Amy, welcome to the Forum. There is hope indeed. Imperative though that you advocate to get the meds properly adjusted, get a lesson on expressing and begin your IVDD education to be able to stand up for Pickles, recognize when a vet is uncomfortable with their IVDD knowledge.
Links to quickly access info are included in this post. As soon as you can take the time, begin your IVDD studies at the main website to learn why Pickles has every chance of a recovery:
dodgerslist.com/in-the-right-placeFor your fridge to keep you on the conservative treatment tract print out and tape up the
ROADMAP. VIEW, DOWNLOAD and print: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdfPRED test for pain taper: ANSWER- needs another course!
The pred taper test for pain began today 11/12. With a new pain med (gabapentin) being Rx'd today, it is very clear it is not time to be continuing the prednisolone taper!
Pred needs to go back up to the anti-inflammatory level (5mgs 2x/day) for a longer course than the initial 5-day course. Tapering doses are no longer working on the swelling in the spinal cord. Time matters with the spinal cord asap advocate for:
--another prednisolone course of 5-7 days. It can take total of several courses adding up to somewhere in the range of 7-30 days before all the spinal cord swelling is gone. Taper days are not included in that count.
-- If your Pickles has no liver or kidney or heart murmur, he needs PEPCID AC (famotidine) on board to suppress the acids. He is showing red flag signs of damage with not wanting to eat/drink. Available at the grocery— over the counter Pepcid AC containing one single active ingredient (famotidine).
PEPCID AC asap now from the grocery store.
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.
Keep your vet in the loop at first opportunity he's open and confirm 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!)
Stuff you need to know about use of anti-inflammtories during a disc epidode: dodgerslist.com/2020/04/18/steroids-vs-nsaids/ MANUAL EXPRESSING of BLADDER
There was no mention of expressing Pickles since he has no bladder control. IMPERATIVE you get vet help to learn how to express.
dodgerslist.com/2020/05/05/bladder-bowel-care/Are you doing these
extra things at home for a neck disc: dodgerslist.com/2020/05/05/cervical-care-tips/Have you since 11/7 been doing 100% very STRICT rest with Pickles inside of a recovery suite? Only out to potty and now to express his bladder?
Please let us know that you're on the same page about strict crate rest. 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.
Excellent tips and ideas to set up your recovery suite and make the rest period go smoother:
dodgerslist.com/2020/05/14/strict-rest-recovery-process/STRICT means:
◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you
◼︎no chiro therapy whys:
dodgerslist.com/2020/04/22/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. It is proper Meds that fully handle pain. It is the body that will self heal nerves.
Is there still currently pain after the addition of gabapentin today? ◻︎ shivering-trembling ◻︎ slow to move ◻︎ tight tense tummy
◻︎ arched back, ears pinned back ◻︎ head held high or nose to the ground
◻︎ yelping when picked up or moved ◻︎ restless, can't find a comfortable position
◻︎ slow or reluctant to move much in crate such as shift positions
◻︎ not their normal perky interested in life selves
+ pain from neck disc:
◻︎ looks up with just eyes and does not move head and neck easily.
◻︎ not eating due to painful chewing or in too much overall pain
◻︎ holds front or back leg flamingo style not wanting to bear weight
Full pain relief is expected in 1 hour and stays that way dose to dose.
If the pain meds are not yet right, as the eyes and ears for your vet, please call your vet ASAP to report your observations so meds can be adjusted. The three pain meds are very likely under medicated with only once or twice a day dosing. These pain meds do not last in the body at a high enough level when not Rx'd 3x/day. The vet also has much room to move up in mgs for the tramadol and the gabapentin. Neck discs are just a more painful thing as the had needs to move when other parts of the body move or shift.
Advocate for any of the pain meds be given 3x/day (every 8 hours) for round the clock coverage, dose to dose coverage.
— Methocarbamol works on the pain of muscle spasms.
— Tramadol is the general pain reliever.
— Gabapentin works on nerve pain.
There should be no sign of pain from one dose of meds to the next. Have no patience with pain as it does hinder healing.
Is surgery a consideration, an option for your family: Surgery vs. conservative information:
dodgerslist.com/2020/02/10/surgery-vs-conservative/ NOTE surgeons are not only for surgery, but can be considered for consultation when a family DVM is not comfortable in using IVDD meds during conservative treatment.
1. Board certified surgeon directory:
find.vetspecialists.com Look into Care Credit now just in case things go into crisis mode and surgery is needed. It is best to know all your options, financially and where surgery would be done, ahead of time rather than scrambling for that information in an emergency. No or low interest credit for veterinary costs can be obtained from Care Credit. You find out online if you qualify:
www.carecredit.com/faqs.html2. Dodgerslist FORUM member vet recommendations, costs, etc.:
dodgerslist.boards.net/board/13/member-reported-surgery-costs-recommendationsWill be watching for your update to learn more about Pickles treatment with answers to questions. Is he out of pain now? Pepcid AC on board? Did you get a lesson expressing?
