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Post by Marissa & Ruby on Jul 17, 2013 4:52:49 GMT -7
The shock. Ruby is a 5 1/2 year old long haired mini and she sadly suffered her first ever episode of IVDD just over one week ago. We were stunned because she has never had a health issue in her life. She was young and playful. She did not have any specific injury that preceded her inability to stand up or walk. In fact, she had seemed perfectly normal all day. Until about 9pm when my younger son noticed Ruby kept sitting down and would not stand. Having (unfortunately) been through this before with a rescue dachshund we had adopted 2 years ago, I knew I needed to take Ruby to the ER immediately, that treatment as soon as possible was vital. When this happened to my other dachshund, we were not fully aware of the lethality of this disease. We knew she was in pain and we tried to treat her as best we could. Howeber, she had suffered previous trauma in an abusive home and sadly, she did not make it.
Once at the ER, the vet confirmed what we already had a inkling of. Ruby had an injured disc. We agreed to bring Ruby home with NSAID (Rimadyl) and pain reliever (Tramadol). Looking back on it, I feel somewhat regretful that I did not insist on steroids for her right away, however, the vet assured me that "newer research" showed that the NSAIDs worked as effectively as steroids. I brought Ruby home and monitered her through the night, but she got worse. She no longer had proprioceptive reflex. She seemed in more and more pain and her ability to stand up was gone. We were very scared and brought her back to the hospital first thing in the morning.
Then more bad news. Surgery was indicated, however the hospital quoted us at $7,000.00+ making it not an option for our family. We also knew that the longer we waited, the lower the chances of success for surgery. I asked the vet to proceed with steroid treatment and told her we wished to opt for "conservative management" for Ruby, knowing that even if she recovered, she would have a high percentage chance that it would happen again in her future. I also asked them to keep Ruby overnight where she could have an IV for meds as well as monitoring of her bladder/bowel. Because Ruby had already taken one dose of the NSAID, we had to sign a consent form that the steroids would possibly cause an ulcer or sever gastric problems. Still, I insisted on the steroids as I felt they were her only hope.
Better news. We picked Ruby up at the hospital the next day and the good news was that she seemed to show a slight improvement in that one overnight at the hospital. Ruby could still wag her tail and still had deep pain sensation. The vet there says she felt perhaps the Mannitol IV in conjunction with the Dexamethasone injection helped bring down a bit of the swelling in the spinal cord that night. She was sent home on Prednisone, Tramadol, Sucralfate, Misoprostol, and Famotidine.
The long haul. The first couple of days at home were beyond stressful. However, Ruby has thankfully shown some slight improvements, none of them are sudden, but more gradual. Initially, there were concerns because Ruby was having trouble eliminating. She had only urinated twice (in her crate) and had not defecated at all in the first 48+ hours that she had been home. I indicated that I had started giving her canned pumpkin in case she had constipation. The ER vet suggested bring Ruby to my regular vet to see if she needed to be expressed or at least have her abdomen felt. So, I had made the appointment and taken Ruby out of her crate to get her ready for the trip when she urinated and defecated on her own in front of her crate on her “wee wee pad.” From that point on, I have been able to take her outside on the grass on a schedule and she is able to hold herself up enough (with the additional help of me holding a sling) to eliminate. So, Ruby seems to have no problems holding and/or indicating that she is uncomfortable and then waiting until I take her outside for potty. That has been a tremendous relief for me!
As for her mobility, Ruby is able to sit up in on her own in her crate (she does this mainly if someone comes home, doorbell, sounds of food in the kitchen, etc.). She is able to change positions and shift herself from one side to another when she is lying down. When I take her out of her crate for potty, Ruby cannot go from a sitting position to a standing position and can only stand on her own for a couple of seconds before she sits down. She cannot stand without her hind legs slipping down on a surface that does not have a lot of traction (like her wee wee pad on a smooth floor.) However once she is standing, with the sling, Ruby can ambulate herself on grass and (even carpet) and can move her back legs as she is walking. She can actually walk (assisted by the sling) a few feet as she sniffs to go potty. She also wags her tail once she finishes her ‘business’ and indicates by turning back toward the house, that she is finished and ready to go in.
