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Post by Julie & Harley on Feb 26, 2020 7:25:04 GMT -7
[Original subject line: New to this, Harley just started this issue yesterday ]
☆ Yes he yelps when you try to move him. In his crate he seems to rest contently in his crate He’s constipated, so don’t want to give pain meds
☆ 2 14lbs He just started prednisone, 5mg 2x/day
[Moderator's Note. Please do not edit
14lbs
prednisone as of 2/25: 5mgs 2x/day for 8 days, then 3/4 test taper for _pain/_neuro
no pain meds on board with a dog in pain
needs GI tract protector, Pepcid AC, on board w/prednisone! ]
☆ 3 -- Not drinking. I’m giving him some every couple hours with a syringe No nausea/not eating, no vomit? No
☆ 4 What breed? ShihTzu What is your dog’s name? HarleyYour name, too? Julie
☆ 5 The X-ray was suspect and he is dragging his foot, which led the vet to say back issues
-- Is the vet ? DVM
☆ 6 What was the date you saw the vet 2/25/20
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Feb 26, 2020 8:46:46 GMT -7
Julie, welcome to the Forum. We are glad you are here. You can deal with constipation on your own (see below). What you need help with is prompt attention to prescriptions of pain meds the very soonest today or first thing in the a.m. Harley is suffering with pain needlessly and that pain is hindering the healing process. Call in to your vet and report what you are observing and very strongly advocate for pain meds to be on board asap, now, today. Pred could take anywhere from 7-30 days to resolve the painful state. NO WAY should Harley be subjected to having to deal with pain. Advocate that any of the pain meds be given 3x/day (every 8 hours) for round the clock, dose to dose full relief from pain. A disc episode has several different kinds of pain. Each kind of pain needs the match in a pain meds. Often all three kinds of pain accompany a disc episode: —Methocarbamol works on the pain of muscle spasms. — Tramadol is the general pain reliever. — Gabapentin works on nerve pain. Have no patience with pain as it does hinder healing. Look for your dog to be acting their normal, perky self when pain is fully under control round the clock.
STOMACH PROTECTION is a MUST
Proactive vets don’t wait til there is lip licking of nausea, not eating, vomit, diarrhea leading to serious bleeding ulcers, red or black blood in stool due to the extra stomach acids anti-inflammatory drugs cause. Pepcid AC (famotidine) blocks the production of acid. The usual dose of Pepcid AC (famotidine) with a disc episode is 0.44mg mg per pound every 12 hours. Pepcid AC has a very limited potential for side effects. Ask if your dog 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).
HEALTH ISSUES: “Mar Vista Vet reports: Pepcid AC has a very limited potential for side effects, the reason of release to over-the-counter status. The dose of famotidine may require reduction in patients with liver or kidney disease as these diseases tend to prolong drug activities. There have been some reports of exacerbating heart rhythm problems in patients who already have heart rhythm problems so it may be prudent to choose another means of stomach acid control in heart patients.” marvistavet.com/famotidine.pml Constipation
Plain pureed canned pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation. NOTE: alternatives are really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potatoe. -- To loosen the stool, add equal parts water to each kibble meal and soak overnight. At mealtime add one teaspoon of plain canned pureed pumpkin 1x a day. -- To firm up the stool add 1 teaspoon plain canned pureed pumpkin 1x a day to kibble. QUESTION
For how many days is the Pred Rx before a reduction starts (taper dose starts)? |
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Post by Julie & Harley on Mar 6, 2020 8:40:28 GMT -7
I couldn’t figure out how to find this again. Sorry it took so long. Harley is feeling much better! He is in his crate all the time except for the bathroom and seems content as long as I have him where I am. He dropped down to one 5 mg prednisone on Tuesday. He goes to 1/2 next Tuesday. I’m feeding him pumpkin, yogurt, part of his usual kibble and extra chicken for extra protein.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Mar 6, 2020 13:08:26 GMT -7
Julie, glad to hear Harley is doing well on the test for pain prednisone taper. What date did the pred taper begin?
His usual kibble is a diet balanced in minerals to protein. You can feed some chicken but not that much or the balance of the kibble can be adversely affected. Here is just one example of the many wondrously intricate ways of the body and why a balanced diet. Eating excess protein, means the body would need calcium from other sources in order to process the excess protein. The heart relies on calcium in the blood to beat. If not enough calcium in the blood stream, then the body will need to take calcium from bones. Over feeding meats, can unbalance the kibble food's balanced formula. Try not to feed more than 10% extra chicken meat (protein). For example, if his normal portion is 1/3 of a cup kibble (which equals 5 tablespoons = 15 teaspoons) then you should only supplement with a max 1.5 to 2 teaspoons of chicken on top. the math: 15 tsp x .10 = 1.5 tsp
Harley's body is taking on alot of repair jobs and needs the calories and all that comes with his balanced normal portions. After crate rest is over then if needed you can begin a slight reduction of kibble coupled with then safe and allowed more physical activity. Weight should come off in a matter of several months with a slight reduction in kibble.Bookmark a thread to receive an email alert when someone has replied1. Go to your Profile> Profile Edit > Notifications: checkmark BOOKMARKS + "instant" email2. Next, go to the CONSERVATIVE Board: checkmark Harley's thread, then use the ACTIONS button to select "bookmark"**  |
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Post by Julie & Harley on Mar 10, 2020 5:44:34 GMT -7
Harley is feeling wonderful!!! Getting very bored of crate. I’ve done some measures to help with this. He goes to the vet today and starts his prednisone taper tomorrow. He’s acts so lively when we go out for potty. It’s hard to keep him to a few steps 😀
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Post by Judy & Vesper on Mar 10, 2020 6:31:45 GMT -7
Hi there Julie, it's normal for them to feel happy and energetic when they start feeling better. However, this is the time when you need to be strict. Please make sure he has a harness on when going to potty, to limit his excitement and not to stop his crate rest too early. You don't want the process to start again. I find putting on the childrens channel on tv helps.
