Kelsey's Brownie 7/28 Conservative

Hi, my name is Maureen, what's yours? Welcome to Dodger's List, I am glad that you found us. It its very important that you get Brownie confined to a crate ASAP, you should NOT be walking her.
100% STRICT crate rest 24/7 only out to potty for a full 8 weeks is the SINGLE most important thing you can do to help Browne-- it is the hallmark component of conservative treatment. …. 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.
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. 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. Immediate neuro improvement may or may not come during the 8 weeks of crate rest… as nerves may take more than 8 weeks to heal.

Can you give us the following information, so that we can better assist you?

-- How much does Brownie weigh?

-- Is there still currently pain - shivering, trembling, yelping when picked up or moved, reluctant/slow to move head or body, tight hard tummy? It sounds like there is still pain present from your first post, and pain needs to be controlled for healing to really take place. www.dodgerslist.com/literature/healingpain.htm

-- What are the exact names of meds currently given, their doses in mgs and frequencies?

Here is a good place to start reading www.dodgerslist.com/healingindex.htm

Here is some information on how to lift and carry her out to potty

I know that this can seem so incredibly overwhelming. We are all here for you and will do anything that we can to help. You are not alone anymore!!
Keeping you in thought and prayer.

Kelsey, you likely have a dangerous situation developing with the red flag sign of diarrhea.

Please get with the vet asap, now and ask this question in this manner: 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 and thereafter every 12 hours.  

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. We ask that all members read about each med their dog is on or may take as a safety measure. This directory is in alpha order and is my go to place for my own dog's meds:
www.marvistavet.com/html/pharmacy_center.htm

Also ask for a 2nd stomach protector that works in a different way to bandaid the damaged mucus lining and also promotes a healing environment. Sucralfate will require timing with other meds…so do your homework so you can discuss things with the vet: www.marvistavet.com/html/sucralfate.html

Next to deal with is the pain, the pain should be covered when the med combo is just right for Brownie's body, dose to doses. There is no one size fits all deal with pain meds, every dog is individual. So it takes feedback to the vet for him to know further tweaking is in order.

Is the .5mg Buprenorphine delivered orally, a shot or an applied gel to ear flap?   Buprenorphine is likely to be an ineffective pain reliever when swallowed. www.vasg.org/chronic_pain_management.htm   You might discuss gabapentin as that is a med also often used with success by vets to disc related pain as it works synergistically with Tramadol and is safe to use with metacam and methocarbamol.  Let us know what adjustments your vet makes.

Med names can be such a bear! Here is list of NSAIDs of which Metacam is one: www.dodgerslist.com/literature/healingsweling.htm This page gives the adverse signs to be aware of when using any anti-inflammatory. Including the red flag one of Diarrhea. Vets do not always have time in the short visit to go over all details…this is why we do have to do reading on our own. Have you started here at the index to all the phases of healing: www.dodgerslist.com/healingindex.htm

Do not delay, get help for her stomach lining asap today with both pepcid AC, the generic active ingredient is famotidine) and get an Rx for sucralfate. Brownie does not need another problem on top of dealing with a disc episode. My advice is to get on the phone with the vet now. Tell him of the diarrhea and advocate strongly for sucralfate and ask about pepcid AC (famotidine) in the manner I suggested. Obviously your vet is not a proactive vet in stomach protection and now Brownie is likely suffering with damage to her GI tract.

May I ask if you are a minor living at home just to know how much authority you have to advocate on Brownie's behalf.

Brownie has a good chance to recover with conservative treatment with your good care. Hang in there, just got to get through these current challenges:
1. stomach protection
2. pain control if you believe pain is not fully controlling dose to dose with current pain meds. There should not be any shivering/trembling, yelps, etc nearing the next dose of meds nor after moving. Let us know your current observations. Wobbly walking is nerve damage. Let us know if you see her body tembling with pain.

Yes, both stomach protectors…they work in different ways to protect and aid in damage control that Metacam has done evidenced by diarahea, a BIG red flag.

You are amazing for an 18 year old in your contribution to Brownie's healing… my hat is off to you, girl!!! Keep on keeping what you are doing, read all you can about your dog's disease. We all, even us old folks, have had to learn, because not all vets can know every disease in detail…but we can know just one. We need to recognize when harmful advise is given and say "no thank you"

As Dr. Nancy Kay, DVM, ACVIM says:
"Gone are the days when you simply followed your vet's orders and asked few, if any questions. The vet is now a member of your dog's health-care team, and you get to be the team captain!" www.speakingforspot.com/PDF/Medical%20Advocacy%20101.pdf

Once pain is fully under control, dogs will be their usual perky selves, interestest in life. So if her legs trembly and she is not herself, that is pain…and something to tell you observations to the vet… it is how we advocate for our dogs who can't speak up for themselves.

