Dulce's Honey 10/24 conservative; San Diego, GRAD 12/19

Dulce, sorry to hear about Honey. Kudos to you for crating at once. Vets prescribe treatments/meds made on their diagnosis.  So Honey did get a diagnosis.  So do ask for the name of the diagnosis and let us know.  With her past history of being born with IVDD, the back leg neuro damage it may be likely the diagnosis is an IVDD disc episode. We are not vets, so we make no assumptions, but instead depend on the vet's diagnosis.

Since she is still in pain with only one pain med on board (traMADol) clearly the medication is not yet right.  It will usually take 3 different pain meds to address each of the three sources of pain during a disc episode and prescribed for every 8 hrs. Pain meds are effective for 8 hrs.
  traMADol ⚠️5mg 3x/day is a VERY low dose for a 22lbs/9.98kg dog!  The usual in controlling pain is to Rx at the higher end of the mg range AND promptly every 8 hours.

Plumb's is considered the "drug bible" of the veterinary world.
Advocate for covering the other two typical sources of pain during a disc episode"
    Gabapentin for nerve pain 3x/day
    Methocarbamol for muscle contraction pain 3x/day

Once pain meds are correctly adjusted for Honey's needs, pain should be in control in hour and stay that way round the clock, dose to dose. Please update us that she is fully in comfort and displays no signs of pain when having to move or being lifted.

Pepcid AC how many mgs are in one whole tablet?  NOTE for a 22 lbs dog the dose would be 10 mgs Pepcid AC (famotidine) 2x/day.  Let us know what you have been giving?

Prednisone.  The important part of the Rx is the number of days at the anti-inflammatory level dose of 5mgs 2x/day.  The date the taper starts is a lower dose/frequency no longer working on swelling.
    The taper is for health reasons. AND it is a perfect opportunity/test to see if another anti-inflammatory level pred course is needed or if pred can continue to the taper conclusion.  All vets must take a guess on how many days to use the anti-inflammatory dose. Often the guess is a 7-day or maybe even a 14-day course of pred, then its taper. How many days is Honey to stay on the 5mgs 2x/day level?

Neuro function tell us more about those back legs excluding any movement you may see at potty time.
   -- does she use the back legs (left/right?) to reposition in her recovery suite?
   -- does she make an attempt to move up into a stand position with back legs?

Dulce, a vet's training is to list the diseases that are most likely. Most typical for a disc episode the diagnosis is based on his hands on exam, the breed, and the dog's health history.  Xrays don't prove a disc episode. Xrays are used to rule out a high suspicion of a disease than could mimic a disc episode. With the diagnosis, the vet is then able to prescribe the treatment.    So, of course your Mexican vet made a diagnosis with the name of the disease he believes is most likely. The meds he prescribed and are typical to a disc episode.   

Bring us up to date:
Neuro function tell us more about those back legs (excludE any movement you may see at potty time).
-- does she use the back legs (left?/right?) to reposition in her recovery suite?
-- does she make an attempt by her self to move up into a stand position with back legs?
-- do her back paws knuckle under?  Or do they knuckle is she able to right them slowly or not at all?

Pain?
Being off all meds since week of Nov 7, are all signs of pain gone? 

Disc Healing
  Conservative treatment for a disc episode is all about allowing the disc to heal in 8 weeks of limited movement.      The self healing of nerves may or may not heal in that short of time.  Often it is better to think in terms of months rather than days/weeks.  The time to consider if a cart is with graduation day. Then you will observe her neuro status at that time and determine  if $$ are better spent on a cart or to pursue PT to help Honey relearn the art of walking.  Kudos to you for recognizing your vet is not IVDD savvy to have recommended a wheelchair before graduation day!!

Graduation Day
Is scheduled for Dec 19. Mark your calendar. We will have lots of tips and ideas for transitioning her back to family life.

Strict rest is key to healing the disc. Here are some ideas to help keep her calm.
Consider some of these ideas:

-- 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 for her to smell and feel comforted.

-- Spend some time wearing your dog out with mental stimulation with tricks that do not make the back move such a nose touch a paw or a food bowl. Of course the training takes place inside the crate. www.clickertraining.com/15tips
    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 she 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 she 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 her a 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

-- At night, try placing the crate on a sturdy bedside table to sleep next to you.

-- During the day try the coffee table or the dinning room table so there will be a view out a window and a better perspective on what is going on in the house from a high.

-- Make the crate or ex-pen more cozy by draping a blanket over part of the top.
dodgerslist.com/wp-content/uploads/2020/05/blanketTOP150.jpg **

-- Carry her in a secure manner to overcome a wriggly dog.
LIFT and CARRY (support both ends, keep back horizontal to the ground). Use a harness and leash to control speed, a sling if she is wobbly.

Dulce, nice to hear no knuckling under paws!!

At potty time the sling is just as a back up. A bit slack on her body in case her butt should tip over you can quickly catch her.  In other words the back legs can be weight bearing and limbs can move in a walking motion for a very, very minimal footsteps.  I'm not exactly clear what she is doing that is jumping like a rabbit.

Honey having a physical and a visual of the limits of the potty area, sounds like this is a need for her.  Do you have an ex-pen you can put in the grass area? In your area the hardware stores should still be carrying wire poke in the grass garden edging fence.   
    Poke in the ground garden edging fence or an ex-pen in the grass to form a 6 foot diameter will let your dog know with the visible and physical barrier there is not going to be any sniff fests going on and help with the jumping like a rabbit (?).

Good plan to bring her to the patio to potty. There will be fewer distractions and less chance of too much movement

Dulce, good to hear that neuro functions have self-healed enough to allow pretty good walking gait.  No need of acupuncture- nerves have healed & she is not in pain.   The very limited footsteps she takes at potty time is enough therapy to keep the joints and muscles limber.

1. Conservative treatment is all about self-healing of the disc.
2. Her body's ability to form good strong disc scar tissue, needs your help.

Think of a time when you maybe scraped a knuckle and tore the skin.
The skin could self heal and form scar tissue only when you did not move the knuckle very much. Move it too much and the early forming scar tissue would tear/bleed and have to start from square one again in healing.

The disc also only heals with limited movement.
Too much movement of the back and the vertebrae can push on the healing disc. The early healing scar tissue can be torn. For Honey that would mean pain again, a real potential to re-damage the nerves and having to start from square one of 8 weeks of rest to heal the disc. For you that would mean not just more $$ spent in vet visits, more meds prescriptions and a twinge of guilt knowing STRICT rest is how the disc heal.

Stay the course of limited footsteps (no walking around). There is too much excellent healing of nerves to jeopardize slacking on strict rest for Honey's disc.

STRICT rest until Graduation day Dec 19th means:
◼︎no laps ◼︎no couches ◼︎no baths ◼︎no sleeping with you
◼︎no chiro therapy WHYs:     dodgerslist.com/2020/04/22/chiropractic/
◼︎no meandering at potty times.
◼︎no PT for conservative dogs during 8 weeks to heal disc

We have 11 days to go until Honey’s graduation. I had said that apparently Honey walks fine but I am not sure if it’s the lost of muscle that makes her hind lega weak for its something else. I will know when she finally gets to be out of the crate. What do you recommend after graduation day, just let her out of the crate and just keep an eye on her? Any tips are greatly appreciated

Graduation day !!!!
Honey is enjoying walking a little more when out to potty. Honey lost weight during these two months so seems weak. She drags one leg once in a while.

Our home has tile and her back legs sometimes slide open again like she is not strong enough. Sometimes she gets out of crate that I left open today but some other times she cries so I take her out. Not sure if it’s again because she feels weak.