bed next to me. She found that more satisfactory and slept through the night. She is unbelievably stubborn when she decides something is not to her liking. Speaking of.....she has a history of breaking out of crates and pens of all kinds, sometimes in an almost Houdini-eque manner. The trick now is keeping her in her pen when I'm gone. I'm at home most of the time (or I can be), but when I go out and come back, I see she's pushed the pen over slightly, even if she hasn't escaped. I have 3 carabiners holding the panels of the pen together after she broke out when it was only secured by 2.

Any ideas on how to keep her busy and calm when I'm gone? As long as I'm in the room, she's happy in the pen. If I go  downstairs (living area is upstairs in my house), she tries to break out. She has a bone to chew on, but it doesn't distract her. She just doesn't like being confined when she's alone. My concern is that she's going to hurt herself trying to get out.

-Amy

Thanks very much, Paula. I'll give it a try.

Another question- I was speaking to my human acupuncturist (he treats me) today about how well Rosie responded to her acupuncture, plus the fact that after a few days of pain, I am pretty sure she's now pain-free underneath the pain meds, plus the fact that she showed no neurological impairment during this episode, and he said it sounds like her back pain may not have involved the discs. I'm not disputing that she has IVDD, she's had several episodes of neck pain, but it's also possible that given her body shape, her back could just go into painful spasm sometimes. There'd be no way to verify this except for to do diagnostic testing.

It makes me wonder whether confinement and rest are the best things for her if the pain wasn't caused by a disc. I know that if humans have back pain that's not directly related to discs, the medical advice is to get up and move once the pain isn't acute, otherwise you lose muscle strength and restrict blood flow.

Of course, I will keep her in the pen until speaking to the neurologist next week, but I'm wondering if others have dealt with this situation.

Thanks,
Amy

So...we went back to the neurologist about 6 weeks ago, and he said Rosie was doing great. She didn't seem to be in pain. The doctor advised 8 weeks of crate rest, and meds for a couple of weeks. I weaned her off the meds after about a week, and she continued to do well. Here's where I messed up. The vet said after 4 or 5 weeks, I could let her out of her xpen for periods of time, as long as I was supervising her. I did so, and even though I have ramps for her, she started jumping up on furniture before I could stop her, several times. I should've just realized she needed to be confined the entire 8 weeks, but I didn't. I came home last night and picked her up and she screamed. I started her on pain meds right away, and she hasn't shown signs of pain since, but I know she doesn't feel right. She's been in her xpen since then, mostly sleeping. I need to call the neuro on Monday and talk to him. I'm thinking I need to redo crate rest and do it for the entire period, strictly, although I'm sure I'll have to sedate her. I told my cousin, who's a vet neuro, but not in my state, what happened. She said Rosie shouldn't have relapsed, and that I probably should get diagnostics and possibly surgery. I think I really need to talk to her in more depth (we had a quick text exchange), and also Rosie's neuro, and see what they say. I'll do whatever is best for her, but I don't want her to have surgery because I didn't do crate rest correctly. All I can say in my defense is that she hates being confined, and it was really hard dealing with her after the first few weeks- she is an older dog who lives for affection, and was adopted by me a couple of years ago. She really panics in the xpen, will fight to get out if I leave her alone, screams if I step foot outside the house if she's confined (she's fine about me leaving if she's not in the pen). I'm struggling with my own health problems, so I admit I've sometimes taken the path of least resistance, but this just seems impossibly hard at times. Am I supposed to keep her drugged for 8 weeks, and sleep on the couch every night? There doesn't seem to be any other way to keep her calm and happy. Thanks for letting me vent- I'm trying to stay calm and productive, and take it one day at a time.

Thanks, Marjorie. I did start Rosie back on her anti-inflammatory (
14 lbs
12.5 mg Rimadyl 2x day plus
Pepcid AC as soon as this happened. I'm giving her
25 mg of Tramadol every 8 hours
25 mg of Gabapentin every 8 hours.

She doesn't seem like she's in any pain this morning, and she doesn't have any neurological deficits. I may call the vet today and leave a message anyway. I'm pretty sure he'll tell me to do what I'm doing.

I appreciate being held accountable, and I will do better this time. I know I have to be strong for my girl.

