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Post by Dorthia & Puppy on Aug 8, 2019 16:05:38 GMT -7
Yesterday, the vet said to keep her on prednisolone 5mg 2x a day, until I see marked improvement or at least 10 days. She gave me 60 pills.
She said once I see improvement [of what??] for 3 days straight, after it’s been at least 10 day, to start tapering Stella’s dose.
She said to do,the same thing during the tapering period. No more than 14 days, on each dose though. So we are looking at around 30 days to be off the prednisolone completely.
[Moderator's Note. Please do not edit 23 lbs Prednisone as of 7/8: 5mg 2x/day for 7 days, 7/14 test taper _pain _neuro as of 8/5: taper dose of 5mgs 1x/day due to 8/3 storm, worse wobbly walk prednisolone as of 8/8: 5mgs ▲2x/day for 10 days, 8/18 test taper _pain _ neuro famotidine 10mgs 2x/day ]
Metformin [decreases the amount of glucose absorbed from food and the amount of glucose made by the liver] was the bad meds , they are sold in little white round pills. I will never allow a human pharmacy to fill my pet prescriptions ever again.
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Aug 9, 2019 5:03:39 GMT -7
Dorthia, what did your vet mean by "marked improvement"? Did she mean improvement in walking or did she mean improvement in pain control? Either way, I'm concerned about this advice. Prednisolone does not heal nerve damage, only time and the self-healing ability of the body can do that. Sometimes nerve healing can be seen in a matter of weeks, but many times it can take months for improvement to be seen or sometimes there is no improvement at all. The purpose of Prednisolone is to work on getting the swelling pressing on the nerves of the spine down. It can take 7-30 days for that swelling to resolve. The only way to tell if the swelling is gone is to stop pain meds and start to taper off of the Pred. If pain returns, that would mean there is still swelling and the original anti-inflammatory dosage would need to start again. If no pain returns during the taper, then the swelling has resolved and meds are no longer needed. To keep a dog on an anti-inflammatory until improvement is seen is not something we see vets prescribe and is a dangerous practice. No one wants their dog on an anti-inflammatory for longer than is absolutely necessary. That is the reason for a test for pain after a short (7-10 day) course of anti-inflammatory (a tapering off of the anti-inflammatory and a stopping or tapering off of pain meds to see if there is still pain/swelling). More info on the inflammation stage of IVDD here: dodgerslist.com/literature/healingsweling.htmDo you see any sign of pain now that Stella is no longer on pain meds?
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Post by Dorthia & Puppy on Aug 9, 2019 14:00:41 GMT -7
She said that Stella should improve [what exactly??] on the prednisolone, in a few days. Stella seems like she is feeling great, off all the pain killers, and Stella is improving overall. She seems much better now, on only the famotidine & prednisolone. Stella is not acting like she is in any pain. The vet said, not to put Stella on any painkillers, unless she acts like she is uncomfortable. At day 10 we start the taper. She said if she looks uncomfortable, during the taper, we can resume for up to fourteen days all together, at 5mg if Pred 1x a day. I think my vet was just concerned , because she felt that Stella was taken off of prednisone too soon, and was given too conservative of a dose at 5mg 2x day, when she relapsed. I’ll go ahead and call the vet, because maybe I didn’t understand, I was terrified by the time I got Stella to the vet. The picture below was Stella this morning when I was encouraging her to get up and go to the bathroom, she looks so happy, and not like she is in any pain. It does take her awhile to get up, but she doesn’t,whine,Yelp, or seem uncomfortable.
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Post by Romy & Frankie on Aug 9, 2019 14:14:50 GMT -7
The picture of Stella is really cute. I am very happy to hear that she is improving.
What both prednisone and prednisolone do is work on the swelling of the spinal cord which causes the pain. If Stella is not taking any pain meds and is not in pain, the swelling is probably gone and the taper can begin. Of course if any pain emerged during the taper you would know immediately that there was still swelling and a need for Stella to go back to the full dose of prednisolone and pain meds if necessary.
