Aleisha's Emma 3/2021 RELPSE conserv-Beagle mix; GRAD 5/13

Hello! We finally brought Emma home tonight. They did not assign her a stage, but said they would recommend just going with conservative treatment. They said even from this morning to tonight, she made progress and responded to medication. She's wagging her tail, eating and drinking, and able to walk with a sling.

However, once the sling is removed (such as we put her in her crate) it seems as though she can't support her hind end. For example, when I put her in her crate, she quickly kind of landed on her backside in an odd way. She didn't pull her legs underneath her. She adjusted herself, but by mainly using her front limbs to pull herself into her desire position. This scares and worries us greatly. She has been prescribed prednisone, gabepentin, and codeine. We also we're given acepromazine incase we need something to aid in keeping her calm. We're happy to have her home, but overwhelmed and scared.

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39 lbs
prednisone as of 3/15: 7.5mgs 2x/day for 7 days, 3/22 test taper: _pain/neuro
gabapentin 200 mgs 3x/day
codeine 15mgs 3x/day
needs GI tract protector, Pepcid AC, on board w/prednisone! 

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Hi! Sorry this took a little bit.. But here's those answers

1) Prednisone started on what date? 3/15
-- How many mgs is a dose? 7.5
-- How often do you give? 2 times a day
-- For how many days is it Rx'd before the 1st reduction (taper) starts? 7 days
2) Gabapentin 200mg 3x/day
3) Codeine 15mg 3x/day
4) Is pain fully in control dose to dose, round the clock with gabapentin? Yes. Before pain s meds were even started, Emma was showing no signs of pain.
5) How much does Emma weigh? 39lbs
6) Does Emma have bladder control? As far as I can tell, yes. When taken out, she sniffs and voluntarily lowers her hips to pee (with sling support of course).

What was the neuro's diagnosis? Did the surgeon believe it was same disc as operated on or another disc in the back?
The paperwork says "suspected IVDD," though given she already had surgery six weeks ago, we know she has it. He said based on her movements, she may had slipped a disc but could not confirm. Did not say if it could be the same disc or not.

They also recommend we start omeprazole and famotidine immediately. They started her on it in the hospital, and we picked some up on the way home. She gets 20mg of each twice a day.

[Moderator's Note. Please do not edit
39 lbs
prednisone as of 3/15: 7.5mgs 2x/day for 7 days, 3/22 test taper: _pain/neuro
gabapentin 200 mgs 3x/day
codeine 15mgs 3x/day
famotidine 20mgs 2x/day
omeprazole 20mgs 2x/day]

Here are the things that scare/overwhelm us:
1. She has not pooped yet since we brought her home from the hospital last night. She likes to spin in circles to poop, but obviously that is not an option. Could she have an issue with her bowels from an IVDD episode without being incontinent?
2. Getting her in/out of the crate. She has motor in her legs and can support herself, but it doesn't last long. She does not knuckle anymore, but typically by the time I carry her back to her crate (I always carry to and from going potty, she is only allowed limited steps) she is losing strength and dragging a bit. I worry about the dragging movement into the crate causing her to hurt herself. Getting her out of the crate is easy enough, as she can stand up and walk out. It's getting her back in that concerns me.
3. Her regaining full mobility. She's such a happy, playful dog. I worry she won't regain her full mobility and she'll always be like this - dragging and struggling to support herself with her hind legs.
4. Her getting depressed from too much time in the crate. How can I provide her with a little safe entertainment?
5. Keeping her calm in her crate. We have her crate set up in our bedroom at the moment and an ex-pen on the way for the living room. We use white noise machines and I put on calming dog TV for her, but we have two other dogs (we've been not allowing them in the room for now) and she reacts to noises or when we get home from work. She tends to sit/astand in her crate. She doesn't thrash or get upset, she doesn't mind the crate, but I worry about this little bit of sitting and standing delaying progress.

Overall, I just have a lot of anxiety about conservative treatment being successful. We spent so much on surgery, and when we brought her back to the hospital that day the emergency vet was so full of doom and gloom since we said a second surgery (especially only 6 weeks later) was not an option. We love her so much and she is such a happy, good girl.. We just want to successfully and safely get her back to semi-formal life. We just hope we're making the right choice for her and she isn't suffering.

Hi!

So, per usual, I'm worried. Here's what going on.

