jiorio
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Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38 
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Post by jiorio on May 13, 2013 2:59:01 GMT -7
Lily seems to yelp when she moves from her right side to left side (the more painful side) and she likes to sleep on her left side. Woke up around 10:00pm and yelped. Gave her the supplements from the acupuncture vet which the vets said were okay to keep giving her. Rested comfortably until about 5:30am. Just gave her the steroids, pain med, and muscle relaxer. Ordered the 100mg gabapentin through 1800PetMeds at 11:00pm and paid the extra to have it Fedexed. Am calling the vet today and found an acupuncture vet I am going to call and see about getting her into.
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jiorio
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Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 13, 2013 4:21:12 GMT -7
Lily took a significant turn for the worse! Gave her pain med, muslce relaxer and steroid at 5:30am. Followed by stomach protector 1 hour later. She is panting and won't come out of the crate! She is also whimpering. She growled when we tried to take her own. Surpriingly, she did eat and drink well this morning.
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Post by Sherry Layman on May 13, 2013 6:47:00 GMT -7
The steroids can cause panting, though seems strange you are just now seeing it. She is definitely in pain so you need to get a hold of your vet for a conversation to see if she just needs time for the new meds to take hold or if adjustments need to be made.
Acupuncture will be a great help. See if they can get you in right away. Take her in her crate and pad it well so she can't be jarred or joggled as you stop and go.
As for repositioning her in her crate from right to left side I'd let her choose what the position of comfort is. Dogs that don't have the ability to move themselves need to be moved so they don't get skin sores as they can't tell when they need to move but dogs that are able to move should be left to position themselves as long as they have a good pad under them to prevent too much pressure from the firm surface of the crate.
Let us know what the vet and acupuncturist have to say.
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 13, 2013 6:54:44 GMT -7
Just got back from the vet. They didn't even try to take her out of the crate. She seems to be resting now and I don't want to disturb her. The vet gave her some liniment that they use alot there and some syringes of BuPrerex that were donated. Still looking for someplace that has the gabapentin tablets. I accidently ordered the capsules from 1800PetMeds and the neuro vet called me about it. Luckily I was able to cancel the order in time. Next call is to acupuncture vet.
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Post by Sherry Layman on May 13, 2013 7:21:19 GMT -7
I'm glad she's resting and glad you were able to cancel that order in time! Though if worse came to worse find out about the capsules...sorry I don't have time to do a little research...if they aren't timed release of other reasons you cannot open them and take the powder inside then perhaps you could sprinkle it on food and use the capsules if you cannot find the tabs. Just a suggestion if it's all you can get.
I've had acupuncture myself and on two of my dogs. It's amazing!!! Hope you can get her in quickly!
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Post by natureluva on May 13, 2013 7:26:46 GMT -7
I got my gabapentin from a compounding pharmacy. The 100 mg capsules were too high of a dose for my 14-pound doxie, so my vet wrote out a script for the correct amount (can't remember exactly what it was, maybe 33 mg or 50 mg) and I had it compounded into liquid form. It was expensive.
As Sherry said, I have heard of owners dividing the contents of a capsule in half and mixing it into food, but you must ask your vet if it is ok to do this.
Best wishes, ~Lisa
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 13, 2013 9:02:36 GMT -7
I am waiting for a call back from the neuro vet on the gabenpentin. I have called 3 Walgreen's, 2 CVS, 1800PetMeds, a Target, and a Banfield Animal Clinic to see if any of them have that does. None of them do! Also waiting to hear back from 2 acupuncture vets to see if she can get seen today. While waiting, Lily drank drank about 1/2 cup of the special concoction she likes of Activia Vanilla yogurt, low salt chicken broth and water. When my daughter got home from class we took her out of the crate for the first time since yesterday afternoon. She took about 5 steps and peed but she yelped (I think now she yelps in anticipation of the pain). While she was out for all of 2 minutes, I put the TemperPedic pillow back in the crate to give her more support. I also put some of the liniment on her back and she yelped when it touched her back. (I think it was too cold) The fact that she can still walk, is continent and is still eating/drinking makes me have faith that she can recover if we can just get the pain under control. However, it is so heartbreaking to hear her yelp every time she moves out of the crate. My husband came to the vet with me this morning and he asked the vet tech point blank when to consider putting her down. She agreed with me that since she is still alert and eating and drinking that now is not the time. While I was typing this, the neuro vet called back. I told him the problems I am having finding the 100mg tablets. He said to give her the 100mg capsule for right now, not to open it. At this point, her sleeping and being able to relax is probably the thing she needs most. This has been so hard and frustrating for everyone in the family, especially Lily! We are trying to be strong for her and each other.