Unfortunately, there are no meds that can heal the nerve damage that has already occurred. Time alone can heal the nerves. Leaving Stella on medication longer will not make the nerves heal more quickly.
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Post by Dorthia & Puppy on Aug 9, 2019 17:14:21 GMT -7
All of Stella’s blood work came back good, but her pancreas came back at 370, can this happen with prednisolone? The vet left me a voicemail and won’t be back in until Sunday. She said it was slightly high, how worried about this should I be ? Stella is already on metabolic support -low fat food.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 10, 2019 10:02:26 GMT -7
There is a reason why no one would want a dog on prednisone any longer than when the benefit has been reached. The benefit that prednisone gives is to get rid of all painful swelling around the spinal cord. Pred not does not help nerves to repair, that is something the body does on its own just like the body can mend a broken bone on its own. There is only one way to know when the prednisone benefit has been reached. It is the tapering of prednisone at the same time all pain meds have been stopped. So right now here is what you know -- Prednisolone can affect many body systems. When its benefit is needed, it is a godsend to get swelling resolved as protection to the spinal cord nerves. But taking when not needed just subjects a dog to the adverse side effects. Full article by the Mar Vista Vet is here: www.marvistavet.com/prednisone.pml -- "Exposure to steroid hormones have traditionally been thought to be involved as a potential cause of pancreatitis but this appears not to be true. Steroids are able to cause an increase in pancreatic lipase blood tests, though at this point diagnostic tests for pancreatitis have moved towards more specific assays. last updated: 1/4/2017 " Full article by the Mar Vista Vets is here: www.marvistavet.com/canine-pancreatitis.pml-- you have no way of knowing for sure if there is even a need to be on the anti-inflammatory dose of prednisolone. Sunday question for the vet: What harm would there be to begin a pred taper today while I'm home to monitor for revealed pain? Rule of thumb for pred taper: pain revealed = swelling still exists = immediately back up at anti-inflammatory pred dose +pain meds and Pepcid AC back on board
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Post by Dorthia & Puppy on Aug 11, 2019 19:18:42 GMT -7
Ok, We talked with the vet today, we start the prednisolone taper tomorrow [Aug 12]. Going down to 5mg 1x daily. [Moderator's Note. Please do not edit 23 lbs prednisone as of 7/8: 5mg 2x/day for 7 days, 7/14 test taper _pain _neuro as of 8/5: taper dose of 5mgs 1x/day due to 8/3 storm, worse wobbly walk prednisolone as of 8/8: 5mgs 2x/day for 3 days, 8/12 test taper _pain _ neuro famotidine 10mgs 2x/day ]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 12, 2019 7:58:34 GMT -7
Dorthia, glad you were able to state your cose and advocate for a test for pain taper. Got our fingers crossed no pain will reveal itself nor any step back in neuro diminshment so that the pred taper can continue on to conclusion.
For how many days will be be on pred taper dose of 5mgs 1x/day? What date does the every other day pred taper dose begin on?
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Post by Dorthia & Puppy on Aug 17, 2019 8:28:53 GMT -7
We are at 1x a day until Aug, 18th. Which is sunday. Stella has had slightly worse wobbly walking since taking her off of prednisolone 2x a day.
