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Post by Paulette & Henry on May 6, 2022 8:06:43 GMT -7
[Please add corrections or additional information in a new post. Thanks]
[Original subject line: Introduction to Henry]
1. Henry is on strict crate rest subsequent to a new herniating T13/T14 suspected event was Feb 10 and was confirmed by MRI on Tuesday, May 3. He is now in 2 weeks strict crate rest and is resting comfortably on Gabopentin, Prednisone and CBD. In Oct. he had surgery for L1/L2 rupture and paralysis.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
24lbs 3 1/2 y.o. a
Feb 10 disc episode
crate rest started on 5/6 for 2 weeks
MRI 5/3
Carprofen as of 2/28: 50mgs 2x/day for 14+? days
Prednisone as of 4/22: ?mg ?x/day for ? days, test taper: √pain
as of 4/26: 5mgs 2x/day for 6 days, then taper test: √ 4/30 pain
as of 4/30: 5mg 2x/day for 5 days, then test taper: √ pain
as of 5/3: 5mgs 2x/day for 5 days, then test taper: _ pain/ _ neuro
Double P II with prednisone!
Omeprazole 10 mgs 1x/day ]
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 6, 2022 8:42:02 GMT -7
Paulette, welcome to the Forum! Is it a bit fuzzy about the date of the disc episode, etc. Can you clarify --- A disc episode happened on Feb 10. But no crate rest was employed to allow the disc to heal. It takes 8 weeks for the disc to heal. --- Is Henry showing you signs of pain while on prednisone and gabapentin? --- A lot of medication history is missing from Feb 10 What date did pred start? What was the initial dose in mgs and times a day given? How many prednisone tapers where tried? What date did pain return and another course of pred given? What is the current prednisone course start date? What was the inintil dose in mgs and times per day? For how many days then a taper started? What is the name of the Chinese herb Henry is taking with an anti-inflammatory drug prednisone? Why did you just start crate rest today and not with the Feb 10th disc episode? MED LIST/HISTORY- 24lbs age? Feb 10 disc episode crate rest started on 5/6 for 2 weeks MRI 5/3 Prednisone as of 2/10: ?mg ?x/day for how days. then taper additional courses of pred?: ?mg ?x/day for ? days, then taper Gabapentin ?mg ?x/day Name of CHINESE pills Henry needs GI tract protector, Pepcid AC, on board w/PREDNISONE! What is the name of the hospital where the surgery could/might be performed?
STRICT rest properly given is how the disc heals. Excellent tips info for carrying out STRICT REST: dodgerslist.com/2020/05/14/strict-rest-recovery-process/ |
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Post by Paulette & Henry on May 6, 2022 9:31:58 GMT -7
After the opossum episode on Feb 10 he seemed fine but over the course of a few weeks he seems to be in pain and not as comfortable. He wasn’t put on crate rest, I didn’t even know about IVDD until last week. He did have surgery but I didn’t know about the strict crate rest.
He was put on Gabopentin 100 mg, 2 times a day, Methocarbamol 500 mg every 8 hours and Carprophen 50 mg twice a day on Feb. 28 by his primary care vet.
On 3/16 the primary care vet said to DC the muscle relaxer Methocarbamol first and stay on the gabopentin and Carprophen as prescribed and restrict activity. He never said strict crate rest and I restricted him being “active”. I could kick myself for not clarifying and Indidnt find this group or the IVDD support group on Facebook until this week. 😭. The vet also suggested back strengthening exercises when the acute episode was over. He said no walks until the following week, which I adhered to. He said to watch for any changes in sedation and comfort as well as any neurologic changes.
SomInfollowed the schedule as recommended and on the 19th I started weaning him off of the Methocarbamol. On. March 22 he was taking just the Carprophen twice a day for two more weeks During this whole time he was getting acupuncture and laser.
I ended up calling his surgeon and he said to put him back on the gabapentin 100 mg twice a day, Carprophen 50 mg and to make an appointment.
We saw him on 4/19 he said Henry had a good exam, was strong and was a little painful so he started him on the prednisone.
