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Post by lolalulu on Jul 20, 2013 12:01:34 GMT -7
My 7 1/2 year old female doxie has been diagonised w/ IVDD as of last Wednesday, 7/17/13. She has been placed on medical management for 3 weeks & crate rest. Prescribed Carprofen 25mg 1/2 a caplet 2x a day & Tramadol 50 mg 1/4 to 1/2 tablet 2 to 3 times a day, they did not say anything about Pepcid. I will call & ask though. She can still walk a little on her back legs, and is still peeing & pooping w/ no change in stool. We can't afford surgery as it is btw $5-$6000. She whines a lot in her crate, I have it inside a portable pen in the house, would it be ok if I leave the crate door open so she can come out or does she have to stay in the crate 24x7 for the next 3 weeks? The specialist said to keep her in a 4x4 area to keep her movements minimal, but didn't say to keep her in the crate 24x7. Now that I am reading the articles on your page I am really confused !!!
I can get to the add photo part but after that nothing happens.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Jul 20, 2013 15:30:05 GMT -7
Lolalulu, you selected a jpg from your computer's desktop to upload and wrote in a caption ? After clicking the "upload now" button" you did not see a progress screen? You may send me your photos plus caption including your name, I'll be glad to upload to you. Use the email address you find by clicking my name on the left.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Jul 20, 2013 16:09:33 GMT -7
Lola, welcome to Dodgerslist. Lulu has a good chance to heal under conservative treatment. The big IF on the that is if you have an understanding of the disease so you won't inadvertently take the wrong path because you did not understand how a disc heals and really how long that process is. This is a really good page to get alot of information and concepts about why strict rest is so critical to healing. The animation on that page is very helpful in visualizing what happens with movement. www.dodgerslist.com/literature/healingpage.htm-- Did you see a neuro (ACVIM) or an ortho (ACVS) specialist? -- 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 that you actually are giving them? -- Currently does she wobbly walk with back legs, knuckle her paws? Lulu, doesn't need another problem on top of dealing with a disc. The FDA and manufacturer pkg insert indicate gastrointestinal problems are side effects of using NSAIDs. The natural defenses of the stomach to shield against stomach acid is hindered when taking NSAIDs. Serious gastrointestinal toxicity such as bleeding, ulceration, and perforation, can occur at any time, with or without warning symptoms. Phrase the question to your vet this particular way:" Is there a medical/health reason for my dog not to take Pepcid?" If there is no reason, we follow vets who are proactive in stomach protection by giving doxies 5mg Pepcid (famotidine) 30 minutes before the NSAID. This directory is in alpha order and is what i use to look up my own dog's meds: www.marvistavet.com/html/pharmacy_center.htmDo let us know you are doing 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. Every moment out of the crate is a dangerous time for the early healing disc. Dogs always do the unexpected in a blink of an eye, jump, bolt, run down stairs…oh boy have we heard some stories from very guilty owners… as they just did not believe their cute little pooch would (fill in the blank here). So do everything you can to avert a surgery. Lulu needs to be out of her recovery suite for vet visits and for potty time otherwise the very safest place for her to heal in is her recovery suite. 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 The purpose of crate rest is to act as a cast of sorts to let the disc heal… only limited movement of STRICT crate rest allows that to happen…there are no meds to heal a disc.
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Post by lolalulu on Jul 20, 2013 22:33:38 GMT -7
Hi Paula,
-have to find out about the vets speciality -she is showing some signs of pain, everything you mentioned above, not constant, but 2-3 times a day -Carprofen 25 mg1/2 caplet 2x a day, 6am & 6 pm w/ meals -Tramadol 50 mg 1/2 tablet 3 x a day, 6am, noonish & 6pm -was wobbly walking but just sat most of the time today,unless in her crate
She is eating fine but not drinking as much as I wished she would. She peed this morning but nothing the rest of the day.
It's hard to keep her crated, she doesn't chew at the bars or anything but she softly whines a lot.
