PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,544
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Post by PaulaM on Dec 27, 2020 9:06:14 GMT -7
Bridget would you describe what you observe at potty time, so we can visual what you can see regarding your thought of pain at potty time. Are his poops normal or too hard?
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Post by Bridget & Cooper on Jan 1, 2021 21:04:04 GMT -7
His poops are totally normal, maybe a little on the hard side but I’ve increased the amount of pumpkin ive added to his food. I give him pumpkin about 4 times a day. I mix it in his food with every meal. I give him many small meals throughout the day. Now his bowels are mostly soft but still healthy. I believe, Its more of the position, arched back, that hurts him. Whenever he poops, he tries to run away during. Because of this pain, I got them to move his neurologist appointment up and now we go back for a follow up on 1/7. Other than this pain, he is making excellent improvements. His hind legs now move appropriately when assisted with a sling on walks for potty. He continues to stand more in the crate too. It’s definitely not perfect walking or consistent but the progress is there.
Side note. He did have diarrhea once, I think it’s a reaction to the trazodone. Cooper’s energy levels have been high and crating him continues to be a challenge. The trazodone seems to help but I wish there was another way to keep him calm other than medication.
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Marjorie
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Member since 2011. Surgery & Conservative
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Post by Marjorie on Jan 2, 2021 8:09:20 GMT -7
The vet had previously said that if there was pain upon the taper, he would provide an additional course of Prednisone. Is that what has been done? Has Cooper now been returned to the anti-inflammatory dosage of Prednisone (2.5mg 2x/day)? That is what should have been done by the vet as soon as pain arose. If that has not yet been done yet (which seems to be the case since Cooper is still in pain), please immediately (TODAY) speak to the vet to advocate strongly for a return to the anti-inflammatory dosage of Prednisone (2.5mg 2x/day) for a bit longer. This CANNOT wait until 1/7. There is no reason a physical exam needs to be done in order for a vet to adjust meds.
I'm very glad to hear that Cooper has shown such good signs of nerve healing. But do speak to the vet today about Cooper's pain (which is showing even with pain meds on board). Nerves do not like being compressed and the swelling is pressing on those nerves, which could lead to nerve damage and a worsening of neuro function.
What reason has the vet given you for a follow-up exam? Transport involves risk of too much movement of the spine. A vet who understands the importance of strict crate rest during conservative care will not demand a physical exam but rather would agree to take phone updates. Please speak to the vet prior to the 1/7 visit about allowing phone updates rather than physical exams. Cooper is doing too well to risk a relapse.
Has the diarrhea resolved at this point? Occasionally in some dogs, Pepcid AC is not enough to completely avoid the side effects of Prednisone. Should there be any further bouts of diarrhea, please speak to the vet about adding a second stomach protector - Sucralfate.
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Post by Bridget & Cooper on Jan 8, 2021 10:59:48 GMT -7
Due to his bowel movement pain, I aggressively asked to get Cooper into his follow up appointment sooner rather than later. However, within this timeframe Cooper has made serious improvements and can walk!
I had my follow up appointment on 1/7 with Cooper yesterday. The bowel movement pain is not something that concerns Dr. Williams neurologist because Cooper is able to walk now. He went from standing to full on walking!! He started moving his legs correctly while assisted with the sling but now at home, he is able to get enough strength to walk and even eat standing up. I continue to use the sling for potty breaks outside. DR. Williams mentioned that typically amantadine doesn't take full effect until using for 6 weeks so she thinks that when this medication reaches that point, some of the pain/discomfort associated with bowel movements should be relived. But do to his walking and progress there is no reason to increase any medications at this time.
We are still on crate rest for 2 more weeks [1/22!]. The walking I mentioned above is short, not longer than 1 minute or so and just in the living room. After the 2 weeks is over, the plan is to taper off the tramadol. Then we can monitor for continued pain and see if medications need to be increased.
[Moderator's Note. Please do not edit 13 lbs, 8.5 y.o. PT stopped 12/16 True very STRICT crate rest started 12/17 12/18 Dr. Williams, DVM, ACVIM identified slight DPS prednisone as of 12/5: 2.5mgs 2x/day for 3 days, then a 12/8 test taper for: √ pain / _neuro 10mgs tab as of 12/18: 2.5mg 2x/day for 7 days. 12/25 test taper: √1/1-8 pain / _neuro tramadol 50 mgs 3x/day gabapentin 50mg/mL : 50mgs (1.4mL) 3x/day diazepam 5mg 3x/day trazadone as of 12/26 Amantadine as of 12/23 10mg 1x/day Pepcid AC 5mg 2x/day; for 13lbs dog should be 5mgs 2x/day]
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,544
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Post by PaulaM on Jan 8, 2021 12:02:39 GMT -7
Bridget, what wonderful news of Cooper already self healing his nerves during the 8 weeks it takes a disc to self heal and graduation day of 2/11. Nerve healing won't necessarily mean that all of the spinal cord swelling has resolved. Prednisone is the drug that helps resolve swelling which is the root cause of pain. So a bit confused. What does neuro think the root cause of painful pooping is if not caused from spinal cord swelling? Cooper should not have to be in pain. What is the diagnosis of the painful poops and why was nothing recommended, Rx'd now to relieve that pain? Very confusing. -- constipation making pooping painful = use of 1 tsp plain pureed pumpkin once a day + soaked kibble meals to increase moisture in poop. -- spinal cord swelling, then another short course of pred to resolve. Proof is the pred taper to see if any pain resurfaces. -- Call and find out what is going on with pain and what you should be doing. Not fair at all (read that as not humane) to not be concerned about an animal in discomfort! As long as I have been on this Forum since 2007 and the over 10,000 dogs with their owners reports, I have not heard of harm from making sure the disc is well healed with 8 weeks of STRICT very few limited footsteps. But I have heard of heartbreak, pain to owners pocket book with a disc relapse of meds, maybe a surgery. Pain to the dog when the disc re-tears and having to start at square one in meds, 8 weeks of rest when choosing to short cut the STRICT rest. Your dog, your pocket book to decide what is best for Cooper. STRICT rest means: ◼︎ no walking around house — only a few limited footsteps at potty time ◼︎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. What dose and x/day of Prednisone is Cooper currently if any mgs?
