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Post by momfortimmie on Jul 3, 2013 9:29:42 GMT -7
Timmie is a male Yorkie between the ages of 5-6. I have had Timmie for approx 3 years. Before me he was always kept in a tiny cage let out for potty time. His right back leg was broken when he was young and was never set correctly. Despite his previous life he is the most loving dog. Five weeks ago I started to notice that he was falling more frequently but at that time the vet and i were more concerned about surgery on his teeth so he was not diagnosed. He basically said hethe has arthritis andthat need toto lose weight. He prescribed Metacam. After two more weeks I went back to the vet, 6/24/13 and told him this was not working. Finally after a couple of neurological tests he concluded spine/nuerological. He then prescribed prednisone at 1the 2.5mg twice daily for three days, then 2.5 mg dail for three days then 2.5mg every other day for three more days. Tramadol 0.25 tab of 50 mg three times daily for pain. After reducing predinsone to once daily we had to ▲increase pred to twice daily again and holding. This has been so hard. He did not prescribe crate rest just not to let him get to rambunctious. I want to cry.
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 3, 2013 9:40:43 GMT -7
Welcome to Dodgerslist. My name is Paula what is yours? 100% STRICT crate rest 24/7 only out at potty times for 8 weeks is what allows the disc to heal. Movement is what tears the weak and early healing scar tissue on the disc. 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. So true conservative treatment with the single most important part of the care…crate rest…. starts today. The crate is the only surface that is firm, supportive for the spine, not inclining, always horizontal and keeps a dog from darting off at a TV doorbell and safe from other pets and kids from bothering them. The rest of the details of doing crate rest to ensure the best recovery in this excellent document: www.dodgerslist.com/literature/CrateRRP.htm Was there a washout from Metacam to the start of pred of 4-7 days? -- How much does Timmie weigh? -- Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy? -- What are the exact names of meds currently given, their doses in mgs and frequencies? Pepcid AC to protect the stomach should also be on board. We follow proactive vets and give our approx 13-20 lbs doxies 5mg 30 mins prior to Pred. Phrase the question to your vet in this particular way: "Is there any medical reason my dog may not take Pepcid AC?"
-- Currently can your dog wobbly walk? move the legs at all? or wag the tail when you do some happy talk? -- Eating and drinking OK? -- Poops OK - normal color and firmness, no dark or bright red blood? In the early days of learning our dogs have IVDD, everyone needs a shoulder to lean on while getting things figured out, dealing with emotions, getting up to speed on meds, what disc disease is, etc. Your job in the coming days is to become a reader so you become the confident leader of the health care team.... to discuss confidently various issues from medications to recognizing if suggestions of activity would be harmful to the healing disc. All that takes being a reader. Start on our main website with "Overview: the essentials" yellow button it will give you the degree of understanding you need right away…. as time permits continue to read all the orange buttons and the blue button "Disc Disease 101 core readings" to complete your education. Here is the link www.dodgerslist.com/healingindex.htm |
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Post by momfortimmie on Jul 3, 2013 10:30:34 GMT -7
My name is Rhonda. The washout period was 24 hrs between metacam and prednisone. Prednisone was prescribed as 2.5 mg twice a day for 3 days, then 2.5 mg once daily for 3 days, then 2.5 mg every other day for 3 days. Tramadol prescribed 0.25 tab of 50mg 3 times daily. His pain signs were shivering and holding himself stiff. He can walk with wobbly legs which come and go. His appetite is usually normal but he is drinking more water. He is pooping daily except yesterday. He was constipated for 24something hrs then pooped at 2am this morning. Normal color.
