Deborah's Killian 1/14 Conservative GRAD 3/11

Welcome to Dodgerslist, Deborah.

While we are not vets we do have much to share with you - things we have learned from the neuros and other professionals who Dodgerslist consult with, our own personal experience with IVDD plus observing the many, many thousands of dogs who pass through this Forum and what their vets prescribe. We can help you to interpret what you observe and make sure you relay the important feedback to your vet quickly to get speedier help for your dog. You will see we point you to invaluable background info to read. The reason is that with this particular disease, knowledge IS most definitely the power to fight the IVDD enemy and win. Many vets know IVDD and some are new to it. You can play an instrumental role in working with the vet you have hired when you bring the best command of this disease to the table.

There has been a dangerous switch between NSAIDs without the necessary 4-7 day washout period. Carprofen, aspirin (which should never be given to dogs) and Previcox are all NSAIDs. Did the vet know that you had given Killian Carprofen and aspirin before he prescribed Previcox? If not, please make him aware of that. Please immediately contact him this morning ASAP and strongly advocate for the addition of BOTH Pepcid AC and Sucralfate to protect against the side effects of the NSAIDs. Serious gastrointestinal toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms and the danger of this has been increased due to the switching between 3 NSAIDs without a washout period.

Let us know you are on the same page about crate rest. The hallmark component of conservative treatment is the crate rest part. With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. That 6 weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form. Super tried and true tips for setting up the recovery suite: www.dodgerslist.com/literature/CrateRRP.htm
STRICT means:
- no laps - no couches
- no baths - no sleeping with you
- no chiro therapy - no dragging or meandering at potty times.
Carry to and from the recovery suite to the potty place and then allow a very few limited footsteps. Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog's back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on! www.dodgerslist.com/literature/slingwalk.jpg

IVDD episodes are usually very painful and require pain meds. Usually Tramadol, Methocarbamol and/or Gabapentin are prescribed. Be sure there are none of the following signs of pain and if there are, please contact the vet - shivering, trembling, yelping when picked up or moved, reluctant to move much in crate such as shift positions or slow to move, tight tense tummy, restless, can't find a comfortable position. Ears pinned back, arched back. Holding front or back leg flamingo style not wanting to bear weight, head held high or nose to the ground. Not their normal perky selves.

During conservative treatment, anytime out of the recovery suite is a dangerous time for the healing disc. Movement of the back can increase a disc tear and escape of disc material into the spinal cord . For an animal with mild neuro deficits, the risk of transporting to therapy has to be carefully weighed against what benefit is to be gained. If you do decide to take Killian for this type of treatment, be sure that his crate in the car is padded well with blankets/towels to prevent him for being moved around too much during stopping and turning of the car.

Orthotics such as a back brace should require an Rx from a board certified neurologist (ACVIM) who is well educated in disc disease. An ill fitting product that is not custom made can do more harm and the Rx would be for a specific reason.
Dodgerslist has consulted with several neuro and rehab specialists. The overriding concern is that owners may buy a brace on their own thinking it will be instead of strict crate rest or think it would prevent a future disc problem.
During a disc episode these are the concerns:
- Getting them on without causing any more pain or damage to the spine is on top of the list. Too much movement to get the brace on is not good for a dog that you are trying to limit movement of the back.
- Additional muscle atrophy in the spine is another big concern as muscle strength is very important to maintaining spinal health.
- Unnecessary discomfort, pain and anxiety caused by having to wear this device tight enough to limit movement… adequate limited movement is supplied with owner commitment to safe and effective 100% STRICT crate rest 24/7.
- Braces would require monitoring for pressure (rub) sores. Also, if not properly fitted (not covering from thoracic down to tail) there is the potential to create a fulcrum. It is hard to immobilize the entire back and not end up creating a fulcrum that stresses out adjacent disks.
- A brace would not be a preventative measure. Disc disease is the cause of prematurely aging discs…a disc problem happens at the point the disc has hardened too much. Any activity such as turning to lick a paw or putting on and off a brace could be the last straw for a disc that is no longer flexible.
At this time there isn’t enough research on them for Dodgerslist to support their use with an IVDD dog.

Question everything and read so you become the most important part of your dog's health care team. Good place to start your self education: www.dodgerslist.com/healingindex.htm

Healing prayers for Killian.

Deborah, do phone your vet to verify Killian could take Pepcid AC because he has no health issues. IF there are no health issues you get it at the grocery store. Buy brand name Pepcid AC or Brand X. There should be only one active ingredient: famotidine.   As always, the extra layer of protection for your dog is doing your own reading about every med that goes in your dog's mouth.  I use this vet's med directory for my own dogs:  
www.marvistavet.com/pharmacy-center.pml

Is pain being fully controlled as he is not on any pain med, just the anti-inflammatory, Previcox.  Usually 2-3 pains meds are required to keep pain at bay.  Let us know if you are observing pain:  shivering, trembling, yelping when picked up or moved, reluctant to move much in crate such as shift positions or slow to move, tight tense tummy,  can’t find a comfortable position,   Arched back,  pinned back ears.  Holding leg flamingo style not wanting to bear weight, head held high or nose to the ground. Not their normal perky interested in life selves.  

Did you get the ok for Pepcid AC 5mgs 2x/day? What are your observations of pain today, fully in control still? Did you vet write on the the Previcox bottle the number of days to take it?

The stop day of Previcox is the guess a vet makes that all swelling is gone. So that your job of monitoring for re-surfacing pain is accurate and quick, pain-masking pain meds are also either backed off or stopped.

Let us know which your vet is wanting (backing off or stop of pain meds)  when Previcox is scheduled to stop.