I have tried Rescue Remedy, but it doesn't work on Rosie. I'm going to order some of the other calming stuff recommended by Paula, but I have a question. I live in a very open plan house, and I'm worried the diffusers won't work. Is there a reason not to try the DAP collar? Rosie's not wearing a collar right now, and her pain isn't cervical.

My other question is about her bed. She has this bed

www.amazon.com/gp/product/B003YIHXO6/ref=wms_ohs_product?ie=UTF8&psc=1 (K&H Lounge Sleeper Self-Warming Pet Bed). Do you think the bed is ok for her crate? I'm really worried about taking it away from her- she spends the day lying in it, I think it's her only comfort. I have other flatter beds, but she doesn't like them, or lying on foam. If I have to take it away from her, I will, but I wish I didn't have to.

I will start thinking more about what we're going to do after the 8 weeks. Rosie doesn't go up and down stairs at all anymore- I carry her (which is hard, because we have lots of stairs). The big problem is her jumping on furniture, even though I have ramps everywhere. I really can only think about so much at one time, so maybe I'll give myself a week or so before I figure that out.

Whew! She'll be happy to hear it. I just want to thank you and the other moderators for being a firm, yet non-judgmental presence....I really appreciate you being there for me and Rosie, and so many other suffering animals (and humans).

I ordered basically all the calming items you suggested, and I'll let you know if any of them work.

I'll let you know what the neuro says- I'm going to call him and leave a message.

One of the reasons for considering surgery would be repeated disc episodes at the same site. Often with a neck disc there will not be any neuro loss as it often is for a back disc.

A repeated disc problem in the same disc might mean there is a piece of disc material that just will not be reabsorbed enough to allow the nerves live with it, not get inflammed and swollen causing the pain. In that case surgery would physically remove the piece and Rosie could live pain free. If the discs were all in a different place, well, then that is IVDD. Any of the 26 discs have potential to prematurely age, bulge out of shape or even have a significant tear. Surgery deals with one disc and perhaps fenestration of the two adjacent discs as a preventative measure

Of course there is no guarantee with either surgery or with conservative treatment. The best thing is to read about surgery, discuss all with your vet and maybe a consultation with a boarded neuro (ACVIM). Then you will know you have made the best decision you can with the knowledge at hand should the outcome not go as you expected. That is all any of us can do be educated to the best of our ability and choose wisely on that basis.

Have you checked out the article over at our main web page on surgery vs. conservative.....good reading in preparation to discussing this topic. www.dodgerslist.com/literature/healingsurgery.htm You will also find it worthwhile to read the Dr. Isaacs answers about surgery: www.dodgerslist.com/literature/surgery.htm

Hi Amy, I'm Sabrina. So sorry you and Rosie have to deal with IVDD, but I'm so glad you are researching the best ways to help her!

Great news that Rosie's pain is fully controlled!

Did Rosie's vet call for tapering off of the pain meds before stopping the Rimadyl? That's a good way to test the waters on her pain, and if there still is pain then you will know she needs longer on the anti-inflammatory dose of the Rimadyl.

With conservative treatment for a disc episode, the reason behind the 8wks of 100% crate rest (only out to potty and for necessary vet visits) is for Rosie's body to develop secure scar tissue to protect the healing disc(s). The crate acts as a sort of "cast" while Rosie's body works on forming the scar tissue. The real worry with less that 8wks of crate rest is that the scar tissue won't be strong enough, and that Rosie will re-injure that area:
www.dodgerslist.com/literature/healingdisc.htm

Have you seen the page on the main Dodger'sList site that overviews the 4 Phases of Healing from a Disc Episode: www.dodgerslist.com/literature/healingpage.htm I've found it to be such a great resource to read and re-read! Really helped me wrap my head around what is really going on during an episode:
Medications for =
--Phase 1: total pain control dose to dose of pain meds, while
--Phase 2: the anti-inflammatory resolves the swelling/inflammation causing the pain.
Time and the Body work to =
--Phase 3: develop secure scar tissue over the 8wks of 100% strict crate rest to protect the healing disc(s)
--Phase 4: regain neurological function, which can happen weeks, months, or years later. The great thing is that there is no "expiration date" for healing nerves!
www.dodgerslist.com/literature/healingnerves.htm

I know that when faced with 8wks of crate rest it seems like such a long time! But you can help your Rosie through it!

))Hugs!((