Christina's Karma 10/21 conservative -LVR/KDNY terrier/corgi

Welcome to Dodgerslist, Christina. We are glad you’ve joined us on the support Forum! While we are not veterinarians, we have lots to share with you.
Our main goal is to help you become educated about IVDD so you can better work with the vet you’ve hired, protect your dog and give proper care during this episode, but also to be able to live many happy years ahead with the disease your dog was born with. Thank you for providing all this helpful information. Please feel free to reach out anytime with any questions that come up.

First thing with the begin of the taper today is to alert your vet. The tapering of pred to 1x/day that happens today 10/26 is a test for pain. You have the answer of still seeing pain that needs to be reported to the vet asap to get pred back up on the anti-inflammatory dose.

Be sure to clarify at the Forum and when you call your vet the exact observations you see nearing next dose. Did you see ALL or just some (which ones?) of the signs of pain were listed that could happen?

The single most important care is always STRICT rest to prevent more nerve damage if the disc is further damaged with too much movement. Transports are always risky to the disc. Do you know what may be involved with the follow up visit on 10/28? Often medication adjustments can be done over the phone to limit movement. If Karma is showing signs of pain now, can you call the vet today about adjusting medications? You can also ask at the same time, if your dog has any health issues to prevent use of Pepcid AC (famotidine). Anti-inflammatory drugs increase stomach acids, and a stomach protector like Pepcid AC can help protect her.

Pepcid AC (famotidine) for dogs is 0.44mg. per pound, 30 mins before the anti-inflammatory and thereafter every 12 hours for as long as your dog is on the anti-inflammatory. At 12.6lbs, Karma's recommended dose would be 5.5mg. - round down to 1/2 a tablet of 5mg. (most at 10mg.). www.1800petmeds.com/Famotidine-prod11171.html

If transport is necessary, you can create a safer environment by padding a travel crate with rolled up blankets or towels to restrict movement.

To help with accidents, layer bedding in this manner: Trash bag enclosed mattress, pee pad*, fleece bottom sheet tucked in all around mattress.

*OPTION to disposable pee pads are reusable waterproof absorbent bed pads. Look for children’s disposable bed mats at your grocery store. Cut down the twin size to make several suite size ones.


After calling your vet today, please let us know what you hear. We are looking forward to learning more about Karma.

Yes, holding up a leg flamingo style, not wanting to put weight on it, IS a sign of pain and that pain must be brought completely under control TODAY. Karma was put on the low end of the anti-inflammatory dosage of Prednisone originally. Speak to a vet today about bringing her up to the higher end of the anti-inflammatory dosage of Prednisone - 5mg 2x/day for possibly another 5-7 days before tapering again.

Prednisone. Anti-inflammatory doses range from 0.1 to 0.3 mg per pound (0.2 to 0.6 mg/kg) up to twice daily. Dr. Dawn Ruben "Prednisone/Prednisolone" www.petplace.com/article/drug-library/library/prescription/prednisone--prednisolone

If the Gabapentin was not enough to bring her pain completely under control (resolution of the flamingo style leg), then speak to a vet about adding a general pain med, Tramadol, and also Methocarbamol, which is a muscle relaxer and works on the pain of muscle spasms. It often takes all three pain meds at three times a day to get pain of IVDD under control. Have no patience with pain as it does hinder healing.

"Codeine is not a recommended analgesic for dogs or cats. It is generally only available in combination with acetaminophen (Tylenol) which makes it completely unsuited to feline use. Its use in dogs is discouraged as most dogs lack the CYP2D6 enzyme primarily responsible for the conversion of codeine to morphine, its most active metabolite. That being said, there may be some analgesic value to codeine in dogs via the C6G metabolite."
www.vasg.org/newer_options_for_chronic_pain_management.htm

Karma may be suffering from nerve root signature pain. Something is irritating the nerve root as it exits the spinal cord to travel down the leg. Severe leg pain is one of the main symptoms. The pain may take a combo of meds rather than just one. Do speak to the vet about the possibility of this.

Here's some info to read as a background for discussion with your vet.
dodgerslist.com/2020/08/20/nerve-root-signature-pain/
Dr. Bagley. Lateral and Foraminal Disk Extrusion in Dogs [Root Signature Pain] www.scribd.com/doc/23748101/CANINE-Lateral-and-Foraminal-Disk-Extrusion-in-Dogs

Does Karma have a liver problem for which she's taking Denamarin? If so, then Omeprazole may be a better stomach protector than Pepcid AC and the reason that was prescribed. Glad to see that is on board.

Why was Karma taken to the primary vet yesterday? Vets who understand the importance of strict crate rest during conservative care will agree to take phone updates rather than risk the transport and exam, which could involve too much movement of the spine.

Prednisone is the steroid most often prescribed by vets for IVDD; however, we also see Dexamethasone prescribed occasionally.

Is Karma still able to hold her urine until you take her out? If so, then no need for Proin. Do you still find wet bedding? Prednisone causes increased thirst/urination so you may need to take her out more often (carry her out, allow only a very few steps to potty, then carry back in). Take away access to water a couple of hours before bedtime and take out to potty right before bedtime to help avoid night accidents.

Is Karma having appetite issues? Why was Entice prescribed?

Please speak to one of the vets who has already examined Karma about the above issues today. If they are able to work with you and get a steroid back on board and get Karma's pain completely under control within one hour of taking any new course of meds, then there would be no need to see another vet. If they are not able to do this, then it may be necessary to risk transport to the neurologist.