I'm concerned cause I have to go back to work on Monday & she'll be by herself for about 10 hrs , I am going to see if my mother in law can come by around noon & give her pain meds but she's not in the best of health either & won't be able to pick her up to take her out.
Should I be using a sling to help her stand up when I take her outside? If so, where do I place it , it front of her back legs?
This is very hard on me emotionally as I am sure you all understand,,,,,I so wish everything was back to the way it used to be. I want to thank you for your support & advice.
Lola & Lulu
12midnight- little stinker, I'm laying in bed watching tv & I hear Lulu whining , I go check on her & I must if not latched the kennel all the way cause she's laying outside of it, the kennel is in a indoor fence, I pick her up & take her outside & she PEES !!!! YES !!! I pick her back up & put her back in her kennel & latch BOTH latches, making sure there secure. I also gave her 1/2 a Tramadol , her last 1/2 was at 6pm, I was reading the posts & I don't think her pain is being relieved as well as it could be & that being pain free has to occur so healing can progress.
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Post by lolalulu on Jul 21, 2013 6:39:57 GMT -7
Good morning,
The specialists we saw is Marty L. Aitken, DVM, DACVS out of Sage, Center for Veterinary Specialty & Emergency Care He seemed pretty knowledgeable about IVDD
I took Lulu outside this morning but she didn't pee. I'm waiting for her food to soften so I can put some pumpkin in,so she doesn't get constipation. We don't need that on top of the IVDD .
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 21, 2013 7:16:46 GMT -7
I, too, thought that the vet who saw my Jeremy when he had his first IVDD episode was knowledgeable, too. He mentioned crate rest but when I said Jeremy got anxious in a crate, he said to keep him small room and not to let him roam the whole house. Said I could walk him in and outside to do his business. He then walked him down a long hall to be weighed, walked him back and then walked him out to the parking lot to the car. The next afternoon, Jeremy's hind legs were completely paralyzed with no deep pain sensation and he was completely incontinent. This group has extensive knowledge about IVDD through experience. Please trust them and keep Lulu crated 24/7 for a full 8 weeks. It's sounds rough but it's the only way to give her spine time to heal. As long as that disc is pressing on the spine, it can cause nerve damage. Moving around causes the vertebrae in the back to move and tear open the disc, not allowing it to heal. It has to scar over and it takes time for that. There are others here who are much more knowledgeable than I am about pain medication and I'm sure they'll be able to help you get Lulu's pain under control. Yes, you can use a sling to help Lulu stand when you hold her up. You do place it in front of her hind legs. You can use a towel. Carry her in and out of the house to do her business. Use a short leash to limit how many steps she can take. The less movement, the better. Just enough steps for her to sniff and pee. Then carry her back into the house and place her in the crate. Read everything you can about IVDD - so much information is contained on dodgerslist.com. You'll become an expert in no time!