He is also 7.6 lbs.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 3, 2013 13:01:02 GMT -7
Rhonda, so are you saying Timmie is still currently showing these signs of pain: shivering and stiff? If so his pain meds are not yet right. Your vet has so many more options to get pain fully in control dose to dose of the pain med Tramadol. He can add in what most vets prescribe right off the bat with Tramadol….methocarbamol. So let us know if he is still showing any signs of pain especially nearing the next dose or after moving. It is expected with prednisone to be more thirsty and have to drink water. Do make sure he has access to water inside his crate. You might want to attach his bowls.  Now by following good crate rest principals, Timmie is a very good candidate to recover under conservative treatment!! Please read up on the two classes of anti-inflammatories and the need to protect the stomach by 4-7 days of washout when switching and to be on a stomach protector with their use. Timmy does not need another problem of GI upset to the more threatening bleeding ulcers or holes in the stomach or intestine. Please get Pepcid AC on board today. Another page on Pepcid AC: www.petplace.com/drug-library/famotidine-pepcid/page1.aspx |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 4, 2013 12:05:12 GMT -7
Posted on behalf of Timmy's mom, July 4, 1pm
Timmy was doing so well, no signs of pain. I tapered his steroids back as recommended by vet yesterday. He was doing well. I came home today from work around 12:30 and gave him his prednisone and tramadol. 1:30 i was feeding him and he started shaking very badly and not moving very well. He continued to eat but now after eating he wants me right with him. I can't afford er vet, what do i do? His med dose were 2.5 mg prednisone and 0.25 part of 50 mg tramadol. I have to go to my second job in approx 30 minutes.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 4, 2013 12:09:10 GMT -7
Rhonda, can you call your vet on the phone…. see if you can get another round of Prednisone prescribed at the original dose. There should not be a charge for calling your vet on the phone. Do you have any meds at all left over still you can use? It would be best if you posted on the forum, because I'm not at my computer all the time and some days not at all. I would be horrrified to find you did not get a timely answer. Also posting on the Forum keeps all moderators in the loop on Timmy's important history. $4 per prescription/30 tabs program are at Walmart, Target, Kroger's for the IVDD med and dose listed below. Call your local store genericmedlist.com/ to verify before asking your vet to write an Rx for you to bring into the pharmacy. pepcid AC (Famotadine) 20mg [to protect against GI upset] *prednisone 2.5 mg and 5 mg [steroid anti-inflammatory] tramadol 50mg [general pain reliever] www.dodgerslist.com/literature/IVDDcourse/medications_used.html |
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Post by momfortimmie on Jul 4, 2013 12:57:27 GMT -7
Sorry i don't know how to post to the forum. I am new to this. I had extra prednisone and tramadol. I called er vet and his advice was to give another dose of both immediately and tonight. I will continue with ▲original prescribed prednisone and see if he can add pain med tomorrow. I felt so helpless, if you will give me a tutorial on being on forum would be glad to as i need support as well as he does. My brother is babysitting right now as i have to work. I sound very scattered and i apologize for it. Are these episodes normal or should i expect the worst?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 4, 2013 13:28:10 GMT -7
Rhonda, you did great and posted to the forum. I'm so glad you had some extra prednisone tramadol until you can call your local vet for another round of pred and tramadol. It is pretty typical that only one round of pred may not do the job of getting all the swelling down in the spinal cord. That 3 day course of Pred at 2x a day was a VERY short round. Alot of times a round can be for 5-7 days before the reduction (taper) starts. Often it takes being at the anti-inflamamtory dose of prednisone 2x/day for 1-2 weeks or even for some dogs more like a month before all the swelling is gone. On the taper the dose is lowered to less than the anti-flammatory dose and that is the time to assess just how well reduction of swelling is going by observing for pain. Rule of thumb is: pain = swelling = more time on Pred needed. If there is no pain on the taper then it goes to completion. Then no meds at all are needed any longer. To have a clear picture on a taper, pain meds are also stopped or back off too. I would recommend to bookmark Timmie's thread. That way when anyone responds you will get an email alert and link to read what was posted on the forum  |
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Post by momfortimmie on Jul 5, 2013 4:38:06 GMT -7
An update on Timmy, we had a long night last night. I was home from work at 8:30pm and gave him his next dose of Prednisone and Tramadol which did help with his pain. He was no longer shaking and was able to extend his legs. I took him to use the potty and he did very well. We then went to bed, with his crate next to the bed but whenever I would turn the light off to sleep Timmy would start barking. If the light was on and he could see me he was fine. Finally, about 2am I put a flex seed pillow that had been in the freezer along his spine while he laid down, then I heated it just to luke warm and laid it along his spine he was able to relax and we both slept till 4am and then we were up for work. Another dose of meds, potty time and breakfast. Appetite is good. I will be home around 12:30 and hopefully he continues to improve. I will call his vet today and speak to him concerning breakthrough pain and keeping original dose of prednisone for a while longer. Thanks to this website, I did not lose my mind and I still feel hope even with this set back. Paula, a special thanks to you. I will give further updates and any advice on how to handle this and Timmy is greatly appreciated.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 5, 2013 9:25:46 GMT -7
Rhonda, good news that going back on Pred and Tramadol is controlling the pain. It is prudent for a vet to try one course of pred and test the waters to see if the swelling is gone. All the big gun meds can carry with them adverse side effects…so the idea is to only use them to the point they have served their purpose and then get off of them. Hopefully the next course of pred will have completed the mission of getting rid of all the painful inflammation.
