Janet's Macey 10/7 conservative; GRAD 12/2

Janet,

Clarify please:
The vet prescribed on 10/7 (Fri) anti-inflammatory prednisone dose of 5mg 2x/day for 3 days with the taper to start on 10/10 (Mon) ?

Prednisone may take in the range 7-30 days to resolve swelling excluding taper days. Taper days no longer work on swelling around the spinal cord (dose is too low).

First thing 10/10 (mon) alert the vet via a phone call about any specific diminishment you have observed. We really can't tell specifically from what you described where Macey is on the list below.

How to indentify & monitor Neuro Functions
As damage to the spinal cord increases, there can be a predictable stepwise deterioration of functions if excessive back/neck movement for example.
1. Pain with initial tear of disc and ensuing swelling
2. Wobbly walking
legs cross
3. Nails/toes scuffing floor
4. Paws knuckle under. Dog is slow to correct or can't right the paw(s) at all
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 general vet who 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/

Has Macey been on very, very STRICT rest since 10/7?
Does anything come to mind that would be extra movement of the back to cause one back leg (right or left?) to move less?

STRICT rest means:
◼︎Carried to and from the potty place, very minimal footsteps to take care of business?
◼︎no meandering at potty times. ◼︎ support both end with lifting & carrying
◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you
◼︎no chiro therapy WHYs: dodgerslist.com/2020/04/22/chiropractic/
◼︎no PT for conservative dogs during 8 weeks to heal disc
◼︎At home laser or acupuncture for 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

POTTY TIME strictness
Carry her 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.

dodgerslist.com/wp-content/uploads/2020/04/Potty-leash-harness400-19kb.jpg

▶︎ Super tried and true tips for setting up the recovery suite, the mattress and more! dodgerslist.com/2020/05/14/strict-rest-recovery-process

Hope this information helps you sort out specifically where Macey's neuro function is in order to know when to alert your vet. A three-day course of prednisone is VERY short. Often it takes a 5-7day or even at times a 14-day course of anti-inflammatory level prednisone.

This disc episode, did the vet say the disc was in the neck or the back? Neck discs can affect both front or back legs.

No toys to chew on if this time is  also a neck disc.

Consider some of these ideas to help Macey be able to relax in her recovery suite:

-- Many members have found a pet stroller to solve the whining problem because the stroller can be wheeled from room to room as you go about your activities. Pet strollers, however, should only be used when you are directly supervising. More details on strollers: dodgerslist.com/2020/05/17/pet-stroller-conservatve-treatment/

-- Put a garment you have been wearing and have not washed in the crate.

--  Teaching self-calming exercises can also help your dog to relax more. You can make something as simple as eye contact a very rewarding behavior that also acts as a way for your dog to “ask permission” when he wants something. When dogs have a focus and an understanding about how to behave to get what they want, they are much calmer overall. To do this, each time your dog looks at you, say, something like, “Yes!” or use a clicker to mark the second he looks at you, and then give your dog a high-value food reward. [NOTE: for crate resting dogs, shift your body a bit] .... wait for your dog to look up at you again, say, “Yes,” and reward again. Do this exercise 10 or so times and then say, “All done,” and put the treats away. Come back later and do it again until you can see that your dog is really starting to make automatic eye contact in hopes you will say, “Yes,” again and give him his reward.

[NOTE: treats should be subtracted from the normal daily kibble ration so as not to gain weight during crate rest. To dogs the size of the treat matters not. ]
wholedogtraining.com/images/stories/Are_all_dogs_trainable.pdf

-- Provide a lick mat in the recovery suite. Freeze with some soaked and mushed up kibble, a slight slather of canned dog food or other lo-cal smear, as a very tiny treat but one that will take a lot of time to consume. Use as long as your dog is not exceeding the requirement of little neck/back movement during the recovery rest period www.amazon.com/s?k=lick+mat+for+dogs&hvadid=78202818358910&hvbmt=be&hvdev=c&hvqmt=e&tag=mh0b-20&ref=pd_sl_3b30nygjvi_e

Sounds like that small travel crate is good way to transport her to the potty place.

Perhaps too much jumping against side of crate has aggravated the disc and then the spinal cord.

