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Post by Kristi & Khaleesi on Jul 31, 2019 12:12:56 GMT -7
[Original Subject Khaleesi the Cardigan Corgi]Hi Folks, We are not yet sure what Khali's affliction is, but it sounds like IVDD/ herniated disc as I myself had back problems and surgery some years ago. A few days ago, Khaleesi, a beautiful brindle Cardigan Corgi (the kind with tail) wasn't feeling well & we took her to the local animal ER. She walked in just fine but walked out dragging her hind legs. We were frankly shocked. She is age 8.5, a former grand champion show girl, we got her at age 2 after her glory days from a wonderful breeder. She is currently on crate rest, 7 day round of prednisone (10 mg, tapering), and Gabapentin (100 mg, 3/day). She weighs 35 lbs and has been an active mountain-dog with us, hiking almost every day. We will see the vet at the animal hospital after one week, and we'd like an MRI to see about her spinal condition and prognosis. Thank you for all the information that we are reading and following here. [Moderator's Note. Please do not edit 35lbs prednisone 10mg tab as of 7/28: 15mgs 1x/day for 4 days, 8/1 test taper for _pain/ _neuro gabapentin 100mgs 3x/day no GI tract protector Pepcid AC on board! ]
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Post by Romy & Frankie on Jul 31, 2019 13:31:14 GMT -7
Welcome to Dodgerslist. We are so glad you’ve joined us all. We’ve got valuable information we’ve gleaned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you. I am sorry that Khali is having a disc episode. It is important to know that disc disease is not a death sentence! Struggling with quality of life questions for your dog? Re-think things: www.dodgerslist.com/index/SDUNCANquality.htmIs your name Kristi? I am Romy. It will help us work together with you and avoid offering ideas that could cause harm or lead the discussion in the wrong direction delaying help for your dog — please share a bit more detail with us: Is there currently pain? The signs of pain we look for are; ☐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 ☐Not their normal perky selves? Full pain relief is expected in 1 hour and stays that way dose to dose. If not in control your vet needs to know asap to adjust meds. What was the start date & dose of the pred ? Date of pred taper? All anti-inflammatories including pred cause excess stomach acid. This excess acid can lead to stomach damage. Pepcid AC can be used to help prevent this damage. Ask the vet if Khali has any health issues to prevent use of Pepcid AC (famotidine)? (doesn’t need it, we wait til there is problem…are NOT answers to your question!) If you get a “no health” issues answer, 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 The usual dose of Pepcid AC (famotidine) for dogs is 0.44mg per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory. www.1800petmeds.com/Famotidine-prod11171.htmlIs Khali showing any signs of GI Tract problems? —Eating and drinking OK? No nausea/not eating, no vomit? —Poops OK? Normal firmness & color -no dark black or bright red blood indicating bleeding ulcers? No diarrhea? What was the date you saw the vet for CONSERVATIVE treatment of meds and started crate rest? The hallmark component of conservative treatment is the very STRICT crate rest part (no PT, little movement). With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. Those weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form. www.dodgerslist.com/literature/CrateRRP.htmSTRICT means: ◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you ◼︎no chiro therapy whys: www.dodgerslist.com/literature/chiropractic.htm ◼︎no dragging or meandering at potty times. ◼︎no PT for conservative dogs during 8 weeks to heal disc ◼︎At home laser or acupuncture for severe neuro damage is best. Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment. Can Khali specifically sniff and squat and then release urine which is bladder control – OR- do you find wet bedding or leaks on you when lifted which are indication of an overflowing bladder and loss of bladder control? Overflowing bladders need to be expressed to avoid UTIs. Review video then get a hands-on-top-of-your-hands expressing lesson. www.dodgerslist.com/literature/Expressing.htmCarry to and from the recovery suite to the potty place and then allow a 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! www.dodgerslist.com/literature/slingwalk.jpg If Khali is too big to carry, (35 lbs might be too much), it is still important that the amount of movement to the potty place be minimized. Try a pee pad right outside the crate. Currently can Khali wobbly walk? move the legs at all? or wag the tail