Who does not want to snuggle up to a warm body! What good thinking on your part to warm up the flax seed pillow for Timmie to snuggle against.
We await hearing how your vet extends tramadol and pred..and you know by now we LOVE the details of mg, frequency, etc. LOL
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Post by momfortimmie on Jul 5, 2013 9:37:16 GMT -7
Poor guy has been through the wringer just like they all have. Everytime i leave the house i become nervous as to what i will find when i get home. I do have hope due to this site. I just pray that Timmy will be better than thiz morning and continue to. I do have a question, what is the proper way to hold him when i take him outside?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 5, 2013 10:32:06 GMT -7
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Post by momfortimmie on Jul 6, 2013 4:02:00 GMT -7
I did speak to Timmy's vet about pain control and prednisone. What he wants to do is up the ▲prednisone to 5 mg twice daily for 3-4 days then try to wean him down again. He also did not want to give him anymore pain meds before he sees what happens with the higher dose of prednisone. Timmy does seem to be comfortable but with him, he does not always show pain. He is bright eyed this morning. I do tend to worry about his belly, it sometimes gets so swollen but is it pain or the fact that he does drink a lot of water and he does gulp it causing him to belch.
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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 Jul 6, 2013 10:20:58 GMT -7
Pain medication is to provide physical ease and comfort while the swelling goes down - if he does start to show signs of pain INSIST that your Vet provides pain relief or look for another Vet that will. No level of pain is acceptable - it is an antiquated barbaric practice, and you are Timmy's best advocate and in charge of his health care team. You are doing a great job with Timmy, under tough circumstances. Keeping you in thought and prayer.  |
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Post by momfortimmie on Jul 6, 2013 15:37:46 GMT -7
If Timmy is still showing signs of pain i sure will ask for pain relief. Being a nurse i understand that if all your systems are working on pain relief they are not working on healing. His front paws are knuckling under more than before, is this a major set back?
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Post by Pauliana on Jul 6, 2013 20:41:01 GMT -7
Hi Rhonda!
Knuckling paws is a sign of nerve damage from the disc pressing on the spine.. However with crate rest and lack of movement the disc has a chance to heal. If it's front paws knuckling that means it's a cervical disc involved.. Please read this page on tips for the Cervical disc episode..This will give you lots of information on how to help Timmie.
REGAINING NEUROLOGICAL FUNCTION has no time limit for nerves to heal. Nerve repair is individual as each injury is different and each dog’s ability to heal is different. Thousands of dogs on Dodgerslist have regained functions in as little as 2 weeks, others 11 months, and still others 3 years later. IVDD is a disease of patience to allow the body to heal on its own terms. Acupuncture and Laser Therapy stimulate the cell’s metabolism that leads to the body’s natural repair abilities and can be started at any time.
Sending healing prayers Timmie's way.. You are doing great posting on the forum!!
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Post by momfortimmie on Jul 6, 2013 23:40:46 GMT -7
Thank you all so much again for your responses. I just worry so much, especially when he has a bad day such as when the pain is greater or he can't roll himself over like he did the day before. I have to take a deep breath and remember, just like us he will have bad days and good days.
