Nicole's Randi 3/31 Conservative Beagle mix Neck

Welcome to Dodgerslist. My name's Marjorie - what's yours? What was the date when you first saw the vet, received the diagnosis of IVDD and started crate rest?

Randi is most definitely still in pain. The reluctance to move, shaking, crying are all signs of pain that must be brought under control today. How much does she weigh? Gabapentin works wells with Tramadol and can be added. Also Methocarbamol can be added. It's most important that you speak to your vet today about adjusting Randi's pain meds.

It sounds as though Randi has started the taper of the Prednisone. Was the pain under control before the taper began? Pain = swelling = more time on all meds. Randi must be brought back up today to the anti-inflammatory level of the Prednisone - 5 mgs 2x/day - to address the swelling. It's most important that this be done today as pain indicates swelling pressing on the spine which can cause neuro deficits.

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.

To allow Randi to walk around the house, to take more than a very few steps at potty time, sleeping in bed with you, sleeping in a bed other than her crate and to allow her out of her crate at all other than to go potty is not in Randi's best interests. Think of the crate as a cast for her back. It must only be large enough for her to stand up, turn around and lie down with her legs extended comfortably. Since true crate rest has not yet been started, I'm putting today's date in the subject line of your thread so we can keep track of the 8 weeks starting today. Any time of the crate is a dangerous time for Randi. The crate rest must be strict to protect Randi's spine from further damage.

Pepcid AC should be given to protect your dog from the excess acid produced by the anti-inflammatory. Please get your vet's permission to give 5 mg of Pepcid AC (generic is famotidine) 30 minutes before the dose of the anti-inflammatory and thereafter every 12 hours). Phrase the question to your vet in this particular way: "Is there any medical reason my dog may not take Pepcid AC?" If your vet says your dog has no health issues such as liver, heart, etc to keep her from taking Pepcid AC, then do get it on board.

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

Can you give us a bit more in essential information about your dog:

1. Currently can your dog wobbly walk? move the legs at all? or wag the tail when you do some happy talk?

2. Can your dog sniff and squat and then release urine or do you find wet bedding or leaks on you when lifted up?

3. Eating and drinking OK?

4. Poops OK - normal color, firmness, no dark or bright red blood?

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.
NOTE: Chiropractic is not recommended for IVDD dogs.

Please let us know what the vet says after speaking to them today.

Healing prayers for Randi.

Hi Nicole, I'm Sabrina. I'm so sorry Randi is having a disc episode, but I'm so glad that you are researching and working with your vet to get her the best care possible!

I hope that the gabapentin and more frequent tramadol get Randi completely pain free dose to dose. With the right combo/frequency, total pain control should happen within an hour. If you are still seeing pain, don't hesitate to call your vet - pain meds often need multiple adjustments to find the combo/frequency that works:
www.dodgerslist.com/literature/healingpain.htm

Was the x-ray Randi had a traditional x-ray? Generally speaking, X-rays are used to rule out other problems mimicking IVDD as they show bone and not soft tissue. Some institutions have the new, state- of-the-art x-ray technology not available in most general practices that can offer better disc information. Typically X-rays can be used to “suspicion” a disc problem if read and interpreted by a vet experienced in diagnosing IVDD from x-rays.

"The rupture site [that is, the disc(s) that are causing the current episode] may or may not be obvious on a plain (non -myelogram) radiograph even to a trained eye." Read more about x-rays here: www.dodgerslist.com/literature/CalcifiedDiscs.htm

As the vet and radiologist are suspecting a cervical (neck) episode, are you seeing signs like: pain when moving the head/neck, holding head high or low, trouble with front legs?

Here are more strategies to help with a cervical (neck) episode:
www.dodgerslist.com/literature/cervical.htm

Like Marjorie said, at Dodger'sList we work to be proactive about stomach protection. So instead of waiting to see if a problem develops, we like to protect the stomach from the start in hopes that that will prevent trouble from starting at all! Apart from the fact that GI trouble can advance to a dangerous stage quickly, it is horrible with a capital H to deal with diarrhea/vomiting while on crate rest!