when you specifically do some happy talk? Did the ER doctor diagnose a herniated disc? Most disc episodes are diagnosed by a hands on exam, the breed often prone to disc disease and how the dog appears at the vet visit. An MRI is usually only done right before surgery so a surgeon knows where to operate or if another disease or condition besides IVDD is suspected. If surgery is not being considered, then an MRI is not really required. The conservative treatment of strict crate rest and medication treats all the discs at once so it is not necessary to know exactly where the problem is. MRIs require anesthesia and that can be dangerous for an IVDD dog as all core muscles of the spine would be relaxed and they can be injured if moved wrong or not handled carefully. This goes for any thing requiring anesthesia. Knowledge is the power to fight the IVDD enemy and win!! The very best thing you can do for YOU, the caregiver, and for your dog is to get up to speed on IVDD soonest possible. Begin absorbing the must-have overall sense of meds, care and how the treatment works. Your dog will be depending on your ability to learn - excellent video series here: www.dodgerslist.com/literature/theater.htm --PRINT OUT this link and tape to your fridge: www.dodgerslist.com/literature/healingpage.htm --use the printout as your roadmap to avoid dangerous detours in your dog’s care --make notes/highlight to keep yourself on track --follow all the links in the next days to become the IVDD savvy pet parent your dog needs. Use the “search box” to easily locate topics over at our Main www.Dodgerslist.com website. www.dodgerslist.com/index/searchBOX.jpgHealing thoughts for Khali.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Jul 31, 2019 19:19:27 GMT -7
Kristen, would you provide a bit more detail on the med list too when you answer Romy's questions. The info in pink is what we are not sure of. Thanks.
prednisone started on 7/??: 10mgs dose ?x/day for 7 days, then test taper for _pain/ _neuro gabapentin 100mgs 3x/day no GI tract protector Pepcid AC on board!
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Post by Kristi & Khaleesi on Jul 31, 2019 23:13:31 GMT -7
Hi Romy, thank you so much.
When we saw the Emergency Clinic vet on Sunday, July 28 Khaleesi was fine. We took her in because she seemed ill. She had literally no back IVDD distress except the vet said after examining her that she had back pain. There were no physical conditions manifest at that time. One foot started dragging while in the clinic. After I lifted her butt up (the first time ever), Khali walked properly to car. An hour later however the full gamut of rear paralysis hit her. So I would say that basically no vet has seen our corgi for her current condition.
On Sunday July 28 we started our corgi on the proscribed meds, as mentioned before: Gabapentin 100 mg, Give 1 - 2 capsules every 8 hours (3 times day). Vet Tech suggested trying one each time (rather than 2) as it causes drowsiness.
Prednisone 10 mg, Give 1.5 tablets once a day for 4 days, then give 1 tablet once a day for 4 days, then 1/2 tablet for once a day for 3 days, then 1/2 tablet every other day for 3 doses.
[Moderator's Note. Please do not edit 35lbs prednisone 10mg tab as of 7/28: 15mgs 1x/day for 4 days, 8/1 test taper for:/ _neuro gabapentin 100mgs 3x/day no GI tract protector Pepcid AC (famotidine) on board! ]
The vet said crate rest for 2 weeks. Since Sunday then, we have given these meds for 4 days (Sun - Wed).
By the time we got home Sunday afternoon, Khali had no function of her rear legs or tail. This was sudden and shocking. She doesn't walk. Her front legs are strong and functioning. She wants to scoot around on the floor but we have her caged or in a laundry basket.
Because she was walking and normal at the ER clinic, we got no instruction on what to do about her condition. We figured out ourselves how to express urine & poop, and she is going regularly. Khali pretty much holds it in until we get her 'in position' outside. This evening she lifted her tail when she was going to poop (small win??), and whined so I knew she had to go potty, and helped her do so. If we just put her on the ground she does not sniff and go.
We will get the Prilosec tomorrow for her. Khali is thirsty and hungry and eats and drinks normally. Her waste looks normal and no blood.
Her pain level has definitely decreased since Sunday, much less yelping and crying out when we pick her up.
Instead of our normal vet in a small town, because it was Sunday, our vet (luckily) sent us to one of Colorado's most well known animal hospitals. We are fortunate that she is at a major facility with all possibilities including surgery.
