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Post by Sherry Layman on May 10, 2013 20:49:36 GMT -7
I'm glad she enjoyed the laser treatment. Hugs and praise to Penny for that one! Sorry it was a difficult trip though. Hang in there. Glad you enjoyed the facebook page.
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Post by Pauliana on May 10, 2013 20:52:23 GMT -7
Penny will come around with love, time and patience.. It is so hard considering she came from an abusive past but she has known only love from you and your family. Once she is past the crate rest period and gradually returns to a careful new normal, she will come around..Crate rest is hard in the best of conditions for special circumstances it's even harder.. In the long term it's her recovery that has to take first priority so that she will heal and have the best chance to have that happy new life after recovery..
My heart goes out to you and to Penny..
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Post by Jude & Penny Lane on May 11, 2013 8:08:03 GMT -7
I hope it's okay to post frequently. Penny is still knuckling over and doesn't seem to be improving even with the increased Prednisone. I am wondering if a sonogram might be helpful in figuring out just what is going on with her disc.
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Post by Sherry Layman on May 11, 2013 12:02:40 GMT -7
You may post as often as you like, we welcome your questions. Apologies ahead of time if responses are slow, we are all just volunteers...people who have been through this and hope to help others get through it but have busy lives and try to get to our computers whenever we can.
The knuckling is a sign of nerve damage, signals from her brain not properly reaching her legs and feet. Pain control is the first thing we strive for because that is the indicator that there is no longer pressure on the spinal cord. Nerves can repair over time, there is no schedule for healing though. Sometimes it takes some therapy after the crate rest period is over to correct gait deficits and muscle weakness. Priority right now is rest so the disc can really heal. If her symptoms worsen it's a sign that the disc has started pushing on the spinal cord again.
Tests to look at the disc can be done but it leads to the question how will you change the course of treatment with the new information?
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Post by Jude & Penny Lane on May 11, 2013 13:59:48 GMT -7
We have many dog cushions around the house - it's sort of "dog land" around here. We've been using a thin cushion and today cut up a large orthopedic cushion for Penny's crate and put two large trash bags around it. When Penny went into the crate, she sort of sank in it but the plastic bags made it wobbly, as well. We removed the plastic bags. It's still very cushy and I'm concerned about it and wondering if we should put the old cushion back in.
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Post by Sherry Layman on May 11, 2013 16:13:40 GMT -7
I think it sounds fine. There is a balance between support and cushioning/comfort. I know it sure seems like it at this point but truly her back isn't made of crystal. :-) If it's an orthopedic type cushion it's giving plenty of support while still cushioning her. Crate rested dogs are spending a lot of time lying around so good cushioning is also important to prevent aches and pains and even sores on the skin from decreased circulation due to pressure if there isn't enough padding between them and the firm bottom of the crate.
The plastic bags are to protect the pad from water spills, vomit, urine, etc. If you aren't worried about that then no need for the bags. I am curious if there was some air trapped in them that made them wobbly? You could poke some small holes at corners to allow the air to escape but still give protection to the pad if you think it was air. Just a thought.
I know the look of dog land, I have dog beds, blankets, pillows every where for mine too. I think it's an awesome decorating theme.
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Post by Jude & Penny Lane on May 12, 2013 14:11:25 GMT -7
I just uploaded two photos of Penny Laine.
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Post by Jude & Penny Lane on May 14, 2013 17:37:21 GMT -7
Penny is down to one prednisone pill a day. She is still knuckling over. What should I do now?
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 14, 2013 18:52:31 GMT -7
Can you update us on all her meds now... is she now stopping/cutting back on the pain meds too? Any signs of pain?
Knuckling is nerve damage and that will take time for the nerves to heal. It may happen during the 8 weeks of crate rest or it may take longer.
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Post by Jude & Penny Lane on May 14, 2013 21:31:08 GMT -7
All Penny's meds are the same, except she is on a 7-day schedule with the prednisone after going through much of the the 5-day schedule, when she regressed during the every other day of the weaning schedule. We're now giving her one prednisone a day. She's still on Tramadol, Sucralfate, famotodine, Valium, Prozac, all the same dosages as earlier. She seems to have made a tiny bit of progress this second time around, but the knuckling over with her hind feet continues. I don't want to keep her on prednisone for a lengthy period but I don't want to wean her off it too soon. My question at this time is are we doing everything correctly?
