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Post by Erika & Sophie on Jun 21, 2022 9:43:34 GMT -7
[Original subject line: Sophie Introduction ] QUESTIONS ☆ 1 Is there still currently pain? Yes- Vet just changed up meds [6/20] last night. ☐ reluctant to move much in crate such as shift positions or slow, ginger movements ☐ yelping when picked up or moved ☐ Arched back ☐Not their normal perky selves? No, but tail still wagging 2 12.5 lbs 4 y.o.Carprofen 25 mg(1/2 tablet) every 12 hours Gabapentin .75 ml every 8-12 hours Methocarbamol 500 mg(1/4 tablet) every 8-12 hours [MED LIST/HISTORY- Moderator's Note. Please do not edit
12.5 lbs 4 y.o.
not been in a recovery suite as of 6/21
Carprofen 25mg tab as of date? 12.5mgs 2x/day for ? days, then TEST stop for _pain/ _neuro
Gabapentin ?mgs per 1 mL liquid: ?mgs (0.75mL dose which 8 or 12 hrs?
methocarbamol 125mgs which 8 or 12 hrs?
Sophie needs GI tract protector, Pepcid AC, on board w/CARPROFEN! ☆ 3 -- List any red flag signs of stomach damage.
Not eating, vomit, loose stool, bleeding ulcers, red or black blood in diarrhea. ☆ 4 CHIWEENIE , SOPHIE. ERIKA ☆ 5 diagnosis IVDD YES- but only X-rays done and they could not see it on those. Referred for a cat scan, possible surgery which we are trying to avoid. -- General Vet- no specialists within 4 hours from us. ☆ 6 CONSERVATIVE treatment [6/20] Yesterday. -- Took her to emergency clinic [6/17] Friday. -- She went from being perfectly fine Thursday 6/16 to barely being able to get around Sunday 6/19 Super tried and true tips for setting up the recovery suite, the mattress and more! —> dodgerslist.com/2020/05/14/strict-rest-recovery-process/
STRICT means:
- no laps - no couches
- no baths - no sleeping with you
- no dragging or meandering at potty times.
- no PT - no chiro therapy
IM WORKING ON GETTING HER A CRATE “suite” put together in the ⚠️ next few days. And⚠️ taking her for accupuncture tomorrow. ☆ 7 bladder control? YES DOGs with BLADDER 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!
☆ 8 Currently can wobbly walk? Yes, but barely. move the legs at all? Yes, front legs weaker than back. or wag the tail when you specifically do some happy talk? Yes
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Post by Erika & Sophie on Jun 21, 2022 10:06:23 GMT -7
I just tried to take her outside woth support harness and she now can’t put any weight on her front legs(paw knuckles) and very little on her back. No interest in trying to go to the bathroom. 😔😔😔
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PaulaM
Moderator. 
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,568
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Post by PaulaM on Jun 21, 2022 11:49:20 GMT -7
Erika, the single most important care is to protect the disc from worsening and impacting nerve functions (legs, bladder,...) That mean inside a recovery suite asap now. After med adjustments is pain fully in control now? NOTE: pain meds are effective for only about 8 hrs. This is why it is typical to dose promptly every 8 hrs. Please provide details of what you have been actually giving: Carprofen 25mgs tab: 12.5 mgs 2x/day for how many days? Carprofen stated on what date?
Gabapentin what is the formula? How many gabapentin mgs in one mL of liquid? Which to you actually give promptly every 12 hrs or evert 8 hrs.
Methocarbamol 500mg tab: 125mgs which every 8 or 12 hrs?
Sophie needs GI tract protector, Pepcid AC, on board w/Carprofen! Dogs don't speak up at first signs of trouble like a person would. Red flag signs can progress from nausea> vomit> loose stool>.... Bleeding ulcers (red or black blood in diarrhea) can turn to a life-threatening perforated stomach lining. LEARN MORE: dodgerslist.com/2020/05/06/stomach-protection/
FIRST do ask your vet in this very, very particular way... --Is there a medical/health reason my dog may not take Pepcid AC (famotidine)? --Doesn’t need it, we wait til there is problem…are NOT answers to your question! --The dose of famotidine may require reduction in patients with liver or kidney disease. -- It may be prudent with heart patients to choose another class of acid reducer.
The usual dose of Pepcid AC (famotidine) for dogs is 0.44mg per pound.
Sophie 12.5 lbs X 0.44 famotidine = 5mgs Pepcid AC 2x/day --Give 30 mins before the anti-inflammatory. --Dose thereafter every 12 hours for as long as your dog is on the anti-inflammatory. thumb.ibb.co/mEGRuy/91x_Aj_s00z_L_SY355.jpg ** Can you get Sophie inside of a recovery suite ASAP right now, today?A playpen, a child's Pac N Play, a wire crate, an 8 panel ex-pen. Only enough space to easily turn around in. And when lying down to fully stretch out her legs. More room than that defeats the limited movement principal to allow the disc to heal.  CONSERVATIVE treatment starts the day true strict rest starts. Relapse to the disc, worsening neuro function negate previous days of meds. TODAY 6/21 can be the first day of healing BUT ONLY if she is inside of a recovery suite. PLEASE let us know.
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. Transports are always a risk to the disc of too much movement. ◼︎ 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
There should be no car trips to appts unless they are of the utmost urgent reasons. STRICT rest (very limited movement) at home is how the disc heals
◽️Seek a mobile vet who comes to your home if you want accupuncture.
◽️How to set up the recovery suite:https://dodgerslist.com/2020/05/14/strict-rest-recovery-process
◽️ What you can do at home to help with the neck disc: dodgerslist.com/2020/05/05/cervical-care-tips/
Sophie has potential to heal under conservative treatment is you follow the principals of strict rest.
Alert the vet via the phone you've not been doing strict rest and there is a decline of neuro functions. He may deem it an emergency to dispense with a 5-7 day washout from the lessor class Carprofen and move immediately today to the more powerful class steroids such as PREDNISONE.
When deemed an emergency, with no 5-7 days of washout from carprofen but immediately today dosing steroid PREDNISONE:
--- Two (2) GI tract protectors must be on board: Pepcid AC from grocery store + Vet Rx for Sucralfate
MONITOR NEURO FUNCTIONS as well as pain
As damage to the spinal cord increases, there is a predictable stepwise deterioration of functions. When nerve healing begins, often it follows the reverse order.
1. 6/17 Pain caused by the intial disc tear & inflammation in the spinal cord
2. 6/19 Wobbly walking, legs cross
3. 7/19 Nails/toes scuffing floor
4. 6/21 Paws knuckle under
5. 6/21 Weak/little front + rear leg movement,
? can't move up into a stand with __rear; __with front legs
6. ? Legs __ front; __ rear do not work at all (paralysis, dog is down)
7. ? Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors.
