Zach's Simon 7/26 conservative

Welcome!   Hi, my name is Paula, what's yours? Sorry to hear Simon's having another disc episode. With the mild symptoms you describe of wobbly walking he'll likely be a very good candidate for conservative treatment. Especially since you've taken it upon your self to start getting up to speed on IVDD.  100% STRICT crate rest 24/7 only out of recovery suite for a very, very few footsteps at potty time will be the single most important care in getting the disc to heal!

The centerpiece of "DISC disease" treatment is the healing of the disc via limited movement of the back via a recovery suite. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong disc scar tissue to form.
-- Super tried and true tips for setting up the recovery suite: www.dodgerslist.com/literature/CrateRRP.htm
-- PLUS further guidance on conservative treatment on our "All Things IVDD page: www.dodgerslist.com/literature/healingpage.htm www.dodgerslist.com/healingindex.htm

STRICT means:
- no laps - no couches  - no steps/ stairs
- no baths             - no sleeping with you
- no chiro therapy - no meandering at potty times.
- phoning in updates , med adjustments, etc. to vet where possible to avoid risky vehicle transports.

POTTY TIME
Carry your dog to and from the recovery suite to the potty place and then allow a very, very few limited footsteps.
     Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog's back aligned and butt from tipping over. A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot. An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on!



~~ During conservative treatment, anytime out of the recovery suite is a dangerous time for the healing disc. Movement of the back can increase a disc tear and escape of disc material into the spinal cord . For an animal with very mild neuro deficits, the risk of transporting to laser or acupuncture therapy has to be carefully weighed against what benefit is to be gained.   Proper pain meds would control pain fully.  Mild neuro diminshment is quite likely to self repair on its own.


NEURO DAMAGE
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/toes scuffing floor
4. ? Paws knuckle under
5. ? Weak/little leg movement, can't move up into a stand
6. Legs do not work at all (paralysis, dog is down)
7. Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors.
8. Tail wagging with joy is lost
9. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. If surgery is not an option (for whatever reason) then the best option is conservative therapy.

SWITCH to steroid
When vets choose to switch form the lessor non-steorid (NSAID) class to the more powerful steroid class, it is because they deem it an emergency to take quick action to prevent further severe neuro damage.  Could you tell us more about the switch:
---  What observation did the vet see to deem an emergency to quickly switch to a steroid when there is wobbly legs?
--- When there is an actually emergency of loss of leg, then vets switch without the normal safety of 5-7 days of washout by using two GI tract protectors.  If there is an emergency, then why is there a wait of a few days?  It takes 5-7 days for the previous med to clear the body.  Why is Pepcid AC and sulcralfate not being prescribed today so that prednisone can start today....again if this is an emergency sitatuion?  IF not  an emergency then why is  carprofen being switched to a steroid (pred)?

You will find excellent reading on how anti-inflammatory drugs like carprofen and steroids are used with a disc episode:  www.dodgerslist.com/literature/healingsweling.htm Knowledge puts you in position to have the best discussion with your vet and ask good questions.

Here is the link to Dodgers position on things like CBD oil and braces:  www.dodgerslist.com/literature/Supplements.htm

PAIN
Have no patience with pain, any pain!  Report pain so that the vet can adjust meds for full comfort.
any SIGNS OF PAIN ?
◻︎ shivering-trembling                 ◻︎ yelping when picked up or moved
◻︎ slow to move                          ◻︎ tight tense tummy
◻︎ arched back, ears pinned back ◻︎ head held high or nose to the ground.
◻︎ restless, can't find a comfortable position
◻︎ slow or reluctant to move much in crate such as shift positions
◻︎ difficulty getting into potty position due to pain
◻︎ not their normal perky interested in life selves

Often it does taking an aggressive approach with pain meds. That means every 8 hrs dosing AND a combo of pain med each working on a different  kind of pain:
-- tramadol as the general analgesic. It may work well at every 8 hrs when there is the proper  combo of pain meds on board.  Every 6 hrs is tough on the care giver's needed sleep. So you might  mention if tramadol every 8 hr with gabapentin and methocarbamol is an option.
-- gabapentin for nerve pain
-- methocarbamol for the pain of muscle contractions.

D/l med chart and print from here: www.dodgerslist.com/literature/crateRRP/medchart.pdf




When you have the new Rx's please do provide full information of ? mgs ?x/day for each med.  With carprofen stopped, it is expected there will be more pain and the need to counteract with aggressive pain meds use.

  

All anti-inflammatories cause excess stomach acid which can cause stomach damage. When a change from an NSAID to a steroid is made the risk of stomach damage becomes higher because the two types of medication are in the body at once. The 5-7 day washout is to ensure that the NSAID has totally left the body and therefore not producing excess acid before the steroid is started. I am not sure why the vet didn't suggest any stomach protection for Simon. Dodgerslist follows those vets who are proactive in protecting the stomach, choosing not to wait until signs of stomach damage appear.

All IVDD dogs should use stomach protection, especially those on an anti-inflammatory because excess stomach acid puts a dog at risk for stomach damage. Pepcid AC can help protect from stomach damage. Phrase the question to your vet this particular way:" Is there a medical/health reason for my dog not take Pepcid?" If the answer is "no reason" then go to the grocery store to purchase over the counter Pepcid AC containing one single active ingredient (famotidine).


canigivemydog.com/wp-content/uploads/2011/10/can-i-give-my-dog-pepcid-ac-300x300.jpg


For inside the crate you can try a 2 inch 4 lb density memory foam or an egg crate foam mattress to relieve pressure points. NOTE: protect the foam mattress by inserting in a large trash bag and duct taping closed. Tuck in/cover with synthetic fleece. www.foambymail.com Check Walmart, etc. for human memory foam bed topper can be cut down and stacked for several recovery suite locations.

We have some more information on setting up the crate here:
www.dodgerslist.com/literature/cratesupplies.htm

If you want to try a pack and play use rolled up blankets or towels to pad out any extra space to prevent too much movement. Dogs sometimes do better in a pack and play or ex-pen because it seems less restricting to them. Here is a picture of how you can set it up. This picture shows an ex-pen but a pack and play can be organized in the same way.
www.dodgerslist.com/literature/cratesupplies/cratesize.jpg

The whimpering/crying when picked up may be pain. I am listing the signs of pain again here for your easy reference; ☐shivering, trembling ☐yelping when picked up or moved ☐reluctant to move much in crate such as shift positions or slow to move ☐tight tense tummy ☐can’t find a comfortable position ☐Arched back ☐ Holding front or back leg flamingo style not wanting to bear weight ☐head held high or nose to the ground If he is showing any of these other signs pain is confirmed. In that case, let the vet know as soon as possible.

Dodgerslist just doesn't know enough about CBD oil to recommend for an IVDD disc episode. Not enough scientific research has been done on it to determine how effective it would be on pain/inflammation for dogs or as a sedative and what the optimal dose would be. We know what does work (pain meds, anti-inflammatory drug and Pepcid AC) and that's all we can recommend. Make sure your vet is aware of all medications and supplements you are giving. Herbs, supplements, potions can adversely interact with the necessary big gun medications your vet has prescribed for a disc episode.

I sometimes think crate rest is as hard on us as it is on our dogs. We know how necessary it is though.

Your Simon has just the beginnings of neuro defict from IVDD, wobbly walking. This means that he is a very good candidate for conservative treatment.