Rachael’s Destiny 10/22 conservative

Welcome, Rachael. From what I see from the chain of events (kinda hard to know for sure without dates) It seems she is currently on a pred taper of 2.5 mgs 2x/day.

The taper is to test for pain or increased/new neuro diminishment. You report pain.

ASAP first thing in the morning advocate for getting back up on the actual anti dose of pred (5mgs twice a day). The number of days she is on that dose is VERY important information. We need to know how many days each course of pred (anti-inflammatory level) has been prescribed. It can take 7-30 days at the anti-inflammatory level before all the painful swelling is gone.

PREDNISONE QUESTIONS
-- On 10/22 did the first prednisone start at 2.5 mgs or a 5 mgs tab twice a day?
-- For how many days did she take before it was lowered in times per day or mgs/
-- The next pred course on Wed 10/28 was that for a 5mg dose? ?x/day for ? days?
-- What dated did she jump of couch?

PEPCID AC
Destiny NEEDS an acid suppressor while on Pred! Already showing red flag signs if GI damage with loose poop.
PEPCID AC (famotidine)
Dogs don't speak up at first signs of stomach damage like a person would. By the time we notice black or red blood in the stools, things can quickly go from bleeding ulcers to a life threatening perforated stomach.
Proactive vets don’t wait til there are red flag signs of: 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. www.1800petmeds.com/Famotidine-prod11171.html
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).

thumb.ibb.co/mEGRuy/91x_Aj_s00z_L_SY355.jpg
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

Excellent reading about use of anti-inflammtories during a disc epidode: dodgerslist.com/2020/04/18/steroids-vs-nsaids/

I'd like to welcome you to Dodgerslist, too, Rachael. And I'd like to add the following info to Paula's in-depth posts - please let us know that you're on the same page concerning strict crate rest. It's very important to limit the movement of the spine to protect the disc from further damage and increased loss of neuro function.

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 chiro therapy whys: dodgerslist.com/2020/04/22/chiropractic/?highlight=chiropractic◼︎no dragging or meandering at potty times. ◼︎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 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! i.ibb.co/K7HNj10/slingwalk.jpg

Healing prayers for Destiny.

What was the name of the steroid shot?

How serious was the slipped knee cap? Did the vet have to assist in relocating it? Did he indicate a need for surgery or just the common ailment for many doxies.  If  had you seen your dog running and seemingly skipping a beat with the back legs, that may be an instance when the patella slips a bit and then relocates itself--- a very, very mild case of Patellar Luxation.

All I can say is the Pred taper dose is the time for you to observe and assess for pain. 

If you see pain you must report to vet ASAP in order to resume the higher level anti-inflammatory dose of pred. 

With any taper, it is always good to have worked out in advance a "PLAN B" should pain re-surface at night or on the weekend when your vet is not open. Could be an emergency RX script you could fill at local 24 hr pharmacy or some extra pills at home til the vet opens again. An ER visit is very expensive, a "Plan B" is free!

Pain= another course of prednisone + all pain meds, protectors back on board.
No Pain= go to conclusion of Pred taper + finish out the 8 weeks of very STRICT 100% rest for the disc to heal.

What is the last date for final pred dose?  Do you have Pepcid AC on board?

Please keep us updated as the pred taper continues.