8. ? Tail wagging with joy is lost
9. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. If surgery is not an option (for whatever reason) then the best option is conservative therapy.
Surgery can still be successful in the window of 12-24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance. Precious hours can be lost with a vet that gets DPS wrong. Trust only the word of a neuro (ACVIM) or ortho (ACVS) surgeon about DPS.
A quick overview of conservative treatment vs. a surgery:
dodgerslist.com/2020/02/10/surgery-vs-conservative/
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Post by Erika & Sophie on Jun 21, 2022 13:33:50 GMT -7
Hi Paula, I really appreciate your quick response! Firstly-I do h ave her in a crate and have since [6/19] Sunday. However, I did not learn of strict crate treatment until I came across your page this morning so yes I still had her outin the yard last night to go to the bathroom. On STRICT now. I’m just going to order her a bigger exercise pen to set her up in. To answer your med questions- After med adjustments is pain fully in control now? Still whined when I moved her. But resting better [Removed other person's quoted text] She’s been on [carprofen] this since [6/17] Friday when we took her to the emergency clinic.[Removed other person's quoted text] Gabapentin -50 mg/ml And I am making sure she gets it every eight hours. [Removed other person's quoted text] Methocarbamol 8 hrs
[Removed other person's quoted text]
Carprofen starting 6/18 25mg tab 12.5mgs 2x/day for ? days, then TEST stop for _pain/ _neuro
Gabapentin 50 mgs per 1 mL liquid: 37.5mgs 3x/day
methocarbamol 125mgs 3x/day
✙Pepcid 5mg 2x/day
[MED LIST/HISTORY- Moderator's Note. Please do not edit
12.5 lbs 4 y.o.
Started STRICT rest 6/20
Carprofen 25mg tab as of 6/18 12.5mgs 2x/day for ? days, then TEST stop for √6/21 pain/ _neuro
Gabapentin 50mg/mL: 37.5mgs (0.75mL) 3x/day
methocarbamol 125mgs 3x/day
✙Pepcid AC 5mgs 2x/day]
Calling her vet now about changing to the stronger steroid and pain management.
Thank you for the ✙Pepcid dosage info- giving that to her now.
I’m so upset that neither the emergency clinic nor her vet even mentioned strict rest!
After much research and lots of calling, I found a local vet that does acupuncture and cold laser therapy. Taking her there tomorrow! I have put her in my bigger dogs crate so she has a little more room [?only enough to fully stretch out legs, pad out extra room!] and I am getting a flatbed with pads here in a few minutes..
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Post by Romy & Frankie on Jun 21, 2022 14:02:39 GMT -7
Romy here. I am happy to hear that you have started strict crate rest. It is the immobility enforced by crate rest that allows the disc to heal. Ex-pens make excellent recovery suites. They can be configured in so may different ways. Just be sure that the main area is only large enough for Sophie to stand up, turn around and stretch out fully when lying down.
Laser therapy and acupuncture are good therapies. Transport, however, is risky during a disc episode. Weigh the risk vs. benefit when transporting Sophie. If you choose to transport her to any of these therapies, pad out the crate with rolled up towels or blanket so that she will not shift in the crate as you turn a corner or brake.
Whining when picked up can be a sign of pain. You know your dog best, and so you are in the best position to determine if she is in pain. When we are in doubt, we look for a second, confirming sign. I am glad you are speaking to the vet about adjusting the meds.
After reading your post again, I see that you are going to speak to the vet about the stronger anti-inflammatory, the steroid type like pred.
If you go in this direction, I want to emphasize what Paula said in an earlier post. Changing from a NSAID type medicine like Carprofen to a steroid type like pred requires either a 5-7 day washout or two types of stomach protection. This would be Pepcid AC to control excess acid and Sucralfate which serves as a sort of bandage to any damaged areas of the stomach. Sucralfate also facilitates the healing process.
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Post by Erika & Sophie on Jun 21, 2022 14:53:12 GMT -7
So, Just got off the phone with the vets office and they wanted me to bring her up there so they could feel her paw responses to pain. Wanted to see if her quality of life of lack there of qualifies her for euthanasia or needs to go to surgeon. I was a bit taken aback by that. And I told them that it’s best not to move her again today unless absolutely necessary. They then said they will have steroids for me ready soon.
I’m upset that they did not even address the fact that she still in pain. I’m confused but I’m going to stick with my plan and possible start using the vet that will be doing the accupuncture exam tomorrow.
Question- She’s had all her meds had her pain med and muscle relaxer an hour ago. She is currently whimpering in her crate while wagging her tail like she’s trying to do something or tell me something. But I have no idea. I’m imagining she needs to go to the bathroom and doesn’t know what to do since she hasn’t gone today.
[Removed another person's quoted text]
Do I have to get Sucralfate from vet?
Sidenote- should I administer the muscle relaxer and the pain med at different times?