When I tried to wean him off of it as prescribed Henry didn’t tolerate it well. So I started the twice a day again and 4/21 - 4/26 and every other day 4/26- 4/30 along with the Gabopentin the entire time twice a day. When Henry wasn’t getting relief I called the neurosurgeon again and he said go back up to the Full dose of Prednisone and use the gabopentin 3 x day.
Still no one told me about strict crate rest but to limit his activity and that is when started I started researching the back issue, re read his surgery report of Oct. 21 and saw the diagnosis of IVDD Stage I. I hadn’t even heard the term before that. I found this group and the Facebook support group just a few days ago because I was beside myself.
On April 28 I called the neurosurgeon again and requested an MRI because I said we don’t even know what we are treating. This was performed this past Tuesday, the 3rd. So, then, it follows that he has been on STRICT crate rest, the meds described above and acupuncture as prescribed and directed by the neurosurgeon. And, no one has said 8 weeks in the crate u til I saw your post a minute ago. I hope this fills in some gaps.
he is on omperazole which is for generic Pepcid as prescribed by his neurosurgeon 1/2 20 mg once a day.
Henry is 3 1/2 years old.
Prednisone wasn’t started in 2/10/22 as he wasn’t in pain. He just seemed a little ouchy. I believe that is the date of his injury no confirmation. He wasnt started on prednisone until
April 4/21. 4/21 - 26 twice a day, 4/ 26 - 29 only once a day but then he went back on the full dose. He had one attempt to taper. After his appt on 5/3 he is back on the full dose 5mg twice a day for 5 days then once a day for 5 days then every other day for 5 days. the. Once a day attempt and Henry’s increasing pain when I petted him or lifted him into his car seat I knew that the course of treatment wasn’t working and requested the MRI. Is on generic Pepcid- omperazole as prescribed. The name of the hospital where He had surgery at Blue Pearl Neurology, Orange Park, FL. His surgeon is Dr. Michael Rushing.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 6, 2022 10:19:52 GMT -7
Paulette, this is my attempt to put things in a brief, less wordy way to describe the chain of events so you can see the pattern. Basing my comment on: [MED LIST/HISTORY-24lbs 3 1/2 y.o. Feb 10 disc episodeMRI 5/3Carprofen as of 2/28: 50mgs 2x/day for 14+? daysPrednisone as of 2/10: ?mg ?x/day for how days. then taper as of 4/21: ?mg ?x/day for ? days, test taper: √pain as of 4/26: 5mgs 2x/day for 6 days, then taper test: √ 4/30 pain as of 4/30: 5mg 2x/day for 5 days, then test taper: √ 5/5 paingabapentin 100mgs 2x/dayTrue conservative crate rest on 5/3 for 2 weeksOmeprazole 10 mgs 1x/day With lack of crate rest the disc could never heal. It may have been tiny tears that is painful, bulged into the spinal cord or a worse disc damage. The Neuro's MRI report would give complete understanding for us if you can up load.
So in effect all the prednisone has been for naught because of lack of true conservative principals of Crate rest.
It takes prednisone about 7 to 30 days to resolve swelling when STRICT rest has been employed. So basically you are starting at square one with prednisone and REAL TRUE STRICT rest as of 5/6. It takes 8 weeks for the disc scar tissue to form securely. If your dog moves around too much, the disc cannot heal. With pain medications to mask pain, dogs will not be in pain and want to be more active. So it is up to you to restrict your dog’s activity for them.
POTTY TIMES
Carry to and from the recovery suite to the potty place and then allow a very few limited footsteps.
Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog's back aligned and butt from tipping over.
A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot.
An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on!
dodgerslist.com/wp-content/uploads/2020/04/Potty-leash-harness400-19kb.jpg **
Please confirm that we're on the same page as to conservative care.
The hallmark component of conservative treatment is the very STRICT crate rest part (no PT, little movement). With little blood supply discs are much slower to form good scar tissue than it takes a blood rich broken bone to heal. Those weeks of a cast for a broken arm to heal is similar to the recovery suite being a kind of cast for the disc. 100% STRICT crate rest 24/7 for 8 weeks provides limited movement to allow good strong scar tissue to form.