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StevieLuv
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Conservative Treatment 3x. It really does work!
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Post by StevieLuv on May 13, 2013 9:44:43 GMT -7
What is the dose that she should have?? Is compounding yourself an option?? (I do it for medicating birds) Check with your vet, but as an example: If the dose is supposed to be 25mg every 12 hours ( this is an example not a real dose!) and you have a 100 mg capsule, you can dump the contents of the capsule into 4ml of corn syrup and mix well. Then to give a 25mg dose you just have to give 1ml of your syrup mix. You can use pancake syrup too - or mix the syrup with water 1/2 and 1/2 if you are worried about too much sugar in her diet. Something sweet usually works better because most drugs that are in capsule form can be VERY bitter  Get some syringes from your Vet to measure and to put it into her mouth. Let me know if I can do anything to help you measure it out or for anything else. Keeping you both in thought and prayer. |
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Post by Linda Stowe on May 13, 2013 10:59:22 GMT -7
Hi Jill, want to make sure I'm reading this right. The neuro said to give her a 100 mg capsule all at once. I take Gabpentin and take 4 100 mg capsules a day but at different times during the day. I'm a little concerned of this high a dosage all at once. I know what it did to me the first time I took 100 mg. It took care of my pain alright but I was also a little giddy and very happy. At one time, I took 2 pretty close together and it made me very dizzy and uncoordinated. So really wondering what it would do to a small dog.
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jiorio
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Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 13, 2013 11:23:44 GMT -7
The prescription he wrote was for 100mg tablet of gabapentin but to cut it in half and give her half a pill twice/day for a total of 100mg/day. When I told him of the problems I was having finding the 100mg tablets (the standard is 100mg capsules), he said to give her the whole 100mg capsule since she seems to be in so much pain. I specifically asked him about opening the capsule and dividing it. He said he wouldn't recommend that as it is harder to get the dose right. Oddly enough, after we got her in the crate after we changed the bedding, I put a few drops of the analgesic lotion on her left back area (it is camphor and menthol). She is the most quiet but alert she has been in about 24 hours. Still eating and drinking well. My daughter doesn't want to give her that high a dose of the gabapentin as she is afraid of it effecting her kidneys or liver. I am so confused and tired right now that I can barely think straight! I am open to any and all suggestions! Still haven't heard about the acupuncture. Called a mobile one that the regular vet(as well as a coworker and my boss) recommended. She didn't think she could come out today. I called a number she gave me and they haven't called back. How I wish our regular acupuncture vet was back!