Emma seems to be able to still pee on her own and she finally popped. No leaking, she voluntarily lowers her hips and pees. To take her out of her crate, I let her step out and I immediately put a harness on her. While I get the harness on, I support her hind end by holding my for arm under her tummy. I then carry her to the back door, sit her down for just a minute (again, support her hind end with my forearm under her belly similar to how a sling works) so I can can get a sling under her and then use it to hold her while I hook her leash on. I do let her then walk out the door, across a concrete pad, and on to the grass. In total, she probably walks maybe 5 feet. I do this because it's too hard to get her sling and leash on while I hold her, and if I put it on immediately out of the crate and then pick her up, when I set her back down everything gets tangled. I worry that I may be handling potty time wrong.

She pooped, but it was when I sat her down at the back door so I could get her harness on her and walk her out the door. She didn't poop in her crate, she didn't poop on me, it was right at the back door as she was standing. Poop looked normal and firm. This is the first poop she's taken since she came home from the hospital Monday night. But she didn't lower her back end to poop, she just did it standing up.

Nothing is incrementally worse. It's not like she's clearly lost dps or is all of a sudden incontinent. We're still getting lots of happy tail wags. Emma just seems like her hind end is giving her a little more trouble today. Like she's weaker and can move her legs less. When she's in the crate and adjusting positions, she's relying on her front legs more to pull herself into position and using her hind legs less. If she sits, she sits on her back end with her legs splayed out underneath her, not pulling them in. When sling walking, she's not able to fully pick up her legs, she kind of waddled and swings her legs, causing her to knuckle. If she does knuckle, she will correct it within 30 seconds or so.

I've noticed her tummy feels really tense. She's not shaking, whining, or showing us any signs of pain. Pain meds are being given around the clock. Is this maybe because she's working so hard to try to use her legs? It's not like she's taken a step back. More like a tiny fraction of a step back.

She's currently getting 4 potty breaks a day. Otherwise, she's been in the crate. I know it's only day 3 of 8 weeks. I just hope I'm not doing anything wrong that could be hindering her healing. I want to make sure I'm not missing any red flags or warning signs.

The ex pen hasn't been delivered yet, should get here tomorrow. Unfortunately an ex pen outside isn't an option because we live in an apartment complex. However, I did carry her all the way outside, quickly put the sling under her, carried her all the way in. Still. Voluntarily peeing, still no incontinence. When she knuckles, it's not that she's placing her paws wrong, it's that she's having trouble lifting her legs so she drags her paws a little. She shortly corrects them.

Tonight when I took her out, she had to drag her hind end more to get out of the crate. When I picked her up, she whined. This is the first sign of pain we've seen from her since this relapse. I'm worried that she may be declining slowly, showing a sign of pain is definitely a step back. This happened at 11:30. She has her last dose of pain medication at 6.

Should I be worried here or is this a normal part of the process? Should I be calling a vet and trying to figure out how to afford surgery? Outside of the little bit of walking to go potty, it's been nothing but strict, strict rest. I don't know how she could have injured herself further. When I lift her, I put one arm under her chest but in front of her front legs, and one arm under her butt and behind her back legs, keeping her back as straight as I can. Should I be lifting her differently?

Went to take her out this morning and as I was trying to get her out of her crate, she peed in her crate. No accidents or leaking overnight or otherwise. Took her out, she wanted to come right back in (it's pouring). As I was putting her in her crate, she pooped. But like I said, these accidents don't happen otherwise. Only when I'm in the process of getting her outside.. It's like she doesn't quite make it. It seems like she's just getting worse, I don't get it.

Talked everything through with neurology. They said that as long as signs of pain haven't continued (which they have not, she only whined that one time last night when I picked her up) and she's comfortable, then she should be okay. They said that sometimes dogs going through this recovery get a little apprehensive about being lifted. The dog anticipate pain even if it is not there. Outside of this one incident, she has showed no other signs of pain. They said if she begins yelping, snapping when we try to touch her, screaming/crying when not being touch, visibly in pain, then we have an emergency and need to call them. Luckily, we haven't had this problem.

We discussed DPS, how she is walking, and her overall slight decline in mobility. They said what's going on is normal. Recovery is not just a straight forward thing, there's good days and not so good ones. But if we're medicating her, keeping her on strict rest, and keeping comfortable, then we're good. They determined she still absolutely has DPS.

We also talked about her bathroom habits. They said given that she is holding her pee until she leaves her crate, she's absolutely not incontinent. She is not leaking. They also explained to me the role that the brain plays in defecating and poop will come when it comes. They said as long as she is peeing voluntarily and able to poop, we have nothing to worry about.

