PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on May 9, 2022 14:46:10 GMT -7
I'm sorry it has been a challenge to have your vet leave and now have a vet not so comfortable with their knowledge of IVDD when you need it now. At the point if, IF you would find you discover pain at any point along the tapering process, hopefully you have enough pills to go to 2x/day til you can quickly interview and hire a vet who is on board helping Tyson. To get a new vet/new clinic who knows their IVDD, would be a risk of a transport for an exam. The benefit would outweigh the risk in getting meds Tyson would need. Lets hope no signs of pain will surface indicating there is still a need for prednisone to resolve the painful inflammation around the spinal cord. Some positives that hopefully are proved to be true during the pred taper on Thursday and ea additional lowering PLUS when the last dose of gabapentin is given: dodgerslist.com/wp-content/uploads/2020/12/disc-damage-296-25kb.jpg--- Nerves do not like being pressured by swollen tissue around the cord nor being pressured by a bulging disc. Too much pressure and the nerves cells can die (loose function) HOWEVER, at this point in time you are reporting a lot of nerve repair!!! Fingers crossed this can mean swelling might be gone????? -- Each time gabapentin is lowered in times per day and mgs dose, the more you MIGHT know if swelling no longer exists.
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Post by Mark & Tyson on May 10, 2022 5:29:11 GMT -7
What I have gathered from my vet in terms of her rationale for staying on the pain meds during the prednisone taper is that because the cervical disc is in the neck, which has a larger spinal canal than elsewhere in the spine, there is more room for inflamed tissue that does not necessarily put pressure on the cord. That means that if the prednisone has reduced the swelling enough to relieve the cord but not sufficiently to eliminate all pain, it would be appropriate to taper the prednisone but to maintain the pain meds. In her mind, pain does not necessarily mean pressure on the spinal cord, so neuro loss would be the only accurate signal of that. This makes the taper a little scarier because I have to watch neuro function very closely rather than monitor for pain. In the event that I see confirmed neuro loss, I would have to return to the 2x/day dose and contact her ASAP.
[MED LIST/HISTORY- Moderator's Note. Please do not edit 15 lbs 11 y.o. prednisone as of 4/12: 5mgs 2x/day for 6 days as of 4/18: 5mgs 2x/day for 5 days, 4/23 test taper: √4/29 pain / _neuro as of 4/30: 5 mgs 2x/day for 9 days, 5/12 test taper: _ pain/_neuro; last dose 5/31 Methocarbamol 200mgs/1 mL: 120mg (0.6mL dose) 3x/day runs out before 5/12 gabapentin 50mgs tab: 50mg 3x/day traMADol 25 mg 3x/day Pepcid AC 5mgs 2x/day ]
Administered final dose of Methocarbamol [5/11] this morning. Prednisone taper starts [5/12]tomorrow. Fingers crossed!
So far, so good. Just wanted to report that this morning at potty time [5/14], Ty did his first "leg-lift" pee since before the incident. Not sure whether it is significant, but to my mind it suggests increased confidence and sense of balance.
He's taking a lot more steps than previously, and I am now having to hold him back from too much movement inside and out. Certainly sleeping soundly and showing no signs of pain, though we won't know that for sure until all pain meds are stopped later in the month. So far, neuro signs are all giving the green light.
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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 14, 2022 8:04:55 GMT -7
Mark, agree with you. Tyson's neuro function and coordination are continuing to improve. That is very, very good. Can't wait til there is proof when pain meds stop.
You are doing an excellent job of attending to Tyson's disc care with limited movement.
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Post by Mark & Tyson on May 18, 2022 4:35:51 GMT -7
One week into the first stage of the taper and no sign of neuro diminishment. Just administered final half dose of tramadol and half dose of Gabapentin. I plan to stop all pain drugs as of now in order to get an accurate read on whether there are any signs of pain before final taper begins on Saturday (first day without any Prednisone).