The only recent sign of pain she has expressed is a high-pitched whine, the same as before her accident, due to her arthritic hips. She was on Metacam for quite awhile at the full 80-lb level and we couldn't reduce it or she would be in more pain. I was very glad to get her off the Metacam and onto Tramadol, which is very effective at the 1.5 tablets level. We tried giving her one Tramadol instead of 1.5 and she did the above mentioned whining. She's a very good patient but somewhat morose about being in her crate because she misses her close body contact with us. We love to hug, kiss and cuddle with all our dogs, and we miss that, too.
All three of our Rotties were on Metacam and are now on Tramadol. Our 10-y.o. girl has something going on with her neck and ears, in addition to her severe hip arthritis, and the ointment for her ears is very thick, so she's temporarily deaf. Our 11-y.o. male has very bad hips and chronic kidney failure, which is getting worse. I'm thinking of making a sign to post on our front yard fence: The Essex Street Hospice.
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StevieLuv
Helpful Member 
Conservative Treatment 3x. It really does work!
Posts: 1,335 
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Post by StevieLuv on May 15, 2013 9:08:07 GMT -7
Knuckling over is one of the things that sems to take longer to heal up. You really seem to have gotten things under control. I really do undertand what you mean about the loss of cuddling and contact - even though I lie on the floor right next to the crate with Stevie's little body pushed up against the bars so I can pet her, it really isn't the same. Just keep thinking about how great it will be to have close contact again at that magical 8 week mark  Keeping you in thought and prayer |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 15, 2013 11:01:23 GMT -7
So Penny is on 10mg Prednisone 1x a day? Prednisone's job is to take care of swelling/inflammation. Swelling is the cause of pain. Initial swelling can cause a loss of neuro function such as knuckling. If the function is lost for a short time, it can also return in a short time in a matter of even hours with prednisone. However if knuckling has been going on for some time, the nerves may be more damaged and may take time to regrow/regenerate in terms weeks or months.
So on the pred taper (reduction to less than an anti-inflammatory dose) you will want to observe for any hint of pain that would tell you swelling in the spinal cord is not yet gone. This is more of a challenge for you and your vet because Penny has arthritic pain and you are still giving Tramadol which of course masks pain. May things turn for the better at the Essex Street Hospital!! You are doing a good job with all those needing your help.
Do keep us all updated on what you and your vet decide on the Prednisone and how Penny is doing.
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Post by Jude & Penny Lane on May 15, 2013 13:06:28 GMT -7
My error regarding the Prednisone. When she first came to this site, she was weaning off the 5-day step-schedule of Prednisone and was on 1/2 dosage, or 10 mg. Her dosage went back to 20mg on May 6th when she started on a 7-day step-schedule, which she is on now, so she took 20mg twice a day for 7 days and now is taking [prednisone] 20mg once a day for 7 days. To date, she has maintained her status quo. Today, after a pee run, I let her lie on the kitchen tile floor for a wee bit of time so that I could touch her feet and kind of test her sensations. She had no response on either foot. I then pinched her just above her hock and she didn't respond.
We discussed everything thoroughly with our vet this afternoon and she felt that things were a bit more dire due to Penny's lack of response to the Prednisone. We discussed having an MRI and eventually decided to add acupuncture to Penny's treatment. I will be emailing Penny's info to the acupuncturist when I finish here. She knows that I am interacting with you on this site.
Thoughts?
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StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
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Post by StevieLuv on May 15, 2013 13:53:32 GMT -7
Accupuncture is a great treatment to add - I can't praise it enough! It helps with pain and with healing. Most dogs find the treatments very relaxing. Stevie's accupuncture Vet always finishes her session with a laser treatment too, I really noticed an overall positive response to accupuncture, and the research supports it as a beneficial treatment. Hope that this helps |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 15, 2013 14:21:58 GMT -7
Agreed with Stevieluv as it lines up with studies that show not only does acupuncture help with pain but can excite the nerve cells to regenerate. When nerves have healed enough then, the knuckling nerve damage will reverse.
Likely you will not learn anything from pinching as many general vets also do not have the daily practiced eye of interpreting correctly what they see in a neuro exam. The pinching could cause extra movement of the back that Penny doesn't need right now. The neuro functions that you could observe for and correctly identify are these:
As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order.
