|
Post by Rose & Smokie on Oct 23, 2020 13:38:24 GMT -7
[Original subject line:Rose's Smokie 9/10 Conservative Treatment - Dachshund ]
My Smokie came down with IVDD on September 10th. He is a 6 year old dachshund. We've followed conservative treatment the past 6 weeks and his neurologist has released him from strict rest but limited activity for the next 4 weeks. I'm here looking for support in his continual recovery.
★1 17 Lbs Gabapentin 100mg 1 X daily (Given at breakfast). Was previously on Prednisone 5mg and Methocarbamol 500mg but has tapered off of both.
[Moderator's Note. Please do not edit 17 lbs crate rest stopped 10/20 ish? crate rest resumed 10/23 pred taper off; last dose on 10/5. gabapentin 100mgs 1x/day]
★2 Dachshund dog’s name? Smokie Your name, too? Rose ★3 Yes, level 1 Disk herniation T13-L1. Diagnosis was through DVM but confirmed by Neurologist ★4 date you saw the vet for conservative treatment? 9/13/20 ★5 currently pain? No ★6 Eating and drinking, Poops OK? Yes all, normal ★7 Dog walks, rarely stumbles from missteps. Overall happy. Tail wagging. ★8 Bladder control? Yes
|
|
|
Post by Romy & Frankie on Oct 23, 2020 14:01:06 GMT -7
Welcome to Dodgerslist Rose. We’ve got valuable information we’ve learned from the vets Dodgerslist consults with and our own experiences with IVDD since 2002 to share with you! Know more about us and how we team up with veterinarians: dodgerslist.com/about-team-dodgerslist/Is Rose strictly crated now? 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. STRICT means:
◼︎no laps
◼︎no couches
◼︎no baths
◼︎no sleeping with you
◼︎no dragging or meandering at potty time ◼︎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. Carry Smokie 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 a 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!
We have more information on the strict crate rest process here:' dodgerslist.com/2020/05/14/strict-rest-recovery-process/
It is excellent that Smokie is happy and can walk well. The stumbling is likely caused by nerve damage. No medication can heal nerve damage. Only time can do that. Nerves are slow to heal but heal they can.
Is the gabapentin being continued because the vet thinks there would be pain without it? Consider speaking with your vet about stopping or cutting back on the gabapenin. It may be that no meds are needed. If pain is seen when the gabapentin is stopped than there is still swelling in the spinal cord and more time on all meds are needed. We have some information about healing swelling here. dodgerslist.com/healing-the-disc/
It is always scary when our dogs are diagnosed with IVDD. It becomes less scary when we learn all we can about the disease. At the MAIN WEBSITE, use the orange SEARCH bar feature to easily access more IVDD information.
|
|
|
Post by Rose & Smokie on Oct 23, 2020 14:16:36 GMT -7
Thanks for the welcome. Smokie was strictly crated for 6 weeks. His neurologist released him from strict crate rest at 5 weeks but we kept him in an extra week for good measure. At the 5 week mark, the neurologist changed his Gabapentin from 2x daily to 1x daily and said to continue dosing until meds were all gone. Smokie had high crate anxiety and perhaps this is what the continual daytime dosage is for, but I am not totally certain. It doesn't seem like Smokie is in pain at all. He doesn't show signs of it when you touch his back and will roll on his back and do full body stretches like he used to. The only thing different about him is the weakness in his hind legs, rare stumbling if he takes an off-step, and you can feel the spot on his back where the disk was damaged when you pet him. It sticks up a bit but he has also lost a bit of weight and feels thin all over from this process. It doesn't bother him when you touch it and his back is no longer hunched. The neuro said it just may be that way from now on.