[MED LIST/HISTORY- Moderator's Note. Please do not edit 15 lbs 11 y.o. prednisone as of 4/12: 5mgs 2x/day for 6 days as of 4/18: 5mgs 2x/day for 5 days, 4/23 test taper: √4/29 pain / _neuro as of 4/30: 5 mgs 2x/day for 9 days, 5/12 test taper: _ pain/_neuro; last dose 5/31 Pepcid AC 5mgs 2x/day ]
So far, things look hopeful. No real progress to report on front paw proprioception, unfortunately.
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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 18, 2022 8:10:46 GMT -7
Mark can you tell us what you currently observe about proprioception in his front paws? How much ability do the front paws have to sense movement and position of each paw? --- Do his paws knuckle under all of the time? --- " " " but he can very slowly right them? --- " " " but he can right them quickly? i.postimg.cc/V6X4H88V/paw-knuckls-under-nerve-damage.jpg **
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Post by Mark & Tyson on May 18, 2022 8:45:46 GMT -7
It is difficult to determine exactly since he spends most of his day lying down rather than standing. I mostly see short bursts of activity during potty time or when he is being nosy / fussing. At those times, I see proper paw placement / knuckling in the front limbs about half the time. Should I maybe be doing some standing exercises with him and observing his ability to stand correctly / orient his paws correctly? I don't want him to languish if it is safe to start doing some light exercise daily.
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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 18, 2022 11:54:52 GMT -7
Mark, knuckling is nerve damage. It can take time to heal. Nerve repair may or may not come back in the short 8 weeks it takes to heal a disc.
At the times you might see him standing with a knuckled paw you can right the paw for him to help train the nerves/muscle what is correct. He CAN move his legs so that is the light movement of limbs for now. Upon graduation, when it is safe for the then healed disc, you can pursue an active physical exercise program at home or at a clinic. We'll have much to share with you on graduation when we learn exactly where he is on that day and make comments for the current— and not what may turn out to be old news from today.
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Post by Mark & Tyson on May 18, 2022 12:10:13 GMT -7
Okay, thanks Paula. Yes -- he definitely CAN walk and has displayed that ability on numerous occasions, but he is weak and tires easily and seems to knuckle especially when tired or unmotivated. I just wanted to make sure I wasn't neglecting anything, but it sounds like less is still more at this point -- and will be until he is completely finished with the prednisone (6/13).
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Post by Mark & Tyson on May 19, 2022 16:55:27 GMT -7
Happy to report NO signs of pain today. Happy, frisky, alert, playful and engaged. Looks like we are ready for our final prednisone taper!
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on May 19, 2022 17:07:50 GMT -7
Mark, this will be good to have proof positive all swelling is gone when the final dose of pred is given on June 13. It is a good idea to be off all meds before graduation day.
You've been a good care giver and can pat your self on the back for providing a safe environment to heal in. Just around the corner will be graduation day June 13th where we will be happy to share tips and ideas for getting back to family life and activities in a safe way.
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Post by Mark & Tyson on May 26, 2022 6:18:44 GMT -7
Just checking in to report that we are now about a week into the final prednisone taper and all is well -- no signs of pain or inflammation, and diminishment of side effects (panting, restlessness).
About 4 days ago (5/22) Ty began walking in earnest on the yoga matted areas in his suite. I have continued to restrict his movement outside the suite, but he is definitely able to walk around independently now, and his proprioception is greatly improved (foot placements are almost always correct). Our appointment with the physiotherapist 6/13 seems like it should be well timed. I am personally feeling a sense of incredible relief and profound gratitude, especially for you, Paula! I don't think I could have done this on my own, and I will be forever grateful for your knowledge and kindness, but most importantly your generous willingness to share your time, advice, and experience. Thank you again, from the bottom of my heart, and I look forward to discovering more as we continue on this recuperative journey toward wellness!
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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 26, 2022 7:23:28 GMT -7
Mark, so very happy to hear from you and the very positive report on Tyson's progress of placing his paw correctly almost always. Good news, indeed!