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Deborah & Angel
Helpful Member
No current back issues... Living Life.. <3
Posts: 294
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Post by Deborah & Angel on Jul 21, 2013 8:04:47 GMT -7
Hi Lola, you are not alone here, we are all here to help you through this. I have been where you are, and I was VERY emotional. Please don't let you FurBaby see you cry, I had to leave the room many times, I felt so bad and helpless. I would of lost my mind if it weren't for this group, and the members. There is ALWAYS someone here to talk to you. You are your FurBaby voice, so if you think she's still in pain, let the vet know...she needs to be comfortable. She will adjust to the crate. Mine did. If you EVER have issues getting her to take her meds, try cream cheese, works very well. We are here, follow these guideline, your FurBaby should be just fine. Read, read, and read some more. Praying for you and your FurBaby...many (((hugs)))
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Post by lolalulu on Jul 21, 2013 8:29:22 GMT -7
Thank you Marjorie & djaustin !!! It is overwhelming, I love her so very much. The first few days have been the hardest for me, so much that I was seriously thinking of putting her to sleep or turning her over to a rescue group I know that sounds like I don't care/love her but I think I was feeling that way cause she was trembling, shaking, yelping when I would pick her up so I thought I wasn't doing right by her. I know now that it's just going to take time & that we can DO THIS !!! This morning went well so far. Her water cup was almost empty this morning. 6:15-Pepcid 6:45- breakfast, dry dog food soften w/water, teaspoon of pumpkin, teaspoon of cottage cheese w/meds 7:15-DOG LOG (BM) yes !!!!! She's in her crate resting now, she was whining softly for awhile ( I don't think she's in pain , she didn't yelp when I picked her up & took her out). I will try the scarf sling next time I take her out. I have to go back to work tomorrow & I'm really worried about that. I normally leave around 6:30am & get home around 6:30pm, I work 8 hrs but the rest is due to commuting ( I live in the Bay Area of Northern CA). My friend can come over a little before 9am to check on her but then she has to leave for work. My husband, Rob leaves at the same time I do, commutes in a different direction & gets home later then I do. I'm hoping my mother in law can come & give her her pain med at noonish but her health is not the best & there is no way she could take her outside. I'm hoping my boss see's how stressful it will be for me & her if I'm at work all day & allows me to work from home, I can access all the programs I need from my laptop & VPN....wish me luck on convincing him.
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Post by Pauliana on Jul 21, 2013 11:07:46 GMT -7
Hi Lola, I noticed you said she had her Pepcid AC that's great but I didn't see anything about her pain medications and I hope she got those down as well. Once her pain is under control you will see a different dog.. Pain control dose to dose makes all the difference.. Tramadol is normally given every 8 hours.. such as around 6am, 2pm and 10pm, so she has pain control for her night sleep and good coverage for the day. Carprofen at 6 am and 6pm with meals with Pepcid AC 30 minutes before. Do you have a trusted friend or neighbor that could give the Tramadol mid day and make sure she gets a pee break, since that would be hard for your Mother in Law? Make sure to disguise it in cream cheese or lunchmeat so she doesn't get the taste as it is extremely bitter.. Did she ever pee when you took her out today? If not here is a document that explains how to express her.. www.dodgerslist.com/literature/Expressing.htmHave a Vet tech give you a hands on hands lesson.. It's a skill that takes practice but once you have that under your belt, it is easier than taking them outside.. As far as the whining.. Ignore her when she whines and give her attention and praise when she is quiet, she will soon learn which behavior gets rewarded..
I hope your boss will let you work from home.. I have my fingers crossed for you.. You can do this, I know how stressful and hard it is.. I am currently going through it with my Tyler and all our members here are going through it now or have graduated crate rest.. I am glad I stuck with my Tyler, he is a good boy that asks only to be loved in the good times and the bad..
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Post by lolalulu on Jul 21, 2013 11:53:26 GMT -7
Hi Paulina , Yes, she had her meds w/ her breakfast at 6:45 w/ water softened dog food, teaspoon of pumpkin & cottage cheese I am using the scarf sling when I take her out which is easier then I thought it would be. She hasn't peed since midnight last night, I've been reading how to express her, but haven't attempted it yet. I'm afraid I'm going to hurt her. The video link you supplied above takes me to an episode of swamp people , is that where you wanted me to go ?? I saw the one on how to pick her up & that is working out better for me & is easier then I thought it would be If my boss won't let me work from home the whole day I am going to ask if I can work 1/2 a day at the office & the other 1/2 at home, that way I can be here to give her the pain med & go potty. I will ignore her whining & praise her being quiet. I am starting to understand that this is just going to take time, each day that goes by takes us one day closer to recovery & am so grateful to of found you all, I was so upset because I thought we would have to put her down but the more I read the more I am convinced there is another way.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Jul 21, 2013 12:04:22 GMT -7
I corrected the link to take you to the expressing information.
Currently can she move her legs at all, wobbly walk? Can she wag her tail with joy if you specifically do some happy talk or give a treat?