I have▼ tapered her prednisone down to one dose per day and have kept all other of her medication the same. I also give her the usual fish oil, multivitamin and glucosamine tablets she has always taken, plus a couple of tablespoons of the pumpkin with her dinner and to hide her medications. She still shows a small amount of pain when I lift her out/up from her crate but much less than last week. When she has been resting in her crate for a period of time, she shows no obvious pain.
I guess this is all great news for us and we are continuing to hope for more gradual improvements. Her state of mind seems pretty good as she takes interest in family members’ comings & goings, wags her tail and sometimes barks if she hears other dogs outside. So, her crate rest continues...more updates later!
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PaulaM
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Post by PaulaM on Jul 17, 2013 8:08:09 GMT -7
Welcome to Dodgerslist. My name is Paula what is yours? I'm glad to read your vet appreciated the danger of a switch from a NSAID to a steriod and really took pains to protect Ruby's stomach in three ways: Famotidine aka Pepcid AC, sucralfate and Misoprostol. My consern is that you say Ruby show some evidence of pain on the taper. Have you relayed your observations of pain to the vet?
Often it takes being at the anti-inflamamtory dose of prednisone (5mg 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.
Looks like Ruby is going to be a good candidate to recover with conservative treatment. The big IF on that is if you can commit to 100% STRICT crate rest 24/7 only out to potty for a full 8 weeks …. No laps, no couch, no sleeping in bed with you, no meandering, scooting or dragging around during potty times. No baths, no chiro (aka VOM). In other words do everything you can to limit the vertebrae in the back from moving and putting pressure on the bad disc.
Some good details of doing crate rest to ensure the best recovery in this excellent document:
www.dodgerslist.com/literature/CrateRRP.htm
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Post by Marissa & Ruby on Jul 17, 2013 8:32:09 GMT -7
Hi Paula,
Thanks so much for your reply. My name is Marissa. Are there any disadvantages to lowering the dosage as I already did 2 days ago and then ago and then increasing it back up? She was on the 2x day dose for 5 days and then on the 6th day (per vet's instructions) lowered it down. How do I check if she is in pain? She is at ease and shows no pain in her crate and walks around a small amount (on the sling) out on the grass before/after potty. I am extremely careful when I lift her to make sure her back is stable and parallel to the ground. She just tenses up a bit. So is this painful? I will call my vet and ask based on your notes. I would much prefer to keep her on a higher dose of the prednisone that risk swelling that could otherwise be controlled.
Another question you may be able to help me with. Is is ok for Ruby to sit up and move in her crate as she wishes? Or should I trust that she knows what feels comfortable? She particularly does this when food is being preparing in the kitchen or family members are coming home. (I know NO JUMPING UP--ever). She has been sitting up much more often in the last day (and for longer amounts of time) and I want to make sure that is not bad for her. If it is, I can put her crate in a quieter area.
I must say a 'thank you' for this website. I had referenced it 2 years ago when my older dachshund had her back issues so I knew right where to go when I committed to helping Ruby through her recovery....I have already looked at and continue to go back to the link you show!!
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PaulaM
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Post by PaulaM on Jul 17, 2013 8:46:36 GMT -7
Marissa, you will have to put on your detective hat about pain. Tensing up could be a learned expectation that moving could be painful so she tenses up. Do you also see she has a tight tense belly when lying down in her crate or any shivering and other pain signs to confirm pain?
If you do not see any other signs of pain, then along with your noting that she sitting up more, being more her perky self…. interested in life and the kitchen, she may not be in pain.
The only true test if all the swelling is gone is to be off pain meds as well as tapering to a stop of pred. That is why on the pred taper, pain meds are also backed off and stopped.
Delighted to hear you are a reader!!! That is one of the best ways to help our dogs…being informed.
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StevieLuv
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Post by StevieLuv on Jul 17, 2013 8:47:13 GMT -7
Hi, my name is Maureen. Welcome to Dodgers List. Ruby is a lucky lady to have a Mom that is versed in IVDD! Don't worry too much about Ruby moving about to get comfortable, sitting up or turning over. These are all great signs that her pain is being well controlled. Watch out for excessive burrowing, jumping (like you said) or playing with any toys in a manner that is too vigorous. Prednisone can be increased back to twice a day if needed, watch for the signs of pain that mean that swelling is still present, shivering, trembling, tight belly, reluctance to move andd loss of appetite. I would recommmend that you contact your Vet prior to changing her medication schedule- keeping them in the loop helps them learn about IVDD too  |
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Post by Marissa & Ruby on Jul 17, 2013 9:00:56 GMT -7
Hi Maureen. Thank you for the opinion. We are 100% committed to strict crate rest. I just feel so much guilt that we were not stricter with Ruby up until now. I am sure it is a common emotion for many dachshund owners who end up in this same boat. We knew she shouldn't be jumping or going up the stairs (she did not go down the stairs)and we did our best to try to keep her from doing things we knew could take a toll.