So glad he is so much better.
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Mar 10, 2020 6:38:28 GMT -7
Julie, so glad to hear that Harley is doing well. What is the purpose of today's vet visit? Vets who understand the importance of strict crate rest also understand that there is a risk of too much movement of the spine when transporting to and from a vet's office. Most vets will agree to obtaining status updates by phone rather than an office visit. Please speak to your vet about a phone update rather than an office visit today.Please clarify the Prednisone taper for us. On March 6th, you said that the Prednisone had tapered down to 5mg 1x/day on Tuesday (March 3rd). 5mg 1x/day is a taper dose so the taper actually started on March 3rd, correct? with a second taper starting tomorrow? Do keep a close eye out for any sign of pain returning during the taper of the Prednisone and if you see any sign of pain, do contact your vet ASAP. Pain means there is still swelling pressing on the nerves of the spine and still a need for the original dosage of Prednisone for a bit longer. When a dog starts to feel better, it can be difficult to keep them from moving too much at potty time. Do be vigilant about keeping his steps to a very, very few at potty time and continue to carry him in and out to potty. You can use a 6' leash and stand in one spot to limit his steps. You also could make a 6' potty area using push-in-the-ground plastic fencing or an ex-pen. i.ibb.co/K7HNj10/slingwalk.jpgWhat measures are you taking to help with Harley's boredom in the crate? Prayers for a pain-free taper off of the Prednisone. |
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Post by Julie & Harley on Mar 10, 2020 7:41:28 GMT -7
Thanks!!! I didn’t think of the tv. I move his crate to different spots depending on time of day. Windows not in direct sun. The kitchen when cooking, etc. also got him some new toys and put his kibble in a kong. His prednisone taper started on March 4th he started on 5mg, 2xdaily then March 4th went to 5mg/day and March 11th goes to 2.5mg daily for a week.
I am using a harness when we go out. I’ll call vet. They are not sold on the 8 weeks of crate rest. One of my friends had two paralyzed pups, which is how I heard of you. I was going to discuss further today. I’ll call them. Not sure what they would do anyway.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,541
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Post by PaulaM on Mar 10, 2020 9:31:21 GMT -7
Julie, do you mean that Prednisone 5mgs TWICE a day started on Feb 25 when he first when to the vet for the disc episode. THEN on March 4 the taper began by going to 5mgs ONCE a day?
Crate rest does not cost anything, You need no prescription to carry out crate rest.
There is an abundance of information written about the post-op dog and not so much for the conservatively treated one. This is a shame because today's medical community likes to practice with evidenced based data. Because there are no trials or studies to follow for conservative treatment, a vet must go on their schooling, what they have personally experienced and opinion of colleagues. It is really a guess how many weeks are needed. So the question is what is a good compromise in crate rest time to let a slow-to-heal disc enough time to avoid tearing scar tissue still forming? Dodgerslist follows those vets prescribing 8 weeks. And then there would be several more weeks after graduation of superivsed slow and gradual intro back into physical activity to give further time for more strengthening of the disc.
From Bron's paper, we learn disc healing is really a pro-longed process.
I'll share that we have seen more dogs heal on this Forum without a relapse to the disc scar tissue forming when there has been 8 weeks of crate rest for the conservatively treated dog.
All of life is a weighing of the risks vs. benefits. To me there is great benefit in protection of the spinal cord to prevent worsening, possibly permanent paralysis and to avoid surgery... I have chosen for my own dogs 8 weeks.
This is your choice to make. No vet can make it for you and neither can we. But I can tell you from my 13 years here at Dodgers and watching over 15,000 dogs that nothing good ever comes from ignoring crate rest.
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Post by Julie & Perry on Mar 10, 2020 9:49:04 GMT -7
Hi, I'm also Julie and I have two IVDD shi-tzu's.
I can personally highly recommend 8 weeks of crate rest.
Every dog is different but both my dogs have had grade 4 episodes treated this way and recovered.
Early on, before I learned better, I didn't crate rest strictly and my dogs had more complications and many more episodes.
Think of it as Harley being in a cast. He feels better but needs the full time to form healthy scar tissue and fully heal the affected area.
It only costs for the medications and your time.
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