Nerves heal typically in the reverse order of the damage to the spinal cord:
1. Deep Pain Sensation (Only correctly identified by a specialist.) 2. Tail wagging with joy at seeing you or getting a treat or meal. 3. Bladder and bowel control verified with the "sniff and pee" test. 4. Leg Movement, and then ability to move up into a standing position, and then wobbly walking. 5. Being able to walk with more steadiness and properly place the feet. 6. Ability to walk unassisted and perhaps even run.
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Post by lolalulu on Jul 21, 2013 12:40:25 GMT -7
Thanks ! She can wobbly walk & still wags her tail yes. She hasn't lost all feeling & hopefully with the crate rest she won't I have been ignoring her whining & she is now sleeping in her crate 2:15 pm........ SHE PEED !!!!!!!! YAAAAAAAAAYYYYYYY I wish she would drink more water so I came up w/ an idea, cooked some chicken & drained the broth, let it cool, spooned off the fat & poured about 1/8th of a cup into a small bowl w/ some crushed ice, she 'drank" it all ..... Is it ok to supplement her water like that? She has fresh water in her crate at all times.
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Post by jochs311 on Jul 21, 2013 17:37:55 GMT -7
Hi Lola, I'm Jen. Since LuLu hasn't been peeing as much as you think she should you should try to express her to make sure she goes. Even to make sure she empties. We had to express our Tucker for about 2 weeks and even as he regained his bladder control we would just make sure he emptied. If her urine is dark or smells strong you want to take her to your vet to make sure she doesn't have a urinary tract infection. You may want to call your vet with your concern about her not peeing. They could show you how to express so you will feel more secure that you won't hurt her.
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Post by lolalulu on Jul 21, 2013 21:38:39 GMT -7
Hi Jen! Nice to meet ya! Yeah, it's a growing concern, she peed at 2:15 today & that's it. Going to call vet in the morning. Been watching the videos & have tried suppression 3 times today w/ no luck her tummy is really tight though so that may be why it's not working, she's to tense I also think her pain is still not managed we'll, she yelped this evening w/ I picked her up & she was trembling earlier. I think she'll need a pain supplement , been reading about ... Gabapentin may be added to the mix for hard to control pain. Veterinarians are finding this medication works very well in combination with Tramadol.trying to educate myself & with this site/ forum /people on the site, it will be much easier. She is still eating well, only 1 'dog log' today but that's not unusual for her. She' ll have her last pain med here shortly & I'll take her out one last time then back in her crate. She would sleep in her crate normally, since we got here 5 yrs ago, so she's been sleeping well. I go back to work tomorrow & hopefully my boss will let me work from home for a few weeks. We have another dog, Bella Boo. She's 1 & 1/2yr old mix, Chihuahua, Maltese & Pomerania , blond mosly & the cutest little button eyes & nose. I call her my little 'Ewok'. Bella & Lulu are very close & since Lulu got sick, Bella has been very,very good w/her 'sister'. Doesn't try to play, wrestle, run w/her, she must be able to sense that Lulu isn't felling well.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Jul 22, 2013 10:29:31 GMT -7
Without pain control Lulu won't want to move to potty and you can't properly care for her.
Discuss being more aggressive in dose for the Tramadol. Discuss adding methocarbamol for the pain so often associated with muscle pain with a disc episode. Gabapentin could also be added if further pain control is necessary.
How much does Lulu weigh?
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Post by lolalulu on Jul 22, 2013 11:10:07 GMT -7
Hi Paulia--- She is on Pepcid 10mg 1x per day. She weighs about 15 pounds. I did come to work today & spoke w/ my manager. He will let me work 1/2 day at work & 1/2 day at home, which is better then nothing & I think will work out ok.
I have a call into the vets office regarding her pain.
