Sarah's Dexter 4/8 conservative England

Sarah, welcome to Dodgerslist. I'm so very glad to hear you have started reading and have already applied the single most important part of conservative treatment... the 100% STRICT crate rest 24/7 only out at potty times for 8 weeks.   Let us know if you are doing it this way: 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.

Dexter could be a good candidate for conservative treatment now that you are understanding more how it works. With this disease the very best defence and the way to win is self education. This page will give you the over all picture of how meds, work, how long things take....all things IVDD. So will want to read it right away: www.dodgerslist.com/literature/healingpage.htm

A very important drug to on on board with the use of a NSAID such as Metacam is a stomach protector. The FDA and manufacturer pkg insert indicate gastrointestinal problems are side effects of using NSAIDs.  The natural defenses of the stomach to shield against stomach acid is hindered when taking NSAIDs. Serious gastrointestinal toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms.  Phrase the question to your vet this particular way:" Is there a medical/health reason for my dog not to 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 NSAID.  Pepcid is only available via prescription in the UK so you would need to ask for one from the vet.  Ranitidine, a different acid reducer, is  available over the counter at the chemist there in the UK.

Do make sure the only massage/range of motion you do is what is highlight in PINK and red numbers in this information below.  The very, very lightest least aggressive range of motion and leg massage is necessary for paralyzed legs during conservative treatment.   www.dodgerslist.com/literature/massagepassiveexercises.htm

Do keep a watchful eye on his neuro functions and read up on surgery ahead of time so you are well-informed to make good decisions. www.dodgerslist.com/literature/healingsurgery.htm

Can you give us some specifics so we can better help:
-- Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant to move much or slow to move, tight tense tummy?

-- What are the exact names of meds currently given, their doses in mgs and frequencies?

-- Eating and drinking OK?

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

Hi Sarah, I understand your fears, but please know that you will feel calmer about his disease if you know more about it. Here is a brief tutorial on IVDD: www.dodgerslist.com/literature/IVDDcourse/index.html . If a dvd is more your style, we have an excellent one available for only $3 including shipping. It's great to have on hand to show to family/friends/petsitters so they will know what they can and cannot do with your dog and how they can help: www.dodgerslist.com/store/DVDorder.htm

You will see that the reason Dexter is starting to lose neurological functions is because a disc is causing pressure on the spinal cord. This in turn is causing the nerves within the spinal cord to be compressed. These nerves are responsible for neurological functions such as standing/walking, bladder control, and tail wagging. Right now Dexter still has a fair amount of neurological functions. Your goal is to minimize his movements at all costs so that his disc can heal. It is the strict crate rest for 8 weeks that heals the disc while the meds help reduce inflammation and pain. Glad to hear you are carrying Dexter to and from the potty spot and only allowing a couple of steps for him to do his business. Here is how to pick up and carry an IVDD dog: youtube.googleapis.com/v/kyD2IW5m0qY

Be sure to get a stomach protectant on board to protect Dexter from internal bleeding due to the excess acid caused by the NSAID, Metacam.

Hang in there! We've helped over 4,000 IVDD dogs and their owners here, so you are in good company. Feel free to read through some of our Success Stories to get an idea of the recoveries our pups can have. The most important thing to remember is that a pain-free dog is a happy dog, whether walking or not. Although many dogs do walk on their own after healing from an IVDD episode, those that don't simply use a cart to get around and have a wonderful quality of life.

We look forward to your next update. Best wishes, ~Lisa

Hi everyone,

Still no change in Dexter's condition. He's been in the crate for 9 days - am I being impatient expecting to see a difference at this stage? I know the advice says the spinal cord swelling can take up to 1-2 weeks to reduce. Did/do other people have similar experiences to this but then one day you get up to find the dog's condition has improved? At the moment I can't imagine him ever getting better. The vet wants us to give them a call at the beginning of next week to organised the referral to a specialist for a consultation and MRI scan.?

Thanks,
Sarah

Hi Sherry,

Thanks for the post. Yeah we got a med to protect his stomach but he's eating and drinking is still the same as it was before he became poorly. He's still got bladder and bowl control but there hasn't been any improvement in his condition. This afternoon when I carried him back from the toilet his 'good' back leg started vibrating. He wasn't trembling with pain or anything so I don't know if that's a good sign or not?

The vet said we should see a specialist in case Dexter has done irreparable damage to his spinal cord.

I am trying to stay up for his sake but you're right it is so hard because I can't make him better. I do hope you're right so we can eventually get the old Dexter back.