Knowledge is key!
Owner understanding ensures proper conservative treatment principals:
▶︎ 4 phases of healing, what it takes to heal each phase: dodgerslist.com/healing-the-disc/
▶︎ Roadmap for your fridge. Stay the course, avoid dangerous detours for the healing disc: dodgerslist.com/wp-content/uploads/2020/07/Roadmap-for-Fridge.pdf
STRICT rest means:
◼︎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.
◼︎ 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
Transports are always a risk to the disc of too much movement. Vet visits must be weighed risk vs. benefit for dogs with little to mild neuro diminishment.
POTTY TIME strictness
Carry your dog to and from the recovery suite to the potty place and then allow a very, very few limited footsteps.
Using a sling (long winter scarf, ace bandage, belt) will save your back and help to keep a wobbly dog's back aligned and butt from tipping over.
A harness and 6 foot leash is to control speed and keep footsteps to minimum as you stand in one spot.
An ex-pen in the grass is an excellent alternative to minimizing footsteps with the physical and visual to indicate there will be no sniff festing going on!
The time for a surgery can be if the pain won't go away when true rest has been employed and an aggressive use of pain meds keep pain away during the 7-30 days it may take Pred to complete its mission.
Your neuro may not have fully understood, the mishandling past event that Harry has been subjected to and the reason to want a surgery now.
Your choice is to see if REAL TRUE conservative treatment will do the job. If after 8 weeks all pain is not gone, then it can mean you may wish to pursue a surgery. OR you can go ahead with a surgery now to remove what ever pieces of disc material are not where they are supposed to be (inside the disc!).
If you are thinking about a surgery, know the facts so you are confident in your decision. It is YOU who knows what all has happened with Harry's supposed conservative treatment that did not happen.
Good place to bone up on decisions:
** dodgerslist.com/wp-content/uploads/2020/05/dr-isaacs-surgery-interview-1.png
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/
Please keep us updated.
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Post by Paulette & Henry on May 6, 2022 10:54:25 GMT -7
Henry didn’t have prednisone in February he started it April 22 with one failed attempt to wean. He is back on 5 mg twice a day before the weaning for 5 days.
here is his exam and mri result. I didn’t even know not let him walk to the potty place.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
24lbs 3 1/2 y.o.
Feb 10 disc episode
MRI 5/3
5/3 true crate rest started
Prednisone as of 5/3: 5mgs 2x/day for 5 days, Sun 5/8 test taper: _ pain/ _ neuro
Gabapentin 100 mg 2x/day
Omeprazole 10 mgs 1x/day as of 5/4]
GAINESVILLE I 7314 W. University Ave, Gainesville FL 32607 JACKSONVILLE I 3444 Southside Blvd, Suite 103, Jacksonville FL 32216 ORANGE PARK I 275 Corporate Way, Suite 100, Orange Park FL 32073
NORTH FLORIDA NEUROLOGY
280 Corporate Way, Orange Park, FL 32073 P 904.269.7070
Tuesday, May 3, 2022
Client: Paulette
Patient: Henry, 3 Yrs. 7 Mos., Neutered Male, Beagle
Veterinarian: Dr. Unknown; Veterinary Acupuncture and Wellness
Problem/Diagnosis: Type I IVDD T12-13, IVDD L1-2 10/21/21 right sided hemilaminectomy
P 352.672.6718 P 904.646.1287 P 904.278.0287
F 352.333.9151 F 904.645.5585 F 904.278.5587
History: Henry presented to BluePearl Neurology for a recheck. His owner reports that on February 10th Henry was seen jumping up on his hind legs when chasing after an opossum. Shortly after this incident Henry began to act painful. It is reported that at times Henry will suddenly cry out and then seclude himself in his crate. He continued to have increased pain although this improved with an increase in prednisone over the weekend. He only cried out once when being lifted out of the dog stroller.
