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Post by Stephanie & Baby on Sept 16, 2020 17:42:49 GMT -7
[Moderator's Note. Please do not edit 14lbs Prednisone as of 8/31: 2.5mgs 2x/day for 3 days, 9/2 test taper for √9/4 pain/ _ neuro as of 9/10: 2.5mgs 2x/day for 7 days; 9/17 taper test: _ pain/_neuro methocarbamol 250mgs 3x/day NOT stopping on the 9/17 taper! gabapentin 200mgs 3x/day NOT stopping on the 9/17 taper! metronidazole (antibiotic) 125mgs 2x/day Pepcid AC 10mgs 2x/day]
Today (9/16) marks 7 days straight of prednisone (1/2 of 5mg 2x per day). I’m starting tomorrow the 1/2 1x per day for 7 days. Then the 1/2 1x per day every other day. She wants me to finish the methocarbamol (8 days left).
She said the gabapentin can be used as long as needed, so no end exactly and could be through her entire crate rest.
Is that helpful?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Sept 16, 2020 19:30:37 GMT -7
Your job is to monitor for pain on the taper of pred on 9/17. How can you do your job if both pain meds (gabapentin and methocarbamol) are on board blind folding you to the true situation if there is still painful swelling going on.
Being blindfolded about pain, might mean, if there is swelling, there is delayed proof in getting Pred back on board at the original dose. How long should the cord be delayed in getting anti-inflammatory back on board if to finishing its job?
Pain meds are part of the test for pain that is done on 9/17 when pred is tapered. Why would one choose to be blindfolded by keeping them on board during the test. ---- Discusss and advocate re: what harm full stop or backing off the pain meds tomorrow will do. ---- Ask yourself, how will you monitor for pain with a blindfold on? ---- As a significant part of Baby's IVDD health care team, you are supposed to know how the treatment works and why your vet is choosing to keep pain meds on board. How did your vet explain her taper treatment and the reason behind keeping pain meds on board?
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Post by Stephanie & Baby on Sept 17, 2020 17:10:43 GMT -7
Thanks for that. I will ask when I do the check in tomorrow to see if I should taper the Pain meds at the same time.
Another night last night and all day today pain free. She whines and wants out of the play pen. So it’s definitely working. Even with the pain meds before she was crying in pain so I feel hopeful. I’ll check in tomorrow when I speak to the vet.
Again, thank you.
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Post by Stephanie & Baby on Sept 17, 2020 18:49:59 GMT -7
Spoke to vet tonight. We’re adjusting as follows:
▼Methocarbamol reduce to 1/2 500mg tablet 2x day for 2 days. Then 1x day until finished. Gabapentin remains same 2x100mg 3x day.
Prednisone Tapering plan same as above. Pepcid same.
[Moderator's Note. Please do not edit 14lbs Prednisone as of 8/31: 2.5mgs 2x/day for 3 days, 9/2 test taper for √9/4 pain/ _ neuro as of 9/10: 2.5mgs 2x/day for 7 days; 9/17 taper test: _ pain/_neuro methocarbamol 250mgs ▼2x/day; 9/20 1xday gabapentin 200mgs 3x/day NOT stopping on the 9/17 taper! metronidazole (antibiotic) 125mgs 2x/day - STOPPED Pepcid AC 10mgs 2x/day]
Oh one other thing. Antibiotics stopped. I forgot about that.
Not quite sure why that was even prescribed.
