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Post by Jessica & Roxy on Jun 15, 2021 10:57:10 GMT -7
Hi Paula - Thanks for your input! I think it was helpful in the sense that we now know the results of the MRI and that the injury is mild and prognosis good!
The update from yesterday includes her current medication list and the dates of her last taper — my understanding is that she’ll be fully off of prednisone starting today (she’s been 1/2 a 5 mg pull every other day for the last few days) and also pain medications will start to taper until she is off of those as well.
[Moderator's Note. Please do not edit
12lbs 11 y.o.
crate rest started 4/20
prednisone as of 4/25: 5mgs 2x/day for 5 days, 4/30 test taper √4/28 pain/ √4/28 neuro
as of 4/28: 5 mgs 3x/day for 1 day
as of 4/29: 5 mgs 2x/day for 4 days; 5/3 test taper √5/21 pain/_neuro final taper dose 5/17
as of 5/21: 5mgs 2x/day for 7 days, 5/27 test taper √5/28 PAIN. Last dose 6/15
gabapentin 100mgs 2x/day?
methocarbamol 125mg 2x/day?
tramadol 12.5mg 2x/day? ]
We’re waiting on the discharge summary for the specific taper instructions but sounds like she’ll be fully stopped on all medications to see how she reacts - Roxy is still at the U, said she should be ready to come home soon.. They say there is a 50/5 chance it could come back without surgery but feel in her case unless the pain comes back that that is the best choice given how well she’s doing.. hopefully she continues down this path! Thanks for all your help —
Jessica
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Post by Jessica & Roxy on Jun 16, 2021 8:14:05 GMT -7
Good morning, just the latest update - We we’re advised to do a full stop on pain meds upon her discharge yesterday to see her pain level. There was a little whimpering through the afternoon and some rubbing of her head/neck on the ground. Around 11 pm, we put her outside to go bathroom and she was limping  when we brought her back inside she was painful. Our discharge instructions said to restart medications if clinical signs reappear so for her comfort we gave her medications again. [Moderator's Note. Please do not edit
12lbs 11 y.o.
crate rest started 4/20
prednisone as of 4/25: 5mgs 2x/day for 5 days, 4/30 test taper √4/28 pain/ √4/28 neuro
as of 4/28: 5 mgs 3x/day for 1 day
as of 4/29: 5 mgs 2x/day for 4 days; 5/3 test taper √5/21 pain/_neuro final taper dose 5/17
as of 5/21: 5mgs 2x/day for 7 days, 5/27 test taper with pain meds still on board √5/28 PAIN. Last dose 6/15
as of 6/16 : 5mgs 2x/day for ? days; then test taper _pain/_neuro
gabapentin 100mgs 2x/day? STOPPED 5/15, restarted 5/16 due to pain
methocarbamol 125mg 2x/day? STOPPED 5/15, restarted 5/16 due to pain
tramadol 12.5mg 2x/day? STOPPED 5/15, restarted 5/16 due to pain
Pepcid AC ]We have a call into the vet this morning and will post our feedback.. she comfortable now that meds are back on board but I’m worried that she was really limping so quickly after being pulled off of meds, especially with such mild spinal compression.. Thank you again for all your advice and thought.. Jessica & Roxy |
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PaulaM
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Post by PaulaM on Jun 16, 2021 9:18:31 GMT -7
Jessica, I'm sorry to hear that the full stop of pain meds has revealed not all the swelling was eradicated by prednisone use for 17 days at the anti-inflammatory dose level (5mgs 2x/day). Often it will take several courses at the anti-inflammatory level adding up to a range of 7 to 30 days before that is accomplished. So you and your vet will have to put your heads together to decide if another course, maybe a 14-day course should be tried or if the path should be a surgery now. Helpful information in getting up to speed on treatment decisions: **  Dr. Isaacs answered alot of questions we've had about surgery: "Surgery needs to be a decision an owner enters into recognizing the risk, but also recognizes the benefit. This way if something unforeseen occurs an owner can be comforted and at peace with the fact that surgery was the right decision and they did all they could for their dog." You will find it worthwhile to read the rest of his answers about surgery: dodgerslist.com/2020/05/12/dr-isaacs-surgery-answers/More excellent info to help with conservative vs. surgery decisions: dodgerslist.com/2020/02/10/surgery-vs-conservative/Looking forward to your next update. Are you giving the pain meds 2x or 3x/day? Pepcid AC back on board with the prednisone? |
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Post by Jessica & Roxy on Jul 1, 2021 12:36:52 GMT -7
Hi Paula -- I just wanted to update with some good news! Roxy hasn't been on prednisone or pain medication since her last dose on 6/15 (after the limping we noticed above). The vet said to try again, thinking she may have just had a long day at the vet. Knock on wood - But she's been pain-free and normal since then and with no meds! We're continuing on crate rest until 7/13 per the Vet's recommendations. And then we're told we can start progressing back to normal. We've purchased ramps for all the furniture and have continued with laser and PEMF therapies every other day in the interim. She'll be confined to one level at all times, and we never allow her to do stairs only her ramps. She is happy and anxious for freedom but is being a good sport about the continued crate rest for now. I'm sure she'll be thrilled when she can roam about the house again. We're so relieved that things are going so well! Any tips on preventing a future episode or transitioning back to normalcy would be much appreciated  And I just want to extend a big thank you for being there w/ advice during those times that were very stressful, it helps so much to have the resources to take care properly. Thank you thank you thank you! Jessica & Roxy |
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Post by Romy & Frankie on Jul 1, 2021 13:20:44 GMT -7
Thank you for the kind words. I am very happy to hear that Roxy is off all meds and pain free.