Does the blanket drop down to the level of her head? That way should she jump against side, her eyes will be in the dark. That should extinguish the jumping.

We will assume then that this is a neck disc. With meds on board, you should no longer see the pain of not wanting to move head to look up.

The single most important care for a disc episode is the the 100% STRICT rest at home in a recovery suite.

MRIs are used for surgery and when there is a high suspicion of another disease that mimics IVDD.

XRAYS do not prove a disc episode.
Pressure to the spinal cord does not have to be a disc herniation; it could be a spine fracture or dislocation, a tumor, or a disk infection. Xrays should be used with caution with a suspected disc episode. The dog's main defense from further disc damage depends on controlling their trunk muscles. Anesthesia puts those muscles to sleep.
Because your vet  has not yet examined Macey for this disc episode, he may want to do an exam.

Thank you. However, I’m unable to select “new post” under notification options when my thread is checked. I can only choose the last three options- someone liking, quoting, or tagging me in a post.

We will call the vet tomorrow and ask for prednisone to be extended through the end of this week or next weekend and let them know about her diminished use of back legs.

Good morning. 10/10. Macey cannot use her back legs at all now. She can't get up to standing. We think she has lost DPS. We can't get her to pee or poop.

We are calling our vet as soon as they open this AM. We aren't sure that we can deal with this. Is there a way to make a dog pee or poop? We have full time jobs.

Macey is a rescue. I think that when we adopted her they said that if we can't care for her we need to contact them. We are seriously considering this. I'm afraid that it might already be too late for them to get her to surgery. We are really struggling with what to do.

------
[10/9 posts:]

I received an email about your last post, so I think it is working. Thanks again!

Taking her out tonight [10/9], she would not move into a standing position so It seems she is at a 5 on your scale. We can’t afford to do surgery so I guess we just do what we can with the conservative treatment. We don’t think she has pooped today.

Janet, so sorry to hear of neuro decline.  Do know all is not lost.  The body can have the potential to heal nerves.  A dog can enjoy life again after 8 weeks STRICT rest to heal the disc. The focus for 8 weeks is disc healing. The body's ability to self heal nerves may or may not take place in that short a time. At graduation if waiting on more nerve healing to take place, a dog can lead a very happy life with the assist of a wheelchair.

The only neuro function you can be assured of is the one BEFORE the loss of deep pain sensation (DPS).  The "happy tail wag" due to your specifically doing some happy talk or showing a yummy treat coming her way.  Many general vets can't correctly identify DPS, as it is a tricky thing to  correctly interpret what is seen.  Trust only the word of a neuro or an ortho about DPS.

IF a dog can no longer pass the sniff and pee test, then you would need to manually express the bladder. It is a new skill, but one you CAN, indeed, learn.  
---Expressing for poop is not a health concern as all poop can be ejected by body reflex.  Poop expressing is to to avoid Macey having anxiety of finding poop where she sleeps.  dodgerslist.com/2020/05/05/bladder-bowel-care/#poop
--- Expressing for urine is a health issue. Reflexes will only allow some urine to escape. The urine remaining can turn to a UTI, when expressing is not being done. Finding urine leaks in bedding AND leaks on you when lifted ARE signs of bladder control loss.  If it turns out she can no longer sniff and then release urine, get hands on top of your hands lesson.  Review first to get more out of the lesson:  dodgerslist.com/2020/05/05/bladder-bowel-care/


Please re-review so you can discuss which of the two treatment options (surgery or conservative) works for you family.

Remember, neuro loss goes in a step by step order.

5.10/9 Weak/little back right leg movement,
   10/10 can't move up into a stand
6. 10/9? 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.Trust only the word of a neuro (ACVIM) or ortho (ACVS) surgeon about DPS.
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 general vet who gets DPS wrong. 
    A quick overview of conservative treatment vs. a surgery:
dodgerslist.com/2020/02/10/surgery-vs-conservative/

Please keep us posted as you can, we are thinking of you all and Macey.

Thank you, Paula, for all of your help.

We have made the very difficult decision to surrender her back to the rescue from which we adopted her. They have agreed and are making arrangements for her to possibly have surgery and rehabilitation. They are picking her up in 2 hours. We are so very sad but grateful that they will try to help provide the best care for her.