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Mary & Mila
Helpful Member
FEMALE— DACHSHUND
Posts: 218
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Post by Mary & Mila on Sept 18, 2020 4:45:23 GMT -7
HI Stephanie, Here are some tips on calming your dog while on crate rest. It may be trial and error for a while until you find one of them that works. dodgerslist.com/2020/05/14/strict-rest-recovery-process/Calmers:
Normally these calmers are not a problem to help your dog relax in the recovery suite, but always let your vet know of everything your pet is taking. A dog that is rambunctious in the crate defeats the purpose of crating. It is better to have the edge taken off than facing paralyzed legs with too much movement. Is your dog rambunctious? Ask your vet about Rescue Remedy Pet, Plain Benadryl or some other calming aid. It is imperative that during the healing period the dog rests. Being inside the crate jumping against the crate is not resting. The dog must be calm. Make sure you are not inadvertently training the dog for unwanted behavior. Rewards are food, eye contact, speaking, approaching the crate. Music: Hours of Relaxation Music for Dogs Great for people too 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 such as Acepromazine, Trazodone, etc. Of course always keep your vet in the loop on all things you give your dog. Other product brands may be available in your area or on-line… just shop by the active ingredient(s) on the label and the quantity for best price. Place a DAP pheromone diffuser at floor level where the recovery suite is. --Dogs: Adaptil (DAP) wall plug in diffuser 48ml www.adaptil.com/us/Products/ADAPTIL-Calm-Home-Diffuser with dog pheromones Use a DAP diffuser with one oral calmer from below: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine 2) Composure Soft Chews are colostrum based like calming mother's milk and contain 21 mg of L-Theanine. -- Put a garment you have been wearing and have not washed in the crate. If a dog is jumping up at the sides of the crate, you can lower the ceiling of the crate. Cut a piece of cardboard the size of the top of the crate, punch holes in the corners and tie the cardboard down into the crate to the level of the top of the dog's head when standing. Or cover the top of the crate with a blanket or towel, bringing the blanket/towel down to the level of the dog's eyes so when he/she jumps up, he won't be able to see anything. That may discourage him/her from jumping up. Calming Meds for the crate The medications for calming that we see the members vet's use are Acepromazine or Trazadone. They work and our members have had good results from them.. kind regards Mary
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Post by Stephanie & Baby on Sept 18, 2020 21:59:27 GMT -7
Another full day (9/18) and overnight of no pain. Eating. Can walk. Tail wagging. A little limp but walking. Carrying out for potty and she’s doing both. Today took her for a walk in the stroller. She sat still and enjoyed it. She’s sleeping soundly in her pen. She does get whiny during the day and wants out but I just leave her be. At night while we watch tv I let her lay next to us on the couch. She lays still and sleeps.
No medication change.
Quick med correction as of yesterday: The ▼gabapentin is 3x a day, but just 1 100mg each time. ▼Methocarbamol 1x per day 1/2 tab at night. Prednisone 1/2 5mg tab 1x per day with Pepcid.
Sorry for the confusion.
[Moderator's Note. Please do not edit 14lbs Prednisone as of 8/31: 2.5mgs 2x/day for 3 days, 9/2 test taper for √9/4 pain/ _ neuro as of 9/10: 2.5mgs 2x/day for 7 days; 9/17 taper test: _ pain/_neuro methocarbamol 250mgs ▼1/xday gabapentin ▼100mg 3x/day Pepcid AC 10mgs 2x/day]
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Sept 19, 2020 4:46:08 GMT -7
Glad to hear there is still no sign of pain. In order for conservative care to work, the crate rest must be kept very, very strict. Stroller use should only be for inside use to wheel Baby around so she can be near you, not outside yet (never left in stroller unsupervised). Roads and sidewalks are not smooth enough and could jostle Baby around too much, causing too much movement of the spine. More info on stroller use: dodgerslist.com/2020/05/17/pet-stroller-conservatve-treatment/?highlight=strollerAlso, please don't let her lay on the couch with you. Dogs so often do the unexpected. If someone should come to the door or something fly by the window, Baby could jump from the couch causing more damage to her spine. Also the couch is not as level and supportive as the recovery suite. When you take her out to potty, carry her in and out and allow only a very, very few steps at potty time. Think of the crate as a cast for the spine. Any time out of the crate is a dangerous time for a dog going through a disc episode. Baby should only be out of the crate at potty time. Too much movement of the spine and the damaged disc could tear more and she would be back to square one or much, much worse. Paralysis, loss of bladder/bowel control is very possible should the disc worsen. Please watch this video for an understanding of how a disc herniates: I was given incorrect directions about crate rest by vets when my Jeremy first went down. He only had signs of pain with no loss of neuro function at first but because he was allowed too much movement, within a couple of days, his hind end was completely paralyzed and he required emergency surgery. Even with the surgery, it took six months for him to walk again but over the last 9 years, he has never regained bladder/bowel control. Please, please keep Baby confined to the recovery suite (cast for spine), only carried in and out to potty with very few steps allowed at potty time. That's the safest place for her. Please take a look at the tips that Mary gave you about how to calm her during the 8 weeks of strict crate rest so she can rest quietly and heal.