Thank you both! And I’m grateful I found this resource.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,568
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Post by PaulaM on Jun 21, 2022 16:29:01 GMT -7
Erika, Some signs can also be for other than pain. So you may have to do some detective work to figure out if anxiety whining or pain whining. Shivering cold or pain. Also if you observe two or more signs of pain with say "whimpering" that would help to confirm actual pain rather than anxiety of wanting attention. Signs of pain nearing the next dose or pain meds or when having to move would also confirm existence of pain. SIGNS OF PAIN: ⚙︎ shivering-trembling ⚙︎ yelping when picked up or moved ⚙︎ tight tense tummy ⚙︎ arched back, ears pinned bac ⚙︎ restless, can't find a comfortable position ⚙︎ slow or reluctant to move in suite such as shift positions ⚙︎ not their normal perky interested in life selves ➕ these are particular to a NECK disc that Sohpie has: ◻︎ head held high/ nose to the ground ◻︎ looks up with just eyes and does not move head and neck easily. ◻︎ not eating due to painful chewing or in too much overall pain ◻︎ holds front or back leg up flamingo style not wanting to bear weight The size of the recovery suite must only be large enough to fully stretch out the legs when lying down. Stand on all four legs and to easily turn around. Pad out the extra space with a rolled up blanket. Setting up the Recovery Suite for limited movement. Ex-pens can be sized down by folding panels back on themselves to give the snuggest fit to the dog's mattress.  *
 **TRANSPORTING If absolutely necessary to get proper meds on board, support with prednisone change, then a new vet would first required a hands on exam. If you can get support with current vet, then you eliminate risky to the disc car transports. Do not go for acupuncture/laser if that is the only reason for a car transport. Seek a mobile vet who comes to your home. Did you call the proposed new vet and find out their stance on steroids. How they feel about ethanansia for a dog who may need a wheelchair. Find out before you get there to avoid disappointment with another vet who is not comfortable in their IVDD knowledge and have risked the disc with a car transport.  **With urgent vet visits, secure the crate in your vehicle. Transport carefully using a crate padded out with rolled up towels on either side of the dog to prevent movement or jarring the spine when braking or turning corners. Rx = prescription. Sucralfate is a Rx item that your vet has to write or he may have sucralfate on hand in his clinic. MEDICATION CHART Pain meds can be and most often are given at the same time for a more sane schedule. Gabapentin with methocarbamol **  A medication chart is useful to see patterns, have dates and specific facts handy as you discuss things with the vet. D/l a sample and a blank form to use with your dog's meds dodgerslist.com/wp-content/uploads/2020/02/med-chart-printable.pdfPEEING at POTTY time (has bladder control)Carry in your arms out every 2-3 hours to start with to potty. Give her a few minutes and a very, very few footsteps to take care of business. If she doesn't do anything carry her back to the suite. Try again in an hour or 2. Eventually you may be able to do the potty thing every 3-4 or 4-6 hours. 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! OVERFLOWING, loss of bladder controlIf she can't sniff and old pee spot out side, and then make the decision to release urine AND she leaks on you when lifted AND you find urine leaking in bedding, she has likely lost bladder control and you will need a vet to give you a hands on top of your hands lesson. dodgerslist.com/2020/05/05/bladder-bowel-care/ That trip into a vet would be a very urgent matter worth the risk of too much movement for the important health benefit of avoiding bladder infection. Keep us posted as you have been doing. |
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Post by Erika & Sophie on Jun 21, 2022 19:30:57 GMT -7
Turns out, the whining was because she needed to potty. She actually stood up in her crate while whining to let me know! Carrying her outside and with assistance she was able to urinate. I’m concerned because she has not pooped since Sunday but I’ve been feeling her soft canned food(provided by her vet), Since yesterday. At what point should I get worried that she has not had a bowel movement? And how do I help her with that?
Vet reluctantly prescribed her 5mg prednisone(every 24 hrs) and 5 mg Famotidine every 12 hrs. She did mention the 5-7 day washout but said it’s ok to bypass that given her progressive situation. Since I am seeing the other vet for acupuncture treatment tomorrow I am holding off on the steroid until then. Is that a good choice?
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,568
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Post by PaulaM on Jun 21, 2022 22:58:07 GMT -7
Erika, if there is not be be a 5-7 day washout from carprofen til starting pred, THEN the stomach needs double protection!!!!
1) Pepcid AC which you already have on board suppresses acid production.
2) SUCRALFATE which is a prescription item works in a different way to immediately bandaid any early disruption to the stomach lining.
To give pred without double GI protection is just asking for trouble. Not fair to Sophie. Why do you not have sucralfate tablets in your hands via an Rx from that vet? Hours matter in getting the more powerful prednisone on board. Delay is not good.
It is NOT a good idea to be changing food while on any anti-inflammatory drug (Carprofen nor prednisone). It could be difficult to determine if the anti-inflammatory med caused GI tract problem or a benign temporary thing of change in food. GI symptoms include vomiting, loose stools, diarrhea, bleeding ulcers. Those signs can be life threatening if not attended to promptly. It is important to quickly and correctly narrow down the cause to take the right action when treating problem.
If it has only been one or two meals, go back to her usual kibble her system is used to.
PUMPKIN
Plain pureed canned pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation.
NOTE: alternatives are really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potatoe.
--To loosen the stool, add equal parts water to each kibble meal and soak overnight. At mealtime add one teaspoon of plain canned pureed pumpkin 1x a day.
-- To firm up the stool add 1 teaspoon plain canned pureed pumpkin 1x a day to kibble.
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Post by Erika & Sophie on Jun 23, 2022 21:40:55 GMT -7
Hi there!
Her new vet prescribed the med that starts with an ✙S[ulcralfate] to go with her ✙Pred. She also gave us instructions on taking it over the next 10 days to taper it.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
12.5 lbs 4 y.o.
Started STRICT rest 6/20
Disc relapse 7/9
Carprofen 25mg tab as of 6/18 12.5mgs 2x/day for ? days, DATE STOPPED? √6/21 pain/
✙Prednisone as of date?: ?mg ?x/day for ? days, then a test taper for: _pain / _neuro
Gabapentin 50mg/mL: 37.5mgs (0.75mL) 3x/day
methocarbamol 125mgs 3x/day
✙sucralfate ?mg ?x/day
Pepcid AC 5mgs 2x/day]
We did acupuncture and cold laser therapy Weds, another appt Friday and Tuesday. I could tell that the steroid has made her feel better as she’s more alert and moving her head around more & trying to do more. But I won’t let her because it’s strict crate rest. Wagging tail, reflexes in paws, getting around very good outside with the support belt and harness.
A couple of things- she has been urinating outside twice a day and pooped in her crate twice and once outside all normal stools no diarrhea. But tonight when I was moving her into a new bed in a new space, I picked up the dog bed she’s been laying in and it was soaked and leaking urine. I don’t know if that means she’s lost her bladder control or not 😔
Another thing I have noticed, is that she is super aggressive with our other dog when he gets near her crate
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,568
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Post by PaulaM on Jun 24, 2022 8:03:30 GMT -7
Erika, so glad to hear being on prednisone has eased her neck pain. Having a new vet explain things and give you support during the use of meds is such a good thing! You may have noticed how we love the detail? Details give us proper info to base our comments on. Would you fill us in: PREDNISONE -- Date prednisone started?-- How many mgs is each dose? 5mgs?-- How many time a day? 2x/day?-- For how many days til the taper starts? Taper days are not counted in the 7 to 30 days it may take pred to fully resolved inflammation. Taper days serve a different purpose.CARPROFEN-- What date was carprofen last given?SUCRALFATE-- ?mg ?x/day LEAKING
While on pred, you will need to carry Sophie to and from the potty place about every 3-4 hours. Pred causes increased urine.
You'll need to be a detective about the leaking.
-- Did she pee on purpose in her bed because she had no choice. She was not carried out to potty on time? Start with every 3-4 hours and adjust sooner or later as you see she stays dry.
-- OR has she truly lost bladder control? Meaning she leaks on you when lifted. She can no longer sniff an old pee spot in the grass and make the choice to pee there?
-- Lost ability to control the bladder to wait until in an appropriate place release urine means urine gets released when the bladder OVERFLOWS. Reflexes kick in when the bladder is filled to capacity to release some but not all urine. In a matter of days, UTIs can develop into a concerning bladder infection (UTI).