Neurological Examination: Mentation; Normal. Cranial Nerves; Normal. Gait and Posture; low head posture no ataxia or paresis Postural reactions; Normal. Spinal Reflexes; Normal., Cutaneous Trunci Normal. Anal Reflex Normal. Nociception; Normal. Palpation; discomfort on TL palpation and questionable on cervical palpation Localization T3-L3
Clinical Pathology: previous CBC - normal; Chemistry - normal
Radiology:
Findings
MRI, 195 images of the spine dated May 3, 2022, with cervical and thoracic transverse images.
There are seven lumbar vertebrae, two ribs associated with the last thoracic vertebra, and the celiac and cranial mesenteric arteries are located at the level of L1. There is multifocal intervertebral disc desiccation.
There are minimal sites of cervical intervertebral disc herniation with no spinal cord or nerve compression seen. No abnormal STIR cervical vertebral intensity is seen.
There is a large amount of hypointense tissue within the ventral vertebral canal at T12-T13, which markedly compresses the spinal cord. There is circumferential attenuation of the CSF/epidural fat signal.
In the sagittal study of the lumbar spine, there is mild multifocal intervertebral disc herniation with no suggestion of significant spinal cord or nerve compression. There is a focal region of T2 weighted hyperintensity superimposed over the dorsal spinal cord at L2 in both the transverse and dorsal T2 weighted studies, which is not convincingly corroborated in the STIR study. This is also corroborated in the T2 weighted myelo study with no loss of CSF signal.
Conclusion
-Marked extradural spinal cord compression secondary to herniation of desiccated intervertebral disc material at T12-T13.
-Focal intramedullary T2w hyperintensity dorsally at L2. This may be a focal region of gliosis or edema. A prior vascular event is a possibility.
-Relatively normal cervical spine.
Read By:
David Szabo, DVM, DACVR
Summary & Recommendations:
Henry's MRI showed a disc herniation at T12-13. In the case of a herniated disc, options include medical management vs surgery. If a dog is walking, as Henry is, medical management is often attempted first and ~50-60% of pets can recover without surgery. However, if they are not improving over the first 1-2 weeks or if they become unable to walk then surgery is recommended (85-95% success rate). There is ~15% chance of future disc herniations and it is impossible to predict if an individual will suffer from future issues.
After discussion, the plan is to continue treatment with medical therapy for 2 weeks. If he continues to be in pain or becomes weaker before then I would recommend surgery.
• Strict Crate/Enclosure Rest for 2 weeks
• Gabapentin 100 mg capsules - Give 1 capsule by mouth every 12 hours.
• Prednisone 5 mg tablet - Give 1 tablet by mouth every 12 hours for 5 days, then once daily for 5 days then every
other day until gone. Yours sincerely,
Robert E. Rushing, DVM Diplomate ACVIM (Neurology)
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Post by Romy & Frankie on May 6, 2022 14:27:59 GMT -7
Henry has IVDD with a disc herniation at T12-T13, the lower part of the thoracic spine. For dogs on Dodgerslist, this is a fairly common spot for herniation. The two treatments for IVDD are conservative and surgery.
