Sabrina's Lily 4/3 conservative Peke/Shih CALGARY, ALBERTA

Hi there! Welcome to Dodger'sList. My name's Sabrina - what's yours?

Know that it IS in the cards for your dog to get back to enjoying life after recovering.

With this disease self education is critical - not just so you make sure the right things are being done for Lily's best recovery, but also 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. Are you ready? Here's the link www.dodgerslist.com/healingindex.htm

Add this comprehensive "must-have" $3 DVD on IVDD to your arsenal of educational resources. Friends, family and those who will be caring for your dog should also watch this DVD www.dodgerslist.com/store/DVDorder.htm
Tape this flyer to your fridge so the whole family knows what things are emergencies: www.dodgerslist.com/literature/FridgeInfo81907.pdf

In order to help you more, could you please answer these questions?

► Lily was specifically diagnosed with IVDD? aka: a disc problem, a disc herniation, a bulging disc, slipped disc?

► What was the date you saw the vet and started the all important 100% STRICT crate rest 24/7 only out to potty for this current disc episode? …. STRICT means 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)?
www.dodgerslist.com/literature/CrateRRP.htm

► Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy?

► How much does your dog weigh? List the exact names of meds currently given, their doses in mg's and times per day given? What was the start dose if a steroid, date of taper? Please include the all important stomach protector such as Pepcid AC. Phrase the question to your vet this particular way:" Is there a medical/health reason for my dog 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.

► 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 nt once off of all meds and there is no more pain. The information highlighted in PINK pertains to a dog who can't walk.
www.dodgerslist.com/literature/massagepassiveexercises.htm

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

► Eating and drinking OK? Poops OK - normal firmness & color -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.

))Hugs!(( We are here to support you as you care for Lily!

Hi, welcome to Dodgerslist. Crating is the most important thing you can do for your dog.   It will effectively act as a cast for Lily, giving her back time to heal and limiting the motions that may tear or damage the disk further.  Not all vets understand the importance of crate rest, but the good thing is you found this site and now you know.  You may have seen this already, but here is a great link to understanding crate rest and the creation of a recovery suite.
www.dodgerslist.com/literature/IVDDcourse/crate_rest.html

You are observing signs of pain - have no tolerance for it. When pain medications are correct, pain should be resolved within one hour. If you are still seeing signs of pain while on the pain medications, please contact your vet right away and tell him your observations. Gabapentin is another pain medication that works synergistically with Tramadol to help control pain and many vets are finding it very effective. Here is a great link to understanding pain and pain medications. www.dodgerslist.com/literature/healingpain.htm

I don't see that your doctor has Pepcid on board to help protect the GI tract.  NSAIDS are notoriously rough on the GI tract.  Ask your vet this way...Is there any medical reason why Lily cannot take Pepcid AC? If there is no reason, the typical dosage for doxies is 5mg Pepcid (famotidine) 30 minutes before the NSAID/ Steroid. Pepcid is generally considered a safe over-the-counter anti-acid for a healthy dog and good insurance. Dogs don't speak up at the first signs of stomach problems like people do. By the time we notice symptoms the problem has headed in a dangerous direction.

Keep advocating for Lily, you can do it!

Sabrina, just want to confirm the very good advice Jean and Sabrina have given you. Good news — because Lily's symptoms are still mild with pain only and no neuro functions she is liely a good candidate to recover under conservative treatment! So hang in there, become a confident care taker... you can be instrumental in Lily having a smooth time of recovering. Outside of the 100% STRICT crate rest 24/7 for a full 8 weeks becoming an educated, savvy owner about IVDD will be the best investment for living with an IVDD dog. Are you ready to get started. Here's "the" link to book mark — absorb as quickly as you can www.dodgerslist.com/literature.htm

Please update us today about these very important things:
1. You have a red flag warning with not eating. If there is no health issue of heart or liver, get Pepcid AC on board and keep your vet in the loop asap.  We ask that all members read about each med their dog is on or may take as a safety measure. This directory very good for learning about each of your dog's meds:
www.marvistavet.com/html/pharmacy_center.htm

2. Pain meds have not yet been adjusted so there is NO pain dose to dose. When meds are correct pain will be in control in one hour and stay that way. Your vet does have PLENTY of room to move on mgs for both tramadol and methocarbamol. Make sure you are promptly giving Tramadol every 8 hours not as needed. Methocarbamol can also be prescribed for every 8 hours. In addition for hard to control pain, gabapentin is added. Background reading to be able to discuss getting meds right for Lily: www.dodgerslist.com/literature/healingpain.htm

Normally when the vet guesses swelling might be gone there will be a stop of anti-inflammatory and pain meds. Usually the first course of anti-inflammatory will be 5 or 7 days and then a test stop. Your job at home would be to assess just how well reduction of swelling is going by observing for any hint of pain (shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy, holding leg flamingo style not wanting to bear weight). To have a clear picture on a stop, pain meds are also stopped or backed off too.  You will want to coordinate a  plan B incase pain would surface at night or the weekend when the vet is not open on what to do. That might mean having an Rx in hand you can   take to a 24 hour pharmacy or a few extra pills to tide you over til you can get to a vet. Otherwise and expensive ER visit would be your other option.