-- Lost bladder control would demand you get an expressing lesson as a health issue to prevent urinary tract infection. Expect to express every 2-3 hrs as you are learning. When your proficiency skills is perfected you can move to every 3-4 and then 4-6 hrs. Get more out of the lesson by first knowing something about expressing: dodgerslist.com/2020/05/05/bladder-bowel-care/What kind of recovery suite does Sophie use now?The single most important care you can give is the 100 STRICT rest inside the recovery suite at home. Weigh the many risk potentials of transports (wed, fri, tues) with benefits of any treatment.--- Sophie's pain can be managed with at home pain pills. Acupuncture and laser can help with pain but for Sophie requires risk to the healing disc of a transport. Curious what is your thinking for choosing to transport to these two therapies?-- Sophie has neuro diminishment on 6/21 of front and rear leg weakness. Nerves can self heal on their own with time. With the switch to prednisone to relieve inflammation, has there been any improvement in front and back legs? Can you bring us up to day on the front and rear leg abilities?BEST BUDDIES For dogs the inborn instinct about weakness is for survival protection of the pack as a whole. There are two things that can happen in pack dynamics when a dog has been or is sick.
1. The healthy one may try to eliminate the weaker in the pack.
2. For the sick one, now the weaker in the pack to become more protective and aggressive because they know they are weaker now and may be subject to being attacked. Make sure after graduation day that Sophie feels protected from her best bud when home alone... the crate will be that source of protection. Whenever you leave the house and they are not supervised, it is a good idea to crate them for their own safety. We have had many instances where a deadly attack among best buds could have been avoided by crating. One I recall is of two sisters who had grown up together and never showed any signs of aggression to one another. The two dogs were put in the kitchen while their owners went out to dinner. They came home to find the IVDD dog almost dead from the vicious attacks of the other. |
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Post by Erika & Sophie on Jul 9, 2022 23:35:39 GMT -7
[7/8 Disc relapse due to STRICT crate rest stopped prior to Aug 19 grad date] Hi everyone. I’m sorry that I never got back her to post until now. I know you were asking specifics about the meds but I followed all of your recommendations along with the vets assistance and was using both of the meds to protect her digestive system along with the prednisone and the gabapentin. And she got so much better. I was still enforcing the recovery suite rest protocol. I will note that she was pretty peppy and jumping her paws up on the sofa de of the suite wanting to get out. About [7/7] 2 days ago I left the house for a few hours and my daughter took her out and was holding her on our bed near her suite. Something excited her and she jumped. My daughter lost control of her and she landed on the fooor ☹️🥺 Last night I noticed [7/8] that she was wobbly on her legs. Restarted the ✙ Gabapentin to make sure she would not have pain. [MED LIST/HISTORY- Moderator's Note. Please do not edit
12.5 lbs 4 y.o.
Grad date was 8/19 prior to relapsed disc
Strict rest stopped 7/7; dog jumped off a bed
7/8 Neuro diminishment wobbly left or back legs? knuckling front or rear paws?
Prednisone final taper dose 7/4
Carprofen as of 7/5: 12.5mgs 2x/day for ? days Rx'd Pepcid but not sucralfate!
as of 7/8 disc relapse: 12.5mgs 2x/day for ?days, then test STOP: _pain/_neuro
✙Gabapentin 50mg/mL: 37.5mgs (0.75mL) 1x/day (7/10 dog suffering neck pain!)
methocarbamol 125mgs 3x/day STOPPED
sucralfate ?mg ?x/day STOPPED
✙Pepcid AC 5mgs 2x/day ]
During the day today she was OK walking on her potty break. Tonight [7/9] trying to eat in her recovery sweet and go to the bathroom she just kept falling to the left, not able to stay up. I’m guessing we are back at square/day one with recovery rest after 4 weeks? |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,568
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Post by PaulaM on Jul 10, 2022 6:58:09 GMT -7
Oh, gosh darn Erika! I'm really sorry to hear Sophie's healing has been setback with a jump off a bed. The original graduation date was Aug 19. MARK your calendar for the NEW GRADUATION date of Sep 3.
You are our eyes and ears to provide info we are not able observe for ourselves. Without accurate details, specific comments for Sophie are not possible. Please fill us in. Until we know, these are general comments and actions you could be taking depending..... 1. ANTI-INFLAMMATORY drug is a priority to start asap with any re-lapse to a healing disc. Hours matter with what sounds like new loss or a diminishment of neuro functions as we don't know where she was before the jump. Call ER or whatever vet is available today to get anti-inflammatory started now. Know your anti-inflammatory drugs and the need to use PEPCID AC with any one of them: dodgerslist.com/2020/04/18/steroids-vs-nsaids/2. 100% STRICT inside of a suite rest. There are no safe couches, laps or beds. Sophie should only be taken out of the suite when carried to and from the potty place. There should be no walking around. Only the very fewest of footsteps to take care of business. Use either a 6' leash w/harness where you stand in one spot. The 6' leash limits Sophie's ability to take but a few footsteps. Better option is to use an 6' diameter ex-pen in the grass. 3. Pain meds Gabapentin ?mg ?x/day. Seeing any pain surface since gabapentin doses? Pain meds last 8 hrs. There are 3 kinds of pain each needing a pain med: Gabapentin, methocarbamol and traMADol. 4. How old is your daughter? Dependent on age, there are suggestions to involve her and teach good care habits that would protect Sophie in the future.Where is Sophie currently 7/10 with neuro function for the front legs and for the back legs?1. 7/7 Pain caused by the intial disc tear & inflammation in the spinal cord 2. 7/8 Wobbly walking, ? legs cross 3. ? Nails/toes scuffing floor 4. ? Paws knuckle under: front? Rear? 5. ? Weak/little leg movement, ? can't move up into a stand 6. Legs do not work at all (paralysis, dog is down) 7. Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors. 8. Tail wagging with joy is lost 9. Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal after surgery or with conservative treatment. If surgery is not an option (for whatever reason) then the best option is conservative therapy. Surgery can still be successful in the window of 12-24 hours after loss of deep pain sensation. Even after that window of time, there can still be a good outcome. Each hour that passes decreases that chance. Precious hours can be lost with a vet that gets DPS wrong. Trust only the word of a neuro (ACVIM) or ortho (ACVS) surgeon about DPS. A quick overview of conservative treatment vs. a surgery: dodgerslist.com/2020/02/10/surgery-vs-conservative/ |
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Post by Erika & Sophie on Jul 10, 2022 7:19:09 GMT -7
Thanks Paula. I’m absolutely devastated. I will be calling the vet tomorrow to talk to them. If they want to see her, I will take her in. I’m not sure if they would want to do another round of steroids.
