Annette's Roux 12/3relapsd disc conservative; GRAD 1/29

Annette, welcome to Dodgerslist Forum.  Getting quickly up to speed on intervertebral DISC disease helps you in understanding the why of what your vet advises and the ability to bring things to the table in working together to help heal the disc. You will be very amazed how quickly you can learn a lot about just one disease which a vet is not able to know in great detail for every single disease known to cats, dogs, birds, and many other species they treat.

Most excellent hear, 12/3 you learned the single most important care for a diseased disc is to imply 100% STRICT rest inside of a recovery suite. Now Roux has the chance he deserves to heal the disc.  

What is lacking are medications. RXs are not yet right. Upon notifying your vet during the Prednisone test for pain taper as of 11/31, observing pain would have been the signal for your vet to identify that not all swelling had been taken care. It would have been the signal to get back up on the prednisone anti-inflammatory level to resume work to rid the body of all spinal cord swelling.

Pain= another course of anti-inflammatory
+ all pain meds back on board + Pepcid AC acid suppressor

The full details on how Pred, an anti-inflammatory works with a disc episode. Good reading to be able to ask the right questions and advocate for Roux' needs:
dodgerslist.com/2020/04/18/steroids-vs-nsaids/

Steps you can take to get things right for Roux:
--- Let us know you are now carrying him TO AND FROM the recovery suite for potty times. No walking around. He is limited to a very, very few footsteps to take care of business.  Tell us about your potty place set up.
-- Call your vet to avoid a risky for the healing disc transport in for adjustments of meds. Vets who know IVDD understand the need for VERY strict rest and do med adjustments over the phone.
-- Advocate for Prednisone to get back up on the "anti-inflammatory" level dose of 2.5mg 2x/day.  The initial 3-day course is rather short and not likely to have gotten all the spinal cord swelling down. It can take 7-30 days (made up of several courses) before prednisone can get rid of swelling pain. Pred taper days are too low and thus do not count towards the 7-30 days.
-- Very often there are 3 sources of pain with a disc episode. Thus vets use three pain meds.

Annette, good job on getting another course of pred on board.  

For how many days is this course of pred 2.5mgs 2x/day?  Hope is is longer than the first at  a 3-day course!  Let us know what your Plan B is at the end of this current Pred course.

Pepcid ac:  ?mgs   ?x/day


Is the Friday check up via phone or teleconference?  It is a risk to an early healing disc to transport in for a vet visit when updates about pain level, adjustments to pain meds can be handled over the phone.

When things are of a nature that a vet visit is extremely important to health, etc, then that benefit is worth the risk to the disc.  
     With urgent vet visits, secure the crate in your vehicle. Transport carefully using a crate padded out with rolled up towels on either side of the dog to prevent movement or jarring the spine when braking or turning corners.

MONITOR & report PAIN
◻︎ shivering-trembling ◻︎ yelping when picked up or moved
◻︎ slow to move ◻︎ tight tense tummy
◻︎ arched back, ears pinned back ◻︎ head held high or nose to the ground.
◻︎ restless, can't find a comfortable position
◻︎ slow or reluctant to move much in crate such as shift positions
◻︎ 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
◻︎ not their normal perky selves

MONITOR and report NEURO FUNCTION diminishment. Are you/had you observed any neuro diminishment?
As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order.
1. YES Pain caused by the tearing disc & inflammation in the spinal cord
2.  ?   Wobbly walking, legs cross (front or back legs?)
3. ? Nails/toes scuffing floor
4. ?   Paws knuckle
5. Weak/little leg movement, can't move up into a stand
6. Legs do not work at all (paralysis, dog is down)
7. Bladder control is lost
8. Tail wagging with joy is lost
9. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment.


With very STRICT rest inside of a recovery suite and carrying to and from the potty place, Roux is a very good candidate to heal under conservative treatment.

Annette, a happy and healthy New Year to you!

A bit of clarification please:

-- Prednisone 2.5mgs 2x/day (after 21 days straight?) began a taper to 2.5mgs 1x/day on what date?

-- Your family vet suggested backing of pain meds OR wanted a full stop on same day Pred taper (12/29??) began?

When a dog self heals nerve function, the functions return in the reverse order they were lost.    

Order of nerve improvements:
5. __weak or little leg movement, can move up to a stand position
     You gave no details for us go on, just a "more normal gait" as of 12/9
4. Knuckling improves to no knuckling
3. Nails/ toes scuff floor to no scuffing floor
2. Wobbly walking goes to improved gait
1. Pain is not a neuro function, it is the first disc episode sign caused by tearing of disc.

Where is Roux currently in his neuro functions?  
   -- any paws knuckling under? or can he right quickly
   --  any nails/toes grazing floor?
   -- Legs cross?  or just a bit wobbly when walking?

It is appearing that the prednisone taper may have begun 12/29 (do let us know the correct date). Therefore the pred taper test is in effect and your job is to monitor for pain.

Backing off of pain meds or full stop of them takes the blindfold off of your eyes to be able to really asses what is going on, if there is any hint of pain starting to resurface. Pain means the body had not been able to get rid of all inflammation in the spinal cord.  Fingers crossed after 21 straight days of pred 2.5mgs 2x/day  all pain will be gone.



The full details on how XXX, an anti-inflammatory works with a disc episode. Good reading to be able to ask the right questions and discuss treatment:
dodgerslist.com/2020/04/18/steroids-vs-nsaids/

Roux' Pain meds (tramadol, gabapentin) can be reduced in only two ways other than a full abrupt stop:
   --  reduce dose in mgs  and/or  reduce how often given.  Your vet gave you no directives whether to do both or how much less for each?

-- A plan B means you would have enough meds (pred + the 2 pain meds) on hand (or an Rx you could fill for a few pills) should you see pain resurface you and your vet would plan that you go back up on all meds to original dose until he reopens.

Please stay in touch to let us know how the pred taper is going.  Fingers crossed no pain will surface!!