Sometimes it takes several courses of the anti-inflammatory totaling 7-30 days to get rid of all inflammation. Here is the rule of thumb;

The full details on how Previcox, an anti-inflammatory works with a disc episode. Good reading to be able to ask the right questions and discuss Killian's treatment: www.dodgerslist.com/literature/healingsweling.htm

Deborah you and your vet need to work together. What did you and your vet come up with as a guess when all spinal cord swelling might be resolved. Most vets will try a guess of 7 or 14 days, then stop the NSAID and observe for re-surfacing pain.  It has now been 13 days on Previcox, 2 days on Carprofen, 2 days on aspirin for a total of about 17 days of anti-inflammatory use.  No one wants to use any anti-inflammatory any longer past the benefit that all swelling is gone. The only way to know, is to stop the Previcox and observe.

I like what Marjorie wrote you. Here it is again as I know there is alot of info to absorb when you first get an IVDD diagnosis

How is Killian's right hind leg doing today? Any signs of nerves damage reversing, nerve function improving? Less dragging, not knuckling under, able to move it when repositioning him self, use it to push up at potty times?  So it would be your decision to weigh risk to the early healing disc with transport movement vs. the benefit to help kick start nerves to start self repair. 

Some vets will make a house call for acupuncture and maybe laser light. If you are not comfortable in transporting him thinking it could be too much movement, see if there is a mobile vet in your area.

That would be a very good sign of nerve repair beginning if your are seeing something new of trying to use the right leg.

Let us know what you decide on.

Deborah, what good news of observing that left leg moving! Nerve repair is happening.

We will keep our fingers crossed that no pain will surface on the stop of Previcox. That would mean all swelling is gone and all that is left to do is complete the balance of the 8 weeks so that the disc can heal.

Deborah, thank you for the update. Most wonderful news you are seeing more nerve improvement of the foot moving and not knuckling under as much! After he grauates on March 11, you will be able to begin a slow introduction back to physical activity. Including focusing on some PT whether at home or at a PT clinic. Please do update us where he is on graduation day, we have lots of information to share with you about how to handle things after crate rest is over.

He is off all meds now?

Hi Deborah! How is Killian doing? I just wanted to check in and see your plans for graduating from crate rest and remind you that activity should be reintroduced gently - www.dodgerslist.com/literature/AfterCrateRest.htm I'm sure Killian isn't going to want to take it slowly so it'll be up to you! I know Emmie spent the first while trying to bolt around with a back end that wouldn't quite cooperate. I had to put some grippy yoga mats down on the hardwood floor as it was too dangerous to risk another injury. I kept up with the sling for potty for a long time as she just couldn't get purchase outside in the snow/ice. We're all excited for Killian's "release"!

Hi Deborah!

I know how much you have missed cuddling with Killian and how you are looking forward to crate rest graduation.  What we do with our Tyler is cuddle with him on our bed BEFORE we go to sleep. When we are ready to sleep we put him down on his own bed that is right beside our bed. We don't want to take the chance he would jump off the bed while we are sleeping.  Jumps and falls can easily cause another disc episode and we won't take that chance.. As far as couch time, when both Neil and I are sitting on the couch we allow Tyler to sit between us but only when we are with him.. We never leave him alone on the couch to avoid him jumping down and getting hurt.. IVDD is a lifetime disease and while we give him lots of cuddling and loving, we are careful not to let our guard down.. 

Here is how to set up a safe cuddle space on the floor.. This article also has lots of great tips to create a back friendly home:   dodgerslist.com/literature/protectback.htm

It's wonderful you have Killian ramp trained!!  Sounds like you have everything well in hand!  

It won't be long now!     Here's some after crate rest info on how to gradually ease back into activity!

dodgerslist.com/literature/AfterCrateRest.htm

Killian seems to be doing very well. When my Frankie was recovering he would lose his balance when he tried to squat to poop also. By this time he was walking fairly well and wanted nothing to do with the sling. I used to bend down and support his hips, otherwise there was a risk that he would actually tip over.

Thank you, its not easy going slow some days. He's all excited to be able to be going about the yard. The last couple of days he's taken to going to the gate and looking hopefully at me. After all, he's got his harness on and his leash on. That means going on a walk, right?
He's also been able to go in and out of his kennel on his own. Though he's starting to balk a little bit about going back in. All in all, he's coming along pretty well.

What a wonderful day. Killian scratched at his ear with his hind leg and boy did he look in heaven. He is so happy being able to lay down with our other dog Widget. They've missed being able to be together. The last couple of nights he's been pretty good about going back into his kennel for bed since he's been able to spend more time outside of his kennel. Everyone, including our neighbor, has noticed that he has become more ambulatory. He does waddle still as his right is still a little wonky, and with the weight he's put on with the enforced rest it's quite noticeable.

Carrots, not so much and apples it varies. Though he does like a bit of cucumber here and there. Also been reading up on canine nutrition to make sure he's getting what he needs without getting too much. My family was also asking about suppliments. To my knowledge, if I remember right, the intervertebral discs themselves are avascular which would limit the benefits of most joint suppliments. But I said I would ask anyways. I am curious if anyone has had any success with suppliments or additions of certain foods to the diet.

We've had success with aromatherapy for keeping stress and anxiety down which as been great this week with time out of the kennel. Gives the body a chance to heal itself. But man, the number of people I've run into who have told me to use raindrop therapy or put the EOs in his water. *shudder*. And then there have been the suggestions is certain EO's that are great for people but harmful to dogs and potentially fatal to cats, which we have one of. They have no idea on how dangerous it is for the health of their dog, and this has included a few vets. That's scary. I've been pondering trying to find a decent holistic vet, but I don't want to run into a different set of risks with suppliments.