When the prednisone tapering ended(7/4) I started back with the
Carprofen 25mg tab, 12.5mgs 2x/day on 7/5 as per vet instructions so I’m continuing that.
Gabapentin 50mg/mL: 37.5mgs (0.75mL) once 7/8 and one 7/9
Of course, strict crate rest only out to potty. It will be very clear to everyone in the house to NOT get her out. I’m hoping she can come back from this 🙏🏻
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Jul 10, 2022 7:25:29 GMT -7
Erika, do refresh your browser to make sure your have read ALL of my post above.
With your still having some carprofen at the house, and having started it on 7/5, there is no reason to transport Sophie in and risk more movement to the back. The best thing you can do is the STRICT rest to make sure that disc heals by Sep 3. The whole focus is on healing the disc during the 8 weeks. Nerve healing may or may not come back in that short of time. There is a good possibility that Sophie will be able to self heal her nerves too. No one can give you a date... just have patience to let her body self heal.
Just put all your info in order and see there was NO 5-7 days washout from 7/4 pred to carprofen 7/5. And no mention of your using both Pepcid AC and sucralfate. Did you? Please make a note somewhere about the danger of using both drugs at once. It takes days for these meds to fully leave the body.
At this point in time, if you did not double protect her both GI tract drugs (Pepcid AC & Sucralfate), she was a lucky girl.
At this point she SHOULD be on Pepcid AC 5mgs 2x/day. Is she?
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Post by Erika & Sophie on Jul 10, 2022 7:37:39 GMT -7
4. How old is your daughter? 17. Unfortunately, I think we all just let our guard down a little because she was feeling so much better  We haven’t had a potty break since 6 am [7/10]. At that time, she was able to walk and urinate but only because I was using the support harness. Now she’s laying sit in one spot and will not move her neck [pain]. It’s like we’re back at day one. Will update you on the rest at our next potty break Yes I am giving her Pepcid twice a day [5mgs each dose?] |
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PaulaM
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Post by PaulaM on Jul 10, 2022 7:45:38 GMT -7
Do alert your vet on Monday with the details you have now provided us.
Find out the course of carprofen he suggests: a 5- or 7-day course then a TEST stop to see if carprofen has done its job. On the date of the test stop, pain meds would also be stopped so you can very quickly get an assessment if painful inflammation is gone. To also monitor if there is any set back in neuro function. If YES to either, then another course of carprofen would be needed. You know the routine! Please keep us posted when you can. We always worry how a member of our Dodgerslist family is doing with their conservative treatment. She is in needless pain! Gabapentin only lasts for 8 hrs. Make sure you are giving promptly every 8 hrs. Methocarbamol is VERY typically needed for NECK disc pain. Do you still have on hand? If yes, start it ASAP NOW: methocarbamol 125mgs promptly every 8 hrs. Set up a med chart so no doses are skipped. A medication chart is useful to see patterns, have dates and specific facts handy as you discuss things with the vet. D/l a sample and a blank form to use with your dog's meds dodgerslist.com/wp-content/uploads/2020/02/med-chart-printable.pdf** QUESTION
"prednisone tapering ended(7/4) ...Carprofen 25mg tab, 12.5mgs 2x/day on 7/5 as per vet instructions"
1. Upon the end of pred taper 7/4, was there still pain? If no pain, then what was the reason for Rxing carprofen (a different kind of anti-inflammatory)?
2. Did the vet instruct using Pepcid AC on 7/5 with the carprofen?
3. Did the vet also instruct using sucralfate on 7/5 with the carprofen?
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Post by Erika & Sophie on Jul 10, 2022 8:32:22 GMT -7
We no longer have any more of this [methocarbamol] but I will be asking the vet for it tomorrow along with more gabapentinWe ended Gabapentin on 6/30. Vet told me to stick with giving her Carprofen until next accupuncture visit, which was supposed to be 7/7. yes, [vet instructed Pepcid AC]
no, [vet did not instruct sucralfate]
[Posted four hours later:]I am afraid we will be going to the ER with her shortly. Her legs are wanting to stay straight [Neuro decline?] and she is trembling [pain]. She vomited [GI tract damage] as well. Just not looking good
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Post by Erika & Sophie on Jul 11, 2022 5:31:06 GMT -7
Update- did not go to ER. I made sure she was cleaned up and comfortable, and covered her up so she was not cold. Sat near her suite and pet her, talked to her. The trembles stopped. I’m guessing it was pain causing that.
I had to wash everything in the suite after the ruins and vomit so her regular items weren’t in there. I’m thinking that was uncomfortable for her anyway, have her “regular” things make in there and she seems to be resting comfortably. Calling her shortly. Thanks for the space here. It’s been very helpful and a nice place to chat/vent.
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
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Post by PaulaM on Jul 11, 2022 6:40:50 GMT -7
Erika, please let us know what the vet does to help. So sorry to hear things did not go well last night. With runs and vomit sounds very much like GI tract damage: nausea> not eating> vomit> loose stool/diarrhea> BLEEDING ULCER> red or black blood in diarrhea> severe damage to stomach lining There are a number of things that cause acid production: stress due to change in routine, taking carprofen or a steroid. Damage to the spinal cord that affects the body's ability to protect the stomach. Full info so you are informed to best discuss things with a vet: dodgerslist.com/2020/05/06/stomach-protection Pepcid AC suppresses stomach acids. For most dogs Pepcid does a good job. For some few dogs they need a 2nd protector added to the Pepcid AC. Sucralfate works in a different way to "bandaid" the damaged areas of the stomach lining. Discuss and advocate for an Rx to this stomach protector. Read the link so you know the timing with food, with Pepcid AC. If there would be a switch from carprofen to the steroid class (prednisone) then most definately both Pepcid and sucralfate are a must to be on board. |
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Post by Erika & Sophie on Jul 11, 2022 8:54:07 GMT -7
I have been giving the Pepcid(5mg) 30 min Prior to the Carprofen. Vet said she is Refilling the gabapentin and the ✙methocarbamol [7/11] for me today, But wants me to bring her in tomorrow. Said she may need some injections.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
12.5 lbs 4 y.o.
Grad date was 8/19 prior to relapsed disc
Strict rest stopped 7/7; dog jumped off a bed
7/8 Neuro diminishment wobbly left or back legs? knuckling front or rear paws?
Prednisone final taper dose 7/4
Carprofen as of 7/5: 12.5mgs 2x/day for ? days Rx'd Pepcid but not sucralfate on 7/5!
as of 7/8 disc relapse: 12.5mgs 2x/day for ?days, then test STOP: _pain/_neuro
Gabapentin 50mg/mL: 37.5mgs (0.75mL) 1x/day (7/10 dog suffering neck pain!)