And as Randi has pooed in her crate, it would be good to get her stomach protected asap in case that is the first sign of a brewing problem.

As for the peeing on the rug... At potty times, is Randi still able to sniff an old potty spot and then release urine? That's the only way us humans can tell if she still has bladder control. Typical nerve damage follows this 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 is lost
8. Deep pain sensation
(If at any point Randi has neuro loss, that means a call to the vet asap.)
www.dodgerslist.com/literature/healingnerves.htm

Also, Pred causes increased thirst/need to pee, so while on Pred Randi will likely need to pee every 2 - 3 hrs.
www.dodgerslist.com/literature/drugs.htm#steroids

))Hugs!((

You know I am not sure what type of x ray. My nice vet specializes in treating pain with laser therapy so I hope that means he has the most up to date technology but I could be wrong. The office did call me today to ask about Randi and I told them she was doing very well, in which she was until tonight. I thought we had her pain under control but we have had a set back. She was given 100mg of gabapentin and her prednisone a little after 5 but then around 6 began panting and shaking. I then gave here a dose of tramedal and it is now after 8 and she has not stopped shaking and panting. Her behind is tucked under, her tummy is rock hard and she is lifting her front legs. Whenever I pet her she stops bug as soon as I move my hand off of her she starts back up. Besides speaking with the vet tomorrow I am not sure what to do.  

I would like like to say that you all have been so extremely helpful. I am not sure what I would do if this forum wasn't available. So thank you so much! Randi is also very thankful.  

Ok so I talked to the vet and he has upped The
prednisone to 7mg twice a day and we have added
28 lbs
Pepcid 5g twice a day  
tramadol 50 mg every 8 hours
gabapentin 100mg every 8 hours.

The vet had also recommend laser therapy to help manage the pain and swelling. I don't know much about the laser therapy so if anyone is familiar with It, I would love to hear your thoughts. I have decided to see if we can manage the pain with the increase in prednisone before trying the laser therapy. 

Nicole, how much does Randi weigh?

Your vet still has options to give full pain control that is not yet in effect. Often there is the pain stemming from muscle spasms that methocabamol addresses.

If laser therapy or acupuncture is in your budget they can be an adjunct to pain medications as John as explained. Prices do vary across the US. Here is one vet's price schedule for acupuncture: www.serenityvetacupuncture.com/index.php/faq_/ Chiropractic is not recommended for IVDD dogs.

Hi Nicole,

Prednisone is an anti inflammatory and not a pain reliever.  It works in a different way to eliminate the swelling in the spinal cord that is causing the pain.    It can take from 7 days to 2 weeks and for some dogs more like a month to get the swelling down..  When the Vet guesses that the swelling may be gone, he calls for a taper. At that time he will reduce the amount of the Prednisone given to less than the anti inflammatory dose and the Tramadol and Gabapentin will be stopped so you can see if Randi is in pain.  If she has  pain, the  taper stops immediately and she should be returned to the 7mg twice a day dose.  It is best to have a plan in place with your Vet should that happen so she can go back up to that dose quickly should pain happen.   If she doesn't show pain and the taper is completed, that means the swelling is gone and no Prednisone, Tramdol and Gabapentin would be needed any longer.. Just the completion of crate rest..

Both prednisone and tramadol can cause panting. Try a fan near the recovery suite but not pointed at Randi to gently circulate air. Prednisone could have side effects of behavioral changes such as anxiety.