Conservative treatment takes 8 weeks for secure scar tissue to form. The 8 weeks of crate rest are very, very strict. Strict crate rest, anti-inflammatories, pain meds and stomach protection have helped many dogs. I don't know if you have yet had a chance to read the information Paula pointed you to at the page below: dodgerslist.com/2020/05/14/strict-rest-recovery-process
If you decide on surgery, the surgery will immediately remove any disc material pressing on the nerves. Henry may be a candidate for conservative treatment because he has minimal neuro symptoms. If during the two-week period your vet mentioned, Henry has worsening of neuro symptoms surgery could be more of a consideration. |
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Post by Paulette & Henry on May 6, 2022 14:58:52 GMT -7
Thank you for your information. I have read the information Paula put out and Henry is now on strict crate rest. He was beginning Tuesday except for walking to go outside to potty. Now he wont be doing that either.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 6, 2022 16:08:53 GMT -7
Paulette, this is my take away from the information you've shared plus the Neuro report. -- True Conservative STRICT rest has not been employed until 5/6 5/3 --The neuro shows no indication of knowing Henry was not afforded true crate rest principals. Meaning his disc was not allowed to heal since Feb 10. -- It can take prednisone anywhere in the range of 7-30 days to fully rid the body of inflamed tissue. -- Pred prescription is for 5 days at the anti-inflammatory level dose. Taper days do not work on swelling/inflammation. -- Pred begins the taper on Sunday 5/8. Your job is to monitor for pain and alert the neuro or his fill in vet immediately if any hint of pain surfaces. -- Typically, pain meds such as gabapentin that keep you from monitoring about existence of pain are stopped at the begin of the pred taper. Keeping pain meds on board delays finding out the truth of pain. -- Do not be disheartened if pain should surface on the tapering of prednisone. Remember it may take 7-30 days for prednisone to do its work. A 5-day course of prednisone is short. Remember also the neuro showed no indication of knowing there never was strict rest and that Henry is starting at square one as of May 3! 1. Square one with count of 8 weeks to allow the disc to heal 2. " " with use of prednisone. Very unfortunate that any use of prednisone prior to 5/6 has been negated with constant aggravation of the spinal cord with the disc not healing. Neuro reports MRI showed a herniation with a lot of compression of the cord and "stuff" (hypointense tissue) within the vertebral canal. Did the neuro explain if the "stuff" was likely escaped disc material? That would be my guess. If disc material escapes from the disc, it releases chemical irritants that contribute to painful nerve inflammation. i.postimg.cc/VvytgLLC/Disc-Problems-Spine-Universe250x400.jpgPAiN MEDS- have no patience with pain.
Pain meds last for about 8 hrs in the body. If any pain is surfacing before the next dose, that tells you right away that gabapentin 100mgs 2x/day (every 12 hrs) is insufficient to control pain. CALL THE VET and get the fill-in vet on duty (not the vet tech or anyone else). Only a vet can prescribe. Describe the pain signs you see and when and advocate for at minimum gabapentin 3x/day. A normal pain med cocktail includes addressing each of the three usual sources of pain: traMADol, methocarbamol and gabapentin.
There is a good chance that conservative treatment can work to get the disc to heal, allow the body to shrink back disc material to no longer aggravate the cord.
--To continue conservative treatment, Henry has to be allowed to heal pain free with the miracle of pain meds at the right frequency and right combo of meds.
--Prednisone has to be allowed to get the work done in 7-30 days to fully get rid of inflammation. Only time will give the answer.
As you can please, do update us with reports on Henry's pain level. If he is in pain today, Friday or even Saturday, then of course it would not be time to even start a taper on Sunday May 8. The vet at the hospital needs you to be his eyes and ears at home. |
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Post by Paulette & Henry on May 6, 2022 16:38:18 GMT -7
My vet did not mention not being off Gabopentin [gabapentin] once the tapering starts which would be on Sunday pm dose or Monday AM dose. He has been on it but official with crate strict rest since Tuesday [5/3] pm.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 6, 2022 17:36:23 GMT -7
Correct the email is just an alert for you.
You CAN click on the part of the email that has Henry's title and it will swiftly take you to the Forum and Henry's thread. Login and then you can respond.
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Post by Paulette & Henry on May 6, 2022 17:48:03 GMT -7
Henry had a really good day today. He is such a good boy in his crate and I have rigged up a floor chair right next to him so I can still be by him to watch TV together - actually on my IPAd though. I can reach in and pet him and we are both happy. He is resting very peacefully in here on Day 3 of strict crate rest. Thanks all for your patience, experience and wisdom. I can feel your love out there for Henry and I. Tomorrow I am going to look for rollers for the crate.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 6, 2022 18:45:15 GMT -7
Paulette, it warms my heart to hear you are implementing things to let Henry know everything is going as it should. Nice idea of the floor chair near the recovery suite! Crate rollers can give Henry a change in views.
How are you doing carrying 24 lbs Henry to and from the potty place back to his suite?
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Post by Paulette & Henry on May 6, 2022 20:00:57 GMT -7
I just finished reading about all the newbie things. I was wondering about using the stroller to transport him from the recovery suite to outside and back in. I have been carrying him. Also I ordered the universal wheels for the crate. I also have a second crate that I can use so he can sit by the door or maybe outside with me. It is cloth and smaller and just something for a short while. I can use it when I change his bedding. I was wondering about the “green tea” thing. When I cLick on it I don’t see anything about it. I did freeze some bone broth bowls for him tonight and he already has been getting frozen kings and lick mats. He gets one when I have my dinner. He already has raised bowls.