Ultimately, they said everything we described is nothing we need to worry about. She's not declining, she's just healing and it's hard. They said we're doing the right things, we just need to keep doing them.

We have now transitioned her to an ex-pen recovery suite. Instead of trying to get her outside because this has been so challenging and worrisome for us, we have opted to having her go potty on a pee pad directly in front of her recovery suite. This has worked significantly better. We had restarted her 8 weeks, but are leaving the medication the same for now. If there's a significant change or we finish the medication and she's still showing signs of pain, we'll address it.

I'd say her neurological functions have stabilized. The haven't gotten worse. She can't seem to stand and hold herself up with her hind legs at all. If she sits up in her bed, it's her pushing herself up with her front legs and her back legs splayed underneath them. Almost like she can't move them at all. But then I'll run my fingers through the webbing in her back paws, and she'll get annoyed and pull it back. The loss of a lot of mobility/motor function in her legs has been alarming to me, but it was the same way yesterday. It's a not a new development.

No change in bladder control and we're still getting happy tail wags.

Such wonderful signs of nerve healing so soon during conservative care, Aleisha! She even scratched her head! Great to hear.

UTIs can be very painful and they make it painful to urinate. Emma may not want to urinate due to the burning caused by the UTI and may be trying to hold it. I hope you see improvement soon with the antibiotic though it may take a few days.

Please let us know what the dosage of Amoxicillin is and how often given.

She is still tapering down prednisone, 1 dose every other day, she gets acepromazine as needed to keep her calm, and amoxicillin.

She peed Sunday morning and continued to have a normal day, peeing a few other times. But now we're back to where we were and she hasn't peed in 24 hours again. It's odd though because again, she's acting 100% normal otherwise. Eating, drinking, tail wagging, no signs of pain. It's not that she is trying to go but can't or in pain or straining, she literally just won't even try to pee.

Hello! It’s been quite some time since I’ve posted. Emma is more or less four months out from her last episode. She regained 100% of her mobility and is able to support herself, walk, kick, scratch her head, just about anything you can think of. Her bladder function and bowel function are 100% normal, no more UTIs and she has complete control. Once she hit the 8 week mark, we started doing walks once a day that are increased by a minute every few days to help her rebuild strength, stamina, and coordination. Though she’s completely mobile, these things are still very much a work in progress. We walk her with a harness and sling assisted on either flat grass or flat sidewalk, no hills or stairs. We have not returned her to full freedom in the home yet. When we’re not home or at night, she is crated. When we are home she is either in her ex pen or supervised in a room with one of us. Outside of the walks, we are not doing any other physical therapy.

Almost a week ago Emma’s tail started hanging limp. When she’s excited or we’re walking, she’ll wag it, but not hold it up past being level with her back. If we touch her tail, she’ll react in an annoyed way. If she wags it too hard, she’ll whine. However, that is the only time she will show any sign of pain.

To me, it looks like she has limber tail, which she’s had a few times before and has presented itself identical to this. Outside of the symptoms with the tail, everything is 100% normal and the same. She’s walking the same, if anything it’s still gradually improving. She’s not hunched. She’s not trembling or panting. Appetite is the same. Urinating and defecting are the same. Everything is the same. She’s a beagle mix with a long tail. My point being, there are no other indicators of an episode. Plus, she hasn’t had the opportunity to do anything to cause an episode as her return to a normal, IVDD safe life has been very gradual.

When we would not opt for a second surgery her last episode, our neurologist basically abandoned us. We were prescribed the medication to complete conservative treatment and kicked to the curb. If we had an issue and were lucky, we could get one of his techs to call us back. Our primary vet is IVDD friendly. Not the way a neurologist is, but enough. But he’s the one that when she had her first episode in January, referred us to this neurologist. We haven’t called our vet yet because we’re very hesitant to transport Emma unless it’s necessary because of the risk it opens her up to. We’re also not sure if it’s necessary as limber tail is something that resolves on its own with rest and time.

My question is, do we have something to be worried about here? Is it possible that it is just limber tail? That’s what it looks like to me, but I’m also not a vet and we don’t want to overlook anything. Is it unusual or unheard of for an IVDD dog to get limber tail?

Hi! It’s been almost a week since my last post, figured I’d provide an update. Emma hasn’t shown any other indications or symptoms of a disc episode. There’s been zero neurological diminishment. We’ve taken it easy the last week (no walks, no supervised out of crate/pen time). She’s just about 100% back to normal.