Rule of thumb is: pain = swelling = more time on non-steroid anti-inflammatory (NSAID), pain meds and Pepcid AC needed.

Let us know the details on med changes with the morning call to the vet.

100% STRICT crate rest 24/7 only out at potty times for 8 weeks means all day she is inside her recovery suite. The only time she comes out is to be carried to and from the potty place. Set her down she may only take a very, very few footsteps to take care of business.  Sometimes using a 6 foot diameter fenced areas works better as it give both a physical and visual limit so the dogs knows there will be no sniff fests at potty time.

Also - for her crate, I currently do not have a memory foam pad or anything, she just has her favorite comfy blankets in there. Will that suffice? Where can I get an inexpensive mat if thats best for her? (its just me and Lily, and with vet bills I need to be careful with $$).

I will be right beside her whenever she is in the stroller - otherwise she will be in her crate. I just need to get something for her to sleep in at night in my room now.

I will send an update on how Lily is doing when I get home tonight. Thank you again - I am truly grateful I dont have to go through this alone.

What did the vet say Lily could use as a stomach protector. The reason she is likely not eating is the effect of Metacam. The stomach needs to be protected. Wet dog food does not get to the root of the problem. Change in food can cause GI upset and then we don't know if just a temporary food problem or a progressing serious problem with Metacam. Changing foods while on meds is not a good idea.

Soak her kibble in equal part low salt, low fat broth. Boil up some hamburger, cool and discard fat disc that gels at the top. crumble a teaspoon of hamburger on top of the soaked kibble.

Both tramadol and sucralfate can cause constipation. Not eating much would of course not produce much feces.

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.

More pain ... Oh no

Hi Sabrina! I'm in Calgary too. Are you happy with the vet you've got treating Lily now? Don't panic - the first bit of this is the hardest and darkest. We'll get you through this. I have just started with Emmie out of her crate - and I can attest to the fact that the 8 weeks of crate rest (STRICT) is tough but very necessary. I got a memory foam crate liner at HomeSense for $5! (I know...who would have thought HomeSense has a pet section). I cover it with plastic bag and then put a blanket over it for Em. That way the fancy foam doesn't get wet or soiled. I saw your question re acupuncture - my holistic vet does electro-acupuncture for $70 per session and it takes about 40-60 minutes per session. I had Em on it for 3 times per week for the first 6 weeks and then on to twice and now once but keep in mind Emmie cannot walk - she was totally back legs paralyzed. There is a rider you can have on your pet insurance that covers it - maybe you have that. Also, I'm sure the vet understands finances and could help create a program within your comfort.

I find the one in the NE the best for pet accessories. Market Mall secondary. Do you live in the North? Dr. Diaz is one of the vets that does spinal surgery at the C.A.R.E. clinic (wonderful but $$!). All the staff at that centre are amazing. I didn't have coverage for the acupuncture either but believe it is money well spent. I've seen it work miracles on dogs (my own and others that I've seen carried into the clinic and the next time running circles around their owners). Number one priority is to get rid of the pain so Lily can heal comfortably. Pain stops adequate rest in pets (and people)

Sabrina, did you read over the link I gave you on Apr 4? "Pain meds have not yet been adjusted so there is NO pain dose to dose. When meds are correct pain will be in control in one hour and stay that way. Your vet does have PLENTY of room to move on mgs for both tramadol and methocarbamol. Make sure you are promptly giving Tramadol every 8 hours not as needed. Methocarbamol can also be prescribed for every 8 hours. In addition for hard to control pain, gabapentin is added. Background reading to be able to discuss getting meds right for Lily: www.dodgerslist.com/literature/healingpain.htm ?

Acupuncture is not a replacement for getting the proper dose in mgs, the proper frequency and the proper mix of pain medications.

I'm glad to hear Tramadol was moved to every 6 hours.  Still your vet is very tentative on pain management with only 25mg.  He's also tentative with methocarbamol.

CAVEAT: It is important to do your own reading about meds so you can participate in discussions and be Lily's strong advocate. The reason for you to not self prescribe 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. If you are not satisfied with how your vet handles this disc episode, then there is a need to hire a different vet who is comfortable in treating a disc episode.
vasg.org/g_drugs.htm#GABAP
vasg.org/t_drugs.htm#TRAM
www.petplace.com/drug-library/methocarbamol-robaxin-v/page1.aspx

When you get the pain issue taken care of for Lily, please give us an accurate med list:
11.6 pounds
Methocarbamol 60mg twice a day
Metacam 5kg once a day
Tramadol 25mg every 6 hours
Sucralfate  ?mgs, ?x/day

Sabrina,

Have Lily's pain medications been adjusted yet? What did Dr Diaz have to say? 

Sucralfate comes in a one gram tablet (1000 mgs). What does "1.5 sulcrate" mean? Are you giving 1 and 1/2 tablet which would be 1,500 mgs? how many times a day do you give this dose?

Both sucralfate and tramadol can be constipating. A 1 and 1/2 tablet of sucralfate given in one dose is a rather large amount for a 11.6 pound dog and that would be quite constipating. Please double check the Rx.

When she poops is it hard, very firm? Are you giving pumpkin with each kibble meal soaked in equal parts of liquid?