Perhaps, as you said Paula, Ruby's tensing up is a learned behavior that moving could be painful. I kind of think that is what's going on. Her mental state and attitude seem better each day, as I said, and she is definitely getting to be more like her usual nosy little self...taking interest in what is going on around her. She is not, I suppose, feeling well enough to protest being in her crate. She is actually happy in there (which is kind of strange since she would never have 'tolerated' it pre-ivdd.
Thanks again for now and I'll keep you posted~
Marissa
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StevieLuv
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Post by StevieLuv on Jul 17, 2013 20:37:29 GMT -7
We all live and learn when it comes to the "I wish that I would haves...." Stevie is a Pekingese for crying out loud - LOL - not even a doxie and I was drowning in guilt too. Good to hear that Ruby is getting back to normal as far as her interest in life |
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Post by Marissa & Ruby on Jul 19, 2013 8:22:40 GMT -7
I spoke to Ruby's vet yesterday and based on what I told her, she recommeneded to keep Ruby ▼ tapering down the prednisone. So Ruby is now getting 1/2 of a 5mg tablet once per day...ans starting in a few days will be at that same dose every other day.
Once she finishes the complete course of prednisone, if I feel she is in any pain, I will bring her in for a visit at the vet to discuss her medications. She said it is important to try to have her off the steroids & there are other pain meds that can be tried if she is in any pain at that point.
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PaulaM
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Post by PaulaM on Jul 19, 2013 9:22:23 GMT -7
It is always a good idea to stop using meds once they have achieved the goal. The goal when using pred is to get all the swelling down in the spinal cord. The taper of pred along with backing off or stopping the pain meds as well, gives the proof of whether all the swellining/inflammation is gone. Are you also backing off or stopping the pain med, Tramadol to have a clear picture to assess swelling?
If she would show signs of pain, then at once the vet needs to know so t hat pred can be used a bit longer. Pain meds do nothing to work on inflammation, they just mask the pain. Often it can take more than a 5 day course of Pred to get all the swelling down. Some dogs may use pred for 2 weeks or even more like a month.
Let us know how the taper goes…we hope, of course, to hear no signs of pain and the 5 day course did the trick for Ruby.
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Post by Marissa & Ruby on Jul 19, 2013 9:35:28 GMT -7
Yes, I think am going to be backing the tramadol down to 1/2 of a 50mg from 3x per day to 2x per day. That way, I can better assess if/how much her true pain level is. Hoping for the best...thank you for your support!
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Post by Marissa & Ruby on Jul 22, 2013 8:13:53 GMT -7
Today starts the completion of Ruby's second full week of crate rest and she has come further than we could haver hoped for after she lost the use of her hind legs on the evening of 7/7. In fact this morning, when I was preparing her breakfast, Ruby was excited enough from her crate that I turned around as she was barking and she was actually standing up on her own(albeit using the soft padding in her crate to prop herself.) She sat down and then "stood up" (the same way) again when I gave her her food dish. Yay Ruby! Ruby continues to do well on my homemade sling out in the grass for potty but since she is never off the sling, I do not know what she can really do of her own strength. I can tell she wants to be able to walk and even attempts to "pick up the pace" a bit (relatively speaking, of course  ) when she finished her 'business' and turns to go inside, before I pick her up to carry her back in. I can tell that I am going to need to start keeping a harness on her for front end for more control. Right now, I have been using the sling alone around her back half and that has been enough for her to ambulate safely. However, not that she is moving a bit more I do not want to risk her moving too quickly and hurting herself. I will do that this week. Regarding medications: Ruby is doing well on the prednisone every other day, with 3 doses left to go. We have also reduced her tramadol to 2x per day which I am reducing t ramadol to 1x per day and then only if needed. So, in a few days she will be off all her medications, which is a big plus. When I spoke to the vet last week, she said that I did not need to bring Ruby in for a check at this point, as long as I did not notice any pain. So I guess at this point, the next six weeks will just be a matter of keeping Ruby happy in her crate and making sure she shows no new symptoms. PS--- I LOVE Dodger's List for helping me get through these first difficult 2 weeks when Ruby was weakest and hope was hard to come by. As Ruby gets stronger, I feel more and more shock at the people ("well-meaning" family and friends) who suggested that she "wouldn't make it" and that "she can't live like that..." and that we really had some "decisions to make..." I had always said that if Ruby could just get to the point where she is not in pain and she is able to go potty on her own without problems, that would be enough for me to know that she can survive this...and here she is now at that point...and we are hoping for more recovery as the weeks go by. Anything from this point on is icing on the cake! |
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Post by Marjorie on Jul 22, 2013 8:30:15 GMT -7
What wonderful news! And in such a short time! Great job in caring for Ruby.