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Post by Bridget & Cooper on Jan 19, 2021 9:01:28 GMT -7
Wanted to give an update. All Cooper's pain is gone even during bowel movements. I'm now starting to think what I thought was bowel movement pain was actually embarrassment because I made him go in the house. It's been hard to take him up and down the apartment stairs and I live in the city with little grass so I thought this was best. What I thought was running away in pain, I'm now thinking was running away because he knew going poop in the house is a bad thing. When he poops outside there is no pain. We have gotten into a good potty break routine and I've noticed that when we started this, the "pain" subsided.
He is making incredible strides. He is able to walk unassisted, run if I would let him (which I do not). I still continue to assist him during potty walks but I let him walk inside on carpet for about 1 minute a day to make sure he doesn't lose any more muscle. We go to back to the neurologist this week for another check up and will work with Dr. Williams on what is best for Cooper in terms of continuing crate rest and starting PT.
Right now, we have tapered off ▼tramadol to once a day. So far, no pain. He is ready to get back to his old self. He has unzipped and jumped out of his pen (two times) when I've ran to the bathroom. So now, I have to bring him into the bathroom every time I go. He is ready to roam, which is terrifying. I continue to give him trazodone to make sure he finished crate rest. Although, hee was on the trazodone when he jumped out of his pen but usually he does well and sleeps while he's on the traz. [Moderator's Note. Please do not edit 13 lbs, 8.5 y.o. PT stopped 12/16 True very STRICT crate rest started 12/17 12/18 Dr. Williams, DVM, ACVIM identified slight DPS prednisone as of 12/5: 2.5mgs 2x/day for 3 days, then a 12/8 test taper for: √ pain / _neuro 10mgs tab as of 12/18: 2.5mg 2x/day for 7 days. 12/25 test taper: √1/1-8 pain / _neuro tramadol 50 mgs ▼1x/day gabapentin 50mg/mL : 50mgs (1.4mL) 3x/day diazepam 5mg 3x/day trazadone as of 12/26 Amantadine as of 12/23 10mg 1x/day Pepcid AC 5mg 2x/day; for 13lbs dog should be 5mgs 2x/day]
He is finishing up his package of 6 laser treatments and has gotten at home electro-acupuncture twice. This seems like a very quick recovery, from paralyzed to walking within 5-6 weeks. I understand that relapses are common. I hear you when you say that 8 weeks is the minimum. If Dr. Williams thinks thats Cooper is ready to be off create rest during our appointment this week, should I continue until a proper 8 week is complete? Her initial treatment plan was crate rest for 4-8 weeks and then 2 weeks after resolution of symptoms. Now that his symptoms have been resolved, I worry about reintroducing back to "normal".
Really grateful for all your help! It's tough for you to understand exactly how Cooper is doing when it's all via words but helping me advocate for him was life changing!
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,544
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Post by PaulaM on Jan 19, 2021 10:04:13 GMT -7
Bridget some very excellent news of self healing of nerves to bring back walking. Sorry to rain on your parade, though. 8 weeks of rest is for the purpose of letting the disc heal. You are jeopardizing all the excellent progress of Cooper's body doing the job of self healing nerves with allowing going on walks. Cooper should only be allowed footsteps, very, very minimal footsteps when necessary. Necessary is potty time only. All other times, his disc should be safe inside of the recovery suites. The suite for a healing disc is akin a cast for a broken arm, limiting movement so the bone can heal. Why would you jeopardize the healing disc and all the good work of self healing nerves by a risky to the disc transport into a neuro appt? At the end of crate rest with graduation date, then if you feel there is a need for seeing if some sort of formal PT for back legs is necessary, then seek those appts. Vets who understand conservative treatment, understand the need to treat the disc with limited movement and will take phone calls, phone updates, phone questions in order to protect the healing disc. Relapse to the healing disc IS common when very STRICT rest is not carried out until graduation day. Multiple disc episodes could happen over a life time. They are not relapses, but a new disc episode to the same disc or to a different disc. All the disc are degenerating. Understand more about IVDD: dodgerslist.com/2020/06/26/what-is-disc-disease/Once crate rest has been completed then it will be safe for the conservative treated dog to begin a slow introduction back to activity. Muscles will bulk up again. click to enlarge picture: PREDNISONE Please tell us where prednisone is now. Fully off or still on tapering doses? When will be the last taper dose? What about all the other meds, what changes to med list have been made? 13 lbs, 8.5 y.o. prednisone as of 12/5: 2.5mgs 2x/day for 3 days, then a 12/8 test taper for: √ pain 10mgs tab as of 12/18: 2.5mg 2x/day for 7 days. 12/25 test taper: √1/1-8 pain / _neuro tramadol 50 mgs ▼1x/day gabapentin 50mg/mL : 50mgs (1.4mL) 3x/day diazepam 5mg 3x/day trazadone Amantadine as of 12/23 10mg 1x/day Pepcid AC 5mg 2x/day; for 13lbs dog should be 5mgs 2x/day
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