Casey's Charlie 5/22 conservative

Welcome to Dodgerslist.  My name is  Paula  what is yours?

Pleased to hear you knew to crate at once and get vet help asap.  Worrying about the future is a scary thing…what can most help you is to understand the disease, how healing happens and  how long it takes for each of the phases. In addition 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. A very quick way to get up to speed on meds, how healing happens and when for each of the phases is the "Overview: the essentials" yellow button. Then work your way through the rest of the orange and blue buttons to complete your education. Here's the link www.dodgerslist.com/healingindex.htm

Do make sure you advocate for a stomach protector when any anti-inflammatory is on board. 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.   We ask that all members read about each med their dog is on or may take as a safety measure.  This directory is in alpha order:
 www.marvistavet.com/html/pharmacy_center.html

Charlie is a good candidate for conservative treatment if this is a disc episode since his signs are mild of ain only…that is 100% STRICT crate rest 24/7 only out to potty for a full 8 weeks …. 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.

Let us know what your vet diagnoses, what meds are prescribed (dose in mg and frequency to give) and that you do have a stomach protector on board and what he says about crate rest.

Sucralfate works in a different way than the acid reducer Pepcid AC. Sucralfate coats areas of the GI tract that have damage. Usually Pepcid AC does a good job for most dogs. When it is noted there is a GI problem, then Sucralfate is added to the Pepcid AC.

The is so good to hear that Charlies is not having any pain. What meds did the vet prescribe... and did he diagnose a disc episode? We are a group who LOVE details. LOL

Some dogs are very active when chewing which would not be a good thing during crate rest..and the need to keep the neck/back quiet. Also consider most dogs need some 16-18 hours of sleep per day, people sleep 8-9 hours day. What are they doing in the crate? Laying around and sleeping! Don't give into the temptation to start a treat routine to combat non-existent boredom. Adding a bunch of treats as entertainment contributes to weight gain which isn't a good thing; Bullie Sticks are high calorie items speakingforspot.com/blog/2013/03/24/the-lowdown-on-bully-sticks/

This article can help you through the maze of supplement offerings: www.dodgerslist.com/literature/Supplements.htm

Hi Casey, so glad Charlie's disc episode was caught early! It's great that the Vet didn't include steroids along with the Metacam, that is a dangerous combination. Good for you getting Pepcid on board to protect his tummy. Remember to give it to him 30 minutes before the metacam and always give Metacam with food.   Keep in mind however, that Metacam reduces inflammation and is not a pain killer.  If Charlie is still in pain, that should not be tolerated.  Ask the vet for a pain medication as disc episodes are very painful. Once he is pain free dose to dose he can begin to heal.  www.dodgerslist.com/literature/healingpain.htm

What is the dosage on the Metacam and the frequency it is to be given?

How to lift and carry your dog. 

This video shows how a disc can damage the spinal cord:  www.dodgerslist.com/literature.htm

The best tool for healing short of when surgery is indicated is – Crate rest— 100% STRICT crate rest for 8 weeks. That means 24/7 in the crate except for potty breaks. No laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no Chiro, no VOM. The rest of the details of doing crate rest:  www.dodgerslist.com/literature/cratesupplies.htm  www.dodgerslist.com/literature/CrateRRP.htm

One reason some vets may be reluctant to give a full prescription of time is knowing many owners will not follow through. Perhaps not fully understanding the reason for it, is why people tend not to do it. Observation of 1000’s of Dodger dogs over years, has shown a conservative approach to crate-rest time, results in fewer relapses. Dodgers prefers the safer, more conservative recommendations of neuros and other vets using 6 weeks for surgery or 8 weeks for crate rest for conservative treatment. 

Healing wishes for Charlie!

That is an antiquated and uninformed idea that a dog should be in pain to limit movement. Vets up to date on pain control know the crate is what keeps them with limited movement. Advocate for proper pain control if you are seeing any one of these signs of pain. - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy. Know the pain meds and advocate strongly if necessary. Healing can't fully get underway when a dog is in pain. www.dodgerslist.com/literature/healingpain.htm

Metacam can be given any time of the day.

Treating pain early usually brings quicker and better results. Healing occurs faster when pain is under control. Pain affects blood pressure, heart rate, appetite, and general mood. Until all the swelling is resolved on the inside via surgery or conventional medical treatment, there will still be a source of pain. Herniated discs, damaged spinal cord require a significant amount of time to heal. New tissue must be generated. Swelling must have time to subside. Pain is so important to the overall well-being of a patient that it has become the 5th cardinal sign of human assessment. (Philips DM. JCAHO pain management standards are unveiled. J.Am Med Association 284(4):428-429, 2000) Institutions can risk their federal funding if they do not routinely assess for pain. Why would we do less for our own dogs who feel the same pain we can feel?

Casey, can you help us out, please list his meds, with the dose in mg and how often you are to give them.

Kudos to you for getting a pain med on board. Tramadol has a short half life of 1.7 hours. Often it does not control IVDD pain unless given at least every 8 hours. We look to learn the details on Charlie's meds and that now his pain is fully under control dose to dose of Tramadol.

