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Post by Jody & Newman on Dec 29, 2020 19:10:12 GMT -7
My name is Jody. This is the second time here. I rehabbed my dog Bentley a few years back and he’s doing great.
Now for another one of my dogs.
Newman 8.5 years old French Bulldog 26 pounds. Otherwise healthy.
Had a few minor back pain episodes when he was younger, but nothing that last too long.
A few months ago I noticed him “skipping” on of of our walks. I thought maybe a patella and didn’t think much of it.
Fast forward a few weeks and I noticed he started to show a little Wonkie gait. Took to a vet (not normal vet as she was on vacation.) November 4.
This vet said that he appeared possibly a bit painful in the rear and prescribed Dermaxx. Said was ok for normal activities. I did as she prescribed for 3-4 weeks but he seemed to get worse. I made another appt with my vet for Dec 23 (soonest) for regular well visit and to check his rear. During the wait, Newman gait got more drunk looking and I noticed poo during nighttime while asleep.
Dec 23 vet check
My vet took X-rays and bloodwork
Xrays shows thoracic and sacral abnormalities (kind of normal for frenchies).
She agreed he showed ataxia in the rear but no pain. We decided on prednisone course, sucralfate (1 hour before prednisone) and strict crate rest. But she wanted me to wait several days till blood work came back (holiday delay) and because I had given deramaxx three days prior.
Dec 25-28 Newman was most crate rested with no meds. No more poo episodes at night. No obvious pain. Still drunk looking in rear but seemed better with crate rest.
[Moderator's Note. Please do not edit
26lbs 8y.o.
STRICT rest as of 12/25
Prednisone as of 12/29: 5mgs 2x/day for 5 days, then 1/3 taper test: _pain/_neuro
sucralfate ?mgs ?x/day]
Monday December 28 blood work good ok per vet to start prednisone/sucralfate (1 hr before pred)
Dec 29 started Prednisone 5mg 2x/day 5 days
5mg. 1x/day 5 days
5mg 1x. Every other day 5 days
Will keep tabs on how he’s doing to add other meds (pain or muscle relaxers) as needed.
Strict crate rest. 24/7 will carry to/from potty. Set up several crates in different rooms so he has several areas he can be with family.
*** I am confused if I should add Pepcid (10mg) 1 hour before prednisone rather than the sucralfate?
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Dec 29, 2020 20:18:04 GMT -7
Jody, sorry to hear your other Frenchie having a disc episode. Are the two dogs siblings? What did your family vet on Dec 23 diagnose, what did she name as the disease? Pepcid AC is a special antihistamine that suppress the production of stomach acids. Start with Pepcid AC (0.44mg famotidine per lbs) round to size of tab = 10mgs dose twice a day. Give Pepcid AC 30 mins prior to prednisone. A medication chart is useful to see patterns, have dates and specific facts handy as you discuss things with the vet. D/l a sample and a blank form to use with your dog's meds www.dodgerslist.com/literature/crateRRP/medchart.pdfMost dogs have good stomach protection with Pepcid AC (famotidine) alone. If Newman would show you beginning red flag signs (not eating, nausea, vomit, diareah) then immediate get an Rx from your vet for SUCRALFATE. It works in a different way to form a gel coat over any damaged areas of the stomach lining. Read up on sucralfate so you know the timing with food and with Pepcid AC (famotidine): marvistavet.com/sucralfate.pml PREDNISONE Jan 3 taper The prednisone taper is to signal the body to again make cortisol (steroid). That taper just happens to be a perfect test for painful swelling for IVDD dogs! Here is how that "test for pain" taper works: --- Your job at home is to watch for any hint of pain and report to the vet at once. Pain=
another course of PRED +
pain meds, Pepcid AC on board.