I also had to use a harness, together with the sling, when taking Jeremy out to do his business, once he was feeling better. He would pull ahead with his front legs and I didn't want to only have the sling to restrain him. I would hold the leash attached to the harness with my left hand and hold up the sling with my right. I'm sure Ruby thinks she can pick up the pace and it's great that she's feeling well enough to do that. But as I can tell from your posting, you understand how necessary it is not to let her take more than those few steps to do her business. Kudos to you both!
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Post by Marissa & Ruby on Jul 27, 2013 6:13:12 GMT -7
Well now that Ruby is more stable I have been able to take some time to read some of the other posts here and I am amazed by the similarities in our dogs' stories. Whether there is an obvious event leading to an injury or the dog just "doesn't seem right" knowledge of what to do and speed of getting treatment are critical. As I mentioned earlier, we had adopted a rescue dachsie 2 years ago and I was not familiar with IVDD. I was not educated about looking for symptoms & (unfortunately) also not told about how crucial the entire 8 weeks of crate rest are. I look back on Dixie's IVDD episodes (her first one only 2 weeks after we rescued her) and wished we had known what we know now.
Back to Ruby. She is now almost completely off her meds (her last prednisone dose will be tomorrow) and that is good news...this means she is more alert and less tired. Yesterday when she standing was out on the grass for potty time, I did a test of her proprioceptive reflex on both hind legs. Very slow...took maybe 5 seconds or so, but she did turn each foot back. I think that is good news. She seems to have a little more strength to stand up. Again, all of Ruby's improvements have been subtle and gradual...never anything major or sudden all at once. So, I am careful not to impose my "wishful thinking" upon her recovery, but I do see it is there!
So the fact that she is feeling better all around is creating a situation (and believe me I am not complaining!!) where she is no longer completely content within her crate all day...particularly when all of our family is around. She is starting to whine to get our attention, and recently started more time pawing at the front of the crate to get out...not that she could mobilize herself out but she wants to come out.
I would love some suggestions on whether/how we can make her feel more at ease. Obviously general training would tell me to ignore her 'unwanted' behaviors, like the whining, but maybe she should be treated differently because of her confinement. What kind of interaction does a crated dog (who is off meds and feeling better) need? Or doesn't she need this, since in actuality she should be resting/sleeping/recovering? I am thankful that Ruby seems to be on the road to recovery, but this new phase will be a challenge.
Thanks,
Marissa
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StevieLuv
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Post by StevieLuv on Jul 27, 2013 9:12:31 GMT -7
Yes indeed the "I feel better now, so LET ME OUT!" stage of crate rest is almost as challenging as learning all about IVDD in the first place. Ruby has to learn to accept that she is stuck there for the duration, and that can be hard on your nerves if there is alot of whining going on. One of the important things to remember is that the whining is rewarded when you give her attention while she is doing it - even looking her way counts!-kind of like a kid having a tantrum...we have to remember to reward the good behaviour, offering praise or low cal treats when they are quite and ignoring the other behaviours. We have members that have resorted to having to hide out in another room to teach their dogs to deal with the crate. Another thing that you can do is move her crate from place to place so that she is with the family and can feel included in family life. Crates have been put on coffee tables, kids wagons, and casters to help with this, or on tables so that they can see out of windows. You can take her crate outside if you are doing yardwork too. She might be crated, but still wants and needs to be included. We had Stevie's crate right in the middle of all of the action (the shape of our house allowed for that) and she had a different crate for bedtime so that she could be right by our bed. Hope this helps a bit - keep us posted |
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Post by Marissa & Ruby on Aug 5, 2013 12:37:12 GMT -7
Time for an update as Ruby has now completed 4 of her 8 weeks strict crate rest! Ruby continues to amaze us as she gains gradual strength. She is completely medication free and appears to be in no pain. As has been her story over the past 4 weeks, Ruby has had a slow and steady improvement, nothing shocking or monumental all at once.