Once a dog completes crate rest, it is best that they move to regular activities gradually. This allows the dog to build up strength and stamina. The idea is to gradually give more freedom under controlled conditions. Overdoing things at this point, can cause muscle pain which makes it difficult to determine if the pain indicates a disc issue or just temporary muscle soreness. We have a sample schedule for reintroducing activity and other information about the after crate rest period here: dodgerslist.com/2020/06/15/back-friendly
We have some ideas on making your home back friendly below: dodgerslist.com/2020/07/09/home-protect-ivdd-backs |
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PaulaM
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Post by PaulaM on Jul 1, 2021 16:00:55 GMT -7
Jessica which vet (credentials DVM? neuro?) wants crate rest extended to 12 weeks from the date of the disc episode on 4/20?
Did the vet give a reason for the extension past the 8 weeks it takes a disc to heal in and the last date off of all meds?
We will be excited to share all the ideas and tips that are tailored to Roxy's needs on graduation day if July 13 is, indeed, the confirmed new graduation day.
Please make sure to remind us when graduation day is here.
Appreciate hearing from you we have played a roll in making things less stressful for you in the things you have learned here. Thank you!
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Post by Jessica & Roxy on Jul 2, 2021 9:40:25 GMT -7
Thank you both! We will work on a gradual transition, thank you for the articles! The recommendation for the 12 week total came from the University of MN, Dr. Arnold. She is a board-certified neurologist and the one that examined Roxy on 6/15 and did the MRI. My understanding was that they restarted the 8 week clock after the time that Roxy had that bad pain flair up and was crying badly after walking in her crate. That happened 4 weeks into crate rest. So that would put us to 7/13. She recommended a gradual transition as well to out of crate life and gave us a walking schedule to adhere to. I also have a call in to her primary vet to talk about the transition as well. Thanks again, Jessica |
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PaulaM
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Post by PaulaM on Jul 2, 2021 10:12:25 GMT -7
When you can do share the walking schedule/timeline to transition back to family life Dr. A. gave you regarding this neck disc. Thanks!
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Post by Jessica & Roxy on Jul 6, 2021 6:49:05 GMT -7
Here's what she said --
Start with five minute walks three times per day and increase the length of the walk by a minute each day until she is back to her previous activity level.
She can have supervised time outside of her crate but should always be prevented from jumping on/off furniture, so if she is prone to doing that, she should be kenneled when unsupervised. Ramps are fine.
We're still waiting to hear back from the primary vet about her thoughts as well on the transition
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PaulaM
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Post by PaulaM on Jul 6, 2021 7:22:27 GMT -7
Jessica, sounds like a reasonable gradual plan for introduction back to physical activity to start on graduation day July 13th. At graduation day we'll be looking forward to sharing with you lots of ideas and tips tailored to Roxy's needs as you provide up to date current observations. Fingers crossed for all good days as July 13th approaches!
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PaulaM
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Post by PaulaM on Jul 21, 2021 6:52:00 GMT -7
Jessica, would you update us on Roxy?
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Post by Jessica & Roxy on Aug 5, 2021 9:57:07 GMT -7
Hi Paula — Roxy has been doing really well! We still use the crate when we’re not here during the day and she’s been feeling and getting around great! We haven’t been doing walks really but letting her move about the house when we’re here - We have her set up with one level and ramps to all furniture. Just trying to take things slow to make sure we don’t have any flair ups or at least trying to! There’s been a day or too where she’s looked a little tired or where we’ve second guessed if she was feeling some stiffness or pain but there have been no obvious symptoms— knock on wood! We do have meds ready for her in case of an emergency as the vet told us to expect that she could have some flair ups in the future. But overall a good report |
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Post by PaulaM on Aug 5, 2021 11:27:39 GMT -7
Jessica, with graduation comes the rehab part. Roxy came off of STRICT rest and needs to strengthen her core muscles. These muscles support the spine where is the discs are. Meandering around the house or out in the yard doesn't target or work the core muscles enough. Figure out a schedule based on your vet's or the sample given in this link in the " 2nd week" section with a quick pace 5 min walk outside 1x a day early in the week building to 3x a day later in the week. Encourage Roxy to do the back friendly activities and avoid the never again things. Very good to hear Roxy is enjoying family life again. LOVE hearing you are prepared to act quickly should you suspicion disc episode.
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when we brought her back inside she was painful. Our discharge instructions said to restart medications if clinical signs reappear so for her comfort we gave her medications again. 