No Pain=
go to TAPER conclusion...
finish out the 8 weeks of crate rest for the disc to heal
. --- Getting all the swelling down can possibly take from 7-30 days excluding any days that pred is at a taper lower dose/frequency. --- Always have a plan "B" in place with the vet during a taper on what you should do should pain surface. A plan "B" might be an Rx you could fill or having enough meds on hand should that happen over a weekend or evening when the Vet is closed, to save an expensive ER visit. 🍫The full details on how Prednisone, 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/ |
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Post by Jody & Newman on Dec 29, 2020 20:41:36 GMT -7
My vet said there was a lot of areas of narrowing between the discs in the thoracic and sacral areas of the spine on the X-rays. His hips looked good. Therefore along with the signs (way he was walking and poo accidents at night) she assumed the problem was coming from the sacral region (perhaps inflamed nerve or pinched nerve). She indicated IVDD. We chose to try conservative treatment and see how he does.
She prescribed 500 mg sucralfate 1 hour before prednisone (pred with a meal).
I can talk to her about switching to Pepcid 10mg (he’s 26 pounds) 1/2 hour before prednisone instead of the sucralfate if that seems more advisable?
My two frenchies with the back issues are not related to each other.
*****Newman is still a wild child at 8.5 years old. He runs around full speed and will run and try to stop and then slide into things and walls. It wouldn’t surprise me if he hurt himself at some point (which maybe could have started this current back issue) without my knowledge. I’m hopeful for him to recover.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Dec 29, 2020 21:13:11 GMT -7
Jody, ask your vet about the sucralfate. Perhaps there is a health reason that Newman may not take Pepcid AC and thus the sucralfate?
How many times a day is the Sucralfate Rx for?
Sucralfate is given 1 hour before a meal as the acids in the stomach are needed to form the protective gel coating.
Pepcid AC should be given 30 mins before prednisone as it supresses production of stomach acids.
With your doing the single most important care (100% very STRICT rest 24/7), Newman is a good candidate to heal his disc with conservative treatment.
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Post by Jody & Newman on Jan 1, 2021 8:17:07 GMT -7
Update
Talked to my vet. Giving 10mg ✙Pepcid 1/2 hour before prednisone doses (right now those pred doses are 5mg am and pm with meals) Will give 500mg sucralfate in the middle of the day (hours after the prednisone) just as a second safeguard to coat stomach.
[Moderator's Note. Please do not edit
26lbs 8y.o.
STRICT rest as of 12/25
Prednisone as of 12/29: 5mgs 2x/day for 5 days, then 1/3 taper test: _pain/_neuro
sucralfate 500mgs 1x/day
✙Pepcid ?mgs 2x/day]
Newman has been being crated other than going potty (carrying him to/from potty area). He hasn’t had any those poo accidents (while asleep) and the small amount of walking he does do for potty seems to be somewhat better (more stable and not as “drunk” looking). Although I’m not letting him walk much -only to potty and more “in place” walking...so I’m only going by a small sample of his walking).
He’s currently on the fourth day of the 5mg prednisone twice daily. He will start to wean after the fifth day to 5mg once a day (for 5 days).
I am hopeful he can make good recovery.
He doesn’t seem to be in any pain. Seems pretty relaxed in his crate.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Jan 1, 2021 11:41:58 GMT -7
Jody, we've got our fingers crossed that on the start of the prednisone taper test for pain Jan 3, the test will not be showing you any signs of pain surfacing. Meaning no need of another course of prednisone. Meaning you can go to the conclusion of the pred taper and complete the 8 weeks of rest for the disc to self heal.
Keep up the good work you are doing on STRICT rest for the healing disc. When you can do keep us posted how the test taper is going.
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Post by Jody & Newman on Jan 3, 2021 12:55:46 GMT -7
Talked to my vet today over the phone. Newman is doing well I think. He’s still a bit stiff when he comes out of the crate and walks but walking looks better (the small amount he’s doing to potty). I asked the vet if I could extend the prednisone (2xday) a few more days before starting the wean. I feel that may be better for him as my gut says he needs more anti-inflammatory effect.