Challenges in life stretch all of us. I know cause I got stretched myself with my own doxies. It turns out so many times that what we think we "can't" is doable. All along you had inside you all the elements needed to properly care for Tyson. Our goal at the Forum is to assist in teaching owners they "can." My heart is warmed to have played a part in your success with your sweet Tyson!
I'm not picturing the amount of walking space the yoga mats provide inside the suite. Taking some footsteps is OK, but walking around not OK. Just review if Tyson's suite provides only enough room to easily turn around in and only enough room to fully stretch out the legs when lying down.
I'm so looking forward to the approaching date of graduation on June 13th. Learn where Tyson will be in a little over two weeks and offer ideas for living many happy years ahead.
Hey, if you have a jpg of Tyson, would LOVE to see him.
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Post by Mark & Tyson on May 27, 2022 8:38:36 GMT -7
Not much walking space, Paula -- but I let him take a few steps when I give him breakfast and lunch, or else he jumps up and down, which I try to discourage. I am keeping him down to as few steps as possible, but his balance and proprioception are vastly improving and he now seems to want to roam outside his suite, so his confidence is also returning. Yesterday I saw him sleeping stretched out on his back, which I haven't seen since the episode. Not only is the pain apparently gone, but he's also stretching those areas, which seems to me a very good sign. Thanks again!
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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 27, 2022 10:13:10 GMT -7
Does he eat inside of the recovery suite?
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Post by Mark & Tyson on May 27, 2022 10:43:56 GMT -7
Until recently, yes, but I have trouble when I am preparing his food with him standing up against the doors of the crate or the suite gate, jumping, barking, etc., so now I carry him while I am preparing his food, which forces him to be more settled. I set him down once the food is ready in the dish just outside his crate, and he stands to eat it. Meals have always caused him excitement, but the prednisone made it 10x greater. Hopefully that will settle down again once the prednisone is done.
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Post by Romy & Frankie on May 27, 2022 13:08:08 GMT -7
If carrying him with you when you are preparing his food keeps him calmer and more settled, that is the way to go. Can you put him and his food dish back in the crate instead of having him eat just outside the crate?
Prednisone does make some dogs a bit hyper, so you are right that he may be calmer when the pred is finished.
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Post by Mark & Tyson on May 27, 2022 17:57:35 GMT -7
Well, no. He is literally uncontrollable once food is in the picture, so trying to get him into the crate at that point would be higher risk than setting him right outside the crate opening with his face in the dish since he has no incentive to move at that point. I have literally tried every other way I can think of to make meals as low-activity as possible, and this is the best solution I've been able to manage. The general hyperactivity is calming as he tapers off the prednisone, but at meal times he is uncontrollably RAVENOUS beyond belief.
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Post by Romy & Frankie on May 28, 2022 13:05:10 GMT -7
I know that you are aware that our goal is minimal activity. This is what allows the disc to heal. If what you are doing is the best way you have found to keep him calm and quiet during feedings, than you are working towards that goal.
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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 28, 2022 21:07:23 GMT -7
Mark try some things that are lo cal throughout the day and may help alleviate the prednisone side effects of increased appetite: -- frozen no-salt, no fat broth ice cubes in a bowl to lick on in his suite. Easy DIY bowl attached to side of suite. dodgerslist.com/wp-content/uploads/2020/05/bowl-holder-DIY-320x240.jpg --Frozen green beans, small pieces of apple or carrot.
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Post by Mark & Tyson on May 29, 2022 8:40:59 GMT -7
Thanks for those tips. Unfortunately, Ty is a gulper rather than a grazer and I have to be careful about giving him anything that isn't finely chopped or ground into powder (and sometimes rehydrated) since he'll gulp anything I give him down without chewing first (and then, if his tummy protests, he'll often throw it back up, rinse and repeat). He has always been a very enthusiastic eater but the prednisone has made all food preparation (including mine!) a hyperactive anticipatory ordeal. Like Romy said, I know the ultimate goal is rest, so I am trying every trick in the book to make meals as low-key as possible. That said, he's already gained a few pounds, which isn't ideal but perhaps unavoidable given the lack of exercise. Hopefully, this too shall pass. Just a few more weeks to go!
