Kayla’s Lucy 7/20 Conservative- JRT

Kayla, welcome to the Forum!

STOMACH DAMAGE
Sounds like Lucy is showing you red flag signs of stomach damage due to carprofen and no acid suppressor on board of not eating her normal kibble.  Chicken is not a balanced diet she needs for all the repair jobs her body is attempting.
     
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. marvistavet.com/famotidine.pml  

Kayla, see if some of these emergency crate training ideas can help Lucy be able to relax in her recovery suite.
dodgerslist.com/2020/02/24/tips-to-help-with-recovery-suite/

Lots more handy member ideas for making the STRICT rest period go smoother: dodgerslist.com/2020/05/14/strict-rest-recovery-process/

Your Lucy is a good candidate to heal her disc with very STRICT rest and at some point self heal that wobbly walk nerve damage, too.  The key is owner knowledge with a willingness to read and learn about the disease your dog was born with.

-- Healing the disc: dodgerslist.com/healing-the-disc/
-- Understanding the meds so you know what to monitor for:  dodgerslist.com/meds-used-during-disc-episode/
-- Understanding your role at home at the test stop of carprofen:  dodgerslist.com/2020/04/18/steroids-vs-nsaids/

LET US KNOW
Are you on the same page about very STRICT 100% rest in the recovery suite?

The centerpiece of "DISC disease" treatment is the healing of the disc via limited movement of the back via a recovery suite. Crate rest is not your dog in a cage. It's a "recovery suite" with room service!
100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong disc scar tissue to form.

STRICT means:
- no laps - no couches
- no baths - no sleeping with you
- no chiro therapy - no dragging or meandering at potty times.

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!

**

ROAD MAP for the next 8 weeks
Avoid dangerous detours with the Conservative Roadmap for your fridge.
      VIEW, DOWNLOAD and print from here: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf


QUESTIONS
-- Carprofen: how many days is she to take it?
-- Gabapentin:  how often do you actually give gabapentin every 8 or 12 hrs?

Good job on getting Pepcid AC on board, Kayla! Hopefully now Lucy's GI system will settle down and she'll go back to eating her regular kibble. A good quality kibble is a balanced diet rather than chicken alone. If she does not go back to eating her regular kibble soon, please do speak to the vet about adding Sucralfate. Sucralfate 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/sucralfate.pml

If giving Tramadol and Gabapentin 2x/day has Lucy's pain completely under control, then that's the dosage that works. Should you see any sign of pain arise at any time of the day, then you'll need to speak to the vet about giving the meds 3x/day. Signs of pain to be on the lookout for are:

◻︎ restless, pacing, can’t find a comfortable position
◻︎reluctant to move much in crate such as shift positions
◻︎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.
◻︎looks up with just eyes and does not move head and neck easily.
◻︎ not eating due to pain of moving jaw with a neck disc or pain of back disc
◻︎ holds front or back leg flamingo style not wanting to bear weight
◻︎not their normal perky selves

The vet has prescribed Carprofen for 7 days. What instructions has he given as to also stopping or at least tapering the pain meds when the Carprofen stops? Swelling can take 7-30 days to resolve and until then, meds are needed. Once the swelling resolves, meds are no longer needed and only the 8 weeks of strict crate rest need to be done. The stopping of the Carprofen (and hopefully the pain meds as well) is a test for pain/swelling. Should you see any sign of pain return when Carprofen is stopped, you'll need to immediately alert the vet so the meds can be started again for a bit longer. Pain = swelling = more time on all meds.

Please be sure to read all of the links that Paula gave you. The more information you have, the better armed you will be to fight this disease.

Healing prayers for Lucy.

Hi Kayla, 

We usually advocate giving your vet updates via phone when dealing with an IVDD episode, less movement and time out of the crate the better. Most vets understand this. 

However if it is absolutely necessary to take her to the vet then we can give you some advice here:




kind regards

Mary

I am giving Lucy 5mg of Pepcid AC every 12 hours.

I spoke with her regular vet and he gave me advice to full stop both pain meds along with the Carprofen on 7/27 since she will have only been on Gabapentin for a short period.

After this, I will monitor her for pain and any different behavior.

Thank you!

Update!

I bought a small travel cage and was able to take lucy to the vet without her moving at all. She has been off of all meds for well over 24 hours with no signs of pain. The vet tested if she would respond to any pain in her lower back which is where her pain was located before, and she had no pain response!

The vet gave her two more weeks of Gabapentin and Carprofen just to ensure all inflammation goes down as he said it often takes longer than just 7 days.

Gabapentin - 100MG every 12 hours for 2 weeks
Carprofen - 25MG every 24 hours for 2 weeks

[Moderator's Note. Please do not edit
16.5 lbs
carprofen as of 7/20: 12.5mgs 2x/day for 7 days, 7/27 test stop for: 7/27 no pain / _neuro
               as of 7/28: 25mgs 1x/day for 14 days,  8/11 test stop for: _ pain/ _ neuro
gabapentin 100mgs 2x/day
Pepcid AC (famotidine) 5mg 2x/day]


She is walking fine, eating, drinking and using the bathroom normally.

7 weeks of crate rest to go!

Excellent news that Lucy had no pain after having been off of the meds for 24 hours, Kayla. It can take 2-3 days for all of the meds to completely leave the system but not having pain for more than 24 hours while off of all meds is a very good indication that all swelling is gone and no more meds are needed. So I'm having a hard time understanding why the vet would give another two weeks of meds. No one wants their pet to be on meds for any longer than absolutely necessary due to side effects. The only reason meds should have been resumed after stopping them is if pain should again arise. Pain means there's swelling - no pain means there's no swelling.

Even should the vet suspect there is still pain/swelling, which even a physical exam did not reveal, he has not returned Lucy to the original dosages of the meds. So even if there should still be swelling, the dosages of the meds are not sufficient to reduce the swelling. Anything less than the anti-inflammatory dosage will not be effective at reducing swelling.

More information on the inflammation phase of IVDD here for your understanding in speaking with the vet: dodgerslist.com/2020/04/22/healing-swelling-inflammation/

Please speak to the vet about stopping all meds again.

Hi! I wanted to update because Lucy’s crate rest ended on the 14th.


She has been doing great and still is. She’s back to normal! I have bought ramps for everything she likes to climb on and she has adjusted well to using the ramps. It gives me peace of mind to know she is no longer jumping on and off of things. Thanks to all on this forum who helped me with this process!