He is definitely comfortable in his little suite and thank goodness doesn’t seem to be in any pain or discomfort.
I am so grateful just to have you all as a lifeline out there. I actually haven’t cried in two days. ♥️
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 7, 2022 7:28:02 GMT -7
Paulette, good to hear gabapentin is blocking pain. When on the pred taper you would want to know if pain still exists due to inflammed tissue around the cord. Discuss with the neuro if gabapentin can be either stopped or begin backing it off via mg dose and times per day on Sun 5/8. RE: GREEN TEA Knowing the page where the problem exists, would be helpful in trouble shooting. Were you looking at newbie post: Tips and supplies to make a great recovery suite! ? Under the : " ▼Incontinence tips" is an expandable section. If on an iPad view in Reader Mode, you'd first have to hide Reader to view the tips. Now you can click on the section to reveal info about green tea to use during conservative treatment when a bath is too dangerous for early healing disc: CLEAN UP Unscented baby wipes for quick clean up on skin & fur. Marjorie’s tip: boil and cool decaf green tea to dampen a washcloth, neutralizes urine on skin and fur to avoid rashes from urine scald + leaves a clean fragrance. Use white vinegar in a spray bottle to kill the bacteria and the odor they cause on floors, linens, carpets. Your positive attitude and taking actions to make the rest go smoothly is fantastic for Henry. Maybe more than you realize. Henry's nose is millions of times more sensitive than yours. Remember to put a big smile on your face and in your voice and carry it in your heart while your dog is recovering! Dogs CAN smell when you are happy, sad or scared because each emotion has a subtle change in your scent. Many times their behavior reflects our mood and they may even misinterpret our sadness and tears and believe they have done something wrong. Be mindful Henry will be reading your tone of voice, watching your body language to be comforted that everything will be OK. Everyone heals better in a positive energy environment. STROLLER IF the path to the potty place is smooth and not jarring or bumpy, strolling him out to the place in the grass could help your back with a 24 lbs dog. Otherwise you could place a pee pad adjacent to the his suite. Then he'd take a few footsteps to the pad. You could place a paper towel saved in a zip lock bag with some of his urine or another dog's urine to incentivise him to pee indoors on the pad. With this first sniff or circling, command "go potty." When he does, praise lavishly. Soon Henry will go on command. If your deck permits, you can set up a pee area right outside the slider door for a potty place. Some straw, dirt, even a pee pad for the area. This is a shot in winter time with a snow patch on a deck. An ex-pen surround is to prevent darting off in the same way a leash/harness would. Use a sling if at all wobbly to prevent back twisting and butt falling down.
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Post by Paulette & Henry on May 7, 2022 12:28:44 GMT -7
Thank you Paula. That was the section I couldn’t read about the green tea. Since tomorrow would be taper day one I am going to still give him both doses of Gabopentin then Monday call the neurosurgeon about the taper of the gabopentin. So if he doesn’t tolerate the prednisone taper without pain meds then what? Last time we went back on twice a day prednisone and the Gabopentin but that was without strict crate rest like he has been on. 🤞🙏
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Post by Romy & Frankie on May 7, 2022 13:09:18 GMT -7
When the pred is tapered and the pain meds (gabapentin) are stopped or cut back it will quickly be obvious if there is still swelling in the spinal cord. The swelling in the spinal cord is what causes pain. If pain is seen during the taper, there is still swelling and Henry should go back on the pred at the full 2x a day dose and the pain meds. This would work the same way even though he is now on Strict crate rest.
It is not uncommon for dogs to try and taper more than once. A pain free taper, with no meds masking pain, would mean the inflammation in the spinal cord is gone. At this point, no meds will be needed, only the remainder of the 8 weeks of crate rest.