She transitions from laying to sitting to standing in her crate easily these days. I have even noticed her on one occasion twisting around to scratch a bit...something she had not been able to do since before her injury (hope this is not bad for her.) Ruby also chooses to stand up while she is eating her meals. The soft memory foam in her crate allows her to stand up and remain standing easily. (I have noticed she still cannot stand up in place alone without her hind legs slipping on the surface of the harder floor.)
I also see clear positive changes when Ruby is out in the grass for her potty breaks. She stands nicely due to the texture of the grass helping her and she walks pretty well with the sling. I do not need to hold her rear half up much at all (the exception is when she is defecating--she still needs support from the sling to squat for this); but while walking, the sling more just gives her a little support so she does not sway from side to side or slip. Ruby is happy to be "walking" outside and wags as she moves around. She had also has gone back to her usual sniffing around in the grass. At the same time, she always waits for me to pick her up to carry her back inside...kind of like she either likes it, expects it or knows it would be too much for her.
I am taking Maureen's advice and we have been moving Ruby's crate wherever the action is...from the kitchen, to the patio, to on the front lawn to watch other neighborhood dogs go by...wherever she would want to be if she were not restricted to her crate. Her whining has not been too bad (basically back to her usual begging noises before her injury) and I would say she is still well-adjusted to crate life. I am thinking of eventually setting up another crate for upstairs, so that we are never tempted to let her sleep on any bed or furniture again.
Four weeks ago we did not think Ruby was going to survive at all. Ruby has gone from intense pain and almost complete paralyzation of her hind legs to being medication and pain free, walking around our yard on her own with just a sling for support. So all in all, we are thrilled!! In fact, Ruby has come far enough in her recovery that I can now look forward to her completion of the 8 weeks and her life after recovery. I am optimistic that at that time she can have a little bit more exercise and therapies to help her walking and general stability.
(Another shout-out to Dodgerslist and another THANK YOU for all the advice here and access/links to important information!!)
Thanks again!
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Post by PaulaM on Aug 5, 2013 13:03:01 GMT -7
Thank you for that update…what a wonderful report. Dodgerslist is all about giving these dogs a chance to heal…correct meds and the proper environment to do the healing in….a recovery suite for 8 weeks and 100% STRICT rest 24/7.
You make our day by having applied what you read and learned from our webpages!!! Ruby is in the best of hands… yours.
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Marjorie
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Post by Marjorie on Aug 5, 2013 13:39:25 GMT -7
What a wonderful update. You've done a great job with Ruby - she's a lucky little dog! Way to go, Ruby and Ruby's mom! Keep up the good work and I hope you'll see more improvement as each day goes by.
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Post by Marissa & Ruby on Aug 9, 2013 6:07:59 GMT -7
Ruby tried to run this morning after she finished her potty! I was excited but scared...have a big fear that she will do something to hurt herself now that she is feeling better. I have noticed that she is always pleased with herself when she finishes her "business" and she sometimes picks up the pace to go back inside - lol! I was thankful I had the sling steady and in place as this was able to prevent her from trying to take off and possible falling or hurting herself. I guess she really needs a harness now. Luckily it is raining today (which she hates) so she will not be happy outside & I will have time to go buy her one!
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PaulaM
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Post by PaulaM on Aug 9, 2013 9:08:42 GMT -7
You might want to also consider making a fenced area of about 6 feet in diameter so she is not inclined to sniff fests. A harness, 6 foot leash and sling can also limit her footsteps at potty time as you would stand in one spot. |
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StevieLuv
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Post by StevieLuv on Aug 9, 2013 11:13:19 GMT -7
Wonderful that she is doing so well. Now comes the challenge of keeping her from overdoing it. That push in the ground garden edging makes an inexpensive fence for limiting her potty area.