I'll update as things develop - thanks.

Sarah, it would be a good idea to help Dexter's legs. Until he can move them himself to keep his joints flexible and keep up circulation in the back legs, you will need to do that for him.

While on conservative treatment it is very important to continue with the principal of limited movement for the back. So that means you would do the very, very lightest and least aggressive therapy for his back legs.... only passive PT. That is all explained in the PINK highlighted test and the red numbered exercises.  Here is the link for how to do range of motion and massage for Dexter: www.dodgerslist.com/literature/massagepassiveexercises.htm

As you can see Dexter is very likely to heal and have return of neuro functions because he not only has deep pain sensation but also even has bladder control. Nerves are very slow to heal, think in terms of months. The focus on 8 weeks of crate rest is to let the disc heal.  Nerve repair may  or may not come during the 8 weeks. There is no time limit for nerve healing.

Nerves heal typically in the reverse order of the damage to the spinal cord:
1. Deep Pain Sensation (Only correctly identified by a specialist.)
2. Tail wagging with joy at seeing you or getting a treat or meal.
3. Bladder and bowel control verified with the "sniff and pee" test.
4. Leg Movement, and then ability to move up into a standing position, and then wobbly walking.
5. Being able to walk with more steadiness and properly place the feet.
6. Ability to walk unassisted and perhaps even run.

Sarah, good news for Dexter. You are now starting to see the healing begin. Are you sure he is still in pain? Since he is doing so much better, you might want to discuss with your vet to see if he thinks you can try tapering to see if the swelling is down.

Yes, you will want to wait at least the eight weeks or more and at least until you are sure the disc is fully healed and he has been pain free before starting hydrotherapy. You can discuss this too with the therapist and vet. Never know, he might be doing well enough that its not needed.

Hey everyone, the vet wants us to take Dexter to a specialist because he thinks we could be losing time to aid Dexter's recovery. The vet doesn't seem convinced by conservative therapy even though Dexter has improved, The vet hasn't seen Dex since the 5th April but he says he should be able to walk without dragging his paws!! He believes Dexter is likely to need decompressive surgery on the protruding disc. He wouldn't prescribe anymore ACP but he did prescribe more Tramadol. I do think Dex is still in some pain because he's now holding the back left paw up off the ground when he attempts to stand. The absence of ACP has made toileting Dex very difficult because he wants to wriggle, lick and move all the time. I am concerned good work is being undone by this. He's also developed a skin complaint on his belly which is caused by peeing on himself then by me using sensitive baby wipes to keep him clean! I know it's going to be a long process but his tail wag is definitely improving and becoming more purposeful and regular. I don't know what to do for the best because the vet thinks we're losing potential recovery time if we leave Dex for another 5 weeks.

Sarah, can you give us some specifics. Since we are not there to see, so we need your observations:

Since you last wrote Apr 23, has there been worsening in Dexter's ability to sniff, attempt to squat and then release urine?  If he can still do it, that tells us he still has bladder control.  Is he getting urine on his belly because of having to sit when he pees? Does he not allow you to hold his thighs a bit off the ground? This figure 8 sling is often more tolerated by male dogs at potty time.

After each potty, break do you wipe urine off his skin with a damp washcloth or non-scented baby wipes?  Is the skin damage, red and puffy, any broken skin?  Are you using an anti-biotic ointment to help healing or a diaper rash cream (one without any toxic Zinc)?
OR…...

at potty time when you go to lift him does he leak on you? Do you find urine leaks in his bedding?  That would then tell us he his neuro functions had diminished… bladder control was lost and the need to express his bladder.  Let us know your observation on bladder control.

Not wanting to bear weight on the left back leg is a sign of pain. Does Dexter's back leg look like this: www.dodgerslist.com/neurocorner2/rootsignature.htm

Do you also see any other signs of pain such as nearing the next dose of meds-- shivers, reluctant to move about much in his crate, yelps? 

Does his tail wag when you do some happy talk to him?  Or if he thinks he'll get a treat or when you walk into the room?

ACP (ACE) is a pretty strong sedative. If the problem is too much movement at potty time, are you using a sling, a leash and a harness to control him from sniff fests and darting off?  An option is to set up an ex-pen or some wire garden edging fence you poke into the grass so there is a both a physical and visual barrier to let Dex know he's just there to do his business.  With the fenced 6 foot area then all you need do is carry him to and from the potty place and use a sling.  Let us know when you are needing the help of ACE, there are other less powerful calmers to help Dex relax in his recovery suite if that is the general need.