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Post by lolalulu on Jul 22, 2013 16:15:03 GMT -7
Ok, now they are changing her meds to Prednisone
I am to stop giving her the Carprofan ( last dose was 1/2 a caplet @ 6am this morning) she's been on it since last Wednesday 7/17. They want me to start tomorrow 7/23/13/ late evening/Prednisone /5 mg/chew/ break in half, 2 x day for 5 days, then 1/2 tab 1 x day for 5 days , then 1/2 tab every other day till gone. They gave me 10 pills, so that would be 20 total pills.
Do you think that's enough time to flush the Carprofan out of her system?
Will this help her pain get under control? She is on the same dosing for Tramadol & I am to stay on that ad well as the Pepcid.
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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 22, 2013 19:45:31 GMT -7
Hi, my name is Maureen. I am just getting caught up on Lulu's story. Be cautious, as FDA and manufacturer package inserts warn against use of a NSAID with a steroid or with another NSAID without a washout period of 4 to 7 days before starting the new medication. Vets that practice safe medicine require a 4- to 7-day washout period between the medications. Carprofen is an NSAID, and prednisone is a steriod. Do confirm with your vet that they are recommending a 1 1/2 day washout rather than the 4-7 days, because taking the medications to close together without an adequate washout period can cause dangerous bleeding issues. I'm not trying to frighten you - just make sure that you know all of the risks. Prednisone is a very powerful anti-inflammatory - I sure do hope that you see great results once the switch has been safel made. Keeping you in thought and prayer
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,935
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Post by PaulaM on Jul 22, 2013 20:13:16 GMT -7
When there is increased neuro diminishment and it is deemed an emergency, a vet may choose to move to the strongest of anti-inflammatories, the steroids. You have not mentioned any increased diminishment of neuro functions. If it is deemed an emergency a vet would make a hard decision and then take extra precautions to the stomach by adding in a 2nd stomach protector, sucralfate on top of Pepcid AC. No washout is like double jeopardy for the GI tract... a dangerous thing! Best is to do the washout if a steroid is deemed necessary unless the risk of no washout outweighs the danger of loosing neuro functions. See if you can advocate for staying on the NSAID, thus requiring no need of 4-7 days washout and avoiding having no anti-inflammatory on board during washout days. Discuss trying first being more aggressive in pain meds: 1. Moving tramadol up to 50mg every 3 hours 2. Adding in a pain med to deal with muscle pain so often associated with a disc episode: methocarbamol 3. If necessary, a 3rd pain med could be added which vets find good success with hard to manage pain: gabapentin. So your vet still has many options to get pain under control without resorting to a dangerous switch with no washout. There are no safe medicines. It depends on a vet who practices safe use and an owner who has informed themselves of each med. I use this vet webpage to do my looking up and highly recommend it: www.marvistavet.com/html/pharmacy_center.html
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Post by lolalulu on Jul 23, 2013 5:49:03 GMT -7
Good morning Paula & Maureen--- my thoughts exactly regarding the switch !!! I was thinking the same thing. Will call the Vet today & discuss & let you know the outcome.
Update: spoke w/ Sandy at Sage Vet & gave her the info regarding the time frame from the NSAID & steroid , also regarding keeping her on the NSAID & adding additional meds for pain. She will get it to the Drs & have one of them call me. More to follow.....
I just got home about an hour ago, no call back from the Vet yet
Lulu was happy to see me but when i went to pick her up to take her out she yelped in pain a few times, i took her out but no results , brought her back inside and offered her a little warm chicken broth that i made for her, she did take a few sips. It's about an hour before she is due for Tramadol but I offered her the pill in peanut butter and she took it ! So i offered her some dog food with a little boiled chicken and she ate all of that and then took a few sips of water. She's in her crate whining now but i am ingnoring that so hopefully it will stop. I know she's in worse pain then she was in yesterday but I am not going to start her on the Predinsone yet, i feel as you do that it's too soon !! I would like to keep her on the NSAID and supplement with the pain meds that you recommended. I am Lulu's voice and if the vet doesn't call me back by 2pm I will be calling them again. I am starting to get a bit upset with this Vet practice. I am sure they are busy but i need their help in managing her pain and I'm not getting it. More to follow......