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Post by momfortimmie on Jul 7, 2013 6:56:56 GMT -7
Timmy seems to be getting worse he is not able to stand at all. His belly gets very swollen. Yesterday he had three poo's and his belly became soft. Now it is tight and swollen. I know this is a sign of pain, but he also is gulping his water down so that would put air in his belly. I am considering giving another tramadol so that would be four doses today instead of three. Does anyone know if that would be ok? Again for my own peace of mind, he will have good days and bad days? So i should not panic if today is not as good ss yesterday?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 7, 2013 8:23:26 GMT -7
There really should not be good then bad days regarding pain. Pain meds have to be adjusted to provide comfort consistently and fully dose to dose. Your vet would be doing a great disservice to Timmy by not providing extra pain meds other than tramadol if Timmie is in pain. This would be unforgivable! A disc problem is a very painful thing. Timmy is not a science experiment to see how prednisone works by reducing other variables that my effect pain. We know pred works but takes time… during the time pred works adequate pain meds must be on board so Timmy is not in discomfort. Bone up on the pain meds used with IVDD and demand help for Timmie. Most vets prescribe right away at least two pain meds: methocarbamol for the painful muscle spasms and tramadol for general pain relieve. Read more about pain meds: www.dodgerslist.com/literature/healingpain.htm You are there with Timmie and will have to use your judgement and observations to conclude if Timmie is showing any of these signs of pain: does not move much in the crate, or moves gingerly, not his bright perk self, yelps. Diminishment of neuro functions is due to increasing damage to the spinal cord's nerves. Your vet is giving VERY short courses of pred at the antiinflammatory dose at 3-4 days and then already calling for a taper. Be watchful when the taper starts there are no hints of pain surfacing. Can Timmy move his legs at all? Being on crate rest can also make leg muscles a bit weak, just as we get weak from being bedridden. Does he still have bladder control…no leaking in his bed nor leaking on your when lifted? The tight tense belly muscles can be that way when the tummy is also empty of water/food and body wastes. IT is the muscle themselves that tighten up due to referred pain from the back area. So there is a difference in the belly being full of water. Let us know what you are observing. How is his poop, normal firmness or constipated? Tramadol can cause constipation. 1 teaspoon of plain pureed pumpkin 1x a day (or mashed microwaved sweet potatoe) PLUS soaking each of his kibble meals in equal parts of water or broth can help with constipation…. the key is the extra water with the high fiber that help to loosen stools. Doing 100% strict crate rest 24/7 is the single most important care to keep the disc from worsening and in turn damaging nerves. 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 correctly identified by a specialist is gone. |
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Post by momfortimmie on Jul 7, 2013 8:51:32 GMT -7
I will be calling the vet tomorrow to demand another pain med or muscle relaxer. His legs become very stiff at times and I believe that muscle spasms are happening. On the prednisone, what would be a normal treatment dose? I have thought that the dose was too short and too low compared to an episode that happened in the winter. At that time the er vet gave steroid with iv then prednisone 7.5 mg for 5 days and 7.5 mg every other day for 7 days. How long should he take treatment dose before tapering.
Timmy does move his legs when we go potty, he "walks" with me supporting him. He also turns around in his crate. His legs do tend to become very stiff before his next dose of pain med is due.
He does have at least one BM daily, yesterday it was three, all normal color and firmness. No signs of blood. I have been feeding him a mixture of canned food, dry food and broth all blending smooth in a food processor. Timmy has many teeth removed so dry food is very difficult for him to try to eat. Sometimes when Timmy drinks he starts gulping water and then belching that is why I am wondering if some of his firmness may be caused by that.
He has access to a water bowl in his crate, which he uses. We also stop by the big water bowl when he takes a trip outside to potty. He has no loss of bladder control, no leaking and can wait until we get outside. Yesterday, we didn't get outside for a BM but that was my fault and he went on the way outside.
On the nerve damage list, Timmy has the first four listed but he does not have 4-8. He is interested in things going on around him and his personality peaks through a lot.
I do appreciate answers to these questions as each day I have more questions. I am glad for this site and the information. I think I am on this site at least half the day and I continue to learn.
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Post by Pauliana on Jul 7, 2013 13:59:41 GMT -7
Hi Rhonda,
Can you call your vet's office phone number today and get the answering service and ask them to let the Vet know that Timmie is in considerable pain and needs something besides the Tramadol such as Methocarbamol for the muscle spasms? You have to be pushy with some of these vets to help Timmie. Tell them you can't stand to watch him be in pain when he can be helped with a simple prescription that can be called in to the pharmacy..
Healing prayers for Timmie..
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Post by momfortimmie on Jul 8, 2013 11:43:47 GMT -7
Timmy's vet wanted to see him today before any changes or add on to meds. He was not encouraging, I know that Timmy is worse than before but not completely down, he was leaning towards putting Timmy to sleep. I told him that I wanted him comfortable so that he will have time to heal and we, Timmy and I, planned on proving him wrong. He might not be 100% but he will be better and pain free. I am having faith on this but I see in Timmy's eyes that he wants to live. Anyway, our vet told us that he certainly hopes that we do prove him wrong and that he will help to do so in anyway and support in anyway. The vet tech was wonderful as well, cheering us on. Timmy will stay on Prednisone 10 mg daily, Tramadol can/will go up to 50 mg daily divided into four doses and add on is Codeine, 0.25 ml solution up to 4 times daily. Today is the trial run so keep your fingers crossed, we need all the prayers and good thoughts sent our way.