✙methocarbamol 125mgs 3x/day
sucralfate ?mg ?x/day STOPPED
✙Pepcid AC 5mgs 2x/day ]
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,568
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Post by PaulaM on Jul 11, 2022 11:23:22 GMT -7
What are the "some" injections. Makes a big difference to you in able to discuss and advocate if "some" were to be a "risky-to-the-disc" transport of too much movement of the spine (neck and back) pain med injection. A pill cocktail that addresses each of the 3 sources of pain AND Rx'd for every 8 hrs should full control pain w/o a trip in. GI TRACT problems injection? Adding Sucralfate pills to Pepcid AC pills for at home could provide excellent protection and healing of the existing damage of vomit/diarrhea Change (switch) the anti-inflammatory to an injection of a steroid (than pred pills) from the non-steroid carprofen as an emergency measure, means Pepcid AC + Sucralfate. If that would be the decision, why would this not be done today? Hours matter in helping to stop declining neuro functions (legs now stiff).
1. What about the now (today 7/11) still has: bladder control, ability to do happy tail wag ?
2. What date are the carprofen pills to end as per the Rx to "continue them"? The "some" injections don't make sense without your understanding the thinking behind that statement. 6. _?__Legs do not work at all (paralysis, dog is down) "Stiff" back leg due to lost leg neuro function. Dog can no longer moved back legs. 7. ? Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors. 8. ? Tail wagging with joy is lost 9. ? Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal again with conservative treatment or after a surgery. Dr. Nancy Kay, DVM, ACVIM has hit it on the nail especially with IVDD. Each of us needs to be self educated so we can team up to work with our vets. "Gone are the days when you simply followed your vet's orders and asked few, if any questions. The vet is now a member of your dog's health-care team, and you get to be the team captain!" READ MORE: www.speakingforspot.com/PDF/Medical%20Advocacy%20101.pdfAlong with our pointing out pertinent links for the now.....our hope is in the next few days you will have a chance to delve into the readings on our Main Webpage and be the prepared IVDD savvy owner your dog needs to be a good advocate. It feels good to have an understanding. To have the ability to participate in discussions and and the wisdom to follow through on treatments of merit. 1) This is a good spot to start : dodgerslist.com/in-the-right-place/ 2) Then click on the rest of the "KNOWLEDGE" pull down menu items. 3) We owe our dogs to be worthy of such devotion to us: He is your friend, your partner, your defender, your dog. You are his life, his love, his leader. He will be yours, faithful and true, to the last beat of his heart. ~Author Unknown |
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Post by Erika & Sophie on Jul 11, 2022 19:39:24 GMT -7
That poem is so sweet and true! OK update back from the vet today. She was pretty honest(I feel) about Sophie’s demeanor and Neuro degeneration. She of course said if we are not looking to go the surgery route then we just need to do everything that we can to try to get her better and see how it goes. She did advise strict crate rest for six weeks along with the following meds that I will list. And she said that if she’s not better in about a week or so then we may want to consider our options of letting her go And even if she does recover from this and she has an injury quickly after we are done with the treatment that we may want to again consider. But I appreciate the fact that she was very open to treatment in the best capacity that we could. So- I’m doing strict crate rest. She is not able to stand on her own at all I tried multiple times to take her outside and that’s not happening so we I’m hoping she will continue to relive bladder and stool regularly. Meds added- Methocarbamol 125mg every 12 hours Prednisone liquid 10mg/bacon 30ml- 1/2 mill twice a day for three days and then taper off another three days and then every other day for five. Continuing the Pepcid & sucralfate before the prednisone. She also recommended LACTULOSE at about half to 1 mL once a day to make sure that she is not having a hard time producing stools since she can’t go outside. I have not started that yet. [MED LIST/HISTORY- Moderator's Note. Please do not edit
12.5 lbs 4 y.o.
Grad date was 8/19 prior to relapsed disc
Strict rest stopped 7/7; dog jumped off a bed
7/8 Neuro diminishment wobbly left or back legs? knuckling front or rear paws?
7/11 lost rear leg function
Carprofen as of 7/8 disc relapse: 12.5mgs 2x/day for 3 days SToPPED 7/11
Prednisone formula ?mgs in 1 mL? as of 7/11: ?mgs ?x/day for 3 days, then test taper: _pain/_neuro
Gabapentin 50mg/mL: 37.5mgs (0.75mL) 1x/day (7/10 dog suffering neck pain!)
methocarbamol 125mgs 2x/day
sucralfate ?mg ?x/day
Pepcid AC 5mgs 2x/day ]We did acupuncture and cold laser therapy today and she is resting very comfortably. I’m not sure what else I can add to this but I really do appreciate all of your feedback thank you so much |
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PaulaM
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Member since 2007: surgery, conservative . Montana, USA
Posts: 19,568
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Post by PaulaM on Jul 11, 2022 21:11:37 GMT -7
Erika, now you know you are dealing with a vet who is not comfortable with their knowledge of IVDD with PTS talk! You will have to lead this wagon train and selectively take only treatments/ advise that is of merit. That means learning and paying attention on behalf of Sophie. Can you fill us in on the med details so we understand the treatment: Prednisone formula ?mgs in 1 mL? as of 7/11: ?mgs ?x/day for 3 days, then test taper: _pain/_neuro Gabapentin formula 50mg/mL: 37.5mgs (0.75mL) ?x/day sucralfate ?mg ?x/day
Where is Sophie re: neuro function? Can she move her legs at all to attempt to reposition in the suite?
To attempt to scratch an ear?