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jiorio
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Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 13, 2013 11:29:35 GMT -7
I actually like that idea of mixing the capsule with liquid and giving it to her that way. My husband is a nurse and he is going to check with the pharmacist where he works to find out if they even make the 100mg tablets. If not. I still want to get the capsules so we have them on hand.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on May 13, 2013 11:30:51 GMT -7
Jill, it is no problem to divide the powder in a capsule to get the dose the vet has prescribed if the tablets are not available or available fast enough from mail order. Keep things simple when dosing. Just make a ball of mashed sweet potatoe or ball of mashed banana. Make a well with your finger and put powder in...then close up. If you feel you need to wrap with a thin piece of deli meat to entire Lily to eat, then do so. Most all local pharmacies carry a 100mg capsule (the smallest size it comes in)... just call around your local pharmacies for the best price and have your vet call in the Rx. My 13 pound doxie was prescribed 25mg of gabapentin powder. All I needed to do was divide the 100mg capsule powder into four equal parts by dumping into a creased pieced of paper and with a razor blade move the powder into four equal piles. Also just as easy to get 33mg by dividing one 100mg capsule powder into three parts. The remainder of the powder piles I stored in one of those 7 day pill boxes with a lid for each day. I would have the same concern as Linda on giving a 100mg dose 1x a day because this med has a short half life AND the effects are not dose proportional. After reading the information below, I would discuss with your vet about giving this Gabapentin several times a day rather than in one big dose of 100mg. Gabapentin bioavailability is not dose proportional; i.e., as dose is increased, bioavailability decreases. Bioavailability of Gabapentin is approximately 60%, 47%, 34%, 33%, and 27% following 900, 1200, 2400, 3600, and 4800 mg/day given in 3 divided doses, respectively. www.drugs.com/pro/gabapentin.htmlOral Bioavailability in dogs In dogs, oral gabapentin is well-absorbed in the duodenum, with peak levels occurring approximately one to two hours after administration. It is partially metabolized by the liver and excreted by the kidneys. Gabapentin has a short half-life of between two to four hours.www.wedgewoodpetrx.com/learning-center/professional-monographs/gabapentin-for-veterinary-use.htmlI would be important to stay with her prescribed meds and not delete the Robaxin, as it addresses pain from muscles. Once pain is fully under control, then you can see about tapering back. But right now be punctual in giving the meds. You have a lot of meds, a chart may be helpful so all family members know what med is up next and that none have been missed. www.dodgerslist.com/literature/crateRRP/medchart.pdfWhen you have a chance can you update us on all of Lily's meds (dose in mg and the frequency)? |
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 13, 2013 11:52:05 GMT -7
Thank you all! The neuro vet wants me to give her 100mg 2x/day just to try to get the pain under control. Therefore, that would mean a 12lb dog is getting a total of 200mg/day. I did call another acupuncture vet and the soonest they can see her for a new patient appointment is May 21 at 9:00am. I can't wait that long for her to see someone. I described her situation and told them to put me a cancellation list. I also told them who she sees but that he is out until at least June 1. I just want someone to see her to hold her over until he gets back!
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on May 13, 2013 11:58:36 GMT -7
Jill, did you read about the SHORT half life of Gabapentin? Did you read that Gabapentin is NOT dose proportional? Discuss with the vet about giving more often than every 12 hours with smaller doses to help control pain.
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Post by Pauliana on May 13, 2013 12:50:14 GMT -7
Just chiming in here in addition to what Linda and Paula have said. Gabapentin is very powerful..I have taken 100mgs to start with and I weigh a lot more than your little dog and it knocked me for a loop. It is better to divide that dose into smaller increments for your Lily at 3 times a day. Tyler had liquid Gabapentin 100mg/ML suspension and we were instructed to give him .55 ML (on the liquid syringe) 3 times a day. He weighs 12 lbs. His pain was under control without being overdosed.
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jiorio
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Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 13, 2013 15:36:21 GMT -7
Ok, here is the latest on Lily and her meds/symptoms. We got the gabapentin filled but haven't given it her yet. What our pharmacist told us the vet told him was 100/mg once/day. I gave her the BuPrerex at 4:0opm, the muscle relaxer at 5:00pm and I just gave her the stomach protector at 6:15. Right how she is panting very heavily but does not appear to be in pain. She is sitting up, drinking and eating but just panting! I heard this could be from the Prednisone. We were going to start to taper the dose of the prednisone tomorrow anyway with the support from the MD but my husband, who is a nurse, told her just to skip tonight's dose. We will give her the gabapentin in 2 hours and see how she reacts. If it is too much, I will divide it and give her 2 half doses. Whereas I was worried about the pain, my husband is more worried about the heavy panting. Any thoughts? Also, the acupuncture is coming over tomorrow night to see her. I would love to be able to get her off all these meds but I know she needs them!
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Post by Sherry Layman on May 13, 2013 20:50:56 GMT -7
Don't skip tonights Prednisone just because of the panting. The Prednisone is vital for decreasing the swelling, the panting is a small price to pay in exchange. With all the issues Lily has had I think you want those precious steroids. Sometimes a fan on low blowing nearby but not necessarily directly on her will help, you can certainly put it righ on her if she tolerates it.
I think you are right in that they can begin to yelp in anticipation of pain so it's hard to determine if they really have pain or not. This does indeed sound like anticipation.