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Post by Ann Brittain on Sept 20, 2020 10:53:23 GMT -7
Rather than putting Baby on the couch with you, consider sitting on the floor near her crate. It will make her feel more included. When Buster was on crate rest, we set up a recovery suite for him in the living area and in the office where I worked during the day. That way he didn't feel isolated. You could also try putting a piece of your clothing in the crate. Your scent may calm Baby and help her feel close to you.
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Post by Stephanie & Baby on Sept 20, 2020 16:47:32 GMT -7
9/19 and 9/20. Two more overnights and full days of no pain and no worsening with the tapering of meds. She’s still in the confinement area and mostly ok. She gets whiny and wants to be out but the only time I take her out is when she makes potty. Eating and eliminating normally. No limp or trouble walking. She’s wanting to walk more but we’re not letting her. Just while she finds a place to make.
Only time she shows pain is once or twice when we lift her and i notice it’s under her right arm. Wonder if it’s her leg that is bothering her.
[Moderator's Note. Please do not edit 14lbs Prednisone as of 8/31: 2.5mgs 2x/day for 3 days, 9/2 test taper for √9/4 pain/ _ neuro as of 9/10: 2.5mgs 2x/day for 7 days; 9/17 taper test: √9/20pain/_neuro methocarbamol 250mgs 1/xday gabapentin 100mg 3x/day Pepcid AC 10mgs 2x/day]
No meds change.
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Post by Stephanie & Baby on Sept 20, 2020 16:48:56 GMT -7
"Rather than putting Baby on the couch"
I did that while she was very painful. I also laid with her on the floor or her bed before I got the play pen. She’s pretty still on the couch but it’s not worth the risk.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Sept 20, 2020 18:13:05 GMT -7
Stephanie, often a dog will only show pain when lifted or moved. It's unlikely that there's anything wrong with Baby's leg and that the pain is actually coming from the neck/shoulder area. When you move the right front leg, that causes movement to her shoulder/neck area. The pain that you're seeing when lifting Baby must be immediately reported to the vet. It does appear as though there is still swelling pressing on the nerves of the spine and thus still a need for all of the original meds at the full dosages. It's very important to get Baby back on the original dosages of all meds ASAP for a bit longer.
It's common for there to still be pain during a taper of the meds. It can take 7-30 days for the swelling to resolve.
At 14 lbs., Baby is on the low end of the anti-inflammatory range of the Prednisone. We usually see vets prescribe 5mg 2x/day for a period of 7 days to get the inflammation down. The sooner the inflammation is brought under control, the better. It would be advisable for you to speak to the vet about increasing the Prednisone to 5mg 2x/day for 7 days before the next taper is attempted.
Please let us know what the vet says after speaking to them about Baby's pain.
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Post by Stephanie & Baby on Sept 23, 2020 14:47:10 GMT -7
Pain free since last post on 9/20 through today 9/23.
Starting tomorrow 9:24 prednisone goes 1/2 5mg tablet 1x every other day until completed (about 6 doses). Methocarbamol is done since taper began 7 days ago. Speaking to vet tomorrow morning regarding if gabapentin should be tapering further.
She’s still in her confinement suite and whining to get out. She’s not happy lol. Eating. Making potty normally. Stands and walks normally. She only takes brief steps to potty and to get water.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Sept 23, 2020 16:11:07 GMT -7
Stephanie, gabapentin 100mg 3x/day is a blind fold on you if any pain is really still going on . If there were to be pain, then there is delay in seriously getting back to work on spinal cord swelling...not good to delay that!
Got my fingers crossed with either a full stop of gabapentin or getting on board with backing off dose and frequency, and then finally full proof when gaba is stopped you will have a true assessment about any remaining pain. Let us know what the vet Rx's gabapentin to.
Keep up the essential work you are doing to limit movement of the back and neck so there can be a graduation on 10/26.
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Post by Stephanie & Baby on Sept 24, 2020 7:50:32 GMT -7
She said the gabapentin is not masking. She doesn’t want me to change the dose. She said it is helping the healing.
Another pain free night.