Keep us update on any diminishment to these neuro functions. 7. ? Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors. 8. ? Tail wagging with joy is lost 9. ? Deep pain sensation, the last neuro function, a critical indicator for nerves to be able to self heal again with conservative treatment or after a surgery. Only trust the word of a surgeon for this very trick to correctly identify function. As you can see, your vet's talk of PTS shows her lack of IVDD expertise. The focus is all about getting the disc to heal with EIGHT (8) weeks of rest graduating on Sep 3. Nerve healing may or may not come back in the short weeks it takes to heal the disc. Often we need to think more in terms of months rather than days/weeks for this slowest part of the body to heal. If after graduation there needs to be more nerve healing, Sophie will not care one bit how she get from one place to the other or care is she may need a wheelchair. So stand firm on Sophie's behalf. Study learn and be ready to advocate when needed. Be strong to politely say no thanks to well intentioned but harmful advise. If acupuncture or laser is something you want, then seek a mobile vet who will come to your home. Any time Sophie is out of her suite is a danger to the healing disc. The things worth take a bit of risk because you are supervising and taking extreme care are potty times and only the most urgent of vet visits. One such urgent health reason to visit would be IF, if, Sophie would loose bladder control. You would need to transport her to the vet to get a hands on top of your hand type of lesson. You would first review the video and tips to get more out of the lesson: dodgerslist.com/2020/05/05/bladder-bowel-care/PUMPKIN If you are seeing that poop is too firm/constipated, try pumpkin. Plain pureed canned pumpkin is a magical fruit - its high fiber can firm up stools and help with diarrhea or loosen the stool to help with constipation. NOTE: alternatives are really ripe mashed fresh pear, just take off the peel off; microwaved and mashed peeled sweet potatoe --To loosen the stool, add equal parts water to each kibble meal and soak overnight. At mealtime add one teaspoon of plain canned pureed pumpkin 1x a day. -- To firm up the stool add 1 teaspoon plain canned pureed pumpkin 1x a day to kibble. Give a teaspoon of pumpkin for every 10 pounds of body weight. PAIN MEDS It normally takes 7-30 days to get all painful swelling down with prednisone or any other anti-inflammatory. Your vet has only called for a VERY short 3-day course of prednsone! It may not be time enough to get all the inflammation down. In the meantime it will be the pain meds that do the work of blocking all pain. Methocarbamol lasts for only about 8 hrs. Your vet has Rx'd for every 12 hrs. Did you get a range that you could dose at 3x/day (every 8rs) if you see any hint of pain? Gabapentin DITTO. Did you get a range to use it 3x/day if pain surfaces? If you observe any hint of pain, it is likely that a pred taper would not be able to take place on Thur 7/14. Instead know the plan B Knowing about prednisone will be important to you in driving this wagon train. An ER visit is very expensive, a "Plan B" is free! Please read and let us know the answers you and your vet worked out: dodgerslist.com/2020/04/18/steroids-vs-nsaids/ RULE OF THUMB during pred taper Pain= another course of PRED + all pain meds, GI protectors back on board. No Pain= go to TAPER conclusion...finish out the 8 weeks of crate rest for the disc to heal. By the way good work on vet's part if she Rx'd both Pepcid & Sucrafate. If you advocated for it then kudos go to you! Please keep us posted, hoping to hear the two pain meds provide full comfort dose to dose, round the clock. If not.... have no patience at all with pain, get the meds properly adjusted via a phone call 1st thing A.M. Also let us know if she can still sniff on an old pee spot and then her brain directs releasing urine there (that is bladder control proof). Leaking on you when lifted or urine leaks in bedding, means she has lost bladder control and you'd need to transport her in for a lesson in the a.m. |
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Post by Erika & Sophie on Jul 12, 2022 4:30:22 GMT -7
I’m going try and answer everything.
The PRED treatment plan is for 11 days. Should end 7/30. Correction- PRED plan ends 7/27
Yes, I am able to dose the ▲Gabapentin and muscle ▲relaxer every 8 hrs and
probably will because she is still in pain.
[MED LIST/HISTORY- Moderator's Note. Please do not edit
12.5 lbs 4 y.o.
Grad date was 8/19 prior to relapsed disc
Strict rest stopped 7/7; dog jumped off a bed
7/8 Neuro diminishment wobbly left or back legs? knuckling front or rear paws?
7/11 weak rear leg function
Carprofen as of 7/8 disc relapse: 12.5mgs 2x/day for 3 days SToPPED 7/11
Prednisone 10 mg/mL as of 7/11: 5mgs (1/2mL dose) 2x/day for 3 days, then test taper: _pain/_neuro
Gabapentin 50mg/mL: 37.5mgs (0.75mL) ▲3x/day (7/10 dog suffering neck pain!)
methocarbamol 125mgs ▲3x/day
sucralfate ?mg ?x/day
Pepcid AC 5mgs 2x/day ]
She has not sniffed a spot since Sunday early am. I have tried, but even with harness, she leans so far to left that she just collapses. She has been going in her suite on the pads. But last urination was 11am yesterday and last bowel movement on Sunday afternoon.
She can still move her legs some and is wagging tail, however her mobility is bad. She is basically laying in once spot and shuffles around a little.
Deep pain sensation- not real sure. Her left side seems entirely unusable.
She is not voluntarily eating or drinking. I am having to syringe meds, water and pedialyte. She will no longer eat her wet food. I boiled chicken and got her to eat some last night. I will get more pumpkin.
This is tough.
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,568
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Post by PaulaM on Jul 12, 2022 6:45:48 GMT -7
Erika, this is awful that vet did not have Sophie on on every 8 hrs pain meds dose right away yesterday. She may well need the 3rd pain med, if all pain is not in control in one hr with Gabapentin 0.75mL dose 3x/day AND methocarbamol 125mgs 3x/day 3rd PAIN MED: traMADol also 3x/day Have no patience at all with pain, when t here are pain meds that can be adjusted to give full comfort within an hour and thereafter dose to right up to next dose. Please provide missing info on prednisone. What is the formula for the liquid?
How many mgs pred in one mL of liquid. That information should be on the bottle. PREDNISONE The only important part of pred for resolving inflammation is the part BEFORE the taper. Sophie was only Rx'd a rather SHORT 3-day course. Typical courses are 5-7-day courses or even a 14-day course. Taper days do not work on swelling! SUCRALFATE: how many mgs dose? how many times per day? WHICH TIMING ARE you DOING?: Sucralfate reacts with stomach acids to form a protective paste at the site of any ulcerations. ~Ideally give Sucralfate on an empty tummy at least 1 hour before feeding or 2 hours after feeding ~If possible, it should be given 30+ minutes prior to the administration of Pepcid AC. ~Give Pepcid AC 30minutes before Prednisone ~Give prednisone with a meal. Pred could be given along with pain meds IF also due at that time. --- resource: www.marvistavet.com/sucralfate.pmlAre you using a med chart? Printable med chart includes how to use and a blank to personalize to your dog's meds: dodgerslist.com/wp-content/uploads/2020/02/med-chart-printable.pdfOne sucralfate dosing schedule for first dose of the day could be:5am sucralfate 5:30m pepcid AC 6 am antiinflammatory, tramadol, methocarbamol and gabapentin with a breakfast Avoid discussing or talking about deep pain sensation (DPS). Many general vets do not have the knowledge to correctly identify DPS. You, of course, also would not have that ability. This is VERY good news that her back legs are NOT paralyzed. She can move them even if weakly!!!! Keep up monitoring for any back leg movement that is not associated with going potty. And of course the happy tail wag when you specifically do happy talk or show her a yummy treat. |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,568
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Post by PaulaM on Jul 12, 2022 7:05:30 GMT -7
PAIN With Sophie in pain, the not moving much should be greatly lessened so she can comfortably reposition her body. NEURO FUNCTION Describe what "left side unusable" means for the FRONT legs, for the REAR legsURINATIONSophie should not be allowed to go potty inside of her recovery suite on pee pads. Take her out of the recovery suite every 2-3 hours to pee on a pee pad adjacent to the suite. As you see she stays dry, you can move up potty time to every 3-4 hrs.IF she is releasing urine in the suite you want to know if:
--- she is releasing urine because you are not taking her out in a timely manner OR..