I'm sorry you're having such a hard time finding an acupuncture vet. I'd get that gabapentin started. As Paula so expertly explained it's very easy to divide that powder and make several doses out of one capsule. If you opt to go with the one bigger dose just be aware that dizziness is a side effect so when you take her outside keep an extra close eye on her, if she's dizzy she could be wobbly and hurt herself. Also somnolence, drowsiness and lethargy are effects of overdose so if she shows these symptoms you'll know it's from the gabapentin. I'll just chime in here...and I'm a nurse too...I'd give it twice daily. My thoughts on the bigger dose are that given the bioavailability issues she isn't going to benefit from the 100mg all in one dose but it isn't likely to overdose her either. If you'd split it into two 50mg doses...well, I stink at math but it will be a huge percent. Run it by your husband but that's my thoughts.
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 14, 2013 2:42:48 GMT -7
Lily had a good night! She stopped panting around 9. Oddly, it coincided with me putting a little more of the analgesic lotion and a cool washcloth on her back. She just took a deep breath and laid her head down. We gave her the first dose of gabapentin at 9:15 after she went out and pooped and she slept all night. She got up around 5. She was whining and shaking but it in anticipation, not pain. Our coffee maker starts brewing just before 5 and when she smells it she knows it is time for her breakfast. She was able to be picked up and taken out without whining or yelping. She did her business without difficulty. She scarfed down the food and drink I gave her with the prednisone and muscle relaxer. She is resting comfortably now. I will give her the stomach protector in about an hour. I will also take everyone's suggestion and divide the gabapentin and give her 1/2 dose in the morning and 1/2 at night. I will call both the regular vet and neuro vet this morning and give them an update. I am cautiously optimistic but I know we still have a long way to go. I am just relieved she can be touched without pain. Also looking forward to a visit from the acupuncture vet this afternoon.
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Post by Sherry Layman on May 14, 2013 6:58:55 GMT -7
I don't know why but sometimes it just takes time to get it under control. One of mine had a cervical disc problem which is different than lower in the back since they are just moving that neck all the time. But it took about a week before he was finally comfortable. It was a long rough week.
Hang in there!!!
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Post by Linda Stowe on May 14, 2013 10:15:02 GMT -7
Jill, one of our moderators just mentioned that she got Gabapentin from her vet in chewable tablets. www.wedgewoodpetrx.com/items/gabapentin-chew-treat.html These are available in many strengths. Like I said she did get these from her vet, so some vets may be carrying them. Have you vet call other vets in the area to see if they have them available. If your vet won't call, then I would call myself. There may be some vets who are treating epilepsy with Gabapentin and have them in stock. Looks like there is also injectable. Maybe this is something we should all be asking our vets to stock. |
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PaulaM
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Post by PaulaM on May 14, 2013 10:56:59 GMT -7
Good news on finally getting the pain under control! From this point forward you want to make sure the pain stays under control completely dose to dose of the pain meds (gabapentin, Robaxin and tramadol) So watch for any signs of pain surfacing nearing the next dose of the pain meds... your vet would need prompt feedback to see about prescribing them more often. The current pain just now being brought under control with the right combo of pain meds, shows it is not the time to taper off of prednisone. Best explanation on pain control is here: www.dodgerslist.com/literature/healingpain.htmIs Lily now on either of these stomach protectors.... Pepcid AC or sucralfate rather than Misoprostal? Can you bring us up to date on her current meds: Panting can be a temporary side effect of Prednisone. I would avoid putting ANY ointment on her back. Instead you can place a fan near her crate but not pointed at her. The lightly circulating fan can help with the panting. |
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Post by Nancy & Polly on May 14, 2013 12:51:24 GMT -7
I too am skeptical of the ointment. I personally have suffered years of terrible back troubles, before and after having a laminectomy. My doctors have tole me numerous times that "there is nothing you can rub on the outside, that's going to fix anything on the inside.". At best it might provide a tingling or warming sensation, but nothing therapeutic.
