Janice's Jovie 6/17 conservative

Janice, welcome to Dodgerslist.  First thing to know is that it IS in the cards for Jovie to get back to enjoying life after strict rest. What can make a great deal of difference is your own self education. Knowledge is the best defense in fighting and winning with this disease. Reading others posts on the forum can be of comfort. But the meat of what you need to know is on our main web page.

So you are savvy about conservative treatment this page is a wonderful place to get a good overview of each of the phases of healing: www.dodgerslist.com/literature/healingpage.htm Hope to hear you will be able to follow all the informative links and complete your readings in the next couple of days.

This "Disc Disease" DVD is a wonderful way to help other family members understand and even others who might be around or taking care of Jovie: www.dodgerslist.com/store/DVDorder.htm

You will want to give the best gift of a recovery suite to Jovie.... lots of good tips in setting one up and making the crate rest period go smoother:  www.dodgerslist.com/literature/CrateRRP.htm

Let us know some of these detail when you know them:

-- Are you ready to start the all important 8 weeks of 100% STRICT crate rest 24/7 only 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)?

-- Is there still currently pain when she is at home - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy? Then the pain meds are not correct YET, get with the vet for adjustments.

-- How much does she weigh? Would you give us a list of exact med names currently given at the  hospital and what she comes home on, their doses in mg's and frequencies?
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 doxies 5mg Pepcid (famotidine) 30 minutes before the anti-inflammatory and thereafter every 12 hours.  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

-- Eating and drinking OK when she comes home? How are poops today- normal color and firmness, no dark or bright red blood?

-- Currently can she wobbly walk? move the legs at all? or wag the tail when you do some happy talk? Keep in mind the very, very lightest least aggressive range of motion and leg massage will be necessary for paralyzed legs during conservative treatment once off all pain meds and no more signs of pain. The information highlighted in PINK pertains to a dog who can't walk .
www.dodgerslist.com/literature/massagepassiveexercises.htm

-- Do you find wet bedding or leaks on you when lifted up? You will get more out of the vet's hands on top of your hands expressing lesson if that is needed by first reviewing this material:  www.dodgerslist.com/literature/Expressing.htm

-- 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.

Never give up, stay focused, stay postitive and stay strong!  You and Jovie will get through this bump in the road of life.   Do keep us updated as you know more.

Hi Janice...I would be willing to be that by the time a dog sitter shows up your dog will be recovering and be easier to care for. I understand your concern, my Mocha went down on a Sunday night and I took the day off Monday...but then it was back to work. Luckily I have an AMAZING employer who let me leave early for vet and laser appointments and let me take a longer lunch so I can come home during the day to look after her. It's been 2 and a half weeks and Mocha went from having no use of her back legs to being able to stand and walk today (wobbly, but she can do it). She is still on crate rest but she is recovering quickly....my fingers are crossed that your dog recovers quickly too

One more question before she comes home. I have been gathering the stuff for her recovery and I am wondering if I need to purchase a sling for her hind end or is that something I should wait on?

Just spoke with vet-She is not recommending tramadol because she said it tends to cause constipation. She is recommending pupernix (sp) as a pain medication. Does anyone have experience with this or should I push for the tramadol?
Vet is willing to listen and do whichever I prefer which is encouraging.

She said Jovie is able to stand but then falls over. She is sending me home with anti inflammatory and pepcid. She also said when they go near her cage she wants OUT. They had her on pain meds (the pupernix) yesterday which the vet said made her drowsy and kept her sleeping but I am thinking that may not be a bad thing. At first she wasn't planning to send me home with pain meds but I asked to have them.

Is the anti inflammatory enough of a pain med for her to not need the other? It seems contrary to everything I have read.

I am picking her up at 4pm today.

My apologies-It is Buprenex (Buprenorphine) and Prednisone that we will be going home with. I do not know dose yet.

Hello-

Jovie is home and resting comfortably with her super soft blanket.

She can stand but then tips over and she can wag her tail when happy talked (not a lot, but still wagging).

She was sent home with following meds
7.5 pounds.
Liquid Buprenorphine .1 ml every 12 hours
Prednisone 2.5 mg every 12 hours
1/2 of a 10mg pepcid ac 30 minutes prior to prednisone

She is drinking water
Does not have bladder control-Vet expressed her and helped me (hand over my hand) but I am a little nervous about my success at this. She has not pooped on her own. SHe did poop yesterday after rectal temperature and vet was able to expel some today.

She does not seem to be in any pain. Very drowsy from meds. When I picked her up at Vets she was fairly normal personality. Shaking like a leaf when we were expressing her but there were 3 other people in there and I think she was stressed out and just wanted me.

Vet isn't as knowledgable about IVDD as I had previously thought but she is very open and they are supremely accommodating. Told me I am welcome to bring her back if I am unable to express her myself.

I am overwhelmed.

Just tried to express bladder-no luck. Not sure if that is because it's not full or I'm doing it incorrectly. She was fully expressed at 4:30pm and has had a few drinks of water, not a ton. Her legs were crossing and paws were knuckling under while trying to express but she did not act as if in pain-no yelping or shivering or any other signs.