The vet agreed to let me add ✙2 more days (for a total of seven days of 5mg 2xday). Then I will start weaning him to ONCE a day for a week then once every other day for a week.
I will continue with the 10mg Pepcid 1/2 hour before the pred and the 500mg sucralfate mid afternoon.
[Moderator's Note. Please do not edit
26lbs 8y.o.
STRICT rest as of 12/25
Prednisone as of 12/29: 5mgs 2x/day for 7 days, then 1/5 taper test: _pain/_neuro
sucralfate 500mgs 1x/day
Pepcid 10mgs 2x/day]
100% crate rest other than potty.
Praying this works
Just curious what a typical course of pred is used in a case like this? I find different opinions and regiments. Is there a true recommended course that vets are encouraged to prescribe (dose and days prior to weaning)?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Jan 3, 2021 14:42:16 GMT -7
Jody, there is one guiding principle in how long to use the anti-inflammatory dose level of prednisone during a disc episode.
If there is pain, then a dog should be on a prednisone course. Often a vet will take a guess and Rx a 7- or a 14-day course.
At the end of that 7- or 14-day course, is the taper. That taper serves two purposes.
-- the body needs to be signaled to make its own body regulating hormone steroid called cortisol.
-- the taper just happens to be the perfect way for owner and vet to test if all swelling is gone. NOTE is may take several pred courses (several taper tests) before the painful inflammation is finally gone. Often that will fall in the range fo 7-30 day of pred EXCLUDING taper doses which are too low to work on spinal cord swellling/inflammation. Of course, we all have our fingers crossed the pred taper test will show all pain is gone with just one 7-day pred course.
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Post by Jody & Newman on Jan 8, 2021 19:32:33 GMT -7
Update
Newman is on his fourth day of [tapered] prednisone 5 mg one time a day. We have one more day and then we will go to 5 mg every other day.
He has been being crate rested other than potty the entire time.
I feel by watching him walk the small amount during potty that he looks stronger in the rear. He still has a “drunk walk” but it is definitely better and more stable looking. His balance looks better and I feel like he stands more “upright” than he was a few weeks ago. I guess I’m hoping that it will continue to improve? He does not to be appear to be in any pain or discomfort in anyway. Should I hope for more improvement? Or am I being too unrealistic?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,540
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Post by PaulaM on Jan 8, 2021 20:38:16 GMT -7
Jody, the improvement in the pain department on the pred taper is going very well. No signs of pain.
In the neuro department of the whole focus of healing during the 8 weeks is that of the disc healing. Neuro function improvement may or may not come back in that short time. So being more stable with his legs is a good thing as the nerves self repair and can better communicate with the brain.
Feb 29th is graduation day and I will not be surprised if by then even more neuro improvement is showing itself. Keep up the good work of the strict rest for the disc to self heal and in turn the protection of the spinal cord.
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Post by Jody & Newman on Jan 18, 2021 12:14:23 GMT -7
Update 1/18/21
Newman and I have stayed on course. He has one more day of 5mg prednisone taper tommorow.
No signs of pain
Walking during potty has improved some since last update but not 100% back to normal. Still some stiffness looking in his rear legs while moving and slightly drunk looking still. But definitely better than the last time I updated.
Hoping for more improvement (of course).
I will continue to crate him for the duration of the 8 weeks (mid Feb) and watch for any relapse signs or symptoms.