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 14, 2013 16:22:55 GMT -7
Update on Lily...she had a good day. My daughter said she did not show any signs of pain today. The last meds she got were this morning when she got the Prednisone, Robaxin, and a small amount of BuPrenex. She went out and urinated without pain this afternoon at 3:00pm. At 5:00p, she ate a good dinner and my husband gave her the stomach protector. I am getting ready to give her a dose of gabapentin and pain medication in a little while. The current meds she is on are:
1. BuPrenex (buprenorphine) 0.6mg/ml, 0.07 to 0.15ml q 8 hours as needed for severe pain. Last night we gave her the full .15ml but this morning she got the lower amount.
2. ▼Prednisone tapering to 5mg q day from 2x/day. Last had a dose at 5:15am today.
3. Gabapentin 50mg 2x/day
4. Misoprostal 100mcg 1/4 tab 2x/day
5. Robaxin 500mg 1/4-`/2 tab 3x/day
6. Torbutrol 5mg 1/2 tab 2x/day
She does not take both pain medications at the same time! We were giving her the stronger one until the pain was under better control. She has a 0.07ml dose left from this morning so I will give that to her tonight with the gabapentin. I had been giving her the 1/2 tab of Robaxin 3x/day for the past few days but she has only had one dose today. If she needs it tonight I will give her the 1/4 tab. She has had no stomach issues and the Misoprostal seems to be effective. Her appetite is good! I have also been trying to give her meds with a little bit of shredded cheese or vanilla yogurt. As far as the acupuncture, when I called this morning to give the regular vet an update, the tech said that the vet that does acupuncture will be in for a few hours tomorrow. I can drop her off in the morning and they will call my daughter when she is done. They will make sure she gets a treatment from him. Yeah! I cancelled the mobile acupuncture vet since Lily has been seeing this other vet since her first episode 5 years ago.
Will keep you all updated! Thanks for supporting me through this yet again when I had people telling me they would have put her down by now. Like the neuro vet old us, he doesn't see many dachshunds that give up so we won't give up on her!
Jill and Lily
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PaulaM
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Post by PaulaM on May 14, 2013 18:26:33 GMT -7
Jill, the good news is that even though all the swelling is not yet gone, there were enough pain meds on board to mask pain today. I'm confused as to why since there is still obvious swelling going on in the spinal cord evidenced by pain yesterday, the medication, prednisone, that addresses getting all the inflammation/swelling down is being tapered down to less than the anti-inflammatory dose? What is your understanding of this from your vet? A good review of the process of healing from pain is explained quite well here: www.dodgerslist.com/literature/healingpain.htmThere are times when it is necessary to not allow a good 1-2 weeks or even for some dogs more like a month on the anti-inflammatory, prednisone. One reason to go off of Pred is some dogs just can't tolerate prednisone even when their stomachs are well protected by both Pepcid AC and sucralfate or maybe due to other health issues. There are other cases where a vet is just not comfortable in treating a disc episode and they are reluctant to use the meds needed to get the job done. One course of predninsone for 7 days at the anti-inflammatory dose (5mg 2x a day) often is not enough to get the swelling down as it seems to be with Lily. The only way to know for sure is to taper and see if there is pain. In Lily's case you know from yesterday's pain, the swelling is not yet gone, so why continue the taper? Typically pain meds would be backed off or stopped at the same time as a taper to give a clear picture on swelling resolution. If any hint of pain would surface then another course of Pred back at the anti-inflammatory dose would be called for. Pain = Swelling = More time on prednisone neededPain with a disc episode should NOT be given on an as needed basis. This vet explains why: So please do not do Lily a disservice by being inconsistent with pain meds... give them promptly and on schedule... not as needed nor skipping doses. The hope is Torbutrol, Robaxin and Gabapentin can work together to keep pain at bay. Do know that Torbutrol (BUTORPHANOL) duration of effect is 30-60 mins in dogs. www.vasg.org/b_drugs.htm And good that you have the approx 8 hour effectiveness of BuPrenex on hand. Did your vet get feedback about yelping yesterday? Please let us know you are advocating on behalf of Lily for continued prednisone at the original dose.... pain meds will do nothing to address the inflammation that is the root of the pain. Let us know how the acupuncture session goes tomorrow. |
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 15, 2013 4:38:58 GMT -7
Good morning. Lily had a good night. Gave her the Gabapentin and Tobutrol at 7:15pm. She was quiet until 5:00am when she barked to eat. She ate well and I gave her the Prednisone, Tobutrol and Robaxin. an hour later I gave her the stomach protector. She drank well too. She started panting heavily for about 10 min after the Prednisone but quieted down. She was hard to get out of the crate this morning but she got out and pooped. Part of the reason we have been inconsistent with the meds is because my husband is a nurse and he tries to direct things. He thinks we should not give her meds if she is not showing signs of pain. Also, her heavy panting(for 2 hours on Monday night!) from the Prednisone really scared him and the vet wanted to start tapering the dose after a week of being on them. I will check with them today. I work at a hospice and I know it is much easier to keep the pain under control as opposed to getting it under control. I need to stop second guessing myself and go with what I know she needs, which are pain meds consistently. I am leaving now to take her for the acupuncture. I will let you know how it goes.