[Moderator's Note. Please do not edit 23 lbs Prednisone as of 7/8: 5mg 2x/day for 7 days, 7/14 test taper _pain _neuro as of 8/5: taper dose of 5mgs 1x/day due to 8/3 storm, worse wobbly walk prednisolone as of 8/8: 5mgs 2x/day for 3 days, 8/12 test taper √?_pain √?_ neuro famotidine 10mgs ▼1x/day]
Stella is old, and wasn't well cared for before I adopted her, so maybe this is joint pain or discomfort not related to IVDD. Stella has shown very mild discomfort since dropping to 1x a day prednisolone, mainly when first going to bed at night. I also dropped the famotidine down to 1x a day on Aug, 12th. Otherwise everything is running smoothly. I'm becoming concerned about what I will need once Stella graduates, from CR, and what that journey will be like; I want to get prepared ahead of time, as we only have 11 days left.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 17, 2019 9:36:54 GMT -7
Might be a good idea to continue Pepcid AC at every 12 hrs...as that is how long it lasts. Prednisone has a half life of 12-36 hrs in the body depending on a dog's metabolism. So every 12 to 36 hrs Pred decreases in the body by half. Have you alerted your vet to the sign of pain/discomfort and the slightly more wobbliness and get his take? Arthritic pain usually will ease up after a dog becomes active after a night of sleeping and not moving. So do discuss that you feel she is in discomfort at the end of the day before sleeping, too. On Aug 18 you are scheduled to start the every other day dose of prednisone? PLANNING for graduation day At graduation time you will want to have a plan to ease back into more normal activity. The idea is to gradually give more freedom under controlled conditions. Not free reign of the house and yard immediately! LOL Take a look at our information and then come up with a plan to gradually increase activity over about a month's time following the end of crate rest. Also check out how to teach four paws on the floor! www.dodgerslist.com/literature/AfterCrateRest.htmYou can get a jump start on cobbling together appropriate home modifications to reduce the stress on the spine in the future. No more stairs, ramps up to furniture, or blocking furniture all together. All those ideas and more are in this link: www.dodgerslist.com/literature/protectback.htm
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Post by Dorthia & Puppy on Aug 30, 2019 9:11:42 GMT -7
Happy graduation day for Stella. We actually got through 8wks of strict rest ! I feel that we still have a lot more work that needs to be done. We still have wobbly walking, some small set backs in walking slightly more wobbly and some toe knuckling, but Stella can fix and adjust her feet on her own, without too much effort. She is still showing some signs of discomfort( on no medications for about a week now) . She has not been 100% pain free, for long spans of time, without pain meds since her episodes started 3yrs. So where do we go from here ?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 30, 2019 9:44:30 GMT -7
Dorthia, congratulations for sticking to the 8 weeks to get that disc to heal. There are some dogs where the offending disc material did not yet absorb or shrink back enough to no longer painfully aggravate the nerves.
Discuss with your vet what pain med(s) or the smallest of a NSAID dose that would still work to provide pain relief. The NSAID Galliprant was developed to specifcally target the pain of arthritis. Same as people do, use a med to help them get back to enjoying life.
IF the pain is from arthritis, she may benefit from strengthening the muscles supporting an arthritic joint (facet joint in spine, knee joint) maintaining and improving active ROM of all joints, strengthening the core muscles, and maintaining or improving knuckling and balance.
Discuss if laser or acupuncture therapy might provide pain relief.
"[Glycosaminoglycans] neutraceuticals are not likely to be helpful for spinal arthritis as the joint composition of an intervertebral disc (the joint of the spine) is totally different from those of other bones... Remember, treatment for joint disease is likely to involve a combination of medications in addition to physical activity."Arthritis in Dogs. THE PET PHARMACY By Wendy C. Brooks, DVM, DipABVP, Educational Director, VeterinaryPartner.com
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Post by Julie & Perry on Aug 30, 2019 9:55:35 GMT -7
Dorthia, congratulations on Stella's graduation!! Woohoo!!
My Nala takes daily pain meds to stay comfortable. Not sure if it's repeated IVDD episodes or maybe combined with some arthritis. Some dogs do need continuing meds to be comfortable..
I'd work with Stella's vet and/or a neurologist to figure out why she's having pain and what meds will work for her.
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Post by Dorthia & Puppy on Aug 30, 2019 12:56:20 GMT -7
Should I seek out a dog physical therapist as well ? We are thinking about this place:
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Post by Dorthia & Puppy on Aug 30, 2019 13:04:03 GMT -7
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Post by Romy & Frankie on Aug 30, 2019 13:37:08 GMT -7
Acupuncture works well on pain for many dogs. Laser therapy also. Physical therapy is likely to help with Stella's pain. Are there any rehab centers near you that offer water therapy? This can help a dog learn to walk better. It also is good for dogs with arthritis.