I contacted both Khali's breeders today (one is famous, the other not, but both raise champion cardigan corgis). They said they do not have IVDD in their lineages, and not in Khaleesi's litter from 8 years ago. These are the best of breeders. Who knows what happened to Khaleesi.
We are interested in surgery if Khaleesi is a good candidate (the top breeder encouraged us for surgery) and we would like to know her condition and prognosis. Have we waited too long (4 days) since the onset of her paralysis? I have an appointment with a general vet at this hospital on Monday August 5, but I could consult with a surgeon as well, maybe before then?
That's all the questions I remember you asking.
Thank you so much for sharing your deep knowledge with us.
Kristi
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Aug 1, 2019 4:27:12 GMT -7
Kristi, if you are in a financial position to go forward with surgery for Khaleesi, you should arrange for an emergency consult with a Board-certified neurologist ASAP, the sooner the better. Since you're not seeing a tail wag, Khaleesi may already have lost deep pain sensation. However, the fact that she let you know that she had to potty indicates that it is not yet lost, she may not be wagging her tail due to pain. After a dog is paralyzed, the existence of deep pain sensation is an indicator that surgery could STILL be successful. That window of time is 12-24 hours from losing deep pain sensation (DPS). Even after that window of time, surgery is often successful. The spinal cord is very fragile, the more hours after the window, the less chance of a complete recovery. www.dodgerslist.com/literature/healingsurgery.htmMuch less yelping and crying out is not good enough. There should be absolutely NO sign of pain. Pain hinders healing so have no patience with it. IF you're seeing any sign of pain at all, then it would NOT be time to taper off of the Prednisone. Pain means there is still swelling pressing on the nerves of the spine and still a need for the original anti-inflammatory dosage of the Prednisone for a bit longer. If you're still seeing any sign of pain, please immediately contact the hospital (anyone there can look up Khaleesi's records and advise) and speak to them about extending the original dosage of the Prednisone for a bit longer and ask that they adjust Khaleesi's pain meds. Tramadol can be added as a general pain med and Methocarbamol can be added for the pain of muscle spasms. What are you currently giving as a dosage of Gabapentin - 100 or 200 mg 3x/day? Prilosec is a stomach protector that takes 3-5 days to reach peak efficiency, then it is supposed to be very good in humans, possibly not so much for dogs. We do know that Pepcid AC (famotidine) does work quite effectively given every 12 hours. Khaleesi should be taking 10mg of Pepcid AC 30 mins. before the Prednisone and then every 12 hours thereafter for as long as she's on Prednisone (2x/day). PLEASE do not put Khaleesi in a laundry basket. That is not a safe, secure place for her. The basket could tip or she could try to get out of it. The safest place for Khaleesi is a crate or an ex-pen. Think of the crate as a cast for the spine. A full 8 weeks is necessary to heal a damaged disc, not 2 as you have been told.Khaleesi is a larger dog. Are you able to carry her outside to potty? Since she's isn't going on her own and you are expressing her bladder, it would be best to place a pee pad right outside of the crate and express her there. Are you getting a good stream or two of urine each time you express? Are you still finding wet bedding or does she leak on her when picked up? Expressing can take some practice. More information on expressing here: www.dodgerslist.com/literature/Expressing.htmIf you do not go ahead with surgery before your appointment with the general vet on August 5, please know that vets who understand the importance of strict crate rest will agree to phone status updates rather than bringing the dog in for an exam. Transport involves risk of too much movement of the spine. Please contact the hospital and have a phone consult on August 5 rather than an examination. It is most likely that Khaleesi had too much movement of the spine on July 21 and that is why her condition worsened after the exam. Only necessary visits to vets should be done and a status update does not require a visit. Healing prayers for Khaleesi.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 1, 2019 7:22:17 GMT -7