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Post by Marissa & Ruby on Aug 10, 2013 8:01:43 GMT -7
Some great suggestions...thanks! |
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Post by Marissa & Ruby on Sept 2, 2013 13:31:34 GMT -7
8-Week update: I haven't posted anything for a while because Ruby has really been holding her own....Great news and really the best we could have ever hoped for! Ruby has gained enough strength to be able to walk *on her own* in the grass and indoors on carpet or any other stable, textured surface like the yoga mats (...got the idea for the yoga mats on another post her on Dodgerslist.com) Mind you, we do not really let Ruby walk much on her own because (1) she is still a bit wobbly in the rear and so I do not allow her to walk more than a couple of steps without her sling (especially when she needs to squat for potty) and (2) I do not want to do anything that may lead her to re-injure herself. In addition to the sling, I have begun to use her harness with a leash when we are out in the backyard. I guess we will try to gradually increase her time on the leash each week but for now, we will basically keep her in the crate when she is indoors unless we are taking her out for some exercise (just slow walking) or for potty. I don't feel there is really any need for her to be wandering around the house right now as long as she in content in her crate. Thank you Dodgerslist.com!!!...I am still getting ideas from you like the garden fence and the yoga mats. My goal now is, of course, to help Ruby to increase her strength in her back legs, stay strong, never re-injure/or have another disc episode again. I know the chances are high that she may but we will now need to re-evaluate the layout of things (i.e. blocking steps/furniture/prevent jumping, etc.) to keep her safe & healthy. |
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Post by Marissa & Ruby on Sept 2, 2013 13:33:49 GMT -7
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Marjorie
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Post by Marjorie on Sept 2, 2013 13:44:22 GMT -7
Wow, Ruby's doing great! How wonderful! Congratulations on completing the full 8 weeks of crate rest. You've done a fabulous job with her and it shows! Now's the time when she needs to gradually increase her muscle strength and stamina. Here's a good schedule that I'm using for my Jeremy. He was very weak and wobbly the first couple of days out of the crate but it didn't take long for him to get his strength back. It's been slow and he wants to do more but I'm determined to do it gradually so he has no muscle soreness or strain. You should continue to use the sling to help stabilize Ruby's spine when walking. Here's the link: www.dodgerslist.com/literature/AfterCrateRest.htm |
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Post by Marissa & Ruby on Sept 2, 2013 14:42:57 GMT -7
Thank you Marjorie---this is perfect...just what I need to read!
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StevieLuv
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Post by StevieLuv on Sept 3, 2013 10:53:06 GMT -7
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Post by Marissa & Ruby on Sept 3, 2013 12:32:11 GMT -7
More excellent info! I was actually just going to inquire about the "sunken living room" issue since we have a single full-sized step down...and then another small step down to the outside patio. So I see it is not being "over-protective" for me to ramp these!
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Post by Marissa & Ruby on Sept 8, 2013 8:53:11 GMT -7
Ruby has been doing well and is taking it slowly out on the grass (with her sling for stability, although she can walk fairly well without any real support from the sling)...
However, I have a question...I have begun leaving Ruby's crate door open during the day when she is just sitting in her crate...the crate is in our living room, but it is penned by fencing (i.e. her crate is surrounded by a small wire animal pen about 3x4 feet). She occasionally comes out of her crate and sniffs around for a few seconds or walks a bit & then goes back into her crate. The floor in the penned area is lined with 2 yoga mats for cushioning and traction for her. So finally my question: Is this safe? Is it OK for her to venture in and out of her crate on her own during the daytime, since once she comes out of the crate she is still restricted by the confines of the pen? Or should I continue to just keep her crate door locked when she is inside it?
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Marjorie
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Post by Marjorie on Sept 8, 2013 11:50:18 GMT -7
Ruby's starting her second week after crate rest. So according to the general schedule on www.dodgerslist.com/literature/AfterCrateRest.htm, she can move about the house under supervision for 5-10 minute periods 3x day, no rough housing, running, jumping. Plus she can have 5 min walk outside 1x a day early in the week building to 3x a day later in the week. This is a general schedule but I tended to follow it strictly with Jeremy. He's finishing up his third week after crate rest tomorrow and I still see some tiredness even after a short 10-min. walk. So I'm still going gradually with him. So my suggestion to you would be to follow the schedule and when Ruby's not taking her short walks or having her free time periods in the house, keep her in the crate. She may be coming out of the crate and walking around more than you think and you don't want her to overdo it. |
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) when she finished her 'business' and turns to go inside, before I pick her up to carry her back in. 