|
|
|
Post by Romy & Frankie on Oct 23, 2020 14:56:08 GMT -7
Is Smokie no longer strictly crated? It has been six weeks. No studies have been done on how long it take a disc to heal. So here at Dodgerslist we go by vets who are successful in avoiding a relapse by being more conservative on length of time. We also have multiple of thousands of dogs since 2002 when this group was established. We see a pattern of which dogs relapse with an early release from crate rest and better results with 8 weeks of making sure the body formed good strong disc scar tissue. Gabapentin is sometimes sedating but there are some natural calmers that have worked for some of our members. Try using an oral calmer in combination with a Pheromone diffuser. This seems to work best. It takes several days for these to start working 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. Some brands to consider: --Adaptil (DAP) wall plug in diffuser www.adaptil.com/us/Adaptil/Adaptil-DiffuserUse a diffuser with one oral calmer from below: 1) ANXITANE® S chewable tabs contain 50 mg L-Theanine, an amino acid that acts neurologically to help keep dogs calm, relaxed us.virbac.com/product/behavior/anxitane-chewable-tablets2) 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.phpSometimes just placing a blanket covering the top half of crate which creates a den-like feeling can help to calm. More tips on calming are here: dodgerslist.com/2020/02/24/tips-to-help-with-recovery-suite/
|
|
|
Post by Rose & Smokie on Oct 23, 2020 14:59:57 GMT -7
Okay so if I put him back on strict rest do I just do it for 2 more weeks or do I need to start the process all over?
It has been a few days since he has been off of strict rest and I have been taking him on 5 minute walks 2 x a day.
|
|
|
Post by Romy & Frankie on Oct 23, 2020 15:09:07 GMT -7
There is no need to start at the beginning unless Smokie is showing sings of a relapse. Even five minute walks may result in too much movement for a healing disc.
Eight weeks would mean graduation day is November 14
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Oct 23, 2020 16:37:30 GMT -7
Rose with the pain masking pain med, gabapentin still on board, no one has proof positive that all painful swelling is really gone. Discuss the stop of gabapentin to remove that blindfold to get your proof all spinal cord swelling is really gone. If it is a matter to keep Smokie calm in his recovery suite, then seek some of the options Romy lists in her above post.
What date was the last dose of pred?
|
|
|
Post by Rose & Smokie on Oct 23, 2020 17:26:06 GMT -7
Okay, he hasn't shown any signs of relapse. He is back on strict rest now in his recovery suite. I got him a new bed a few days ago and he loves it so I don't think I'm worried about anxiety at this point. If he shows signs I will try those other options mentioned above. I'll check with his neuro on why they still have him on the Gabapentin. I figured it was just a normal part of the recovery process. It does take a few days to get a reply from them and with the weekend that will add a few more. He tapered off of Prednisone and I estimate his last dose to be around 10/5.
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
|
Post by Marjorie on Oct 24, 2020 4:36:09 GMT -7
I'm very relieved to hear that Smokie has shown no signs of a relapse, Rose, and that he's back on strict crate rest. To do the full 8 weeks is the only way to be sure enough time has been given to heal the damaged disc and to form secure scar tissue before gradually reintroducing movement again.
We'll be awaiting word as to what the vet says about stopping or tapering off of the Gabapentin.
|
|
|
Post by Rose & Smokie on Oct 26, 2020 10:25:03 GMT -7
Now, that the vet is back open I've left a message for them to call me back regarding Smokies medication. What is the length most vets are prescribing medications for dogs on conservative treatment?
He's made it through the weekend fine but wasn't really happy being back in his suite and was extra rambunctious when I took him out to potty each time. Luckily it will be colder here the next few days so he was quick to want to get back in his bed with his blanket over him when I took him out this morning.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Oct 26, 2020 11:01:45 GMT -7
Rose there can be no exact answer to your question for how long to use the anti-inflammatory drug Prednisone. It can take that med in a range of 7-30 days at the anti-inflammatory level. Taper days are not counted. The pain masking pain meds (such as Smokie's gabapentin) are used right up to the day of the test for pain taper. Owners do not want to be blindfolded about monitoring for pain with gabapentin on board upon beginning a pred taper. There may be a reason your vet has Smokie still on gabapentin. Gabapentin has many uses other than masking nerve pain. Owners should always be aware of treatments, what a med is expected to do, etc. You are not just a member of of Smokie's health care team you are the captain! Dr. Nancy Kay, DVM, ACVIM has hit it on the nail especially with IVDD. Each of us needs to be self educated so we can team up to work with the vet we've hired. Our hope is in the next few days you will have a chance to delve into the readings on our Main Webpage and be the prepared savvy owner your Smokie needs. 1) This is a good spot to start : dodgerslist.com/in-the-right-place/ 2) Then click on the rest of the "KNOWLEDGE" pull down menu items.