And as a last note, Timmy at this time is not standing on his own but he continues to move his legs, he sometimes can roll over. The vet seems to think that maybe his disc completely ruptured but could not confirm. I think maybe pain and weakness from being crated is not helping any but crating is what we will do to heal. As was said and we all know, you can not heal yourself when you are in pain, that is form humans and animals alike.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 8, 2013 13:50:24 GMT -7
Rhonda, wish I could reach through this post and give you a great big hug! We want all owners to do as you did. Know the disease, know the meds and then strongly advocate for the services you want your vet to provide. You did great!!!!! Kudos to you.
There is one more important thing to address right away tonight. Get Pepcid AC (famotiine) on board. Timmie does not need another problem of bleeding ulcers or worse of life threatening perforated stomach lining. Let us know when you have begun giving 5mg pepcid AC 30 mins before the Prednisone and there after every 12 hours.
Is the pred being given 2x a day at 5mg for a total of 10 mg per day? As the vet indicated the day he will call for a taper to begin?
Please keep us posted on how the new med prescriptions are working for Timmie.
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Post by momfortimmie on Jul 8, 2013 13:56:23 GMT -7
I have had the Pepcid on board for approx 5 days as i did not want any stomach problems as well. He did not give me a taper day as i really think he believes Timmie won't live through this. He does not think i should wait 6-8 weeks to make my decision, i told him as long as Timmie was not hurting we are seeing this through i don't care how tough it is.
To answer Prednisone question, 5 mg twice daily for a total of 10 mg. Oh, and to go on.....I mentioned crate rest for 6-8 weeks for conservative treatment. Vet seemed to think that this was after surgery. I explained Dodger's List and the support, again he was thinking that the treatment was for patients who did not have severe symptoms. The veterinarians do not understand the treatment and prognosis so i am 100% in favor of getting news out there. If i had not researched then i would have lost a big light in my life without even fighting for him.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jul 8, 2013 14:20:00 GMT -7
OK, then all is good Pepcid AC is on board, Prednisone 5mg 2x a day (which is the anti-inflammatory level dose. Tapering is all guess work as to when the vet thinks the swelling might all be gone…and they they try a taper to less than the anti-inflammatory dose and back off the pain meds as well to assess swelling in the spinal cord. How many pred pills did he give you? Disc disease is not a fatal disease…so there is no reason Timmie will not live through this disc episode to provide your vet a front row seat on how conservative treatment works. Timmie will be back to enjoying family life after crate rest has been completed. If you have not ordered our free brochures, please get some for your vet. He is going to need them with his next client to help the owner know how important crate rest is. Print our our intro letter so you vet knows he will be in good company with specialists and other veterinary professionals who know conservative treatment is a viable treatment choice. Ask Linda for free brochures here: www.dodgerslist.com/literature/litorder.htmPlease do keep us updated on how pain control goes. |
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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 Jul 9, 2013 9:04:45 GMT -7
Rhonda you ROCK!!!! Timmie you keep getting better and stronger and show those nay sayers just what love and patience and great care can do!!!! |
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Post by momfortimmie on Jul 9, 2013 9:21:41 GMT -7
We both thank you.
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Post by Pauliana on Jul 9, 2013 19:38:19 GMT -7
Rhonda, you are awesome fighting for Timmie!! You and Timmie will teach that vet a thing or three.. A big education for him about conservative treatment that will help future IVDD patients. Yes!!!!
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Post by momfortimmie on Jul 9, 2013 19:48:27 GMT -7
Update on Timmie, he is actually more alert and vocal than he has been in days. He is definitely telling me what he wants and when he wants it and I love it. He is moving his legs more and trying to sit up. We have also started the massage and passive range of motion exercises three times daily.....he likes that. Long way to go yet but little steps will move us forward as much as big steps. I am currently trying to figure out how to add pictures so you can see my cuddle baby. [Editor's note] first have your photo uploaded to any website (Flicker, Dodgerslist Gallery, etc.) Copy the photo's address (http://www.XXX.com/dog.jpg) paste into your post. Directions to upload to Dodgerslist Gallery: dodgerslist.boards.net/thread/260/upload-photo-dog |
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Post by Pauliana on Jul 9, 2013 20:34:02 GMT -7
Sounds like Timmie is getting his personality back.. He is adorable, by the way! Glad he likes his PT and is making improvements!
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