Good report that pain is now under control. The painful muscles spasm associated with a disc episode are internal and may possibly not be observable. So be observant for these signs of pain appearing next dose of the pain meds to let your vet know further tweaking is necessary. Shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy, head held high or nose to the ground, not normal perky self,

You might try a rice sock to provide something comforting to lean against or rest the head on. Fill a sock with 1-2 cups of dry rice. Knot the end. Microwave for 1-2 minutes. Test in crook of your arm for warm not hot temperature. Wrap in a towel so it's not too hot for the skin and place in crate. Let your dog snuggle against when you are present to supervise in case your dog has a desire to munch on the warm rice. Note: human heating pads can get too hot burning skin on an IVDD dog.
Snuggle Safe is a commercial product that will keep warm the whole night. www.valleyvet.com/ct_detail.html?pgguid=E53AAF66-347A-4789-AFCC-5D6FA77ED8B6&item=30459&ccd=IFP003&utm_source=froogle&utm_medium=free&utm_content=30459

Nicole with several people doing meds it can be a safer idea to have a med chart to check off. That way meds are more likely to be on time and not any missed doses. Here's a sample chart... I know it made my life much easier:

www.dodgerslist.com/literature/crateRRP/medchart.pdf

This is good news that pain is being controlled if the meds are on time.  Another option to move the crate is casters from your pet shop or at an on-line shop  www.revivalanimal.com/Universal-Crate-Casters.html?feed=googleproductsearch&gdftrk=gdfv2457_a_7c543_a_7c1841_a_7c3060

Any time pain is showing my advice is always the same: Be observant for signs of pain appearing after moving, nearing next dose of the pain meds, to let your vet know asap further tweaking is necessary. There is no one size fits all pain relief. You and your vet are a team working, communicating to get full pain control. Pain signs are: shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy, head held high or nose to the ground, not normal perky self.

Neck discs are often accompanied by the pain of muscle spasm. So it is pretty normal to Rx methocarbamol from the get go. Background reading so you can get on the phone now to advocate for pain meds to be adjusted and to check if you are doing all the extra things to help: www.dodgerslist.com/literature/cervical.htm
   Your vet has room with a 28 lbs dog to increase Tramadol, can add methocarbamol,
   
It is important to do your own reading about meds so you can participate in discussions. The reason for you to not self prescribe, of course, is your vet has responsibility for the health of your dog in meds he prescribes based on his exam, the health history of your dog, how meds interact, not things we or you might know as we are not veterinarians. 
vasg.org/g_drugs.htm#GABAP
vasg.org/t_drugs.htm#TRAM
www.petplace.com/drug-library/methocarbamol-robaxin-v/page1.aspx

Is prednisone still at 7mg 2x a day?  On a taper off of pred, is the time to be particularly observant of pain signs. The taper is both a test and for health reasons.  Could it be Randi has moved more than necessary at potty time to account for the pain?

This is the normal expected procedure of how Pred is used: 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.


28 lbs
prednisone to 7mg 2x day
Pepcid 5g 2x day
tramadol 50 mg 3x day
gabapentin 100mg 3x day

Let us know the changes your vet makes to get the pain in control. 

Kudos, Nicole, on getting the methocarbamol on board. You did a fine job advocating for Randi's needs. Let us know the details on mgs and how often when you get the Rx.

Remember it can take anywhere from 7-30 days to get all the swelling down with Pred. It has only been 9 days on the anti-inflammatory dose of 7mgs 2x/day. Have you let your vet know that surgery will not be a financial option so that he fully understands the need for him to stay the course with Pred PLUS be aggressive with pain meds?

There are times when surgery would be a consideration, you are not there yet as all the medical options have not yet been taken. This article will cover those options and when to consider surgery: www.dodgerslist.com/literature/healingsurgery.htm You may wish to look into Care Credit now for just in case. It can ease your mind to know all your options, financially and where surgery would be done. No or low interest credit for veterinary costs can be obtained from Care Credit. You find out online if you qualify:
www.carecredit.com/faqs.html

Board-certified neuros (ACVIM) and ortho (ACVS) surgical specialists can be found at University vet teaching hospitals. You can locate others in your area here:
www.acvim.org
online.acvs.org/acvsssa/rflssareferral.query_page?P_VENDOR_TY=VETS
www.dodgerslist.com/literature/healingsurgery.htm