[Moderator's Note. Please do not edit 14lbs Prednisone as of 8/31: 2.5mgs 2x/day for 3 days, 9/2 test taper for √9/4 pain/ _ neuro as of 9/10: 2.5mgs 2x/day for 7 days; 9/17 taper test: √9/20pain/_neuro gabapentin 100mg 3x/day Pepcid AC 10mgs 2x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Sept 24, 2020 10:42:59 GMT -7
Stephanie, if gabapentin is not being used for its masking qualities, then what is the reason it is being used? IF there is pain being masked by remaining gabapentin, then where could that pain possibly becoming from? With a disc episode the pain is in the spinal cord tissue. VERY BAD then to have pain. Nerves do not like being compressed or squished. Too much pressure and the nerve cells die. Pain meds themselves do not fix anything other that to quickly mask/hide pain. Anti-inflammatory drugs such as pred CAN clear away the cause of pain, the swollen and inflamed spinal cord tissue. Have you ever had a bad cut on your finger or your leg bumped into a furniture corner. I bet these kinds of tissue damage would cause painful swelling. What harm is there to very quickly find out if the remaining gabapentin is hiding any painful swelling? A backing off via less times per day dosing or smaller mgs dose. If no pain surfaces then another backing off. If pain would surface on the backing off, then you have proof positive that the anti-inflammatory Prednisone needs to be back on board right away to finish the job of all pain gone, all swelling gone. Pain meds and Pepcid AC back on board too. So the question is how long to delay finding out the proof positive answer in case the spinal cord needs help or all is actually good and no meds at all are needed. Owner knowledge for gabapentin: www.marvistavet.com/gabapentin.pml
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Post by Stephanie & Baby on Sept 24, 2020 15:20:21 GMT -7
Methocarbamol was discontinued earlier this week I think. It’s in a prior post.
Spoke to vet and we will reduce the ▼gabapentin by one dose. So now it’s 1 100mg capsule 2x per day, one am. One pm.
[Moderator's Note. Please do not edit 14lbs Prednisone as of 8/31: 2.5mgs 2x/day for 3 days, 9/2 test taper for √9/4 pain/ _ neuro as of 9/10: 2.5mgs 2x/day for 7 days; 9/17 taper test: √9/20pain/_neuro gabapentin 100mg ▼2x/day Pepcid AC 10mgs 2x/day]
Today (9/24) first day of that taper. Today she had one in am with the prednisone dose and the Pepcid. Nothing since. No pain signs at all. Still alert and standing in the playpen. Goes to potty and walks small steps in order to make. No pain or tensing when she’s lifted or carried. Next dose of gabapentin is at midnight.
Tomorrow no prednisone, just the gabapentin doses 2x day.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Sept 24, 2020 15:43:21 GMT -7
Excellent on your part to be able to voice getting a faster read if painful swelling is actually gone or if not, then the need to get all meds back on board for a bit longer.
Have my fingers crossed for another backing off level or full stop of gabapentin in a couple of days will give proof no pain truly exists and thus the reason no meds at all are needed. All meds have side effects, so who wants a dog on meds when there is no work for them to do.
Is Baby on an every other day pred taper now or has pred been completely finished?
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Post by Stephanie & Baby on Sept 24, 2020 19:42:01 GMT -7
Yes. Today was [9/24] first day of every other day prednisone taper.
Should I suggest the pain pills taper the same way? Not sure what to ask for.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Sept 24, 2020 20:57:36 GMT -7
Bring up for discussion with your vet whether in a couple of days can gabapentin go down to 50mgs 1/day and then a couple of more days stop it. You two need to work out a plan to get off of gabapentin so you can accurately assess if all pain is really gone.
Pain pill do not back of with an every other day dose. Every other day is just for prednisone.
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Post by Stephanie & Baby on Sept 26, 2020 5:35:45 GMT -7
9/25 another pain free day and night. Baby is walking faster and wanting to move. Previously when I took her out she just stood and took a step or two after 5 minutes to potty and then stopped again. Now she is walking and I have to go after her. This is problematic because I live in nyc and she is on a busy avenue or a street. I figured it was time to use her harness. She allowed the harness to go on but when I lifted her she squeaked. Not squealing. Or yelping. Almost like a quick squeak when you accidentally walk into them.
She displayed not tensing or trembling but when I placed her down to potty she wouldn’t walk. She stood with her tail between her legs. I removed the harness to no issue and she then took steps and did business. I carried her the other time we went out with no harness. And she showed no pain or hesitation and again was walking and I had to go get her. I don’t believe this was a set back but it happened.