--- She is leaking during because she has lost bladder control because you are taking out to potty in a timely manner.
--- No dog wants to pee where they sleep unless they have no choice or that have lost bladder control.
AT pottytime on the pee pad adjacent to the suite, use both a harness and a sling to keep her body from collapsing and twisting the spine. You can also hold her up by her thighs if that would be enough support. However that would be hard on your own back. Rear slings: long belt, long winter scarf, athletic exercise resistance bands as a sling.
Front end slings if front legs need assistance that a harness does not provide: A sling is used as back up to catch a wobbly dog's butt and prevent twisting the back. Any sling needs to be accompanied by a front harness and leash to control speed to the very slow minimal footsteps at potty time especially during conservative treatment when pottying outdoors.1) DIY sweatshirt sling...can be used for front or the back legs. Use same concept with cut out leg holes in a long strip of towel: www.lyonpuffpetsit.com/htmlslp/sling.html2) DIY figure-8 sling: dodgerslist.com/wp-content/uploads/2020/05/Figure8.jpg ** INCENTIVE TO PEE If Sophie needs permission to pee indoors, then keep small piece of urine stained paper towel in a ziplock bag. At potty time put the towel piece on the pee pad so she knows it is ok to pee in the house.PREDNISONE:What is the formula for the liquid?
How many mgs pred in one mL of liquid. That information should be on the bottle.SUCRALFATE how many mgs dose? how many times per day? |
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Post by Erika & Sophie on Jul 12, 2022 10:03:36 GMT -7
Hi Paula. Thanks again for all the info! I believe she’s whining because she needs to use the restroom maybe? We seem to have gotten her pain free with the 2 meds together. I have been taking her out and trying, not every 2 to 3 hours because it’s difficult and I’m afraid she’s going to injure herself. What she’s doing is she’s arching her back [Pain] and sticking her back leg straight [nerve damage] out so as not to to be in a standing or squated position. So it’s making it impossible for her to be in a position to go to the restroom. I tried the P pad thing outside of her suite just now with an exercise band around her back end and no luck. As far as her left side I am noticing that she has a lot less function/strength in her left legs than the right. I am concerned because it is now 24 hours since she has urinated.The prednisone is liquid suspension and it’s 10 mg/mL. I’ll have to get back with you on the other G.I. medication. But I’m giving them [Pepcid & sucralfate] 30 minutes prior to the prednisone[hour later post]:Another concern if she still has no interest in eating and I’m barely getting the liquid suspensions in her [one hour 24 mins later:]Just checked on her and she had gone tinkle in her suite she is trying to move more. And she seems pain free. I got her all cleaned up and bedding changed out. Do you recommend still going to the vet because she may have lots of bladder control? |
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PaulaM
Moderator.
Member since 2007: surgery, conservative . Montana, USA
Posts: 19,568
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Post by PaulaM on Jul 12, 2022 12:05:38 GMT -7
Erika, I'm sorry that there are a lot of things you are having to learn all at once. We too have a lot of things we can't see that you see and depend on you for our learning. Bear with us as we seek to know the full story and be able to make quality comment. PAIN Doesn't sound like all pain is in control when you see arched back. IF that is now gone, then the pain meds would seem to be fully controlling pain. NEURO FUNCTION Is it only the LEFT back leg that has lost nerve function where it stick straight out? It is not necessary to squat to have brain directed urination. If she is directing her brain to release urine, she can do so if standing.
LOSS OF BLADDER control happens after full loss of leg function. It is evidenced by the dog leaking on you when lifted. Tell what you observe.
"gone Tinkle" - you will have to observe and decide if: 1. urine was released in bedding because she had no choice, was not taken out of suite to the pee pad to Pee in a timely manner. 2. That is why you need to take her out of her suite every 2-3 hours while on Prednisone and give her a chance to pee. Prednisone causes more thirst, more urine production. 3. If she leaks on you when lifted and you are finding urine leaks in bedding then bladder control is lost. Her reflexes kick in to allow the bladder to overflow (She is not peeing, not urinatining.) The term is "overflowing". Loss of bladder control comes after there is full paralysis of the rear legs (left and right legs).What is the difficulty to take her out to adjacent pee pad every 2-3 hours? Maybe we can help if you explain.
ACCURATELY MONITOR FOR you and us NEURO FUNCTION Be specific. For example "a lot less function" does not explain what is happening. "trying to move more" what is moving more? in what manner? Indicate: left or right leg; front or back legs with an observation of what you see. OBSERVE for the very typical step by step order of nerve function loss:2. 7/8 Wobbly walking, ? legs cross 3. ? Nails/toes scuffing floor 4. ? left ? right Paws knuckle under: ? front ? Rear 5. ? Weak/little leg movement ? front ? rear 7/11 can't move up into a stand6. 7/10 Stiff" left back leg due to lost leg neuro function. ? both rear legs do not work at all (paralysis, dog is down) 7. ? Bladder control is lost. Leaks on you when lifted. Can no longer sniff and then pee on that old urine spot outdoors or on pee pad adjacent to suite. 8. ? Tail wagging with joy is lost 9. ? Deep pain sensation, the last neuro function, a critical indicator for nerves to self heal DOUBLE check your timing of SUCRALFATE. Does not sound like your timing is correct that enables this stomach protector to work! And we don't know how many times a day are you giving: 2x a day or 3x day? plus how many mgs dose. Sucralfate reacts with stomach acids to form a protective paste at the site of any ulcerations. ~Ideally give Sucralfate on an empty tummy at least 1 hour before feeding or 2 hours after feeding ~If possible, it should be given 30+ minutes prior to the administration of Pepcid AC. ~Give Pepcid AC 30minutes before Prednisone ~Give prednisone with a meal. Pred could be given along with pain meds IF also due at that time. resource: www.marvistavet.com/sucralfate.pmlOne dosing schedule for first dose of the day could be:One schedule could be this first dosing in the am: 5:00 am sucralfate 5:30 am pepcid AC 6:00 am Prednisone, tramadol, methocarbamol and gabapentin with breakfast |
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Post by Erika & Sophie on Jul 12, 2022 15:07:58 GMT -7
It’s hard for me to explain I guess. Is there a way for me to send a picture or a video of what she’s doing when I try to put her on a pad
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