1. Pain caused by the tearing disc & inflammation in the spinal cord
2. Wobbly walking, legs cross
3. Nails scuffing floor
4. Paws knuckle
5. Legs do not work (paralysis, dog is down)
6. Bladder control is lost
7. Tail wagging with joy is lost
8. Deep pain sensation, the last neuro function, a critical indicator for successful surgery and only correctly identified by a board certified specialist,
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Post by Jude & Penny Lane on May 15, 2013 17:42:25 GMT -7
Penny has 2, 3 and 4. She has not gone any further down the steps. Perhaps because of the meds, she is showing very brief pain only when she lies down from a sitting position, which is what she has had right along. I don't know if her disc problem is causing that whining or if her hips are simply more painful than the disc problem.
When I pinched her, it was just a light squeeze. I won't do it again.  Thanks for your input, yours and Stevieluv.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 16, 2013 8:06:38 GMT -7
Good news that there have been no more diminishment in neuro function beyond knuckling.
It is difficult to know with two things going on that can cause pain (arthritis and a disc episode). Hopefully your vet and you together can determine if Pred should be continued to be tapered. Let us know his thoughts.
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Post by Jude & Penny Lane on May 16, 2013 17:27:20 GMT -7
Ward took Penny for her laser therapy today and she got weighed. She's lost six pounds in the last few weeks. We switched her food from California Natural Chicken and Rice to Fromm Adult Chicken, chicken meal and brown rice. She's been getting extra food in the form of dog biscuits for various things and cheese to take her 1/2 Tramadol, as the split pill tastes terrible.
Her lost weight would not be questioned but racked up to be the change in food if Roxie had also lost weight. But Roxie has gained pounds and we have to cut back on her food. We gave Penny about 1/2 more than her usual 2/3 cup tonight, so I hope that will help. She pants a lot due to the prednisone, so that uses up calories. We keep a fan about 8' from her to try to keep her cool.
Is it common for prednisone to cause dogs to lose weight? I'm not terribly concerned about her weight loss, just curious. 
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Post by Sherry Layman on May 16, 2013 18:46:28 GMT -7
Humans generally gain weight on Prednisone. However that is generally caused by an increase in appetite stimulated by the Prednisone. Since you totally control Penny's intake it's possible that even though it stimulated her appetite she avoided the weight gain. Additionally, the cravings in humans tend towards carbs. It seems that if the diet is changed to one high in proteins weight loss can actually occur. Dog food leans toward higher proteins than carbs so I guess a dog on a well controlled high quality dog food could theoretically lose some weight on the steroids. Many of us likely over-treat our dogs during this process out of pity...on the dog or ourselves or both...so they are probably doing the over eating with our assistance. I suspect most of us don't have the opportunity to weigh our dogs during this process so we don't notice whether they gain or lose...and for most of us it would amount to more like ounces. ;-)
If she continues to lose I'd say it would warrant further investigation. Hopefully everything returns to normal soon!!!
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Post by Jude & Penny Lane on May 19, 2013 17:49:35 GMT -7
I had a great big scare yesterday morning. Ward was up early, fed the dogs and let them out for their morning "killing the grass" time. Then he was off on a mining trip with our daughter until late in the evening. When I got up, Penny was in her crate lying on her back. When she rolled over onto her side, she didn't move her legs. I did several things to get her to move her back legs and nothing worked. I was a bit panicked, thinking Penny was paralyzed. I had to figure a way to get her out of the house and into our new car, which I still haven't driven (!), and race her to the vet hospital 140 miles away for emergency surgery while figuring out how to drive the car! I called my daughter and was able to learn that Penny walked out to do her potty duty after Ward fed her, so I opened her crate door and she walked out. I then took her outside and she did well except for her usual issues with her legs and paws. Whew! Today was a great day. Penny was walking better and only her left foot was knuckled over whenever she went potty. And her scootch down to poo was steady! She was in a very up mood, too. Yay for Penny! |
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Post by Pauliana on May 19, 2013 20:20:18 GMT -7
Nothing like a scare first thing in the morning, right Jude? So glad that everything turned out to be ok. Sounds like great progress today though. So glad she is walking better and only knuckling on the left foot. She is starting to feel better from the sound of it too.
Keep on healing Penny! Thanks for the update and keep up the wonderful care you are giving her!
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Post by Jude & Penny Lane on May 21, 2013 17:41:03 GMT -7
Would it be harmful for me to lie down beside Penny and cuddle with her and then put her back in her crate? When I take her out for potty time, she goes and then sits and leans against me so that I can put my arms around her and ruffle her hair and kiss her sweet head and face. I think we're equally rather desperate for closeness.