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Post by Paulette & Henry on May 7, 2022 13:20:47 GMT -7
Ok that makes sense. It is nice to know that a failed prednisone doesn’t mean failed conservative care. ❤️. Anyway, fingers crossed as we start the process on Monday. He didn’t get a full two times a day on Tuesday as he was at the vet having his MRI. So I am going to start the once a day weaning on Monday.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
24lbs 3 1/2 y.o.
Feb 10 disc episode
MRI 5/3
5/3 true crate rest started
Prednisone as of 5/3: 5mgs 2x/day for 6 days, Mon 5/9 test taper: _ pain/ _ neuro
Gabapentin 100 mg 2x/day
Omeprazole 10 mgs 1x/day ]
Henry has a little bit of loose stools [5/7] tonight. I gave him some pumpkin. Also he did whimper just a tiny bit when I took him out last time. Maybe because he really had to release that stools. I Eill be observing for more pain symptoms. Thanks all.
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Post by Paulette & Henry on May 7, 2022 19:02:19 GMT -7
Henry is on 10 mg omperazole (prilosec) once a day as prescribed by his neurosurgeon. Most of the posts talk about Pepcid. Does one work better than the other while the pup is on prednisone? Henry vomited tonight. Thanks.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 7, 2022 20:40:38 GMT -7
OMEPRAZOLE– Prilosec® can take 3-5 days before peak effectiveness in suppressing stomach acid production. Pepcid AC® is effective in 30 mins. Full info about stomach protectors with a disc episode: dodgerslist.com/2020/05/06/stomach-protection/The first you mentioned using Omeprazole was yesterday, is that correct? Has there been any change in food that could cause stomach upset? IF not, then the first thing is suspicion of stomach damage from acids. For tonight if Omeprazole is not fully effective because 3-5 days have not yet been reached, then 1)see if you can get Pepcid AC for him tonight from the grocery store. Give the Pepcid AC tonight if you are confident Henry has no health issues and keep your vet in the loop as soon as they open. 2) I would discuss with the vet adding the Rx item sucralfate to the Pepcid AC. Sucralfate works in a different way to bandaid the damaged areas of the stomach lining and aid in healing. |
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Post by Paulette & Henry on May 8, 2022 6:47:30 GMT -7
He started on the omperazole on [5/4] Wednesday. Yesterday [5/8] he had a half of a Yak bone which I think was part of the problem because before that his tummy has been fine. I gave it to him for something to do. He vomited it up at least three times in the night. I gave the omperazole this morning. It is supposed to last 24 hours but I am going to buy the Pepcid AC today and start him on that tonight before dinner? Or tomorrow before bfast? His stools seem fine. NO MORE YAKs.
I will let the vet know tomorrow when I call about the gabopentin weaning along w the prednisone wean.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 8, 2022 8:15:57 GMT -7
If the Yak bones was the root cause of diarrhea, then do NOT give Pepcid AC. Continue with Omeprazole.
Giving Pepcid AC may slow the omeprazole's rate of efficiency peak
Pepcid AC was only if thought was root cause was prednisone GI damage and thus of an emergency nature. Food changes are temporary and not dangerous. Good lesson to learn, avoid food changes when on anti-inflammatory drugs such as prednisone to avoid being confused what is an emergency and what is just food change.
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Post by Paulette & Henry on May 8, 2022 10:04:22 GMT -7
Thank you. He us very comfortable today and no tummy issues. I am pretty sure it was that stupid bone.
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Post by Paulette & Henry on May 8, 2022 10:43:13 GMT -7
I noticed yesterday his stools were a little mucousy and they are today also. No dark or bright blood. I will let the vet know tomorrow. Just double checking.
The [√] omperazole says it 24 hour pill so I am giving him the The [√]10 mg once a day.
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Post by Paulette & Henry on May 8, 2022 11:36:53 GMT -7
Oh my goodness. Henry just vomited a little again. I just don’t know what is going on. Should I withhold his dinner. I swear I just do t kniw what the right thing to do is while he is taking all of this medication.
What is an alert vs what isn’t. And I hate the weekend when the vets are closed. I swear if you weren’t on the other end if this forum I would have list my mind. I am trying to stay calm and happy but the back is one thing. Is the stomach this is yet another. To think we have 7 more weeks of this. Where is that Time Flies when you need it??
