Chantel's Sasha 4/30 Conserv. UK Grad: off meds, no pain

Welcome to Dodgerslist, Chantel. IVDD is a lifelong disease and a disc injury can occur at any time. Some dogs only have one disc episode their entire lives while others can have several. Hopefully, this will be the last time Sasha will have a disc episode.

Good to see that you've been reading and educating yourself about IVDD. 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

I'm glad to hear that Sasha is currently in her crate to protect her spine and that you're seeing the vet as soon as they open. When Sasha had the disc episode in April, was she on 100% strict 24/7 crate rest, only carried in and out to potty, for a full 8 weeks? If not, then the disc most likely did not heal properly and that may well be why she is now once again in pain. Too much movement of a not-healed disc can cause a re-tear and you're back to square one.

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

In addition, the steroid was just stopped four days ago.  There may well have still been swelling of the damaged disc.  When was the Gabapentin stopped so a test for pain/swelling could be made?  Please know that the anti-inflammatory dose of Prednisone for a dog of Sasha's weight is 5 mg 2x/day.  It doesn't sound as though Sasha was on an anti-inflammatory dose for the second episode.  Anything under an anti-inflammatory dose would not be effective in bringing the swelling down.

You are correct - a stomach protector should have been prescribed while on the anti-inflammatory. If she is indeed having another disc episode and an anti-inflammatory is prescribed today, 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. Pepcid AC is only available via prescription in the UK so you would need to ask for one from the vet.

If it's determined today that Sasha is having a disc episode, now would not be the time for a diet. She has a lot of repair jobs to do so continue her normal food rations. Treats if any should be low cal carrots, piece of apple or some frozen broth ice cubes to lick. If you feel after crate rest she has gained a bit then it will be safe for more activity plus she can go on a bit of a diet to slowly get her down to a good weight over a period of several months.

You are correct that there should have been a wash-out period between the NSAId and the steroid. However, that was a month ago and she had no problem. Just be sure to get a stomach protector on board this time.

Please let us know what the vet says after his examination today and what is prescribed. And please try to stay positive. I know how overwhelming this can be, believe me. However, as I mentioned, if Sasha didn't have a full 8 weeks of strict crate rest for the second problem and/or she was not given a dosage of Prednisone sufficient to bring the swelling down, that is most likely why she is having a problem today. It doesn't mean that she will have a disc episode every few months from now on. She may never have another one. She sounds like a good candidate for conservative care as the only nerve deficit you're seeing is being slow to correct.  It doesn't sound as though your vet is comfortable in treating IVDD and you may need to find a more knowledgeable vet.

We're here for you and Sasha and will help you through this.  Healing prayers for Sasha.

Sasha should not be off of 100% STRICT crate rest 24/7 until she is proved to not have any painful swelling going on in the spinal cord. The only way you can prove resolution of inflammation is the taper off of both the pred and all the pain meds. So crate rest should not end until a week after being off all meds and there is no hint of pain. Let us know when all meds will have been stopped.

100% rest means, no running around the consulting room at top speed, no excited to be free run around the room, no going on 5 minute walks. No laps, no couch, no sleeping in bed with you, no meandering 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 disc in question. Immediate neuro improvement may or may not come during the 8 weeks of crate rest… as nerves may take more than 8 weeks to heal.

I don't think we have a proper date for the beginning of this current disc episode. Was it when Onsior was Rx'd in April ... guessing April 30th?

It is possible she re-injured that pretty much healed disc with too much movement.  The pain  could also be associated with the going off of Pred, the med that deals with inflammation.  In any event, she need to stay on crate rest until off all meds for a week and there is absolutely no sign of pain.

She should not be off of crate rest until a week has passed since the stop of Pred and pain meds. She is only now on Gabapentin? What date will it stop?

Pain, would be the reason to resume Prednisone as this is the medication that resolves painful inflammation. Pain meds would need to be on board because pred often can range in time of 7-30 day to get swelling down. A dog should be able to heal in comfort from pain. Anytime pred or NSAIDs are used they can do damage to the stomach lining. Here at Dodgerslist we have seen multitude of 1000's of IVDD dogs. We follow the vet who understand being proactive in stomach protection to avoid bleeding ulcers to life threatening perforated stomachs. Not all vets are proactive. But owners can ask a simple question: is there any health reason my dog may not take Pepcid AC. if you dog has no health issues, then make the decision to be proactive... use Pepcid AC.

Nerve damage (knuckling, wobbly walking) heals on its own...think in terms of months rather than days/weeks.

Muscle atrophy comes back quite quickly when crate rest has been completed and off all meds. Then it is safe to slowly introduce physical activity such as under water treadmill or even a child's plastic wadding pool in your own backyard.

Please make sure you spend your money on things that actually work with IVDD and do no harm. Lots of labels promise results, where are is their research, clinical trials to support claims? Our job is to research and wade through promises to the truth. There is a discussion about Braces here on the Forum Board called DOG UPDATES. Just scroll down to find "Back Braces" here dodgerslist.boards.net/board/8/updates

Hi,

Over this weekend and today I have been speaking to other vets in the area about Sasha. Firstly, they have said the amount of prednisolone they would administer is 2.5mg a day (0.5mg for every kg) so I think this must be different in the US.

Secondly, their view is that if Sasha does not get any better I have to consider another surgery. I want to scream! She is still walking, wagging her tail and is happy! There is no way she should need another surgery with the right care right now. But nobody seems to understand the 8 weeks of care with meds route here. I did ask my vet why there wasn't any reason Sasha could have a stomach protector if she were on anti-inflammatories and they said because when Sasha was taking them it was only 2.5mg a day- if it were a higher dose they would consider stomach protector. But of course- they won't give her a higher dose.

Sasha has had her ▼gabapentin tapered and has been med free for a couple of days. She is still happy to walk for potty and it doesn't seem to bother her. I don't know whether she has some pain in her lower back as when I stroke her there she does look at me a bit. She has been doing more stretching than usual. Her back legs still cross and she wobbles. There has been no improvement there for 9 weeks. But everything else is normal. She goes back to our vet in a week for a B12 injection. They gave her one this weekend just gone too.

Thank you for sending me a contact here- I spoke to Val and she was lovely, but said she couldn't help with a vet recommendation. She has had dachshunds for years but none with back problems and doesn't have much faith in the vets here. I'm beginning to feel the same.

I feel so hopeless and trapped and that Sasha is going to end up in a wheelchair because nobody is listening to me (although I know that would not be the end of the world for her, it is still something I want to avoid if possible). I'm willing to travel outside of where I live to get her the right help.

Sasha is off all meds. "Better" to me means, no pain and no swelling. These are what I am not yet convinced of. I understand nerve damage can take up to a year to heal, my mother, a doctor, explained this to me. If Sasha wobbly walks the rest of her life but is pain free, I will be happy.

Since she has come off all meds and has rested for 8 weeks I have been allowing her to walk around the house with me before we introduce proper walks outside. This has led me to not being convinced she is pain free. Just from the look she gives me when I touch her back. She sometimes doesn't want to follow me, when usually she is glued to my heels and is a little shadow.

Anyway, I will keep a close eye on her movement and see if there are any other signs of pain. I guess as long as it is not getting worse, it is a good sign.