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Post by Sally & Vinnie on May 21, 2013 18:23:03 GMT -7
I think a bit of cuddling is ok. You're doing such a grat job caring for her!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 21, 2013 19:06:17 GMT -7
At potty times is a good time to get in some hugs and kisses when it is necessary to risk being out of the crate. Basically anytime out of the crate is a dangerous time for the early healing disc..because dogs will always do the unexpected especially as they are feeling good again. How about opening her crate door and cuddling as much as you can that way. Maybe you can put a pillow at the crate door for your head and snuggle that way. Right now the focus is all about protecting a healing disc… it is the time for tough love.
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Post by Jude & Penny Lane on May 21, 2013 19:14:52 GMT -7
Cuddling with her with the door open is good advice, and that is what I'll do! How these dogs do muckle onto our hearts...
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Post by Jude & Penny Lane on May 23, 2013 20:15:48 GMT -7
Last night I was doing the dishes and Ward opened Penny's crate to take her out for a potty break. So suddenly that Ward didn't even know what was happening, Penny sprang from her crate and slipped on the kitchen floor - splat - and then ran around in the kitchen. I was heartsick. I always block her from exiting the crate until she is leashed up, and I ended up taking her out last night, with me feeling horrible and praying that she would be okay. We gave her an additional dose of Tramadol (1/2 of 50 mg tab) to get her through the evening. It's been raining off and on for quite a few days, so the floors do get wet with all of us going in and out so much. Ward put down an indoor-outdoor mat in front of the crate so that she won't slip again. Today, her gait was pretty wobbly and she knuckled under with both rear feet when she was outside. Her left leg is worse than her right, as always. I'm not sure just what to do. Thoughts???
She had her laser therapy this afternoon and really loves that. Ward puts a Vari-Kennel in the back of the CRV and with Penny in her "Help 'Em Up" harness, he does a smooth heave-ho and she is safely in the crate. I could never do that, so Penny has to accept that Ward will be doing things with her. We all have medical or other appointments every week, so we do as best as we can with her. This is all so very hard. We've done very difficult things for some of our others in the past, but I was younger and stronger then. Now so much falls on Ward and poor Penny is afraid of him. She is being quite good about all this, however, so we'll get through this. Please forgive me for going on about our difficulties here.
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StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
Posts: 1,335
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Post by StevieLuv on May 23, 2013 21:20:09 GMT -7
Accidents happen so don't beat yourself up. The mat by her kennel door is a great idea. Stevie has done that bolt for freedom when I go to get her out of her crate and nearly gotten away on me, and she only weights 14 1/2 pounds! Keep an eye on Penny and realize that she may have what appears to be a bit of a setback, hopefully just a bump in the road of her healing journey. Don't hesitate to call your Vet if you think that she is having a setback as she may need an extension on her medications - especially those that control swelling. Keepiong you in thought and prayer (((hugs)))
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Post by Jude & Penny Lane on May 25, 2013 22:43:00 GMT -7
Today was a good day with Penny. I got part way into the crate with her and gave her lots of physical contact and love. She snuggled and we set our worlds right again. It was a good good feeling to see her happier. If it ever stops raining here, I think her progress will go faster. We have an appointment next week with the vet who does acupuncture. He will assess the situation to see if this is appropriate for her. I used to complain about how quickly the days and weeks fly by, but with Penny crated, the days and weeks seem so long...
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Post by Sherry Layman on May 26, 2013 4:05:29 GMT -7
I'm so glad you got to snuggle with Penny for a while. I'm sure it was great for both of you!
We'll be anxious to hear what the acupuncture vet says.
Indeed a dog on crate rest can make time grind to a halt!!!
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StevieLuv
Helpful Member
Conservative Treatment 3x. It really does work!
Posts: 1,335
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Post by StevieLuv on May 26, 2013 20:05:04 GMT -7
Jude, check out the website for Toe Grips. My Accupuncture Vet was just at a conference and attended a seminar on rehab for back injured, neck injured and elderly dogs with mobility issues. The presenter is a rehab specialist and swears by the things - using them for all of her elderly or recovering or back injured or dysplastic patients. We are getting Stevie fitted and I found the information on the site fascinating. I thought of you and your Rottweillers when we were talking about the Toe Grips www.toegrips.com |
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Thanks for your input, yours and Stevieluv.