It's hard to determine if her personality has changed as it seems the pain meds really knock her for a loop and make her sleepy. She is so tiny.

Stressing out about not expressing although she was never a dog that peed a lot prior to this. She would mostly go out around 8 and then be good for 12 hours. I will try again in an hour and then in the morning. If I cannot then I will head back to vet. Luckily vet is only 1 mile away.

Hi Janice, my name is Lola. It sounds like a wise decision to take her back to the vet so that they can show you again how to express, it takes a bit of practice so do not be discouraged. Prednisone should be making her much more thirsty so keep an eye on her drinking - she should be drinking steadily (sometimes even "excessively" - this was the case with my Hurley), so there should be plenty of expressing for you to do as well, every 2-3 hours or so. Sometimes, if a dog cannot be expressed it can be a sign of bladder control returning. In that case, you would not find wet beddings or leaking either. Let us know how it goes and what your vet thinks of the situation.

Continue to give her the pain medication as prescribed. At some point, the vet will call for a taper of the Prednisone. At that time, the pain meds should also be tapered or stopped so there can be a good test for pain. During the taper of the Prednisone, you'll need to be on the close lookout for signs of pain. If there are signs of pain, you'll need to immediately advise your vet so Jovie can be returned to the anti-inflammatory dose of the Prednisone and the pain meds. Pain = swelling = more time on all meds. It can take 7-30 days for the swelling to resolve.

How long has it been since she urinated? If her bladder is full and it certainly should be by now, it will fill the whole abdominal cavity and you won't actually feel it. Have you watched our video on expressing and read our tips - they should help you get an understanding on how to express - www.dodgerslist.com/literature/Expressing.htm

If she's leaking, then the bladder is overflowing. That can stretch the bladder out of shape and can cause bladder damage. Also, any urine left too long in the bladder can cause a urinary tract infection. Please contact your vet ASAP to have him express her and give you another lesson.

Expressing is a matter of physics. That means the pressure applied to the bladder has to be greater than the strength of the urinary sphincter. Sometimes you have to hold that pressure many seconds longer than you think before the sphincter is overcome. As the bladder empties, it gets smaller and can slip away. Sometimes it will move back by the hip area and you'll need to find it again.

It took quite some time for me to learn how to express. It does take a bit of practice so don't be discouraged. Please let us know how your lesson with the vet goes. It's great that her pain is under control.

Blessings to you both.

OH! She just cried/whined and scratched at cage so I thought I'd go ahead and do the sniff test. Took her to her pee spot and did the sling support. She sniffed around and then squatted and peed a ton!

I am so relieved. I think if I'd let her sniff a bit more she would've pooped as well because about 5 minutes after putting her back in kennel she had an accident. It seems the pear really loosened her up as she had not pooped on her own since Tuesday morning.

Another indication to go out and this time poop. Pretty runny. I am thinking from the pear. Hasn't peed since 8:15. Not showing signs of pain or distress other than whining to get out to potty. A little shaking when I pick her up after going but I think it is nerves. She is not shaking at all in her crate and is resting comfortably.

She just indicated again to go out and urinate. This time no shaking whatsoever when picking her up and lots of tail wagging.
No more bowel movements.
I will keep an eye on bowels. This morning when she had her first one it was very dark, almost black, and a large hard chunk surrounded by looser stool. This last stool, while still runny was normal brown in color. I read the black stool could be from constipation caused by the meds. She is eating and drinking well.
She always was kind of a shaky nervous little thing if there was unfamiliar people or surroundings. She's not used to an audience cheering her on when pooping so maybe that made her nervous?
I am keeping an eye out for pain. Spoke with vet this morning and she said she would call back this evening at closing to check on her.

Thank you all so much. You are all angels!

Thank you Paula.
She did go again last night around 9 and it had firmed up quite a bit from the episode prior but I will take no chances and ask for that as soon as they open.

Janice, CLEARLY her pain meds are not yet right.... she is in pain as evidenced by reluctance to move.  I have provided you with references in previous posts why oral Buprenorphine may not be the best choice for pain relief.

Because Prednisone can take 7-30 days to get all the spinal cord swelling down, it is imperative to have the right mix of pain meds on board.  That will take communication between you and the vet. The vet prescribes, you watch and give feedback so they know if further adjusting is necessary.  Pain control is not a one size fits all deal... each dog has individual needs.  

Please discuss Tramadol as the general pain reliever Rx'd at least 3x/day, discuss methocarbamol to address pain stemming in particular from muscle spams also 3x per day.  There would still be an option to add gabapentin to these two if pain is still not 100% in control.  Vets find that gabapentin works synergistically with Tramadol in dealing with hard to control pain.

7.5 pounds.
Liquid Buprenorphine .1 ml every 12 hours
Prednisone 2.5 mg every 12 hours
1/2 of a 10mg pepcid ac 30 minutes prior to prednisone