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Post by Jody & Newman on Feb 24, 2021 7:15:11 GMT -7
Update Newman and I have stayed the course. Been crate 24/7 other than potty and carried to/from potty area. He is doing relatively well considering where we started. No more meds. No apparent pain. Walking is about 85% normal. Some wobbly left when walking. He does seem to have some issues with bowel. When he walks sometimes he starts to go poop and then realizes and gets into position to finish. I’m slowly starting to walk him from his crate (with leash) to the outside using ramp for outdoor steps. I allow him to potty and walk back to crate. I also am not allowing him to come out of crate (while leashed) to sit and hang outside the crate. Will do this a few times a day. And move up/down from there. I’m not sure if this is progressive for him? I guess time will tell. Will take things slow and hope for the best. Question for Moderator: My vet said Newman could stay on low dose prednisone every few days for “maintenance” if needed. I’m not sure on that?. Maybe feedback from you would help me know if that is a good idea?  |
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Marjorie
Moderator~ 
Member since 2011. Surgery & Conservative
Posts: 5,724 
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Post by Marjorie on Feb 24, 2021 7:39:28 GMT -7
Congratulations on completing the 8 weeks of strict crate rest, Jody. It sounds like Newman is doing very well indeed. Please do take it very slowly. Too much movement too soon and it would be difficult to determine whether any pain that might arise is from another disc episode or from sore muscles. During the first week, walking up and down a hallway for only a minute is recommended and then in the crate to observe. Here is a sample schedule to slowly introduce your dog back to family life and physical activity (click on arrow right under Graduate photo): dodgerslist.com/2020/06/15/back-friendly/ An anti-inflammatory such as Prednisone is given at the beginning of a disc episode to work on resolving the swelling that presses into the nerves of the spine, which causes pain and can damage nerves. That swelling usually takes 7-30 days to resolve and once it resolves, then there is no longer a need for any meds, including the Prednisone. If meds have been stopped for at least 5-7 days and no sign of pain has returned, then you have proof that the swelling has resolved and Prednisone is no longer needed. I do not understand your vet's advice to give a low-dose Prednisone every few days for "maintenance". Should you see any sign of pain at any time in the future, you would need to immediately crate Newman to protect his spine from further damage, have him seen by a vet ASAP to determine if he's having another disc episode and should he be having another disc episode, at that point he would again need an anti-inflammatory, pain meds and a stomach protector and be treated either with conservative care again or surgery. Anti-inflammatories do not prevent another disc from tearing or rupturing. Preventing Newman from going up and down stairs, jumping up or down can help reduce stress in the spine but with IVDD any disc can tear or rupture at any time should it degenerate enough. With a dog that can walk, the best PT that you can give is gradually increasing his walking. If he is wobbly enough that his hips fall to the side, you should use a sling while walking to help stabilize his spine. Hopefully his bowel control will improve in time. Furniture blockers, etc.: dodgerslist.com/2020/07/09/home-protect-ivdd-backs/More tips on living with IVDD: dodgerslist.com/living-with-ivdd-tipsWe love it when members have a mind to pay forward and help another. We invite you to hop on to our educational bandwagon team in any way that makes you happy. Education about disc disease is our number one mission! We wish we did not have to hear of another dog that was put to sleep because of disc disease nor one denied the correct principles of crate rest to help them heal.
--- You've been there, and are doing it....if you see another member on the Forum needing support or information share what you know to be true or point them to one of our many IVDD articles. The "search box" on each page makes quick work to find the right helpful link: www.dodgerslist.com/-- "Share" our FB/twitter/ posts to widen the reach of IVDD knowledge www.facebook.com/Dodgerslist twitter.com/DodgersList-- Hand carry our literature and introduce us to your vet. When in conversation at the grocery store line or wherever you meet breeds most prone to IVDD (Dachshunds, Beagles, Poodles, Spaniels, Shih Tzus, Pekingese, and Chihuahuas) to give out our little cards. Ask Linda to send you our free packet: dodgerslist.com/free-literature-2 -- Check out our dog collar tag shop! Our earnings go to paying for our webpage and literature to hand out. dodgerslist.com/2020/08/08/collar-tag-shop -- Don't forget to add a photo to the gallery and 1-2 sentences. Give inspiration to others just starting a scary IVDD journey. Directions to u/l here: dodgerslist.boards.net/thread/2262/put-dodgerslist-photo-gallery-calendarPrayers for many happy, healthy years ahead for you and Newman. Please do keep in touch as we love getting updates from our Dodgerslist graduates. |
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