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 8, 2022 11:43:49 GMT -7
Vomiting can be caused by a multitude of things so your vet should always be made aware.
What does the vomit look like?
REGURGITATION is more of a burp in which some of the contents in the esophagus, either liquid or solid, come back up. Although there might be some gagging or a bit of coughing as the contents move up, there’s no abdominal heaving involved. Usually, the food brought up is undigested and is covered with mucus. Regurgitation generally happens quite soon after the pet eats.
Feed small portions Tablespoon or two. Wait to see if he holds it down. In an hour or two another bit of food.
VOMITING is when the contents of the stomach and upper intestine are forcefully ejected. Signs of vomiting are nausea (drooling) and abdominal heaving.
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Post by Paulette & Henry on May 8, 2022 12:22:53 GMT -7
It looks like undigested food with a little bile this time.
He eats Honest Kitchen. I fed him his bfast divided in thirds over two hours. I will slow feed him his do. We as well.
I will definitely let the vet know.
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Post by Paulette & Henry on May 9, 2022 5:59:20 GMT -7
Henry had a great night. Slept through from 10 - 7. No upset tummy. S[poke]/w the neurosurgeon office today as we start weaning off Prednisone while upon strict crate rest. They said Gabopentin is strictly for pain and to use at my discretion so if he isn’t in pain no need to give it. So here we go! Let the weaning begin. Actually is started yesterday with one dose of Prednisone 5 mg once a day for 5 days. I just needed to check on the Gabopentin 100 mg continued use. Wish us luck for a successful weaning and weak 2 of strict crate rest.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
24lbs 3 1/2 y.o.
Feb 10 disc episode
MRI 5/3
5/3 true crate rest started
Double P II with prednisone
Prednisone as of 5/3: 5mgs 2x/day for 5 days, Sun 5/8 test taper: _ pain/ _ neuro
Gabapentin 100 mg 2x/day SToPPED 5/9
Omeprazole 10 mgs 1x/day ]
Also, I have been carrying Henry from the crate to the potty place which for me is a total of ten steps. The potty area is right out the porch door to an artificial grass area in the deck. I met him out of is crate, pick him up, carry him the 12 steps and put him down, to open the door onto the potty area with his leash on. Then pick him back up walk the 12 steps and put him back down to go into his crate. I was just wondering if he could walk those twelve steps.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 9, 2022 7:44:19 GMT -7
Paulette, fingers crossed that on the prednisone taper and the stop of the pain blocking gabapentin, you will not see any signs of pain.
Excellent potty time care you are doing. That carrying him so there are no excessive footsteps is perfect. Keep up the good work.
Henry should only be taking a very, very few minimal footsteps on the fake grass to take care of business then get carried back to his suite.
Having the potty place on the deck with artificial grass is such a good idea. Did you/do you "salt the mine" with a bit of paper towel with some old urine so Henry knows to pee on the fake grass? How did you train Henry?
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Post by Paulette & Henry on May 9, 2022 10:03:09 GMT -7
The fake grass has been on the deck since I got him 3 years ago. He uses it and before his injury he had access to the entire deck through a doggie door. The deck takes up the whole back yard. No other grass.
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Post by Paulette & Henry on May 9, 2022 16:43:48 GMT -7
If Henry should have any yelp or breakthrough pain on the wean from prednisone and gabopentin do I put him back on the gabopentin once a day or twice a day. The vet said I have it to use as needed. Then how long would he be on it before stopping it again to try if the prednisone is working. Not anticipating and very hopeful but want to be ready just in case. Thank you.
NEW POST on WED JULY 20th:
Henry had his percutaneous laser disc ablation this morning in Ft. Walton Beach, FL. The vet said he did very well and should do very well post op and into his doggie life. They ablated the 8 most likely discs to herniate. Now time for some more healing, rest and of course maintaining IVDD precautions with hopefully just a tad bit less anxiety on my part as he goes along throughout his life. This little guy has been through a lot in his young life. I will update this blog as he progresses.
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