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Post by Mark & Tyson on Jun 1, 2022 6:16:38 GMT -7
This morning, Ty threw up his dose of Pepcid-AC, which I administered in a chunk of cheese as always. I am wondering, is there a limit to how long they can take fatomidine without side effects? We have only five more doses of prednisone to go -- should I risk cutting out the Pepcid, or what do you advise? Perhaps the nausea was from something else? How to be sure? I administered a new dose of Pepcid before the prednisone and he seems to be fine. Perhaps I shouldn't be giving him the Pepcid first thing in the morning on an empty stomach?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jun 1, 2022 9:16:07 GMT -7
Mark, You will have to decide, because too many surrounding observations/info are missing. If you have concerns, do check with your vet.
--- Mark, the prednisone is on an every other day dose (EOD)? EOD prednisone is pretty small dose. With your monitoring for any GI problems, you might be able to stop Pepcid AC. GI signs to monitor for: lip licking of nausea> not eating> vomit> loose stool> bleeding ulcers> diarrhea with red or black blood in stool due -- While Pepcid AC has a a limited potential for side effects, there are some very few dogs who vomit up Pepcid AC and can't use Pepcid AC. How long after dosing was the vomit? -- 2nd attempt in dosing Pepcid AC, it stayed down may well indicate Pepcid AC not the problem. Did Tyson regurgitate OR actually vomit (indicates a potential problem such as with Pepcid AC)?
VOMIT vs. regurgitation?
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Post by Mark & Tyson on Jun 2, 2022 4:19:44 GMT -7
Thanks for that fulsome disambiguation. I think Ty regurgitated the cheese containing the Pepcid after drinking some water. There were no stomach contents -- just the dose inside the chunk of cheese and some water. He was fine for the rest of the day, by the way. I am going to proceed as if it was just an anomalous episode. If it happens again, I will need to rethink that, though. Otherwise, everything is proceeding well with no problems or concerns.
p.s., I notice you have Ty's new graduation day down as 6/13, but I think it is actually 6/12 [graduation day], since his final prednisone dose is on 6/11. As you can tell, we are counting the days -- literally!
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Post by Mark & Tyson on Jun 6, 2022 7:19:28 GMT -7
Hard to believe it will be eight weeks tomorrow since Ty's IVDD episode! Here we are, finishing up the prednisone this weekend and off to the physiotherapist next Tuesday. Just wondering whether you might have any advice to share on preparing for this next stage? Will Ty need a room fitted out now rather than just a crate suite? Will we need to prepare an exercise area? Should I continue sling walking him, or only as needed? What sort of activities will be allowed, limited, or prohibited? Are there important questions I should be asking the physiotherapist at our initial consultation next week? So many questions!
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Post by Romy & Frankie on Jun 7, 2022 13:37:49 GMT -7
Sunday is graduation day. Wonderful!
Tyson should be able to get back to most of his usual activities, minus only a few. We can discuss more details when graduation day arrives.
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Post by Mark & Tyson on Jun 11, 2022 12:55:00 GMT -7
Gave final dose of prednisone this morning -- hooray! Also decided to finally fit Ty in his Help 'Em Up harness for potty time, which he seems to have adjusted to fairly seamlessly. His proprioception is vastly improved -- not only are his paw placements correct when he stands on all fours and walks, but he also now corrects his paws if I turn them under. He is still excited about meals but has calmed sufficiently that I am no longer worried for his wellbeing when I am preparing his food. Everything seems to be on track with no issues to report. Still curious whether there are any pressing questions I should ask the physiotherapist Monday morning?