Let us know what the vet says.

Yes, her GI track is a mess with diarrhea, you know it makes you feel pretty crummy when your GI tract is not right. Can your mom join us here on the Forum so they will get as educated as you are doing?

We await hearing what the vet says.

Kelsie,

Did the Vet prescribe the Sucralfate and say Pepcid AC is ok for Brownie to take?  Taking him off the Metacam is not enough to heal his stomach. He needs Pepcid AC and Sucralfate to do that.  Plus taking Brownie off Metacam, the anti inflammatory, leaves him without anything to deal with the swelling in his spine which is a necessity in order for the disc to heal. Once the swelling is gone, so is the pain.. That is the goal, as well as healing his stomach with the Pepcid AC and Sucralfate while Metacam continues to do what it is meant to do..  I have this feeling this Vet is not comfortable treating IVDD..  Here is some info that teaches what to look for in a Vet that specializes in IVDD.   www.dodgerslist.com/literature/VetchkList.htm

You are awesome taking such good care of Brownie at 14 years old. I really admire you.. and I think you have it in you to be a wonderful advocate for him.. It would be wonderful if your parents could join us here too. 

Sending comforting and healing thoughts to you and Brownie..

My mom has been so busy lately. I've told her all about what you have said, but she is still following the vets orders. And the vet we go to is a back specialist and a pet neurosurgeon. He would do surgery on her if we were to go that route.

Brownie is improving. Her diarrhea is basically gone, her poop is just soft. She does NOT cry as much anymore, so I was right about her stomach hurting her. I think her back is doin okay. I go to the vet again on Monday for a one week checkup.
She has not been as hungry lately, which is weird because she eats like a hippo. I think it's a side effect of one of the medicines? She is still off Metacam.
My sister slept on the floor with her last night, which was a treat! I haven't slept in my bed since Saturday! She told me Brownie did okay during the night but went out to potty at about 3am.
Overall, Brownie seems comfortable and I think her pain medicine is working well. She has been pretty quite and sleepy, which I guess is good!  

Okay. I have no idea what any of these letters mean but: BVSc, MS, ACVS, DACVS
I also am giving Brownie water through a syrringe because she doesnt want to drink. She is doing the same.

Brownie does fine with a syringe, she just wont drink on her own. (She is still physically able though). We have tried chicken broth but she showed no interest.
Yeah the vet is a surgeon and back specialist. The day we came in he had just finished back surgery on this dog. It was his fourth time.
I am not currently with Brownie now, but my dad told me she is resting well.

**it was that dogs fourth time not the surgeon!!!

Im in the US. That is one of the things beside his name. Maybe he used to work in another country? Not sure.

Kelsey would you describe Brownie's cries more of letting you know she needed to get readjusted, maybe wants your attention? Or are they yelps or cries that it is painful to move?  Tell us more about the circumstances when she cries.  She should not be crying when moving or getting up…that is pain cause by moving.  Healing really can't get underway til pain is fully under control dose to dose of the pain meds. Is she still on the same meds as you reported:
Right now if she is out of pain, the most important thing you can be doing is the 100% STRICT crate rest 24/7 only out at potty times to protect her early healing disc.  If your observations are that she is still suffering with pain, the vet needs to be given a phone call so the vet knows he needs to tweak/adjust the pain meds a bit more.   Let us know what you think is going on regarding pain.

Most dogs need some 16-18 hours of sleep per day, people sleep 8-9 hours day. What are they doing in the crate? Laying around and sleeping! Don't give into the temptation to start a treat routine to combat non-existent boredom. Adding a bunch of treats as entertainment contributes to weight gain which isn't a good thing.

Peanut butter is pretty high in calories and probably not a good idea for couch-potatoe Brownie right now. If she is not rambunctious in chewing, not a lot of pulling and tugging and back movement with the bone, it may be alright.

I use peanut butter sparingly as a "mortar" when I fill Polly's kong with kibble, strips of carrot, chunks of banana, and other low cal treats.

Hi Kelsey my name is Jen. Brownie needs to be on crate rest right now. Even if she seems good to go the disk needs time to heal. Things could get worse if she continues to be active. You really need to stress this to your Dad as much as you can. I hope he can understand. Healing thoughts and prayers sent your way. Good luck.