Kristi, the reason pain has never been resolved NOR kept under control dose to dose is the meds have never been right. So there is still a choice of conservative or seeking a consult about surgery. Keep in mind never take the word of a general DVM vet about deep pain sensation (DPS). It is too tricky to get right. Take only the word of a board certified neuro (ACVIM) or ortho (ACVS) about DPS. PAIN control Requires most typically the use of three (3) pain meds: tramadol, gabapentin and methocarbamol Rx'd for every 8 hrs. PREDNISONE It can take 7- 30 days to resolve painful inflammation EXCLUDING any taper days. A short 4 day course it not likely, then to have resolved pain. In fact pain was never in control. Thus there never should have been a taper on 7/25. Pain indicated another course of pred 15mgs 1x/day was needed. TODAY Your job today is to successfully lobby for another course of pred, proper combo of pain meds every 8 hrs and find out if Khaleesi has any health issues to prevent Pepcid AC. It is not fair for Khaleesi to be suffering when there are pain meds to keep her in comfort while Prednisone works on swelling. When an animal has lost leg function, that is deemed an emergency and the surgeon will likely take her today if you are intent on a surgery. Please know both treatments so you can have a good discussion and make decisions on which treatment to pursue. We support you with either decision. Here is the link to read now: Surgery vs. conservative information: www.dodgerslist.com/literature/healingsurgery.htm
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Post by Kristi & Khaleesi on Aug 1, 2019 9:55:56 GMT -7
Thank you so much for your extensive replies. We will get the Pepcid AC, thank you & speak to our clinic about continuing the steroid . Thank you again, we are working to figure out the best place to go with Khaleesi, it's probably 1.5 hours away at Colorado's highly regarded CSU Veterinary Hospital. Thank you again. I did read through the healing surgery section, extremely informative.
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Post by Kristi & Khaleesi on Aug 2, 2019 7:55:46 GMT -7
My Friends, Khaleesi is undergoing remarkable healing. Yesterday I took her to Colorado's renowned CSU Fort Collins Vet Hospital. They told me to come in to the ER & a neurologist would see her. While Khali was in the exam she stood up & walked! The vets said they had seen it before. Afterwards, she walked a bit outside the hospital in some grass, and later at home she actually ran a bit, like 8 ft. (we were quite surprised) before we stopped her.
We feel good that she is under the best vet care available in our area. Thanks to y'all, I felt informed in my discussions with the vets, and told them about Dodgerslist.
Following the exam, our protocol is to continue strict crate rest for 3+ weeks til we see the neurologist on August 26. Meds are re-prescribed by the neurologist:
Starting August 1, Khali's meds are: Prednisolone: 20mg tablets, 1/2 tab for 5 days; 1/4 tab for 5 days; 1/4 tab every 48hrs for 10days Gabapentin: 100mg capsules, 1 - 2 capsules every 8 - 12 hrs (and Pepcid AC) The neurologist wants her off the steroids when he next sees her on Aug.26.
This morning Aug. 2,Khaleesi rolled on her back, stretched out her legs, stood up to eat, and is doing well. We are committed to the conservative method and hope that with this strict protocol she will move forward so that she can avoid surgery. We are relieved to have the advice of the neurologist at CSU Fort Collins.
[Moderator's note: please do not modify 35 lbs Prednisolone as of 8/1: 10mg 1x/day for 5 days; 8/6 test for pain taper Gabapentin 100-200 mgs 3x/day Pepcid AC ? mgs 2x/day]
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Post by Romy & Frankie on Aug 2, 2019 13:32:34 GMT -7
Very good news about Khali. Standing to eat is is just great.
Is she showing any signs of pain? Sometimes when dogs are at the vet they try to hide signs of pain because they do not want to show weakness in a unfamiliar situation. Are you giving Khali the gabapentin every 8 or every 12 hours? If she is showing any signs of pain at home and you are giving the full dose of gabapentin every 8 hours, it may be that more than gabapentin is needed to control it. In that case, let the vet know as soon as you can so that the medications can be adjusted. That way Khali can heal in comfort.
Usually when the steroid taper begins, the pain masking meds (gabapentin) are backed off or stopped so that it will very quickly be obvious if all the swelling in the spinal cord is gone. If pain arises at this time, then you and the vet will know there is still inflammation in the spinal cord . Did the vet say he wanted to stop or back off the gabapentin when the taper starts?
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Post by Kristi & Khaleesi on Aug 5, 2019 14:02:37 GMT -7
Hi Romi & Frankie, I missed your message from 8/2, sorry. I try to give Khaleesi her pain [gabapentin] med every 8 hours, usually give her just one Gabapentin, and 2 if she yelps which might happen once a day at most. The vet did not suggest tapering the Gabapentin along with the steroid.