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Post by Dorthia & Puppy on Aug 31, 2019 10:10:11 GMT -7
Should we start therapy with a physical therapist now ? Or wait a month ?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Aug 31, 2019 11:37:17 GMT -7
At graduation time you will want to have a plan to ease back into more normal activity at home. The underwater treadmill therapy, now, can begin at a clinic if that is in the budget— could help with painful arthritis and can help a dog relearn how to walk a normal gait after nerve damage from a disc episode. Take a look at our information and then come up with a plan to gradually increase activity over about a month's time following the end of crate rest. www.dodgerslist.com/literature/AfterCrateRest.htm On that page you'll see you can also do water therapy at home..good ideas on how to go about it.
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Post by Danielle & Otto on Sept 3, 2019 18:44:04 GMT -7
If you are closest to East San Diego county, try K9 aquatics for water therapy.
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Post by Dorthia & Puppy on Sept 14, 2019 22:31:17 GMT -7
Hi, wanted to let everyone know that Stella is doing well. She went to the groomer today. Stellas walking has improved a bit, as of late. We are setting up therapy sessions for her in California. I didn’t feel that she was quite ready, for therapy, at first and decided to continue crate resting her until she stopped acting like she was in pain. She seems to not be in any pain lately so that is good. We will update again when she starts therapy.
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Marjorie
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Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Sept 15, 2019 5:08:13 GMT -7
Great news that Stella's walking has improved and that she no longer seems to have pain, Dorthia. That's excellent. Be sure the rehab takes it nice and slow with the therapy and that they're aware that Stella has had extended crate rest. Stella's muscle strength and stamina will need to be very gradually built up. Too much too soon and it would be difficult to know if any pain is due to sore muscles or another disc problem. Here's our page again with a suggested schedule on how to slowly reintroduce movement after crate rest that will give you an idea of how slowly it needs to be done. www.dodgerslist.com/literature/AfterCrateRest.htmPlease do continue to keep us updated.
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Post by Dorthia & Puppy on Oct 14, 2019 12:31:14 GMT -7
Hi everyone, I just wanted to wish you all a happy Halloween 🎃 👻 and, to do a quick Stella update. After driving Stella back home from Arizona the physical therapist gave us a couple of sessions to teach us how to do therapy at home, for a bit. She still wasn’t strong enough for any physical therapy that we couldn’t do at home. Stella has improved and gotten stronger over time. She now takes herself out to go potty, enjoys playing, and sun bathing in the yard. Stella also still seems to be pain free, it’s truly amazing, she hasn’t been pain free in a long time. ( please excuse the mess, we are renovating) yahtzee rolls
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Oct 14, 2019 15:01:53 GMT -7
Dorthia, love to hear this kind of update!! Stella walking and going potty and best of all playing and enjoying life!!
Is she off all pain meds and pain free or taking a pain med to be pain free and active?
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Post by Dorthia & Puppy on Oct 14, 2019 18:15:16 GMT -7
She is on no medications at all and hasn’t been since we stopped the steroids and stomach protectant.
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Post by Dorthia & Puppy on Oct 15, 2019 8:56:45 GMT -7
Stella just made a puppy sandwich by pulling back the zipper and laying between the mattress and foam. 😂😄 I had to share it with you.
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Post by Julie & Perry on Oct 15, 2019 14:01:45 GMT -7
How adorable! And clever! I'm glad she's feeling so well.😀
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Post by Dorthia & Puppy on Oct 25, 2019 17:45:20 GMT -7
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Post by Julie & Perry on Oct 25, 2019 21:08:53 GMT -7
Stella looks awesome!! It's great she's doing so well.😀
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Oct 26, 2019 5:54:36 GMT -7
Look at beautiful Stella, all ready for Halloween! Enjoy!
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Post by Dorthia & Puppy on Dec 1, 2019 13:50:58 GMT -7
Hi everyone, Stella has been doing good. Today I noticed that Stella is a little less active and splooting. We are in the middle of a cold spell in SoCal right now, can that be a reason ?
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