Current med situation: 1/2 5mg prednisone every other day (9/26 is 2nd day of taper, we have 4 doses left). 1 100mg of gabapentin at night before bed (midnight or so, began 9/25)
She went the whole day with no gabapentin until midnight and showed no pain other than the harness incident.
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Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,724
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Post by Marjorie on Sept 26, 2020 7:15:54 GMT -7
The incident is worrisome, Stephanie. Keep a close eye on her for any other sign of pain. With this type of incident happening, it's even more important that the Gabapentin continue to be tapered. Please speak to the vet ASAP about tapering the Gabapentin more as Paula recommended in her last post. That's the only way you're truly going to have proof that pain/swelling is gone. A harness and leash are very important, whether on a NYC street or safely in a fenced-in backyard, since the steps taken at potty time must be kept to a very, very few. A harness must be used to keep Baby from taking too many steps. What type of harness are you using? There should be no collar being used and the harness must sit across the shoulders, not the neck.
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Post by Stephanie & Baby on Sept 27, 2020 16:51:18 GMT -7
She has the harness on her shoulders. It clasps on her back not neck.
We are tapering ▼gabapentin to 1x per day at night.
[Moderator's Note. Please do not edit 14lbs Prednisone as of 8/31: 2.5mgs 2x/day for 3 days, 9/2 test taper for √9/4 pain/ _ neuro as of 9/10: 2.5mgs 2x/day for 7 days; 9/17 taper test: √9/20pain/_neuro gabapentin 100mg ▼1x/day Pepcid AC 10mgs 2x/day]
So prednisone 1/2 5mg tablet 1x every other day for 2 more doses. 1 100mg gabapentin 1x per day at bedtime.
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Post by Stephanie & Baby on Sept 29, 2020 13:33:03 GMT -7
I forgot to give baby the gabapentin for two nights in a row (9/27&9/28)so she’s two days no pain meds and has no signs of pain. Last dose of tapered prednisone is tomorrow. Should I use the pain meds again? She’s still in the play pen and strict confinement.
[Moderator's Note. Please do not edit 14lbs Prednisone as of 8/31: 2.5mgs 2x/day for 3 days, 9/2 test taper for √9/4 pain/ _ neuro as of 9/10: 2.5mgs 2x/day for 7 days; 9/17 taper test: √9/20pain (final taper dose 9/30) gabapentin stopped 9/27 Pepcid AC 10mgs 2x/day stops with final Pred dose on 9/30]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Sept 29, 2020 14:04:36 GMT -7
Good job in finding out the truth if there is any remaining swelling. No pain = no swelling = no meds at all except the final taper dose of pred tomorrow.
All that remains is to carry out the remainder of the 8 weeks of rest to ensure the disc has had opportunity to form some secure scar tissue.
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Post by Stephanie & Baby on Sept 29, 2020 15:06:44 GMT -7
Oh good to know. I will keep the pain meds in case she has an episode and then talk to the vet. But once her confinement period is up, I’d say we’re successful. I don’t let her walk but a few steps to potty. She wants to walk away fast but I was able to put the harness on her and now she stays still. She is whining and wants out of the play pen. It’s a lot, but good news because she seems well on her way to health.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Sept 29, 2020 15:33:14 GMT -7
Stephanie, when they start to feel good it is more of a challenge to ensure they are able to relax in their 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 Stephanie & Baby on Sept 29, 2020 15:48:51 GMT -7
I have the cbd oil, my vet said that is fine. Do you have an opinion on it? It’s cbd oil for dogs.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,528
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Post by PaulaM on Sept 29, 2020 16:08:06 GMT -7
Our opinion is not to use CDB when on big gun meds due to lack of research: dodgerslist.com/2020/02/24/devices-supplements/When off all the big gun meds, we have no opinion as there is only one disease we know and that is IVDD. You will need to be guided by your own research and your vet's for the issue Baby is being given this supplement. Hope this helps.
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Post by Stephanie & Baby on Oct 3, 2020 15:03:24 GMT -7
Pain free since 9/29 and no meds at all. Completed prednisone taper on 9/29. . Still keeping her confined in the play pen. She is walking a little more, to the door to put her leash on and then after going potty. No problem in her gait. No limp. No head down. She seems back to normal, but will continue with crate rest to 10/26. She lets us pick her up without pain signs as well or tensing. Tail is up again.
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Post by Stephanie & Baby on Oct 3, 2020 15:09:35 GMT -7
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