Khali continues to improve, now pooping on her own outside, and standing at eating and other wobbly-walking activities. We are containing her well.
Regarding the laser therapy, we'd like to start that as we've heard such beneficial results. Is that possible now? Do we buy a little home laser machine or unit from Amazon for under $200 or take her now to a laser therapy clinic? Is there a model you recommend or do not recommend? What do you advise, please?
Thanks again,
Kristi
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 5, 2019 17:38:28 GMT -7
Kristi, the prednisone taper is to test for pain. If Khaleesi is still on pain masking pain med gabapentin AND she is yelping once a day, it would not be time to begin the taper test tomorrow (8/6) to find out if she still has pain. Make sense? Have you alerted your vet to Khaleesi showing signs of pain (yelping) while still taking gabapentin 100 mgs 3x/day. Sounds like you need to be aggressive with the gabapentin by always giving 200 mgs for every dose and do that every 8 hrs. Resource to understand the using of prednisone with a disc episode www.dodgerslist.com/literature/healingsweling.htmRULE of THUMB with test for pain tapering Often when the anti-inflammatory predniosone begins the taper the pain meds ares stopped also. This is done to determine if the swelling in the spinal cord is gone. It is this swelling that causes the pain and neuro deficits. If the dog is still taking pain meds it will mask the pain that indicates the swelling is still there. If the anti-inflammatory and pain meds are both stopped and no pain surfaces the swelling is gone and only the remaining period of crate rest is needed. If pain returns when these meds are stopped, more time on all meds is needed.
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Post by Kristi & Khaleesi on Aug 8, 2019 21:24:19 GMT -7
We started Khaleesi on her taper of prednisone today, to 5 mg x 1 per day for 5 days. Other meds the same with increase of ▲gabapentin to 200 mgs as needed. Pain under control [with one pain med increased].
[Moderator's note: please do not modify 35 lbs Prednisolone as of 8/1: 10mg 1x/day for 8 days; 8/9 test for pain taper 8/9 increased pain meds during taper test! Gabapentin ▲200 mgs as needed Pepcid AC ? mgs 2x/day]
Khali controls her tail now, it wags a lot, and she lifts it regularly to potty. She has improved noticeably on her potty functions. She now poops and pees on her own, although with wobbly walking. She started the regular, self-pooping 3 days ago, and the peeing on her own yesterday. She sleeps a lot and is pretty good about being satisfied to be in her crate. She stands up to eat.
We feel a lot of progress has been made in the 9 days since the start of Khaleesi's sudden paralysis on Sunday July 31 and the start of her Conservative Treatment.
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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 4:40:41 GMT -7
Wonderful news that Khaleesi's pain is under control and that she's had so many improvements in neuro function in such a short time, Khaleesi! However, as Paula said in her previous post, with pain still being present necessitating an increase in Gabapentin, it is NOT time to taper off of the Prednisolone. Pain means there's still pressure on the nerves of the spine and still a need for the anti-inflammatory dosage of the Pred. Anything less than the anti-inflammatory dosage will not be effective on reducing swelling. It's that pressure on the spine that causes pain and can cause the nerves to be damaged. Khaleesi is doing so well, it would be such a shame for her neuro function to worsen at this point. Please do speak to the vet about keeping Khaleesi on the original dosage of the Prednisolone for a bit longer, maybe another 5-7 days. It can take 7-30 days for the swelling to resolve and until then, the anti-inflammatory dosage is needed. More info here: dodgerslist.com/literature/healingsweling.htmPlease let us know what the vet says after speaking to them this morning about extending the original dosage of the Pred for a bit longer.
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Post by Kristi & Khaleesi on Aug 9, 2019 10:33:16 GMT -7
OK, thank you Marjorie and Paula! Will do. Thank you so much for your support, knowledge and kindness (and kicks in the corgi-buttocks 😍🧡💜) Kristi & Khaleesi
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Post by Kristi & Khaleesi on Aug 10, 2019 17:13:39 GMT -7
Hello Friends, I touched base with the neurology folks to get their thoughts & they recommend continuing to taper the prednisolone as they initially directed, as long as she seems to be doing well.
