Brenda's Maggie 12/17 conservative GRAD 2/11

Welcome Brenda!  A gold star goes to you and your vet for prompt action upon suspicion of a disc episode!  ⭐️

The very STRICT crate rest part of conservative treatment is to allow the disc to form good secure scar tissue by the end of 8 weeks of STRICT rest you have been doing. Keep up the good work. Confirm you are on the same page about potty times, and STRICT rest:
---- carried to and from the potty place. Only a the very fewest of footsteps permitted that a 6 foot diameter area allows:
 

STRICT rest means:
◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you
◼︎no chiro therapy WHYs: dodgerslist.com/2020/04/22/chiropractic/
◼︎no  meandering at potty times.
◼︎no PT for conservative dogs during 8 weeks to heal disc 
◼︎ avoid dangerous detours. Follow the "Roadmap." Tape it to your fridge. D/L and print out: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf

MEDS
Wonderful to hear all pain is being well managed while Galliprant works in 7 to 30 days to resolve all spinal cord swelling.
1)  What date will Galliprant stop so YOU can assess if there is any remaining swelling. Most vets take a guess with a 7- or 14-day course of the NSAID.  On the stop of Galliprant you can go by this rule of thumb in what to expect:


The full details on how Galliprant, 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/

2)  FDA and package insert info is:

Concerns and Cautions
Grapiprant should not be given with food. It will not absorb into the body predictably.

Side Effects and Client Information Sheet: Because all NSAIDs interfere with the other positive functions of prostaglandins, they can cause side effects, some of which are serious. Galliprant is no exception.  www.fda.gov/animal-veterinary/animal-health-literacy/galliprant-nonsteroidal-anti-inflammatory-drug-nsaid-dogs-osteoarthritis
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Owners should be advised of the potential for adverse reactions and be informed of the clinical signs associated with drug intolerance. Adverse radians may include vomiting, diarrhea, decreased appetite. www.elancolabels.com/us/galliprant-with-tear-off

3) Disc episode dogs  and Pepcid AC
    Be aware of the three factors during a disc episode that can all contribute to increased stomach acids. Pepcid AC works to suppress these acids. Makes sense to be proactive not waiting til red flag signs of GI tract damage arise. dodgerslist.com/2020/05/06/stomach-protection/

GALLIPRANT stop test for pain
The date that Galliprant stops, will be a perfect time to test if all swelling is gone.
With any STOP, 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!
Let us know what you have worked out with your vet for Maggie's Plan B.

Brenda, a lot about a disc episode is guess work.
  
--- most diagnosis are achieved by an exam, breed, prior health history. Xray's do not prove a disc episode, but might help to give suspicion to one. Xray are to rule out other diseases such as a broken vertebrae which can mimic a disc episode.

-- Most Rx's for meds are guessing the times per day, the mgs per dose based somewhere in the low to the high range for a med.  Owners need to actively participating in monitoring for adjustments in meds if pain would surface.

-- How long to use an anti-inflammatory is also guess work. No one wants a dog on any anti-inflammatory longer than necessary due to the side effects the all have.  So this is why most vets will guess at a 7-day if the symptoms are mild or maybe a 14-day course if there is a lot of pain and neuro diminishment. The stop of the NSAID course allows checking to see if it is needed or  that all swelling is gone. With Maggie's rather mild symptoms, it may be worthwhile to advocate a sooner stop than the planned Jan 6th 20-day course. 

-- Without taking expensive $1200 MRIs which do show soft tissue of discs and spinal cord, a vet must guess how long crate rest should be.  I've been on this Forum since 2007, I am not a vet, just a layperson observer in the stands reading owner reports of over 15,000 dogs passing thru the Forum. I have not heard of harm to ensuring the disc has healed with 8 weeks of STRICT rest. But I have read too many posts of sad owners who did not give the full 8 weeks causing a relapse to the still early healing disc, starting from square one in pain, meds and 8 weeks count for rest.

Once crate rest has been completed then it will be safe for the conservative treated dog to begin a slow introduction back to activity. Mild to moderate muscle disuse will soon bulk up again.



All tissues in the body go through a predictable healing step by step process. The disc is a little bit different because it is avascular (basically no blood supply) to speed healing of forming strong scar tissue. Dr. Nicholas Sharp, DVM, ACVIM (neurology) explains further: "a disc takes on average about twice as long as a broken bone to heal, as a disc has a very poor blood supply compared to most other tissues including bone."

So the 8 weeks of disc rest is similar to need for a broken bone to have limited movement to heal. It is just that the disc takes longer than it takes broken bone to knit back.

POTTY TIME
See if you can condition Maggie to make quicker work of business to limit her to footsteps, avoid walking around. Place her on an old pee spot for more immediate inspiration.  When you  see her sniff, maybe start to circle, give the command, "Go Potty!"  When she does it, give lavish praise "Good Potty!!!"  I believe practicing your command after a few foot steps to Go Potty will culminate in a faster poop or pee.  Let us know 

I am glad that Maggie is taking fewer steps at potty time. It is so important that their movements are limited to give the disc time to heal. The x-pen may make this easier.

Very good that Maggie is still content in the crate. It is sometimes hard for us pet parents to crate our dogs for eight weeks. It might help to think of the crate as a relaxing recovery suite with room service and not a sort of prison.

I hope that the stop of Galliprant goes well. If no pain is seen when it is stopped, Maggie will no longer need meds. Only the rest of the eight weeks of crate rest remain. If pain is seen, Maggie will need more time on the Galliprant and Pepcid.

So just a quick update.  Maggie has successfully been on strict crate rest for 6 weeks now, and last night she let out a very loud yelp when I picked her up to take her potty, but otherwise, was acting completely normal, able to pee/poop/walk just fine. Took her to my vet this morning who did an x-ray and found absolutely no sign of any disc issue at all in her spine. He tested her neurologically and consulted with another vet and they both agreed that her spine looked completely normal and they did not think this was early IVDD based on the x-rays. He did, however, say she had huge anal glands and he expressed those. He was it wouldn't be completely out of the question for that to make her yelp if I picked her up in a certain way.  He did give me some more Galliprant but said not to use it for a day or two because if it was the anal glands causing the problem, hopefully it was resolved when he expressed them. He also said based on the x-ray that he thought I could relax a little bit on the crate rest.  Your thoughts?

Ok, will keep up the crate rest for a couple more weeks.  He did say that if she yelped again to give her the Galliprant and call them back and then they would more than likely go ahead with a CT because, as you said, he did say that x-ray was not as sensitive as CT in picking up disc issues.