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Post by lolalulu on Jul 23, 2013 16:27:49 GMT -7
Ok- got a callback from Dr. Aikans w/ Sage Vet. He said that Carprofen has a life of about 8 hrs in the system & it'll be 36 hrs if I start her on the prednisone tonight @ 6pm like they want me to. She is on Pepcid to help protect her stomach. I have to trust that these Dr's know what they are doing & start her on the prednisone tonight, we have to bring the swelling on her spinal cord down. I'm going to trust their judgement & do it. Wish us luck & please continue your prayers for her. XooX
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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 23, 2013 17:55:31 GMT -7
Ask the Vets for Sulcralfate to protect her gi tract when making the switch, that would make it a safer bet
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Post by lolalulu on Jul 23, 2013 18:16:02 GMT -7
Will do Maureen....will go by tomorrow afternoon on my way home from work and get it for her. Thank you so much, she does seem to be doing better tonight regarding the pain (cross my fingers). It's funny cause she whines and whines in her crate, then when i take her outside, she'll lay in the cool grass and guess what !! no more whining.I know she is tired of being in there but i tell her she has to so she can get better. I wish there were some toys i could give her but i was reading to not give her anything she would have to pull on, or chew on that's hard. I don't know how to keep her a little busy in there...any suggestions?
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Post by Nancy & Polly on Jul 23, 2013 18:24:18 GMT -7
Unless she is having a cervical disc issue, a stuffed kong or something similar should be alright. With a cervical issue you don't want to have them move their neck unnecessarily. Smear a little bit of peanut butter inside the kong, add some low cal treats and/or banana, freeze it for awhile, and let her work on it.
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Post by lolalulu on Jul 23, 2013 20:08:46 GMT -7
She doesnt have a cervical issue, I do have a kong,she loves peanut butter and will do that right now!!! Thanks!!
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Post by jochs311 on Jul 23, 2013 20:10:10 GMT -7
Oh you can also use a no sodium broth and freeze it in a Kong. You will just have to cover the small side with plastic wrap to keep from leaking. Also peanut butter and bananas frozen in there is good too. There is so much you could freeze in a Kong.
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Post by lolalulu on Jul 23, 2013 21:53:43 GMT -7
Thanks for the great kong ideas !!! I have one in the freezer right now w/ a little peanut butter & banana & will pick up some no sodium broth tomorrow.
She is really panting a lot right now from the prednisone correct ? Will that lessen or will she be this way the whole time she's on it ? I do have a small crate water bowl & have also hung a water bottle off the side, she's never used one before though. Hopefully she'll figure it out.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 24, 2013 4:30:07 GMT -7
The panting is a temporary side effect, Lola. Having the water available that you've set up for her will help. You can set up a small fan near her crate, not directly on her, that will stir up the air a bit and will help cool her off.
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Post by lolalulu on Jul 24, 2013 7:47:30 GMT -7
Thanks Marjorie ! I have the overhead fan on as it has been pretty warm in our part of CA ! Update: this morning I took her out at 5:30 & the 1st thing she peed !! ( never thought I would be so happy about dog pee). Brought her in & made her breakfast, softened dry dog food, teaspoon of pumpkin, a little rice & chicken & the prednisone & Pepcid . She ate that right up so I slipped the Tramadol in a piece of cheese & she gulped that down. So we're all good with that this morning. Now just have to wait for a 'dog log' as Rob calls it ! I have noticed that if Tramadol 'dust ' gets on your fingers when trying to disguise it, she's able to smell that & won't take the disguised pill & I have to start all over smart girl !!
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Jul 24, 2013 9:06:38 GMT -7
Yes, dogs can be very smart about avoiding their medicine! If only they understood. I'm lucky with Jeremy. If it resembles food - or even if it doesn't - he'll eat it! And yes, it's crazy how excited we can get about pee and poop! Such is life with an IVDD dog.
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