"The steroid is typically used for the initial inflammation and a slow taper is usually recommended by neurologists who prescribe steroids for a suspected IVDD (and some don't recommend steroids at all). Of course if her condition worsens in any way before her neurology appointment, please bring her in have her re-evaluated through our urgent care service."
K & Kh
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 10, 2019 17:21:16 GMT -7
Kristi, but you reported here that she was not doing well, that she was in pain, pain med was increased. Why the pain?---- cause there is still swelling prednisone at the anti-inflammatory dose needs to attend to. Pred taper days are not dealing with the inflammation.
Did we misunderstand your report when you wrote she was yelping at least once a day? Was that why gabapentin, a pain med, was increased? Can you see why we find your report does not mesh with the action to adjust her meds. Maybe we have missed something...would you be able help explain these contradictions?
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Post by Kristi & Khaleesi on Aug 10, 2019 18:49:47 GMT -7
Yes, thank you and I apologize. This is one big mystery for us and we appreciate your help so much. Khali was yelping occasionally when we would lift her, up to August 1, when we visited the neurologist. The original vet tech on July 28 indicated that we should not give Khali the max of 2 gabapentin each dose because it would make her too sleepy. After the neurologist visit on Aug. 1, we boosted the gabapentin dose to 2 each time [?x/day], and have done so til yesterday [8/10 as per owner], when we started tapering the steroid to 5 mg each day (from 10 mg since July 28), and confirmed same with the neurologist. We can increase gabapentin any time if she yelps in pain again.
[Moderator's note: please do not modify 35 lbs Prednisone as of 7/28: 15mgs 1x/day for 4 days √ 8/1 pain Prednisolone as of 8/1: 10mg 1x/day for 9 days; 8/10 test taper _pain/ _neuro Gabapentin as of 8/10: backing off ▼100 mgs 3x/day Pepcid AC 10 mgs 2x/day]
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Aug 11, 2019 7:33:08 GMT -7
Kristi, can you clarify exactly what dosage of Gabapentin Khaleesi is now on? How many mgs and how many times a day given?
It's good to know that you can increase the Gabapentin to 200 mg (how many times a day?) should Khaleesi start yelping again. If she starts to show signs of pain again, it's also very important that you immediately alert the vet of the sign(s) of pain she's showing so she can immediately be brought back up to the original dosage of Pred (10 mg). I know we've said that a few times but I just want to make sure you have a good understanding of the inflammation phase of IVDD. Pain = swelling = more time on the original dosages of all meds.
Did the vet tell you for how many days you're to give this course of meds for?
Please continue to give the Pepcid AC 2x/day for as long as Khaleesi is on any dosage of Pred.
Prayers for a pain-free taper off of all meds.
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Post by Kristi & Khaleesi on Aug 11, 2019 8:31:20 GMT -7
Dear Friends, Thank you for caring. We have been on this journey with Khali for 2 weeks now. She has always been on Gabapentin every 8 hrs (or 3 x day), dosage of 100 mg to 200 mg. Per your all's advice she is on Pepcid Ac 2x/day.
Khali's taper of prednisone started on 8/10, 5 mg x 1 per day for 5 days; followed by 5mg every 48 hrs for 10 days.
By the time the neurologist sees Khaleesi on 8/29, they want her to be off steroids for close to a week.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 11, 2019 9:07:11 GMT -7
Kristi how many mgs of gabapentin are you actually giving: 100mgs or 200 mgs every 8 hrs?
How many mgs of Pepcid AC do you give twice a day?
You can give the clarity we need by providing specifics. --Avoid using terms like yesterday, last week-- instead give the date --Nice you give the range of a med. However, for clarity, please give the exact mgs and frequency you actually give meds.