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Post by Romy & Frankie on Jun 11, 2022 13:32:13 GMT -7
Congratulations on Tyson's graduation tomorrow! Now is the time to determine how you are going to ease Tyson back into more normal activity. The idea is to gradually give more freedom under controlled conditions. Not free reign of the house and yard immediately! Take a look at our information and then come up with a plan to gradually increase activity over about a month's time following the end of crate rest. Here is a sample schedule to slowly introduce your dog back to family life and physical activity: dodgerslist.com/2020/06/15/back-friendly/?highlight=sample%20scheduleMake your home back friendly with ramps instead of stairs, blocking off furniture and training to keep all four paws on the ground:https://dodgerslist.com/2020/07/09/home-protect-ivdd-backs Lots more ideas and tips in living with an IVDD dog: dodgerslist.com/living-with-ivdd-tipsWe 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 posts to widen the reach of IVDD knowledge: www.facebook.com/Dodgerslist -- Hand carry our literature. 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. Literature can be ordered here: dodgerslist.com/free-literature-2Please keep us updated from time to time on how Tyson is doing. We love these updates.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,928
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Post by PaulaM on Jun 13, 2022 7:38:01 GMT -7
Mark, let me also add my congratulations on Tyson's graduation! Wow, what a journey. Thanks to your diligence in care a wonderful outcome under conservative treatment of all four legs again walking and no knuckling paws! If you want formal PT, at this point underwater therapy would be like you going to the gym to bulk up and get in shape. Underwater treadmill therapy is excellent walking exercise. At home you can also gradually build up his muscle strength. - Walk along a sandy shoreline. Walk in the water. Start at Tyson's knee height then reduce to more difficult ankle height water. - At home water therapy: dodgerslist.com/2020/05/28/surgery-dog-water-therapy/ - Walk across a slope, up and down a slope - Do back leg push ups from a sit to a stand exercises - Strengthen his core muscles supporting the back. You should always consult with a veterinarian before starting any exercise program with your dog. Core exercises don't require specialized equipment. 5 exercises: totofit.com/five-basic-exercises-essential-to-building-core-strength/
HAPPY DAYS NOW and AHEAD Enjoy fun activities with summer weather. -- OUTDOORS Nose work is a safe and fun for IVDD dogs. Serve Tyson’s dinner outside on the lawn. Scatter kibble in the grass. Why? Because dogs need opportunities to do what is natural for them. Hunting relies on nose work, problem solving and body agility and it is just plain fun!  Scatter some kibbles in a saucer of water!
INDOORS Hide some kibble on lower bookshelf, behind the leg of a chair. Does Tyson like tennis balls? A child's $10 inflatable pool can be cool and lots of fun.
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Post by Mark & Tyson on Jun 18, 2022 13:41:19 GMT -7
Dear Paula, Thanks so much -- what a journey, indeed! There were days I honestly felt like I could not continue, but this board and you in particular gave me the strength and above all the knowledge to push ahead! Ty is now incredibly walking two blocks at potty times, frolicking and playing like his old self, and most recently able to walk on hardwood and laminate flooring without any evident difficulty. He has improved significantly in just a single week post-crate rest. I am literally having to hold him back from running at this point! The wading pool was a great idea, Paula, and it has really given him a fun, different, and cool (literally) challenge. He used to be slightly fearful of water, but he's quickly gotten past that fear now that food is involved! We've already had some great bonding moments splashing around and drying off, and I really feel it has helped him to quickly regain some muscular strength. The visit to physio earlier this week was enlightening and ought to yield a helpful daily exercise routine. All in all, Ty is still showing amazing progress, and I am absolutely thrilled with his recovery so far. The rest is truly icing on an already fabulous cake!
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Post by Romy & Frankie on Jun 18, 2022 13:53:27 GMT -7
This is just wonderful to hear. Tyson is walking so well, even on hardwood. Hardwood is often very difficult for IVDD dogs.
Glad he is enjoying his wading pool.
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