See if you can give a command to "go to bed" or whatever works for you... to get him to stop or reducing the amount of fluffing his blankets. At night maybe a clamer would help???

Using any oral calmer in combination with a Pheromone diffuser seems to work best.  It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives.

Farnum's Comfort Zone with D.A.P. www.petcomfortzone.com/dogs.html [pheromone diffuser] with one oral calmer from below:

Oral calmers:
1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed www.virbacvet.com/products/detail/anxitane-l-theanine-chewable-tablets/behavioral-health
2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. www.vetriscience.com/composure-soft-dogs-MD-LD.php [Composure]
3) Rescue Remedy is a liquid herb combo to help with relaxation www.bachrescueremedypet.com

Plain Benadryl (Diphenhydramine) with no additional medications added. Buy at your grocery store or pharmacy. Get the dosage from your vet. The wrong dose can have dangerous side effects, so your vet needs to prescribe the proper amount for your dog.

Using an expen or some poke in the ground garden edging fencing to form a 6 foot diameter potty area would help to limit footsteps and let him know sniff fests are not going to happen to poop or pee. Then you can back away a bit to give him privacy since he out be secure in the fenced area IF he is not wobbly and needing a sling to keep his rear from tipping over.

Is the pain now under control with Tramadol 3x a day?

Pepcid AC takes about 30 mins to be effective and lasts for about 12 hours. Are you giving it 2x a day and 30 mins before the Metacam. Metacam should also be given with a meal for further stomach protection.

I love Charlie's photo...he's quite handsome. He has a great mom, you are doing a good job in his care!

Wonderful news. Hoping hes done with the pain. Now comes the tough love part but you are doing a great job and its paying off seeing Charlie heal.

Casey, I am so sorry to hear that Charlie had a retear on his early healing disc due to too much movement and the stopping of crate rest before graduation date of June  25.

The only way a disc heals is with limited movement… only the very, very fewest of footsteps at potty time. 100% STRICT crate rest 24/7 only out to potty for a full 8 weeks. There simply can be no cheating.  …. 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.

What are the current meds on board now, dose in mg and frequency you are to give them. Pepcid AC, too?

We highly recommend laser therapy to help not just with pain but to kick start nerve repair.

I'm liking very much what your new vet says about 8 weeks of crate rest! We are starting a directory of vet recommendations so we can help one another find IVDD knowledgeable vets. Will you help by posting on this board in the forum: dodgerslist.boards.net/board/10/guidelines-posting

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Subject: Vet recommendation: your CITY, STATE
Clinic:
Vet's name:
Title: DVM or DVM specialist--- neurology ACVIM or ortho ACVS
Address of hospital (Street, city, state):
Phone number of hospital

Your comments or additional information:
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Thanks so much Stevie! He is beginning Laser Therapy next week.

At this time, Charlie is on:

Pepcid - 1/2 pill in the morning
Melatonin - 1 mg every 8 hours
Tramadol - As needed for pain (at this juncture, he is on 1 in the morning and 1 at night)
Metacam - per his weight - once in the evening (with dinner)

He is on very strict crate rest, has an ex pen in the yard for potty breaks. He is wobbly in the hind end, but has not shown any signs of pain in the past 3 days.

Laser treatments begin next week.

I am happy to recommend this vet. They have been fabulous for all of our dogs.

Helping to soften his poop with 1 tsp plain canned pumpkin daily will ease that difficulty.

Remember that the Tramadol has a short half life and to be effective needs to be given every 8 hours. If during pooping is truly the only time you see signs of pain see if the pumpkin regimen helps. If you see any signs at all that he has pain the tramadol needs to be given every 8 hours. Giving it every 12 means he has several hours between doses where there is little to no effective dose in his system.

Good job

We were curious about the laser tech's statement too. Dodgerlist just received consultation answers back from two certified rehab practitioners, 2 neurologists and a DVM certified in rehab who do not know of any published contraindications of laser and steroids. Do find out what the reason he said not to use Prednisone with Laser therapy.

Glad to hear Charlie is more accepting of his recovery suite by not trying to dig out. The whines though can be irritating. Be aware you might be inadvertently training for unwanted behavior.  To dogs rewards are: food, looking at them, talking to them, eye contact, approaching the crate, petting.  So anytime you see unwanted behavior ignore it, turn your back, leave the room if you have to. Anytime your dog is sitting or lying down quietly, give a reward.  Soon Charlie will learn which of the behaviors receive reward.

I have a floor cleaner too and I must admit I'd be the one whining if she ever needs crated.

As for your vets concern regarding simultaneous use of Prednisone and laser we just can't find evidence to support this concern in spite of contacting the experts Paula mentioned above.

Some vets do take the approach of desiring to see what therapy is having the most impact so they do one thing at a time. But in the end who really cares which did the most? You just want your dog to heal and heal rapidly so all appropriate available therapies should be used. If there were a true research study going on that you were participating in obviously that would be a different story. And I'm not saying this IS what your vet is doing but we've seen that approach here before and it just isn't the most effective. Contact your vet again and see if he's open to a discussion now that you have more knowledge and can advocate for the use of both together with good rationale.

I'm sorry to hear about Mac. Hope he's fully recovered soon.