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Post by Kristi & Khaleesi on Aug 11, 2019 11:04:43 GMT -7
1) we are giving Khaleesi 100mgs of gabapentin 3 x day
2) original, pink tabs, Pepcid Ac 10 mg x 2/ day
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 11, 2019 11:11:24 GMT -7
When will be the next reduction of gabapenin (backing off of pain meds) as the test for pain pred taper continues? Reduced by the mgs or reduced by times per day
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Post by Kristi & Khaleesi on Aug 13, 2019 16:29:48 GMT -7
Hi, Thanks for your question & support. I'm waiting to hear back from the neurologist about reducing the gabapenin/ pain med. Now we are at 2 x 100 mg ▼gabapenin / day. She is showing no signs of pain. the downside is Khali is more active and excited, which is not so good for crate rest as when she was knocked out with the higher dose.
[Moderator's note: please do not modify 35 lbs Prednisone as of 7/28: 15mgs 1x/day for 4 days √ 8/1 pain Prednisolone as of 8/1: 10mg 1x/day for 9 days; 8/10 test taper _pain/ _neuro Gabapentin as of 8/10: 100 mgs ▼2x/day Pepcid AC 10 mgs 2x/day]
Overall, what do you folks advise for the pain meds and to keep dogs low key for crate rest.
Thanks K & Kh
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Aug 13, 2019 20:09:42 GMT -7
Help Khaleesi be able to relax in her recovery suite. Using any oral calmer in combination with a Pheromone diffuser seems to work best. It takes several days for these to start working - it isn't immediate but they are a much better option if you can avoid heavy duty prescription sedatives (ACE, alprazolam or trazodone). Of course always keep your vet in the loop on all things you give your dog. Place a DAP pheromone diffusor at floor level where the recovery suite is: --DOG Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/Use diffusor with one oral calmer from below: Oral calmers: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed www.virbacvet.com/products/detail/anxitane-l-theanine-chewable-tablets/behavioral-health 2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. www.vetriscience.com/composure-soft-dogs-MD-LD.php
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Post by Kristi & Khaleesi on Aug 15, 2019 19:17:53 GMT -7
Hi Friends When do you think is time to go to a vet rehab clinic for Khaleesi, the laser therapy, maybe water therapy, hyperbaric chamber, massage, those types of therapies? Thanks for advice. Kh & K
Thank you for these herbal-type relaxing recommendations. The vet did reply for us to continue with the gabapentin 2 x/ day @ 100 mg; and that Khaleesi could start laser therapy.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
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Post by Marjorie on Aug 16, 2019 4:19:38 GMT -7
Once the 8 weeks of strict crate rest have been completed and movement has been very gradually reintroduced for a couple of weeks following that, then rehab can be done. You'll want to take it slowly after graduating from 8 weeks of strict crate rest. If Khaleesi were too move too much too soon and have pain, it would be difficult to determine whether the pain is from sore muscles or another disc problem.
Khaleesi is wobbly walking and most times, walking is the best therapy for a dog that can wobbly walk. So you may not need additional therapy. You'll be better able to assess her status once crate rest has finished and movement has gradually been reintroduced.
The only therapy that you mentioned above that could be started now is laser therapy if you can find someone to come to your home to give it. Transport during strict crate rest is risky and can cause too much movement of the spine. The benefits of laser therapy must be weighed against the risks of transport. At this point, you're already doing the most important treatment for Khaleesi - the 8 weeks of strict crate rest.
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Post by Kristi & Khaleesi on Aug 16, 2019 13:18:10 GMT -7
Alright, thank you Marjorie, that's what I was thinking too. Do you recommend any laser therapy unit that I could buy on-line and administer myself? I live in the mountains and having difficulty finding someone to come to our house for laser therapy. Thanks again, K & Kh
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Post by Romy & Frankie on Aug 16, 2019 14:11:51 GMT -7
I know that some of our members have purchased laser units and used them at home. Perhaps they will chime in with their experiences.
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Post by Kristi & Khaleesi on Sept 17, 2019 16:15:14 GMT -7
Here is our update on Khaleesi, who went paralyzed on her hind end on July 28, about 7 weeks ago. She sees a board certified vet neurologist. They have not wanted to do surgery and want her to heal without surgery. They tapered Khali off all meds one month into her disease. We most recently visited her vet neurologist on August 29 & have another appointment, at the 8 week mark, next week.