|
|
|
Post by Rose & Smokie on Oct 26, 2020 11:49:47 GMT -7
Thanks for the reply Paula, however, your response leaves me a bit confused. Smokie was tapered off of Prednisone 3 weeks ago and was taking Gabapentin during the whole tapering process. He is now solely on Gabapentin and has a 60 day supply left. Are you saying they should have tapered him off of Gabapentin before tapering him off of Prednisone? That's what I'm getting out of your previous comment. Either way, I'll talk them them about out why they still have him on, what it is supposed to be doing for him, and if it is necessary for him to continue to take it.
I've checked out all of the resources on the website and feel confident I can follow the recommendations. I just want to make sure we cross the finish line at the right time and pace.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Oct 26, 2020 12:17:02 GMT -7
While still on pain masking gabapentin, there really is no proof all the painful swelling in the spinal cord is gone. The Prednisone taper is done for health reasons. It just happens to also be a perfect time to verify if all spinal cord swelling is gone. The usual is at the begin of pred taper way back when for Smokie (?) all the pain meds would be stopped or begin a gradual backing off. This gives the owner the ability to quickly report should any hint of pain surface. On graduation day dogs are off all meds unless there is another disease where a med would be needed. Rule of thumb is pain = swelling = back up at anti-inflammatory pred dose, pain meds and Pepcid ACSo as you can see, we too are confused why gabapentin is still on board at this date. Your vet may have a good reason. As mentioned gabapentin is used for several diseases, not just for the pain from a disc episode. We owners should fully understand why any med is on board, its expectations and what it is treating.
|
|
|
Post by Rose & Smokie on Oct 29, 2020 12:04:19 GMT -7
So after 4 days and endless phone calls I received a VM from the office of Smokies neuro. They said they had him on Gabapentin to control nerve pain and if he is no longer in pain we can stop giving it to him. They said he does not need to be tapered off of it but research I've done is conflicting. What are your thoughts? He is on 100mg 1X per day.
|
|
|
Post by Romy & Frankie on Oct 29, 2020 13:01:36 GMT -7
Although some vets prefer to taper gabapentin, the majority of members on this list have been able to just stop it. When my dog was taking gabapentin I did not taper. I just stopped.
|
|
|
Post by Rose & Smokie on Oct 29, 2020 13:13:39 GMT -7
Okay, thanks for the reply. I gave him his last dose [gabapentin] this morning and will discontinue use without tapering. I'll keep you updated on his progress.
[Moderator's Note. Please do not edit 17 lbs crate rest stopped 10/20 ish? crate rest resumed 10/23 pred taper off; last dose on 10/5. gabapentin 100mgs 1x/day STOPPED Graduation day Nov 11 and gradually increases activity]
|
|
|
Post by Romy & Frankie on Oct 29, 2020 13:28:25 GMT -7
Fingers crossed that Smokie will remain pain free when the gabapentin is stopped.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Oct 29, 2020 16:05:13 GMT -7
Rose, keep us all posted. My fingers cross, too, you will not observe any pain.
Mark your calendar for Graduation day of Nov 5.
We'll have lots of tips, a schedule and ideas for getting him slowly back into shape and from there living many happy years ahead together.
|
|
|
Post by Rose & Smokie on Nov 3, 2020 12:50:52 GMT -7
Wanted to send an update that Smokie has not experienced any pain or discomfort since taking him off of the Gabapentin. We have graduation day marked on our calendars and are awaiting it happily.