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Post by Pauliana on May 15, 2013 7:48:54 GMT -7
Hi Jill!
Good for you in realizing she needs her medications on schedule so she can heal in comfort. It is indeed easier to keep pain under control if it's not allowed to get out of control. Let us know what the Vet says about the Prednisone and the panting and also about her Acupuncture treatment.
Heal in comfort Lily!
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jiorio
New Member
Treatment: Conservative. Status: Continent and walking; Number of IVDD episodes: 4
Posts: 38
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Post by jiorio on May 15, 2013 7:49:18 GMT -7
Quick upate...talked to the vet who has been seeing her for the past week. let her know aobut my husband's concerns about the heavy panting on the Prednisone. We both agreed the panting is preferable to the inflammmation. Her Prednisone will be 2.5mg 2x/day instead of giving her 5mg daily. It is still down from the 5mg/2x/day that she had been on for a week. The vet only wanted to keep her on the 5mg 2x/day for 1 week anyway and it has already been almost a week. She agreed that Lily needs to get the pain meds and robaxin on a regular basis and not as needed. The gagapentin does seem to be helping. She tolerated a 1/2 hour car ride in rush hour traffic in her carrier for the first time since this latest episode. Her crate was getting kind of cumbersome to carry all over the place. She yelped when I was carrying her in but I think she was scared and I wasn't supporting the bottom enough. She is still able to turn and reposition herself in the crate. Waiting for them to let us know she has had her acupucnture and how that went. I am very comfortable with the way the vet is managing her. They know dachshunds much better than our previous vet. There was another dachsshund in the waiting room as I was leaving. Also, when the neuro vet reviewed the meds she was on he couldn't find fault with how they were being managed. The vets at North Florida Neurology know dachsshunds well and the founding member of the practice has 2 dachshunds. He is also friends with the acupuncture vet. I feel Lily is in good hands with her care. Will keep you posted.
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PaulaM
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Post by PaulaM on May 15, 2013 10:32:12 GMT -7
If you are seeing continued evidence of pain (yelping) then please advocate for getting Lily back on the anti-inflammatory level of Pred. She should not be yelping at all. She yelped yesterday and now again today. Prednisone is the med that works on reducing and getting rid of inflammation.... none of the pain meds can do that. Prolonging inflammation by not using the needed med is not a good thing for the delicate spinal cord and of course not a nice for Lily to endure. You are there to observe Lily and you will be the one who she depends on to speak up for her needs.
The reason for the taper schedule off of Pred down to the lower non-anti-inflammatory dose is to signal Lily's body to make her own steroid hormone. The body's hormone production is not at the anti-inflammatory level needed to reduce the swelling in the spinal cord.
If all the swelling were gone, on this taper then there would be no reason to continue to give pain meds... which you are still giving. The clearest way to know if swelling is gone on a taper is to stop the pain meds.
Rule of thumb:
pain = swelling = more time on the anti-inflammatory level of Pred.
If panting persist, then place a fan near her recovery suite, but not pointed at Lily. The slight air circulation should help with the panting.
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Get some syringes from your Vet to measure and to put it into her mouth. Let me know if I can do anything to help you measure it out or for anything else. Keeping you both in thought and prayer.