On Aug. 29, one month in, the vet was very pleased with Khaleesi's progress. First, she was in absolutely no pain and she was walking fairly well. They determined her disc issue happened along the spine just below where her ribs connect to spine. They hope she heals without surgery. On Aug. 29, her potty breaks were good, and still keep improving. At first she had very limited control of peeing, then she would not be able to squat for long, and sort of peed & pooped while she wobbled in the back yard. Now, at 7 weeks, Khaleesi does perfect with her potty. She does seem to have an upset stomach the past 10 days and I can't figure where that comes from, a bit of diarrhea twice, which is unusual. She's on no meds.
The vet neurologist did not want Khaleesi on any supplements or meds, so she's been off everything since Aug. 29. I had purchased the above advised supplements for discs on Amazon, and brought them to vet for them to see. They said no, we don't know for sure what is in them and how they will interact with dog. Better for her not to take any supplements. Supplements don't help nerves. I returned both supplements to Amazon at full refund.
The neurologist definitely wanted to continue strict crate rest for Khali til next appointment of Sept.26. They said car travel OK as long as not bumpy, and stroller rides OK for Khali too.
We've definitely made some mistakes, after so much restrained crate time, Khali has gotten tricky. Once she snuck out of her crate & went all the way down the carpeted basement steps, to our great shock. Another time, she snuck out of backyard and went for a 5 minute frolic with 2 neighboring dogs while I frantically searched the yard & house. She's jumped off a small chair at least 3 times. Our goal is to be perfect with her strict crate rest however we now realize that 'sh*t' is going to happen, and do our very best.
Per above, we've tried 3 calming supplements, including Tramadol from the vet. Khali does not do well or calm down for crate rest using any of these, including a CBD supplement for dogs. Our main method is to give her peanut-butter-filled dog bones only when Khaleesi is in her crate. Sometimes she paws to get in & stay in her crate because the favorite bone is in only there.
We believe that Khali will come back strong - to her former self. She was very strong and athletic prior to the sudden paralysis, walked miles a day every week in the Colorado mountains. She's lost 4 lbs during crate rest which is good, may however be loss of muscle mass, but we've also tried to feed her less. Her back right leg is her weakest part right now. She walks well, even on our wood floors. We use a ramp for Khaleesi to travel the few stairs in the backyard. We plan to purchase a few ramps next week when her 8 weeks crate rest is up, to use for her small chair and for our bed. The vet neurologist did not want Khali to do any sort of therapy until they see her at the 8 week mark.
Any questions or concerns? Thanks for caring & sharing 💜💜🧡🧡💚💚🌺🌷
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
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Post by PaulaM on Sept 17, 2019 18:19:19 GMT -7
Kristi, the point with conservative treatment is all about getting the disc to heal. It appears despite the escapes she did not further damage the disc and cause a setback. By Sep 25, the disc will have had time to heal. A gradual introduction back to family activity would then begin over the course of a month. Your neuro will likely give you the slow progression of back to family life. The idea is not to have a dog having overdone things. Then you are not sure if pain is disc related (new or same disc) or just sore muscles. She is off all meds and there is no observation of pain...so all the painful inflammation is resolved. Any diminishment in nerve function you mention about one leg is weaker, will very likely self repair with time. There are no meds, no supplements to help nerves heal. That is something the body self repairs with time. It may be there is no need for any formal therapy unless that is your desire and as an exercise program thing. Likely just walking and time will allow the nerves to better connect with the muscles in coordination..kinda like a stroke victim having to learn the art of walking again. With gradual introduction to walking, her muscles will also get stronger. Since you now know that Khaleesi was born with disc disease (it usually shows up if a dog were to be born with it at 2-7 years old but can be earlier or later) you will want to make sure she is not involved in any activities of jumping, competing, etc. Check out this "After Crate Rest, Then What?" artcle on back friendly activities and lots of good information living with an IVDD dog: www.dodgerslist.com/literature/AfterCrateRest.htmKeep us posted on what the neuro says at your appt next week. Would you consider helping another trying to find an IVDD knowledgeable vet (your neuro) to help during conservative treatment by adding to our directory at this link: dodgerslist.boards.net/board/10/guidelines-posting vet recommendations: Name of Vet Name of Clinic Street Address City: State or country: Type of vet (general/board certified surgeon, acupuncture, etc.) Comments:
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