|
|
Marjorie
Moderator~
Member since 2011. Surgery & Conservative
Posts: 5,722
|
Post by Marjorie on Nov 4, 2020 5:28:24 GMT -7
Wonderful news indeed, Rose! So glad to hear it. On what date did the Gabapentin actually stop? Gabapentin can stay in the system for a few days so Smokie shouldn't begin gradually increasing movement again until it's completely out of his system so you have proof that the swelling is fully gone. Now is the time to determine how you are going to ease back into more normal activity at graduation. The idea is to gradually give more freedom under controlled conditions. Not free reign of the house and yard immediately! Take a look at our information and then come up with a plan to gradually increase activity over about a month's time following the end of crate rest. Here is a sample schedule to slowly introduce your dog back to family life and physical activity: dodgerslist.com/2020/06/15/back-friendly/Make some home modifications so that you can reduce the stress on the spine in the future. No more stairs, ramps to slide down from furniture: Ramps: dodgerslist.boards.net/thread/867/rampsFurniture blockers, etc.: dodgerslist.com/2020/07/09/home-protect-ivdd-backs/
|
|
|
Post by Rose & Smokie on Nov 4, 2020 9:30:29 GMT -7
Smokie has been off of Gabapentin as of 10/30. It has been 6 days since his last dose. Thanks for the info on slowly getting his strength back up. I'll look into these further so we can have a plan come graduation. Nov 5 graduation!
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Nov 4, 2020 10:59:53 GMT -7
Rose, congratulations for tomorrow on sticking with strict rest to ensure the disc has formed good secure scar tissue! Do keep us posted on how Smokie does with his slow graduation re-introduction back to family life and activity. We invite you to hop on to our educational bandwagon team. Education about disc disease is our number one mission! We wish we did not have to hear of another dog that was put to sleep because of disc disease nor one denied the correct principles of STRICT rest to help them heal. We would like all of our members to pay forward for the help they have received with their dog by helping us educate!
We depend on YOU. Here are 3 ways to help... -- "Share" our FB posts www.facebook.com/Dodgerslist-- When in conversation at the grocery store line or wherever you may meet breeds most prone to IVDD (Dachshunds, Beagles, Poodles, Spaniels, Shih Tzus, Pekingese, and Chihuahuas) give out our little wallet cards. Hand carry our literature and introduce us to your vet. Ask Linda to send you a free brochure packet for your vet: dodgerslist.com/free-literature-2/ -- Offer your talent and skills to enhance the Forum, Website or Facebook. Let us know here where you'd best fit: dodgerslist.com/about-team-dodgerslist/#volunteer
|
|
|
Post by Rose & Smokie on Nov 16, 2020 10:47:17 GMT -7
Hi Team,
Just sending an update to let you know Smokie is doing really good so far. He's doing great with his ramp training and enjoying walks outside (we live in Phoenix so it's still warm). His muscle mass is starting to increase and he has less wobbling in his legs. It's definitely been a lifestyle change for us but I am hopeful of many more years together with a pain-free pup. Thanks for the wealth of knowledge you've provided us and I'll continue to send folks to your site when they need guidance for their own pets.
|
|
|
Post by Jessica on Nov 16, 2020 11:03:15 GMT -7
|
|
|
Post by Rose & Smokie on Nov 19, 2020 8:48:08 GMT -7
This morning I noticed Smokie was [11/19] favoring his right hind leg (he favored left hind leg with IVDD diagnosis). I crated him immediately and gave him some Gabapentin we have on hand. We've increased his exercise the last 3 days and I'm wondering if this is muscle weakness or another flare up. How can you tell the difference? I've got a call into the vet but probably won't hear back until this afternoon.
|
|
PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,493
|
Post by PaulaM on Nov 19, 2020 8:58:30 GMT -7
Rose when there is just discomfort (pain only) it can be a challenge to tell if a neuro issue or having overdone exercise. You did the right thing to crate at once and call your vet.
In what manner did you increase exercise?
Let us know what your vet thinks about the right hind leg.
|
|
|
Post by Rose & Smokie on Nov 19, 2020 9:39:43 GMT -7
We increased from a 5 min walk every other day to a 5 min walk every day for the past 3 days. He is overall just an active pup and runs around the living room quite frequently on his own since his graduation. I did hear back from his vet who advised to keep him crated and on the Gabapentin for the next few days and monitor his condition. She said without a physical exam they are unable to determine if it is a flare-up or a soft tissue injury or something else. I've scheduled the next available appointment for Tuesday 11/24 just in case he ends up needing to be brought in.
|
|